WorldWideScience

Sample records for passive surgical guiding

  1. Active and passive beam application design guide for global application

    CERN Document Server

    Rimmer, Julian

    2015-01-01

    The Active and Passive Beam Application Design Guide is the result of collaboration by worldwide experts to give system designers a current, authoritative guide on successfully applying active and passive beam technology. Active and Passive Beam Application Design Guide provide energy-efficient methods of cooling, heating, and ventilating indoor areas, especially spaces that require individual zone control and where internal moisture loads are moderate. The systems are simple to operate, with low maintenance requirements. This book is an essential resource for consulting engineers, architects, owners, and contractors who are involved in the design, operation, and installation of these systems. Building on REHVA’s Chilled Beam Application Guidebook, this new guide provides up-to-date tools and advice for designing, commissioning, and operating chilled-beam systems to achieve a determined indoor climate, and includes examples of active and passive beam calculations and selections. Dual units (SI and I-P) are...

  2. Medical Visualization and Simulation for Customizable Surgical Guides

    NARCIS (Netherlands)

    Kroes, T.

    2015-01-01

    This thesis revolves around the development of medical visualization tools for the planning of CSG-based surgery. To this end, we performed an extensive computerassisted surgery (CAS) literature study, developed a novel optimization technique for customizable surgical guides (CSG), and introduce

  3. A Simple and Automatic Method for Locating Surgical Guide Hole

    Science.gov (United States)

    Li, Xun; Chen, Ming; Tang, Kai

    2017-12-01

    Restoration-driven surgical guides are widely used in implant surgery. This study aims to provide a simple and valid method of automatically locating surgical guide hole, which can reduce operator's experiences and improve the design efficiency and quality of surgical guide. Few literatures can be found on this topic and the paper proposed a novel and simple method to solve this problem. In this paper, a local coordinate system for each objective tooth is geometrically constructed in CAD system. This coordinate system well represents dental anatomical features and the center axis of the objective tooth (coincide with the corresponding guide hole axis) can be quickly evaluated in this coordinate system, finishing the location of the guide hole. The proposed method has been verified by comparing two types of benchmarks: manual operation by one skilled doctor with over 15-year experiences (used in most hospitals) and automatic way using one popular commercial package Simplant (used in few hospitals).Both the benchmarks and the proposed method are analyzed in their stress distribution when chewing and biting. The stress distribution is visually shown and plotted as a graph. The results show that the proposed method has much better stress distribution than the manual operation and slightly better than Simplant, which will significantly reduce the risk of cervical margin collapse and extend the wear life of the restoration.

  4. A Low-Cost, Passive Navigation Training System for Image-Guided Spinal Intervention.

    Science.gov (United States)

    Lorias-Espinoza, Daniel; Carranza, Vicente González; de León, Fernando Chico-Ponce; Escamirosa, Fernando Pérez; Martinez, Arturo Minor

    2016-11-01

    Navigation technology is used for training in various medical specialties, not least image-guided spinal interventions. Navigation practice is an important educational component that allows residents to understand how surgical instruments interact with complex anatomy and to learn basic surgical skills such as the tridimensional mental interpretation of bidimensional data. Inexpensive surgical simulators for spinal surgery, however, are lacking. We therefore designed a low-cost spinal surgery simulator (Spine MovDigSys 01) to allow 3-dimensional navigation via 2-dimensional images without altering or limiting the surgeon's natural movement. A training system was developed with an anatomical lumbar model and 2 webcams to passively digitize surgical instruments under MATLAB software control. A proof-of-concept recognition task (vertebral body cannulation) and a pilot test of the system with 12 neuro- and orthopedic surgeons were performed to obtain feedback on the system. Position, orientation, and kinematic variables were determined and the lateral, posteroanterior, and anteroposterior views obtained. The system was tested with a proof-of-concept experimental task. Operator metrics including time of execution (t), intracorporeal length (d), insertion angle (α), average speed (v¯), and acceleration (a) were obtained accurately. These metrics were converted into assessment metrics such as smoothness of operation and linearity of insertion. Results from initial testing are shown and the system advantages and disadvantages described. This low-cost spinal surgery training system digitized the position and orientation of the instruments and allowed image-guided navigation, the generation of metrics, and graphic recording of the instrumental route. Spine MovDigSys 01 is useful for development of basic, noninnate skills and allows the novice apprentice to quickly and economically move beyond the basics. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Reliability of implant surgical guides based on soft-tissue models.

    Science.gov (United States)

    Maney, Pooja; Simmons, David E; Palaiologou, Archontia; Kee, Edwin

    2012-12-01

    The purpose of this study was to determine the accuracy of implant surgical guides fabricated on diagnostic casts. Guides were fabricated with radiopaque rods representing implant positions. Cone beam computerized tomograms were taken with guides in place. Accuracy was evaluated using software to simulate implant placement. Twenty-two sites (47%) were considered accurate (13 of 24 maxillary and 9 of 23 mandibular sites). Soft-tissue models do not always provide sufficient accuracy for fabricating implant surgical guides.

  6. TouchTokens: Guiding Touch Patterns with Passive Tokens

    OpenAIRE

    Morales Gonzalez , Rafael; Appert , Caroline; Bailly , Gilles; Pietriga , Emmanuel

    2016-01-01

    International audience; TouchTokens make it possible to easily build interfaces that combine tangible and gestural input using passive tokens and a regular multi-touch surface. The tokens constrain users' grasp, and thus, the relative spatial configuration of fingers on the surface, theoretically making it possible to design algorithms that can recognize the resulting touch patterns. We performed a formative user study to collect and analyze touch patterns with tokens of varying shape and siz...

  7. Numerical optimization of alignment reproducibility for customizable surgical guides.

    Science.gov (United States)

    Kroes, Thomas; Valstar, Edward; Eisemann, Elmar

    2015-10-01

    Computer-assisted orthopedic surgery aims at minimizing invasiveness, postoperative pain, and morbidity with computer-assisted preoperative planning and intra-operative guidance techniques, of which camera-based navigation and patient-specific templates (PST) are the most common. PSTs are one-time templates that guide the surgeon initially in cutting slits or drilling holes. This method can be extended to reusable and customizable surgical guides (CSG), which can be adapted to the patients' bone. Determining the right set of CSG input parameters by hand is a challenging task, given the vast amount of input parameter combinations and the complex physical interaction between the PST/CSG and the bone. This paper introduces a novel algorithm to solve the problem of choosing the right set of input parameters. Our approach predicts how well a CSG instance is able to reproduce the planned alignment based on a physical simulation and uses a genetic optimization algorithm to determine optimal configurations. We validate our technique with a prototype of a pin-based CSG and nine rapid prototyped distal femora. The proposed optimization technique has been compared to manual optimization by experts, as well as participants with domain experience. Using the optimization technique, the alignment errors remained within practical boundaries of 1.2 mm translation and [Formula: see text] rotation error. In all cases, the proposed method outperformed manual optimization. Manually optimizing CSG parameters turns out to be a counterintuitive task. Even after training, subjects with and without anatomical background fail in choosing appropriate CSG configurations. Our optimization algorithm ensures that the CSG is configured correctly, and we could demonstrate that the intended alignment of the CSG is accurately reproduced on all tested bone geometries.

  8. Effect of passive polarizing three-dimensional displays on surgical performance for experienced laparoscopic surgeons.

    Science.gov (United States)

    Smith, R; Schwab, K; Day, A; Rockall, T; Ballard, K; Bailey, M; Jourdan, I

    2014-10-01

    Although the potential benefits of stereoscopic laparoscopy have been recognized for years, the technology has not been adopted because of poor operator tolerance. Passive polarizing projection systems, which have revolutionized three-dimensional (3D) cinema, are now being trialled in surgery. This study was designed to see whether this technology resulted in significant performance benefits for skilled laparoscopists. Four validated laparoscopic skills tasks, each with ten repetitions, were performed by 20 experienced laparoscopic surgeons, in both two-dimensional (2D) and 3D conditions. The primary outcome measure was the performance error rate; secondary outcome measures were time for task completion, 3D motion tracking (path length, motion smoothness and grasping frequency) and workload dimension ratings of the National Aeronautics and Space Administration (NASA) Task Load Index. Surgeons demonstrated a 62 per cent reduction in the median number of errors and a 35 per cent reduction in median performance time when using the passive polarizing 3D display compared with the 2D display. There was a significant 15 per cent reduction in median instrument path length, an enhancement of median motion smoothness, and a 15 per cent decrease in grasper frequency with the 3D display. Participants reported significant reductions in subjective workload dimension ratings of the NASA Task Load Index following use of the 3D displays. Passive polarizing 3D displays improved both the performance of experienced surgeons in a simulated setting and surgeon perception of the operative field. Although it has been argued that the experience of skilled laparoscopic surgeons compensates fully for the loss of stereopsis, this study indicates that this is not the case. Surgical relevance The potential benefits of stereoscopic laparoscopy have been known for years, but the technology has not been adopted because of poor operator tolerance. The first laparoscopic operation was carried out

  9. Undergraduate surgical nursing preparation and guided operating room experience: A quantitative analysis.

    Science.gov (United States)

    Foran, Paula

    2016-01-01

    The aim of this research was to determine if guided operating theatre experience in the undergraduate nursing curricula enhanced surgical knowledge and understanding of nursing care provided outside this specialist area in the pre- and post-operative surgical wards. Using quantitative analyses, undergraduate nurses were knowledge tested on areas of pre- and post-operative surgical nursing in their final semester of study. As much learning occurs in nurses' first year of practice, participants were re-tested again after their Graduate Nurse Program/Preceptorship year. Participants' results were compared to the model of operating room education they had participated in to determine if there was a relationship between the type of theatre education they experienced (if any) and their knowledge of surgical ward nursing. Findings revealed undergraduates nurses receiving guided operating theatre experience had a 76% pass rate compared to 56% with non-guided or no experience (p nurses achieved a 100% pass rate compared to 53% with non-guided or no experience (p research informs us that undergraduate nurses achieve greater learning about surgical ward nursing via guided operating room experience as opposed to surgical ward nursing experience alone. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. How to write a surgical clinical research protocol: literature review and practical guide.

    Science.gov (United States)

    Rosenthal, Rachel; Schäfer, Juliane; Briel, Matthias; Bucher, Heiner C; Oertli, Daniel; Dell-Kuster, Salome

    2014-02-01

    The study protocol is the core document of every clinical research project. Clinical research in studies involving surgical interventions presents some specific challenges, which need to be accounted for and described in the study protocol. The aim of this review is to provide a practical guide for developing a clinical study protocol for surgical interventions with a focus on methodologic issues. On the basis of an in-depth literature search of methodologic literature and on some cardinal published surgical trials and observational studies, the authors provides a 10-step guide for developing a clinical study protocol in surgery. This practical guide outlines key methodologic issues important when planning an ethically and scientifically sound research project involving surgical interventions, with the ultimate goal of providing high-level evidence relevant for health care decision making in surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Accuracy of Implants Placed with Surgical Guides: Thermoplastic Versus 3D Printed.

    Science.gov (United States)

    Bell, Caitlyn K; Sahl, Erik F; Kim, Yoon Jeong; Rice, Dwight D

    This study was conducted to evaluate the accuracy of implants placed using two different guided implant surgery materials: thermoplastic versus three-dimensionally (3D) printed. A cone beam computed tomography (CBCT) scan previously obtained and selected for single-tooth implant replacement was converted into a Digital Imaging and Communications in Medicine (DICOM) file. All models were planned and exported for printing using BlueSkyBio Plan Software with the DICOM files. A total of 20 3D-printed mandibular quadrant jaws replicating the CBCT were printed by Right Choice Milling, as was the control model to accept the control implant. Previously, 10 thermoplastic and 10 3D-printed surgical guides had been made by the same lab technician at Right Choice Milling. One Nobel Biocare implant with a trilobe connection was placed per guide and replica jaw model pair. Implants were placed using the thermoplastic and 3D-printed surgical guides, representing the two test groups, following the Nobel Biocare guided surgical protocol. A total of 21 CBCT scans were then taken, one for the control implant and one for each test implant. The CBCT volume was converted to a DICOM file and transferred to Invivo5 software version 5.4 (Anatomage). The DICOM file of each test implant was superimposed over the DICOM file of the control. The deviation of the head of the implant, the deviation of the apex of the implant, and the angle of deviation were evaluated from measurements on the superimposition of the control and test implants. Mann-Whitney U test was used to test the null hypotheses at α = .05 and a confidence interval of 95%. Descriptive statistics were used for the average ± standard deviation. The implants placed with the thermoplastic surgical guides showed an average of 3.40 degrees of angular deviation compared to 2.36 degrees for implants placed with the 3D-printed surgical guides (P = .143). The implants placed with the thermoplastic surgical guides showed an average of 1

  12. Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides.

    Science.gov (United States)

    Farley, Nathaniel E; Kennedy, Kelly; McGlumphy, Edwin A; Clelland, Nancy L

    2013-01-01

    Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design. Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05). Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance. Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides.

  13. Processing system of jaws tomograms for pathology identification and surgical guide modeling

    Energy Technology Data Exchange (ETDEWEB)

    Putrik, M. B., E-mail: pmb-88@mail.ru; Ivanov, V. Yu. [Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg (Russian Federation); Lavrentyeva, Yu. E. [Private dental clinic «Uraldent», Yekaterinburg (Russian Federation)

    2015-11-17

    The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient’s examination always includes up to 600 images (or tomograms), that’s why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation – for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation.

  14. Processing system of jaws tomograms for pathology identification and surgical guide modeling

    International Nuclear Information System (INIS)

    Putrik, M. B.; Ivanov, V. Yu.; Lavrentyeva, Yu. E.

    2015-01-01

    The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient’s examination always includes up to 600 images (or tomograms), that’s why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation – for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation

  15. Tailor-made Surgical Guide Reduces Incidence of Outliers of Cup Placement.

    Science.gov (United States)

    Hananouchi, Takehito; Saito, Masanobu; Koyama, Tsuyoshi; Sugano, Nobuhiko; Yoshikawa, Hideki

    2010-04-01

    Malalignment of the cup in total hip arthroplasty (THA) increases the risks of postoperative complications such as neck cup impingement, dislocation, and wear. We asked whether a tailor-made surgical guide based on CT images would reduce the incidence of outliers beyond 10 degrees from preoperatively planned alignment of the cup compared with those without the surgical guide. We prospectively followed 38 patients (38 hips, Group 1) having primary THA with the conventional technique and 31 patients (31 hips, Group 2) using the surgical guide. We designed the guide for Group 2 based on CT images and fixed it to the acetabular edge with a Kirschner wire to indicate the planned cup direction. Postoperative CT images showed the guide reduced the number of outliers compared with the conventional method (Group 1, 23.7%; Group 2, 0%). The surgical guide provided more reliable cup insertion compared with conventional techniques. Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  16. Reliability of computer designed surgical guides in six implant rehabilitations with two years follow-up.

    Science.gov (United States)

    Giordano, Mauro; Ausiello, Pietro; Martorelli, Massimo; Sorrentino, Roberto

    2012-09-01

    To evaluate the reliability and accuracy of computer-designed surgical guides in osseointegrated oral implant rehabilitation. Six implant rehabilitations, with a total of 17 implants, were completed with computer-designed surgical guides, performed with the master model developed by muco-compressive and muco-static impressions. In the first case, the surgical guide had exclusively mucosal support, in the second case exclusively dental support. For all six cases computer-aided surgical planning was performed by virtual analyses with 3D models obtained by dental scan DICOM data. The accuracy and stability of implant osseointegration over two years post surgery was then evaluated with clinical and radiographic examinations. Radiographic examination, performed with digital acquisitions (RVG - Radio Video graph) and parallel techniques, allowed two-dimensional feedback with a margin of linear error of 10%. Implant osseointegration was recorded for all the examined rehabilitations. During the clinical and radiographic post-surgical assessments, over the following two years, the peri-implant bone level was found to be stable and without appearance of any complications. The margin of error recorded between pre-operative positions assigned by virtual analysis and the post-surgical digital radiographic observations was as low as 0.2mm. Computer-guided implant surgery can be very effective in oral rehabilitations, providing an opportunity for the surgeon: (a) to avoid the necessity of muco-periosteal detachments and then (b) to perform minimally invasive interventions, whenever appropriate, with a flapless approach. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  17. Passive breath gating equipment for cone beam CT-guided RapidArc gastric cancer treatments

    International Nuclear Information System (INIS)

    Hu, Weigang; Li, Guichao; Ye, Jinsong; Wang, Jiazhou; Peng, Jiayuan; Gong, Min; Yu, Xiaoli; Studentski, Matthew T.; Xiao, Ying; Zhang, Zhen

    2015-01-01

    Background and purpose: To report preliminary results of passive breath gating (PBG) equipment for cone-beam CT image-guided gated RapidArc gastric cancer treatments. Material and methods: Home-developed PBG equipment integrated with the real-time position management system (RPM) for passive patient breath hold was used in CT simulation, online partial breath hold (PBH) CBCT acquisition, and breath-hold gating (BHG) RapidArc delivery. The treatment was discontinuously delivered with beam on during BH and beam off for free breathing (FB). Pretreatment verification PBH CBCT was obtained with the PBG-RPM system. Additionally, the reproducibility of the gating accuracy was evaluated. Results: A total of 375 fractions of breath-hold gating RapidArc treatments were successfully delivered and 233 PBH CBCTs were available for analysis. The PBH CBCT images were acquired with 2–3 breath holds and 1–2 FB breaks. The imaging time was the same for PBH CBCT and conventional FB CBCT (60 s). Compared to FB CBCT, the motion artifacts seen in PBH CBCT images were remarkably reduced. The average BHG RapidArc delivery time was 103 s for one 270-degree arc and 269 s for two full arcs. Conclusions: The PBG-RPM based PBH CBCT verification and BHG RapidArc delivery was successfully implemented clinically. The BHG RapidArc treatment was accomplished using a conventional RapidArc machine with high delivery efficiency

  18. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage.

    Science.gov (United States)

    Biron, Vincent L; Kurien, George; Dziegielewski, Peter; Barber, Brittany; Seikaly, Hadi

    2013-02-26

    Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases. To compare I&D vs USD of well-defined DNAs, using a randomized controlled clinical trial design. The primary outcome measure was effectiveness (length of hospital stay (LOHS) and safety), and the secondary outcome measure was overall cost to the healthcare system. Patients presenting to the University of Alberta Emergency Department with a well-defined deep neck space abscess were recruited in the study. Patients were randomized to surgical or US-guided drainage, placed on intravenous antibiotics and admitted with airway precautions. Following drainage with either intervention, abscess collections were cultured and drains were left in place until discharge. Seventeen patients were recruited in the study. We found a significant difference in mean LOHS between patients who underwent USD (3.1 days) vs I&D (5.2 days). We identified significant cost savings associated with USD with a 41% cost reduction in comparison to I&D. USD drainage of deep neck space abscesses in a certain patient population is effective, safe, and results in a significant cost savings to the healthcare system.

  19. In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery.

    Science.gov (United States)

    Bencharit, Sompop; Staffen, Adam; Yeung, Matthew; Whitley, Daniel; Laskin, Daniel M; Deeb, George R

    2018-02-21

    Desktop stereolithographic printers combined with intraoral scanning and implant planning software promise precise and cost-effective guided implant surgery. The purpose of the present study was to determine the overall range of accuracy of tooth-supported guided implant surgery using desktop printed stereolithographic guides. A cross-sectional study comparing fully and partially guided implant surgery was conducted. Preoperative cone beam computed tomography (CBCT) and intraoral scans were used to plan the implant sites. Surgical guides were then fabricated using a desktop stereolithographic 3-dimensional printer. Postoperative CBCT was used to evaluate the accuracy of placement. Deviations from the planned positions were used as the primary outcome variables. The planning software used, implant systems, and anterior/posterior positions were the secondary outcome variables. The differences between the planned and actual implant positions in the mesial, distal, buccal, and lingual dimensions and buccolingual angulations were determined, and the accuracy was compared statistically using the 1-tail F-test (P = .01), box plots, and 95% confidence intervals for the mean. Sixteen partially edentulous patients requiring placement of 31 implants were included in the present study. The implant deviations from the planned positions for mesial, distal, buccal, and lingual dimensions and buccolingual angulations with the fully guided protocol (n = 20) were 0.17 ± 0.78 mm, 0.44 ± 0.78 mm, 0.23 ± 1.08 mm, -0.22 ± 1.44 mm, and -0.32° ± 2.36°, respectively. The corresponding implant deviations for the partially guided protocol (n = 11) were 0.33 ± 1.38 mm, -0.03 ± 1.59 mm, 0.62 ± 1.15 mm, -0.27 ± 1.61 mm, and 0.59° ± 6.83°. The difference between the variances for fully and partially guided surgery for the distal and angulation dimensions was statistically significant (P = .006 and P guided implant surgery is more accurate than

  20. The application of 3D printed surgical guides in resection and reconstruction of malignant bone tumor.

    Science.gov (United States)

    Wang, Fengping; Zhu, Jun; Peng, Xuejun; Su, Jing

    2017-10-01

    The clinical value of 3D printed surgical guides in resection and reconstruction of malignant bone tumor around the knee joint were studied. For this purpose, a sample of 66 patients from October 2013 to October 2015 were randomly selected and further divided into control group and observation group, each group consisted of 33 cases. The control group was treated by conventional tumor resection whereas, in the observation group, the tumor was resected with 3D printed surgical guide. However, reconstruction of tumor-type hinge prosthesis was performed in both groups and then the clinical effect was compared. Results show that there was no significant difference in the operation time between the two groups (p>0.05). However, the blood loss, resection length and complication rate were found significantly lower in the observation group than in the control group (p0.05) between two groups were statistically the same (p>0.05), whereas the Musculoskeletal Tumor Society (MSTS) score of the knee joint in the observation group was significantly better than that of the control group (p3D printed surgical guides can significantly improve the postoperative joint function after resection and reconstruction of malignant bone tumor around the knee joint and can reduce the incidence of complications.

  1. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, M.; Yasunaga, T.; Konishi, K. [Kyushu University, Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Fukuoka (Japan); Tanoue, K.; Ieiri, S. [Kyushu University Hospital, Department of Advanced Medicine and Innovative Technology, Fukuoka (Japan); Kishi, K. [Hitachi Ltd, Mechanical Engineering Research Laboratory, Hitachinaka-Shi, Ibaraki (Japan); Nakamoto, H. [Hitachi Medical Corporation, Application Development Office, Kashiwa-Shi, Chiba (Japan); Ikeda, D. [Mizuho Ikakogyo Co. Ltd, Tokyo (Japan); Sakuma, I. [The University of Tokyo, Graduate School of Engineering, Bunkyo-Ku, Tokyo (Japan); Fujie, M. [Waseda University, Graduate School of Science and Engineering, Shinjuku-Ku, Tokyo (Japan); Dohi, T. [The University of Tokyo, Graduate School of Information Science and Technology, Bunkyo-Ku, Tokyo (Japan)

    2008-04-15

    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  2. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    International Nuclear Information System (INIS)

    Hashizume, M.; Yasunaga, T.; Konishi, K.; Tanoue, K.; Ieiri, S.; Kishi, K.; Nakamoto, H.; Ikeda, D.; Sakuma, I.; Fujie, M.; Dohi, T.

    2008-01-01

    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  3. Developer's guide to multi-family passive housing

    Energy Technology Data Exchange (ETDEWEB)

    Rouse, R.E.

    1983-10-01

    The role that passive solar design plays in good multi-family housing design is discussed. Knowing the special priorities of passive multi-family projects can improve designs and give developers and architects an advantage on the competition.

  4. Design and implementation of a PC-based image-guided surgical system.

    Science.gov (United States)

    Stefansic, James D; Bass, W Andrew; Hartmann, Steven L; Beasley, Ryan A; Sinha, Tuhin K; Cash, David M; Herline, Alan J; Galloway, Robert L

    2002-11-01

    In interactive, image-guided surgery, current physical space position in the operating room is displayed on various sets of medical images used for surgical navigation. We have developed a PC-based surgical guidance system (ORION) which synchronously displays surgical position on up to four image sets and updates them in real time. There are three essential components which must be developed for this system: (1) accurately tracked instruments; (2) accurate registration techniques to map physical space to image space; and (3) methods to display and update the image sets on a computer monitor. For each of these components, we have developed a set of dynamic link libraries in MS Visual C++ 6.0 supporting various hardware tools and software techniques. Surgical instruments are tracked in physical space using an active optical tracking system. Several of the different registration algorithms were developed with a library of robust math kernel functions, and the accuracy of all registration techniques was thoroughly investigated. Our display was developed using the Win32 API for windows management and tomographic visualization, a frame grabber for live video capture, and OpenGL for visualization of surface renderings. We have begun to use this current implementation of our system for several surgical procedures, including open and minimally invasive liver surgery.

  5. Surgical neuro navigator guided by preoperative magnetic resonance images, based on a magnetic position sensor

    International Nuclear Information System (INIS)

    Perini, Ana Paula; Siqueira, Rogerio Bulha; Carneiro, Antonio Adilton Oliveira; Oliveira, Lucas Ferrari de; Machado, Helio Rubens

    2009-01-01

    Image guided neurosurgery enables the neurosurgeon to navigate inside the patient's brain using pre-operative images as a guide and a tracking system, during a surgery. Following a calibration procedure, three-dimensional position and orientation of surgical instruments may be transmitted to computer. The spatial information is used to access a region of interest, in the pre-operative images, displaying them to the neurosurgeon during the surgical procedure. However, when a craniotomy is involved and the lesion is removed, movements of brain tissue can be a significant source of error in these conventional navigation systems. The architecture implemented in this work intends the development of a system to surgical planning and orientation guided by ultrasound image. For surgical orientation, the software developed allows the extraction of slices from the volume of the magnetic resonance images (MRI) with orientation supplied by a magnetic position sensor (Polhemus R ). The slices extracted with this software are important because they show the cerebral area that the neurosurgeon is observing during the surgery, and besides they can be correlated with the intra-operative ultrasound images to detect and to correct the deformation of brain tissue during the surgery. Also, a tool for per-operative navigation was developed, providing three orthogonal planes through the image volume. In the methodology used for the software implementation, the Python tm programming language and the Visualization Toolkit (VTK) graphics library were used. The program to extract slices of the MRI volume allowed the application of transformations in the volume, using coordinates supplied by the position sensor. (author)

  6. Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides.

    Science.gov (United States)

    Ganry, L; Hersant, B; Quilichini, J; Leyder, P; Meningaud, J P

    2017-06-01

    Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX ® , Meshlab ® , Netfabb ® and Blender ® . Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. [Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant].

    Science.gov (United States)

    Kenngott, H G; Wagner, M; Preukschas, A A; Müller-Stich, B P

    2016-12-01

    Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

  8. Bedside intravascular ultrasound-guided inferior vena cava filter placement in medical-surgical intensive care critically-ill patients

    Directory of Open Access Journals (Sweden)

    Mohammad A. Abusedera

    2015-09-01

    Conclusions: Bedside IVUS-guided filter placement in medical-surgical critically ill patient in intensive care unit is a feasible, safe and reliable technique for IVC interruption. IVUS may be the most appropriate tool to guide filter insertion in obese patient.

  9. Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics

    International Nuclear Information System (INIS)

    Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M.

    2000-01-01

    Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

  10. Tracking and Interception of Ground-Based RF Sources Using Autonomous Guided Munitions with Passive Bearings-Only Sensors and Tracking Algorithms

    National Research Council Canada - National Science Library

    Ezal, Kenan; Agate, Craig

    2006-01-01

    This paper considers the problem of tracking and intercepting a potentially moving ground-based RF source with an autonomous guided munition that has a passive bearings-only sensor located on its nose...

  11. Accuracy Assessment of Immediate and Delayed Implant Placements Using CAD/CAM Surgical Guides.

    Science.gov (United States)

    Alzoubi, Fawaz; Massoomi, Nima; Nattestad, Anders

    2016-10-01

    The aim of this study is to assess the accuracy of immediately placed implants using Anatomage Invivo5 computer-assisted design/computer-assisted manufacturing (CAD/CAM) surgical guides and compare the accuracy to delayed implant placement protocol. Patients who had implants placed using Anatomage Invivo5 CAD/CAM surgical guides during the period of 2012-2015 were evaluated retrospectively. Patients who received immediate implant placements and/or delayed implant placements replacing 1-2 teeth were included in this study. Pre- and postsurgical images were superimposed to evaluate deviations at the crest, apex, and angle. A total of 40 implants placed in 29 patients were included in this study. The overall mean deviations measured at the crest, apex, and angle were 0.86 mm, 1.25 mm, and 3.79°, respectively. The means for the immediate group deviations were: crest = 0.85 mm, apex = 1.10, and angle = 3.49°. The means for the delayed group deviations were: crest = 0.88 mm, apex = 1.59, and angle = 4.29°. No statistically significant difference was found at the crest and angle; however, there was a statistically significant difference between the immediate and delayed group at the apex, with the immediate group presenting more accurate placements at the apical point than the delayed group. CAD/CAM surgical guides can be reliable tools to accurately place implants immediately and/or in a delayed fashion. No statistically significant differences were found between the delayed and the immediate group at the crest and angle, however apical position was more accurate in the immediate group.

  12. Bone Reduction to Facilitate Immediate Implant Placement and Loading Using CAD/CAM Surgical Guides for Patients With Terminal Dentition.

    Science.gov (United States)

    Alzoubi, Fawaz; Massoomi, Nima; Nattestad, Anders

    2016-10-01

    The aim of this study is to present a method, using 3 computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides, to accurately obtain the desired bone reduction followed by immediate implant placements and loading for patients diagnosed with terminal dentition. Patients who had bone reduction, implants placed, and immediate loading using Anatomage Invivo 5 CAD/CAM surgical guides between the period 2013 and 2015 were evaluated retrospectively. Patients diagnosed with terminal dentition and treated using the "3-guide technique" were identified. Pre- and postsurgical images were superimposed to evaluate deviations of the bone reduction and deviations at the crest, apex, and angle of implants placed. Twenty-six implants placed in 5 patients were included in this study. The overall deviation means measured for bone reduction was 1.98 mm. The overall deviation means measured for implant placement at the crest, apex, and angle were 1.43 mm, 1.90 mm, and 4.14°, respectively. The CAD/CAM surgical guide fabrication is an emerging tool that may facilitate the surgical process and aid in safe and predictable execution of bone reduction and immediate implant placement. Using 3 CAD/CAM surgical guides, a method is presented to obtain the desired bone reduction followed by immediate implant placement and loading for patients diagnosed with terminal dentition. This method may improve guide stability for patients with terminal dentition undergoing complete implant-supported treatment by taking advantage of the teeth to be extracted.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  14. Accurate pre-surgical determination for self-drilling miniscrew implant placement using surgical guides and cone-beam computed tomography.

    Science.gov (United States)

    Miyazawa, Ken; Kawaguchi, Misuzu; Tabuchi, Masako; Goto, Shigemi

    2010-12-01

    Miniscrew implants have proven to be effective in providing absolute orthodontic anchorage. However, as self-drilling miniscrew implants have become more popular, a problem has emerged, i.e. root contact, which can lead to perforation and other root injuries. To avoid possible root damage, a surgical guide was fabricated and cone-beam computed tomography (CBCT) was used to incorporate guide tubes drilled in accordance with the planned direction of the implants. Eighteen patients (5 males and 13 females; mean age 23.8 years; minimum 10.7, maximum 45.5) were included in the study. Forty-four self-drilling miniscrew implants (diameter 1.6, and length 8 mm) were placed in interradicular bone using a surgical guide procedure, the majority in the maxillary molar area. To determine the success rates, statistical analysis was undertaken using Fisher's exact probability test. CBCT images of post-surgical self-drilling miniscrew implant placement showed no root contact (0/44). However, based on CBCT evaluation, it was necessary to change the location or angle of 52.3 per cent (23/44) of the guide tubes prior to surgery in order to obtain optimal placement. If orthodontic force could be applied to the screw until completion of orthodontic treatment, screw anchorage was recorded as successful. The total success rate of all miniscrews was 90.9 per cent (40/44). Orthodontic self-drilling miniscrew implants must be inserted carefully, particularly in the case of blind placement, since even guide tubes made on casts frequently require repositioning to avoid the roots of the teeth. The use of surgical guides, fabricated using CBCT images, appears to be a promising technique for placement of orthodontic self-drilling miniscrew implants adjacent to the dental roots and maxillary sinuses.

  15. Building with passive solar: an application guide for the southern homeowner and builder

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-03-01

    This instructional material was prepared for training workshops for builders and home designers. It includes: fundamental definitions and equations, climate and site studies, building components, passive systems and techniques, and design tools. (MHR)

  16. Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following caesarean section: a prospective randomised study

    OpenAIRE

    Urfalıoğlu, Aykut; Bakacak, Murat; Boran, Ömer Faruk; Yazar, Fatih Mehmet; Arslan, Mahmut; Öksüz, Hafize

    2016-01-01

    Abstract Background and objectives Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus ab...

  17. Surgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography.

    Science.gov (United States)

    Kim, Seong-Hun; Choi, Yong-Suk; Hwang, Eui-Hwan; Chung, Kyu-Rhim; Kook, Yoon-Ah; Nelson, Gerald

    2007-04-01

    This article illustrates a new surgical guide system that uses cone-beam computed tomography (CBCT) images to replicate dental models; surgical guides for the proper positioning of orthodontic mini-implants were fabricated on the replicas, and the guides were used for precise placement. The indications, efficacy, and possible complications of this method are discussed. Patients who were planning to have orthodontic mini-implant treatment were recruited for this study. A CBCT system (PSR 9000N, Asahi Roentgen, Kyoto, Japan) was used to acquire virtual slices of the posterior maxilla that were 0.1 to 0.15 mm thick. Color 3-dimensional rapid prototyping was used to differentiate teeth, alveolus, and maxillary sinus wall. A surgical guide for the mini-implant was fabricated on the replica model. Proper positioning for mini-implants on the posterior maxilla was determined by viewing the CBCT images. The surgical guide was placed on the clinical site, and it allowed precise pilot drilling and accurate placement of the mini-implant. CBCT imaging allows remarkably lower radiation doses and thinner acquisition slices compared with medical computed tomography. Virtually reproduced replica models enable precise planning for mini-implant positions in anatomically complex sites.

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Reliability of Soft Tissue Model Based Implant Surgical Guides; A Methodological Mistake.

    Science.gov (United States)

    Sabour, Siamak; Dastjerdi, Elahe Vahid

    2012-08-20

    Abstract We were interested to read the paper by Maney P and colleagues published in the July 2012 issue of J Oral Implantol. The authors aimed to assess the reliability of soft tissue model based implant surgical guides reported that the accuracy was evaluated using software. 1 I found the manuscript title of Maney P, et al. incorrect and misleading. Moreover, they reported twenty-two sites (46.81%) were considered accurate (13 of 24 maxillary and 9 of 23 mandibular sites). As the authors point out in their conclusion, Soft tissue models do not always provide sufficient accuracy for implant surgical guide fabrication.Reliability (precision) and validity (accuracy) are two different methodological issues in researches. Sensitivity, specificity, PPV, NPV, likelihood ratio positive (true positive/false negative) and likelihood ratio negative (false positive/ true negative) as well as odds ratio (true results\\false results - preferably more than 50) are among the tests to evaluate the validity (accuracy) of a single test compared to a gold standard.2-4 It is not clear that the reported twenty-two sites (46.81%) which were considered accurate related to which of the above mentioned estimates for validity analysis. Reliability (repeatability or reproducibility) is being assessed by different statistical tests such as Pearson r, least square and paired t.test which all of them are among common mistakes in reliability analysis 5. Briefly, for quantitative variable Intra Class Correlation Coefficient (ICC) and for qualitative variables weighted kappa should be used with caution because kappa has its own limitation too. Regarding reliability or agreement, it is good to know that for computing kappa value, just concordant cells are being considered, whereas discordant cells should also be taking into account in order to reach a correct estimation of agreement (Weighted kappa).2-4 As a take home message, for reliability and validity analysis, appropriate tests should be

  20. Endoscopic ultrasound-guided pancreaticobiliary intervention in patients with surgically altered anatomy and inaccessible papillae: A review of current literature

    Science.gov (United States)

    Martin, Aaron; Kistler, Charles Andrew; Wrobel, Piotr; Yang, Juliana F.; Siddiqui, Ali A.

    2016-01-01

    The management of pancreaticobiliary disease in patients with surgically altered anatomy is a growing problem for gastroenterologists today. Over the years, endoscopic ultrasound (EUS) has emerged as an important diagnostic and therapeutic modality in the treatment of pancreaticobiliary disease. Patient anatomy has become increasingly complex due to advances in surgical resection of pancreaticobiliary disease and EUS has emerged as the therapy of choice when endoscopic retrograde cholangiopancreatography failed cannulation or when the papilla is inaccessible such as in gastric obstruction or duodenal obstruction. The current article gives a comprehensive review of the current literature for EUS-guided intervention of the pancreaticobiliary tract in patients with altered surgical anatomy. PMID:27386471

  1. Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures.

    Science.gov (United States)

    Dagnino, Giulio; Georgilas, Ioannis; Morad, Samir; Gibbons, Peter; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2017-11-01

    Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries.

  2. Radiation exposure to surgical staff during F-18-FDG-guided cancer surgery

    International Nuclear Information System (INIS)

    Andersen, P.A.; Hesse, B.; Chakera, A.H.; Schmidt, G.; Klausen, T.L.; Binderup, T.; Grossjohann, H.S.; Friis, E.; Hansen, C.P.; Kjaer, A.

    2008-01-01

    High-energy gamma probes have recently become commercially available, developed for 18 F-FDG probe-guided surgery. The radiation received by the staff in the operating room might limit the use of it, but has never been determined. We therefore wanted to measure the absorbed staff doses at operations where patients had received a preoperative injection of 18 F-FDG. Thirty-four patients with different cancers (breast cancer, melanoma, gastrointestinal cancers, respectively) were operated. At every operation the surgeon was monitored with a TLD tablet on his finger of the operating hand and a TLD tablet on the abdomen. The surgeon and anaesthesiologist were also monitored using electronic dosimeters placed in the trousers lining at 25 operations. The dose rate to the surgeon's abdominal wall varied between 7.5-13.2 μSv/h, depending on tumour location. The doses to the anaesthesiologists and the finger doses to the surgeon were much lower. About 350-400 MBq, i.e. ca. eight times higher activities than those used in the present study are supposed to be necessary for guiding surgery. It can be calculated from the body doses measured that a surgeon can perform between 150-260 h of surgery without exceeding permissible limits for professional workers. The radiation load to the operating staff will generally be so small that it does not present any limitation for FDG-guided surgery. However, it is recommended to monitor the surgical staff considering that the surgeon may be exposed to other radiation sources, and since the staff often includes women of child-bearing age. (orig.)

  3. Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

    Science.gov (United States)

    Nickenig, Hans-Joachim; Eitner, Stephan

    2007-01-01

    We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

  4. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: an analysis for Austria.

    Science.gov (United States)

    Gruber, R; Walter, E; Helbich, T H

    2010-06-01

    To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Overall cost savings for US-guided LCBB over OSB were euro 977 (euro 2,337/euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were euro 1,542 (euro 2,600/euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be euro 18.5 million. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  5. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, R., E-mail: renate.gruber@meduniwien.ac.a [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Walter, E. [Institute of Pharmacoeconomic Research, Wolfengasse 4/7, A-1010 Vienna (Austria); Helbich, T.H. [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2010-06-15

    Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

  6. Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

    International Nuclear Information System (INIS)

    Gruber, R.; Walter, E.; Helbich, T.H.

    2010-01-01

    Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

  7. Reliability of a CAD/CAM Surgical Guide for Implant Placement: An In Vitro Comparison of Surgeons' Experience Levels and Implant Sites.

    Science.gov (United States)

    Park, Su-Jung; Leesungbok, Richard; Cui, Taixing; Lee, Suk Won; Ahn, Su-Jin

    This in vitro study evaluated the reliability of a surgical guide with regard to different levels of operator surgical experience and implant site. A stereolithographic surgical guide for epoxy resin mandibles with three edentulous molar sites was produced using a computer-aided design/computer-assisted manufacture (CAD/CAM) system. Two surgeons with and two surgeons without implant surgery experience placed implants in a model either using or not using the CAD/CAM surgical guide. Four groups were created: inexperienced surgeon without the guide (group 1); experienced surgeon without the guide (group 2); inexperienced surgeon with the guide (group 3); and experienced surgeon with the guide (group 4). Planned implants and placed implants were superimposed using digital software, and deviation parameters were calculated. There were no significant differences in any of the deviation parameters between the groups when using the surgical guide. With respect to the implant sites, there were no significant differences among the groups in any parameter. Use of the CAD/CAM surgical guide reduced discrepancies among operators performing implant surgery regardless of their level of experience. Whether or not the guide was used, differences in the anterior-posterior implant site in the molar area did not affect the accuracy of implant placement.

  8. Nerve stimulator-guided sciatic-femoral nerve block in raptors undergoing surgical treatment of pododermatitis.

    Science.gov (United States)

    d'Ovidio, Dario; Noviello, Emilio; Adami, Chiara

    2015-07-01

    To describe the nerve stimulator-guided sciatic-femoral nerve block in raptors undergoing surgical treatment of pododermatitis. Prospective clinical trial. Five captive raptors (Falco peregrinus) aged 6.7 ± 1.3 years. Anaesthesia was induced and maintained with isoflurane in oxygen. The sciatic-femoral nerve block was performed with 2% lidocaine (0.05 mL kg(-1) per nerve) as the sole intra-operative analgesic treatment. Intraoperative physiological variables were recorded every 10 minutes from endotracheal intubation until the end of anaesthesia. Assessment of intraoperative nociception was based on changes in physiological variables above baseline values, while evaluation of postoperative pain relied on species-specific behavioural indicators. The sciatic-femoral nerve block was feasible in raptors and the motor responses following electrical stimulation of both nerves were consistent with those reported in mammalian species. During surgery no rescue analgesia was required. The anaesthesia plane was stable and cardiorespiratory variables did not increase significantly in response to surgical stimulation. Iatrogenic complications, namely nerve damage and local anaesthetic toxicity, did not occur. Recovery was smooth and uneventful. The duration (mean ± SD) of the analgesic effect provided by the nerve block was 130 ± 20 minutes. The sciatic-femoral nerve block as described in dogs and rabbits can be performed in raptors as well. Further clinical trials with a control groups are required to better investigate the analgesic efficacy and the safety of this technique in raptors. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  9. [Shall all lobular intraepithelial neoplasia diagnosed on image-guided biopsy require a surgical management?].

    Science.gov (United States)

    Fischer-Hunsinger, Maeva; Guinebretière, Jean-Marc; Lasry, Serge; Langer, Adriana; Berment, Hélène; Nekka, Ibtissem; Nodiot, Philippe; Cherel, Pascal

    2016-05-01

    Lobular intraepithelial neoplasia (LIN) diagnosed on image-guided biopsy may be associated with an undiagnosed cancer. This is called under-diagnosis. The consequence is that management of these lesions is often surgical. But many surgeries finally are unnecessary. The aim of our study was to define criteria to avoid unnecessary surgery. This is a single-center, retrospective after a database collected prospectively study. Fourteen thousand biopsies were analyzed, including 456 diagnosed NLI. Under-diagnosis rates were analyzed according to many criteria. The average duration of following was 45 months. For atypical lobular hyperplasia (ALH), we obtained 7.6% under-diagnosis and combining several criteria, we got a low risk of cancer (2%). For LCIS, this rate was 23% and any low-risk group could be identified. ALH with calcifications≤20 mm, without any atypical lesion associated, histologically focal and whose removal is representative may be safely observed. For other LIN, surgery remains indicated. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  10. Treatment of Brodie's Syndrome using parasymphyseal distraction through virtual surgical planning and RP assisted customized surgical osteotomy guide-A mock surgery report

    Science.gov (United States)

    Dahake, Sandeep; Kuthe, Abhaykumar; Mawale, Mahesh

    2017-10-01

    This paper aims to describe virtual surgical planning (VSP), computer aided design (CAD) and rapid prototyping (RP) systems for the preoperative planning of accurate treatment of the Brodie's Syndrome. 3D models of the patient's maxilla and mandible were separately generated based on computed tomography (CT) image data and fabricated using RP. During the customized surgical osteotmy guide (CSOG) design process, the correct position was identified and the geometry of the CSOG was generated based on affected mandible of the patient and fabricated by a RP technique. Surgical approach such as preoperative planning and simulation of surgical procedures was performed using advanced software. The VSP and RP assisted CSOG was used to avoid the damage of the adjacent teeth and neighboring healthy tissues. Finally the mock surgery was performed on the biomodel (i.e. diseased RP model) of mandible with reference to the normal maxilla using osteotomy bur with the help of CSOG. Using this CSOG the exact osteotomy of the mandible and the accurate placement of the distractor were obtained. It ultimately improved the accuracy of the surgery in context of the osteotomy and distraction. The time required in cutting the mandible and placement of the distractor was found comparatively less than the regular free hand surgery.

  11. MRI-guided Wire Localization Surgical Biopsy in an Adolescent Patient with a Difficult to Diagnose Case of Lymphoma

    International Nuclear Information System (INIS)

    Thompson, Scott M.; Gorny, Krzysztof R.; Jondal, Danielle E.; Rech, Karen L.; Mardini, Samir; Woodrum, David A.

    2017-01-01

    A 17-year-old previously healthy female presented with a progressive soft tissue infiltrative process involving the neck and thorax. Extensive diagnostic evaluation including multiple imaging, laboratory, and biopsy studies was nondiagnostic. Due to an urgent need to establish a diagnosis and several previous nondiagnostic biopsies, she was referred to interventional radiology for MRI-guided wire localization immediately prior to open surgical biopsy. Under general anesthesia, wires were placed in the areas of increased T2 signal within the bilateral splenius capitis muscles using intermittent MRI-guidance followed by immediate surgical biopsy down to the wires. Pathology confirmed the diagnosis of diffuse large B-cell lymphoma.

  12. MRI-guided Wire Localization Surgical Biopsy in an Adolescent Patient with a Difficult to Diagnose Case of Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Scott M., E-mail: Thompson.scott@mayo.edu; Gorny, Krzysztof R.; Jondal, Danielle E. [Mayo Clinic College of Medicine, Department of Radiology (United States); Rech, Karen L. [Mayo Clinic College of Medicine, Department of Laboratory Medicine and Pathology (United States); Mardini, Samir [Mayo Clinic College of Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery (United States); Woodrum, David A. [Mayo Clinic College of Medicine, Division of Vascular and Interventional Radiology, Department of Radiology (United States)

    2017-01-15

    A 17-year-old previously healthy female presented with a progressive soft tissue infiltrative process involving the neck and thorax. Extensive diagnostic evaluation including multiple imaging, laboratory, and biopsy studies was nondiagnostic. Due to an urgent need to establish a diagnosis and several previous nondiagnostic biopsies, she was referred to interventional radiology for MRI-guided wire localization immediately prior to open surgical biopsy. Under general anesthesia, wires were placed in the areas of increased T2 signal within the bilateral splenius capitis muscles using intermittent MRI-guidance followed by immediate surgical biopsy down to the wires. Pathology confirmed the diagnosis of diffuse large B-cell lymphoma.

  13. A simple weighted scoring system to guide surgical decision-making in patients with parapneumonic pleural effusion.

    Science.gov (United States)

    Chang, Che-Chia; Chen, Tzu-Ping; Yeh, Chi-Hsiao; Huang, Pin-Fu; Wang, Yao-Chang; Yin, Shun-Ying

    2016-11-01

    The selection of ideal candidates for surgical intervention among patients with parapneumonic pleural effusion remains challenging. In this retrospective study, we sought to identify the main predictors of surgical treatment and devise a simple scoring system to guide surgical decision-making. Between 2005 and 2014, we identified 276 patients with parapneumonic pleural effusion. Patients in the training set (n=201) were divided into two groups according to their treatment modality (non-surgery vs. surgery). Using multivariable logistic regression analysis, we devised a scoring system to guide surgical decision-making. The score was subsequently validated in an independent set of 75 patients. A white blood cell count >13,500/µL, pleuritic pain, loculations, and split pleura sign were identified as independent predictors of surgical treatment. A weighted score based on these factors was devised, as follows: white blood cell count >13,500/µL (one point), pleuritic pain (one point), loculations (two points), and split pleura sign (three points). A score >4 was associated with a surgical approach with a sensitivity of 93.4%, a specificity of 82.4%, and an area under curve (AUC) of 0.879 (95% confidence interval: 0.828-0.930). In the validation set, a sensitivity of 94.3% and a specificity of 79.6% were found (AUC=0.869). The proposed scoring system reliably identifies patients with parapneumonic pleural effusion who are candidates for surgery. Pending independent external validation, our score may inform the appropriate use of surgical interventions in this clinical setting.

