Detection of 14 MeV neutrons in high temperature environment up to 500 deg. C using 4H-SiC based diode detector

Energy Technology Data Exchange (ETDEWEB)

Szalkai, D.; Klix, A. [KIT- Karlsruhe Institute of Technology, Institute of Neutron Physics and Reactor Technology Karlsruhe 76344 (Germany); Ferone, R.; Issa, F.; Ottaviani, L.; Vervisch, V. [IM2NP, UMR CNRS 7334, Aix-Marseille University, Case 231 -13397 Marseille Cedex 20 (France); Gehre, D. [Inst. for Nucl.- and Particle-Phys., Dresden University of Technology, Dresden 01069 (Germany); Lyoussi, A. [CEA, DEN, Departement d' Etudes des Reacteurs, Service de Physique Experimentale, Laboratoire Dosimetrie Capteurs Instrumentation, 13108 Saint-Paul-lez-Durance (France)

2015-07-01

In reactor technology and industrial applications detection of fast and thermal neutrons plays a crucial role in getting relevant information about the reactor environment and neutron yield. The inevitable elevated temperatures make neutron yield measurements problematic. Out of the currently available semiconductors 4H-SiC seems to be the most suitable neutron detector material under extreme conditions due to its high heat and radiation resistance, large band-gap and lower cost of production than in case of competing diamond detectors. In the framework of the European I-Smart project, optimal {sup 4}H-SiC diode geometries were developed for high temperature neutron detection and have been tested with 14 MeV fast neutrons supplied by a deuterium-tritium neutron generator with an average neutron flux of 10{sup 10}-10{sup 11} n/(s*cm{sup 2}) at Neutron Laboratory of the Technical University of Dresden in Germany from room temperatures up to several hundred degrees Celsius. Based on the results of the diode measurements, detector geometries appear to play a crucial role for high temperature measurements up to 500 deg. C. Experimental set-ups using SiC detectors were constructed to simulate operation in the harsh environmental conditions found in the tritium breeding blanket of the ITER fusion reactor, which is planned to be the location of neutron flux characterization measurements in the near future. (authors)

Laser-mediated perforation of plant cells

Science.gov (United States)

Wehner, Martin; Jacobs, Philipp; Esser, Dominik; Schinkel, Helga; Schillberg, Stefan

2007-07-01

The functional analysis of plant cells at the cellular and subcellular levels requires novel technologies for the directed manipulation of individual cells. Lasers are increasingly exploited for the manipulation of plant cells, enabling the study of biological processes on a subcellular scale including transformation to generate genetically modified plants. In our setup either a picosecond laser operating at 1064 nm wavelength or a continuous wave laser diode emitting at 405 nm are coupled into an inverse microscope. The beams are focused to a spot size of about 1.5 μm and the tobacco cell protoplasts are irradiated. Optoporation is achieved when targeting the laser focal spot at the outermost edge of the plasma membrane. In case of the picosecond laser a single pulse with energy of about 0.4 μJ was sufficient to perforate the plasma membrane enabling the uptake of dye or DNA from the surrounding medium into the cytosol. When the ultraviolet laser diode at a power level of 17 mW is employed an irradiation time of 200 - 500 milliseconds is necessary to enable the uptake of macromolecules. In the presence of an EYFP encoding plasmid with a C-terminal peroxisomal signal sequence in the surrounding medium transient transformation of tobacco protoplasts could be achieved in up to 2% of the optoporated cells. Single cell perforation using this novel optoporation method shows that isolated plant cells can be permeabilized without direct manipulation. This is a valuable procedure for cell-specific applications, particularly where the import of specific molecules into plant cells is required for functional analysis.

Feasibility study of a SiC sandwich neutron spectrometer

Energy Technology Data Exchange (ETDEWEB)

Wu, Jian, E-mail: caepwujian@163.com [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, Sichuan Province (China); Lei, Jiarong, E-mail: jiarong_lei@163.com [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, Sichuan Province (China); Jiang, Yong; Chen, Yu; Rong, Ru; Zou, Dehui; Fan, Xiaoqiang [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, Sichuan Province (China); Chen, Gang; Li, Li; Bai, Song [Nanjing Electronic Devices Institute, Nanjing 210016 (China)

2013-04-21

Semiconductor sandwich neutron spectrometers are suitable for in-pile measurements of fast reactor spectra thanks to their compact and relatively simple design. We have assembled and tested a sandwich neutron spectrometer based on 4H-silicon carbide (4H-SiC) Schottky diodes. The SiC diodes detect neutrons via neutron-induced charged particles (tritons and alpha particles) produced by {sup 6}Li(n,α){sup 3}H reaction. {sup 6}LiF neutron converter layers are deposited on the front surface of Schottky diodes by magnetron sputtering. The responses of SiC diodes to charged particles were investigated with an {sup 241}Am alpha source. A sandwich neutron spectrometer was assembled with two SiC Schottky diodes selected based on the charged-particle-response experimental results. The low-energy neutron response of the sandwich spectrometer was measured in the neutron field of the Chinese Fast Burst Reactor-II (CFBR-II). Spectra of alpha particles and tritons from {sup 6}Li(n,α){sup