  14. Localization techniques for guided surgical excision of non-palpable breast lesions.

    Science.gov (United States)

    Chan, Benjamin K Y; Wiseberg-Firtell, Jill A; Jois, Ramesh H S; Jensen, Katrin; Audisio, Riccardo A

    2015-12-31

    Breast cancer is the most common form of cancer and the second leading cause of death amongst women in Europe. Amongst five invasive cancers per 1000 women detected in screening, 2.7 were localization (WGL). With the clinical setting shifting towards earlier non-palpable breast lesions being detected through screening, we investigated whether the current standard in assisting surgical excision of these lesions, WGL, yields the best therapeutic outcome for women with breast cancer. To assess the therapeutic outcomes of any new form of guided surgical intervention for non-palpable breast lesions against wire-guided localization, the current gold standard. We searched the Cochrane Breast Cancer Group's (CBCG) Specialized Register, MEDLINE (via PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal from the earliest available date up to 30 March 2015. We also handsearched recent conference proceedings and sought information from experts in the field. Two review authors, BC and RJ, independently screened by title and abstract the studies we had identified through the search strategy; when this was inconclusive, they examined the full-text article for inclusion. We resolved any discrepancies regarding eligibility by discussion with a third review author, RA. Three review authors, BC, JW, and RJ, independently extracted data using a standardized data sheet. We performed all analyses using Review Manager (RevMan) or the R meta package, and in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. We reported results via a graphical assessment using forest plots showing the study estimates. We considered and discussed additional subgroup and sensitivity analyses. We identified 11 randomized controlled trials (RCTs) that met the inclusion criteria of this Cochrane review and included eight trials in the meta-analyses. Six RCTs

  15. Complex Osteotomies of Tibial Plateau Malunions Using Computer-Assisted Planning and Patient-Specific Surgical Guides.

    Science.gov (United States)

    Fürnstahl, Philipp; Vlachopoulos, Lazaros; Schweizer, Andreas; Fucentese, Sandro F; Koch, Peter P

    2015-08-01

    The accurate reduction of tibial plateau malunions can be challenging without guidance. In this work, we report on a novel technique that combines 3-dimensional computer-assisted planning with patient-specific surgical guides for improving reliability and accuracy of complex intraarticular corrective osteotomies. Preoperative planning based on 3-dimensional bone models was performed to simulate fragment mobilization and reduction in 3 cases. Surgical implementation of the preoperative plan using patient-specific cutting and reduction guides was evaluated; benefits and limitations of the approach were identified and discussed. The preliminary results are encouraging and show that complex, intraarticular corrective osteotomies can be accurately performed with this technique. For selective patients with complex malunions around the tibia plateau, this method might be an attractive option, with the potential to facilitate achieving the most accurate correction possible.

  16. A novel dental implant guided surgery based on integration of surgical template and augmented reality.

    Science.gov (United States)

    Lin, Yen-Kun; Yau, Hong-Tzong; Wang, I-Chung; Zheng, Cheng; Chung, Kwok-Hung

    2015-06-01

    Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery. The aim of this study was to develop an augmented reality-based dental implant placement system and evaluate the accuracy of the virtually planned versus the actual prepared implant site created in vitro. Four fully edentulous mandibular and four partially edentulous maxillary duplicated casts were used. Six implants were planned in the mandibular and four in the maxillary casts. A total of 40 osteotomy sites were prepared in the casts using stereolithographic template integrated with augmented reality-based surgical simulation. During the surgery, the dentist could be guided accurately through a head-mounted display by superimposing the virtual auxiliary line and the drill stop. The deviation between planned and prepared positions of the implants was measured via postoperative computer tomography generated scan images. Mean and standard deviation of the discrepancy between planned and prepared sites at the entry point, apex, angle, depth, and lateral locations were 0.50 ± 0.33 mm, 0.96 ± 0.36 mm, 2.70 ± 1.55°, 0.33 ± 0.27 mm, and 0.86 ± 0.34 mm, respectively, for the fully edentulous mandible, and 0.46 ± 0.20 mm, 1.23 ± 0.42 mm, 3.33 ± 1.42°, 0.48 ± 0.37 mm, and 1.1 ± 0.39 mm, respectively, for the partially edentulous maxilla. There was a statistically significant difference in the apical deviation between maxilla and mandible in this surgical simulation (p augmented reality technology. © 2013 Wiley Periodicals, Inc.

  17. Custom-Machined Miniplates and Bone-Supported Guides for Orthognathic Surgery: A New Surgical Procedure.

    Science.gov (United States)

    Brunso, Joan; Franco, Maria; Constantinescu, Thomas; Barbier, Luis; Santamaría, Joseba Andoni; Alvarez, Julio

    2016-05-01

    Several surgical strategies exist to improve accuracy in orthognathic surgery, but ideal planning and treatment have yet to be described. The purpose of this study was to present and assess the accuracy of a virtual orthognathic positioning system (OPS), based on the use of bone-supported guides for placement of custom, highly rigid, machined titanium miniplates produced using computer-aided design and computer-aided manufacturing technology. An institutional review board-approved prospective observational study was designed to evaluate our early experience with the OPS. The inclusion criteria were as follows: adult patients who were classified as skeletal Class II or III patients and as candidates for orthognathic surgery or who were candidates for maxillomandibular advancement as a treatment for obstructive sleep apnea. Reverse planning with computed tomography and modeling software was performed. Our OPS was designed to avoid the use of intermaxillary fixation and occlusal splints. The minimum follow-up period was 1 year. Six patients were enrolled in the study. The custom OPS miniplates fit perfectly with the anterior buttress of the maxilla and the mandible body surface intraoperatively. To evaluate accuracy, the postoperative 3-dimensional reconstructed computed tomography image and the presurgical plan were compared. In the maxillary fragments that underwent less than 6 mm of advancement, the OPS enabled an SD of 0.14 mm (92% within 1 mm) at the upper maxilla and 0.34 mm (86% within 1 mm) at the mandible. In the case of great advancements of more than 10 mm, the SD was 1.33 mm (66% within 1 mm) at the upper maxilla and 0.67 mm (73% within 1 mm) at the mandibular level. Our novel OPS was safe and well tolerated, providing positional control with considerable surgical accuracy. The OPS simplified surgery by being independent of support from the opposite maxilla and obviating the need for classic intermaxillary occlusal splints. Copyright © 2016

  18. Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following cesarean section: a prospective randomised study

    Directory of Open Access Journals (Sweden)

    Aykut Urfalıoğlu

    Full Text Available Abstract Background and objectives Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. Methods Seventy-five pregnant women with pre- and post-pregnancy body mass index > 30 were randomized and allocated into two groups: Ultrasound-guided transversus abdominis plane block (UT group; n = 38 and surgical TAP block (ST group; n = 37. Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24 hours (h, time to first analgesic requirement, total analgesic consumption amount in 24 h, post-operative side effects, complications and patient satisfaction were recorded. Results and conclusions Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24 h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10 minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group and four (UT and ST groups patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block.

  19. Reliability of implant placement with stereolithographic surgical guides generated from computed tomography: clinical data from 94 implants.

    Science.gov (United States)

    Ersoy, Ahmet Ersan; Turkyilmaz, Ilser; Ozan, Oguz; McGlumphy, Edwin A

    2008-08-01

    Dental implant placement requires precise planning with regard to anatomic limitations and restorative goals. The aim of this study was to evaluate the match between the positions and axes of the planned and placed implants using stereolithographic (SLA) surgical guides. Ninety-four implants were placed using SLA surgical guides generated from computed tomography (CT) between 2005 and 2006. Radiographic templates were used for all subjects during CT imaging. After obtaining three-dimensional CT images, each implant was virtually placed on the CT images. SLA surgical guides, fabricated using an SLA machine with a laser beam to polymerize the liquid photo-polymerized resin, were used during implant placement. A new CT scan was taken for each subject following implant placement. Special software was used to fuse the images of the planned and placed implants, and the locations and axes were compared. Compared to the planned implants, the placed implants showed angular deviation of 4.9 degrees+/-2.36 degrees, whereas the mean linear deviation was 1.22+/-0.85 mm at the implant neck and 1.51+/-1 mm at the implant apex. Compared to the implant planning, the angular deviation and linear deviation at the neck and apex of the placed maxillary implants were 5.31 degrees+/-0.36 degrees, 1.04+/-0.56 mm, and 1.57+/-0.97 mm, respectively, whereas corresponding figures for placed mandibular implants were 4.44 degrees+/-0.31 degrees, 1.42+/-1.05 mm, and 1.44+/-1.03 mm, respectively. SLA surgical guides using CT data may be reliable in implant placement and make flapless implant placement possible.

  20. Sonographically guided percutaneous muscle biopsy in diagnosis of neuromuscular disease: a useful alternative to open surgical biopsy.

    Science.gov (United States)

    O'Sullivan, Paul J; Gorman, Grainne M; Hardiman, Orla M; Farrell, Michael J; Logan, P Mark

    2006-01-01

    The purpose of this study was to evaluate the feasibility of sonographically guided percutaneous muscle biopsy in the investigation of neuromuscular disorders. Sonographically guided percutaneous needle biopsy of skeletal muscle was performed with a 14-gauge core biopsy system in 40 patients over a 24-month period. Patients were referred from the Department of Neurology under investigation for neuromuscular disorders. Sonography was used to find suitable tissue and to avoid major vascular structures. A local anesthetic was applied below skin only. A 3- to 4-mm incision was made. Three 14-gauge samples were obtained from each patient. All samples were placed on saline-dampened gauze and sent for neuropathologic analysis. As a control, we retrospectively assessed results of the 40 most recent muscle samples acquired via open surgical biopsy. With the use of sonography, 32 (80%) of 40 patients had a histologic diagnosis made via percutaneous needle biopsy. This included 26 (93%) of 28 patients with acute muscular disease and 6 (50%) of 12 patients with chronic disease. In the surgical group (all acute disease), 38 (95%) of 40 patients had diagnostic tissue attained. Sonographically guided percutaneous 14-gauge core skeletal muscle biopsy is a useful procedure, facilitating diagnosis in acute muscular disease. It provides results comparable with those of open surgical biopsy in acute muscular disease. It may also be used in chronic muscular disease but repeated or open biopsy may be needed.

  1. Percutaneous computed tomography-guided core needle biopsy of soft tissue tumors: results and correlation with surgical specimen analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Grigio, Henrique Ramos; Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Tyng, Chiang J.; Cunha, Isabela Werneck da; Aguiar Junior, Samuel; Lopes, Ademar, E-mail: chojniak@uol.com.br [Hospital A.C. Camargo, Sao Paulo, SP (Brazil)

    2012-09-15

    Objective: To evaluate the efficacy of percutaneous computed tomography (CT)-guided core needle biopsy of soft tissue tumors in obtaining appropriate samples for histological analysis, and compare its diagnosis with the results of the surgical pathology as available. Materials and Methods: The authors reviewed medical records, imaging and histological reports of 262 patients with soft-tissue tumors submitted to CT-guided core needle biopsy in an oncologic reference center between 2003 and 2009. Results: Appropriate samples were obtained in 215 (82.1%) out of the 262 patients. The most prevalent tumors were sarcomas (38.6%), metastatic carcinomas (28.8%), benign mesenchymal tumors (20.5%) and lymphomas (9.3%). Histological grading was feasible in 92.8% of sarcoma patients, with the majority of them (77.9%) being classified as high grade tumors. Out of the total sample, 116 patients (44.3%) underwent surgical excision and diagnosis confirmation. Core biopsy demonstrated 94.6% accuracy in the identification of sarcomas, with 96.4% sensitivity and 89.5% specificity. A significant intermethod agreement about histological grading was observed between core biopsy and surgical resection (p < 0.001; kappa = 0.75). Conclusion: CT-guided core needle biopsy demonstrated a high diagnostic accuracy in the evaluation of soft tissue tumors as well as in the histological grading of sarcomas, allowing an appropriate therapeutic planning (author)

  2. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Kim, Yong Joo; Shin, Tae Beom

    2011-01-01

    To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis

  3. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan [Keimyung University, College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of); Shin, Tae Beom [Gyeonsang National University, College of Medicine, Jinju (Korea, Republic of)

    2011-04-15

    To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis

  4. Microscope-integrated intraoperative optical coherence tomography-guided small-incision lenticule extraction: New surgical technique.

    Science.gov (United States)

    Sharma, Namrata; Urkude, Jayanand; Chaniyara, Manthan; Titiyal, Jeewan S

    2017-10-01

    We describe the surgical technique of microscope-integrated intraoperative optical coherence tomography (OCT)-guided small-incision lenticule extraction. The technique enables manual tracking of surgical instruments and identification of the desired dissection plane. It also helps discern the relation between the dissector and the intrastromal lenticule. The dissection plane becomes hyperreflective on dissection, ensuring complete separation of the intrastromal lenticule from the overlying and underlying stroma. Inadvertent posterior plane entry, cap-lenticule adhesion, incomplete separation of the lenticule, creation of a false plane, and lenticule remnants may be recognized intraoperatively so corrective steps can be taken immediately. In cases with a hazy overlying cap, microscope-integrated intraoperative OCT enables localization and extraction of the lenticule. The technique is helpful for inexperienced surgeons, especially in cases with low amplitudes of refractive errors, ie, thin lenticules. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Su, Tian-Hao; Jin, Long; He, Wen [Capital Medical University, Department of Radiology, Beijing Friendship Hospital, Beijing (China); Fan, Yue-Feng [Xiamen University, Department of Interventional Therapy, The First Affiliated Hospital, Xiamen, Fujian (China); Hu, Li-Bao [Peking University People' s Hospital, Department of Radiology, Beijing (China)

    2015-09-15

    To describe and assess the localization of small peripheral pulmonary nodules prior to video-assisted thoracoscopic surgical (VATS) resection using the implantation of microcoils. Ninety-two patients with 101 pulmonary nodules underwent computed tomography (CT)-guided implantation of microcoils proximal to each nodule. Patients were randomly assigned to undergo entire microcoil or leaving-microcoil-end implantations. The complications and efficacy of the two implantation methods were evaluated. VATS resection of lung tissue containing each pulmonary lesion and microcoil were performed in the direction of the microcoil marker. Histopathological analysis was performed for the resected pulmonary lesions. CT-guided microcoil implantation was successful in 99/101 cases, and the placement of microcoils within 1 cm of the nodules was not disruptive. There was no difference in the complications and efficacy associated with the entire implantation method (performed for 51/99 nodules) versus the leaving-microcoil-end implantation method (performed for 48/99 nodules). All nodules were successfully removed using VATS resection. Asymptomatic pneumothorax occurred in 16 patients and mild pulmonary haemorrhage occurred in nine patients. However, none of these patients required further surgical treatment. Preoperative localization of small pulmonary nodules using a refined percutaneous microcoil implantation method was found to be safe and useful prior to VATS resection. (orig.)

  6. Six-month postoperative outcomes of intraoperative OCT-guided surgical cystotomy for refractory cystoid macular edema in diabetic eyes

    Directory of Open Access Journals (Sweden)

    Asahina Y

    2017-11-01

    Full Text Available Yuichi Asahina, Naoko Tachi, Yumi Asahina, Kayoko Yoshimura, Yoshiki Ueta, Yoshihiro Hashimoto Eye Center, Shinseikai Toyama Hospital, Imizu, Toyama, Japan Purpose: This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME.Patients and methods: We analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM and internal limiting membrane (ILM peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT, central minimum macular thickness (CMMT, macular volume (MV and best-corrected visual acuity (BCVA were compared preoperatively and 1 and 6 months post surgery.Results: CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01. Significant improvements in BCVA were only observed 6 months post surgery (P<0.01. No intra- or postoperative complications were observed in all patients.Conclusion: CRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes. Keywords: diabetic retinopathy, cystoid macular edema, intraoperative OCT, cystotomy

  7. [Value of a novel categorization of congenital double-outlet right ventricle on guiding the choice of surgical approaches].

    Science.gov (United States)

    Pang, Kunjing; Meng, Hong; Wang, Hao; Hu, Shengshou; Hua, Zhongdong; Pan, Xiangbin; Li, Shoujun

    2015-11-01

    To explore the feasibility and value of a new categorization of double outlet right ventricular (DORV) on guiding the optimal choices of surgical approaches. Five hundred and twenty one DORV patients diagnosed by echocardiography, angiocardiography and CT at Fuwai Hospital from May 2003 to September 2014 were enrolled in this retrospective study. Congenital DORV was categorized according to three basic factors as follows: the positional relationships of great arteries (normal relation or abnormal relation), the relationships of the ventricular septal defect (VSD) to the great arteries (committed VSD or remote VSD), the presence or absence of pulmonary outflow tract obstruction (POTO). Eight types of DORV were established: type I (normal relation, committed VSD, without POTO), type II (normal relation, committed VSD, POTO), type III (normal relation, remote VSD, without POTO), type IV (normal relation, remote VSD, POTO), type V (abnormal relation, committed VSD, without POTO), type VI (abnormal relation, committed VSD, POTO), type VII (abnormal relation, remote VSD, without POTO), type VIII (abnormal relation, remote VSD, POTO). Feasibility of this classification and the value of this classification on guiding the choice of surgical approaches were analyzed. Among the five hundred and twenty one patients, there were 90 patients (17.3%) with type I DORV, 94 patients (18.0%) with type II, 33 patients (6.3%) with type III, 34 patients (6.5%) with type IV, 64 patients (12.3%) with type V, 61 patients (11.7%) with type VI, 33 patients (6.3%) with type VII, 112 patients (21.5%) with type VIII. Thus, all patients could be typed by this classification method. The echocardiography diagnosis was consistent with the intra-operative and or cardiac catheterization/CT findings. Excluding the contraindications of bi-ventricular repair, different surgical approaches were performed in every subtype of DORV according the classification, which indicated that this novel categorization

  8. Canadian Optically-guided approach for Oral Lesions Surgical (COOLS) trial: study protocol for a randomized controlled trial

    International Nuclear Information System (INIS)

    Poh, Catherine F; Durham, J Scott; Brasher, Penelope M; Anderson, Donald W; Berean, Kenneth W; MacAulay, Calum E; Lee, J Jack; Rosin, Miriam P

    2011-01-01

    Oral cancer is a major health problem worldwide. The 5-year survival rate ranges from 30-60%, and has remained unchanged in the past few decades. This is mainly due to late diagnosis and high recurrence of the disease. Of the patients who receive treatment, up to one third suffer from a recurrence or a second primary tumor. It is apparent that one major cause of disease recurrence is clinically unrecognized field changes which extend beyond the visible tumor boundary. We have previously developed an approach using fluorescence visualization (FV) technology to improve the recognition of the field at risk surrounding a visible oral cancer that needs to be removed and preliminary results have shown a significant reduction in recurrence rates. This paper describes the study design of a randomized, multi-centre, double blind, controlled surgical trial, the COOLS trial. Nine institutions across Canada will recruit a total of 400 patients with oral severe dysplasia or carcinoma in situ (N = 160) and invasive squamous cell carcinoma (N = 240). Patients will be stratified by participating institution and histology grade and randomized equally into FV-guided surgery (experimental arm) or white light-guided surgery (control arm). The primary endpoint is a composite of recurrence at or 1 cm within the previous surgery site with 1) the same or higher grade histology compared to the initial diagnosis (i.e., the diagnosis used for randomization); or 2) further treatment due to the presence of severe dysplasia or higher degree of change at follow-up. This is the first randomized, multi-centre trial to validate the effectiveness of the FV-guided surgery. In this paper we described the strategies, novelty, and challenges of this unique trial involving a surgical approach guided by the FV technology. The success of the trial requires training, coordination, and quality assurance across multiple sites within Canada. The COOLS trial, an example of translational research, may result in

  9. Surgical treatment for mediastinal abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.

    Science.gov (United States)

    Yokoyama, Yujiro; Nakagomi, Takahiro; Shikata, Daichi; Higuchi, Rumi; Oyama, Toshio; Goto, Taichiro

    2017-07-14

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful and less invasive procedure for the definitive diagnosis of mediastinal and hilar lymph nodes. However, infectious complications can occur after EBUS-TBNA, although they are extremely rare. A 66-year-old man with necrotic and swollen lower paratracheal lymph nodes underwent EBUS-TBNA. A mediastinal abscess developed 9 days post-procedure. Surgical drainage and debridement of the abscess were performed along with lymph node biopsy followed by daily washing of the thoracic cavity. Surgical treatment was effective, leading to remission of the abscess. Biopsy revealed that the tumor was squamous cell carcinoma with no radiologically detected cancer elsewhere in the body. Mediastinal lung cancer was thus confirmed. Subsequent chemoradiotherapy led to the remission of the tumor. Mediastinitis after EBUS-TBNA is rare but should be considered, particularly if the target lymph nodes are necrotic. Mediastinitis can lead to serious and rapid deterioration of the patient's condition, for which surgical intervention is the treatment of choice.

  10. A Filtering Approach for Image-Guided Surgery With a Highly Articulated Surgical Snake Robot.

    Science.gov (United States)

    Tully, Stephen; Choset, Howie

    2016-02-01

    The objective of this paper is to introduce a probabilistic filtering approach to estimate the pose and internal shape of a highly flexible surgical snake robot during minimally invasive surgery. Our approach renders a depiction of the robot that is registered to preoperatively reconstructed organ models to produce a 3-D visualization that can be used for surgical feedback. Our filtering method estimates the robot shape using an extended Kalman filter that fuses magnetic tracker data with kinematic models that define the motion of the robot. Using Lie derivative analysis, we show that this estimation problem is observable, and thus, the shape and configuration of the robot can be successfully recovered with a sufficient number of magnetic tracker measurements. We validate this study with benchtop and in-vivo image-guidance experiments in which the surgical robot was driven along the epicardial surface of a porcine heart. This paper introduces a filtering approach for shape estimation that can be used for image guidance during minimally invasive surgery. The methods being introduced in this paper enable informative image guidance for highly articulated surgical robots, which benefits the advancement of robotic surgery.

  11. Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience

    Directory of Open Access Journals (Sweden)

    Chandika Alphonce B

    2012-01-01

    Full Text Available Abstract Background Despite breast abscess becoming less common in developed countries, it has remained one of the leading causes of morbidity in women in developing countries. A randomized controlled trial was conducted at Mulago hospital complex in Kampala Uganda to establish whether ultrasound guided needle aspiration is a feasible alternative treatment option for breast abscesses. Results A total of 65 females with breast abscess were analyzed, of these 33 patients were randomized into the ultrasound guided needle aspiration and 32 patients in the Incision and drainage arm. The mean age was 23.12, most of them were lactating (66.2%, primipararous (44.6% with peripheral abscesses (73.8% located in the upper lateral quadrant (56%.The mean breast size was 3.49 cm. The two groups were comparably in demographic characteristic and breast abscess size. Survival analysis showed no difference in breast abscess healing rate between the two groups (Log rank 0.24 df 1 and P = 0.63. Incision and drainage was found to be more costly than ultrasound guided aspiration (cost effective ratio of 2.85. Conclusion Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for both lactating and non lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune competent patient

  12. Collagen nerve guides for surgical repair of brachial plexus birth injury.

    Science.gov (United States)

    Ashley, William W; Weatherly, Trisha; Park, Tae Sung

    2006-12-01

    Standard brachial plexus repair techniques often involve autologous nerve graft placement and neurotization. However, when performed to treat severe injuries, this procedure can sometimes yield poor results. Moreover, harvesting the autologous graft is time-consuming and exposes the patient to additional surgical risks. To improve surgical outcomes and reduce surgical risks associated with autologous nerve graft retrieval and placement, the authors use collagen matrix tubes (Neurogen) instead of autologous nerve graft material. Between 1991 and 2005, the authors surgically treated 65 infants who had suffered brachial plexus injury at birth. During this time, seven patients were treated using collagen matrix tubes (Neurogen). This study is a retrospective analysis of the initial five patients who were treated using the tubes. Two patients underwent tube placement recently and were excluded from the analysis because of the inadequate follow-up period. Four of the five patients experienced a good recovery (motor scale composite [MSC] > 0.6), and three exhibited an excellent recovery (MSC > 0.75) at 2 years postoperatively. The MSC improved by an average of 69 and 78% at 1 and 2 years, respectively. The movement scores improved to greater than or equal to 50% range of motion in most patients, and the contractures were usually mild or moderate. Follow-up physical and occupational therapy evaluations confirm these patients' functional status. When last seen, four of five of these children could feed and dress themselves. Technically, the use of the collagen matrix tubes was straightforward and efficient, and there were no complications. The outcomes in this small series are encouraging.

  13. Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Vincenzo Luca Zizzari

    2018-01-01

    Full Text Available The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

  14. Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

    OpenAIRE

    Zizzari, Vincenzo Luca; Tacconelli, Gianmarco

    2018-01-01

    The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

  15. Computer-aided design and computer-aided modeling (CAD/CAM) generated surgical splints, cutting guides and custom-made implants: Which indications in orthognathic surgery?

    Science.gov (United States)

    Scolozzi, P

    2015-12-01

    The purpose of the present report was to describe our indications, results and complications of computer-aided design and computer-aided modeling CAD/CAM surgical splints, cutting guides and custom-made implants in orthognathic surgery. We analyzed the clinical and radiological data of ten consecutive patients with dentofacial deformities treated using a CAD/CAM technique. Four patients had surgical splints and cutting guides for correction of maxillomandibular asymmetries, three had surgical cutting guides and customized internal distractors for correction of severe maxillary deficiencies and three had custom-made implants for additional chin contouring and/or mandibular defects following bimaxillary osteotomies and sliding genioplasty. We recorded age, gender, dentofacial deformity, surgical procedure and intra- and postoperative complications. All of the patients had stable cosmetic results with a high rate of patient satisfaction at the 1-year follow-up examination. No intra- and/or postoperative complications were encountered during any of the different steps of the procedure. This study demonstrated that the application of CAD/CAM patient-specific surgical splints, cutting guides and custom-made implants in orthognathic surgery allows for a successful outcome in the ten patients presented in this series. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Reconstruction of a Severely Atrophied Alveolar Ridge by Computer-Aided Gingival Simulation and 3D-Printed Surgical Guide: A Case Report.

    Science.gov (United States)

    Song, In-Seok; Lee, Mi-Ran; Ryu, Jae-Jun; Lee, Ui-Lyong

    Dental implants positioned in severely atrophied anterior maxillae require esthetic or functional compromises. This case report describes the rehabilitation of a severely atrophied alveolar ridge with a three-dimensional (3D) computer-aided design/computer-aided manufacture (CAD/CAM) surgical guide. A 50-year-old woman had a severely atrophied anterior maxilla with unfavorably positioned dental implants. Functional and esthetic prosthodontic restoration was difficult to achieve. An anterior segmental osteotomy was planned to reposition the dental implants. A 3D surgical guide was designed for precise relocation of the segment. The surgical guide firmly grasped the impression copings of the dental implants, minimizing surgical errors. Three-dimensional gingival simulation was used preoperatively to estimate the appropriate position of the gingiva. Rigid fixation to the surrounding bone allowed immobilization of the implant-bone segment. Satisfactory esthetic and functional outcomes were attained 6 months after surgery. Finally, a severely atrophied alveolar ridge with unfavorably positioned dental implants was recovered with minimal esthetic and functional deterioration using gingival simulation and a 3D CAD/CAM surgical guide.

  17. Computer-designed surgical guide template compared with free-hand operation for mesiodens extraction in premaxilla using “trapdoor” method

    Science.gov (United States)

    Hu, Ying Kai; Xie, Qian Yang; Yang, Chi; Xu, Guang Zhou

    2017-01-01

    Abstract The aim of this study was to introduce a novel method of mesiodens extraction using a vascularized pedicled bone flap by piezosurgery and to compare the differences between a computer-aided design surgical guide template and free-hand operation. A total of 8 patients with mesiodens, 4 with a surgical guide (group I), and 4 without it (group II) were included in the study. The surgical design was to construct a trapdoor pedicle on the superior mucoperiosteal attachment with application of piezosurgery. The bone lid was repositioned after mesiodens extraction. Group I patients underwent surgeries based on the preoperative planning with surgical guide templates, while group II patients underwent free-hand operation. The outcome variables were success rate, intraoperative time, anterior nasal spine (ANS) position, changes of nasolabial angle (NLA), and major complications. Data from the 2 groups were compared by SPSS 17.0, using Wilcoxon test. The operative time was significantly shorter in group I patients. All the mesiodentes were extracted successfully and no obvious differences of preoperative and postoperative ANS position and NLA value were found in both groups. The patients were all recovered uneventfully. Surgical guide templates can enhance clinical accuracy and reduce operative time by facilitating accurate osteotomies. PMID:28658139

  18. Imaging of foreign bodies in the face and ultrasound guided surgical removal; Diagnostico por imagem de corpos estranhos da face e retirada cirurgica guiada por ultra-sonografia

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Claudio Marcio Amaral de Oliveira; Gambin, Moises; Ribeiro, Erica Barreiros; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; cmaolima@hotmail.com; Monteiro, Alexandra Maria Vieira [Pontificia Univ. Catolica do Rio de Janeiro (PUC/Rio), RJ (Brazil). Curso de Pos-Graduacao em Radiologia

    2006-10-15

    The identification and surgical removal of foreign bodies is a complex procedure in medical practice, principally when the involved material is radiolucent. The technological advent of the ultrasonography equipment comes enlarging the field of application of this method more and more, in medical practice. The authors describe a case of an ultrasound guided surgical removal of glass fragments from the face of a patient. The foreign bodies were previously diagnosed by ultrasound and computed tomography. The guided technic showed secure, less invasive and efficient, allowing the retreat of all the fragments. (author)

  19. Clinical application of fully digital Cerec surgical guides made in-house.

    Science.gov (United States)

    Bindl, A

    2015-01-01

    It is now possible to produce full-digital drilling templates with Cerec Guide 2 (Sirona) in the dental practice relatively quickly, efficiently, and economically. Here, a patient case example is used to present an exemplary description of the procedure and method to do this. The solution described herein shows the advantageous efficiency, compared with other systems presently on the market, of a procedure that does not require the external production of the drilling template in the laboratory or a manufacturing center.

  20. Putting a face and context on pediatric surgery cancelations: The development of parent personas to guide equitable surgical care.

    Science.gov (United States)

    Vaughn, Lisa M; DeJonckheere, Melissa; Pratap, Jayant Nick

    2016-06-09

    Last-minute cancelation of planned surgery can have substantial psychological, social, and economic effects for patients/families and also leads to wastage of expensive health-care resources. In order to have a deeper understanding of the contextual, psychological, practical, and behavioral factors that potentially impact pediatric surgery cancelation, we conducted a qualitative study to create 'personas' or fictional portraits of parents who are likely to cancel surgery. We conducted in-depth qualitative interviews with 21 parents of children who were considered 'at risk' for surgical cancelation and whose scheduled surgery was canceled at late notice. From the themes, patterns, and associated descriptive phrases in the data, we developed and validated five different personas of typical scenarios reflecting parent experiences with surgery and surgery cancelations. The personas are being employed to guide contextualized development of interventions tailored to prototypical families as they prepare and attend for surgery. © The Author(s) 2016.

  1. Minimally invasive corticotomy in orthodontics using a three-dimensional printed CAD/CAM surgical guide.

    Science.gov (United States)

    Cassetta, M; Giansanti, M; Di Mambro, A; Calasso, S; Barbato, E

    2016-09-01

    The aim of this prospective study was to evaluate the effectiveness of an innovative, minimally invasive, flapless corticotomy procedure in orthodontics. The STROBE guidelines were followed. Ten patients with severe dental crowding and a class I molar relationship were selected to receive orthodontic treatment with clear aligners and corticotomy-facilitated orthodontics. The mean age of these patients was 21 years (range 17-28, standard deviation 6.08 years); the male to female ratio was 2:1. The main outcome was a reduction in the total treatment time to correct dental crowding. The secondary outcomes were periodontal index changes, the degree of root resorption, and patient perceptions of the method used, assessed using the short-form Oral Health Impact Profile (OHIP-14). The occurrence of early surgical complications or unexpected events was also recorded. All patients completed the treatment to correct dental crowding. The average treatment time was reduced by two-thirds. The procedure did not significantly modify the periodontal indices or oral health-related quality of life. No early surgical complications or unexpected events were observed. In short, the results indicate that this new procedure is safe and accelerates tooth movement without periodontal complications or discomfort. However, the efficacy of this procedure must be confirmed in controlled clinical trials. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Classification of instability after reverse shoulder arthroplasty guides surgical management and outcomes.

    Science.gov (United States)

    Abdelfattah, Adham; Otto, Randall J; Simon, Peter; Christmas, Kaitlyn N; Tanner, Gregory; LaMartina, Joey; Levy, Jonathan C; Cuff, Derek J; Mighell, Mark A; Frankle, Mark A

    2018-04-01

    Revision of unstable reverse shoulder arthroplasty (RSA) remains a significant challenge. The purpose of this study was to determine the reliability of a new treatment-guiding classification for instability after RSA, to describe the clinical outcomes of patients stabilized operatively, and to identify those with higher risk of recurrence. All patients undergoing revision for instability after RSA were identified at our institution. Demographic, clinical, radiographic, and intraoperative data were collected. A classification was developed using all identified causes of instability after RSA and allocating them to 1 of 3 defined treatment-guiding categories. Eight surgeons reviewed all data and applied the classification scheme to each case. Interobserver and intraobserver reliability was used to evaluate the classification scheme. Preoperative clinical outcomes were compared with final follow-up in stabilized shoulders. Forty-three revision cases in 34 patients met the inclusion for study. Five patients remained unstable after revision. Persistent instability most commonly occurred in persistent deltoid dysfunction and postoperative acromial fractures but also in 1 case of soft tissue impingement. Twenty-one patients remained stable at minimum 2 years of follow-up and had significant improvement of clinical outcome scores and range of motion. Reliability of the classification scheme showed substantial and almost perfect interobserver and intraobserver agreement among all the participants (κ = 0.699 and κ = 0.851, respectively). Instability after RSA can be successfully treated with revision surgery using the reliable treatment-guiding classification scheme presented herein. However, more understanding is needed for patients with greater risk of recurrent instability after revision surgery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs.

    Science.gov (United States)

    Marković, Aleksa; Lazić, Zoran; Mišić, Tijana; Šćepanović, Miodrag; Todorović, Aleksandar; Thakare, Kaustubh; Janjić, Bojan; Vlahović, Zoran; Glišić, Mirko

    2016-08-01

    During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without) and saline (at 25°C or 5°C). Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p 0.05). Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p < 0.001). Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide.

  4. Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs

    Directory of Open Access Journals (Sweden)

    Marković Aleksa

    2016-01-01

    Full Text Available Background/Aim. During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. Methods. A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without and saline (at 25°C or 5°C. Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. Results. The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p 0.05. Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p < 0.001. Conclusion. Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide.

  5. Probe-guided surgery: metastases of a papillary thyroid carcinoma. Surgical Excision

    International Nuclear Information System (INIS)

    Kowadlo, A.R.; Zund, S.; Perez Irigoyen, C.

    2008-01-01

    A male patient with papillary thyroid cancer -follicular variety- is chosen to be presented. After thyroidectomy, lymphadenectomy and therapeutic dose of radioiodine treatments, cancer relapse was observed. After thyrotrophin suppressive therapy with l-thyroxine, a high serum thyroglobulin concentration was observed. The Ultrasonography (US) and Magnetic Resonance (MR) images showed visible node structures in the neck. This node structures were probably going to concentrate I-131 as seen in the fi rst whole body scan after therapeutic dose. Therefore a radio-guided surgery was planned as the best choice. (Institute Gustave Roussy protocol). A therapeutic dose of radioiodine (I-131) was given and up to the 4th day a whole body scan was performed. In the 5th day a gamma- probe-guided surgery was performed as well, and localized metastatic foci in the pretracheal region and under right recurrent laryngeal nerve. No other foci were identified ed with the probe at surgery. Forty eight hours after surgery a new whole-body scan was made again. The procedure was successful. The metastatic lesions were completely dissected. The last whole body scan showed that radioiodine concentration had disappeared at all. Forty fi ve days and three months after surgery under levothyroxine treatment, the serum thyroglobulin level concentration decrease to very low values. (authors) [es

  6. Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol

    Directory of Open Access Journals (Sweden)

    Evdokia Chasioti

    2015-01-01

    Full Text Available The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.

  7. Autotransplantation of premolars with a 3-dimensional printed titanium replica of the donor tooth functioning as a surgical guide: proof of concept

    NARCIS (Netherlands)

    Verweij, J.P.; Moin, D.A.; Mensink, G.; Nijkamp, P.; Wismeijer, D.; van Merkesteyn, J.P.R.

    2016-01-01

    Purpose: Autotransplantation of premolars is a good treatment option for young patients who have missing teeth. This study evaluated the use of a preoperatively 3-dimensional (3D)-printed replica of the donor tooth that functions as a surgical guide during autotransplantation. Materials and Methods:

  8. A novel approach for computer-assisted template-guided autotransplantation of teeth with custom 3d designed/printed surgical tooling. An ex vivo proof of concept

    NARCIS (Netherlands)

    Anssari Moin, D.; Derksen, W.; Verweij, J.P.; van Merkesteyn, R.; Wismeijer, D.

    2016-01-01

    Purpose: The aim of this study was to introduce a novel method for accurate autotransplantation with computer-assisted guided templates and assembled custom-designed surgical tooling and to test the feasibility and accuracy of this method ex vivo. Materials and Methods: A partially edentulous human

  9. Accuracy of computer-assisted template-guided autotransplantation of teeth with custom three-dimensional designed/printed surgical tooling : A cadaveric study

    NARCIS (Netherlands)

    Anssari Moin, D.; Verweij, J.P.; Waars, H.; van Merkesteyn, R.; Wismeijer, D.

    2017-01-01

    Purpose: The aim of the present cadaveric study was to assess the accuracy of computer-assisted template-guided autotransplantation of teeth with custom 3-dimensional (3D) designed/printed surgical tooling. Materials and Methods: Ten partially edentulous human mandibular cadavers were scanned using

  10. Combined use of rapid-prototyping model and surgical guide in correction of mandibular asymmetry malformation patients with normal occlusal relationship.

    Science.gov (United States)

    Xu, Haisong; Zhang, Ce; Shim, Yoong Hoon; Li, Hongliang; Cao, Dejun

    2015-03-01

    The aim of this study is to discuss the application of rapid-prototyping model and surgical guide in the treatment of mandibular asymmetry malformation with normal occlusal relationship. Twenty-four mandibular asymmetry malformation patients with relatively normal occlusal relationship were included in this study. Surgical 3-dimensional rapid-prototyping mandibular models were made for all patients from the computed tomography (CT) DICOM data. The presurgical plan was designed on the model, and the surgical guiders for the osteotomy lines were manufactured. Genioplasty and/or mandibular osteotomy based on the presurgical plan were performed on these patients with the combined use of the rapid-prototyping model and surgical guides. All patients underwent postoperative CT scan and had at least 3-month follow-up. All patients were satisfied with the final results. According to the postoperative CT images and 3-month follow-up, all patients' mandibular asymmetry malformation was significantly improved, and the operation time was distinctly shortened relative to the conventional method. Rapid-prototyping model and surgical guide are viable auxiliary devices for the treatment of mandibular asymmetry malformation with relatively normal occlusal relationship. Combined use of them can make precise preoperative design, improve effects of operation, and shorten operating time.

  11. Percutaneous ultrasound-guided radiofrequency ablation for kidney tumors in patients with surgical risk

    International Nuclear Information System (INIS)

    Salagierski, Marek; Salagierski, Maciej; Sosnowski, Marek; Salagierska-Barwinska, Anna

    2006-01-01

    The aim of this study was to describe our experience with percutaneous ultrasound-guided radiofrequency ablation of kidney tumors. From July 2002 to August 2005, 45 radiofrequency ablations (RFA) in 42 selected patients with kidney tumor were performed. The patients had either contraindications to surgery procedures or had a solitary kidney. The average tumor size was 37.5 mm (range, 18-59 mm) with the mean age of 68 years (range, 28-83 years). RFA were performed based on radiographic findings. Needle biopsy was made only twice. Monopolar Cool-tip Tyco or bipolar Celon Olympus radiofrequency devices were used. The procedure was performed under conscious sedation with local anesthesia. Treatment efficacy was assessed by computed tomography and by Doppler ultrasound. The absence of contrast enhancement on computed tomography was considered to be a successful treatment. The average follow up was 14 months (range, 3-36 months). In 42 tumors (93%), total absence of contrast enhancement was obtained after the initial RFA and in three tumors (7%) after the second ablation session. There were no complications following 41 procedures, including all ablations in small (<35 mm) renal masses. In four procedures, minor complications were observed. All patients are alive. There has been no need for chronic hemodialysis and, until now, we have not observed any local recurrences with the exception of one metastasis to an ipsilateral adrenal gland. RFA of kidney tumors is a promising alternative treatment which could be considered for patients who are not suitable for surgery. (author)

  12. Study of medical education in 3D surgical modeling by surgeons with free open-source software: Example of mandibular reconstruction with fibula free flap and creation of its surgical guides.

    Science.gov (United States)

    Ganry, L; Hersant, B; Bosc, R; Leyder, P; Quilichini, J; Meningaud, J P

    2018-02-27

    Benefits of 3D printing techniques, biomodeling and surgical guides are well known in surgery, especially when the same surgeon who performed the surgery participated in the virtual surgical planning. Our objective was to evaluate the transfer of know how of a neutral 3D surgical modeling free open-source software protocol to surgeons with different surgical specialities. A one-day training session was organised in 3D surgical modeling applied to one mandibular reconstruction case with fibula free flap and creation of its surgical guides. Surgeon satisfaction was analysed before and after the training. Of 22 surgeons, 59% assessed the training as excellent or very good and 68% considered changing their daily surgical routine and would try to apply our open-source software protocol in their department after a single training day. The mean capacity in using the software improved from 4.13 on 10 before to 6.59 on 10 after training for OsiriX ® software, from 1.14 before to 5.05 after training for Meshlab ® , from 0.45 before to 4.91 after training for Netfabb ® and from 1.05 before and 4.41 after training for Blender ® . According to surgeons, using the software Blender ® became harder as the day went on. Despite improvement in the capacity in using software for all participants, more than a single training day is needed for the transfer of know how on 3D modeling with open-source software. Although the know-how transfer, overall satisfaction, actual learning outcomes and relevance of this training were appropriated, a longer training including different topics will be needed to improve training quality. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention.

    Science.gov (United States)

    Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

    2006-11-28

    To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia. The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases. Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients. Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7 x 10(3)+/-1.3 x 10(3) microg/L vs 13 x 10(3)+/-1 x 10(3) microg/L, P extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients. After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications. Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter. As an alternative to surgery, percutaneous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low mortality and morbidity. Delayed cholecystectomy and ERCP, if needed, can be performed after the acute period has been resolved by percutaneous cholecystostomy.

  14. [Percutaneous ultrasound-guided drainage in the surgical treatment of acute severe pancreatitis].

    Science.gov (United States)

    Delattre, J-F; Levy Chazal, N; Lubrano, D; Flament, J-B

    2004-11-01

    To report results of percutaneous ultrasound-guided drainage, performed by a surgeon, in the treatment of complications of acute pancreatitis (AP), and to determine the role of this technique in the therapeutic armamentarium of severe AP. From 1986 to 2001, 59 patients were included in this retrospective study. All patients initially had severe necrotizing AP (mean Ranson score = 4.1 ; range : 2-7). Anatomical lesions included pancreatic abscess in 6 patients and necrosis in 53 (17 stage D and 36 stage E according to Balthazar's classification). Necrosis was infected in 42 and sterile in 11 respectively. Drainage was performed under ultrasound guidance and local anaesthesia using small-diameter drains (7-14 French). Drainage was performed on average 23 days after onset of AP. Infection was proven by fine-needle aspiration in 47 (80 %) patients (41 infected necrosis and 6 localized abscess). In one patient, culture of aspirated fluid was negative but necrosis was infected (one false negative). Culture of aspirated fluid was negative and necrosis was sterile in 11 patients. Nineteen (32%) patients healed without subsequent surgery: 7 (16%) in the infected necrosis group, 6(55%) in the sterile necrosis group, and 6 (100%) in the abscess group. Forty (68%) patients had subsequent necrosectomy including 8 (14%) who died. Twenty (34 %) digestive fistulas healed spontaneously, except one treated by diversion stomia. Of the 16 (27 %) pancreatic fistulas, 6 needed subsequent interventional treatment. In selected patients, percutaneous drainage can represent an alternative to surgery with a 14% mortality rate. The high rate of subsequent necrosectomy suggests that drains with larger diameter, possibly associated with continuous irrigation, should be used.

  15. USE OF PLASTIC MATERIAL AND TRIPLE SCAN IN THE PREPARATION OF SURGICAL GUIDES FOR THE DENTAL IMPLANT TREATMENT-CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rosen Borisov

    2016-09-01

    Full Text Available The use of surgical guides in implant treatment increases the accuracy of the dental implant positioning compared with manual methods. Regardless of how they are made, deviations of implants from their intended position are established in all kinds of surgical guides. This article considers the use of plastic material and new scanning technique for the production of CAD/CAM surgical guides that aim to overcome the deficiencies of the currently applied technologies in the production of surgical guides. Materials and methods: The study shows the techniques used to overcome degraded by metal artifacts CBCT images in implant treatment of patients with partial edentulism, and located medially to the defect metal-ceramic crowns. When planning implant treatment, a triple scan method has been implied. At the beginning, CBCT scan of the patient with a silicone impression material is made in the zone of interest. Secondly, CBCT scan only of the silicon impression is made, and thirdly - intraoral scanning of the patient with an intraoral scanner. Virtual analogues have been created of images from the three scans and have been repositioned one over another; as thereby an intraoral image have been accurately positioned over the CBCT image of the patient. Virtual planning of the implant positioning has been performed, and a model of surgical guide has been made for their placement. The guide has been printed with an SLA 3D printer technology of photopolymer with dualistic characteristics-rigid in the working part and plastic in the fixing part. Through it, implants have been placed to the treatment planning. Postoperative CBCT has been done on the patient to measure the implant deviation to their position in the treatment planning. Results: Axes angular deviation of the planned and placed implants has not been established. Average linear displacement of 240 μ (+/- 40 μ has been found. Conclusions: Using the triple scan method is possible to overcome the

  16. Radiation brain dose to vascular surgeons during fluoroscopically guided interventions is not effectively reduced by wearing lead equivalent surgical caps.

    Science.gov (United States)

    Kirkwood, Melissa L; Arbique, Gary M; Guild, Jeffrey B; Zeng, Katie; Xi, Yin; Rectenwald, John; Anderson, Jon A; Timaran, Carlos

    2018-03-12

    Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions. Optically stimulated, luminescent nanoDot detectors (Landauer, Glenwood, Ill) inside and outside of the cap at the left temporal position were used to measure cap attenuation during FGIs. To check relative brain doses, nanoDot detectors were placed in 15 positions within an anthropomorphic head phantom (ATOM model 701; CIRS, Norfolk, Va). The phantom was positioned to represent a primary operator performing femoral access. Fluorography was performed on a plastic scatter phantom at 80 kVp for an exposure of 5 Gy reference air kerma with or without the hat. For each brain location, the percentage dose reduction with the hat was calculated. Means and standard errors were calculated using a pooled linear mixed model with repeated measurements. Anatomically similar locations were combined into five groups: upper brain, upper skull, midbrain, eyes, and left temporal position. This was a prospective, single-center study that included 29 endovascular aortic aneurysm procedures. The average procedure reference air kerma was 2.6 Gy. The hat attenuation at the temporal position for the attending physician and fellow was 60% ± 20% and 33% ± 36%, respectively. The equivalent phantom measurements demonstrated an attenuation of 71% ± 2.0% (P < .0001). In the interior phantom locations, attenuation was statistically significant for the skull (6% ± 1.4%) and upper brain (7.2% ± 1.0%; P < .0001) but not for the middle brain (1.4% ± 1.0%; P = .15

  17. A dual-mode hemispherical sparse array for 3D passive acoustic mapping and skull localization within a clinical MRI guided focused ultrasound device

    Science.gov (United States)

    Crake, Calum; Brinker, Spencer T.; Coviello, Christian M.; Livingstone, Margaret S.; McDannold, Nathan J.

    2018-03-01

    Previous work has demonstrated that passive acoustic imaging may be used alongside MRI for monitoring of focused ultrasound therapy. However, past implementations have generally made use of either linear arrays originally designed for diagnostic imaging or custom narrowband arrays specific to in-house therapeutic transducer designs, neither of which is fully compatible with clinical MR-guided focused ultrasound (MRgFUS) devices. Here we have designed an array which is suitable for use within an FDA-approved MR-guided transcranial focused ultrasound device, within the bore of a 3 Tesla clinical MRI scanner. The array is constructed from 5  ×  0.4 mm piezoceramic disc elements arranged in pseudorandom fashion on a low-profile laser-cut acrylic frame designed to fit between the therapeutic elements of a 230 kHz InSightec ExAblate 4000 transducer. By exploiting thickness and radial resonance modes of the piezo discs the array is capable of both B-mode imaging at 5 MHz for skull localization, as well as passive reception at the second harmonic of the therapy array for detection of cavitation and 3D passive acoustic imaging. In active mode, the array was able to perform B-mode imaging of a human skull, showing the outer skull surface with good qualitative agreement with MR imaging. Extension to 3D showed the array was able to locate the skull within  ±2 mm/2° of reference points derived from MRI, which could potentially allow registration of a patient to the therapy system without the expense of real-time MRI. In passive mode, the array was able to resolve a point source in 3D within a  ±10 mm region about each axis from the focus, detect cavitation (SNR ~ 12 dB) at burst lengths from 10 cycles to continuous wave, and produce 3D acoustic maps in a flow phantom. Finally, the array was used to detect and map cavitation associated with microbubble activity in the brain in nonhuman primates.

  18. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention

    Science.gov (United States)

    Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

    2006-01-01

    AIM: To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia. METHODS: The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases. RESULTS: Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients. Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7 × 103 ± 1.3 × 103 μg/L vs 13 × 103 ± 1 × 103 μg/L, P < 0.05 for 24 h after PC; 13.7 × 103 ± 1.3 × 103 μg/L vs 8.3 × 103 ± 1.2 × 103 μg/L, P < 0.0001 for 72 h after PC), C -reactive protein (51.2 ± 18.5 mg/L vs 27.3 ± 10.4 mg/L, P < 0.05 for 24 h after PC; 51.2 ± 18.5 mg/L vs 5.4 ± 1.5 mg/L, P < 0.0001 for 72 h after PC), and fever (38 ± 0.35°C vs 37.3 ± 0.32°C, P < 0.05 for 24 h after PC; 38 ± 0.35°C vs 36.9 ± 0.15°C, P < 0.0001 for 72 h after PC). Sphincterotomy and stone extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients. After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications. Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter. CONCLUSION: As an alternative to surgery, percutan-eous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low

  19. Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following cesarean section: a prospective randomised study

    Directory of Open Access Journals (Sweden)

    Aykut Urfalıoğlu

    2017-09-01

    Full Text Available Background and objectives: Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. Methods: Seventy-five pregnant women with pre- and post-pregnancy body mass index > 30 were randomized and allocated into two groups: Ultrasound-guided transversus abdominis plane block (UT group; n = 38 and surgical TAP block (ST group; n = 37. Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24 hours (h, time to first analgesic requirement, total analgesic consumption amount in 24 h, post-operative side effects, complications and patient satisfaction were recorded. Results and conclusions: Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24 h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10 minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group and four (UT and ST groups patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block. Resumo: Justificativa e objetivos: O bloqueio do

  20. Accuracy of Computer-Assisted Template-Guided Autotransplantation of Teeth With Custom Three-Dimensional Designed/Printed Surgical Tooling: A Cadaveric Study.

    Science.gov (United States)

    Anssari Moin, David; Verweij, Jop Pieter; Waars, Hugo; van Merkesteyn, Richard; Wismeijer, Daniel

    2017-05-01

    The aim of the present cadaveric study was to assess the accuracy of computer-assisted template-guided autotransplantation of teeth with custom 3-dimensional (3D) designed/printed surgical tooling. Ten partially edentulous human mandibular cadavers were scanned using a cone-beam computed tomography (CBCT) system and an intraoral scanning system. The 3D data of these cadavers were imported to specialized software and used to analyze the region of the recipient sites, and the donor teeth were selected. Subsequently, congruent to the donor teeth, custom surgical tooling and surgical-guided templates were designed and 3D printed. The guided osteotomies were performed and the donor teeth transplanted. To evaluate the planned donor teeth positions compared with the transplanted donor teeth positions, the mandibles were scanned again using the CBCT system, and software matching was applied to measure the accuracy of the procedure. The mean angular deflection of the transplanted donor teeth with the planned donor teeth positions was 5.6 ± 5.4°. Comparing the 3D positions of the shoulders, a mean deviation of 3.15 ± 1.16 mm and a mean apical deviation of 2.61 ± 0.78 mm were found. The described method of computer-assisted template-guided autotransplantation of teeth with custom 3D designed/printed surgical tooling could potentially provide a relatively accurate alternative for the currently available treatment approaches. Further research should focus on improving the accuracy of this technique and evaluating the clinical success and advantages of this method. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. A rational approach to estimating the surgical demand elasticity needed to guide manpower reallocation during contagious outbreaks.

    Science.gov (United States)

    Tsao, Hsiao-Mei; Sun, Ying-Chou; Liou, Der-Ming

    2015-01-01

    Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs. To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks. Based on a nationwide research database in Taiwan, we extracted the monthly volumes of major surgery types for the period 1998-2003, which covered the SARS period, in order to carry out a time series analysis. The demand elasticity of each surgery type was then estimated by autoregressive integrated moving average (ARIMA) analysis. During the study period, the surgical volumes of most selected surgery types either increased or remained steady. We categorized these surgery types into low-, moderate- and high-elastic groups according to their demand elasticity. Appendectomy, 'open reduction of fracture with internal fixation' and 'free skin graft' were in the low demand elasticity group. Transurethral prostatectomy and extracorporeal shockwave lithotripsy (ESWL) were in the high demand elasticity group. The manpower of the departments carrying out the surgeries with low demand elasticity should be maintained during outbreaks. In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated. Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.

  2. Guide to Surgical Specialists

    Science.gov (United States)

    ... 0 ) Cart Donate Become a Member Join Member Login Login Enter Keyword Enter Keyword Search Member Services Member ... SSR CMS MIPS ABS Continuous Certification Requirements SSR Login MIPS Resources and Education Quality and Safety Conference ...

  3. Passive safety; Passive Sicherheit

    Energy Technology Data Exchange (ETDEWEB)

    Rueckert, J. [Skoda Auto a.s., Mlada Boleslav (Czech Republic). Interieurentwicklung und Versuche; Hau, M. [Skoda Auto a.s., Mlada Boleslav (Czech Republic). Koordination der Fahrzeugsicherung

    2004-05-01

    The specifications for passive safety are partly based on the legal requirements for all export markets combined with the strict internal standards of Volkswagen Group. The Euro NCAP tests and their precisely defined testing methods using the new point assessment are very important. (orig.)

  4. Autotransplantation of Premolars With a 3-Dimensional Printed Titanium Replica of the Donor Tooth Functioning as a Surgical Guide: Proof of Concept.

    Science.gov (United States)

    Verweij, Jop P; Moin, David Anssari; Mensink, Gertjan; Nijkamp, Peter; Wismeijer, Daniel; van Merkesteyn, J P Richard

    2016-06-01

    Autotransplantation of premolars is a good treatment option for young patients who have missing teeth. This study evaluated the use of a preoperatively 3-dimensional (3D)-printed replica of the donor tooth that functions as a surgical guide during autotransplantation. Five consecutive procedures were prospectively observed. Transplantations of maxillary premolars with optimal root development were included in this study. A 3D-printed replica of the donor tooth was used to prepare a precisely fitting new alveolus at the recipient site before extracting the donor tooth. Procedure time, extra-alveolar time, and number of attempts needed to achieve a good fit of the donor tooth in the new alveolus were recorded. For each transplantation procedure, the surgical time was shorter than 30 minutes. An immediate good fit of the donor tooth in the new alveolus was achieved with an extra-alveolar time shorter than 1 minute for all transplantations. These results show that the extra-alveolar time is very short when the surgical guide is used; therefore, the chance of iatrogenic damage to the donor tooth is minimized. The use of a replica of the donor tooth makes the autotransplantation procedure easier for the surgeon and facilitates optimal placement of the transplant. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

    Science.gov (United States)

    Chana-Rodríguez, Francisco; Cuervas-Mons, Manuel; Rojo-Manaute, José; Mora, Félix; Arnal, Juan; Vaquero-Martín, Javier

    2017-11-01

    Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. Cross-sectional study with cadaveric specimens. Ultrasound-guided pin placement assessed by fluoroscopy and dissection. Fourteen ultrasound-guided supra-acetabular pins were placed in seven cadaveric specimens. Excellent placement in all cases, evaluated with radiological control. Good qualitative bone fixation after dissection. One femoral cutaneous nerve was not found during anatomic dissection and was assumed injured. Ultrasound-guided supra-acetabular pin placement is a feasible and effective technique. Our study indicates that pin placement without intraoperative fluoroscopy is feasible without compromising the reliability of its placement. © 2017 Elsevier Ltd. All rights reserved.

  6. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study.

    Science.gov (United States)

    Schnutenhaus, Sigmar; Edelmann, Cornelia; Rudolph, Heike; Dreyhaupt, Jens; Luthardt, Ralph G

    2018-01-22

    The aim of this study was to investigate differences between the virtually planned and clinically achieved implant positions in completely template-guided implantations as a function of the type of edentulous space, the residual natural dentition, and the surgical implementation. Fifty-six patient cases with a total of 122 implants were evaluated retrospectively. The implantations were completely template-based. The data of the planned implant positions were overlaid with the actual clinical implant positions, followed by measurements of the 3D deviations in terms of coronal (x c ) and apical distance, height (x h ), and angulation (ang) and statistical analysis. The mean x c was 1.2 mm (SD 0.7 mm); the mean x a was 1.8 mm (SD 0.9 mm), the mean x h was 0.8 mm (SD 0.7 mm); and the mean ang was 4.8° (SD 3.1). The type of edentulous space and the jaw (maxilla/mandible) had no significant effect on the results in terms of implant positions. The presence of an adjacent natural tooth at the time of implantation had a significant influence on x h (p = 0.04) and ang (p = 0.05). No significant differences were found regarding the surgical approach for any of the parameters examined. The results of our study are in the same range as those of other studies. Template-guided implantation offers a high degree of accuracy even in the presence of different configurations of the residual dentition or different surgical approaches. A clinical benefit is therefore present, especially from a prosthetic point of view. The clinically achievable accuracy can be described as sufficient for further prosthetic treatment, given the intrinsic and methodological tolerances, making prosthetic rehabilitation safe and predictable.

  7. A Rational Approach to Estimating the Surgical Demand Elasticity Needed to Guide Manpower Reallocation during Contagious Outbreaks

    OpenAIRE

    Tsao, Hsiao-Mei; Sun, Ying-Chou; Liou, Der-Ming

    2015-01-01

    Background Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs. Aim To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks. Materials and Methods Based on a nationwide research database in Taiwan, we extracted the monthly volume...

  8. A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex.

    Science.gov (United States)

    Li, Biao; Zhang, Lei; Sun, Hao; Shen, Steve G F; Wang, Xudong

    2014-03-01

    In bimaxillary orthognathic surgery, the positioning of the maxilla and the mandible is typically accomplished via 2-splint technique, which may be the sources of several types of inaccuracy. To overcome the limitations of the 2-splint technique, we developed a new navigation method, which guided the surgeon to free-hand reposition the maxillomandibular complex as a whole intraoperatively, without the intermediate splint. In this preliminary study, the feasibility was demonstrated. Five patients with dental maxillofacial deformities were enrolled. Before the surgery, 3-dimensional planning was conducted and imported into a navigation system. During the operation, a tracker was connected to the osteotomized maxillomandibular complex via a splint. The navigation system tracked the movement of the complex and displayed it on the screen in real time to guide the surgeon to reposition the complex. The postoperative result was compared with the plan by analyzing the measured distances between the maxillary landmarks and reference planes, as determined from computed tomography data. The mean absolute errors of the maxillary position were clinically acceptable (<1.0 mm). Preoperative preparation time was reduced to 100 minutes on average. All patients were satisfied with the aesthetic results. This navigation method without intraoperative image registration provided a feasible means of transferring virtual planning to the real orthognathic surgery. The real-time position of the maxillomandibular complex was displayed on a monitor to visually guide the surgeon to reposition the complex. In this method, the traditional model surgery and the intermediate splint were discarded, and the preoperative preparation was simplified.

  9. Surgical strategy for malignant gliomas involving pyramidal tracts guided by functional neuronavigation and 5-ALA fluorescence navigation

    International Nuclear Information System (INIS)

    Sato, Ken-ichi; Ito, Tamio; Seo, Yoshinobu; Sunohara, Tadashi; Maeda, Masana; Sasaki, Takehiko; Nakagawara, Jyoji; Nakamura, Hirohiko

    2009-01-01

    For patients with malignant glioma invading pyramidal tracts, maximal resections are difficult to accomplish while preserving their motor function. We used tractography-integrated functional neuronavigation and 5-aminolevulinic acid (5-ALA) fluorescence-guided resection for removal of malignant gliomas involving pyramidal tract. In this study, we analyzed postoperative motor function and extent of resection in a series of patients who underwent surgery in our department. Ten patients with malignant glioma invading pyramidal tracts underwent radical surgery. To preserve pyramidal tracts, we developed a functional neuronavigation-guided fence-post procedure to avoid the problem of brain shift, a disadvantage of the existing neuronavigation systems. Furthermore we have achieved precise resection of tumors using 5-ALA fluorescence navigation. Intraoperatively, tumor fluorescence was visualized using a modified operating microscope. All fluorescing tumor tissue was resected. Motor function was preserved after appropriate tumor resection in all cases. Postoperatively, improvement of motor weakness was observed in seven patients, whereas transient mild motor weakness occurred in two patients. Gross total removals were accomplished in seven patients, and subtotal removal was accomplished in one patient, and partial removal was accomplished in two patients. Combined use of tractography-integrated functional neuronavigation and 5-ALA fluorescence-guided resection contributes to maximal safe resection of malignant gliomas with pyramidal tract involvement. (author)

  10. Passive Education

    Science.gov (United States)

    Bojesen, Emile

    2018-01-01

    This paper does not present an advocacy of a passive education as opposed to an active education nor does it propose that passive education is in any way 'better' or more important than active education. Through readings of Maurice Blanchot, Jacques Derrida and B.S. Johnson, and gentle critiques of Jacques Rancière and John Dewey, passive…

  11. 3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

    Science.gov (United States)

    Meess, Karen M.; Izzo, Richard L.; Dryjski, Maciej L.; Curl, Richard E.; Harris, Linda M.; Springer, Michael; Siddiqui, Adnan H.; Rudin, Stephen; Ionita, Ciprian N.

    2017-03-01

    Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training. Using the Vascular Modeling Toolkit (VMTK), 3D Data from a CTA imaging of a patient scheduled for Fenestrated EndoVascular Aortic Repair (FEVAR) was segmented to isolate the aortic lumen, thrombus, and calcifications. A stereolithographic mesh (STL) was generated and then modified in Autodesk MeshMixer for fabrication via a Stratasys Eden 260 printer in a flexible photopolymer to simulate arterial compliance. Fluoroscopic guided simulation of the patient-specific FEVAR procedure was performed by interventionists using all demonstration endografts and accessory devices. Analysis compared treatment strategy between the planned procedure, the simulation procedure, and the patient procedure using a derived scoring scheme. Results: With training on the patient-specific 3D printed AAA phantom, the clinical team optimized their procedural strategy. Anatomical landmarks and all devices were visible under x-ray during the simulation mimicking the clinical environment. The actual patient procedure went without complications. Conclusions: With advances in 3D printing, fabrication of patient specific AAA phantoms is possible. Simulation with 3D printed phantoms shows potential to inform clinical interventional procedures in addition to CTA diagnostic imaging.

  12. Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial.

    Science.gov (United States)

    Viveen, Jetske; Doornberg, Job N; Kodde, Izaak F; Goossens, Pjotr; Koenraadt, Koen L M; The, Bertram; Eygendaal, Denise

    2017-11-22

    The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country. Options include early- or delayed motion supervised by a physical therapist, immediate continuous passive motion (CPM), (night) splinting and a static progressive or dynamic splinting program. The SET-Study (Stiff Elbow Trial) is a single-centre, prospective, randomized controlled trial. The primary objective of this study is to compare the active Range of Motion (ROM) (flexion arc and rotational arc) twelve months after surgery between three groups. The first group will receive in-hospital CPM in combination with early motion Physical Therapy (PT) supervised by a physical therapist, the second group will receive only in-hospital early motion PT supervised by a physical therapist and the third group will receive outpatient supervised PT from postoperative day seven till ten. Secondary outcome measures will be Patient Reported Outcome Measures (PROMs) including the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), the quick Disabilities of Arm, Shoulder and Hand (qDASH) score, Visual Analogue pain Scale in rest and activity (VAS), Pain Catastrophizing Scale (PCS), the Short Form (SF)-36, the Centre for Epidemiological Studies Depression Scale Revised (CESD-R) and the Work Rehabilitation Questionnaire (WORQ) for the upper limb. A successful completion of this trial will provide evidence on the best rehabilitation protocol in order to (re)gain optimal motion after surgical release of the stiff elbow

  13. Successful surgical management of palatogingival groove using platelet-rich fibrin and guided tissue regeneration: A novel approach

    Directory of Open Access Journals (Sweden)

    J V Karunakaran

    2017-01-01

    Full Text Available Palatogingival groove also known as radicularlingual groove is a developmental anomaly involving the lingual surface of the maxillary incisors. They are inconspicuous, funnel-shaped, extend for varying distances on root surface and occur due to infolding of the hertwigs epithelial root sheath. This encourages adherence of microorganisms and plaque to levels significant for pathological changes resulting in endodontic and periodontal lesions. The variations in anatomy of the tooth as a cause of pulp necrosis in teeth of anterior maxillary segment should be considered by the clinician when other etiological factors are ruled out. Recognition of palatogingival groove is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated. Regeneration is a new emerging approach in endodontics. Choukroun et al. were among the pioneers for using platelet-rich fibrin (PRF to improve bone healing. PRF is rich in platelet cytokines and growth factors. Numerous techniques have been used to eliminate or seal the groove and regenerate endodontic and periodontal tissues. In this case report of two cases, a novel combination therapy involving ultrasonics, blend of PRF with bone graft, guided tissue regeneration membrane was used in the treatment of a palatogingival groove with an endoperio lesion to ensure arrest of disease progression and promote regeneration. The groove was cleaned and prepared ultrasonically and sealed with a bioactive dentin substitute.

  14. Mr.-Guided Cardiac Interventions Using Mr.-Safe Passive Devices: A Preclinical Study and First-in-Man Congenital Interventions

    NARCIS (Netherlands)

    Tzifa, A.; Krombach, G.A.; Kraemer, N.; Krueger, S.; Schuette, A.; Von Walter, M.; Schaeffter, T.; Qureshi, S.; Krasemann, T.; Rosenthal, E.; Schwartz, C.; Varma, G.; Buhl, A.; Kohlmeier, A.; Buecker, A.; Guenther, R.W.; Razavi, R.

    2011-01-01

    Background: Percutaneous cardiac interventions are currently performed under X-ray guidance. Magnetic resonance imaging has been employed to guide intravascular interventions in the past, but mainly in animals. Translation of MR-guided interventions into humans has been limited by the lack of fully

  15. New Dimensional Staging of Bisphosphonate-Related Osteonecrosis of the Jaw Allowing a Guided Surgical Treatment Protocol: Long-Term Follow-Up of 266 Lesions in Neoplastic and Osteoporotic Patients from the University of Bari

    Directory of Open Access Journals (Sweden)

    Simonetta Franco

    2014-01-01

    Full Text Available Bisphosphonate-related osteonecrosis of the jaw (BRONJ is the most serious side effect in patients receiving bisphosphonates (BPs for neoplastic disease and osteoporosis. The aim of this study is to propose a new dimensional stage classification, guiding the surgical treatment of BRONJ patients, and to evaluate the success rate of this new management. From 2004 to 2013, 203 neoplastic and osteoporotic patients with 266 BRONJ lesions were referred to the Odontostomatology Unit of the University of Bari. All patients underwent surgery after suspension of BPs therapy and antibiotic treatment. The surgical procedure was complemented by piezosurgery and followed by the application of hyaluronate and amino acids. The new dimensional staging suggests the choice of the surgical approach, and allows the prediction of postoperative complications and soft and hard tissues healing time, guiding the surgical treatment protocol. This protocol could be a successful management strategy for BRONJ, considering the low recurrences rate and the good stabilisation of the surgical sites observed after a long-term follow-up.

  16. Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry

    Directory of Open Access Journals (Sweden)

    Abhijit Ningappa Gurav

    2015-01-01

    Full Text Available Periradicular (PR bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect.

  17. Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry

    Science.gov (United States)

    Gurav, Abhijit Ningappa; Shete, Abhijeet Rajendra; Naiktari, Ritam

    2015-01-01

    Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect. PMID:26941526

  18. Breast lesions with imaging-histologic discordance during US-guided 14G automated core biopsy: can the directional vacuum-assisted removal replace the surgical excision? Initial findings

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Lee, Ji Young; Youk, Ji Hyun; Oh, Ki Keun; Park, Byeong-Woo; Kim, Seung-Il; Kim, Haeryoung

    2007-01-01

    The purpose of this study was to determine the frequency of carcinoma at percutaneous directional vacuum-assisted removal (DVAR) in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy, and to determine the role of DVAR in breast lesions with imaging-histologic discordance. A US-guided 14-gauge automated core needle biopsy was performed on 837 consecutive lesions. Imaging-histologic discordance was prospectively considered in 33 of 634 benign biopsies. DVAR was recommended in those lesions. Among the 33 lesions, 26 lesions that underwent subsequent DVAR or surgical excision made up our study population. Medical records, imaging studies, and histologic findings were reviewed. Among the 26 lesions, 18 lesions underwent subsequent US-guided DVAR, with 8-gauge probes for 15 of the lesions, and 11-gauge for three of the lesions. Two lesions were diagnosed as having carcinoma (2/18, 11.1% of upgrade rate; 3.1-32.8% CI). The remaining eight lesions underwent subsequent surgical excision, and carcinoma was diagnosed in one case (12.5% of upgrade rate; 2.2-47.1% CI). A US-guided DVAR of the breast mass with imaging-histologic discordance during US-guided 14-gauge automated core needle biopsy is a valuable alternative to surgery as a means of obtaining a definitive histological diagnosis. (orig.)

  19. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  20. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  1. Surgical neuro navigator guided by preoperative magnetic resonance images, based on a magnetic position sensor;Neuronavegador cirurgico guiado por imagens de ressonancia magnetica pre-operatoria, baseado num transdutor de posicao magnetico

    Energy Technology Data Exchange (ETDEWEB)

    Perini, Ana Paula; Siqueira, Rogerio Bulha; Carneiro, Antonio Adilton Oliveira, E-mail: adilton@ffclrp.usp.b [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Dept. de Fisica e Matematica; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Dept. de Informatica; Machado, Helio Rubens [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Dept. de Neurocirurgia

    2009-08-15

    Image guided neurosurgery enables the neurosurgeon to navigate inside the patient's brain using pre-operative images as a guide and a tracking system, during a surgery. Following a calibration procedure, three-dimensional position and orientation of surgical instruments may be transmitted to computer. The spatial information is used to access a region of interest, in the pre-operative images, displaying them to the neurosurgeon during the surgical procedure. However, when a craniotomy is involved and the lesion is removed, movements of brain tissue can be a significant source of error in these conventional navigation systems. The architecture implemented in this work intends the development of a system to surgical planning and orientation guided by ultrasound image. For surgical orientation, the software developed allows the extraction of slices from the volume of the magnetic resonance images (MRI) with orientation supplied by a magnetic position sensor (Polhemus{sup R}). The slices extracted with this software are important because they show the cerebral area that the neurosurgeon is observing during the surgery, and besides they can be correlated with the intra-operative ultrasound images to detect and to correct the deformation of brain tissue during the surgery. Also, a tool for per-operative navigation was developed, providing three orthogonal planes through the image volume. In the methodology used for the software implementation, the Python{sup tm} programming language and the Visualization Toolkit (VTK) graphics library were used. The program to extract slices of the MRI volume allowed the application of transformations in the volume, using coordinates supplied by the position sensor. (author)

  2. A Novel Approach for Computer-Assisted Template-Guided Autotransplantation of Teeth With Custom 3D Designed/Printed Surgical Tooling. An Ex Vivo Proof of Concept.

    Science.gov (United States)

    Anssari Moin, David; Derksen, Wiebe; Verweij, J P; van Merkesteyn, Richard; Wismeijer, Daniel

    2016-05-01

    The aim of this study was to introduce a novel method for accurate autotransplantation with computer-assisted guided templates and assembled custom-designed surgical tooling and to test the feasibility and accuracy of this method ex vivo. A partially edentulous human mandibular cadaver was scanned with a cone-beam computed tomography (CBCT) system and an intraoral scan system. The 3-dimensional (3D) data of this cadaver were imported into specialized software and used to analyze the region of the recipient site and the donor tooth was selected. Subsequently, congruent to the donor tooth, custom surgical tools and a surgical guided template were designed and 3D printed. The guided osteotomy was performed and the donor tooth was transplanted. To evaluate the planned position of the donor tooth in relation to the position of the transplanted donor tooth, the mandible with the transplanted donor tooth was rescanned with the CBCT system and software matching was applied to measure the accuracy of the procedure. The angular deflection of the transplanted donor tooth in relation to the planned donor tooth position was 3.1°. When comparing the 3D positions of the shoulder, there was a deviation of 1.25 mm and an apical deviation of 0.89 mm. With the use of currently available technology, it is feasible to accurately plan and create in a virtual simulation a donor tooth position with congruent custom surgical tools and to transfer this to a clinical setting with 3D printing. However, further research on multiple levels is needed to explore this novel approach. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Development and Assessment of a 3D-Printed Scaffold with rhBMP-2 for an Implant Surgical Guide Stent and Bone Graft Material: A Pilot Animal Study

    Directory of Open Access Journals (Sweden)

    Ji Cheol Bae

    2017-12-01

    Full Text Available In this study, a new concept of a 3D-printed scaffold was introduced for the accurate placement of an implant and the application of a recombinant human bone morphogenetic protein-2 (rhBMP-2-loaded bone graft. This preliminary study was conducted using two adult beagles to evaluate the 3D-printed polycaprolactone (PCL/β-tricalcium phosphate (β-TCP/bone decellularized extracellular matrix (bdECM scaffold conjugated with rhBMP-2 for the simultaneous use as an implant surgical guide stent and bone graft material that promotes new bone growth. Teeth were extracted from the mandible of the beagle model and scanned by computed tomography (CT to fabricate a customized scaffold that would fit the bone defect. After positioning the implant guide scaffold, the implant was placed and rhBMP-2 was injected into the scaffold of the experimental group. The two beagles were sacrificed after three months. The specimen block was obtained and scanned by micro-CT. Histological analysis showed that the control and experimental groups had similar new bone volume (NBV, % but the experimental group with BMP exhibited a significantly higher bone-to-implant contact ratio (BIC, %. Within the limitations of this preliminary study, a 3D-printed scaffold conjugated with rhBMP-2 can be used simultaneously as an implant surgical guide and a bone graft in a large bone defect site. Further large-scale studies will be needed to confirm these results.

  4. Development and Assessment of a 3D-Printed Scaffold with rhBMP-2 for an Implant Surgical Guide Stent and Bone Graft Material: A Pilot Animal Study

    Science.gov (United States)

    Bae, Ji Cheol; Lee, Jin-Ju; Shim, Jin-Hyung; Park, Keun-Ho; Lee, Jeong-Seok; Bae, Eun-Bin; Choi, Jae-Won; Huh, Jung-Bo

    2017-01-01

    In this study, a new concept of a 3D-printed scaffold was introduced for the accurate placement of an implant and the application of a recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded bone graft. This preliminary study was conducted using two adult beagles to evaluate the 3D-printed polycaprolactone (PCL)/β-tricalcium phosphate (β-TCP)/bone decellularized extracellular matrix (bdECM) scaffold conjugated with rhBMP-2 for the simultaneous use as an implant surgical guide stent and bone graft material that promotes new bone growth. Teeth were extracted from the mandible of the beagle model and scanned by computed tomography (CT) to fabricate a customized scaffold that would fit the bone defect. After positioning the implant guide scaffold, the implant was placed and rhBMP-2 was injected into the scaffold of the experimental group. The two beagles were sacrificed after three months. The specimen block was obtained and scanned by micro-CT. Histological analysis showed that the control and experimental groups had similar new bone volume (NBV, %) but the experimental group with BMP exhibited a significantly higher bone-to-implant contact ratio (BIC, %). Within the limitations of this preliminary study, a 3D-printed scaffold conjugated with rhBMP-2 can be used simultaneously as an implant surgical guide and a bone graft in a large bone defect site. Further large-scale studies will be needed to confirm these results. PMID:29258172

  5. In vivo imaging of middle-ear and inner-ear microstructures of a mouse guided by SD-OCT combined with a surgical microscope

    Science.gov (United States)

    Cho, Nam Hyun; Jang, Jeong Hun; Jung, Woonggyu; Kim, Jeehyun

    2014-01-01

    We developed an augmented-reality system that combines optical coherence tomography (OCT) with a surgical microscope. By sharing the common optical path in the microscope and OCT, we could simultaneously acquire OCT and microscope views. The system was tested to identify the middle-ear and inner-ear microstructures of a mouse. Considering the probability of clinical application including otorhinolaryngology, diseases such as middle-ear effusion were visualized using in vivo mouse and OCT images simultaneously acquired through the eyepiece of the surgical microscope during surgical manipulation using the proposed system. This system is expected to realize a new practical area of OCT application. PMID:24787787

  6. Are the surgeon's movements repeatable? An analysis of the feasibility and expediency of implementing support procedures guiding the surgical tools and increasing motion accuracy during the performance of stereotypical movements by the surgeon.

    Science.gov (United States)

    Podsędkowski, Leszek Robert; Moll, Jacek; Moll, Maciej; Frącczak, Łukasz

    2014-03-01

    The developments in surgical robotics suggest that it will be possible to entrust surgical robots with a wider range of tasks. So far, it has not been possible to automate the surgery procedures related to soft tissue. Thus, the objective of the conducted studies was to confirm the hypothesis that the surgery telemanipulator can be equipped with certain routines supporting the surgeon in leading the surgical tools and increasing motion accuracy during stereotypical movements. As the first step in facilitating the surgery, an algorithm will be developed which will concurrently provide automation and allow the surgeon to maintain full control over the slave robot. The algorithm will assist the surgeon in performing typical movement sequences. This kind of support must, however, be preceded by determining the reference points for accurately defining the position of the stitched tissue. It is in relation to these points that the tool's trajectory will be created, along which the master manipulator will guide the surgeon's hand. The paper presents the first stage, concerning the selection of movements for which the support algorithm will be used. The work also contains an analysis of surgical movement repeatability. The suturing movement was investigated in detail by experimental research in order to determine motion repeatability and verify the position of the stitched tissue. Tool trajectory was determined by a motion capture stereovision system. The study has demonstrated that the suturing movement could be considered as repeatable; however, the trajectories performed by different surgeons exhibit some individual characteristics.

  7. Development and Assessment of a 3D-Printed Scaffold with rhBMP-2 for an Implant Surgical Guide Stent and Bone Graft Material: A Pilot Animal Study

    OpenAIRE

    Bae, Ji Cheol; Lee, Jin-Ju; Shim, Jin-Hyung; Park, Keun-Ho; Lee, Jeong-Seok; Bae, Eun-Bin; Choi, Jae-Won; Huh, Jung-Bo

    2017-01-01

    In this study, a new concept of a 3D-printed scaffold was introduced for the accurate placement of an implant and the application of a recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded bone graft. This preliminary study was conducted using two adult beagles to evaluate the 3D-printed polycaprolactone (PCL)/β-tricalcium phosphate (β-TCP)/bone decellularized extracellular matrix (bdECM) scaffold conjugated with rhBMP-2 for the simultaneous use as an implant surgical guide stent an...

  8. Compositional properties of passivity

    NARCIS (Netherlands)

    Kerber, Florian; van der Schaft, Arjan

    2011-01-01

    The classical passivity theorem states that the negative feedback interconnection of passive systems is again passive. The converse statement, - passivity of the interconnected system implies passivity of the subsystems -, turns out to be equally valid. This result implies that among all feasible

  9. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  10. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  11. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  12. Passive solar technology

    Energy Technology Data Exchange (ETDEWEB)

    Watson, D

    1981-04-01

    The present status of passive solar technology is summarized, including passive solar heating, cooling and daylighting. The key roles of the passive solar system designer and of innovation in the building industry are described. After definitions of passive design and a summary of passive design principles are given, performance and costs of passive solar technology are discussed. Passive energy design concepts or methods are then considered in the context of the overall process by which building decisions are made to achieve the integration of new techniques into conventional design. (LEW).

  13. Fundamental studies of passivity and passivity breakdown

    International Nuclear Information System (INIS)

    Macdonald, D.D.; Urquidi-Macdonald, M.; Song, H.; Biaggio-Rocha, S.; Searson, P.

    1991-11-01

    This report summarizes the findings of our fundamental research program on passivity and passivity breakdown. During the past three and one half years in this program (including the three year incrementally-funded grant prior to the present grant), we developed and experimentally tested various physical models for the growth and breakdown of passive films on metal surfaces. These models belong to a general class termed ''point defects models'' (PDMs), in which the growth and breakdown of passive films are described in terms of the movement of anion and cation vacancies

  14. A feasibility study of NIR fluorescent image-guided surgery in head and neck cancer based on the assessment of optimum surgical time as revealed through dynamic imaging

    Directory of Open Access Journals (Sweden)

    Yokoyama J

    2013-04-01

    Full Text Available Junkichi Yokoyama,* Mitsuhisa Fujimaki,* Shinichi Ohba, Takashi Anzai, Ryota Yoshii, Shin Ito, Masataka Kojima, Katsuhisa IkedaDepartment of Otolaryngology-Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan *These authors contributed equally to this study Background: In order to minimize surgical stress and preserve organs, endoscopic or robotic surgery is often performed when conducting head and neck surgery. However, it is impossible to physically touch tumors or to observe diffusely invaded deep organs through the procedure of endoscopic or robotic surgery. In order to visualize and safely resect tumors even in these cases, we propose using an indocyanine green (ICG fluorescence method for navigation surgery in head and neck cancer. Objective: To determine the optimum surgical time for tumor resection after the administration of ICG based on the investigation of dynamic ICG fluorescence imaging. Methods: Nine patients underwent dynamic ICG fluorescence imaging for 360 minutes, assessing tumor visibility at 10, 30, 60, 120, 180, and 360 minutes. All cases were scored according to near-infrared (NIR fluorescence imaging visibility scored from 0 to 5. Results: Dynamic NIR fluorescence imaging under the HyperEye Medical System indicated that the greatest contrast in fluorescent images between tumor and normal tissue could be observed from 30 minutes to 1 hour after the administration of ICG. The optimum surgical time was determined to be between 30 minutes to 2 hours after ICG injection. These findings are particularly useful for detection and safe resection of tumors invading the parapharyngeal space. Conclusion: ICG fluorescence imaging is effective for the detection of head and neck cancer. Preliminary findings suggest that the optimum timing for surgery is from 30 minutes to 2 hours after the ICG injection. Keywords: indocyanine green (ICG, navigation surgery, robotic surgery, endoscopic surgery, minimally invasive

  15. Real-time Continuous Esophageal High-resolution Manometry (HRM) During Laparoscopic Heller Myotomy and Dor Fundoplication for the Treatment of Achalasia. A Promising Novelty in Regards of Perfecting Surgical Technique: Could It Guide Surgical Technique Toward Excellent Results?

    Science.gov (United States)

    Triantafyllou, Tania; Doulami, Georgia; Papailiou, Joanna; Mantides, Apostolos; Zografos, Georgios; Theodorou, Dimitrios

    2016-12-01

    High-resolution manometry (HRM) is the gold-standard diagnostic tool for achalasia of the esophagus. Laparoscopic Heller-Dor technique is the preferred surgical approach with success rate estimated 90%. The use of intraoperative HRM provides real-time estimation of intraluminal esophageal pressures and identifies the exact points of esophageal luminal pressure during laparoscopy. Ten patients with achalasia underwent surgery. All patients preoperatively completed 1 manometric study and Quality of Life questionnaires (EORTC QLQ-C30 version 3.0) with Eckardt scores. We collected intraoperative manometry data and repeated manometric studies, EORTC QLQ-C30, and Eckardt scores postoperatively. Median Eckardt score was decreased from 7.5 to 0.5, mean resting pressure decreased from 51.4 to 11.9 mm Hg, whereas mean residual pressure diminished from 45.9 to 9.5 mm Hg postoperatively. The simultaneous use of HRM during the Heller-Dor technique may lead to an individualized management of the disease.

  16. Catheter Ablation of a Complex Atrial Tachycardia after Surgical Repair of Tetralogy of Fallot Guided by Combined Noncontact and Contact Mapping

    Directory of Open Access Journals (Sweden)

    Eitaro Fujii, MD

    2010-01-01

    Full Text Available A 34-year-old man with a surgically repaired Tetralogy of Fallot complained of palpitation, fatigue, and presyncope. A 12-lead ECG showed atrial tachycardia with a cycle length of 250 ms and a P wave morphology positive in leads II, III and aVF, and negative in lead V1. Although the EnSite system (version 6.OJ made use of noncontact mapping to delineate the counterclockwise reentry around the crista tenninalis, it was difficult to rule out the incisional atrial reentry because the location of the surgical incision was far from the multi-electrode array. Since the bipolar contact mapping of the EnSite system revealed the location of the atriotomy incision, entrainment mapping during the tachycardia demonstrated the critical reentry circuit around the crista terminalis. Radiofrequency ablation targeting the critical isthmus from the lower position of the crista terminalis to the posterior dense scar which was continuous with the inferior vena cava, and to the atriotomy scar, eliminated the tachycardia.

  17. Antenna for passive RFID tags

    Science.gov (United States)

    Schiopu, Paul; Manea, Adrian; Cristea, Ionica; Grosu, Neculai; Vladescu, Marian; Craciun, Anca-Ileana; Craciun, Alexandru

    2015-02-01

    Minuscule devices, called RFID tags are attached to objects and persons and emit information which positioned readers may capture wirelessly. Many methods of identification have been used, but that of most common is to use a unique serial number for identification of person or object. RFID tags can be characterized as either active or passive [1,2]. Traditional passive tags are typically in "sleep" state until awakened by the reader's emitted field. In passive tags, the reader's field acts to charge the capacitor that powers the badge and this can be a combination of antenna and barcodes obtained with SAW( Surface Acoustic Wave) devices [1,2,3] . The antenna in an RFID tag is a conductive element that permits the tag to exchange data with the reader. The paper contribution are targeted to antenna for passive RFID tags. The electromagnetic field generated by the reader is somehow oriented by the reader antenna and power is induced in the tag only if the orientation of the tag antenna is appropriate. A tag placed orthogonal to the reader yield field will not be read. This is the reason that guided manufacturers to build circular polarized antenna capable of propagating a field that is alternatively polarized on all planes passing on the diffusion axis. Passive RFID tags are operated at the UHF frequencies of 868MHz (Europe) and 915MHz (USA) and at the microwave frequencies of 2,45 GHz and 5,8 GHz . Because the tags are small dimensions, in paper, we present the possibility to use circular polarization microstrip antenna with fractal edge [2].

  18. Immunizations: Active vs. Passive

    Science.gov (United States)

    ... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Immunizations: Active vs. Passive Safety & ...

  19. Hydrogenation of passivated contacts

    Energy Technology Data Exchange (ETDEWEB)

    Nemeth, William; Yuan, Hao-Chih; LaSalvia, Vincenzo; Stradins, Pauls; Page, Matthew R.

    2018-03-06

    Methods of hydrogenation of passivated contacts using materials having hydrogen impurities are provided. An example method includes applying, to a passivated contact, a layer of a material, the material containing hydrogen impurities. The method further includes subsequently annealing the material and subsequently removing the material from the passivated contact.

  20. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  1. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  2. Surgical Simulations Based on Limited Quantitative Data: Understanding How Musculoskeletal Models Can Be Used to Predict Moment Arms and Guide Experimental Design.

    Directory of Open Access Journals (Sweden)

    Jennifer A Nichols

    Full Text Available The utility of biomechanical models and simulations to examine clinical problems is currently limited by the need for extensive amounts of experimental data describing how a given procedure or disease affects the musculoskeletal system. Methods capable of predicting how individual biomechanical parameters are altered by surgery are necessary for the efficient development of surgical simulations. In this study, we evaluate to what extent models based on limited amounts of quantitative data can be used to predict how surgery influences muscle moment arms, a critical parameter that defines how muscle force is transformed into joint torque. We specifically examine proximal row carpectomy and scaphoid-excision four-corner fusion, two common surgeries to treat wrist osteoarthritis. Using models of these surgeries, which are based on limited data and many assumptions, we perform simulations to formulate a hypothesis regarding how these wrist surgeries influence muscle moment arms. Importantly, the hypothesis is based on analysis of only the primary wrist muscles. We then test the simulation-based hypothesis using a cadaveric experiment that measures moment arms of both the primary wrist and extrinsic thumb muscles. The measured moment arms of the primary wrist muscles are used to verify the hypothesis, while those of the extrinsic thumb muscles are used as cross-validation to test whether the hypothesis is generalizable. The moment arms estimated by the models and measured in the cadaveric experiment both indicate that a critical difference between the surgeries is how they alter radial-ulnar deviation versus flexion-extension moment arms at the wrist. Thus, our results demonstrate that models based on limited quantitative data can provide novel insights. This work also highlights that synergistically utilizing simulation and experimental methods can aid the design of experiments and make it possible to test the predictive limits of current computer

  3. Safety of panitumumab-IRDye800CW and cetuximab-IRDye800CW for fluorescence-guided surgical navigation in head and neck cancers.

    Science.gov (United States)

    Gao, Rebecca W; Teraphongphom, Nutte; de Boer, Esther; van den Berg, Nynke S; Divi, Vasu; Kaplan, Michael J; Oberhelman, Nicholas J; Hong, Steven S; Capes, Elissa; Colevas, A Dimitrios; Warram, Jason M; Rosenthal, Eben L

    2018-01-01

    Purpose: To demonstrate the safety and feasibility of leveraging therapeutic antibodies for surgical imaging. Procedures: We conducted two phase I trials for anti-epidermal growth factor receptor antibodies cetuximab-IRDye800CW (n=12) and panitumumab-IRDye800CW (n=15). Adults with biopsy-confirmed head and neck squamous cell carcinoma scheduled for standard-of-care surgery were eligible. For cetuximab-IRDye800CW, cohort 1 was intravenously infused with 2.5 mg/m 2 , cohort 2 received 25 mg/m 2 , and cohort 3 received 62.5 mg/m 2 . For panitumumab-IRDye800CW, cohorts received 0.06 mg/kg, 0.5 mg/kg, and 1 mg/kg, respectively. Electrocardiograms and blood samples were obtained, and patients were followed for 30 days post-study drug infusion. Results: Both fluorescently labeled antibodies had similar pharmacodynamic properties and minimal toxicities. Two infusion reactions occurred with cetuximab and none with panitumumab. There were no grade 2 or higher toxicities attributable to cetuximab-IRDye800CW or panitumumab-IRDye800CW; fifteen grade 1 adverse events occurred with cetuximab-IRDye800CW, and one grade 1 occurred with panitumumab-IRDye800CW. There were no significant differences in QTc prolongation between the two trials (p=0.8). Conclusions: Panitumumab-IRDye800CW and cetuximab-IRDye800CW have toxicity and pharmacodynamic profiles that match the parent compound, suggesting that other therapeutic antibodies may be repurposed as imaging agents with limited preclinical toxicology data.

  4. The efficacy of the use of IR laser phototherapy associated to biphasic ceramic graft and guided bone regeneration on surgical fractures treated with miniplates: a Raman spectral study on rabbits.

    Science.gov (United States)

    Pinheiro, Antonio L B; Santos, Nicole Ribeiro Silva; Oliveira, Priscila Chagas; Aciole, Gilberth Tadeu Santos; Ramos, Thais Andrade; Gonzalez, Tayná Assunção; da Silva, Laís Nogueira; Barbosa, Artur Felipe Santos; Silveira, Landulfo

    2013-02-01

    The aim of the present study was to assess, by Raman spectroscopy, the repair of surgical fractures fixed with internal rigid fixation (IRF) treated or not with IR laser (λ780 nm, 50 mW, 4 × 4 J/cm(2) = 16 J/cm(2), ϕ = 0.5 cm(2), CW) associated or not to the use of hydroxyapatite and guided bone regeneration (GBR). Surgical tibial fractures were created under general anesthesia on 15 rabbits that were divided into five groups, maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libitum. The fractures in groups II, III, IV and V were fixed with miniplates. Animals in groups III and V were grafted with hydroxyapatite and GBR technique used. Animals in groups IV and V were irradiated at every other day during 2 weeks (4 × 4 J/cm(2), 16 J/cm(2) = 112 J/cm(2)). Observation time was that of 30 days. After animal death, specimens were taken and kept in liquid nitrogen and used for Raman spectroscopy. Raman spectroscopy showed significant differences between groups (p < 0.001). Basal readings showed mean value of 1,234 ± 220.1. Group internal rigid fixation + biomaterial + laser showed higher readings (3,521 ± 2,670) and group internal rigid fixation + biomaterial the lowest (212.2 ± 119.8). In conclusion, the results of the present investigation are important clinically as spectral analysis of bone component evidenced increased levels of CHA on fractured sites by using the association of laser light to a ceramic graft.

  5. The efficacy of the use of IR laser phototherapy associated to biphasic ceramic graft and guided bone regeneration on surgical fractures treated with wire osteosynthesis: a comparative laser fluorescence and Raman spectral study on rabbits.

    Science.gov (United States)

    Pinheiro, Antônio Luiz Barbosa; Santos, Nicole Ribeiro Silva; Oliveira, Priscila Chagas; Aciole, Gilberth Tadeu Santos; Ramos, Thais Andrade; Gonzalez, Tayná Assunção; da Silva, Laís Nogueira; Barbosa, Artur Felipe Santos; Silveira, Landulfo

    2013-05-01

    The aim of the present study was to assess, by Raman spectroscopy and laser fluorescence, the repair of surgical fractures fixed with wire osteosynthesis treated or not with infrared laser (λ780 nm, 50 mW, 4 × 4 J/cm(2) =16 J/cm(2), ϕ=0.5 cm(2), CW) associated or not to the use of hydroxyapatite and guided bone regeneration. Surgical tibial fractures were created under general anesthesia on 15 rabbits that were divided into five groups, maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet, and had water ad libitum. The fractures in groups II, III, IV, and V were fixed with wires. Animals in groups III and V were grafted with hydroxyapatite (HA) and guided bone regeneration (GBR) technique used. Animals in groups IV and V were irradiated at every other day during 2 weeks (4 × 4 J/cm(2), 16 J/cm(2) =112 J/cm(2)). Observation time was that of 30 days. After animal death, specimens were taken and kept in liquid nitrogen and used for Raman spectroscopy. The Raman results showed basal readings of 1,234.38 ± 220. Groups WO+B+L showed higher readings (1,680.22 ± 822) and group WO+B the lowest (501.425 ± 328). Fluorescence data showed basal readings of 5.83333 ± 0.7. Groups WO showed higher readings (6.91667 ± 0.9) and group WO+B+L the lowest (1.66667 ± 0.5). There were significant differences between groups on both cases (pRaman peaks of calcium hydroxyapatite (CHA) are increased, the level of fluorescence is reduced. It is concluded that the use of near-infrared lasertherapy associated to HA graft and GBR was effective in improving bone healing on fractured bones as a result of the increasing deposition of CHA measured by Raman spectroscopy and decrease of the organic components as shown by the fluorescence readings.

  6. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  7. New multimedia advances in surgical information.

    Science.gov (United States)

    Glenn, Ian C; Abdulhai, Sophia; Lamoshi, Abdulraouf; Ponsky, Todd A

    2018-06-01

    When discussing new trends in pediatric surgery, the tendency is to focus on novel surgical technology and techniques. However, it is equally important to examine how the practicing surgeon stays abreast in an ever-changing field. This article serves as a brief guide to the future of surgical education for the attending surgeon. Broadly, advances in surgical education consist of new methods of filtration and delivery of knowledge.

  8. Passive magnetic bearing configurations

    Science.gov (United States)

    Post, Richard F [Walnut Creek, CA

    2011-01-25

    A journal bearing provides vertical and radial stability to a rotor of a passive magnetic bearing system when the rotor is not rotating and when it is rotating. In the passive magnetic bearing system, the rotor has a vertical axis of rotation. Without the journal bearing, the rotor is vertically and radially unstable when stationary, and is vertically stable and radially unstable when rotating.

  9. Deep influence of passive low energy consumption multi-storey residential building in cold region

    Science.gov (United States)

    Shuai, Zhang; Lihua, Zhao; Rong, Jin; Dong, Junyan

    2018-02-01

    The example of passive architecture demonstration building in Jilin Province, China, based on the practical experience of this project, the control index of passive and low energy consumption residential buildings in cold and passive buildings is referenced by reference to the German construction standard and the Chinese residence construction document, “passive ultra-low energy consumption green Building Technology Guide (Trial)”. The requirement of passive low energy residential buildings on the ground heat transfer coefficient limits is determined, and the performance requirements of passive residential buildings are discussed. This paper analyzes the requirement of the passive low energy residential building on the ground heat transfer coefficient limit, and probes into the influence factors of the ground thermal insulation of the passive low energy consumption residential building. The construction method of passive low energy consumption residential building is proposed.

  10. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  11. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  12. Passive solar construction handbook

    Energy Technology Data Exchange (ETDEWEB)

    Levy, E.; Evans, D.; Gardstein, C.

    1981-08-01

    Many of the basic elements of passive solar design are reviewed. The unique design constraints presented in passive homes are introduced and many of the salient issues influencing design decisions are described briefly. Passive solar construction is described for each passive system type: direct gain, thermal storage wall, attached sunspace, thermal storage roof, and convective loop. For each system type, important design and construction issues are discussed and case studies illustrating designed and built examples of the system type are presented. Construction details are given and construction and thermal performance information is given for the materials used in collector components, storage components, and control components. Included are glazing materials, framing systems, caulking and sealants, concrete masonry, concrete, brick, shading, reflectors, and insulators. The Load Collector Ratio method for estimating passive system performance is appended, and other analysis methods are briefly summarized. (LEW)

  13. Comparative cost-effectiveness of fine needle aspiration biopsy versus image-guided biopsy, and open surgical biopsy in the evaluation of breast cancer in the era of Affordable Care Act: a changing landscape.

    Science.gov (United States)

    Masood, Shahla; Rosa, Marilin; Kraemer, Dale F; Smotherman, Carmen; Mohammadi, Amir

    2015-08-01

    Proven as a time challenged and cost-effective sampling procedure, the use of FNAB has still remained controversial among the scientific community. Currently, other minimally invasive sampling procedures such as ultrasound guided fine needle aspiration biopsy (US-FNAB) and image guided core needle biopsy (IG-CNB) have become the preferred sampling procedures for evaluation of breast lesions. However, changes in the medical economy and the current growing emphasis on cost containment in the era of the Affordable Care Act make it necessary to stimulate a renewed interest in the use of FNAB as the initial diagnostic sampling procedure. This study was designed to define the changing trend in the practice of tissue sampling during the last several years, and to assess the comparative effectiveness and appropriateness of the procedure of choice for breast cancer diagnosis. After Institutional Review Board (IRB) approval, the computer database of the Pathology Department, University of Florida, College of Medicine-Jacksonville at UF Health was retrospectively searched to identify all breast biopsy pathology reports issued during the period of January 2004 to December 2011. The inclusion criteria were all women that underwent any of the following biopsy types: FNAB, US-FNAB, IG-CNB, and surgical biopsy (SB). Diagnostic procedures were identified using current procedural terminology (CPT) codes recorded on claims from the UF Health Jacksonville patient accounting application files. The data obtained was used to determine which technique has the best cost-effectiveness in the diagnosis of breast cancer. The outcome variable for this project was a positive breast cancer diagnosis resulting from these methodologies. The predictor variable was the biopsy type used for sampling. The rate of cancer detection for each procedure was also determined. Among the four groups of procedures compared, the lower cost was attributed to FNAB, followed by US-FNAB, and SB. IG-CNB was the most

  14. Passivity and Evolutionary Game Dynamics

    KAUST Repository

    Park, Shinkyu; Shamma, Jeff S.; Martins, Nuno C.

    2018-01-01

    This paper investigates an energy conservation and dissipation -- passivity -- aspect of dynamic models in evolutionary game theory. We define a notion of passivity using the state-space representation of the models, and we devise systematic methods to examine passivity and to identify properties of passive dynamic models. Based on the methods, we describe how passivity is connected to stability in population games and illustrate stability of passive dynamic models using numerical simulations.

  15. Passivity and Evolutionary Game Dynamics

    KAUST Repository

    Park, Shinkyu

    2018-03-21

    This paper investigates an energy conservation and dissipation -- passivity -- aspect of dynamic models in evolutionary game theory. We define a notion of passivity using the state-space representation of the models, and we devise systematic methods to examine passivity and to identify properties of passive dynamic models. Based on the methods, we describe how passivity is connected to stability in population games and illustrate stability of passive dynamic models using numerical simulations.

  16. Aktiv kontra passiv forvaltning

    DEFF Research Database (Denmark)

    Bechmann, Ken L.; Pedersen, Lasse Heje

    2017-01-01

    Fordele og ulemper ved aktiv og passiv forvaltning har fået fornyet opmærksomhed blandt andet i forbindelse med den forestående implementering af MiFID II. Som bidrag til denne diskussion indeholder dette nummer af Finans/Invest tre artikler, der behandler aktiv og passiv forvaltning fra...... forskellige vinkler. Denne leder forklarer, hvorfor valget mellem aktiv og passiv forvaltning er mere kompliceret, end hvad man kunne tro ved første øjekast, og konkluderer, at der vil være plads til - og behov for - begge typer forvaltning....

  17. Most energetic passive states.

    Science.gov (United States)

    Perarnau-Llobet, Martí; Hovhannisyan, Karen V; Huber, Marcus; Skrzypczyk, Paul; Tura, Jordi; Acín, Antonio

    2015-10-01

    Passive states are defined as those states that do not allow for work extraction in a cyclic (unitary) process. Within the set of passive states, thermal states are the most stable ones: they maximize the entropy for a given energy, and similarly they minimize the energy for a given entropy. Here we find the passive states lying in the other extreme, i.e., those that maximize the energy for a given entropy, which we show also minimize the entropy when the energy is fixed. These extremal properties make these states useful to obtain fundamental bounds for the thermodynamics of finite-dimensional quantum systems, which we show in several scenarios.

  18. Surgical versus Non-surgical Management of Rotator Cuff Tears: Predictors of Treatment Allocation

    OpenAIRE

    Kweon, Christopher Y.; Gagnier, Joel Joseph; Robbins, Christopher; Bedi, Asheesh; Carpenter, James E.; Miller, Bruce S.

    2014-01-01

    Objectives: Rotator cuff tears are a common shoulder disorder resulting in significant disability to patients and strain on the health care system. While both surgical and non-surgical management are accepted treatment options, little data exist to guide the surgeon in treatment allocation. Defining variables to guide treatment allocation may be important for patient education and counseling, as well as to deliver the most efficient care plan at the time of presentation. The objective of this...

  19. Techniques for active passivation

    Science.gov (United States)

    Roscioli, Joseph R.; Herndon, Scott C.; Nelson, Jr., David D.

    2016-12-20

    In one embodiment, active (continuous or intermittent) passivation may be employed to prevent interaction of sticky molecules with interfaces inside of an instrument (e.g., an infrared absorption spectrometer) and thereby improve response time. A passivation species may be continuously or intermittently applied to an inlet of the instrument while a sample gas stream is being applied. The passivation species may have a highly polar functional group that strongly binds to either water or polar groups of the interfaces, and once bound presents a non-polar group to the gas phase in order to prevent further binding of polar molecules. The instrument may be actively used to detect the sticky molecules while the passivation species is being applied.

  20. Passive radon daughter dosimeters

    International Nuclear Information System (INIS)

    McElroy, R.G.C.; Johnson, J.R.

    1986-03-01

    On the basis of an extensive review of the recent literature concerning passive radon daughter dosimeters, we have reached the following conclusions: 1) Passive dosimeters for measuring radon are available and reliable. 2) There does not presently exist an acceptable passive dosimeter for radon daughters. There is little if any hope for the development of such a device in the foreseeable future. 3) We are pessimistic about the potential of 'semi-passive dosimeters' but are less firm about stating categorically that these devices cannot be developed into a useful radon daughter dosimeter. This report documents and justifies these conclusions. It does not address the question of the worker's acceptance of these devices because at the present time, no device is sufficiently advanced for this question to be meaningful. 118 refs

  1. Passive Mixing inside Microdroplets

    Directory of Open Access Journals (Sweden)

    Chengmin Chen

    2018-04-01

    Full Text Available Droplet-based micromixers are essential units in many microfluidic devices for widespread applications, such as diagnostics and synthesis. The mixers can be either passive or active. When compared to active methods, the passive mixer is widely used because it does not require extra energy input apart from the pump drive. In recent years, several passive droplet-based mixers were developed, where mixing was characterized by both experiments and simulation. A unified physical understanding of both experimental processes and simulation models is beneficial for effectively developing new and efficient mixing techniques. This review covers the state-of-the-art passive droplet-based micromixers in microfluidics, which mainly focuses on three aspects: (1 Mixing parameters and analysis method; (2 Typical mixing element designs and the mixing characters in experiments; and, (3 Comprehensive introduction of numerical models used in microfluidic flow and diffusion.

  2. CANDU passive shutdown systems

    Energy Technology Data Exchange (ETDEWEB)

    Hart, R S; Olmstead, R A [AECL CANDU, Sheridan Park Research Community, Mississauga, ON (Canada)

    1996-12-01

    CANDU incorporates two diverse, passive shutdown systems, independent of each other and from the reactor regulating system. Both shutdown systems function in the low pressure, low temperature, moderator which surrounds the fuel channels. The shutdown systems are functionally different, physically separate, and passive since the driving force for SDS1 is gravity and the driving force for SDS2 is stored energy. The physics of the reactor core itself ensures a degree of passive safety in that the relatively long prompt neutron generation time inherent in the design of CANDU reactors tend to retard power excursions and reduces the speed required for shutdown action, even for large postulated reactivity increases. All passive systems include a number of active components or initiators. Hence, an important aspect of passive systems is the inclusion of fail safe (activated by active component failure) operation. The mechanisms that achieve the fail safe action should be passive. Consequently the passive performance of the CANDU shutdown systems extends beyond their basic modes of operation to include fail safe operation based on natural phenomenon or stored energy. For example, loss of power to the SDS1 clutches results in the drop of the shutdown rods by gravity, loss of power or instrument air to the injection valves of SDS2 results in valve opening via spring action, and rigorous self checking of logic, data and timing by the shutdown systems computers assures a fail safe reactor trip through the collapse of a fluctuating magnetic field or the discharge of a capacitor. Event statistics from operating CANDU stations indicate a significant decrease in protection system faults that could lead to loss of production and elimination of protection system faults that could lead to loss of protection. This paper provides a comprehensive description of the passive shutdown systems employed by CANDU. (author). 4 figs, 3 tabs.

  3. Differential effects of active and passive coping on secretory immunity

    NARCIS (Netherlands)

    Bosch, JA; de Geus, E.J.C.; Kelder, A.; Veerman, E.C.I.; Hoogstraten, J.; van Nieuw Amerongen, A.

    2001-01-01

    This study examined the acute immunological effects of two laboratory stressors, expected to evoke distinct patterns of cardiac autonomic activity; namely an "active coping" time-paced memory test, and a "passive coping" stressful video showing surgical operations. We measured salivary S-IgA,

  4. Passive House Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Strom, I.; Joosten, L.; Boonstra, C. [DHV Sustainability Consultants, Eindhoiven (Netherlands)

    2006-05-15

    PEP stands for 'Promotion of European Passive Houses' and is a consortium of European partners, supported by the European Commission, Directorate General for Energy and Transport. In this working paper an overview is given of Passive House solutions. An inventory has been made of Passive House solutions for new build residences applied in each country. Based on this, the most common basic solutions have been identified and described in further detail, including the extent to which solutions are applied in common and best practice and expected barriers for the implementation in each country. An inventory per country is included in the appendix. The analysis of Passive House solutions in partner countries shows high priority with regard to the performance of the thermal envelope, such as high insulation of walls, roofs, floors and windows/ doors, thermal bridge-free construction and air tightness. Due to the required air tightness, special attention must be paid to indoor air quality through proper ventilation. Finally, efficient ((semi-)solar) heating systems for combined space and DHW heating still require a significant amount of attention in most partner countries. Other basic Passive House solutions show a smaller discrepancy with common practice and fewer barriers have been encountered in partner countries. In the next section, the general barriers in partner countries have been inventoried. For each type of barrier a suggested approach has been given. Most frequently encountered barriers in partner countries are: limited know-how; limited contractor skills; and acceptation of Passive Houses in the market. Based on the suggested approaches to overcoming barriers, this means that a great deal of attention must be paid to providing practical information and solutions to building professionals, providing practical training to installers and contractors and communication about the Passive House concept to the market.

  5. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

    Science.gov (United States)

    Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

    2018-01-01

    Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

  6. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

    Science.gov (United States)

    Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

    2018-01-01

    Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

  7. Non-surgical breast-conservation treatment (KORTUC-BCT) using a new image-guided, enzyme-targeted, and breast cancer stem cell targeted radiosensitization treatment (KORTUC II) for patients with stage I or II breast cancer

    International Nuclear Information System (INIS)

    Ogawa, Yasuhiro; Kubota, Kei; Tadokoro, Michiko

    2012-01-01

    injected into breast tumor tissue twice a week under ultrasound guidance, just prior to each administration of radiation therapy, and we confirmed an even distribution of micro-bubbles of oxygen throughout the target tumor. The injection was started at the 6th fraction of radiation therapy. This injection protocol effectively preserves oxygen concentration in the tumor tissue for more than 24 h following intra-tumoral injection (Tokuhiro S, et al: Oncol Letters 1:1025-1028, 2010). Concerning radiation therapy, hypofraction radiotherapy was given using tangential fields approach and Field-in-field method; energy level was 4MV and the total radiation therapy dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added 3 times just following the 14th, 15th and 16th administrations of 4 MV X-ray irradiation. From a needle biopsy specimen, hormonal status (estrogen and progesterone receptors), HER-2 antigen, and CD44 receptor were examined by immunohistochemistry. Treatment was well tolerated with a minimum of adverse effects in all 39 patients. A total of 36 patients achieved clinically complete response on dynamic MRI study, and the study has not been performed yet for another 3. All of the patients did not show any complications (with the exception of mild dermatitis of Grade I for 24 and Grade II for 15), and cosmetic results were excellent/good for 35 patients. 15 patients under 75 y with stage II breast cancer underwent induction chemotherapy (EC and/or Taxan) prior to the KORTUC II treatment, and 36 patients with estrogen receptor-positive tumors also undertook hormonal therapy following KORTUC II. The mean follow-up period at the end of September 2011 was 30.1 months, at which time all 39 patients were alive without any distant metastases. Only 1 patient had local recurrence, which was discovered at 34 months follow-up. Non-surgical BCT (KORTUC-BCT) can be performed with KORTUC II. KORTUC II has 3 major characteristics: it is image-guided by

  8. Measure Guideline: Passive Vents

    Energy Technology Data Exchange (ETDEWEB)

    Berger, David [Consortium for Advanced Residential Buildings, Norwalk, CT (United States); Neri, Robin [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

    2016-02-05

    This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated source of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.

  9. Constructing passive houses

    Energy Technology Data Exchange (ETDEWEB)

    Oehler, S. [Oehler Faigle Archkom Solar Architektur, Bretten (Germany)

    2005-07-01

    Everybody can learn to build energy-efficient. It needs theoretical and practical experience. 1997 we built the first freestanding Passive House in Europe, the Passive House Oehler. There had been a lot of questions, starting with the insecurity, whether the calculation program of the Passive House Institute, the PHPP, is working properly in our case. Nobody knew at that time because nobody tried it out before. It took us a lot of time to find out and every detail of the construction hat to be invented to meet the very high demand of thermal quality. All the following houses needed less time and had fewer open questions, adding one piece of experience with every building. 2002 we realised the biggest Passive House, the office building Energon Ulm with 420 working spaces. In the meantime we have learned a lot like how to produce prefabricated timber elements for the facades, providing good insulation, air tightness and avoiding serious thermal bridges. We have proofed, that any kind of building type can be a Passive House. And with increasing experience the freedom of design and construction is growing. Even the economical efficiency increased. The Energon Ulm is providing a much better indoor climate than any other office building and was build 10 % cheaper than an average German office building. At present the Passive House Standard is the most efficient solution for the user to live in the desired comfort zone between 20 C and 25 C. This zone of individual feeling-well can be described with the term ''operative temperature''. This term is defined by factors like air temperature, radiation temperature of warm and cold surfaces, air speed and humidity. The result of all these factors has to be within 18 C to 25 C without accepting one of the factors getting extreme.

  10. Passive containment system

    International Nuclear Information System (INIS)

    Kleimola, F.W.

    1977-01-01

    Disclosed is a containment system that provides complete protection entirely by passive means for the loss of coolant accident in a nuclear power plant and wherein all stored energy released in the coolant blowdown is contained and absorbed while the nuclear fuel is prevented from over-heating by a high containment back-pressure and a reactor vessel refill system. The primary containment vessel is restored to a high sub-atmospheric pressure within a few minutes after accident initiation and the decay heat is safely transferred to the environment while radiolytic hydrogen is contained by passive means. 20 claims, 14 figures

  11. Wireless passive radiation sensor

    Science.gov (United States)

    Pfeifer, Kent B; Rumpf, Arthur N; Yelton, William G; Limmer, Steven J

    2013-12-03

    A novel measurement technique is employed using surface acoustic wave (SAW) devices, passive RF, and radiation-sensitive films to provide a wireless passive radiation sensor that requires no batteries, outside wiring, or regular maintenance. The sensor is small (<1 cm.sup.2), physically robust, and will operate unattended for decades. In addition, the sensor can be insensitive to measurement position and read distance due to a novel self-referencing technique eliminating the need to measure absolute responses that are dependent on RF transmitter location and power.

  12. Passive cooling of control rod drive mechanisms

    International Nuclear Information System (INIS)

    Hankinson, M.F.; Schwirian, R.E.

    1992-01-01

    A method and apparatus are provided for passively cooling the control rod drive mechanisms (CRDMs) in the reactor vessel of a nuclear power plant. Passive cooling is achieved by dispersing a plurality of chimneys within the CRDM array in positions where a control rod is not required. The chimneys induce convective air currents which cause ambient air from within the containment to flow over the CRDM coils. The air heated by the coils is guided into inlets in the chimneys by baffles. The chimney is insulated and extends through the seismic support platform and missile shield disposed above the closure head. A collar of adjustable height mates with plate elements formed at the distal end of the CRDM pressure housings by an interlocking arrangement so that the seismic support platform provides lateral restraint for the chimneys. (Author)

  13. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    Directory of Open Access Journals (Sweden)

    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  14. Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics; Neurochirurgie guidee par l'image. Concept global d'une tele-assistance chirurgicale a l'aide d'une robotique d'empechement

    Energy Technology Data Exchange (ETDEWEB)

    Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M. [Hopital d' Instruction des Armees du Val-de-Grace, 75 - Paris (France)

    2000-12-01

    Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

  15. Spinal intramedullary ependymoma: surgical approaches and outcome.

    Science.gov (United States)

    Borges, Lawrence F

    2018-02-01

    Intramedullary ependymomas are uncommon tumors that can occur within the medullary substance of the spinal cord. Despite this difficult location, they are typically benign tumors that can most often be removed completely with an acceptable surgical risk. Therefore, the recommended management approach is usually surgical excision. This review will consider the historical context in which surgeons began treating these tumors and then review the more recent literature that guides their current management.

  16. Passiv-Sammler

    OpenAIRE

    Fritsche, U.

    1991-01-01

    The invention relates to a passive collector for air pollution for the determination of emission rates for dry and wet deposits on construction materials such as natural stone, whereby the collector has a surrogate surface of the stone under investigation, the surrogate surface being linked to a collecting vessel such that any dry or wet contamination occurring can be collected.

  17. Passive houses in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Halse, Andreas

    2008-12-15

    The paper analyzes the introduction of passive houses in the Norwegian house market. Passive houses are houses with extremely low levels of energy consumption for heating, and have not yet been built in Norway, but have started to enter the market in Germany and some other countries. The construction sector is analyzed as a sectoral innovation system. The different elements of the innovation system are studied. This includes government agencies, producers, consumers, finance and education. The analysis shows that passive and low-energy houses are on the verge of market breakthrough. This can partly be explained by economic calculations, and partly by processes of learning and change in the institutional set-up of the sector. The construction sector is a sector characterized by low innovative intensity and little interaction between different agents. Those working to promote passive houses have to some extent managed to cope with these challenges. This has happened by breaking away from the traditional focus of Norwegian energy efficiency policies on technology and the economically rational agents, by instead focusing on knowledge and institutional change at the level of the producers. (Author)

  18. Hood River Passive House

    Energy Technology Data Exchange (ETDEWEB)

    Hales, David [BA-PIRC, Spokane, WA (United States)

    2014-01-01

    The Hood River Passive Project was developed by Root Design Build of Hood River Oregon using the Passive House Planning Package (PHPP) to meet all of the requirements for certification under the European Passive House standards. The Passive House design approach has been gaining momentum among residential designers for custom homes and BEopt modeling indicates that these designs may actually exceed the goal of the U.S. Department of Energy's (DOE) Building America program to "reduce home energy use by 30%-50% (compared to 2009 energy codes for new homes). This report documents the short term test results of the Shift House and compares the results of PHPP and BEopt modeling of the project. The design includes high R-Value assemblies, extremely tight construction, high performance doors and windows, solar thermal DHW, heat recovery ventilation, moveable external shutters and a high performance ductless mini-split heat pump. Cost analysis indicates that many of the measures implemented in this project did not meet the BA standard for cost neutrality. The ductless mini-split heat pump, lighting and advanced air leakage control were the most cost effective measures. The future challenge will be to value engineer the performance levels indicated here in modeling using production based practices at a significantly lower cost.

  19. Passive THz metamaterials

    DEFF Research Database (Denmark)

    Lavrinenko, Andrei; Malureanu, Radu; Zalkovskij, Maksim

    2012-01-01

    In this work we present our activities in the fabrication and characterization of passive THz metamaterials. We use two fabrication processes to develop metamaterials either as free-standing metallic membranes or patterned metallic multi-layers on the substrates to achieve different functionalities...

  20. Three-dimensional surgical simulation.

    Science.gov (United States)

    Cevidanes, Lucia H C; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2010-09-01

    In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  1. Image-guided robotic surgery.

    Science.gov (United States)

    Marescaux, Jacques; Solerc, Luc

    2004-06-01

    Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

  2. Intrinsically Passive Handling and Grasping

    NARCIS (Netherlands)

    Stramigioli, Stefano; Scherpen, Jacquelien M.A.; Khodabandehloo, Koorosh

    2000-01-01

    The paper presents a control philosophy called Intrinsically Passive Control, which has the feature to properly behave during interaction with any passive objects. The controlled robot will never become unstable due to the physical structure of the controller.

  3. Passive containment cooling water distribution device

    Science.gov (United States)

    Conway, Lawrence E.; Fanto, Susan V.

    1994-01-01

    A passive containment cooling system for a nuclear reactor containment vessel. Disclosed is a cooling water distribution system for introducing cooling water by gravity uniformly over the outer surface of a steel containment vessel using a series of radial guide elements and cascading weir boxes to collect and then distribute the cooling water into a series of distribution areas through a plurality of cascading weirs. The cooling water is then uniformly distributed over the curved surface by a plurality of weir notches in the face plate of the weir box.

  4. Regulatory Considerations for the Long Term Cooling Safe Shutdown Requirements of the Passive Residual Heat Removal Systems in Advanced Reactors

    International Nuclear Information System (INIS)

    Sim, S. K.; Bae, S. H.; Kim, Y. S.; Hwang, Min Jeong; Bang, Young Seok; Hwang, Taesuk

    2016-01-01

    USNRC approved safe shutdown at 215.6 .deg. C for a safe and long term cooling state for the redundant passive RHRSs by SECY-94-084. USNRC issued COLA(Combined Construction and Operating License) for the Levy County NP Unit-1/2 for the AP1000 passive RHRSs in 2014. Korea Hydro and Nuclear Power(KHNP) is developing APR+ and adopted Passive Auxiliary Feedwater System(PAFS) as a new passive RHRS design. Korea Institute of Nuclear Safety(KINS) has been developing regulatory guides for the advanced safety design features of the advanced ALWRs which has plan to construct in near future in Korea[5]. Safety and regulatory issues as well as the safe shut down requirements of the passive RHRS are discussed and considerations in developing regulatory guides for the passive RHRS are presented herein. Passive RHRSs have been introduced as new safety design features for the advanced reactors under development in Korea. These passive RHRSs have potential advantages over existing active RHRS, however, their functions are limited due to inherent ability of passive heat removal processes. It is high time to evaluate the performance of the passive PRHRs and develop regulatory guides for the safety as well as the performance analyses of the passive RHRS

  5. Passive solar heating

    Energy Technology Data Exchange (ETDEWEB)

    Wiberg, K

    1981-11-10

    The present work treats the possibilities for heating according to the passive solar heating method. Problems of 'spatial organization in an energy-saving society' are distinguished from among other social problems. The final delimination of the actual problems under investigation consists of the use of passive solar heating and especially the 'consequences of such solar heating exploitation upon the form and structures' of planning and construction. In the concluding chapter an applied example shows how this method can be used in designing an urban area and what are its limitations. The results indicate the possibilities and difficulties in attempting to transfer this ideal and general method into models and directives for form and structure from which examples of the actual possibilities in practical planning can be given.

  6. Qademah Fault Passive Data

    KAUST Repository

    Hanafy, Sherif M.

    2014-01-01

    OBJECTIVE: In this field trip we collect passive data to 1. Convert passive to surface waves 2. Locate Qademah fault using surface wave migration INTRODUCTION: In this field trip we collected passive data for several days. This data will be used to find the surface waves using interferometry and then compared to active-source seismic data collected at the same location. A total of 288 receivers are used. A 3D layout with 5 m inline intervals and 10 m cross line intervals is used, where we used 12 lines with 24 receivers at each line. You will need to download the file (rec_times.mat), it contains important information about 1. Field record no 2. Record day 3. Record month 4. Record hour 5. Record minute 6. Record second 7. Record length P.S. 1. All files are converted from original format (SEG-2) to matlab format P.S. 2. Overlaps between records (10 to 1.5 sec.) are already removed from these files

  7. Concept research on general passive system

    International Nuclear Information System (INIS)

    Han Xu; Yang Yanhua; Zheng Mingguang

    2009-01-01

    This paper summarized the current passive techniques used in nuclear power plants. Through classification and analysis, the functional characteristics and inherent identification of passive systems were elucidated. By improving and extending the concept of passive system, the general passive concept was proposed, and space and time relativity was discussed and assumption of general passive system were illustrated. The function of idealized general passive system is equivalent with the current passive system, but the design of idealized general passive system is more flexible. (authors)

  8. Surgical Treatment of Tattoo Complications.

    Science.gov (United States)

    Sepehri, Mitra; Jørgensen, Bo

    2017-01-01

    With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

  9. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  10. Passive Power Filters

    CERN Document Server

    Künzi, R.

    2015-06-15

    Power converters require passive low-pass filters which are capable of reducing voltage ripples effectively. In contrast to signal filters, the components of power filters must carry large currents or withstand large voltages, respectively. In this paper, three different suitable filter struc tures for d.c./d.c. power converters with inductive load are introduced. The formulas needed to calculate the filter components are derived step by step and practical examples are given. The behaviour of the three discussed filters is compared by means of the examples. P ractical aspects for the realization of power filters are also discussed.

  11. Expansion of passive safety function

    International Nuclear Information System (INIS)

    Inai, Nobuhiko; Nei, Hiromichi; Kumada, Toshiaki.

    1995-01-01

    Expansion of the use of passive safety functions is proposed. Two notions are presented. One is that, in the design of passive safety nuclear reactors where aversion of active components is stressed, some active components are purposely introduced, by which a system is built in such a way that it behaves in an apparently passive manner. The second notion is that, instead of using a passive safety function alone, a passive safety function is combined with some active components, relating the passivity in the safety function with enhanced controllability in normal operation. The nondormant system which the authors propose is one example of the first notion. This is a system in which a standby safety system is a portion of the normal operation system. An interpretation of the nondormant system via synergetics is made. As an example of the second notion, a PIUS density lock aided with active components is proposed and is discussed

  12. Passive cooling containment study

    International Nuclear Information System (INIS)

    Shin, J.J.; Iotti, R.C.; Wright, R.F.

    1993-01-01

    Pressure and temperature transients of nuclear reactor containment following postulated loss of coolant accident with a coincident station blackout due to total loss of all alternating current power are studied analytically and experimentally for the full scale NPR (New Production Reactor). All the reactor and containment cooling under this condition would rely on the passive cooling system which removes reactor decay heat and provides emergency core and containment cooling. Containment passive cooling for this study takes place in the annulus between containment steel shell and concrete shield building by natural convection air flow and thermal radiation. Various heat transfer coefficients inside annular air space were investigated by running the modified CONTEMPT code CONTEMPT-NPR. In order to verify proper heat transfer coefficient, temperature, heat flux, and velocity profiles were measured inside annular air space of the test facility which is a 24 foot (7.3m) high, steam heated inner cylinder of three foot (.91m) diameter and five and half foot (1.7m) diameter outer cylinder. Comparison of CONTEMPT-NPR and WGOTHIC was done for reduced scale NPR

  13. Fly ash carbon passivation

    Science.gov (United States)

    La Count, Robert B; Baltrus, John P; Kern, Douglas G

    2013-05-14

    A thermal method to passivate the carbon and/or other components in fly ash significantly decreases adsorption. The passivated carbon remains in the fly ash. Heating the fly ash to about 500 and 800 degrees C. under inert gas conditions sharply decreases the amount of surfactant adsorbed by the fly ash recovered after thermal treatment despite the fact that the carbon content remains in the fly ash. Using oxygen and inert gas mixtures, the present invention shows that a thermal treatment to about 500 degrees C. also sharply decreases the surfactant adsorption of the recovered fly ash even though most of the carbon remains intact. Also, thermal treatment to about 800 degrees C. under these same oxidative conditions shows a sharp decrease in surfactant adsorption of the recovered fly ash due to the fact that the carbon has been removed. This experiment simulates the various "carbon burnout" methods and is not a claim in this method. The present invention provides a thermal method of deactivating high carbon fly ash toward adsorption of AEAs while retaining the fly ash carbon. The fly ash can be used, for example, as a partial Portland cement replacement in air-entrained concrete, in conductive and other concretes, and for other applications.

  14. Surface Passivation in Empirical Tight Binding

    OpenAIRE

    He, Yu; Tan, Yaohua; Jiang, Zhengping; Povolotskyi, Michael; Klimeck, Gerhard; Kubis, Tillmann

    2015-01-01

    Empirical Tight Binding (TB) methods are widely used in atomistic device simulations. Existing TB methods to passivate dangling bonds fall into two categories: 1) Method that explicitly includes passivation atoms is limited to passivation with atoms and small molecules only. 2) Method that implicitly incorporates passivation does not distinguish passivation atom types. This work introduces an implicit passivation method that is applicable to any passivation scenario with appropriate parameter...

  15. Passive-solar construction handbook

    Energy Technology Data Exchange (ETDEWEB)

    Levy, E.; Evans, D.; Gardstein, C.

    1981-02-01

    Many of the basic elements of passive solar design are reviewed. Passive solar construction is covered according to system type, each system type discussion including a general discussion of the important design and construction issues which apply to the particular system and case studies illustrating designed and built examples of the system type. The three basic types of passive solar systems discussed are direct gain, thermal storage wall, and attached sunspace. Thermal performance and construction information is presented for typical materials used in passive solar collector components, storage components, and control components. Appended are an overview of analysis methods and a technique for estimating performance. (LEW)

  16. The Global Spine Care Initiative: a consensus process to develop and validate a stratification scheme for surgical care of spinal disorders as a guide for improved resource utilization in low- and middle-income communities.

    Science.gov (United States)

    Acaroğlu, Emre; Mmopelwa, Tiro; Yüksel, Selcen; Ayhan, Selim; Nordin, Margareta; Randhawa, Kristi; Haldeman, Scott

    2017-10-16

    The purpose of this study was to develop a stratification scheme for surgical spinal care to serve as a framework for referrals and distribution of patients with spinal disorders. We used a modified Delphi process. A literature search identified experts for the consensus panel and the panel was expanded by inviting spine surgeons known to be global opinion leaders. After creating a seed document of five hierarchical levels of surgical care, a four-step modified Delphi process (question validation, collection of factors, evaluation of factors, re-evaluation of factors) was performed. Of 78 invited experts, 19 participated in round 1, and of the 19, 14 participated in 2, and 12 in 3 and 4. Consensus was fairly heterogeneous for levels of care 2-4 (moderate resources). Only simple assessment methods based on the clinical skills of the medical personnel were considered feasible and safe in low-resource settings. Diagnosis, staging, and treatment were deemed feasible and safe in a specialized spine center. Accurate diagnostic workup was deemed feasible and safe for lower levels of care complexity (from level 3 upwards) compared to non-invasive procedures (level 4) and the full range of invasive procedures (level 5). This study introduces a five-level stratification scheme for the surgical care of spinal disorders. This stratification may provide input into the Global Spine Care Initiative care pathway that will be applied in medically underserved areas and low- and middle-income countries. These slides can be retrieved under Electronic Supplementary Material.

  17. Early results of surgical intervention for elbow deformity in cerebral palsy based on degree of contracture.

    Science.gov (United States)

    Carlson, Michelle G; Hearns, Krystle A; Inkellis, Elizabeth; Leach, Michelle E

    2012-08-01

    Elbow flexion posture, caused by spasticity of the muscles on the anterior surface of the elbow, is the most common elbow deformity seen in patients with cerebral palsy. This study retrospectively evaluated early results of 2 surgical interventions for elbow flexion deformities based on degree of contracture. We hypothesized that by guiding surgical treatment to degree of preoperative contracture, elbow extension and flexion posture angle at ambulation could be improved while preserving maximum flexion. Eighty-six patients (90 elbows) were treated for elbow spasticity due to cerebral palsy. Seventy-one patients (74 elbows) were available for follow-up. Fifty-seven patients with fixed elbow contractures less than 45° were surgically treated with a partial elbow muscle lengthening, which included partial lengthening of the biceps and brachialis and proximal release of the brachioradialis. Fourteen patients (17 elbows) with fixed elbow contractures ≥ 45° had a more extensive full elbow release, with biceps z-lengthening, partial brachialis myotomy, and brachioradialis proximal release. Age at surgery averaged 10 years (range, 3-20 y) for partial lengthening and 14 years (range, 5-20 y) for full elbow release. Follow-up averaged 22 months (range, 7-144 mo) for partial lengthening and 18 months (range, 6-51 mo) for full elbow release. Both groups achieved meaningful improvement in flexion posture angle at ambulation, active and passive extension, and total range of motion. Elbow flexion posture angle at ambulation improved by 57° and active extension increased 17° in the partial lengthening group, with a 4° loss of active flexion. In the full elbow release group, elbow flexion posture angle at ambulation improved 51° and active extension improved 38°, with a loss of 19° of active flexion. Surgical treatment of spastic elbow flexion in cerebral palsy can improve deformity. We obtained excellent results by guiding the surgical intervention by the amount of

  18. Passive magnetic bearing system

    Science.gov (United States)

    Post, Richard F.

    2014-09-02

    An axial stabilizer for the rotor of a magnetic bearing provides external control of stiffness through switching in external inductances. External control also allows the stabilizer to become a part of a passive/active magnetic bearing system that requires no external source of power and no position sensor. Stabilizers for displacements transverse to the axis of rotation are provided that require only a single cylindrical Halbach array in its operation, and thus are especially suited for use in high rotation speed applications, such as flywheel energy storage systems. The elimination of the need of an inner cylindrical array solves the difficult mechanical problem of supplying support against centrifugal forces for the magnets of that array. Compensation is provided for the temperature variation of the strength of the magnetic fields of the permanent magnets in the levitating magnet arrays.

  19. Image-Guided Cancer Nanomedicine

    Directory of Open Access Journals (Sweden)

    Dong-Hyun Kim

    2018-01-01

    Full Text Available Multifunctional nanoparticles with superior imaging properties and therapeutic effects have been extensively developed for the nanomedicine. However, tumor-intrinsic barriers and tumor heterogeneity have resulted in low in vivo therapeutic efficacy. The poor in vivo targeting efficiency in passive and active targeting of nano-therapeutics along with the toxicity of nanoparticles has been a major problem in nanomedicine. Recently, image-guided nanomedicine, which can deliver nanoparticles locally using non-invasive imaging and interventional oncology techniques, has been paid attention as a new opportunity of nanomedicine. This short review will discuss the existing challenges in nanomedicine and describe the prospects for future image-guided nanomedicine.

  20. Surgical stent for dental implant using cone beam CT images

    International Nuclear Information System (INIS)

    Choi, Hyung Soo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan

    2010-01-01

    The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

  1. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  2. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  3. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  4. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  5. European vehicle passive safety network

    NARCIS (Netherlands)

    Wismans, J.S.H.M.; Janssen, E.G.

    1999-01-01

    The general objective of the European Vehicle Passive Safety Network is to contribute to the reduction of the number of road traffic victims in Europe by passive safety measures. The aim of the road safety policy of the European Commission is to reduce the annual total of fatalities to 18000 in

  6. Passive films at the nanoscale

    International Nuclear Information System (INIS)

    Maurice, Vincent; Marcus, Philippe

    2012-01-01

    Highlights: ► Nanoscale data on growth, structure and local properties of passive films reviewed. ► Preferential role of defects of passive films on the corrosion resistance emphasized. ► Effect of grain boundaries on local electronic properties shown by new data. ► Use of atomistic modeling to test mechanistic hypotheses illustrated. - Abstract: The nanometer scale chemical and structural aspects of ultrathin oxide passive films providing self-protection against corrosion to metals and alloys in aqueous environments are reviewed. Data on the nucleation and growth of 2D anodic oxide films, details on the atomic structure and nanostructure of 3D passive films, the preferential role of surface step edges in dissolution in the passive state and the preferential role of grain boundaries of the passive films in passivity breakdown are presented. Future perspectives are discussed, and exemplified by new data obtained on the relationship between the nanostructure of oxide passive films and their local electronic properties. Atomistic corrosion modeling by ab initio density functional theory (DFT) is illustrated by the example of interactions of chloride ions with hydroxylated oxide surfaces, including the role of surface step edges. Data obtained on well-defined substrate surfaces with surface analytical techniques are emphasized.

  7. Udviklingen i bilers passive sikkerhed

    DEFF Research Database (Denmark)

    Hels, Tove; Lyckegaard, Allan; Prato, Carlo Giacomo

    man mellem aktiv og passiv sikkerhed, det vil sige faktorer, der nedsætter • risikoen for, at der sker et uheld (aktiv sikkerhed), henholdsvis • graden af alvorlighed, givet at uheldet er sket (passiv sikkerhed). Rapporten begrænser sig til at undersøge, om der kan påvises en generel sammenhæng mellem...

  8. The Passive in Singapore English.

    Science.gov (United States)

    Bao, Zhiming; Wee, Lionel

    1999-01-01

    Presents an analysis of the two passive (or passive-like) constructions in Singapore English which exhibit substrate influence from Malay and Chinese. The paper shows that while substrate languages contribute to the grammar of Singapore English, the continued prestige of standard English exerts normative pressure and mitigates the effect of…

  9. Corrosion protection of reusable surgical instruments.

    Science.gov (United States)

    Shah, Sadiq; Bernardo, Mildred

    2002-01-01

    To understand the corrosion properties of surgical scissors, 416 stainless steel disks and custom electrodes were used as simulated surfaces under various conditions. These simulated surfaces were exposed to tap water and 400-ppm synthetic hard water as Ca2CO3 under different conditions. The samples were evaluated by various techniques for corrosion potential and the impact of environmental conditions on the integrity of the passive film. The electrodes were used to monitor the corrosion behavior by potentiodynamic polarization technique in water both in the presence and absence of a cleaning product. The surface topography of the 416 stainless steel disks was characterized by visual observations and scanning electron microscopy (SEM), and the surface chemistry of the passive film on the surface of the scissors was characterized by x-ray photoelectron spectroscopy (XPS). The results suggest that surgical instruments made from 416 stainless steel are not susceptible to uniform corrosion; however, they do undergo localized corrosion. The use of suitable cleaning products can offer protection against localized corrosion during the cleaning step. More importantly, the use of potentiodynamic polarization techniques allowed for a quick and convenient approach to evaluate the corrosion properties of surgical instruments under a variety of simulated-use environmental conditions.

  10. Antireflection/Passivation Step For Silicon Cell

    Science.gov (United States)

    Crotty, Gerald T.; Kachare, Akaram H.; Daud, Taher

    1988-01-01

    New process excludes usual silicon oxide passivation. Changes in principal electrical parameters during two kinds of processing suggest antireflection treatment almost as effective as oxide treatment in passivating cells. Does so without disadvantages of SiOx passivation.

  11. In vivo virtual intraoperative surgical photoacoustic microscopy

    International Nuclear Information System (INIS)

    Han, Seunghoon; Kim, Sehui; Kim, Jeehyun; Lee, Changho; Jeon, Mansik; Kim, Chulhong

    2013-01-01

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

  12. In vivo virtual intraoperative surgical photoacoustic microscopy

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-11

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

  13. Passive nondestructive assay of nuclear materials

    International Nuclear Information System (INIS)

    Reilly, D.; Ensslin, N.; Smith, H. Jr.; Kreiner, S.

    1991-03-01

    The term nondestructive assay (NDA) is applied to a series of measurement techniques for nuclear fuel materials. The techniques measure radiation induced or emitted spontaneously from the nuclear material; the measurements are nondestructive in that they do not alter the physical or chemical state of the nuclear material. NDA techniques are characterized as passive or active depending on whether they measure radiation from the spontaneous decay of the nuclear material or radiation induced by an external source. This book emphasizes passive NDA techniques, although certain active techniques like gamma-ray absorption densitometry and x-ray fluorescence are discussed here because of their intimate relation to passive assay techniques. The principal NDA techniques are classified as gamma-ray assay, neutron assay, and calorimetry. Gamma-ray assay techniques are treated in Chapters 1--10. Neutron assay techniques are the subject of Chapters 11--17. Chapters 11--13 cover the origin of neutrons, neutron interactions, and neutron detectors. Chapters 14--17 cover the theory and applications of total and coincidence neutron counting. Chapter 18 deals with the assay of irradiated nuclear fuel, which uses both gamma-ray and neutron assay techniques. Chapter 19 covers perimeter monitoring, which uses gamma-ray and neutron detectors of high sensitivity to check that no unauthorized nuclear material crosses a facility boundary. The subject of Chapter 20 is attribute and semiquantitative measurements. The goal of these measurements is a rapid verification of the contents of nuclear material containers to assist physical inventory verifications. Waste and holdup measurements are also treated in this chapter. Chapters 21 and 22 cover calorimetry theory and application, and Chapter 23 is a brief application guide to illustrate which techniques can be used to solve certain measurement problems

  14. French concepts of ''passive safety''

    International Nuclear Information System (INIS)

    Dennielou, Y.; Serret, M.

    1990-01-01

    N 4 model, the French 1400 MW PWR of the 90's, exhibits many advanced features. As far as safety is concerned, the fully computerized control room design takes advantage of the operating experience feedback and largely improves the man machine interface. New post-accident procedures have been developed (the so-called ''physical states oriented procedures''). A complete consistent set of ''Fundamental Safety Rules'' have been issued. This however doesn't imply any significant modification of standard PWR with regard to the passive aspects of safety systems or functions. Nevertheless, traditional PWR safety systems largely use passive aspects: natural circulation, reactivity coefficients, gravity driven control rods, injection accumulators, so on. Moreover, probability calculations allow for comparison between the respective contributions of passive and of active failures. In the near future, eventual options of future French PWRs to be commissioned after 2000 will be evaluated; simplification, passive and forgiving aspects of safety systems will be thoroughly considered. (author)

  15. Effectiveness of passive alcohol sensors

    Science.gov (United States)

    1996-03-01

    Author's abstract: The purpose of this study was to evaluate the effectiveness of passive alcohol sensors for youth alcohol enforcement conducted as part of normal or typical police operations. Three municipal police departments of 100 or more sworn ...

  16. The effect of postoperative passive motion on rotator cuff healing in a rat model.

    Science.gov (United States)

    Peltz, Cathryn D; Dourte, Leann M; Kuntz, Andrew F; Sarver, Joseph J; Kim, Soung-Yon; Williams, Gerald R; Soslowsky, Louis J

    2009-10-01

    Surgical repairs of torn rotator cuff tendons frequently fail. Immobilization has been shown to improve tissue mechanical properties in an animal model of rotator cuff repair, and passive motion has been shown to improve joint mechanics in animal models of flexor tendon repair. Our objective was to determine if daily passive motion would improve joint mechanics in comparison with continuous immobilization in a rat rotator cuff repair model. We hypothesized that daily passive motion would result in improved passive shoulder joint mechanics in comparison with continuous immobilization initially and that there would be no differences in passive joint mechanics or insertion site mechanical properties after four weeks of remobilization. A supraspinatus injury was created and was surgically repaired in sixty-five Sprague-Dawley rats. Rats were separated into three postoperative groups (continuous immobilization, passive motion protocol 1, and passive motion protocol 2) for two weeks before all underwent a remobilization protocol for four weeks. Serial measurements of passive shoulder mechanics (internal and external range of motion and joint stiffness) were made before surgery and at two and six weeks after surgery. After the animals were killed, collagen organization and mechanical properties of the tendon-to-bone insertion site were determined. Total range of motion for both passive motion groups (49% and 45% of the pre-injury values) was less than that for the continuous immobilization group (59% of the pre-injury value) at two weeks and remained significantly less following four weeks of remobilization exercise. Joint stiffness at two weeks was increased for both passive motion groups in comparison with the continuous immobilization group. At both two and six weeks after repair, internal range of motion was significantly decreased whereas external range of motion was not. There were no differences between the groups in terms of collagen organization or mechanical

  17. Passive heat removal in CANDU

    International Nuclear Information System (INIS)

    Hart, R.S.

    1997-01-01

    CANDU has a tradition of incorporating passive systems and passive components whenever they are shown to offer performance that is equal to or better than that of active systems, and to be economic. Examples include the two independent shutdown systems that employ gravity and stored energy respectively, the dousing subsystem of the CANDU 6 containment system, and the ability of the moderator to cool the fuel in the event that all coolant is lost from the fuel channels. CANDU 9 continues this tradition, incorporating a reserve water system (RWS) that increases the inventory of water in the reactor building and profiles a passive source of makeup water and/or heat sinks to various key process systems. The key component of the CANDU 9 reserve water system is a large (2500 cubic metres) water tank located at a high elevation in the reactor building. The reserve water system, while incorporating the recovery system functions, and the non-dousing functions of the dousing tank in CANDU 6, embraces other key systems to significantly extend the passive makeup/heat sink capability. The capabilities of the reserve water system include makeup to the steam generators secondary side if all other sources of water are lost; makeup to the heat transport system in the event of a leak in excess of the D 2 O makeup system capability; makeup to the moderator in the event of a moderator leak when the moderator heat sink is required; makeup to the emergency core cooling (ECC) system to assure NPSH to the ECC pumps during a loss of coolant accident (LOCA), and provision of a passive heat sink for the shield cooling system. Other passive designs are now being developed by AECL. These will be incorporated in future CANDU plants when their performance has been fully proven. This paper reviews the passive heat removal systems and features of current CANDU plants and the CANDU 9, and briefly reviews some of the passive heat removal concepts now being developed. (author)

  18. Key issues for passive safety

    International Nuclear Information System (INIS)

    Hayns, M.R.

    1996-01-01

    The paper represents a summary of the introductory presentation made at this Advisory Group Meeting on the Technical Feasibility and Reliability of Passive Safety Systems. It was intended as an overview of our views on what are the key issues and what are the technical problems which might dominate any future developments of passive safety systems. It is, therefore, not a ''review paper'' as such and only record the highlights. (author)

  19. Key issues for passive safety

    Energy Technology Data Exchange (ETDEWEB)

    Hayns, M R [AEA Technology, Harwell, Didcot (United Kingdom). European Institutions; Hicken, E F [Forschungszentrum Juelich GmbH (Germany)

    1996-12-01

    The paper represents a summary of the introductory presentation made at this Advisory Group Meeting on the Technical Feasibility and Reliability of Passive Safety Systems. It was intended as an overview of our views on what are the key issues and what are the technical problems which might dominate any future developments of passive safety systems. It is, therefore, not a ``review paper`` as such and only record the highlights. (author).

  20. Encapsulating peritonitis: computed tomography and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kadow, Juliana Santos; Fingerhut, Carla Jeronimo Peres; Fernandes, Vinicius de Barros; Coradazzi, Klaus Rizk Stuhr; Silva, Lucas Marciel Soares; Penachim, Thiago Jose, E-mail: vinicius.barros.fernandes@gmail.com [Pontificia Universidade Catolica de Campinas (PUC-Campinas), Campinas, SP (Brazil). Hospital e Maternidade Celso Pierro

    2014-07-15

    Sclerosing encapsulating peritonitis is a rare and frequently severe entity characterized by total or partial involvement of small bowel loops by a membrane of fibrous tissue. The disease presents with nonspecific clinical features of intestinal obstruction, requiring precise imaging diagnosis to guide the treatment. The present report emphasizes the importance of computed tomography in the diagnosis of this condition and its confirmation by surgical correlation. (author)

  1. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza

    2016-01-01

    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  2. Passive vapor extraction feasibility study

    International Nuclear Information System (INIS)

    Rohay, V.J.

    1994-01-01

    Demonstration of a passive vapor extraction remediation system is planned for sites in the 200 West Area used in the past for the disposal of waste liquids containing carbon tetrachloride. The passive vapor extraction units will consist of a 4-in.-diameter pipe, a check valve, a canister filled with granular activated carbon, and a wind turbine. The check valve will prevent inflow of air that otherwise would dilute the soil gas and make its subsequent extraction less efficient. The granular activated carbon is used to adsorb the carbon tetrachloride from the air. The wind turbine enhances extraction rates on windy days. Passive vapor extraction units will be designed and operated to meet all applicable or relevant and appropriate requirements. Based on a cost analysis, passive vapor extraction was found to be a cost-effective method for remediation of soils containing lower concentrations of volatile contaminants. Passive vapor extraction used on wells that average 10-stdft 3 /min air flow rates was found to be more cost effective than active vapor extraction for concentrations below 500 parts per million by volume (ppm) of carbon tetrachloride. For wells that average 5-stdft 3 /min air flow rates, passive vapor extraction is more cost effective below 100 ppm

  3. Review of emerging surgical robotic technology.

    Science.gov (United States)

    Peters, Brian S; Armijo, Priscila R; Krause, Crystal; Choudhury, Songita A; Oleynikov, Dmitry

    2018-04-01

    The use of laparoscopic and robotic procedures has increased in general surgery. Minimally invasive robotic surgery has made tremendous progress in a relatively short period of time, realizing improvements for both the patient and surgeon. This has led to an increase in the use and development of robotic devices and platforms for general surgery. The purpose of this review is to explore current and emerging surgical robotic technologies in a growing and dynamic environment of research and development. This review explores medical and surgical robotic endoscopic surgery and peripheral technologies currently available or in development. The devices discussed here are specific to general surgery, including laparoscopy, colonoscopy, esophagogastroduodenoscopy, and thoracoscopy. Benefits and limitations of each technology were identified and applicable future directions were described. A number of FDA-approved devices and platforms for robotic surgery were reviewed, including the da Vinci Surgical System, Sensei X Robotic Catheter System, FreeHand 1.2, invendoscopy E200 system, Flex® Robotic System, Senhance, ARES, the Single-Port Instrument Delivery Extended Research (SPIDER), and the NeoGuide Colonoscope. Additionally, platforms were reviewed which have not yet obtained FDA approval including MiroSurge, ViaCath System, SPORT™ Surgical System, SurgiBot, Versius Robotic System, Master and Slave Transluminal Endoscopic Robot, Verb Surgical, Miniature In Vivo Robot, and the Einstein Surgical Robot. The use and demand for robotic medical and surgical platforms is increasing and new technologies are continually being developed. New technologies are increasingly implemented to improve on the capabilities of previously established systems. Future studies are needed to further evaluate the strengths and weaknesses of each robotic surgical device and platform in the operating suite.

  4. Guided labworks

    DEFF Research Database (Denmark)

    Jacobsen, Lærke Bang

    For the last 40 years physics education research has shown poor learning outcomes of guided labs. Still this is found to be a very used teaching method in the upper secodary schools. This study explains the teacher's choice of guided labs throught the concept of redesign as obstacle dislodgement...

  5. Altered Passive Eruption Complicating Optimal Orthodontic Bracket Placement: A Case Report and Review of Literature.

    Science.gov (United States)

    Pulgaonkar, Rohan; Chitra, Prasad

    2015-11-01

    An unusual case of altered passive eruption with gingival hyperpigmentation and a Class I malocclusion in a 12-year-old girl having no previous history of medication is presented. The patient reported with spacing in the upper arch, moderate crowding in the lower arch, anterior crossbite and excessive gingival tissue on the labial surfaces of teeth in both the arches. The inadequate crown lengths made placement of the orthodontic brackets difficult. Preadjusted orthodontic brackets have a very precise placement protocol which can affect tooth movement in all 3 planes of space if violated. The periodontal condition was diagnosed as altered passive eruption Type IA. Interdisciplinary treatment protocols including periodontal surgical and orthodontic procedures were used. The periodontal surgical procedures were carried out prior to orthodontic therapy and the results obtained were satisfactory. It is suggested that orthodontists should be aware of conditions like altered passive eruption and modalities of management. In most instances, orthodontic therapy is not hindered.

  6. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  7. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  8. Materials for passively safe reactors

    International Nuclear Information System (INIS)

    Simnad, T.

    1993-01-01

    Future nuclear power capacity will be based on reactor designs that include passive safety features if recent progress in advanced nuclear power developments is realized. There is a high potential for nuclear systems that are smaller and easier to operate than the current generation of reactors, especially when passive or intrinsic characteristics are applied to provide inherent stability of the chain reaction and to minimize the burden on equipment and operating personnel. Taylor, has listed the following common generic technical features as the most important goals for the principal reactor development systems: passive stability, simplification, ruggedness, case of operation, and modularity. Economic competitiveness also depends on standardization and assurance of licensing. The performance of passively safe reactors will be greatly influenced by the successful development of advanced fuels and materials that will provide lower fuel-cycle costs. A dozen new designs of advanced power reactors have been described recently, covering a wide spectrum of reactor types, including pressurized water reactors, boiling water reactors, heavy-water reactors, modular high-temperature gas-cooled reactors (MHTGRs), and fast breeder reactors. These new designs address the need for passive safety features as well as the requirement of economic competitiveness

  9. HBR guides

    CERN Document Server

    Duarte, Nancy; Dillon, Karen

    2015-01-01

    Master your most pressing professional challenges with this seven-volume set that collects the smartest best practices from leading experts all in one place. "HBR Guide to Better Business Writing" and "HBR Guide to Persuasive Presentations" help you perfect your communication skills; "HBR Guide to Managing Up and Across" and "HBR Guide to Office Politics" show you how to build the best professional relationships; "HBR Guide to Finance Basics for Managers" is the one book you'll ever need to teach you about the numbers; "HBR Guide to Project Management" addresses tough questions such as how to manage stakeholder expectations and how to manage uncertainty in a complex project; and "HBR Guide to Getting the Right Work Done" goes beyond basic productivity tips to teach you how to prioritize and focus on your work. This specially priced set of the most popular books in the series makes a perfect gift for aspiring leaders looking for trusted advice. Arm yourself with the advice you need to succeed on the job, from ...

  10. Passive and Active Sensing Technologies for Structural Health Monitoring

    Science.gov (United States)

    Do, Richard

    A combination of passive and active sensing technologies is proposed as a structural health monitoring solution for several applications. Passive sensing is differentiated from active sensing in that with the former, no energy is intentionally imparted into the structure under test; sensors are deployed in a pure detection mode for collecting data mined for structural health monitoring purposes. In this thesis, passive sensing using embedded fiber Bragg grating optical strain gages was used to detect varying degrees of impact damage using two different classes of features drawn from traditional spectral analysis and auto-regressive time series modeling. The two feature classes were compared in detail through receiver operating curve performance analysis. The passive detection problem was then augmented with an active sensing system using ultrasonic guided waves (UGWs). This thesis considered two main challenges associated with UGW SHM including in-situ wave propagation property determination and thermal corruption of data. Regarding determination of wave propagation properties, of which dispersion characteristics are the most important, a new dispersion curve extraction method called sparse wavenumber analysis (SWA) was experimentally validated. Also, because UGWs are extremely sensitive to ambient temperature changes on the structure, it significantly affects the wave propagation properties by causing large errors in the residual error in the processing of the UGWs from an array. This thesis presented a novel method that compensates for uniform temperature change by considering the magnitude and phase of the signal separately and applying a scalable transformation.

  11. Passive inhalation of cannabis smoke

    Energy Technology Data Exchange (ETDEWEB)

    Law, B; Mason, P A; Moffat, A C; King, L J; Marks, V

    1984-09-01

    Six volunteers each smoked simultaneously, in a small unventilated room (volume 27 950 liter), a cannabis cigarette containing 17.1 mg delta 9-tetrahydrocannabinol (THC). A further four subjects - passive inhalers - remained in the room during smoking and afterwards for a total of 3 h. Blood and urine samples were taken from all ten subjects and analyzed by radioimmunoassay for THC metabolites. The blood samples from the passive subjects taken up to 3 h after the start of exposure to cannabis smoke showed a complete absence of cannabinoids. In contrast, their urine samples taken up to 6 h after exposure showed significant concentrations of cannabinoid metabolites (less than or equal to 6.8 ng ml-1). These data, taken with the results of other workers, show passive inhalation of cannabis smoke to be possible. These results have important implications for forensic toxicologists who are frequently called upon to interpret cannabinoid levels in body fluids.

  12. Active Versus Passive Academic Networking

    DEFF Research Database (Denmark)

    Goel, Rajeev K.; Grimpe, Christoph

    2013-01-01

    This paper examines determinants of networking by academics. Using information from a unique large survey of German researchers, the key contribution focuses on the active versus passive networking distinction. Is active networking by researchers a substitute or a complement to passive networking......? Other contributions include examining the role of geographic factors in networking and whether research bottlenecks affect a researcher's propensity to network. Are the determinants of European conference participation by German researchers different from conferences in rest of the world? Results show...... that some types of passive academic networking are complementary to active networking, while others are substitute. Further, we find differences in factors promoting participation in European conferences versus conferences in rest of the world. Finally, publishing bottlenecks as a group generally do...

  13. Protocol Monitoring Passive Solar Energy

    International Nuclear Information System (INIS)

    Van den Ham, E.R.; Bosselaar, L.

    1998-01-01

    A method has been developed by means of which the contribution of passive solar energy to the Dutch energy balance can be quantified univocally. The contribution was 57 PJ in 1990 and also 57 PJ in 1995. The efficiency of passive solar energy systems increased from -31.5% to -28.1% in the period 1990-1995, mainly as a result of the use of extra insulating glazing. As a result of the reduction of energy consumption for heating in houses it is expected that the extra contribution of 2 PJ will not be realized in the year 2010. It is suggested that the method to determine the absolute contribution of passive solar energy to the energy demand of dwellings is to be included in the protocol monitoring renewable energy. For the method to be included in the energy statistics of Statistics Netherlands (CBS) it can be considered only to take into account the difference compared to 1990. 11 refs

  14. Passivation of high temperature superconductors

    Science.gov (United States)

    Vasquez, Richard P. (Inventor)

    1991-01-01

    The surface of high temperature superconductors such as YBa2Cu3O(7-x) are passivated by reacting the native Y, Ba and Cu metal ions with an anion such as sulfate or oxalate to form a surface film that is impervious to water and has a solubility in water of no more than 10(exp -3) M. The passivating treatment is preferably conducted by immersing the surface in dilute aqueous acid solution since more soluble species dissolve into the solution. The treatment does not degrade the superconducting properties of the bulk material.

  15. Investigations on passive containment cooling

    International Nuclear Information System (INIS)

    Knebel, J.U.; Cheng, X.; Neitzel, H.J.; Erbacher, F.J.; Hofmann, F.

    1997-01-01

    The composite containment design for advanced LWRs that has been examined under the PASCO project is a promising design concept for purely passive decay heat removal after a severe accident. The passive cooling processes applied are natural convection and radiative heat transfer. Heat transfer through the latter process removes at an emission coefficient of 0.9 about 50% of the total heat removed via the steel containment, and thus is an essential factor. The heat transferring surfaces must have a high emission coefficient. The sump cooling concept examined under the SUCO project achieves a steady, natural convection-driven flow from the heat source to the heat sink. (orig./CB) [de

  16. Passive solar offices: integrated design

    Energy Technology Data Exchange (ETDEWEB)

    Evans, B

    1992-05-06

    Passive solar design in out-of-town offices can remove the need for air-conditioning by making greater use of daylight and natural ventilation. To promote the use of passive solar energy a series of design studies are being run by the Energy Technology Support Unit on behalf of the Department of Energy. The three reported here are designs for out-of-town business buildings. Each is a hypothetical building designed to a realistic brief for an organisation taking the role of real client. (author).

  17. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  18. The Danish Reportive Passive as a Non-Canonical Passive

    DEFF Research Database (Denmark)

    Ørsnes, Bjarne

    2013-01-01

    Danish passive utterance and cognitive verbs allow a construction where the subject of an infinitival complement is raised: Peter siges at være bortrejst (‘Peter is said to be out of town’). Contrary to English, these verbs are not ECM-verbs or subject-to-object raising verbs in the active...

  19. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  20. Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

    Science.gov (United States)

    Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

    2017-12-29

    To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

  1. Factors Affecting Surgical Decision-making—A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Caroline Gunaratnam

    2018-01-01

    Full Text Available Background Guidelines and Class 1 evidence are strong factors that help guide surgeons’ decision-making, but dilemmas exist in selecting the best surgical option, usually without the benefit of guidelines or Class 1 evidence. A few studies have discussed the variability of surgical treatment options that are currently available, but no study has examined surgeons’ views on the influential factors that encourage them to choose one surgical treatment over another. This study examines the influential factors and the thought process that encourage surgeons to make these decisions in such circumstances. Methods Semi-structured face-to-face interviews were conducted with 32 senior consultant surgeons, surgical fellows, and senior surgical residents at the University of Toronto teaching hospitals. An e-mail was sent out for volunteers, and interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding. Results Broadly speaking there are five groups of factors affecting surgeons’ decision-making: medical condition, information, institutional, patient, and surgeon factors. When information factors such as guidelines and Class 1 evidence are lacking, the other four groups of factors—medical condition, institutional, patient, and surgeon factors (the last-mentioned likely being the most powerful—play a significant role in guiding surgical decision-making. Conclusions This study is the first qualitative study on surgeons’ perspectives on the influential factors that help them choose one surgical treatment option over another for their patients.

  2. Mentoring console improves collaboration and teaching in surgical robotics.

    Science.gov (United States)

    Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

    2006-10-01

    One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P nudge mode was particularly useful for guiding a resident's hands during crucially precise steps of an operation (such as proper placement of stitches). The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

  3. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  4. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  5. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  6. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  7. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  8. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  9. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  10. Sonoma House. Monitoring of the First U.S. Passive House Retrofit

    Energy Technology Data Exchange (ETDEWEB)

    German, A. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Weitzel, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Backman, C. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2012-12-01

    The Sonoma Deep Retrofit is a single-story deep retrofit project in the marine climate of Sonoma, California. The design was guided by Passive House principles that promote the use of very high levels of wall, ceiling, and floor insulation along with tight envelope construction to maintain a comfortable indoor environment with little or no need for conventional heating or cooling.

  11. Sonoma House: Monitoring of the First U.S. Passive House Retrofit

    Energy Technology Data Exchange (ETDEWEB)

    German, A.; Weitzel, B.; Backman, C.; Hoeschele, M.; Dakin, B.

    2012-12-01

    The Sonoma Deep Retrofit is a single-story deep retrofit project in the marine climate of Sonoma, California. The design was guided by Passive House principles which promote the use of very high levels of wall, ceiling, and floor insulation along with tight envelope construction to maintain a comfortable indoor environment with little or no need for conventional heating or cooling.

  12. Solar Energy: Energy Conservation and Passive Design Concepts: Student Material. First Edition.

    Science.gov (United States)

    Younger, Charles; Orsak, Charles G., Jr.

    Designed for student use in "Energy Conservation and Passive Design Concepts," one of 11 courses in a 2-year associate degree program in solar technology, this manual provides readings, bibliographies, and illustrations for seven course modules. The manual, which corresponds to an instructor guide for the same course, covers the…

  13. Surface Passivation in Empirical Tight Binding

    Science.gov (United States)

    He, Yu; Tan, Yaohua; Jiang, Zhengping; Povolotskyi, Michael; Klimeck, Gerhard; Kubis, Tillmann

    2016-03-01

    Empirical Tight Binding (TB) methods are widely used in atomistic device simulations. Existing TB methods to passivate dangling bonds fall into two categories: 1) Method that explicitly includes passivation atoms is limited to passivation with atoms and small molecules only. 2) Method that implicitly incorporates passivation does not distinguish passivation atom types. This work introduces an implicit passivation method that is applicable to any passivation scenario with appropriate parameters. This method is applied to a Si quantum well and a Si ultra-thin body transistor oxidized with SiO2 in several oxidation configurations. Comparison with ab-initio results and experiments verifies the presented method. Oxidation configurations that severely hamper the transistor performance are identified. It is also shown that the commonly used implicit H atom passivation overestimates the transistor performance.

  14. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  15. Passivation Of High-Temperature Superconductors

    Science.gov (United States)

    Vasquez, Richard P.

    1991-01-01

    Surfaces of high-temperature superconductors passivated with native iodides, sulfides, or sulfates formed by chemical treatments after superconductors grown. Passivating compounds nearly insoluble in and unreactive with water and protect underlying superconductors from effects of moisture. Layers of cuprous iodide and of barium sulfate grown. Other candidate passivating surface films: iodides and sulfides of bismuth, strontium, and thallium. Other proposed techniques for formation of passivating layers include deposition and gas-phase reaction.

  16. Passive Scalar Evolution in Peripheral Region

    OpenAIRE

    Lebedev, V. V.; Turitsyn, K. S.

    2003-01-01

    We consider evolution of a passive scalar (concentration of pollutants or temperature) in a chaotic (turbulent) flow. A universal asymptotic behavior of the passive scalar decay (homogenization) related to peripheral regions (near walls) is established. The passive scalar moments and its pair correlation function in the peripheral region are analyzed. A special case investigated in our paper is the passive scalar decay along a pipe.

  17. Guide device

    International Nuclear Information System (INIS)

    Brammer, C.M. Jr.

    1977-01-01

    Disclosed is a fuel handling guide tube centering device for use in nuclear reactors during fuel assembly handling operations. The device comprises an outer ring secured to the flange of a nuclear reactor pressure vessel, a rotatable table rotatably coupled to the outer ring, and a plurality of openings through the table. Truncated locating cones are positioned in each of the openings in the table, and the locating cones center the guide tube during fuel handling operations. The openings in the table are located such that each fuel assembly in the nuclear core may be aligned with one of the openings by a suitable rotation of the table. The locating cones thereby provide alignment between the fuel handling mechanism located in the guide tube and the individual fuel assemblies of the cone. The need for a device to provide alignment is especially critical for floating nuclear power plants, where wave motion may exist during fuel handling operations. 5 claims, 4 figures

  18. Two or three decades of passive directions

    International Nuclear Information System (INIS)

    Cook, J.

    1995-01-01

    This paper presents an overview of the direction of passive solar architecture. The topics of the paper include design temperatures for buildings, active vs passive, fuel vs philosophy, engineering vs architecture, the thermal scale: heating vs cooling, fuel subsidies, divergent practices, sustainability, lighting, health, the place of passive technology

  19. Active house concept versus passive House

    NARCIS (Netherlands)

    Zeiler, W.; Boxem, G.; Vehler, R.; Verhoeven, M.; Fremouw, M.

    2009-01-01

    The passive house concept is the present trend in energy efficient sustainable dwellings. Within the passive house concept every effort is made to minimize the energy use. Substantial savings can be achieved by passive energy systems, especially natural ventilation, summer shading and winter solar

  20. Innovative solutions in passive house details

    NARCIS (Netherlands)

    Mlecnik, E.; Hilderson, W.

    2008-01-01

    For the realization of the first passive house demonstration projects in Belgium, passive houses were requested by convinced clients, designed by architects with experience in low energy building, and built by contractors with a feeling for working in building teams. These first passive house

  1. A Lexical Approach to Passive in ESL.

    Science.gov (United States)

    Marshall, Fred

    Dissatisfaction with the standard transformational grammar approach to teaching passive voice sentences gave rise to the method developed. It is based on the framework of a lexical-functional grammar, which claims that both active and passive sentences are base-generated, and that both active and passive verb forms occur in the lexicon. It would…

  2. Introduction of a Surgical Navigator in the Perioperative Process Improves Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Brett G Marshall

    2017-03-01

    Full Text Available Background: Patients who had received surgical services at Bellin Hospital reported anxiety with the surgical flow. This study tested the hypothesis that the introduction of a surgical navigator, someone who guided the patient and their accompanying others throughout the surgical process, would improve patient satisfaction. Methods: Ambulatory surgical patients were randomized to control and study groups. The study group patients were assigned a surgical navigator. Prior to discharge from the hospital, patients were asked to complete a patient satisfaction survey. Results: The study group had significantly higher mean scores (P value ≤ 0.026, top box scores (P value ≤ 0.021, and positive comments. Conclusion: The addition of a surgical navigator to the perioperative process significantly enhanced patient satisfaction in ambulatory surgical patients.

  3. CT-guided biopsies and drainage

    International Nuclear Information System (INIS)

    Scheppers, I.; Wollschlaeger, D.

    2011-01-01

    Following the implementation of computed tomography (CT) or ultrasound-guided biopsy of solid tumors and the puncture and drainage of liquid processes, the number of surgical open biopsies and curative operations for abscess drainage has declined. Such CT-guided interventions are performed in nearly every organ. Instead of aspiration biopsies, more and more core biopsies are being performed to allow histopathological evaluation and thus allowing targeted therapy. This article is intended to give a general overview of techniques, materials, indications and contraindications. Ultrasound-guided biopsies as well as large bore vacuum biopsies of the breast are not included in this review. (orig.) [de

  4. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  5. Homebuyer's Guide.

    Science.gov (United States)

    Sindt, Roger P.; Harris, Jack

    Designed to assist prospective buyers in making such important decisions as whether to buy a new or older home and within what price range, the guide provides information on the purchase process. Discussion of the purchase process covers the life-cycle costs (recurring homeownership costs that must be met every month); selection of a home;…

  6. 21 CFR 886.4300 - Intraocular lens guide.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct... lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this...

  7. Traffic classification with passive measurement

    OpenAIRE

    Pham, Hoang Phong

    2005-01-01

    Abstract This is a master thesis from a collaboration between Oslo University College and Uninett Research. Uninett have a passive monitoring device on a 2.5 Gbps backbone link between Trondheim and Narvik. They uses measurement with optical splitters and specialized measuring interfaces to trace traffic with Gigabit speed. We would like to investigate the structure and patterns in these data. It is of special interest to classify the traffic belonging to different services and protocols. ...

  8. EP1000 passive plant description

    International Nuclear Information System (INIS)

    Saiu, G.

    1999-01-01

    In 1994, a group of European Utilities, together with Westinghouse and its Industrial Partner GENESI (an Italian consortium including ANSALDO and FIAT), initiated a program designated EPP (European Passive Plant) to evaluate Westinghouse Passive Nuclear Plant Technology for application in Europe. In Phase I of the European Passive Plant Program which was completed in 1996, a 1000 MWe passive plant reference design (EP1000) was established which conforms to the European Utility Requirements (EUR) and is expected to meet the European Safety Authorities requirements. Phase 2 of the program was initiated in 1997 with the objective of developing the Nuclear Island design details and performing supporting analyses to start development of Safety Case Report (SCR) for submittal to European Licensing Authorities. The first part of Phase 2, 'Design Definition' phase (Phase 2A) will be completed at the end of 1998, the main efforts being design definition of key systems and structures, development of the Nuclear Island layout, and performing preliminary safety analyses to support design efforts. The second part, 'Phase 2B', includes both the analyses and evaluations required to demonstrate the adequacy of the design, and to support the preparation of Safety Case Report. The second part of Phase 2 of the program will start at the beginning of 1999 and will be completed in the 2001. Incorporation of the EUR has been a key design requirement for the EP1000 from the beginning of the program. Detailed design solutions to meet the EUR have been defined and the safety approach has also been developed based on the EUR guidelines. This paper integrates and updates the plant description reported in the IAEA TECDOC-968. The most significant developments of the EP1000 plant design during Phase 2A of the EPP program are described and reference is made to the key design requirements set by the EUR Rev. B document. (author)

  9. Active and Passive Hybrid Sensor

    Science.gov (United States)

    Carswell, James R.

    2010-01-01

    A hybrid ocean wind sensor (HOWS) can map ocean vector wind in low to hurricane-level winds, and non-precipitating and precipitating conditions. It can acquire active and passive measurements through a single aperture at two wavelengths, two polarizations, and multiple incidence angles. Its low profile, compact geometry, and low power consumption permits installation on air craft platforms, including high-altitude unmanned aerial vehicles (UAVs).

  10. Alternative to Nitric Acid Passivation

    Science.gov (United States)

    Kessel, Kurt R.

    2016-01-01

    Corrosion is an extensive problem that affects the National Aeronautics and Space Administration (NASA) and European Space Agency (ESA). The deleterious effects of corrosion result in steep costs, asset downtime affecting mission readiness, and safety risks to personnel. It is vital to reduce corrosion costs and risks in a sustainable manner. The primary objective of this effort is to qualify citric acid as an environmentally-preferable alternative to nitric acid for passivation of stainless steel alloys.

  11. Interior design for passive solar homes

    Energy Technology Data Exchange (ETDEWEB)

    Breen, J. C.

    1981-07-01

    The increasing emphasis on refinement of passive solar systems has brought recognition to interior design as an integral part of passive solar architecture. Interior design can be used as a finetuning tool minimizing many of the problems associated with passive solar energy use in residential buildings. In addition, treatment of interior space in solar model homes may be a prime factor in determining sales success. A new style of interior design is evolving in response to changes in building form incorporating passive solar design features. The psychology behind passive solar architecture is reflected in interiors, and selection of interior components increasingly depends on the functional suitability of various interior elements.

  12. Interior design for passive solar homes

    Science.gov (United States)

    Breen, J. C.

    1981-07-01

    The increasing emphasis on refinement of passive solar systems brought recognition to interior design as an integral part of passive solar architecture. Interior design can be used as a finetuning tool minimizing many of the problems associated with passive solar energy use in residential buildings. In addition, treatment of interior space in solar model homes may be a prime factor in determining sales success. A new style of interior design is evolving in response to changes in building from incorporating passive solar design features. The psychology behind passive solar architecture is reflected in interiors, and selection of interior components increasingly depends on the functional suitably of various interior elements.

  13. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  14. Degradation of materials and passivity

    International Nuclear Information System (INIS)

    Meisel, W.

    1997-01-01

    Demanding for a reduction in materials degradation is a serious problem all over the world. Moessbauer spectroscopy (MS) is, among others, a very valuable tool to follow many degradation processes. Evidently, Fe is the most important Moessbauer element considering the overall presence of iron in everyday life. MS may contribute to our knowledge about nearly all fields of materials degradation, chemical, mechanical, thermal, irradiative, etc. Following some general lines, corrosion is considered in particular. MS is applicable to investigate the bulk of materials as well as their surface layers with an information depth of ca. 250 nm. In general, it has to be applied as a surface sensitive method in combination with other relevant methods in order to get a detailed insight into ongoing processes. Some examples have been selected to elucidate the application of MS in this field. Another class of examples concerns attempts to prevent corrosion, i.e., the application of coatings and transforming chemicals. A very effective and most natural way to reduce corrosion is the passivation of materials. The effect of passive layers and their destruction by environmental influences are discussed using results of MS and related methods. It is outlined that passivity is not restricted to chemically treated metals but can be considered as a general concept for preventing different kinds of materials from degradation. (orig.)

  15. Passive infrared motion sensing technology

    International Nuclear Information System (INIS)

    Doctor, A.P.

    1994-01-01

    In the last 10 years passive IR based (8--12 microns) motion sensing has matured to become the dominant method of volumetric space protection and surveillance. These systems currently cost less than $25 to produce and yet use traditionally expensive IR optics, filters, sensors and electronic circuitry. This IR application is quite interesting in that the volumes of systems produced and the costs and performance level required prove that there is potential for large scale commercial applications of IR technology. This paper will develop the basis and principles of operation of a staring motion sensor system using a technical approach. A model for the motion of the target is developed and compared to the background. The IR power difference between the target and the background as well as the optical requirements are determined from basic principles and used to determine the performance of the system. Low cost reflective and refractive IR optics and bandpass IR filters are discussed. The pyroelectric IR detector commonly used is fully discussed and characterized. Various schemes for ''false alarms'' have been developed and are also explained. This technology is also used in passive IR based motion sensors for other applications such as lighting control. These applications are also discussed. In addition the paper will discuss new developments in IR surveillance technology such as the use of linear motion sensing arrays. This presentation can be considered a ''primer'' on the art of Passive IR Motion Sensing as applied to Surveillance Technology

  16. A Novel Surgical Template Design in Staged Dental Implant Rehabilitations

    Directory of Open Access Journals (Sweden)

    Michael Patras

    2012-05-01

    Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.

  17. Applied reliability assessment for the passive safety systems of nuclear power plants (NPPs) using system dynamics (SD)

    International Nuclear Information System (INIS)

    Kim, Yun Il; Woo, Tae Ho

    2018-01-01

    The passive system by the free-fall is investigated in the accident of nuclear power plants (NPPs). The complex algorithm of the system dynamics (SD) modeling is done in the passive cooling system. The nuclear passive system by free-fall is successfully modeled for the loss of coolant accident (LOCA). Conventional passive system of gravity or natural circulation is working only when the piping systems is in the good condition. The external coolant supply system is introduced in the case of the piping system failure. The water is poured into the reactor through the guiding piping or tube. If the explosion happens, the coolants could be showering into the reactor core and its building. New kind of passive system is expected successfully in the on-site black out where the drone could be operated by battery or engine.

  18. A review of surgical methods (excluding hair transplantation and their role in hair loss management today

    Directory of Open Access Journals (Sweden)

    Sandeep S Sattur

    2011-01-01

    Full Text Available There is more than one way to manage hair loss surgically. Apart from hair transplantation, there are other techniques which have been used by many to treat baldness. This article attempts to review the surgical methodology and philosophy that have acted as guiding lights in the approach to surgical treatment of baldness over the years and reviews the current role of other techniques in the armamentarium of hair restoration surgeons today.

  19. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  20. The passive of reflexive verbs in Icelandic

    Directory of Open Access Journals (Sweden)

    Hlíf Árnadóttir

    2011-10-01

    Full Text Available The Reflexive Passive in Icelandic is reminiscent of the so-called New Passive (or New Impersonal in that the oblique case of a passivized object NP is preserved. As is shown by recent surveys, however, speakers who accept the Reflexive Passive do not necessarily accept the New Passive, whereas conversely, speakers who accept the New Passive do also accept the Reflexive Passive. Based on these results we suggest that there is a hierarchy in the acceptance of passive sentences in Icelandic, termed the Passive Acceptability Hierarchy. The validity of this hierarchy is confirmed by our diachronic corpus study of open access digital library texts from Icelandic journals and newspapers dating from the 19th and 20th centuries (tímarit.is. Finally, we sketch an analysis of the Reflexive Passive, proposing that the different acceptability rates of the Reflexive and New Passives lie in the argument status of the object. Simplex reflexive pronouns are semantically dependent on the verbs which select them, and should therefore be analyzed as syntactic arguments only, and not as semantic arguments of these verbs.

  1. Surgical bedside master console for neurosurgical robotic system.

    Science.gov (United States)

    Arata, Jumpei; Kenmotsu, Hajime; Takagi, Motoki; Hori, Tatsuya; Miyagi, Takahiro; Fujimoto, Hideo; Kajita, Yasukazu; Hayashi, Yuichiro; Chinzei, Kiyoyuki; Hashizume, Makoto

    2013-01-01

    We are currently developing a neurosurgical robotic system that facilitates access to residual tumors and improves brain tumor removal surgical outcomes. The system combines conventional and robotic surgery allowing for a quick conversion between the procedures. This concept requires a new master console that can be positioned at the surgical bedside and be sterilized. The master console was developed using new technologies, such as a parallel mechanism and pneumatic sensors. The parallel mechanism is a purely passive 5-DOF (degrees of freedom) joystick based on the author's haptic research. The parallel mechanism enables motion input of conventional brain tumor removal surgery with a compact, intuitive interface that can be used in a conventional surgical environment. In addition, the pneumatic sensors implemented on the mechanism provide an intuitive interface and electrically isolate the tool parts from the mechanism so they can be easily sterilized. The 5-DOF parallel mechanism is compact (17 cm width, 19cm depth, and 15cm height), provides a 505,050 mm and 90° workspace and is highly backdrivable (0.27N of resistance force representing the surgical motion). The evaluation tests revealed that the pneumatic sensors can properly measure the suction strength, grasping force, and hand contact. In addition, an installability test showed that the master console can be used in a conventional surgical environment. The proposed master console design was shown to be feasible for operative neurosurgery based on comprehensive testing. This master console is currently being tested for master-slave control with a surgical robotic system.

  2. Tourists Co-producing Guided Tours

    DEFF Research Database (Denmark)

    Larsen, Jonas; Meged, Jane Widtfeldt

    2013-01-01

    The guided tour is a stigmatized tourist practice. In contrast to studies portraying sightseeing tours as an over-determined stage where tourists passively follow prescripted routes and scripts, this article also uncovers creativity, detours and productive practices. We examine how tourists can...... discussion of some of Goffman's central concepts. Second, we move on to a more general discussion of how front-stage tourism services are performances where both tourist staff and guests play their part. Third, we examine ethnographically how participants on guided tours in Copenhagen co...

  3. Compact passively self-tuning energy harvesting for rotating applications

    International Nuclear Information System (INIS)

    Gu, Lei; Livermore, Carol

    2012-01-01

    This paper presents a compact, passive, self-tuning energy harvester for rotating applications. The harvester rotates in the vertical plane and is comprised of two beams: a relatively rigid piezoelectric generating beam and a narrow, flexible driving beam with a tip mass mounted at the end. The mass impacts the generating beam repeatedly under the influence of gravity to drive generation. Centrifugal force from the rotation modifies the resonant frequency of the flexible driving beam and the frequency response of the harvester. An analytical model that captures the harvester system's resonant frequency as a function of rotational speed is used to guide the detailed design. With an optimized design, the resonant frequency of the harvester substantially matches the frequency of the rotation over a wide frequency range from 4 to 16.2 Hz. A prototype of the passive self-tuning energy harvester using a lead zirconate titanate generating beam achieved a power density of 30.8 µW cm −3 and a more than 11 Hz bandwidth, which is much larger than the 0.8 Hz bandwidth calculated semi-empirically for a similar but untuned harvester. Passive tuning was also demonstrated using the more robust and reliable but less efficient polymer polyvinylidene fluoride for the generating beam

  4. Neuronavigator-guided cerebral biopsy.

    Science.gov (United States)

    Koivukangas, J; Louhisalmi, Y; Alakuijala, J; Oikarinen, J

    1993-01-01

    Neuronavigators are new dynamic interactive instruments that use on-line computers to orient imaging data to the surgical field and guide the neurosurgeon to his target. We have been working since 1987 on a neuronavigator that serves not only as a precise pointer, but also as a dynamic arm that can be used to hold instruments, such as biopsy guides. The neuronavigator arm consists of six joints with optical encoders and is attached to the Mayfield headholder. The arm is connected to a workstation running customized 3D image graphics software. Special instruments and surgical technique have been developed. Here, we report on early clinical experience with ten biopsy procedures: 4 low-grade and 3 high-grade astrocytomas, one craniopharyngioma and one chronic intracerebral haematoma and intracerebral cyst, both of the latter with surrounding tumour suspect tissue. In all glioma cases serial biopsies were taken from optimal sites under ultrasound imaging control. Eight cases showed representative tumour tissue, while in two cases neoplasia was ruled out. The neuronavigator proved to be versatile, allowing comprehensive imaging data to be adapted to the surgical field.

  5. Technical innovation: Wire guided ductography

    International Nuclear Information System (INIS)

    Aslam, Muhammad Ovais; Ramadan, Salwa; Al-Adwani, Muneera

    2012-01-01

    To introduce an easy and improved technique for performing ductography using inexpensive easily available intravenous cannula. Guide wire: Prolene/Surgipro 3-0 (Polypropylene mono filament non-absorbable surgical suture). A plastic 26 G intravenous cannula. Disposable syringe 2 ml. Non-ionic contrast (low density like Omnipaque 240 mg I/I). The guide wire (Prolene 3-0) is introduced into the orifice of the duct heaving discharge and 26 G intravenous plastic cannula is then passed over the guide wire. The cannula is advanced in the duct over guide wire by spinning around it. When the cannula is in place the guide wire is removed. Any air bubbles present in the hub of the cannula can be displaced by filling the hub from bottom upwards with needle attached to contrast filled syringe. 0.2–0.4 ml non-ionic contrast is gently injected. Injection is stopped if the patient has pain or burning. Magnified cranio-caudal view is obtained with cannula tapped in place and gentle compression is applied with the patient sitting. If duct filling is satisfactory a 90* lateral view is obtained. A successful adaptation of the technique for performing ductography is presented. The materials required for the technique are easily available in most radiology departments and are inexpensive, thus making the procedure comfortable for the patient and radiologist with considerable cost effectiveness.

  6. Passive houses in Sweden. Experiences from design and construction phase

    Energy Technology Data Exchange (ETDEWEB)

    Jansson, Ulla

    2008-07-01

    The sector of residential buildings and service organizations uses 36% of the total energy in Sweden. In June 2006, it was decided by the Swedish parliament that the energy use in residential buildings and premises should decrease by 20% per heated unit area before 2020. To reach this goal, more energy efficient buildings must be produced as well as energy efficient improvements must be performed on the existing building stock. One way to reduce the energy use in buildings is to build passive houses. A passive house is a mechanically ventilated building that with a highly insulated and air tight building envelope uses a minimum of energy for heating. The method used in this research is to practically participate in four passive house demonstration projects. The results expected are to find guiding principles and tools needed for passive house planning and make the system solutions usable for planning in more general terms. Joining as a part of the planning group; advice and help is given to architects, consultants and to the client. The demonstration projects studied are located in the south-west of Sweden. Three of the projects are new constructions and one is a renovation project. In the centre of Vanirom 40 rental apartments were built in 2005/2006 according to the passive house standard. Solar collectors on the roof contribute to the domestic hot water production. Every apartment has its own mechanical ventilation system with efficient heat recovery. Auxiliary heating is supplied by electricity. The load bearing structure were made of concrete and cast at site. The exterior walls and roof were made of wooden frame construction and mounted at site. The tenants moved in during summer 2006. The passive house project in Failure's consists of three houses with 12 rental apartments. The air is supplied by mechanical ventilation with an air to air heat exchanger, one in each apartment. The domestic hot water is prepared by solar collectors and auxiliary heating

  7. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  8. [Surgical therapy of gynecomastia].

    Science.gov (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  9. Surgical manifestations of filariasis

    Directory of Open Access Journals (Sweden)

    Subrahmanyam M

    1978-01-01

    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  10. Improving surgical weekend handover.

    Science.gov (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  11. [Surgical complications of colostomies].

    Science.gov (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  12. Passive film growth on carbon steel and its nanoscale features at various passivating potentials

    International Nuclear Information System (INIS)

    Li, Yuan; Cheng, Y. Frank

    2017-01-01

    Highlights: • Imaged the topography of passivated steel at various film-forming potentials. • Characterized the nanoscale features of passive films. • Determined the composition of passive films formed at various potentials. - Abstract: In this work, the passivation and topographic sub-structure of passive films on a carbon steel in a carbonate/bicarbonate solution was characterized by electrochemical measurements, atomic force microscopy and X-ray photoelectron spectroscopy. When passivating at a potential near the active-passive transition, the film contains the mixture of Fe_3O_4, Fe_2O_3 and FeOOH, with numerous nanoscale features. As the film-forming potential shifts positively, the passive film becomes more compact and the nanoscale features disappear. When the film is formed at a passive potential where the oxygen evolution is enabled, the content of FeOOH in the film increases, resulting in an amorphous topography and reduced corrosion resistance.

  13. A new image guided surgical robot for precision bone sculpturing

    NARCIS (Netherlands)

    Bos, J.; Steinbuch, M.; Kunst, H.P.M.; Bointon, P.; Leach, R.; Southon, N.

    2016-01-01

    The number of people with hearing loss and tumours increase, as the population is getting older and the world is getting louder. This poses increasing demands on healthcare, both in numbers and capabilities. For a number of specific applications new medical robots possibly can increase quality as

  14. Numerical optimization of alignment reproducibility for customizable surgical guides

    NARCIS (Netherlands)

    Kroes, T.; Valstar, E.R.; Eisemann, E.

    2015-01-01

    Purpose Computer-assisted orthopedic surgery aims at minimizing invasiveness, postoperative pain, and morbidity with computer-assisted preoperative planning and intra-operative guidance techniques, of which camera-based navigation and patient-specific templates (PST) are the most common. PSTs are

  15. Enhanced Attenuation Technologies: Passive Soil Vapor Extraction

    Energy Technology Data Exchange (ETDEWEB)

    Vangelas, K.; Looney, B.; Kamath, R.; Adamson, D.; Newell, C.

    2010-03-15

    Passive soil vapor extraction (PSVE) is an enhanced attenuation (EA) approach that removes volatile contaminants from soil. The extraction is driven by natural pressure gradients between the subsurface and atmosphere (Barometric Pumping), or by renewable sources of energy such as wind or solar power (Assisted PSVE). The technology is applicable for remediating sites with low levels of contamination and for transitioning sites from active source technologies such as active soil vapor extraction (ASVE) to natural attenuation. PSVE systems are simple to design and operate and are more cost effective than active systems in many scenarios. Thus, PSVE is often appropriate as an interim-remedial or polishing strategy. Over the past decade, PSVE has been demonstrated in the U.S. and in Europe. These demonstrations provide practical information to assist in selecting, designing and implementing the technology. These demonstrations indicate that the technology can be effective in achieving remedial objectives in a timely fashion. The keys to success include: (1) Application at sites where the residual source quantities, and associated fluxes to groundwater, are relatively low; (2) Selection of the appropriate passive energy source - barometric pumping in cases with a deep vadose zone and barrier (e.g., clay) layers that separate the subsurface from the atmosphere and renewable energy assisted PSVE in other settings and where higher flow rates are required. (3) Provision of sufficient access to the contaminated vadose zones through the spacing and number of extraction wells. This PSVE technology report provides a summary of the relevant technical background, real-world case study performance, key design and cost considerations, and a scenario-based cost evaluation. The key design and cost considerations are organized into a flowchart that dovetails with the Enhanced Attenuation: Chlorinated Organics Guidance of the Interstate Technology and Regulatory Council (ITRC). The PSVE

  16. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  17. Current Capabilities and Development Potential in Surgical Robotics

    Directory of Open Access Journals (Sweden)

    Mathias Hoeckelmann

    2015-05-01

    Full Text Available Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided robotics focus on surpassing human limitations by introducing automated targeting and treatment delivery methods. Both concepts are discussed based on prototypes and commercial systems. Through concrete examples the possible future development paths of surgical robots are illustrated. While research efforts are taking different approaches to improve the capacity of such systems, the aim of this survey is to assess their maturity from the commercialization point of view.

  18. Surgical training in your hands: organising a skills course.

    Science.gov (United States)

    Burnand, Henry; Mutimer, Jon

    2012-12-01

    The advent of simulated surgical skills courses has brought dynamic changes to the traditional approach to acquiring practical skills in surgery. Teaching is a core part of the surgical profession, and any trainee can be involved in the organisation of skills training courses. This paper outlines the importance of organising surgical skills courses for trainees, and provides a practical guide on how to do so within busy clinical environments. The paper examines how to plan a course, how to design the programme, and provides tips on faculty staff requirements, venue, finance and participants, with additional suggestions for assessment and evaluation. We recommend the organisation of skills courses to any trainee. By following key ground rules, the surgical trainee can enable the acquisition of advanced learning opportunities and the ability to demonstrate valuable organisational skills. © Blackwell Publishing Ltd 2012.

  19. The passive-aggressive organization.

    Science.gov (United States)

    Kaplan, Robert S; Norton, David P

    2005-10-01

    Passive-aggressive organizations are friendly places to work: People are congenial, conflict is rare, and consensus is easy to reach. But, at the end of the day, even the best proposals fail to gain traction, and a company can go nowhere so imperturbably that it's easy to pretend everything is fine. Such companies are not necessarily saddled with mulishly passive-aggressive employees. Rather, they are filled with mostly well-intentioned people who are the victirms of flawed processes and policies. Commonly, a growing company's halfhearted or poorly thought-out attempts to decentralize give rise to multiple layers of managers, whose authority for making decisions becomes increasingly unclear. Some managers, as a result, hang back, while others won't own up to the calls they've made, inviting colleagues to second-guess or overturn the decisions. In such organizations, information does not circulate freely, and that makes it difficult for workers to understand the impact of their actions on company performance and for managers to correctly appraise employees' value to the organization. A failure to accurately match incentives to performance stifles initiative, and people do just enough to get by. Breaking free from this pattern is hard; a long history of seeing corporate initiatives ignored and then fade away tends to make people cynical. Often it's best to bring in an outsider to signal that this time things will be different. He or she will need to address every obstacle all at once: clarify decision rights; see to it that decisions stick; and reward people for sharing information and adding value, not for successfully negotiating corporate politics. If those steps are not taken, it's only a matter of time before the diseased elements of a passive-aggressive organization overwhelm the remaining healthy ones and drive the company into financial distress.

  20. Architectural Qualities in Passive Houses

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla

    2012-01-01

    that it is possible to build this type of houses, but the knowledge and discussion about the architectural quality in the buildings is hardly present. The question is if the strategies for optimising energy use and indoor environment collide with the architectural qualities of buildings. This paper brings forth...... this discussion based in literature and four case studies. The paper highlights cases on how passive strategies for optimising energy use and indoor environment affect, restrict, inspire or create possibilities for the architectural expression and there through the architectural quality of the building....

  1. Passive Containment DataSet

    Science.gov (United States)

    This data is for Figures 6 and 7 in the journal article. The data also includes the two EPANET input files used for the analysis described in the paper, one for the looped system and one for the block system.This dataset is associated with the following publication:Grayman, W., R. Murray , and D. Savic. Redesign of Water Distribution Systems for Passive Containment of Contamination. JOURNAL OF THE AMERICAN WATER WORKS ASSOCIATION. American Water Works Association, Denver, CO, USA, 108(7): 381-391, (2016).

  2. Passive longitudinal phase space linearizer

    Directory of Open Access Journals (Sweden)

    P. Craievich

    2010-03-01

    Full Text Available We report on the possibility to passively linearize the bunch compression process in electron linacs for the next generation x-ray free electron lasers. This can be done by using the monopole wakefields in a dielectric-lined waveguide. The optimum longitudinal voltage loss over the length of the bunch is calculated in order to compensate both the second-order rf time curvature and the second-order momentum compaction terms. Thus, the longitudinal phase space after the compression process is linearized up to a fourth-order term introduced by the convolution between the bunch and the monopole wake function.

  3. Open core control software for surgical robots.

    Science.gov (United States)

    Arata, Jumpei; Kozuka, Hiroaki; Kim, Hyung Wook; Takesue, Naoyuki; Vladimirov, B; Sakaguchi, Masamichi; Tokuda, Junichi; Hata, Nobuhiko; Chinzei, Kiyoyuki; Fujimoto, Hideo

    2010-05-01

    techniques for this purpose were introduced. Virtual fixture is well known technique as a "force guide" for supporting operators to perform precise manipulation by using a master-slave robot. The virtual fixture for precise and safety surgery was implemented on the system to demonstrate an idea of high-level collaboration between a surgical robot and a navigation system. The extension of virtual fixture is not a part of the Open Core Control system, however, the function such as virtual fixture cannot be realized without a tight collaboration between cutting-edge medical devices. By using the virtual fixture, operators can pre-define an accessible area on the navigation system, and the area information can be transferred to the robot. In this manner, the surgical console generates the reflection force when the operator tries to get out from the pre-defined accessible area during surgery. The Open Core Control software was implemented on a surgical master-slave robot and stable operation was observed in a motion test. The tip of the surgical robot was displayed on a navigation system by connecting the surgical robot with a 3D position sensor through the OpenIGTLink. The accessible area was pre-defined before the operation, and the virtual fixture was displayed as a "force guide" on the surgical console. In addition, the system showed stable performance in a duration test with network disturbance. In this paper, a design of the Open Core Control software for surgical robots and the implementation of virtual fixture were described. The Open Core Control software was implemented on a surgical robot system and showed stable performance in high-level collaboration works. The Open Core Control software is developed to be a widely used platform of surgical robots. Safety issues are essential for control software of these complex medical devices. It is important to follow the global specifications such as a FDA requirement "General Principles of Software Validation" or IEC62304. For

  4. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  5. Measurement and Treatment of Passive Muscle Stiffness

    DEFF Research Database (Denmark)

    Kirk, Henrik

    , which aimed to investigate: 1) The development of a clinical method to evaluate and distinguish neural (reflex mediated stiffness) and non-neural (passive muscle stiffness) components of muscle stiffness in adults with CP by objective and reliable measurements. 2) The association between increased...... and reliability of the method, and argue for the use of the method in the clinical practice. The device is able to distinguish between passive muscle stiffness and reflex-mediated stiffness in subjects with CP. It shows good high intrarater and interrater reliability in evaluation of passive muscle stiffness...... to measure muscle stiffness, and distinguish between passive muscle stiffness and reflex-mediated stiffness. Furthermore, it is a reliable device to measure changes in passive ROM. Treatment of passive muscle stiffness should be directed towards intense training, comprising many repetitions with a functional...

  6. Forekomsten af passiv rygning i Danmark

    DEFF Research Database (Denmark)

    Kristensen, T S; Møller, L; Holstein, B E

    1990-01-01

    The occurrence of passive smoking in the adult population in Denmark has not been described previously. This article publishes data from three investigations all of which were carried out in 1987. One was an interview investigation of a random section of the Danish population carried out by the D...... inconvenienced by passive smoking at work and a corresponding fraction had taken steps to reduce the extent of passive smoking in their daily life. Udgivelsesdato: 1990-Aug-27...... showed consistent results as regards the occurrence of passive smoking among adult Danes. About 12% of non-smokers were exposed to passive smoking for at least eight hours and 40% for at least one hour daily. Altogether 73% were exposed to passive smoking daily. About one third of the non-smokers were...

  7. Solar energy guide

    International Nuclear Information System (INIS)

    Lentz, A.; Winter, R.

    1993-07-01

    Many aspects with regard to the practical use of solar energy are discussed. This guide is aimed at informing local and regional administrators, committee members of housing corporations and public utilities and public relations officers on the possibilities to use solar energy. In chapter one an overview is given of the use of solar energy in the housing sector, the recreational sector, agricultural sector, industry, trade and other sectors. In the chapters two, three and four attention is paid to passive solar energy, active thermal solar energy and photovoltaic energy respectively. In the chapters five and six aspects concerning the implementation of solar energy systems in practice are discussed. First an outline of the parties involved in implementing solar energy is given: the municipality, the energy utility, the province, local authorities, advisors, housing constructors and the occupants of the buildings. Then attention is paid to the consequences of implementing solar energy for the building inspection and regulations, the finances, energy savings and the environment. In chapter seven an overview is given of the subsidy regulations of the European Community, the Dutch national and local governments. Chapter contains addresses of solar thermal systems, photovoltaic systems and other institutes operating in the field of solar energy, as well as the titles of a number of brochures and courses. 51 figs., 7 tabs., 86 refs

  8. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

  9. Columbia County Habitat for Humanity Passive Townhomes

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2016-03-01

    Columbia County Habitat for Humanity (CCHH) (New York, Climate Zone 5A) built a pair of townhomes to Passive House Institute U.S. (PHIUS+ 2015) criteria to explore approaches for achieving Passive House performance (specifically with respect to exterior wall, space-conditioning, and ventilation strategies) within the labor and budget context inherent in a Habitat for Humanity project. CCHH’s goal is to eventually develop a cost-justified Passive House prototype design for future projects.

  10. Passive Nuclear Plants Program (UPDATE)

    International Nuclear Information System (INIS)

    Chimeno, M. A.

    1998-01-01

    The light water passive plants program (PCNP), today Advanced Nuclear Power Plants Program (PCNA), was constituted in order to reach the goals of the Spanish Electrical Sector in the field of advanced nuclear power plants, optimize the efforts of all Spanish initiatives, and increase joint presence in international projects. The last update of this program, featured in revision 5th of the Program Report, reflects the consolidation of the Spanish sector's presence in International programs of the advanced power plants on the basis of the practically concluded American ALWR program. Since the beginning of the program , the PCNP relies on financing from the Electrical sector, Ocide, SEPI-Endesa, Westinghouse, General Electric, as well as from the industrial cooperators, Initec, UTE (Initec- Empresarios Agrupados), Ciemat, Enusa, Ensa and Tecnatom. The program is made up of the following projects, already concluded: - EPRI's Advanced Light Water Plants Certification Project - Westinghouse's AP600 Project - General Electric's SBWR Project (presently paralyzed) and ABWR project Currently, the following project are under development, at different degrees of advance: - EPP project (European Passive Plant) - EBWR project (European Advanced Boiling Water Reactor)

  11. A Portable Passive Physiotherapeutic Exoskeleton

    Directory of Open Access Journals (Sweden)

    Dasheek Naidu

    2012-10-01

    Full Text Available The public healthcare system in South Africa is in need of urgent attention in no small part because there has been an escalation in the number of stroke victims which could be due to the increase in hypertension in this urbanizing society. There is a growing need for physiotherapists and occupational therapists in the country, which is further hindered by the division between urban and rural areas. A possible solution is a portable passive physiotherapeutic exoskeleton device. The exoskeleton device has been formulated to encapsulate methodologies that enable the anthropomorphic integration between a biological and mechatronic limb. A physiotherapeutic mechanism was designed to be portable and adjustable, without limiting the spherical motion and workspace of the human arm. The exoskeleton was designed to be portable in the sense that it could be transported geographically. It is a complete device allowing for motion in the shoulder, elbow, wrist and hand joints. The inverse kinematics was solved iteratively via the Damped Least Squares (DLS method. The electronic and computer system allowed for professional personnel to either change an individual joint or a combination of joints angles via the kinematic models. A ramp PI controller was established to provide a smooth response to simulate the passive therapy motion.

  12. Liberal theory of passive citizenship

    Directory of Open Access Journals (Sweden)

    Salatić Stevan

    2013-01-01

    Full Text Available In this seminar paper I will focus on the analysis of liberal theory of citizenship. The focus of the study will be on the liberal-communitarian dispute in the theory of citizenship, with main ideas of the most important representatives of liberal discourse in the field of citizenship also being discussed. I will look more closely at the ideas of T.H. Marshall, as the most significant writer of liberal orthodoxy in the second half of the twentieth century, his contribution to liberal theory of passive citizenship, but I will also deal with the ideas of his biggest critics, both from the aspect of liberalism and from the aspect of communitarianism, including Anthony Giddens, Claus Offe, Michael Mann, Barrington Moore and Brian Turner. The emphasis will be on Marshall's term 'conquest of citizenship', as well as on the derivation of various theories of state from the obtained rights achieved through the expansion of the concept of citizenship. Finally, I will say something about modern obstacles to theories of passive citizenship derived from the communitarian school.

  13. Passive propulsion in vortex wakes

    Science.gov (United States)

    Beal, D. N.; Hover, F. S.; Triantafyllou, M. S.; Liao, J. C.; Lauder, G. V.

    A dead fish is propelled upstream when its flexible body resonates with oncoming vortices formed in the wake of a bluff cylinder, despite being well outside the suction region of the cylinder. Within this passive propulsion mode, the body of the fish extracts sufficient energy from the oncoming vortices to develop thrust to overcome its own drag. In a similar turbulent wake and at roughly the same distance behind a bluff cylinder, a passively mounted high-aspect-ratio foil is also shown to propel itself upstream employing a similar flow energy extraction mechanism. In this case, mechanical energy is extracted from the flow at the same time that thrust is produced. These results prove experimentally that, under proper conditions, a body can follow at a distance or even catch up to another upstream body without expending any energy of its own. This observation is also significant in the development of low-drag energy harvesting devices, and in the energetics of fish dwelling in flowing water and swimming behind wake-forming obstacles.

  14. Expert Guide

    DEFF Research Database (Denmark)

    Heiselberg, Per

    , their benefits and limitations, economical feasibility and impact on energy savings, company image, comfort, productivity, building functionality and flexibility and gives guidance on design of these concepts, including integration of responsive building elements and HVAC-systems and build examples......This guide summarizes the work of Subtask B of IEA-ECBCS Annex 44 “Integrating Environmentally Responsive Elements in Buildings” and is based on the contributions from the participating countries. The publication is an official Annex report. With a focus on innovative building concepts...

  15. Improving surgical weekend handover

    OpenAIRE

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  16. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  17. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  18. Utility requirements for advanced LWR passive plants

    International Nuclear Information System (INIS)

    Yedidia, J.M.; Sugnet, W.R.

    1992-01-01

    LWR Passive Plants are becoming an increasingly attractive and prominent option for future electric generating capacity for U.S. utilities. Conceptual designs for ALWR Passive Plants are currently being developed by U.S. suppliers. EPRI-sponsored work beginning in 1985 developed preliminary conceptual designs for a passive BWR and PWR. DOE-sponsored work from 1986 to the present in conjunction with further EPRI-sponsored studies has continued this development to the point of mature conceptual designs. The success to date in developing the ALWR Passive Plant concepts has substantially increased utility interest. The EPRI ALWR Program has responded by augmenting its initial scope to develop a Utility Requirements Document for ALWR Passive Plants. These requirements will be largely based on the ALWR Utility Requirements Document for Evolutionary Plants, but with significant changes in areas related to the passive safety functions and system configurations. This work was begun in late 1988, and the thirteen-chapter Passive Plant Utility Requirements Document will be completed in 1990. This paper discusses the progress to date in developing the Passive Plant requirements, reviews the top-level requirements, and discusses key issues related to adaptation of the utility requirements to passive safety functions and system configurations. (orig.)

  19. Multiple mechanisms quench passive spiral galaxies

    Science.gov (United States)

    Fraser-McKelvie, Amelia; Brown, Michael J. I.; Pimbblet, Kevin; Dolley, Tim; Bonne, Nicolas J.

    2018-02-01

    We examine the properties of a sample of 35 nearby passive spiral galaxies in order to determine their dominant quenching mechanism(s). All five low-mass (M⋆ environments. We postulate that cluster-scale gas stripping and heating mechanisms operating only in rich clusters are required to quench low-mass passive spirals, and ram-pressure stripping and strangulation are obvious candidates. For higher mass passive spirals, while trends are present, the story is less clear. The passive spiral bar fraction is high: 74 ± 15 per cent, compared with 36 ± 5 per cent for a mass, redshift and T-type matched comparison sample of star-forming spiral galaxies. The high mass passive spirals occur mostly, but not exclusively, in groups, and can be central or satellite galaxies. The passive spiral group fraction of 74 ± 15 per cent is similar to that of the comparison sample of star-forming galaxies at 61 ± 7 per cent. We find evidence for both quenching via internal structure and environment in our passive spiral sample, though some galaxies have evidence of neither. From this, we conclude no one mechanism is responsible for quenching star formation in passive spiral galaxies - rather, a mixture of mechanisms is required to produce the passive spiral distribution we see today.

  20. Inherent/passive safety for fusion

    International Nuclear Information System (INIS)

    Piet, S.J.

    1986-06-01

    The concept of inherent or passive passive safety for fusion energy is explored, defined, and partially quantified. Four levels of safety assurance are defined, which range from true inherent safety to passive safety to protection via active engineered safeguard systems. Fusion has the clear potential for achieving inherent or passive safety, which should be an objective of fusion research and design. Proper material choice might lead to both inherent safety and high mass power density, improving both safety and economics. When inherent safety is accomplished, fusion will be well on the way to achieving its ultimate potential and to be truly different and superior

  1. Passive Wireless SAW Humidity Sensors, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This proposal describes the preliminary development of passive wireless surface acoustic wave (SAW) based humidity sensors for NASA application to distributed...

  2. Passive cavitation imaging with ultrasound arrays.

    Science.gov (United States)

    Salgaonkar, Vasant A; Datta, Saurabh; Holland, Christy K; Mast, T Douglas

    2009-12-01

    A method is presented for passive imaging of cavitational acoustic emissions using an ultrasound array, with potential application in real-time monitoring of ultrasound ablation. To create such images, microbubble emissions were passively sensed by an imaging array and dynamically focused at multiple depths. In this paper, an analytic expression for a passive image is obtained by solving the Rayleigh-Sommerfield integral, under the Fresnel approximation, and passive images were simulated. A 192-element array was used to create passive images, in real time, from 520-kHz ultrasound scattered by a 1-mm steel wire. Azimuthal positions of this target were accurately estimated from the passive images. Next, stable and inertial cavitation was passively imaged in saline solution sonicated at 520 kHz. Bubble clusters formed in the saline samples were consistently located on both passive images and B-scans. Passive images were also created using broadband emissions from bovine liver sonicated at 2.2 MHz. Agreement was found between the images and source beam shape, indicating an ability to map therapeutic ultrasound beams in situ. The relation between these broadband emissions, sonication amplitude, and exposure conditions are discussed.

  3. Hybrid Active-Passive Radiation Shielding System

    Data.gov (United States)

    National Aeronautics and Space Administration — A radiation shielding system is proposed that integrates active magnetic fields with passive shielding materials. The objective is to increase the shielding...

  4. Implementation of surgical quality improvement: auditing tool for surgical site infection prevention practices.

    Science.gov (United States)

    Hechenbleikner, Elizabeth M; Hobson, Deborah B; Bennett, Jennifer L; Wick, Elizabeth C

    2015-01-01

    Surgical site infections are a potentially preventable patient harm. Emerging evidence suggests that the implementation of evidence-based process measures for infection reduction is highly variable. The purpose of this work was to develop an auditing tool to assess compliance with infection-related process measures and establish a system for identifying and addressing defects in measure implementation. This was a retrospective cohort study using electronic medical records. We used the auditing tool to assess compliance with 10 process measures in a sample of colorectal surgery patients with and without postoperative infections at an academic medical center (January 2012 to March 2013). We investigated 59 patients with surgical site infections and 49 patients without surgical site infections. First, overall compliance rates for the 10 process measures were compared between patients with infection vs patients without infection to assess if compliance was lower among patients with surgical site infections. Then, because of the burden of data collection, the tool was used exclusively to evaluate quarterly compliance rates among patients with infection. The results were reviewed, and the key factors contributing to noncompliance were identified and addressed. Ninety percent of process measures had lower compliance rates among patients with infection. Detailed review of infection cases identified many defects that improved following the implementation of system-level changes: correct cefotetan redosing (education of anesthesia personnel), temperature at surgical incision >36.0°C (flags used to identify patients for preoperative warming), and the use of preoperative mechanical bowel preparation with oral antibiotics (laxative solutions and antibiotics distributed in clinic before surgery). Quarterly compliance improved for 80% of process measures by the end of the study period. This study was conducted on a small surgical cohort within a select subspecialty. The

  5. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  7. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  8. CT-guided stereotactic neurosurgery

    International Nuclear Information System (INIS)

    Takizawa, Takaaki; Sato, Shoju; Matsumoto, Akira; Sano, Akira; Takahashi, Kazunori; Murakami, Yuji; Ohta, Kosuke

    1985-01-01

    Brown-Roberts-Wells stereotactic instruments were used for CT guided stereotactic surgery in 54 cases (65 operations). Stereotactic biopsy was done in 9 cases and successive regional chemotherapy was done in 3 cases. Stereotactic drainage was done in 2 cases of bacterial abcess, 3 cases of cystic neoplasm and 33 cases (43 operations) of intracerebral hematoma. CT guided stereotactic procedure was valuable for the correct cannulation to the center of the cavity. We tried to utilize CT image for the selection of targets for stereotactic functional neurosurgical procedures in 6 cases. In the cases of thalamotomy, the information derived from CT made the operation safer than that by contrast ventriculography alone. In all cases of electrode implantation for deep brain stimulation, accurate and precise electrode placement was achieved from CT images alone. This rapid and easy surgical technique was useful also for poor risk patients. (author)

  9. Universality in passively advected hydrodynamic fields : the case of a passive vector with pressure

    NARCIS (Netherlands)

    Benzi, R.; Biferale, L.; Toschi, F.

    2001-01-01

    Universality of statistical properties of passive quantities advected by turbulent velocity fields at changing the passive forcing mechanism is discussed. In particular, we concentrate on the statistical properties of an hydrodynamic system with pressure. We present theoretical arguments and

  10. Computer-guided laser for neurosurgery.

    Science.gov (United States)

    Koivukangas, J; Louhisalmi, Y

    1990-01-01

    On the basis of over 40 neurosurgical laser operations, including CO2, Nd-YAG and simultaneous CO2/Nd-YAG laser procedures, a computer-guided system for spatial control of the laser beam has been developed. The pilot laser has several modes: it can direct the neurosurgeon along the central axis of the surgical microscope to stereotactically determined point-like targets or outline selected layers of underlying volume targets onto superficial surfaces such as scalp and cortex and onto the tissue at the appropriate depth. The active treatment laser can be guided by preoperative CT/MRI or intraoperative ultrasound image data for layer-by-layer resection of tumor. The laser system can be connected to the surgical field by rigid stereotactic means or by neuronavigator. In the present system, a special brain surgery adapter coordinates the imaging system and laser to the surgical field. Thus, the laser system can be used for image-guided surgical orientation, for demarcation of lesions and for actual layer-by-layer removal of tumor.

  11. Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

    Science.gov (United States)

    Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

    2017-03-01

    Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. Health risks of passive smoking.

    Science.gov (United States)

    Papier, C M; Stellman, S D

    1986-01-01

    Passive or involuntary smoking is the inhalation of smoke which escapes directly into the air from the lit end of a burning cigarette. This unfiltered smoke contains the same toxic components of the mainstream smoke inhaled directly by the smoker, including numerous carcinogens, many in greater concentrations. It has long been known that exposure to this type of smoke leads to increased respiratory and other adverse health conditions in non-smokers, especially children. During the past five years, evidence has been accumulating that risk of lung cancer is also higher, particularly in non-smoking women whose husbands smoke. Despite uncertainties and differences in interpretation of various cancer studies, there is ample justification for public health measures now in place or proposed, such as restriction or elimination of smoking in the workplace and in public places.

  13. Integrated Passive And Wireless Sensor

    KAUST Repository

    Li, Bodong

    2015-04-30

    A passive and wireless sensor is provided for sensing at least one of magnetic field, temperature or humidity. The sensor can provide only one of the sensing functions, individually or any combination of them simultaneously. It can be used for various applications where magnetic field changes, temperature and/or humidity need to be measured. In one or more embodiments, a surface acoustic wave (SAW) sensor is provided that can measure one or more of a magnetic field (or current that generates the magnetic field), temperature and humidity. In one or more embodiments, a magnetoimpedence (MI) sensor (for example a thin film giant magnetoimpedance (GMI) sensor), a thermally sensitive (for example a Lithium Niobite (LiNbO.sub.3)) substrate, and a humidity sensitive film (for example a hydrogel film) can be used as sensing elements.

  14. Integrated Passive And Wireless Sensor

    KAUST Repository

    Li, Bodong; Kosel, Jü rgen

    2015-01-01

    A passive and wireless sensor is provided for sensing at least one of magnetic field, temperature or humidity. The sensor can provide only one of the sensing functions, individually or any combination of them simultaneously. It can be used for various applications where magnetic field changes, temperature and/or humidity need to be measured. In one or more embodiments, a surface acoustic wave (SAW) sensor is provided that can measure one or more of a magnetic field (or current that generates the magnetic field), temperature and humidity. In one or more embodiments, a magnetoimpedence (MI) sensor (for example a thin film giant magnetoimpedance (GMI) sensor), a thermally sensitive (for example a Lithium Niobite (LiNbO.sub.3)) substrate, and a humidity sensitive film (for example a hydrogel film) can be used as sensing elements.

  15. Indirect wrist MR arthrography: the effects of passive motion versus active exercise

    Energy Technology Data Exchange (ETDEWEB)

    Schweitzer, M.E.; Natale, P.; Winalski, C.S.; Culp, R. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States)

    2000-01-01

    Purpose. In the wrist, to determine whether passive motion or active exercise yields a better indirect MR arthrographic effect following intravenous gadolinium administration.Design and patients. Twenty-six consecutive patients were studied by indirect wrist MR arthrography. In half active exercise and in half passive motion was performed. Four regions of interest were studied including the distal radioulnar joint, the radiocarpal joint, the midcarpal joint, and the triangular fibrocartilage. Ranges and means of signal intensity were calculated. Surgical follow-up was performed in 22 patients.Results. The joint fluid intensity was greatest in the distal radioulnar joint. Fluid signal intensity was greater and more consistent in the passive motion group although the results did not achieve statistical significance. Imaging accuracy appeared similar in the two groups and was excellent for the triangular fibrocartilage (100%) and scapholunate ligaments (96%).Conclusion. Active exercise and passive motion yield similar degrees of wrist arthrographic effect, but the effect of passive motion is somewhat more consistent. Preliminary data show good accuracy for internal derangements. (orig.)

  16. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  17. Passive and active protection of cotton textiles

    NARCIS (Netherlands)

    Bochove, C. van

    1967-01-01

    In rotproofing of cotton a distinction is made between passive and active protection. In passive protection, the structure of the cotton fibre is modified in such a way that the fibre can longer be attacked. This modification of structure can be effected on different levels: microscopical,

  18. Influence of passivation process on chip performance

    NARCIS (Netherlands)

    Lu, J.; Kovalgin, Alexeij Y.; Schmitz, Jurriaan

    2009-01-01

    In this work, we have studied the performance of CMOS chips before and after a low temperature post-processing step. In order to prevent damage to the IC chips by the post-processing steps, a first passivation layers is needed on top of the IC chips. Two different passivation layer deposition

  19. Passive and Portable Polymer Optical Fiber Cleaver

    DEFF Research Database (Denmark)

    Saez-Rodriguez, D.; Min, R.; Ortega, B.

    2016-01-01

    opening up the possibility of an electrically passive cleaver. In this letter, we describe the implementation and testing of a high quality cleaver based on a mechanical system formed by a constant force spring and a damper, which leads to the first reported electrical passive and portable cleaver....

  20. Passive house networks : How can they deliver?

    NARCIS (Netherlands)

    Mlecnik, E.

    2009-01-01

    This paper examines experiences with the diffusion of the passive house concept, applied to the situation of ‘emerging’ countries like Belgium and the Netherlands. Adopter categories considering the passive house concept are defined. A marketing study based on Rogers’ theory of diffusion of

  1. Passive Solar Construction--Design and Performance.

    Science.gov (United States)

    Conservation and Renewable Energy Inquiry and Referral Service (DOE), Silver Spring, MD.

    Presented is a list of books and reports intended to serve as technical sources of information for the building professional interested in energy conservation. These publications are grouped under these headings: (1) energy-conserving building design; (2) passive systems/design; (3) passive systems/performance; and (4) proceedings (of the American…

  2. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  3. Multi-channel, passive, short-range anti-aircraft defence system

    Science.gov (United States)

    Gapiński, Daniel; Krzysztofik, Izabela; Koruba, Zbigniew

    2018-01-01

    The paper presents a novel method for tracking several air targets simultaneously. The developed concept concerns a multi-channel, passive, short-range anti-aircraft defence system based on the programmed selection of air targets and an algorithm of simultaneous synchronisation of several modified optical scanning seekers. The above system is supposed to facilitate simultaneous firing of several self-guided infrared rocket missiles at many different air targets. From the available information, it appears that, currently, there are no passive self-guided seekers that fulfil such tasks. This paper contains theoretical discussions and simulations of simultaneous detection and tracking of many air targets by mutually integrated seekers of several rocket missiles. The results of computer simulation research have been presented in a graphical form.

  4. Population Games, Stable Games, and Passivity

    Directory of Open Access Journals (Sweden)

    Michael J. Fox

    2013-10-01

    Full Text Available The class of “stable games”, introduced by Hofbauer and Sandholm in 2009, has the attractive property of admitting global convergence to equilibria under many evolutionary dynamics. We show that stable games can be identified as a special case of the feedback-system-theoretic notion of a “passive” dynamical system. Motivated by this observation, we develop a notion of passivity for evolutionary dynamics that complements the definition of the class of stable games. Since interconnections of passive dynamical systems exhibit stable behavior, we can make conclusions about passive evolutionary dynamics coupled with stable games. We show how established evolutionary dynamics qualify as passive dynamical systems. Moreover, we exploit the flexibility of the definition of passive dynamical systems to analyze generalizations of stable games and evolutionary dynamics that include forecasting heuristics as well as certain games with memory.

  5. Considerations on nuclear reactor passive safety systems

    International Nuclear Information System (INIS)

    2016-01-01

    After having indicated some passive safety systems present in electronuclear reactors (control bars, safety injection system accumulators, reactor cooling after stoppage, hydrogen recombination systems), this report recalls the main characteristics of passive safety systems, and discusses the main issues associated with the assessment of new passive systems (notably to face a sustained loss of electric supply systems or of cold water source) and research axis to be developed in this respect. More precisely, the report comments the classification of safety passive systems as it is proposed by the IAEA, outlines and comments specific aspects of these systems regarding their operation and performance. The next part discusses the safety approach, the control of performance of safety passive systems, issues related to their reliability, and the expected contribution of R and D (for example: understanding of physical phenomena which have an influence of these systems, capacities of simulation of these phenomena, needs of experimentations to validate simulation codes)

  6. Passive systems for light water reactors

    International Nuclear Information System (INIS)

    Adinolfi, R.; Noviello, L.

    1990-01-01

    The paper reviews the most original concepts that have been considered in Italy for the back-fitting of the nuclear power plants in order to reduce the probability and the importance of the release to the environment in case of a core melt. With reference either to BWR or PWR, passive concepts have been considered for back-fitting in the following areas: pump seals damage prevention and ECCS passive operation; reactor passive depressurization; molten reactor core passive cooling; metal containment passive water cooling through a water tank located at high level; containment isolation improvement through a sealing system; containment leaks control and limitation of environmental release. In addition some considerations will be made on the protection against external events introduced from the beginning on the PUN design either on building and equipment lay-out either on structure design. (author). 5 figs

  7. State of the art on hydrogen passive auto-catalytic recombiner (european union Parsoar project)

    International Nuclear Information System (INIS)

    Arnould, F.; Bachellerie, E.; Auglaire, M.; Boeck, B. de; Braillard, O.; Eckardt, B.; Ferroni, F.; Moffett, R.; Van Goethem, G.

    2001-01-01

    This paper presents an overview of the European Union PARSOAR project, which consists in carrying out a state of the art on hydrogen passive auto-catalytic recombiner (PAR) and a handbook guide for implementing these devices in nuclear power plants. This work is performed in the area ''Operational Safety of Existing Installations'' of the key action ''Nuclear Fission'' of the fifth Euratom Framework Programme (1998-2002). (author)

  8. State of the art on hydrogen passive auto-catalytic recombiner (european union Parsoar project)

    Energy Technology Data Exchange (ETDEWEB)

    Arnould, F.; Bachellerie, E. [Technicatome, 13 - Aix en Provence (France); Auglaire, M. [Tractebel Energy Engineering, Brussels (Belgium); Boeck, B. de [Association Vincotte Nuclear, Brussels (Belgium); Braillard, O. [CEA Cadarache, 13 - Saint Paul lez Durance (France); Eckardt, B. [Siemens AG, Offenbach am Main (Germany); Ferroni, F. [Electrowatt Engineering Limited, Zurich (Switzerland); Moffett, R. [Atomic Energy Canada Limited, Pinawa (Canada); Van Goethem, G. [European Commission, Brussels (Belgium)

    2001-07-01

    This paper presents an overview of the European Union PARSOAR project, which consists in carrying out a state of the art on hydrogen passive auto-catalytic recombiner (PAR) and a handbook guide for implementing these devices in nuclear power plants. This work is performed in the area ''Operational Safety of Existing Installations'' of the key action ''Nuclear Fission'' of the fifth Euratom Framework Programme (1998-2002). (author)

  9. Passivity-based design of robust passive damping for LCL-filtered voltage source converters

    DEFF Research Database (Denmark)

    Wang, Xiongfei; Blaabjerg, Frede; Loh, Poh Chiang

    2015-01-01

    Passive damping is proven as a robust stabilizing technique for LCL-filtered voltage source converters. However, conventional design methods of passive dampers are based on the passive components only, while the inherent damping effect of time delay in the digital control system is overlooked....... In this paper, a frequency-domain passivity-based design approach is proposed, where the passive dampers are designed to eliminate the negative real part of the converter output admittance with closed-loop current control, rather than shaping the LCL-filter itself. Thus, the influence of time delay...... in the current control is included, which allows a relaxed design of the passive damper with the reduced power loss and improved stability robustness against grid parameters variations. Design procedures of two commonly used passive dampers with LCL-filtered VSCs are illustrated. Experimental results validate...

  10. A projective surgical navigation system for cancer resection

    Science.gov (United States)

    Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald

    2016-03-01

    Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

  11. Epilepsy with temporal encephalocele: Characteristics of electrocorticography and surgical outcome.

    Science.gov (United States)

    Panov, Fedor; Li, Yi; Chang, Edward F; Knowlton, Robert; Cornes, Susannah B

    2016-02-01

    Temporal lobe encephaloceles (TEs) are increasingly identified in patients with epilepsy due to advances in neuroimaging. Select patients become seizure-free with lesionectomy. In practice, however, many of these patients will undergo standard anterior temporal lobectomy. Herein we report on the first series of patients with refractory temporal lobe epilepsy (TLE) with encephalocele to undergo chronic or intraoperative electrocorticography (ECoG) in order to characterize the putative epileptogenic nature of these lesions and help guide surgical planning. This retrospective study includes nine adult patients with magnetic resonance imaging/computed tomography (MRI/CT)-defined temporal encephalocele treated between 2007 and 2014 at University of California San Francisco (UCSF). Clinical features, ECoG, imaging, and surgical outcomes are reviewed. Six patients underwent resective epilepsy surgery. Each case demonstrated abnormal epileptiform discharges around the cortical area of the encephalocele. Two underwent tailored lesionectomy and four underwent lesionectomy plus anterior medial temporal resection. Postoperatively, five patients, including both with lesionectomy only, had Engel class Ia surgical outcome, and one had a class IIb surgical outcome. The role of TE in the pathogenesis of epilepsy is uncertain. ECoG can confirm the presence of interictal epileptiform discharges and seizures arising from these lesions. Patients overall had a very good surgical prognosis, even with selective surgical approaches. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  12. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  13. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  14. German disease management guidelines: surgical therapies for chronic heart failure.

    Science.gov (United States)

    Sindermann, J R; Klotz, S; Rahbar, K; Hoffmeier, A; Drees, G

    2010-02-01

    The German Disease Management Guideline "Chronic Heart Failure" intends to guide physicians working in the field of diagnosis and treatment of heart failure. The guideline provides a tool on the background of evidence based medicine. The following short review wants to give insights into the role of some surgical treatment options to improve heart failure, such as revascularization, ventricular reconstruction and aneurysmectomy, mitral valve reconstruction, ventricular assist devices and heart transplantation. (c) Georg Thieme Verlag KG Stuttgart-New York.

  15. Revealing Nanoscale Passivation and Corrosion Mechanisms of Reactive Battery Materials in Gas Environments.

    Science.gov (United States)

    Li, Yuzhang; Li, Yanbin; Sun, Yongming; Butz, Benjamin; Yan, Kai; Koh, Ai Leen; Zhao, Jie; Pei, Allen; Cui, Yi

    2017-08-09

    Lithium (Li) metal is a high-capacity anode material (3860 mAh g -1 ) that can enable high-energy batteries for electric vehicles and grid-storage applications. However, Li metal is highly reactive and repeatedly consumed when exposed to liquid electrolyte (during battery operation) or the ambient environment (throughout battery manufacturing). Studying these corrosion reactions on the nanoscale is especially difficult due to the high chemical reactivity of both Li metal and its surface corrosion films. Here, we directly generate pure Li metal inside an environmental transmission electron microscope (TEM), revealing the nanoscale passivation and corrosion process of Li metal in oxygen (O 2 ), nitrogen (N 2 ), and water vapor (H 2 O). We find that while dry O 2 and N 2 (99.9999 vol %) form uniform passivation layers on Li, trace water vapor (∼1 mol %) disrupts this passivation and forms a porous film on Li metal that allows gas to penetrate and continuously react with Li. To exploit the self-passivating behavior of Li in dry conditions, we introduce a simple dry-N 2 pretreatment of Li metal to form a protective layer of Li nitride prior to battery assembly. The fast ionic conductivity and stable interface of Li nitride results in improved battery performance with dendrite-free cycling and low voltage hysteresis. Our work reveals the detailed process of Li metal passivation/corrosion and demonstrates how this mechanistic insight can guide engineering solutions for Li metal batteries.

  16. COATING ALTERNATIVES GUIDE (CAGE) USER'S GUIDE

    Science.gov (United States)

    The guide provides instructions for using the Coating Alternatives GuidE (CAGE) software program, version 1.0. It assumes that the user is familiar with the fundamentals of operating an IBM-compatible personal computer (PC) under the Microsoft disk operating system (MS-DOS). CAGE...

  17. Citric Acid Passivation of Stainless Steel

    Science.gov (United States)

    Yasensky, David; Reali, John; Larson, Chris; Carl, Chad

    2009-01-01

    Passivation is a process for cleaning and providing corrosion protection for stainless steel. Currently, on Kennedy Space Center (KSC), only parts passivated with nitric acid are acceptable for use. KSC disposes of approximately 125gal of concentrated nitric acid per year, and receives many parts from vendors who must also dispose of used nitric acid. Unfortunately, nitric acid presents health and environmental hazards. As a result, several recent industry studies have examined citric acid as an alternative. Implementing a citric acid-based passivation procedure would improve the health and environmental safety aspects of passivation process. However although there is a lack of published studies that conclusively prove citric acid is a technically sound passivation agent. In 2007, NASA's KSC Materials Advisory Working Group requested the evaluation of citric acid in place of nitric acid for passivation of parts at KSC. United Space Alliance Materials & Processes engineers have developed a three-phase test plan to evaluate citric acid as an alternative to nitric acid on three stainless steels commonly used at KSC: UNS S30400, S41000, and S17400. Phases 1 and 2 will produce an optimized citric acid treatment based on results from atmospheric exposure at NASA's Beach Corrosion Facility. Phase 3 will compare the optimized solution(s) with nitric acid treatments. If the results indicate that citric acid passivates as well or better than nitric acid, NASA intends to approve this method for parts used at the Kennedy Space Center.

  18. Evaluating the Relationship between Equilibrium Passive ...

    Science.gov (United States)

    Objectives. This review evaluates passive sampler uptake of hydrophobic organic contaminants (HOCs) in water column and interstitial water exposures as a surrogate for organism bioaccumulation. Approach/Activities. Fifty-five studies were found where both passive sampler uptake and organism bioaccumulation were measured and 19 of these investigations provided direct comparisons relating passive sampler uptake and organism bioaccumulation. Polymers compared included low density polyethylene (LDPE), polyoxymethylene (POM), and polydimethylsiloxane (PDMS), and organisms ranged from polychaetes and oligochaetes to bivalves, aquatic insects, and gastropods. Regression equations correlating bioaccumulation (CL) and passive sampler uptake (CPS) were used to assess the strength of observed relationships. Results/Lessons Learned. Passive sampling based concentrations resulted in strong logarithmic regression relationships, most of which were within one to two orders of magnitude of measured bioaccumulation. Mean coefficients of determination (r2) for LDPE, PDMS and POM were 0.68, 0.76 and 0.58, respectively. For the available raw data, the mean ratio of CL and CPS was 10.8 ± 18.4 (n = 609). Passive sampler uptake and bioaccumulation were not found to be identical (i.e., CPS ≠ CL) but the logarithmic-based relationships between these values were consistently linear and predictive. This review concludes that in many applications passive sampling may serve as a

  19. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  20. Surgical Engineering in Cranio-Maxillofacial Surgery: A Literature Review

    Directory of Open Access Journals (Sweden)

    Raphael Olszewski

    2012-01-01

    Full Text Available A systematic review of the literature concerning surgical engineering in cranio-maxillofacial surgery was performed. APubMed search yielded 1721 papers published between 1999 and 2011. Based on the inclusion/exclusion criteria, 1428 articles were excluded after review of titles and abstracts. Atotal of 292 articles were finally selected covering the following topics: finite element analysis (n = 18, computer-assisted surgery (n = 111, rapid prototyping models (n = 41, preoperative training simulators (n = 4, surgical guides (n = 23, image-guided navigation (n = 58, augmented reality (n = 2, video tracking (n = 1, distraction osteogenesis (n = 19, robotics (n = 8, and minimal invasive surgery (n = 7. The results show that surgical engineering plays a pivotal role in the development and improvement of cranio-maxillofacial surgery. Some technologies, such as computer-assisted surgery, image-guided navigation, and three-dimensional rapid prototyping models, have reached maturity and allow for multiple clinical applications, while augmented reality, robotics, and endoscopy still need to be improved.

  1. VEIL Surgical Steps.

    Science.gov (United States)

    Raghunath, S K; Nagaraja, H; Srivatsa, N

    2017-03-01

    Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes. Inguinal node dissection is a morbid procedure with operative morbidity noted in almost two third of the patients. Video endoscopic inguinal lymphadenectomy (VEIL) was described and currently practiced with proven equivalent oncological outcomes. We describe our technique of VEIL using laparoscopic and robotic access as well as various new surgical strategies.

  2. Passive detection of vehicle loading

    Science.gov (United States)

    McKay, Troy R.; Salvaggio, Carl; Faulring, Jason W.; Salvaggio, Philip S.; McKeown, Donald M.; Garrett, Alfred J.; Coleman, David H.; Koffman, Larry D.

    2012-01-01

    The Digital Imaging and Remote Sensing Laboratory (DIRS) at the Rochester Institute of Technology, along with the Savannah River National Laboratory is investigating passive methods to quantify vehicle loading. The research described in this paper investigates multiple vehicle indicators including brake temperature, tire temperature, engine temperature, acceleration and deceleration rates, engine acoustics, suspension response, tire deformation and vibrational response. Our investigation into these variables includes building and implementing a sensing system for data collection as well as multiple full-scale vehicle tests. The sensing system includes; infrared video cameras, triaxial accelerometers, microphones, video cameras and thermocouples. The full scale testing includes both a medium size dump truck and a tractor-trailer truck on closed courses with loads spanning the full range of the vehicle's capacity. Statistical analysis of the collected data is used to determine the effectiveness of each of the indicators for characterizing the weight of a vehicle. The final sensing system will monitor multiple load indicators and combine the results to achieve a more accurate measurement than any of the indicators could provide alone.

  3. Illegal Passive Smoking at Work

    Directory of Open Access Journals (Sweden)

    François-Xavier Lesage

    2011-01-01

    Results. Ninety-five percent of a total group of 172 OP of Champagne county filled the postal questionnaire. More than 80% of OP's replies identified illegal PSW. The average prevalence of PSW exposure was 0.7% of the total working population. Environmental tobacco smoke (ETS levels were considered between low and medium for most passive smokers (71%. Main features exposure to ETS at work for non-smokers was associated with female gender (69.5%, age between 40 and 49 years (41.2% and belonging to tertiary sector (75.6%. Environmental tobacco smoke exposures at work was firstly in the office for 49.7% of the subjects and secondly in the restroom for 18% of them. Main medical symptoms encountered by non-smokers were respiratory tractus irritation (81.7%. Eighty-three percent of OPs indicated solution to eradicate PSW. Illegal PSW is really weaker than fifteen years ago. However, the findings support a real ban on smoking in the workplace in order to protect all workers.

  4. [Passive euthanasia and living will].

    Science.gov (United States)

    Julesz, Máté

    2014-07-06

    This article deals with the intentional distinction between murder of first degree and passive euthanasia. In Hungary, active euthanasia is considered to be a murder of first degree, whilst the Netherlands, Belgium, Luxemburg and Switzerland have legalized the active form of mercy killing in Europe. The palliative terminal care, when e.g. giving pain-killer morphine to the patient, might result in decreasing the patient's life-span, and thus causing indirect euthanasia. However, the legal institution of living will exists in several counter-euthanasia countries. The living will allows future patients to express their decision in advance to refuse a life-sustaining treatment, e.g. in case of irreversible coma. The institution of living will exists in Germany and in Hungary too. Nevertheless, the formal criteria of living will make it hardly applicable. The patient ought to express his/her will before a notary public in advance, and he/she should hand it over when being hospitalized. If the patient is not able to present his/her living will to his/her doctor in the hospital, then his/her only hope remains that he/she has given a copy of the living will to the family doctor previously, and the family doctor will notify the hospital.

  5. PASSIVE DETECTION OF VEHICLE LOADING

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, A.

    2012-01-03

    The Digital Imaging and Remote Sensing Laboratory (DIRS) at the Rochester Institute of Technology, along with the Savannah River National Laboratory is investigating passive methods to quantify vehicle loading. The research described in this paper investigates multiple vehicle indicators including brake temperature, tire temperature, engine temperature, acceleration and deceleration rates, engine acoustics, suspension response, tire deformation and vibrational response. Our investigation into these variables includes building and implementing a sensing system for data collection as well as multiple full-scale vehicle tests. The sensing system includes; infrared video cameras, triaxial accelerometers, microphones, video cameras and thermocouples. The full scale testing includes both a medium size dump truck and a tractor-trailer truck on closed courses with loads spanning the full range of the vehicle's capacity. Statistical analysis of the collected data is used to determine the effectiveness of each of the indicators for characterizing the weight of a vehicle. The final sensing system will monitor multiple load indicators and combine the results to achieve a more accurate measurement than any of the indicators could provide alone.

  6. Passive fault current limiting device

    Science.gov (United States)

    Evans, Daniel J.; Cha, Yung S.

    1999-01-01

    A passive current limiting device and isolator is particularly adapted for use at high power levels for limiting excessive currents in a circuit in a fault condition such as an electrical short. The current limiting device comprises a magnetic core wound with two magnetically opposed, parallel connected coils of copper, a high temperature superconductor or other electrically conducting material, and a fault element connected in series with one of the coils. Under normal operating conditions, the magnetic flux density produced by the two coils cancel each other. Under a fault condition, the fault element is triggered to cause an imbalance in the magnetic flux density between the two coils which results in an increase in the impedance in the coils. While the fault element may be a separate current limiter, switch, fuse, bimetal strip or the like, it preferably is a superconductor current limiter conducting one-half of the current load compared to the same limiter wired to carry the total current of the circuit. The major voltage during a fault condition is in the coils wound on the common core in a preferred embodiment.

  7. Passive Cooling of Body Armor

    Science.gov (United States)

    Holtz, Ronald; Matic, Peter; Mott, David

    2013-03-01

    Warfighter performance can be adversely affected by heat load and weight of equipment. Current tactical vest designs are good insulators and lack ventilation, thus do not provide effective management of metabolic heat generated. NRL has undertaken a systematic study of tactical vest thermal management, leading to physics-based strategies that provide improved cooling without undesirable consequences such as added weight, added electrical power requirements, or compromised protection. The approach is based on evaporative cooling of sweat produced by the wearer of the vest, in an air flow provided by ambient wind or ambulatory motion of the wearer. Using an approach including thermodynamic analysis, computational fluid dynamics modeling, air flow measurements of model ventilated vest architectures, and studies of the influence of fabric aerodynamic drag characteristics, materials and geometry were identified that optimize passive cooling of tactical vests. Specific architectural features of the vest design allow for optimal ventilation patterns, and selection of fabrics for vest construction optimize evaporation rates while reducing air flow resistance. Cooling rates consistent with the theoretical and modeling predictions were verified experimentally for 3D mockups.

  8. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh

    2013-01-01

    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  9. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.

    2013-01-01

    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  10. [Endoscopic ultrasound guided rendezvous for biliary drainage].

    Science.gov (United States)

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

    2015-04-27

    Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

  11. Passivation Effects in Copper Thin Films

    International Nuclear Information System (INIS)

    Wiederhirn, G.; Nucci, J.; Richter, G.; Arzt, E.; Balk, T. J.; Dehm, G.

    2006-01-01

    We studied the influence of a 10 nm AlxOy passivation on the stress-temperature behavior of 100 nm and 1 μm thick Cu films. At low temperatures, the passivation induces a large tensile stress increase in the 100 nm film; however, its effect on the 1 μm film is negligible. At high temperatures, the opposite behavior is observed; while the passivation does not change the 100 nm film behavior, it strengthens the 1 μm film by driving it deeper into compression. These observations are explained in light of a combination of constrained diffusional creep and dislocation dynamics unique to ultra-thin films

  12. Python passive network mapping P2NMAP

    CERN Document Server

    Hosmer, Chet

    2015-01-01

    Python Passive Network Mapping: P2NMAP is the first book to reveal a revolutionary and open source method for exposing nefarious network activity. The ""Heartbleed"" vulnerability has revealed significant weaknesses within enterprise environments related to the lack of a definitive mapping of network assets. In Python Passive Network Mapping, Chet Hosmer shows you how to effectively and definitively passively map networks. Active or probing methods to network mapping have traditionally been used, but they have many drawbacks - they can disrupt operations, crash systems, and - most important

  13. Non-Chromate Passivation of Zinc

    DEFF Research Database (Denmark)

    Tang, Peter Torben; Bech-Nielsen, G.

    1993-01-01

    Phos). The treatments are within the same concentration region, and they have a mutual pat-ent pending. Although some tests still need to be conducted, the following aspects are clear at the present time: The general appearance of the passivated zinc surface is very similar to a standard yellow chromate treatment...... successfully. The corrosion resistance against white rust on zinc and zinc alloys is just as good as that of yellow chromate, although the result de-pends on the corrosion test method as well as on the nature of the zinc substrate pas-sivated. The passivation procedure is simply a dip for approxi-mately 2...

  14. Planning of solar heated plant for low-energy houses and passive houses. An introduction; Planlegging av solvarmeanlegg for lavenergiboliger og passivhus. En introduksjon

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, Inger

    2008-07-01

    This guide gives an introduction to the most important principles in planning and projecting of solar heated plant in low-energy houses and passive houses. It is written mainly for architects and consultants involved in housing projects with ambitions to achieve low-energy or passive house standard, but will also be of value for builders and others interested in the topic. (AG). 35 refs., 27 figs

  15. Augmented reality in laparoscopic surgical oncology.

    Science.gov (United States)

    Nicolau, Stéphane; Soler, Luc; Mutter, Didier; Marescaux, Jacques

    2011-09-01

    Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient's medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon's intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering. But better results are obtained with surface rendering after organ and pathology delineations and 3D modelling. Registration can be performed interactively or automatically. Several interactive systems have been developed and applied to humans, demonstrating the benefit of AR in surgical oncology. It also shows the current limited interactivity due to soft organ movements and interaction between surgeon instruments and organs. If the current automatic AR systems show the feasibility of such system, it is still relying on specific and expensive equipment which is not available in clinical routine. Moreover, they are not robust enough due to the high complexity of developing a real-time registration taking organ deformation and human movement into account. However, the latest results of automatic AR systems are extremely encouraging and show that it will become a standard requirement for future computer-assisted surgical oncology. In this article, we will explain the concept of AR and its principles. Then, we

  16. [Guided bone regeneration: general survey].

    Science.gov (United States)

    Cosyn, Jan; De Bruyn, Hugo

    2009-01-01

    The principle of 'guided bone regeneration' was first described in 1988 on the basis of animal-experimental data. Six weeks after transmandibular defects had been created and protected by non-resorbable teflonmembranes, complete bone regeneration was found. The technique was based on the selective repopulation of the wound: every infiltration of cells outside the neighbouring bone tissue was prevented by the application of the membrane. Additional animal experiments showed that guided bone regeneration was a viable treatment option for local bone defects surrounding dental implants. Clinical practice, however, showed that premature membrane exposure was a common complication, which was responsible for a tremendous reduction in regenerated bone volume. In addition, a second surgical intervention was always necessary to remove the membrane. As a result, resorbable alternatives were developed. Since these are less rigid, bone fillers are usually used simultaneously. These comprise autogenous bone chips and bone substitutes from allogenic or xenogenic origine. Also alloplastic materials could be used for this purpose. Based on their characteristics this article provides an overview of the biomaterials that could be considered for guided bone regeneration. Specific attention goes to their application in clinical practice.

  17. Development of tumor-targeted near infrared probes for fluorescence guided surgery.

    Science.gov (United States)

    Kelderhouse, Lindsay E; Chelvam, Venkatesh; Wayua, Charity; Mahalingam, Sakkarapalayam; Poh, Scott; Kularatne, Sumith A; Low, Philip S

    2013-06-19

    Complete surgical resection of malignant disease is the only reliable method to cure cancer. Unfortunately, quantitative tumor resection is often limited by a surgeon's ability to locate all malignant disease and distinguish it from healthy tissue. Fluorescence-guided surgery has emerged as a tool to aid surgeons in the identification and removal of malignant lesions. While nontargeted fluorescent dyes have been shown to passively accumulate in some tumors, the resulting tumor-to-background ratios are often poor, and the boundaries between malignant and healthy tissues can be difficult to define. To circumvent these problems, our laboratory has developed high affinity tumor targeting ligands that bind to receptors that are overexpressed on cancer cells and deliver attached molecules selectively into these cells. In this study, we explore the use of two tumor-specific targeting ligands (i.e., folic acid that targets the folate receptor (FR) and DUPA that targets prostate specific membrane antigen (PSMA)) to deliver near-infrared (NIR) fluorescent dyes specifically to FR and PSMA expressing cancers, thereby rendering only the malignant cells highly fluorescent. We report here that all FR- and PSMA-targeted NIR probes examined bind cultured cancer cells in the low nanomolar range. Moreover, upon intravenous injection into tumor-bearing mice with metastatic disease, these same ligand-NIR dye conjugates render receptor-expressing tumor tissues fluorescent, enabling their facile resection with minimal contamination from healthy tissues.

  18. Lipid-Based Passivation in Nanofluidics

    Science.gov (United States)

    2012-01-01

    Stretching DNA in nanochannels is a useful tool for direct, visual studies of genomic DNA at the single molecule level. To facilitate the study of the interaction of linear DNA with proteins in nanochannels, we have implemented a highly effective passivation scheme based on lipid bilayers. We demonstrate virtually complete long-term passivation of nanochannel surfaces to a range of relevant reagents, including streptavidin-coated quantum dots, RecA proteins, and RecA–DNA complexes. We show that the performance of the lipid bilayer is significantly better than that of standard bovine serum albumin-based passivation. Finally, we show how the passivated devices allow us to monitor single DNA cleavage events during enzymatic degradation by DNase I. We expect that our approach will open up for detailed, systematic studies of a wide range of protein–DNA interactions with high spatial and temporal resolution. PMID:22432814

  19. Hydrodynamic interaction between bacteria and passive sphere

    Science.gov (United States)

    Zhang, Bokai; Ding, Yang; Xu, Xinliang

    2017-11-01

    Understanding hydrodynamic interaction between bacteria and passive sphere is important for identifying rheological properties of bacterial and colloidal suspension. Over the past few years, scientists mainly focused on bacterial influences on tracer particle diffusion or hydrodynamic capture of a bacteria around stationary boundary. Here, we use superposition of singularities and regularized method to study changes in bacterial swimming velocity and passive sphere diffusion, simultaneously. On this basis, we present a simple two-bead model that gives a unified interpretation of passive sphere diffusion and bacterial swimming. The model attributes both variation of passive sphere diffusion and changes of speed of bacteria to an effective mobility. Using the effective mobility of bacterial head and tail as an input function, the calculations are consistent with simulation results at a broad range of tracer diameters, incident angles and bacterial shapes.

  20. Decision Support on Small size Passive Samples

    Directory of Open Access Journals (Sweden)

    Vladimir Popukaylo

    2018-05-01

    Full Text Available A construction technique of adequate mathematical models for small size passive samples, in conditions when classical probabilistic-statis\\-tical methods do not allow obtaining valid conclusions was developed.

  1. Experiments, Passive Observation and Scenario Analysis

    DEFF Research Database (Denmark)

    Hoover, Kevin D.; Juselius, Katarina

    The paper provides a careful, analytical account of Trygve Haavelmo's unsystematic, but important, use of the analogy between controlled experiments common in the natural sciences and econometric techniques. The experimental analogy forms the linchpin of the methodology for passive observation...

  2. Thermophysiological adaptations to passive mild heat acclimation

    NARCIS (Netherlands)

    Pallubinsky, H; Schellen, L; Kingma, B R M; Dautzenberg, B; van Baak, M A; van Marken Lichtenbelt, W D

    Passive mild heat acclimation (PMHA) reflects realistic temperature challenges encountered in everyday life. Active heat acclimation, combining heat exposure and exercise, influences several important thermophysiological parameters; for example, it decreases core temperature and enhances heat

  3. Passive water and ion transport by cotransporters

    DEFF Research Database (Denmark)

    Loo, D D; Hirayama, B A; Meinild, A K

    1999-01-01

    the Lp of control oocytes. Passive Na+ transport (Na+ leak) was obtained from the blocker-sensitive Na+ currents in the absence of substrates (glucose and GABA). 2. Passive Na+ and water transport through SGLT1 were blocked by phlorizin with the same sensitivity (inhibitory constant (Ki), 3-5 micro......1. The rabbit Na+-glucose (SGLT1) and the human Na+-Cl--GABA (GAT1) cotransporters were expressed in Xenopus laevis oocytes, and passive Na+ and water transport were studied using electrical and optical techniques. Passive water permeabilities (Lp) of the cotransporters were determined from......M). When Na+ was replaced with Li+, phlorizin also inhibited Li+ and water transport, but with a lower affinity (Ki, 100 microM). When Na+ was replaced by choline, which is not transported, the SGLT1 Lp was indistinguishable from that in Na+ or Li+, but in this case water transport was less sensitive...

  4. Climate-Specific Passive Building Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Graham S. [Building Science Corp., Westford, MA (United States); Klingenberg, Katrin [Building Science Corp., Westford, MA (United States)

    2015-07-29

    In 2012, the U.S. Department of Energy (DOE) recognized the value of performance-based passive building standards when it joined with Passive House Institute US (PHIUS) to promote DOE’s Challenge Home program in tandem with the PHIUS+ Certification program. Since then, the number of passive building projects that have been certified under the partnership has grown exponentially because of some synergy. Passive building represents a well-developed approach to arrive at the envelope basis for zero energy and energy-positive projects by employing performance-based criteria and maximizing cost-effective savings from conservation before implementing renewable energy technologies. The Challenge Home program evolved into the Zero Energy Ready Home (ZERH) program in a move toward 1) attaining zero energy and 2) including active renewable energy generation such as photovoltaics (PV)—toward the zero energy goal.

  5. Symmetry Breaking in a random passive scalar

    Science.gov (United States)

    Kilic, Zeliha; McLaughlin, Richard; Camassa, Roberto

    2017-11-01

    We consider the evolution of a decaying passive scalar in the presence of a gaussian white noise fluctuating shear flow. We focus on deterministic initial data and establish the short, intermediate, and long time symmetry properties of the evolving point wise probability measure for the random passive scalar. Analytical results are compared directly to Monte Carlo simulations. Time permitting we will compare the predictions to experimental observations.

  6. Comprehensive Planning for Passive Solar Architectural Retrofit

    Science.gov (United States)

    1980-05-01

    technical information, and the natural environ- ment. Since the Air Force Energy plan stresses Passive Solar (Architecture) before using Active Solar...retrofitted by-1990, and the Air Force Energy Plan stresses Passive Solar Applications. Bdcause of this requirement, you must consider the following retrofit...OF THI SUN AT NOON ON O CUMIN 21 EXAWMKU[ AT 3M. AN I S - W Figure 12-4 12-3 Skylight- use a reflector ,with horizontal skylights to ,iincrease solar

  7. An All-Silicon Passive Optical Diode

    OpenAIRE

    Fan, Li; Wang, Jian; Varghese, Leo T.; Shen, Hao; Niu, Ben; Xuan, Yi; Weiner, Andrew M.; Qi, Minghao

    2011-01-01

    A passive optical diode effect would be useful for on-chip optical information processing but has been difficult to achieve. Using a method based on optical nonlinearity, we demonstrate a forward-backward transmission ratio of up to 28 decibels within telecommunication wavelengths. Our device, which uses two silicon rings 5 micrometers in radius, is passive yet maintains optical nonreciprocity for a broad range of input power levels, and it performs equally well even if the backward input pow...

  8. Technical - Economic Research for Passive Buildings

    Science.gov (United States)

    Miniotaite, Ruta

    2017-10-01

    A newly constructed passive house must save 80 % of heat resources; otherwise it is not a passive house. The heating energy demand of a passive building is less than 15 kWh/m2 per year. However, a passive house is something more than just an energy-saving house. This concept involves sustainable, high-quality, valuable, healthy and durable construction. Features of a passive house: high insulation of envelope components, high-quality windows, good tightness of the building, regenerative ventilation system and elimination of thermal bridges. The Energy Performance of Buildings Directive (EPBD) 61 requires all new public buildings to become near-zero energy buildings by 2019 and will be extended to all new buildings by 2021. This concept involves sustainable, high-quality, valuable, healthy and durable construction. Foundation, walls and roofs are the most essential elements of a house. The type of foundation for a private house is selected considering many factors. The article examines technological and structural solutions for passive buildings foundation, walls and roofs. The technical-economic comparison of the main structures of a passive house revealed that it is cheaper to install an adequately designed concrete slab foundation than to build strip or pile foundation and the floor separately. Timber stud walls are the cheapest wall option for a passive house and 45-51% cheaper compared to other options. The comparison of roofs and ceilings showed that insulation of the ceiling is 25% more efficient than insulation of the roof. The comparison of the main envelope elements efficiency by multiple-criteria evaluation methods showed that it is economically feasible to install concrete slab on ground foundation, stud walls with sheet cladding and a pitched roof with insulated ceiling.

  9. Active and passive cooling methods for dwellings

    DEFF Research Database (Denmark)

    Oropeza-Perez, Ivan; Østergaard, Poul Alberg

    2018-01-01

    In this document a review of three active as well as ten passive cooling methods suitable for residential buildings is carried out. The review firstly addresses how the various technologies cool the space according to the terms of the building heat balance, under what technical conditions...... ventilation, controlled ventilation, roof coating and eco-evaporative cooling are the most suitable passive methods for an extensive use in this country....

  10. New Frontiers in Passive and Active Nanoantennas

    DEFF Research Database (Denmark)

    Arslanagic, Samel; Ziolkowski, Richard W.

    2017-01-01

    The articles included in this special section focus on several recent advances in the field of passive and active nanoantennas that employ not only traditional based realizations but also their new frontiers.......The articles included in this special section focus on several recent advances in the field of passive and active nanoantennas that employ not only traditional based realizations but also their new frontiers....

  11. Uncertainty Prediction in Passive Target Motion Analysis

    Science.gov (United States)

    2016-05-12

    Number 15/152,696 Filing Date 12 May 2016 Inventor John G. Baylog et al Address any questions concerning this matter to the Office of...300118 1 of 25 UNCERTAINTY PREDICTION IN PASSIVE TARGET MOTION ANALYSIS STATEMENT OF GOVERNMENT INTEREST [0001] The invention described herein...at an unknown location and following an unknown course relative to an observer 12. Observer 12 has a sensor array such as a passive sonar or radar

  12. Feasibility of passive heat removal systems

    Energy Technology Data Exchange (ETDEWEB)

    Ashurko, Yu M [Institute of Physics and Power Engineering, Obninsk (Russian Federation)

    1996-12-01

    This paper presents a review of decay heat removal systems (DHRSs) used in liquid metal-cooled fast reactors (LMFRs). Advantages and the disadvantages of these DHRSs, extent of their passivity and prospects for their use in advanced fast reactor projects are analyzed. Methods of extending the limitations on the employment of individual systems, allowing enhancement in their effectiveness as safety systems and assuring their total passivity are described. (author). 10 refs, 10 figs.

  13. Architectural design of passive solar residential building

    Directory of Open Access Journals (Sweden)

    Ma Jing

    2015-01-01

    Full Text Available This paper studies thermal environment of closed balconies that commonly exist in residential buildings, and designs a passive solar residential building. The design optimizes the architectural details of the house and passive utilization of solar energy to provide auxiliary heating for house in winter and cooling in summer. This design might provide a more sufficient and reasonable modification for microclimate in the house.

  14. Brookfield Homes Passive House Performance Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Herk, A. [IBACOS, Inc., Pittsburgh, PA (United States); Poerschke, A. [IBACOS, Inc., Pittsburgh, PA (United States); Beach, R. [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-02-01

    In 2012-2013, IBACOS worked with a builder, Brookfield Homes in Denver, Colorado, to design and construct a Passive House certified model home. IBACOS used several modeling programs and calculation methods to complete the final design package along with Brookfield's architect KGA Studio. This design package included upgrades to the thermal enclosure, basement insulation, windows, and heating, ventilation, and air conditioning. Short-term performance testing in the Passive House was done during construction and after construction.

  15. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY. January 2016 Volume 13 Issue 1 1. EDITORIAL. Access to Specialized Surgical Care. Saidi H. University of Nairobi. Correspondence to: Prof Hassan Saidi, P.O Box 30196-00100, Nairobi. Email: hsaid2ke@yahoo.com. Ann Afr Surg. 2016;13(1):1-2. The narrative of surgical disease in ...

  16. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  17. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  18. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  19. Passive Safety Features for Small Modular Reactors

    International Nuclear Information System (INIS)

    Ingersoll, Daniel T.

    2010-01-01

    The rapid growth in the size and complexity of commercial nuclear power plants in the 1970s spawned an interest in smaller, simpler designs that are inherently or intrinsically safe through the use of passive design features. Several designs were developed, but none were ever built, although some of their passive safety features were incorporated into large commercial plant designs that are being planned or built today. In recent years, several reactor vendors are actively redeveloping small modular reactor (SMR) designs with even greater use of passive features. Several designs incorporate the ultimate in passive safety they completely eliminate specific accident initiators from the design. Other design features help to reduce the likelihood of an accident or help to mitigate the accidents consequences, should one occur. While some passive safety features are common to most SMR designs, irrespective of the coolant technology, other features are specific to water, gas, or liquid-metal cooled SMR designs. The extensive use of passive safety features in SMRs promise to make these plants highly robust, protecting both the general public and the owner/investor. Once demonstrated, these plants should allow nuclear power to be used confidently for a broader range of customers and applications than will be possible with large plants alone.

  20. Active versus passive screening for entrance control

    International Nuclear Information System (INIS)

    McCormick, N.J.

    1976-01-01

    The benefits of different entrance control actions are quantitatively assessed by defining a relative improvement index for the screening activity. Three classes of entrance control measures are investigated: the use of a purely active screening measure (such as a portal monitor), the use of a purely passive screening measure (such as personality typing), and the combined use of active and passive measures. Active entrance control measures have been studied previously [McCormick and Erdmann, Nucl. Mat. Manag. 4, (1975)] where it was determined that the relative improvement index is approximately related to the nondetection probability factor r for the protective system by (1-r + r ln r). It is shown here that the relative improvement index for a purely passive screening system also can be approximately expressed in a convenient manner. Because the probability is very small that a sabotage or diversion action would be attempted, the result for passive screening, multiplied by r, may be combined with the factor (1-r + r ln r) to give the relative improvement index for a combined, active-and-passive entrance control system. Results from simple example calculations indicate that passive screening of nuclear plant personnel or applicants for such positions is orders-of-magnitude less effective than portal monitors or reasonable improvements in them. 5 tables

  1. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.

    2015-05-01

    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  2. Compact instrument for fluorescence image-guided surgery

    Science.gov (United States)

    Wang, Xinghua; Bhaumik, Srabani; Li, Qing; Staudinger, V. Paul; Yazdanfar, Siavash

    2010-03-01

    Fluorescence image-guided surgery (FIGS) is an emerging technique in oncology, neurology, and cardiology. To adapt intraoperative imaging for various surgical applications, increasingly flexible and compact FIGS instruments are necessary. We present a compact, portable FIGS system and demonstrate its use in cardiovascular mapping in a preclinical model of myocardial ischemia. Our system uses fiber optic delivery of laser diode excitation, custom optics with high collection efficiency, and compact consumer-grade cameras as a low-cost and compact alternative to open surgical FIGS systems. Dramatic size and weight reduction increases flexibility and access, and allows for handheld use or unobtrusive positioning over the surgical field.

  3. Passive film growth on carbon steel and its nanoscale features at various passivating potentials

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yuan; Cheng, Y. Frank, E-mail: fcheng@ucalgary.ca

    2017-02-28

    Highlights: • Imaged the topography of passivated steel at various film-forming potentials. • Characterized the nanoscale features of passive films. • Determined the composition of passive films formed at various potentials. - Abstract: In this work, the passivation and topographic sub-structure of passive films on a carbon steel in a carbonate/bicarbonate solution was characterized by electrochemical measurements, atomic force microscopy and X-ray photoelectron spectroscopy. When passivating at a potential near the active-passive transition, the film contains the mixture of Fe{sub 3}O{sub 4}, Fe{sub 2}O{sub 3} and FeOOH, with numerous nanoscale features. As the film-forming potential shifts positively, the passive film becomes more compact and the nanoscale features disappear. When the film is formed at a passive potential where the oxygen evolution is enabled, the content of FeOOH in the film increases, resulting in an amorphous topography and reduced corrosion resistance.

  4. Passivity and passivity breakdown of 304L stainless steel in hot and concentrated nitric acid

    International Nuclear Information System (INIS)

    Gillard-Tcharkhtchi, Elsa

    2014-01-01

    The objective of this study is to characterize the oxidation behavior of 304L stainless steel (SS) in representative conditions of spent nuclear fuel reprocessing, i.e. in hot and concentrated nitric acid. In these conditions the SS electrochemical potential is in the passive domain and its corrosion rate is low. However when the media becomes more aggressive, the potential may be shifted towards the trans-passive domain characterized with a high corrosion rate. Passivity and passivity breakdown in the trans-passive domain are of a major interest for the industry. So as to characterize these phenomenons, this work was undertaken with the following representative conditions: a 304L SS from an industrial sheet was studied, the media was hot and concentrated HNO 3 , long term tests were performed. First, the surface of an immersed 304L SS was characterized with several complementary techniques from the micro to the nanometer scale. Then oxidation kinetics was studied in the passive and in the trans-passive domain. The oxidation behavior was studied thanks to weight loss determination and surface analysis. Finally, oxidation evolution as a function of the potential was studied from the passive to the trans-passive domain. In particular, this allowed us to obtain the anodic curve of 304L SS in hot and concentrated and to define precisely the 304L SS limits of in such conditions. (author) [fr

  5. Output control of da Vinci surgical system's surgical graspers.

    Science.gov (United States)

    Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar

    2014-01-01

    The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Image-guidance for surgical procedures

    International Nuclear Information System (INIS)

    Peters, Terry M

    2006-01-01

    Contemporary imaging modalities can now provide the surgeon with high quality three- and four-dimensional images depicting not only normal anatomy and pathology, but also vascularity and function. A key component of image-guided surgery (IGS) is the ability to register multi-modal pre-operative images to each other and to the patient. The other important component of IGS is the ability to track instruments in real time during the procedure and to display them as part of a realistic model of the operative volume. Stereoscopic, virtual- and augmented-reality techniques have been implemented to enhance the visualization and guidance process. For the most part, IGS relies on the assumption that the pre-operatively acquired images used to guide the surgery accurately represent the morphology of the tissue during the procedure. This assumption may not necessarily be valid, and so intra-operative real-time imaging using interventional MRI, ultrasound, video and electrophysiological recordings are often employed to ameliorate this situation. Although IGS is now in extensive routine clinical use in neurosurgery and is gaining ground in other surgical disciplines, there remain many drawbacks that must be overcome before it can be employed in more general minimally-invasive procedures. This review overviews the roots of IGS in neurosurgery, provides examples of its use outside the brain, discusses the infrastructure required for successful implementation of IGS approaches and outlines the challenges that must be overcome for IGS to advance further. (topical review)

  7. Surgical management and clinical prognosis of adrenocortical carcinoma.

    Science.gov (United States)

    Dong, Dexin; Li, Hanzhong; Yan, Weigang; Ji, Zhigang; Mao, Quanzong

    2012-01-01

    To study the relationship between surgical management and prognosis of adrenocortical carcinoma (ACC) in order to guide the surgical management of ACC. Clinical data of 45 cases of ACC treated in our hospital were retrospectively analyzed. The 45 cases included 3 cases in stage I, 12 cases in stage II, 7 cases in stage III, and 23 cases in stage IV. 17 cases underwent complete excision, 14 cases underwent palliative excision, 8 cases had non-operative treatment and 6 cases gave up treatment. All patients were followed up from 2 to 141 months. The average survival time of 31 patients with surgery was 32.46 months, and the average survival time of 14 patients without surgery was 4.75 months. There were statistically significant differences between the two groups (p 0.05). Surgery is considered to be the only method to cure ACC. For ACC in stage I and II, tumor resection is the most effective treatment, and second surgical operation is recommended for local recurrence. For ACC in stage III, extensive surgical operation is recommended, and for ACC in stage IV, surgical operation has no effect on the prognosis. Copyright © 2012 S. Karger AG, Basel.

  8. Surgical Education's 100 Most Cited Articles: A Bibliometric Analysis.

    Science.gov (United States)

    Matthews, Alexander H; Abdelrahman, Tarig; Powell, Arfon G M T; Lewis, Wyn G

    2016-01-01

    Bibliometric analysis highlights the key topics and publications, which have shaped surgical education. Here, the 100 most cited articles in the arena of surgical education were analyzed. Thomson Reuters Web of Science was interrogated using the keyword search terms "surgery" and ("learning" or "skills" or "competence" or "assessment" or "training" or "procedure-based assessments" or "performance" or "technical skills" or "curriculum" or "education" or "mentoring"] to identify all English language full articles, and the 100 most cited articles were analyzed by topic, journal, author, year, institution, and country of origin. A total of 403,733 eligible articles were returned and the median citation number was 164 (range: 107-1018). The most cited article (by Seymour, Yale University School of Medicine, Annals of Surgery, 1018 citations) focused on the use of virtual reality surgical simulation training. Annals of Surgery published the highest number of articles and received the most citations (n = 16, 3715 citations). The countries with the greatest number of publications were the USA (n = 45), Canada (n = 19), and the UK (n = 18). The commonest topics included simulation (n = 45) and assessment of clinical competence (n = 40). Surgical skill acquisition and assessment was the area of focus of 85% of the most cited contemporary articles, and this study provides the most cited references, serving as a guide as to what makes a citable published work in the field of surgical education. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Optimization in multi-implant placement for immediate loading in edentulous arches using a modified surgical template and prototyping: a case report.

    Science.gov (United States)

    Jayme, Sérgio J; Muglia, Valdir A; de Oliveira, Rafael R; Novaes, Arthur B Júnior

    2008-01-01

    Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance throughout the treatment period. Placement of dental implants requires precise planning that accounts for anatomic limitations and restorative goals. Diagnosis can be made with the assistance of computerized tomographic scanning, but transfer of planning to the surgical field is limited. Recently, novel CAD/CAM techniques such as stereolithographic rapid prototyping have been developed to build surgical guides in an attempt to improve precision of implant placement. The aim of this case report was to show a modified surgical template used throughout implant placement as an alternative to a conventional surgical guide.

  10. Passivation of fluorinated activated charcoal

    International Nuclear Information System (INIS)

    Del Cul, G.D.; Trowbridge, L.D.; Simmons, D.W.; Williams, D.F.; Toth, L.M.

    1997-10-01

    The Molten Salt Reactor Experiment (MSRE), at the Oak Ridge National Laboratory has been shut down since 1969 when the fuel salt was drained from the core into two Hastelloy N tanks at the reactor site. In 1995, a multiyear project was launched to remediate the potentially hazardous conditions generated by the movement of fissile material and reactive gases from the storage tanks into the piping system and an auxiliary charcoal bed (ACB). The top 12 in. of the ACB is known by gamma scan and thermal analysis to contain about 2.6 kg U-233. According to the laboratory tests, a few feet of fluorinated charcoal are believed to extend beyond the uranium front. The remainder of the ACB should consist of unreacted charcoal. Fluorinated charcoal, when subjected to rapid heating, can decompose generating gaseous products. Under confined conditions, the sudden exothermic decomposition can produce high temperatures and pressures of near-explosive characteristics. Since it will be necessary to drill and tap the ACB to allow installation of piping and instrumentation for remediation and recovery activities, it is necessary to chemically convert the reactive fluorinated charcoal into a more stable material. Ammonia can be administered to the ACB as a volatile denaturing agent that results in the conversion of the C x F to carbon and ammonium fluoride, NH 4 F. The charcoal laden with NH 4 F can then be heated without risking any sudden decomposition. The only consequence of heating the treated material will be the volatilization of NH 4 F as a mixture of NH 3 and HF, which would primarily recombine as NH 4 F on surfaces below 200 C. The planned scheme for the ACB denaturing is to flow diluted ammonia gas in steps of increasing NH 3 concentration, 2% to 50%, followed by the injection of pure ammonia. This report summarizes the planned passivation treatment scheme to stabilize the ACB and remove the potential hazards. It also includes basic information, results of laboratory tests

  11. Passivation of fluorinated activated charcoal

    Energy Technology Data Exchange (ETDEWEB)

    Del Cul, G.D.; Trowbridge, L.D.; Simmons, D.W.; Williams, D.F.; Toth, L.M.

    1997-10-01

    The Molten Salt Reactor Experiment (MSRE), at the Oak Ridge National Laboratory has been shut down since 1969 when the fuel salt was drained from the core into two Hastelloy N tanks at the reactor site. In 1995, a multiyear project was launched to remediate the potentially hazardous conditions generated by the movement of fissile material and reactive gases from the storage tanks into the piping system and an auxiliary charcoal bed (ACB). The top 12 in. of the ACB is known by gamma scan and thermal analysis to contain about 2.6 kg U-233. According to the laboratory tests, a few feet of fluorinated charcoal are believed to extend beyond the uranium front. The remainder of the ACB should consist of unreacted charcoal. Fluorinated charcoal, when subjected to rapid heating, can decompose generating gaseous products. Under confined conditions, the sudden exothermic decomposition can produce high temperatures and pressures of near-explosive characteristics. Since it will be necessary to drill and tap the ACB to allow installation of piping and instrumentation for remediation and recovery activities, it is necessary to chemically convert the reactive fluorinated charcoal into a more stable material. Ammonia can be administered to the ACB as a volatile denaturing agent that results in the conversion of the C{sub x}F to carbon and ammonium fluoride, NH{sub 4}F. The charcoal laden with NH{sub 4}F can then be heated without risking any sudden decomposition. The only consequence of heating the treated material will be the volatilization of NH{sub 4}F as a mixture of NH{sub 3} and HF, which would primarily recombine as NH{sub 4}F on surfaces below 200 C. The planned scheme for the ACB denaturing is to flow diluted ammonia gas in steps of increasing NH{sub 3} concentration, 2% to 50%, followed by the injection of pure ammonia. This report summarizes the planned passivation treatment scheme to stabilize the ACB and remove the potential hazards. It also includes basic information

  12. On-call emergency workload of a general surgical team.

    Science.gov (United States)

    Jawaid, Masood; Raza, Syed Muhammad; Alam, Shams Nadeem; Manzar, S

    2009-01-01

    To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients. Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  13. On-call emergency workload of a general surgical team

    Directory of Open Access Journals (Sweden)

    Jawaid Masood

    2009-01-01

    Full Text Available Background: To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. Patients and Methods: During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Results: Total 456 patients (326 males and 130 females were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9% were received from 8 am to 5 pm. 224 (49.1% calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0% patients. Total 73 (16.0% calls were received for trauma. Total 131 (28.7% patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5% patients were discharged from A and E. 92 (20.1% patients were referred to other units with medical referral accounts for 45 (9.8% patients. Total 104 (22.8% emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7% patients. Conclusion: Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  14. Routine ultrasound guided evacuation of first trimester missed abortion versus blind evacuation

    OpenAIRE

    Mostafa Abdulla Elsayed

    2014-01-01

    Background: The clinical management of miscarriage has changed little over the years and many women undergo surgical uterine evacuation. Surgical evacuation of the uterine contents in missed abortion is a challenge to the obstetrician as it is done blindly. The current study recommends the use of ultrasound guided surgical evacuation. It serves two important advantages; the first is to complete evacuation without the need of additional step. The second is to protect against uterine perforatio...

  15. Comparative Analysis of Norwegian Passive House Criteria and of Criteria related to the Concept of International Passive House Standard

    DEFF Research Database (Denmark)

    Anton, Karin; Vestergaard, Inge

    2013-01-01

    The analysis shows differences in definition of apssive house criterias. It also communicates issues os the passive house concept that are nor completely transferred by the Norwegian passive house standard.......The analysis shows differences in definition of apssive house criterias. It also communicates issues os the passive house concept that are nor completely transferred by the Norwegian passive house standard....

  16. Surgical therapy in chronic pancreatitis.

    Science.gov (United States)

    Neal, C P; Dennison, A R; Garcea, G

    2012-12-01

    Chronic pancreatitis (CP) is an inflammatory disease of the pancreas which causes chronic pain, as well as exocrine and endocrine failure in the majority of patients, together producing social and domestic upheaval and a very poor quality of life. At least half of patients will require surgical intervention at some stage in their disease, primarily for the treatment of persistent pain. Available data have now confirmed that surgical intervention may produce superior results to conservative and endoscopic treatment. Comprehensive individual patient assessment is crucial to optimal surgical management, however, in order to determine which morphological disease variant (large duct disease, distal stricture with focal disease, expanded head or small duct/minimal change disease) is present in the individual patient, as a wide and differing range of surgical approaches are possible depending upon the specific abnormality within the gland. This review comprehensively assesses the evidence for these differing approaches to surgical intervention in chronic pancreatitis. Surgical drainage procedures should be limited to a small number of patients with a dilated duct and no pancreatic head mass. Similarly, a small population presenting with a focal stricture and tail only disease may be successfully treated by distal pancreatectomy. Long-term results of both of these procedure types are poor, however. More impressive results have been yielded for the surgical treatment of the expanded head, for which a range of surgical options now exist. Evidence from level I studies and a recent meta-analysis suggests that duodenum-preserving resections offer benefits compared to pancreaticoduodenectomy, though the results of the ongoing, multicentre ChroPac trial are awaited to confirm this. Further data are also needed to determine which of the duodenum-preserving procedures provides optimal results. In relation to small duct/minimal change disease total pancreatectomy represents the only

  17. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  18. PARTOS - Passive and Active Ray TOmography Software: description and preliminary analysis using TOMO-ETNA experiment’s dataset

    Directory of Open Access Journals (Sweden)

    Alejandro Díaz-Moreno

    2016-09-01

    Full Text Available In this manuscript we present the new friendly seismic tomography software based on joint inversion of active and passive seismic sources called PARTOS (Passive Active Ray TOmography Software. This code has been developed on the base of two well-known widely used tomographic algorithms (LOTOS and ATOM-3D, providing a robust set of algorithms. The dataset used to set and test the program has been provided by TOMO-ETNA experiment. TOMO-ETNA database is a large, high-quality dataset that includes active and passive seismic sources recorded during a period of 4 months in 2014. We performed a series of synthetic tests in order to estimate the resolution and robustness of the solutions. Real data inversion has been carried out using 3 different subsets: i active data; ii passive data; and iii joint dataset. Active database is composed by a total of 16,950 air-gun shots during 1 month and passive database includes 452 local and regional earthquakes recorded during 4 months. This large dataset provides a high ray density within the study region. The combination of active and passive seismic data, together with the high quality of the database, permits to obtain a new tomographic approach of the region under study never done before. An additional user-guide of PARTOS software is provided in order to facilitate the implementation for new users.

  19. Accelerating orthodontic tooth movement: A new, minimally-invasive corticotomy technique using a 3D-printed surgical template

    Science.gov (United States)

    Giansanti, Matteo

    2016-01-01

    Background A reduction in orthodontic treatment time can be attained using corticotomies. The aggressive nature of corticotomy due to the elevation of muco-periosteal flaps and to the duration of the surgery raised reluctance for its employ among patients and dental community. This study aims to provide detailed information on the design and manufacture of a 3D-printed CAD-CAM (computer-aided design and computer-aided manufacturing) surgical guide which can aid the clinician in achieving a minimally-invasive, flapless corticotomy. Material and Methods An impression of dental arches was created; the models were digitally-acquired using a 3D scanner and saved as STereoLithography ( STL ) files. The patient underwent cone beam computed tomography (CBCT): images of jaws and teeth were transformed into 3D models and saved as an STL file. An acrylic template with the design of a surgical guide was manufactured and scanned. The STLs of jaws, scanned casts, and acrylic templates were matched. 3D modeling software allowed the view of the 3D models from different perspectives and planes with perfect rendering. The 3D model of the acrylic template was transformed into a surgical guide with slots designed to guide, at first, a scalpel blade and then a piezoelectric cutting insert. The 3D STL model of the surgical guide was printed. Results This procedure allowed the manufacturing of a 3D-printed CAD/CAM surgical guide, which overcomes the disadvantages of the corticotomy, removing the need for flap elevation. No discomfort, early surgical complications or unexpected events were observed. Conclusions The effectiveness of this minimally-invasive surgical technique can offer the clinician a valid alternative to other methods currently in use. Key words:Corticotomy, orthodontics, CAD/CAM, minimally invasive, surgical template, 3D printer. PMID:27031067

  20. [Non-surgical management after blunt traumatic liver injuries: A review article].

    Science.gov (United States)

    Noyola-Villalobos, Héctor Faustino; Loera-Torres, Marco Antonio; Jiménez-Chavarría, Enrique; Núñez-Cantú, Olliver; García-Núñez, Luis Manuel; Arcaute-Velázquez, Fernando Federico

    2016-01-01

    Hepatic trauma is a common cause for admissions in the Emergency Room. Currently, non-surgical management is the standard treatment in haemodynamically stable patients with a success rate of around 85 to 98%. This haemodynamic stability is the most important factor in selecting the appropriate patient. Adjuncts in non-surgical management are angioembolisation, image-guided drainage and endoscopic retrograde cholangiopancreatography. Failure in non-surgical management is relatively rare but potentially fatal, and needs to be recognised and aggressively treated as early as possible. The main cause of failure in non-surgical management is persistent haemorrhage. The aim of this paper is to describe current evidence and guidelines that support non-surgical management of liver injuries in blunt trauma. Copyright © 2016 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  1. Body-mounted robotic instrument guide for image-guided cryotherapy of renal cancer

    Science.gov (United States)

    Hata, Nobuhiko; Song, Sang-Eun; Olubiyi, Olutayo; Arimitsu, Yasumichi; Fujimoto, Kosuke; Kato, Takahisa; Tuncali, Kemal; Tani, Soichiro; Tokuda, Junichi

    2016-01-01

    Purpose: Image-guided cryotherapy of renal cancer is an emerging alternative to surgical nephrectomy, particularly for those who cannot sustain the physical burden of surgery. It is well known that the outcome of this therapy depends on the accurate placement of the cryotherapy probe. Therefore, a robotic instrument guide may help physicians aim the cryotherapy probe precisely to maximize the efficacy of the treatment and avoid damage to critical surrounding structures. The objective of this paper was to propose a robotic instrument guide for orienting cryotherapy probes in image-guided cryotherapy of renal cancers. The authors propose a body-mounted robotic guide that is expected to be less susceptible to guidance errors caused by the patient’s whole body motion. Methods: Keeping the device’s minimal footprint in mind, the authors developed and validated a body-mounted, robotic instrument guide that can maintain the geometrical relationship between the device and the patient’s body, even in the presence of the patient’s frequent body motions. The guide can orient the cryotherapy probe with the skin incision point as the remote-center-of-motion. The authors’ validation studies included an evaluation of the mechanical accuracy and position repeatability of the robotic instrument guide. The authors also performed a mock MRI-guided cryotherapy procedure with a phantom to compare the advantage of robotically assisted probe replacements over a free-hand approach, by introducing organ motions to investigate their effects on the accurate placement of the cryotherapy probe. Measurements collected for performance analysis included accuracy and time taken for probe placements. Multivariate analysis was performed to assess if either or both organ motion and the robotic guide impacted these measurements. Results: The mechanical accuracy and position repeatability of the probe placement using the robotic instrument guide were 0.3 and 0.1 mm, respectively, at a depth

  2. Hands-On Surgical Training Workshop: an Active Role-Playing Patient Education for Adolescents.

    Science.gov (United States)

    Wongkietkachorn, Apinut; Boonyawong, Pangpoom; Rhunsiri, Peera; Tantiphlachiva, Kasaya

    2017-09-01

    Most patient education involves passive learning. To improve patient education regarding surgery, an active learning workshop-based teaching method is proposed. The objective of this study was to assess level of patient surgical knowledge, achievement of workshop learning objectives, patient apprehension about future surgery, and participant workshop satisfaction after completing a surgical training workshop. A four-station workshop (surgical scrub, surgical suture, laparoscopic surgery, and robotic surgery) was developed to teach four important components of the surgical process. Healthy, surgery-naive adolescents were enrolled to attend this 1-h workshop-based training program. Training received by participants was technically and procedurally identical to training received by actual surgeons. Pre- and post-workshop questionnaires were used to assess learning outcomes. There were 1312 participants, with a mean age 15.9 ± 1.1 years and a gender breakdown of 303 males and 1009 females. For surgical knowledge, mean pre-workshop and post-workshop scores were 6.1 ± 1.5 and 7.5 ± 1.5 (out of 10 points), respectively (p education is an effective way to improve understanding of surgery-related processes. This teaching method may also decrease apprehension that patients or potential patients harbor regarding a future surgical procedure.

  3. Neuronavigator-guided glioma surgery.

    Science.gov (United States)

    Du, Guhong; Zhou, Liangfu; Mao, Ying

    2003-10-01

    To evaluate the effectiveness of neuronavigator-guided surgery for the resection of gliomas. A total of 80 patients with gliomas underwent surgical treatment under the StealthStation neuronavigator to estimate the extent of the tumors. In 27 cases, the measurements of brain shifts at the dura, cortical surface and lesion margin were recorded during the operations. A technique termed "micro-catheter fence post" was used in superficial gliomas to compensate for brain shift. Mean fiducial error and predicted accuracy in the 80 cases were 2.03 mm +/- 0.89 mm and 2.43 mm +/- 0.99 mm, respectively. The shifts at the dura, cortical surface and lesion margin were 3.44 mm +/- 2.39 mm, 7.58 mm +/- 3.75 mm, and 6.55 mm +/- 3.19 mm, respectively. Although neuronavigation revealed residual tumors, operations were discontinued in 5 cases of deep-seated gliomas. In the other 75 cases, total tumor removals were achieved in 62 (82.7%), and subtotal removals were achieved in 13 (17.3%). Post-operation, neurological symptoms were improved or unchanged in 68 cases (85.0%), and worsened in 12 (15.0%). No deaths occurred during the operations and post-operations. Intraoperative brain shifts mainly contribute to the fail of spatial accuracy during neuronavigator-guided glioma surgery. The "micro-catheter fence post" technique used for glioma surgery is shown to be useful for compensating for intraoperative brain shifts. This technique, thus, contributes to an increase in total tumor removal and a decrease in surgical complications.

  4. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    Objective: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. ... as risk associated with general anaesthesia (8) they are more .... Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the ...

  5. uniportal vats for surgical repair

    African Journals Online (AJOL)

    2017-03-23

    Mar 23, 2017 ... aDepartamet of Pediatric Surgery, Hospital Teresa Herrera, Complejo Hospitalario. Universitario de A ... Advances in anesthesia, neonatal intensive, surgical, and cardiac care have ... First, these patients are at risk of airway ...

  6. Spinal surgery: non surgical complications

    African Journals Online (AJOL)

    Adele

    surgical procedure). Arterial cannulation ... Acute retinal necrosis syndrome after epidural corticos- teroid injections ... prevented, or respond to early recognition and treatment. ..... drugs should only be administered if there are no alternatives.

  7. Patient-specific surgical simulation.

    Science.gov (United States)

    Soler, Luc; Marescaux, Jacques

    2008-02-01

    Technological innovations of the twentieth century have provided medicine and surgery with new tools for education and therapy definition. Thus, by combining Medical Imaging and Virtual Reality, patient-specific applications providing preoperative surgical simulation have become possible.

  8. Ultrasound-guided wire localization of lesions detected on ...

    African Journals Online (AJOL)

    Background: Wire localization for planned surgical treatment in the management of breast cancer is underutilized in our environment. The objective of this study is to assess the role of ultrasound-guided wire localization of breast masses detected on screening mammography and its impact on biopsy and breast ...

  9. Ultrasound-guided nerve block for inguinal hernia repair

    DEFF Research Database (Denmark)

    Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth

    2012-01-01

    Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

  10. Ultrasound-guided needle aspiration of parotid abscess

    Directory of Open Access Journals (Sweden)

    André Takahashi

    2012-01-01

    Full Text Available Ultrasound (US has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.

  11. Surgical management of Crohn's disease.

    Science.gov (United States)

    Lu, Kim C; Hunt, Steven R

    2013-02-01

    Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  13. COLLABORATIVE GUIDE: A REEF MANAGER'S GUIDE TO ...

    Science.gov (United States)

    Innovative strategies to conserve the world's coral reefs are included in a new guide released today by NOAA, and the Australian Great Barrier Reef Marine Park Authority, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. Referred to as A Reef Manager's Guide to Coral Bleaching, the guide will provide coral reef managers with the latest scientific information on the causes of coral bleaching and new management strategies for responding to this significant threat to coral reef ecosystems. Innovative strategies to conserve the world's coral reefs are included in a new guide released today by NOAA, and the Australian Great Barrier Reef Marine Park Authority, with author contributions from a variety of international partners from government agencies, non-governmental organizations, and academic institutions. Dr. Jordan West, of the National Center for Environmental Assessment, was a major contributor to the guide. Referred to as

  14. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    In addition to a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry, this booklet includes information about radiation protection procedures for brachytherapy

  15. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  16. Alternative to Nitric Acid Passivation Project Overview

    Science.gov (United States)

    Lewis, Pattie L.

    2013-01-01

    The standard practice for protection of stainless steel is a process called passivation. This procedure results in the formation of a metal oxide layer to prevent corrosion. Typical passivation procedures call for the use of nitric acid which exhibits excellent corrosion performance; however, there are a number of environmental, worker safety, and operational issues associated with its use. The longtime military specification for the passivation of stainless steel was cancelled in favor of newer specifications which allow for the use of citric acid in place of nitric acid. Citric acid offers a variety of benefits that include increased safety for personnel, reduced environmental impact, and reduced operational costs. There have been few studies, however, to determine whether citric acid is an acceptable alternative for NASA and DoD. This paper details activities to date including development of the joint test plan, on-going and planned testing, and preliminary results.

  17. Passive Corrosion Behavior of Alloy 22

    International Nuclear Information System (INIS)

    R.B. Rebak; J.H. Payer

    2006-01-01

    Alloy 22 (NO6022) was designed to stand the most aggressive industrial applications, including both reducing and oxidizing acids. Even in the most aggressive environments, if the temperature is lower than 150 F (66 C) Alloy 22 would remain in the passive state having particularly low corrosion rates. In multi-ionic solutions that may simulate the behavior of concentrated ground water, even at near boiling temperatures, the corrosion rate of Alloy 22 is only a few nano-meters per year because the alloy is in the complete passive state. The corrosion rate of passive Alloy 22 decreases as the time increases. Immersion corrosion testing also show that the newer generation of Ni-Cr-Mo alloys may offer a better corrosion resistance than Alloy 22 only in some highly aggressive conditions such as in hot acids

  18. A Passive Optical Location with Limited Range

    Directory of Open Access Journals (Sweden)

    Pavel Fiala

    2008-01-01

    Full Text Available We know active and passive methods of a location. This article deals only with a passive location of dynamic targets. The passive optics location is suitable just for tracking of targets with mean velocity which is limited by the hardware basis. The aim of this work is to recognize plasma, particles etc. It is possible to propose such kind of evaluation methods which improve the capture probability markedly. Suggested method is dealing with the short-distance evaluation of targets. We suppose the application of three independent principles how to recognize an object in a scanned picture. These principles use similar stochastic functions in order to evaluate an object location by means of simple mathematical operations. Methods are based on direct evaluation of picture sequence by the help of the histogram and frequency spectrum. We find out the probability of unidentified moving object in pictures. If the probability reaches a setting value we will get a signal.

  19. Passive heat removal characteristics of SMART

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Kwang; Kang, Hyung Seok; Yoon, Joo Hyun; Kim, Hwan Yeol; Cho, Bong Hyun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1998-12-31

    A new advanced integral reactor of 330 MWt thermal capacity named SMART (System-Integrated Modular Advanced Reactor) is currently under development in Korea Atomic Energy Research Institute (KAERI) for multi-purpose applications. Modular once-through steam generator (SG) and self-pressurizing pressurizer equipped with wet thermal insulator and cooler are essential components of the SMART. The SMART provides safety systems such as Passive Residual Heat Removal System (PRHRS). In this study, a computer code for performance analysis of the PRHRS is developed by modeling relevant components and systems of the SMART. Using this computer code, a performance analysis of the PRHRS is performed in order to check whether the passive cooling concept using the PRHRS is feasible. The results of the analysis show that PRHRS of the SMART has excellent passive heat removal characteristics. 2 refs., 4 figs., 1 tab. (Author)

  20. Protocol Monitoring Passive Solar Energy. Background document

    International Nuclear Information System (INIS)

    Van den Ham, E.R.

    1998-01-01

    A method has been developed by means of which the contribution of passive solar energy to the Dutch energy balance can be quantified univocally. The monitoring will be directed at the absolute amount of used solar energy, the relative contribution of passive solar energy to the energy demand in the Netherlands, and the average efficiency of passive solar energy systems. Based on a model of the total building stock the quantities to be monitored can be determined. The most important parameters in the model are: the window surface per orientation, the average U-value (heat transfer coefficient) of windows, the average ZTA-value (incoming solar radiation factor) of windows, and the presence of sun lounges and atriums

  1. Climate-Specific Passive Building Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Graham S. [Passive House Inst., Westford, MA (United States); Klingenberg, Katrin [Passive House Inst., Westford, MA (United States)

    2015-07-01

    Passive design principles (super insulation, airtight envelopes, elimination of thermal bridges, etc.) - pioneered in North America in the 70s and 80s and refined in Europe in the 90s have proven to be universally effective to significantly reduce heating and cooling loads. However, a single, rigid performance metric developed in Germany has led to limited uptake of passive building principles in many regions of the United States. It has also, in many cases, promoted some design decisions that had negative effects on economic feasibility and thermal comfort. This study's main objective is to validate (in a theoretical sense) verifiable, climate-specific passive standards and space conditioning criteria that retain ambitious, environmentally-necessary energy reduction targets and are economically feasible, such standards provide designers an ambitious but achievable performance target on the path to zero.

  2. A passive sampler for atmospheric ozone

    International Nuclear Information System (INIS)

    Grosjean, D.; Hisham, M.W.M.

    1992-01-01

    A simple, cost-effective passive sampler has been developed for the determination of atmospheric ozone. This passive sampler is based on a colorant which fades upon reaction with ozone, whose concentration can be determined by reflectance measurement of the color change. Direct, on-site measurements are possible, and no chemical analyses are needed. Sampler design and validation studies have been carried out and included quantitative determination of color change vs exposure time (1-8 days), color change vs. ozone concentration (30-350 ppb), and response to changes in sampler configuration that modify the passive sampling rate. With indigo carmine as the colorant, the detection limits are 30 ppb. day and 120 ppb. day using a plastic grid and Teflon filter, respectively, as diffusion barriers. Interferences from nitrogen dioxide, formaldehyde and peroxyacetyl nitrate are 15, 4 and 16%, respectively, thus resulting in a negligible bias when measuring ozone in ambient air

  3. High-order passive photonic temporal integrators.

    Science.gov (United States)

    Asghari, Mohammad H; Wang, Chao; Yao, Jianping; Azaña, José

    2010-04-15

    We experimentally demonstrate, for the first time to our knowledge, an ultrafast photonic high-order (second-order) complex-field temporal integrator. The demonstrated device uses a single apodized uniform-period fiber Bragg grating (FBG), and it is based on a general FBG design approach for implementing optimized arbitrary-order photonic passive temporal integrators. Using this same design approach, we also fabricate and test a first-order passive temporal integrator offering an energetic-efficiency improvement of more than 1 order of magnitude as compared with previously reported passive first-order temporal integrators. Accurate and efficient first- and second-order temporal integrations of ultrafast complex-field optical signals (with temporal features as fast as approximately 2.5ps) are successfully demonstrated using the fabricated FBG devices.

  4. Passivated emitters in silicon solar cells

    International Nuclear Information System (INIS)

    King, R.R.; Gruenbaum, P.E.; Sinton, R.A.; Swanson, R.M.

    1990-01-01

    In high-efficiency silicon solar cells with low metal contact coverage fractions and high bulk lifetimes, cell performance is often dominated by recombination in the oxide-passivated diffusions on the cell surface. Measurements of the emitter saturation current density, J o , of oxide-passivated, boron and phosphorus diffusions are presented, and from these measurements, the dependence of surface recombination velocity on dopant concentration was extracted. The lowest observed values of J o which are stable under UV light are given for both boron- and phosphorus-doped, oxide-passivated diffusions, for both textured and untextured surfaces. Contour plots which incorporate the above data have been applied to two types of backside-contact solar cells with large area (37.5 cm 2 ) and one-sun efficiencies up to 22.7%

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

    Science.gov (United States)

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

    2013-04-01

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

  6. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  7. Role of Passive Safety Features in Prevention And Mitigation of Severe Plant Conditions in Indian Advanced Heavy Water Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Jain, Vikas; Nayak, A.; Dhiman, M.; Kulkarni, P. P.; Vijayan, P. K.; Vaze, K. K. [Bhabha Atomic Research Centre, Mumbai (India)

    2013-10-15

    Pressing demands of economic competitiveness, the need for large-scale deployment, minimizing the need of human intervention, and experience from the past events and incidents at operating reactors have guided the evolution and innovations in reactor technologies. Indian innovative reactor 'AHWR' is a pressure-tube type natural circulation based boiling water reactor that is designed to meet such requirements, which essentially reflect the needs of next generation reactors. The reactor employs various passive features to prevent and mitigate accidental conditions, like a slightly negative void reactivity coefficient, passive poison injection to scram the reactor in event of failure of the wired shutdown systems, a large elevated pool of water as a heat sink inside the containment, passive decay heat removal based on natural circulation and passive valves, passive ECC injection, etc. It is designed to meet the fundamental safety requirements of safe shutdown, safe decay heat removal and confinement of activity with no impact in public domain, and hence, no need for emergency planning under all conceivable scenarios. This paper examines the role of the various passive safety systems in prevention and mitigation of severe plant conditions that may arise in event of multiple failures. For the purpose of demonstration of the effectiveness of its passive features, postulated scenarios on the lines of three major severe accidents in the history of nuclear power reactors are considered, namely; the Three Mile Island (TMI), Chernobyl and Fukushima accidents. Severe plant conditions along the lines of these scenarios are postulated to the extent conceivable in the reactor under consideration and analyzed using best estimate system thermal-hydraulics code RELAP5/Mod3.2. It is found that the various passive systems incorporated enable the reactor to tolerate the postulated accident conditions without causing severe plant conditions and core degradation.

  8. ROLE OF PASSIVE SAFETY FEATURES IN PREVENTION AND MITIGATION OF SEVERE PLANT CONDITIONS IN INDIAN ADVANCED HEAVY WATER REACTOR

    Directory of Open Access Journals (Sweden)

    VIKAS JAIN

    2013-10-01

    Full Text Available Pressing demands of economic competitiveness, the need for large-scale deployment, minimizing the need of human intervention, and experience from the past events and incidents at operating reactors have guided the evolution and innovations in reactor technologies. Indian innovative reactor ‘AHWR’ is a pressure-tube type natural circulation based boiling water reactor that is designed to meet such requirements, which essentially reflect the needs of next generation reactors. The reactor employs various passive features to prevent and mitigate accidental conditions, like a slightly negative void reactivity coefficient, passive poison injection to scram the reactor in event of failure of the wired shutdown systems, a large elevated pool of water as a heat sink inside the containment, passive decay heat removal based on natural circulation and passive valves, passive ECC injection, etc. It is designed to meet the fundamental safety requirements of safe shutdown, safe decay heat removal and confinement of activity with no impact in public domain, and hence, no need for emergency planning under all conceivable scenarios. This paper examines the role of the various passive safety systems in prevention and mitigation of severe plant conditions that may arise in event of multiple failures. For the purpose of demonstration of the effectiveness of its passive features, postulated scenarios on the lines of three major severe accidents in the history of nuclear power reactors are considered, namely; the Three Mile Island (TMI, Chernobyl and Fukushima accidents. Severe plant conditions along the lines of these scenarios are postulated to the extent conceivable in the reactor under consideration and analyzed using best estimate system thermal-hydraulics code RELAP5/Mod3.2. It is found that the various passive systems incorporated enable the reactor to tolerate the postulated accident conditions without causing severe plant conditions and core degradation.

  9. TEPSS - Technology Enhancement for Passive Safety Systems

    International Nuclear Information System (INIS)

    Hart, J.; Slegers, W.J.M.; Boer, S.L. de; Huggenberger, M.; Lopez Jimenez, J.; Munoz-Cabo Gonzalez, J.L.; Reventos Puigjaner, F.

    2000-01-01

    The objective of the TEPSS project was to make significant additions to the technology base of the European Simplified Boiling Water Reactor (ESBWR). The project focused on mixing and stratification phenomena in large water pools, passive decay heat removal from containments, and effects of aerosol deposition inside a passive heat exchanger. The PSI experimental facility LINX (Large-scale Investigation of Natural Circulation and Mixing) has been used to investigate venting of steam and steam-noncondensable gas mixtures into water pools. The test revealed that no significant steam bypass could be detected when injecting a mixture of steam or air and that mixing was very efficient. In addition to the tests, 3-D numerical computations and initial model development have been performed to study the behaviour of bubble plumes in water pools. The major part of the TEPSS project studied selective aspects of the response technology of modem pressure-suppression type containment designs and of passive-type decay heat removal systems. The work included an experimental phase using the large-scale experimental facility PANDA (Passive Nachwaermeabfuhr und Druckabbau), operated by PSI, where eight experiments successfully have been executed to test the performance of the ESBWR containment configuration. The PANDA tests have been analysed successfully using thermalhydraulic system analysis codes and 3-D CFD codes. The AIDA (Aerosol Impaction and Deposition Analysis) experimental facility of PSI has been used to investigate the degradation of passive decay heat removal due to fission product aerosols deposited on the inside surfaces of the PCC (Passive Containment Cooler) heat exchanger tubes. The one test performed revealed that the degradation of the heat transfer in the PCC tubes due to the deposition of aerosols reached about 20%. The test has been analysed using the MELCOR severe accident analysis code. (author)

  10. Fast New Method for Temporary Chemical Passivation

    Directory of Open Access Journals (Sweden)

    Marek Solčanský

    2012-12-01

    Full Text Available The main material parameter of silicon, that influences the effectiveness of photovoltaic cells, is the minority carrier bulk lifetime.It may change in the technological process especially during high temperature operations. Monitoring of the carrier bulk-lifetimeis necessary for modifying the whole technological process of production. For the measurement of the minority carrier bulk-lifetimethe characterization method MW PCD (Microwave Photoconductance Decay is used, where the result of measurement is the effectivecarrier lifetime, which is very dependent on the surface recombination velocity and therefore on the quality of a silicon surfacepassivation.This work deals with an examination of a different solution types for the chemical passivation of a silicon surface. Varioussolutions are tested on silicon wafers for their consequent comparison. The main purpose of this work is to find optimal solution, whichsuits the requirements of a time stability and start-up velocity of passivation, reproducibility of the measurements and a possibilityof a perfect cleaning of a passivating solution remains from a silicon surface. Another purpose of this work is to identify the parametersof other quinhydrone solutions with different concentrations as compared with the quinhydrone solution in methanol witha concentration of 0.07 mol/dm³ marked QM007 (referential solution.The method of an effective chemical passivation with a quinhydrone in methanol solution was suggested. The solution witha concentration of 0.07 mol /dm3 fulfills all required criteria. The work also confirms the influence of increased concentrationquinhydrone on the temporal stability of the passivation layer and the effect for textured silicon wafers. In conclusion, the influenceof an illumination and the temperature on the properties of the passivating solution QM007 is discussed.

  11. Passive remediation strategies for petroleum contaminated sites

    International Nuclear Information System (INIS)

    Everett, L.G.; Cullen, S.J.; Eccles, L.A.

    1991-01-01

    The US EPA is becoming increasingly aware of costs and the limited success of existing remediation strategies. Research teams within the US EPA believe that if passive remediation can be successfully demonstrated, it is a candidate for best available technology. Passive remediation, however, must be demonstrated through the use of monitoring techniques, which demonstrate: contaminants are not moving in the dissolved, adsorbed or free product phase; and contamination is biodegrading in-place. This paper presents a concise monitoring and analysis strategy for passive remediation. Specifically, the paper presents the accuracy, precision and operating range of neutron moderation techniques as a low cost, real-time screening tool to measure the migration of the dissolved phase in soil moisture, the stabilized adsorbed phase and free product movement. In addition, the paper identifies the capillary pressure range through which the dissolved phase will move and identifies techniques for satisfying the risk analysis that movement is not taking place. The rationale for passive remediation taking place is confirmed through a discussion of gas ratios associated with bacterial assimilation of hydrocarbons. Gas ratios which are relatively constant above ground are highly inverted in the subsurface at contamination sites. The use of frequent screening of a vertical geologic profile using least cost techniques and the infrequent analysis of soil gas ratios provides the required data upon which the public will accept passive remediation as best available technology at a particular site. The paper points out that neutron moderation is a high candidate vadose zone monitoring device and identifies alternative techniques using resistivity and dielectric constants, which are in the developmental stage. The economic implications for passive remediation are enormous relative to the excavation and remediation strategies which are currently in use

  12. Visualizing guided tours

    DEFF Research Database (Denmark)

    Poulsen, Signe Herbers; Fjord-Larsen, Mads; Hansen, Frank Allan

    This paper identifies several problems with navigating and visualizing guided tours in traditional hypermedia systems. We discuss solutions to these problems, including the representation of guided tours as 3D metro maps with content preview. Issues regarding navigation and disorientation...

  13. Electromagnetic ultrasonic guided waves

    CERN Document Server

    Huang, Songling; Li, Weibin; Wang, Qing

    2016-01-01

    This book introduces the fundamental theory of electromagnetic ultrasonic guided waves, together with its applications. It includes the dispersion characteristics and matching theory of guided waves; the mechanism of production and theoretical model of electromagnetic ultrasonic guided waves; the effect mechanism between guided waves and defects; the simulation method for the entire process of electromagnetic ultrasonic guided wave propagation; electromagnetic ultrasonic thickness measurement; pipeline axial guided wave defect detection; and electromagnetic ultrasonic guided wave detection of gas pipeline cracks. This theory and findings on applications draw on the author’s intensive research over the past eight years. The book can be used for nondestructive testing technology and as an engineering reference work. The specific implementation of the electromagnetic ultrasonic guided wave system presented here will also be of value for other nondestructive test developers.

  14. Apparatus for guiding workpieces

    International Nuclear Information System (INIS)

    Misty, G.C.

    1984-01-01

    Workpieces are guided to the tool by a resiliently mounted support guide which accommodates irregularities in the profiles of the workpieces to maintain the axes of the workpieces in alignment with the centre line of the tool. (author)

  15. Study on diverse passive decay heat removal approach

    International Nuclear Information System (INIS)

    Lin Qian; Si Shengyi

    2012-01-01

    One of the most important principles for nuclear safety is the decay heat removal in accidents. Passive decay heat removal systems are extremely helpful to enhance the safety. In currently design of many advanced nuclear reactors, kinds of passive systems are proposed or developed, such as the passive residual heat removal system, passive injection system, passive containment cooling system. These systems provide entire passive heat removal paths from core to ultimate heat sink. Various kinds of passive systems for decay heat removal are summarized; their common features or differences on heat removal paths and design principle are analyzed. It is found that, these passive decay heat removal paths are similarly common on and connected by several basic heat transfer modes and steps. By the combinations or connections of basic modes and steps, new passive decay heat removal approach or diverse system can be proposed. (authors)

  16. Image-guided navigation system for placing dental implants.

    Science.gov (United States)

    Casap, Nardy; Wexler, Alon; Lustmann, Joshua

    2004-10-01

    Navigation-guided surgery has recently been introduced into various surgical disciplines, including oral and maxillofacial surgery. Since the advent of dental implants, dental computed tomography (CT) scans have been used as a diagnostic tool for preoperative planning, but not as part of the surgical phase. This article explains the principles of computer-assisted surgery and describes the use of a computer-guided navigation system in dental implantology. The system uses preoperative dental CT scans for planning and as an integral part of the surgical procedure. This system allows continuous intraoperative coordination of the implantation phase with the preoperative plan, optimizing the accuracy of implant surgery. Deviations from the planned location of the implants are minimal. Several cases are discussed.

  17. Inherently safe passive gas monitoring system

    Energy Technology Data Exchange (ETDEWEB)

    Cordaro, Joseph V.; Bellamy, John Stephen; Shuler, James M.; Shull, Davis J.; Leduc, Daniel R.

    2016-09-06

    Generally, the present disclosure is directed to gas monitoring systems that use inductive power transfer to safely power an electrically passive device included within a nuclear material storage container. In particular, the electrically passive device can include an inductive power receiver for receiving inductive power transfer through a wall of the nuclear material storage container. The power received by the inductive power receiver can be used to power one or more sensors included in the device. Thus, the device is not required to include active power generation components such as, for example, a battery, that increase the risk of a spark igniting flammable gases within the container.

  18. Passive Polarimetric Information Processing for Target Classification

    Science.gov (United States)

    Sadjadi, Firooz; Sadjadi, Farzad

    Polarimetric sensing is an area of active research in a variety of applications. In particular, the use of polarization diversity has been shown to improve performance in automatic target detection and recognition. Within the diverse scope of polarimetric sensing, the field of passive polarimetric sensing is of particular interest. This chapter presents several new methods for gathering in formation using such passive techniques. One method extracts three-dimensional (3D) information and surface properties using one or more sensors. Another method extracts scene-specific algebraic expressions that remain unchanged under polariza tion transformations (such as along the transmission path to the sensor).

  19. Piping reliability improvement through passive seismic supports

    International Nuclear Information System (INIS)

    Baltus, R.; Rubbers, A.

    1999-01-01

    The nuclear plants designed in the 1970's were equipped with large quantities of snubbers in auxiliary piping systems. The experience revealed a poor performance of snubbers during periodic inspection, while non-nuclear facility piping survived through strong earthquakes. Consequently, seismic design rules evolved towards more realistic criteria and passive dynamic supports were developed to reduce snubber quantities. These solutions improve the pipe reliability during normal operation while reducing the radiation exposure in a sample line is presented with the impact on pipe stresses compared to the results obtained with passive supports named Limit Stops. (author)

  20. Superacid Passivation of Crystalline Silicon Surfaces.

    Science.gov (United States)

    Bullock, James; Kiriya, Daisuke; Grant, Nicholas; Azcatl, Angelica; Hettick, Mark; Kho, Teng; Phang, Pheng; Sio, Hang C; Yan, Di; Macdonald, Daniel; Quevedo-Lopez, Manuel A; Wallace, Robert M; Cuevas, Andres; Javey, Ali

    2016-09-14

    The reduction of parasitic recombination processes commonly occurring within the silicon crystal and at its surfaces is of primary importance in crystalline silicon devices, particularly in photovoltaics. Here we explore a simple, room temperature treatment, involving a nonaqueous solution of the superacid bis(trifluoromethane)sulfonimide, to temporarily deactivate recombination centers at the surface. We show that this treatment leads to a significant enhancement in optoelectronic properties of the silicon wafer, attaining a level of surface passivation in line with state-of-the-art dielectric passivation films. Finally, we demonstrate its advantage as a bulk lifetime and process cleanliness monitor, establishing its compatibility with large area photoluminescence imaging in the process.

  1. Passive cooling systems in power reactors

    International Nuclear Information System (INIS)

    Aharon, J.; Harrari, R.; Weiss, Y.; Barnea, Y.; Katz, M.; Szanto, M.

    1996-01-01

    This paper reviews several R and D activities associated with the subject of passive cooling systems, conducted by the N.R.C.Negev thermohydraulic group. A short introduction considering different types of thermosyphons and their applications is followed by a detailed description of the experimental work, its results and conclusions. An ongoing research project is focused on the evaluation of the external dry air passive containment cooling system (PCCS) in the AP-600 (Westinghouse advanced pressurized water reactor). In this context some preliminary theoretical results and planned experimental research are for the fature described

  2. Passive cooling in modern nuclear reactors

    International Nuclear Information System (INIS)

    Rouai, N. M.

    1998-01-01

    This paper presents some recent experimental results performed with the aim of understanding the mechanism of passive cooling. The AP 600 passive containment cooling system is simulated by an electrically heated vertical pipe, which is cooled by a naturally induced air flow and by a water film descending under gravity. The results demonstrate that although the presence of the water film improved the heat transfer significantly, the mode of heat transfer was very dependent on the experimental parameters. Preheating the water improved both film stability and overall cooling performance

  3. An all-silicon passive optical diode.

    Science.gov (United States)

    Fan, Li; Wang, Jian; Varghese, Leo T; Shen, Hao; Niu, Ben; Xuan, Yi; Weiner, Andrew M; Qi, Minghao

    2012-01-27

    A passive optical diode effect would be useful for on-chip optical information processing but has been difficult to achieve. Using a method based on optical nonlinearity, we demonstrate a forward-backward transmission ratio of up to 28 decibels within telecommunication wavelengths. Our device, which uses two silicon rings 5 micrometers in radius, is passive yet maintains optical nonreciprocity for a broad range of input power levels, and it performs equally well even if the backward input power is higher than the forward input. The silicon optical diode is ultracompact and is compatible with current complementary metal-oxide semiconductor processing.

  4. Passive containment system for a nuclear reactor

    International Nuclear Information System (INIS)

    Kleimola, F.W.

    1976-01-01

    A containment system is described that provides complete protection entirely by passive means for the loss of coolant accident in a nuclear power plant and wherein all stored energy released in the coolant blowdown is contained and absorbed while the nuclear fuel is continuously maintained submerged in liquid. The primary containment vessel is restored to a high subatmospheric pressure within a few minutes after accident initiation and the decay heat is safely transferred to the environment while radiolytic hydrogen is contained by passive means

  5. The passive diffusion of Leptospira interrogans

    International Nuclear Information System (INIS)

    Koens, Lyndon; Lauga, Eric

    2014-01-01

    Motivated by recent experimental measurements, the passive diffusion of the bacterium Leptospira interrogans is investigated theoretically. By approximating the cell shape as a straight helix and using the slender-body-theory approximation of Stokesian hydrodynamics, the resistance matrix of Leptospira is first determined numerically. The passive diffusion of the helical cell is then obtained computationally using a Langevin formulation which is sampled in time in a manner consistent with the experimental procedure. Our results are in excellent quantitative agreement with the experimental results with no adjustable parameters. (paper)

  6. The passive diffusion of Leptospira interrogans

    Science.gov (United States)

    Koens, Lyndon; Lauga, Eric

    2014-12-01

    Motivated by recent experimental measurements, the passive diffusion of the bacterium Leptospira interrogans is investigated theoretically. By approximating the cell shape as a straight helix and using the slender-body-theory approximation of Stokesian hydrodynamics, the resistance matrix of Leptospira is first determined numerically. The passive diffusion of the helical cell is then obtained computationally using a Langevin formulation which is sampled in time in a manner consistent with the experimental procedure. Our results are in excellent quantitative agreement with the experimental results with no adjustable parameters.

  7. Passive heat transport in advanced CANDU containment

    International Nuclear Information System (INIS)

    Krause, M.; Mathew, P.M.

    1994-01-01

    A passive CANDU containment design has been proposed to provide the necessary heat removal following a postulated accident to maintain containment integrity. To study its feasibility and to optimize the design, multi-dimensional containment modelling may be required. This paper presents a comparison of two CFD codes, GOTHIC and PHOENICS, for multi-dimensional containment analysis and gives pressure transient predictions from a lumped-parameter and a three-dimensional GOTHIC model for a modified CANDU-3 containment. GOTHIC proved suitable for multidimensional post-accident containment analysis, as shown by the good agreement with pressure transient predictions from PHOENICS. GOTHIC is, therefore, recommended for passive CANDU containment modelling. (author)

  8. Technical Assessment: WRAP 1 HVAC Passive Shutdown

    International Nuclear Information System (INIS)

    Ball, D.E.; Nash, C.R.; Stroup, J.L.

    1993-01-01

    As the result of careful interpretation of DOE Order 6430.lA and other DOE Orders, the HVAC system for WRAP 1 has been greatly simplified. The HVAC system is now designed to safely shut down to Passive State if power fails for any reason. The fans cease functioning, allowing the Zone 1 and Zone 2 HVAC Confinement Systems to breathe with respect to atmospheric pressure changes. Simplifying the HVAC system avoided overdesign. Construction costs were reduced by eliminating unnecessary equipment. This report summarizes work that was done to define the criteria, physical concepts, and operational experiences that lead to the passive shutdown design for WRAP 1 confinement HVAC systems

  9. Perfect and Periphrastic Passive Constructions in Danish

    DEFF Research Database (Denmark)

    Bjerre, Tavs; Bjerre, Anne

    2007-01-01

    This paper gives an account of the event and argument structure of past participles and the linking between argument structure and valence structure. It further accounts for how participles form perfect and passiv constructions with auxiliaries. We assume that the same participle form is used...... in both types of construction. Our claim is that the valence structure of a past participle is predictable from its semantic type, and that the valence structure predicts with which auciliary a past participle combines in perfect constructions and whether the past participle may occur in passiv...

  10. Aktive og passive valg i pensionsopsparingen

    DEFF Research Database (Denmark)

    Nielsen, Torben Heien

    2017-01-01

    This paper reviews two papers from my own research. I show that the effect of pension policies are highly dependent on which type of decision maker the policy targets. Specifically, the effectiveness of the policy is stronger if it affects passive choice. Such policies, e.g., employer pensions......, are extremely effective in increasing total individual savings. Tax deductions on the other hand are ineffective. The reason is that an estimated 85 % of the population are passive savers, who do not respond to changes in policies. Consequently, an increased labor market pension rate will also make their total...

  11. Primordial black holes from passive density fluctuations

    International Nuclear Information System (INIS)

    Lin, Chia-Min; Ng, Kin-Wang

    2013-01-01

    In this Letter, we show that if passive fluctuations are considered, primordial black holes (PBHs) can be easily produced in the framework of single-field, slow-roll inflation models. The formation of PBHs is due to the blue spectrum of passive fluctuations and an enhancement of the spectral range which exits horizon near the end of inflation. Therefore the PBHs are light with masses ≲10 15 g depending on the number of e-folds when the scale of our observable universe leaves horizon. These PBHs are likely to have evaporated and cannot be a candidate for dark matter but they may still affect the early universe.

  12. Primordial black holes from passive density fluctuations

    OpenAIRE

    Lin, Chia-Min; Ng, Kin-Wang

    2013-01-01

    In this paper, we show that if passive fluctuations are considered, primordial black holes (PBHs) can be easily produced in the framework of single-field, slow-roll inflation models. The formation of PBHs is due to the blue spectrum of passive fluctuations and an enhancement of the spectral range which exits horizon near the end of inflation. Therefore the PBHs are light with masses $\\lesssim 10^{15}g$ depending on the number of e-folds when the scale of our observable universe leaves horizon...

  13. Passive Smoking in a Displacement Ventilated Room

    DEFF Research Database (Denmark)

    Bjørn, Erik; Nielsen, Peter V.

    The aim of this research is to see if the displacement ventilation principle can protect a person from exposure to passive tobacco smoking. This is done by full-scale experiments with two breathing thermal manikins, smoke visualisations, and tracer gas measurements. In some situations, exhaled...... smoke will stratify in a certain height due to the vertical temperature gradient. This horizontal layer of exhaled tobacco smoke may lead to exposure. In other situations, the smoke is mixed into the upper zone, and the passive smoker is protected to some extent by the displacement principle...

  14. Three-dimensional surgical modelling with an open-source software protocol: study of precision and reproducibility in mandibular reconstruction with the fibula free flap.

    Science.gov (United States)

    Ganry, L; Quilichini, J; Bandini, C M; Leyder, P; Hersant, B; Meningaud, J P

    2017-08-01

    Very few surgical teams currently use totally independent and free solutions to perform three-dimensional (3D) surgical modelling for osseous free flaps in reconstructive surgery. This study assessed the precision and technical reproducibility of a 3D surgical modelling protocol using free open-source software in mandibular reconstruction with fibula free flaps and surgical guides. Precision was assessed through comparisons of the 3D surgical guide to the sterilized 3D-printed guide, determining accuracy to the millimetre level. Reproducibility was assessed in three surgical cases by volumetric comparison to the millimetre level. For the 3D surgical modelling, a difference of less than 0.1mm was observed. Almost no deformations (free flap modelling was between 0.1mm and 0.4mm, and the average precision of the complete reconstructed mandible was less than 1mm. The open-source software protocol demonstrated high accuracy without complications. However, the precision of the surgical case depends on the surgeon's 3D surgical modelling. Therefore, surgeons need training on the use of this protocol before applying it to surgical cases; this constitutes a limitation. Further studies should address the transfer of expertise. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. 3-Dimensional printing guide template assisted percutaneous vertebroplasty: Technical note.

    Science.gov (United States)

    Li, Jian; Lin, JiSheng; Yang, Yong; Xu, JunChuan; Fei, Qi

    2018-06-01

    Percutaneous vertebroplasty (PVP) is currently considered as an effective treatment for pain caused by acute osteoporotic vertebral compression fracture. Recently, puncture-related complications are increasingly reported. It's important to find a precise technique to reduce the puncture-related complications. We report a case and discussed the novel surgical technique with step-by-step operating procedures, to introduce the precise PVP assisted by a 3-dimensional printing guide template. Based on the preoperative CT scan and infrared scan data, a well-designed individual guide template could be established in a 3-dimensional reconstruction software and printed out by a 3-dimensional printer. In real operation, by matching the guide template to patient's back skin, cement needles' insertion orientation and depth were easily established. Only 14 times C-arm fluoroscopy with HDF mode (total exposure dose was 4.5 mSv) were required during the procedure. The operation took only 17 min. Cement distribution in the vertebral body was very good without any puncture-related complications. Pain was significantly relieved after surgery. In conclusion, the novel precise 3-dimensional printing guide template system may allow (1) comprehensive visualization of the fractured vertebral body and the individual surgical planning, (2) the perfect fitting between skin and guide template to ensure the puncture stability and accuracy, and (3) increased puncture precision and decreased puncture-related complications, surgical time and radiation exposure. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. THE USE OF PASSIVE SOLAR HEATING SYSTEMS AS PART OF THE PASSIVE HOUSE

    Directory of Open Access Journals (Sweden)

    Bryzgalin Vladislav Viktorovich

    2018-05-01

    Full Text Available Subject: systems of passive solar heating, which can, without the use of engineering equipment, capture and accumulate the solar heat used for heating buildings. Research objectives: study of the possibility to reach the passive house standard (buildings with near zero energy consumption for heating in climatic conditions of Russia using the systems of passive solar heating in combination with other solutions for reduction of energy costs of building developed in the past. Materials and methods: search and analysis of literature, containing descriptions of various passive solar heating systems, examples of their use in different climatic conditions and the resulting effect obtained from their use; analysis of thermophysical processes occurring in these systems. Results: we revealed the potential of using the solar heating systems in the climatic conditions of parts of the territories of the Russian Federation, identified the possibility of cheaper construction by the passive house standard with the use of these systems. Conclusions: more detailed analysis of thermophysical and other processes that take place in passive solar heating systems is required for creation of their computational models, which will allow us to more accurately predict their effectiveness and seek the most cost-effective design solutions, and include them in the list of means for achieving the passive house standard.

  17. Pocket Spending Guide

    OpenAIRE

    Poff, Karen

    2015-01-01

    Provides an example for how to set up a pocket spending guide. By filling out the guide and keeping it with you, you can easily see at any time how much money you have available to spend in each category. A pocket spending guide will help you adjust your spending plan to make your money go where you really want it to go.

  18. Managerial Accounting. Study Guide.

    Science.gov (United States)

    Plachta, Leonard E.

    This self-instructional study guide is part of the materials for a college-level programmed course in managerial accounting. The study guide is intended for use by students in conjuction with a separate textbook, Horngren's "Accounting for Management Control: An Introduction," and a workbook, Curry's "Student Guide to Accounting for Management…

  19. Optimization of Wireless Power Transfer Systems Enhanced by Passive Elements and Metasurfaces

    Science.gov (United States)

    Lang, Hans-Dieter; Sarris, Costas D.

    2017-10-01

    This paper presents a rigorous optimization technique for wireless power transfer (WPT) systems enhanced by passive elements, ranging from simple reflectors and intermedi- ate relays all the way to general electromagnetic guiding and focusing structures, such as metasurfaces and metamaterials. At its core is a convex semidefinite relaxation formulation of the otherwise nonconvex optimization problem, of which tightness and optimality can be confirmed by a simple test of its solutions. The resulting method is rigorous, versatile, and general -- it does not rely on any assumptions. As shown in various examples, it is able to efficiently and reliably optimize such WPT systems in order to find their physical limitations on performance, optimal operating parameters and inspect their working principles, even for a large number of active transmitters and passive elements.

  20. Surgical innovation: the ethical agenda: A systematic review.

    Science.gov (United States)

    Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

    2016-06-01

    The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation.Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges.To answer the question "What are the main ethical aspects of surgical innovation?", we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers.We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure.We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health care system might

  1. An anthropomorphic phantom study of visualisation of surgical clips for partial breast irradiation (PBI) setup verification

    International Nuclear Information System (INIS)

    Thomas, Carys W.; Nichol, Alan M.; Park, Julie E.; Hui, Jason F.; Giddings, Alison A.; Grahame, Sheri; Otto, Karl

    2009-01-01

    Surgical clips were investigated for partial breast image-guided radiotherapy (IGRT). Small titanium clips were insufficiently well visualised. Medium tantalum clips were best for megavoltage IGRT and small tantalum clips were best for floor mounted kilovoltage IGRT (ExacTrac TM ). Both small tantalum and medium titanium clips were suitable for isocentric kilovoltage IGRT

  2. An anthropomorphic phantom study of visualisation of surgical clips for partial breast irradiation (PBI) setup verification.

    Science.gov (United States)

    Thomas, Carys W; Nichol, Alan M; Park, Julie E; Hui, Jason F; Giddings, Alison A; Grahame, Sheri; Otto, Karl

    2009-01-01

    Surgical clips were investigated for partial breast image-guided radiotherapy (IGRT). Small titanium clips were insufficiently well visualised. Medium tantalum clips were best for megavoltage IGRT and small tantalum clips were best for floor mounted kilovoltage IGRT (ExacTrac). Both small tantalum and medium titanium clips were suitable for isocentric kilovoltage IGRT.

  3. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    NARCIS (Netherlands)

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.

    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection

  4. Preoperative Site Marking: Are We Adhering to Good Surgical Practice?

    Science.gov (United States)

    Bathla, Sonia; Chadwick, Michael; Nevins, Edward J; Seward, Joanna

    2017-06-29

    Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general surgery and opinions of the surgeons, to help guide the formulation and implementation of a regional general surgery preoperative marking protocol. A SurveyMonkey questionnaire was designed and distributed to 120 surgeons within the Mersey region, United Kingdom. This included all surgical trainees in Mersey (47 registrars, 56 core trainees), 15 consultants, and 2 surgical care practitioners. This sought to ascertain their routine practice and how they would choose to mark for 12 index procedures in general surgery, if mandated to do so. A total of 72 responses (60%) were obtained to the SurveyMonkey questionnaire. Only 26 (36.1%) said that they routinely marked all of their patients preoperatively. The operating surgeon marked the patient in 69% of responses, with the remainder delegating this task. Markings were visible after draping in only 55.6% of marked cases. Based on our findings, surgeons may not be adhering to "Good Surgical Practice"; practice is widely variable and surgeons are largely opposed and resistant to marking patients unless laterality is involved. We suggest that all surgeons need to be actively engaged in the design of local marking protocols to gain support, change practice, and reduce errors.

  5. Real time noninvasive assessment of external trunk geometry during surgical correction of adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Mac-Thiong Jean-Marc

    2009-02-01

    Full Text Available Abstract Background The correction of trunk deformity is crucial in scoliosis surgery, especially for the patient's self-image. However, direct visualization of external scoliotic trunk deformity during surgical correction is difficult due to the covering draping sheets. Methods An optoelectronic camera system with 10 passive markers is used to track the trunk geometry of 5 scoliotic patients during corrective surgery. The position of 10 anatomical landmarks and 5 trunk indices computed from the position of the passive markers are compared during and after instrumentation of the spine. Results Internal validation of the accuracy of tracking was evaluated at 0.41 +/- 0.05 mm RMS. Intra operative tracking during surgical maneuvers shows improvement of the shoulder balance during and after correction of the spine. Improvement of the overall patient balance is observed. At last, a minor increase of the spinal length can be noticed. Conclusion Tracking of the external geometry of the trunk during surgical correction is useful to monitor changes occurring under the sterile draping sheets. Moreover, this technique can used be used to reach the optimal configuration on the operating frame before proceeding to surgery. The current tracking technique was able to detect significant changes in trunk geometry caused by posterior instrumentation of the spine despite significant correction of the spinal curvature. It could therefore become relevant for computer-assisted guidance of surgical maneuvers when performing posterior instrumentation of the scoliotic spine, provide important insights during positioning of patients.

  6. Agile practice guide

    CERN Document Server

    2017-01-01

    Agile Practice Guide – First Edition has been developed as a resource to understand, evaluate, and use agile and hybrid agile approaches. This practice guide provides guidance on when, where, and how to apply agile approaches and provides practical tools for practitioners and organizations wanting to increase agility. This practice guide is aligned with other PMI standards, including A Guide to the Project Management Body of Knowledge (PMBOK® Guide) – Sixth Edition, and was developed as the result of collaboration between the Project Management Institute and the Agile Alliance.

  7. The effect of passive exposure to tobacco smoke on perioperative respiratory complications and the duration of recovery.

    Science.gov (United States)

    Simsek, Esen; Karaman, Yucel; Gonullu, Mustafa; Tekgul, Zeki; Cakmak, Meltem

    2016-01-01

    The incidence of perioperative respiratory complications and postoperative care unit recovery time investigated in patients with passive tobacco smoke exposure according to the degree of exposure. Total 270 patients ranging in age from 18 to 60 years with the ASA physical status I or II exposed and not exposed to passive tobacco smoke received general anesthesia for various elective surgical operations evaluated for the study. Patients divided into two groups as exposed and non-exposed to passive tobacco smoke, those exposed to passive smoke are also divided into two groups according to the degree of exposure. Patients taken to the postoperative care unit (PACU) at the end of the operation and monitorized until Modified Aldrete's Scores became 9 and more. Respiratory complications evaluated and recorded in intraoperative and postoperative period. A total of 251 patients were enrolled; 63 (25.1%) patients had airway complications, 11 (4.4%) had complications intraoperatively and 52 (20.7%) patients had complications postoperatively. There has been found significant relation with passive tobacco smoke exposure and high incidences of perioperative and postoperative respiratory complications. The risk of cough, desaturation and hypersecretion complications were found to be increased depending on the degree of exposure. There was significant relation between the degree of passive smoke exposure and the duration of PACU stay. Passive tobacco smoke exposed general anesthesia receiving patients also regarding to the degree of exposure having high rates of perioperative respiratory complications and prolongation of PACU stays when compared with unexposed patients. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  8. [The effect of passive exposure to tobacco smoke on perioperative respiratory complications and the duration of recovery].

    Science.gov (United States)

    Simsek, Esen; Karaman, Yucel; Gonullu, Mustafa; Tekgul, Zeki; Cakmak, Meltem

    2016-01-01

    The incidence of perioperative respiratory complications and postoperative care unit recovery time investigated in patients with passive tobacco smoke exposure according to the degree of exposure. Total 270 patients ranging in age from 18 to 60 years with the ASA physical status I or II exposed and not exposed to passive tobacco smoke received general anesthesia for various elective surgical operations evaluated for the study. Patients divided into two groups as exposed and non-exposed to passive tobacco smoke, those exposed to passive smoke are also divided into two groups according to the degree of exposure. Patients taken to the postoperative care unit (PACU) at the end of the operation and monitorized until Modified Aldrete's Scores became 9 and more. Respiratory complications evaluated and recorded in intraoperative and postoperative period. A total of 251 patients were enrolled; 63 (25.1%) patients had airway complications, 11 (4.4%) had complications intraoperatively and 52 (20.7%) patients had complications postoperatively. There has been found significant relation with passive tobacco smoke exposure and high incidences of perioperative and postoperative respiratory complications. The risk of cough, desaturation and hypersecretion complications were found to be increased depending on the degree of exposure. There was significant relation between the degree of passive smoke exposure and the duration of PACU stay. Passive tobacco smoke exposed general anesthesia receiving patients also regarding to the degree of exposure having high rates of perioperative respiratory complications and prolongation of PACU stays when compared with unexposed patients. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Passive cyclotron current drive for fusion plasmas

    International Nuclear Information System (INIS)

    Kernbichler, W.

    1995-01-01

    The creation of toroidal current using cyclotron radiation in a passive way is, together with the well known bootstrap current, an interesting method for stationary current drive in high-temperature fusion reactors. Here, instead of externally applied RF-waves, fish-scale like structures at the first wall help to create enough asymmetry in the self generated cyclotron radiation intensity to drive a current within the plasma. The problem of computing passive cyclotron current drive consists of actually two linked problems, which are the computation of the electron equilibrium under the presence of self-generated radiation, and the computation of the photon equilibrium in a bounded system with a distorted electron distribution. This system of integro-differential equations cannot be solved directly in an efficient way. Therefore a linearization procedure was developed to decouple both sets of equations, finally linked through a generalized local current drive efficiency. The problem of the exact accounting for the wall profile effects was reduced to the solution of a Fredholm-type integral equation of the 2 nd -kind. Based on all this an extensive computer code was developed to compute the passively driven current as well as radiation losses, radiation transport and overall efficiencies. The results therefrom give an interesting and very detailed insight into the problems related to passive cyclotron current drive

  10. [The consequences of passive smoking in adults].

    Science.gov (United States)

    Trédaniel, J; Savinelli, F; Vignot, S; Bousquet, G; Le Maignan, C; Misset, J-L

    2006-04-01

    Passive smoking is the involuntary inhalation by a non-smoker of smoke generated in his neighbourhood by one or more smokers. The effect of this exposure is already generally recognised in children. In adults the induction of chronic obstructive lung disease has not been demonstrated. This is no longer the case for ischaemic heart disease and lung cancer where the effect of passive exposure of non-smokers to cigarette smoke is recognised. The biological plausibility together with the concordance of results obtained over successive years, as well as the large numbers of patients included in the studies, lead to a confident conclusion that the risks in adult non-smokers are increased by the order of 25%. There is no evidence that bias affects the conclusions reached and the World Health Organisation has recently classified passive smoking as being carcinogenic in man. As a result of these data prevention of passive exposure to cigarette smoke should be part of a larger framework of smoking prevention, especially among the young.

  11. Surface Passivation for Silicon Heterojunction Solar Cells

    NARCIS (Netherlands)

    Deligiannis, D.

    2017-01-01

    Silicon heterojunction solar cells (SHJ) are currently one of the most promising solar cell technologies in the world. The SHJ solar cell is based on a crystalline silicon (c-Si) wafer, passivated on both sides with a thin intrinsic hydrogenated amorphous silicon (a-Si:H) layer. Subsequently, p-type

  12. Recent Developments in SOBEK Passive Sonar Technology

    NARCIS (Netherlands)

    Hunter, A.J.; Fillinger, L.; Zampolli, M.; Clarijs, M.C.

    2012-01-01

    Surveillance of waterside locations for protection against threats from small fast surface vessels and underwater intruders is a very relevant but challenging problem. For this reason, the Netherlands Organisation for Applied Scientific Research (TNO) is developing SOBEK – a family of passive sonar

  13. The MEMOLED: Active addressing with passive driving

    NARCIS (Netherlands)

    Asadi, K.; Blom, P.W.M.; Leeuw, D.M. de

    2011-01-01

    Passive or active matrix driving schemes in large displays are prone to high power consumption and cost, respectively. For signage applications such as large out-door displays with low refresh rates there is as yet no technological solution. Here the MEMOLED solution, an organic light-emitting diode

  14. The MEMOLED : Active Addressing with Passive Driving

    NARCIS (Netherlands)

    Asadi, Kamal; Blom, Paul W. M.; de Leeuw, Dago M.

    2011-01-01

    Passive or active matrix driving schemes in large displays are prone to high power consumption and cost, respectively. For signage applications such as large outdoor displays with low refresh rates there is as yet no technological solution. Here the MEMOLED solution, an organic light-emitting diode

  15. NucleDyne's passive containment system

    International Nuclear Information System (INIS)

    Falls, O.B. Jr.; Kleimola, F.W.

    1987-01-01

    A simple definition of the passive containment system is that it is a total safeguards system for light water reactors designed to prevent and contain any accidental release of radioactivity. Its passive features utilize the natural laws of physics and thermodynamics. The system encompasses three basic containments constructed as one integrated structure on the reactor building foundation. The primary containment encloses the reactor pressure vessel and coolant system and passive engineered safety systems and components. Auxiliary containment enclosures house auxiliary systems and components. Secondary containment (the reactor building), housing the primary and auxiliary containment structures, provides a second containment barrier as added defense-in-depth against leakage of radioactivity for all accidents assumed by the industry. The generic features of the passive containment system are applicable to both the boiling water reactors and the pressurized water reactors as standardized features for all power ranges. These features provide for a zero source term, the industry's ultimate safety goal. This paper relates to a four-loop pressurized water reactor

  16. The passive hamstring stretch test: clinical evaluation.

    Science.gov (United States)

    Fisk, J W

    1979-03-28

    The passive hamstring stretch test is described. Using a modified goniometer it is shown that independent measurements taken by trained examiners approximate very closely to each other. This establishes the test as a valid objective measurement. The possible value of this test as a research tool in low back pain problems is discussed.

  17. Passive containment system in high earthquake motion

    International Nuclear Information System (INIS)

    Kleimola, F.W.; Falls, O.B. Jr.

    1977-01-01

    High earthquake motion necessitates major design modifications in the complex of plant structures, systems and components in a nuclear power plant. Distinctive features imposed by seismic category, safety class and quality classification requirements for the high seismic ground acceleration loadings significantly reflect in plant costs. The design features in the Passive Containment System (PCS) responding to high earthquake ground motion are described

  18. Chances and barriers for passive house renovations

    NARCIS (Netherlands)

    Mlecnik, E.; Opstelten, I.; Rovers, R.; Verdeyen, N.; Wagenaar, A.

    2016-01-01

    There is significant potential for carbon reduction and energy saving in residential buildings. Various market actors are looking for ways to increase the uptake of passive house renovation and its certification.
    This study aimed specifically to draw lessons from research projects towards the

  19. Passive Polarimetric Microwave Signatures Observed Over Antarctica

    Science.gov (United States)

    WindSat satellite-based fully polarimetric passive microwave observations, expressed in the form of the Stokes vector, were analyzed over the Antarctic ice sheet. The vertically and horizontally polarized brightness temperatures (first two Stokes components) from WindSat are shown to be consistent w...

  20. Indoor environment in Swedish passive houses

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Langer, Sarka; Bloom, Erica Bloom

    2014-01-01

    The purpose of this study was to evaluate the indoor air quality (IAQ) in newly built low energy houses. Measurements were performed in 22 passive houses and 21 conventional buildings during 2012-2013 and 2013-2014 heating seasons. The measured parameters were temperature, relative humidity......, concentration of CO2, NO2, formaldehyde, volatile organic compounds, and live microbiological flora. Air exchange rates (AER) were determined from the concentration-time profiles of CO2. The median AER was slightly higher in the passive houses than in conventional buildings (0.66 h-1 vs. 0.60 h-1). The median...... concentrations in passive houses and conventional buildings were 9.7 and 11 μg/m3, respectively, for NO2, 12 and 16 μg/m3 for formaldehyde, and 230 and 145 μg/m3 for TVOC. The indoor microbiological flora did not differ, with a few exceptions, from outdoors. The IAQ in the passive buildings was judged...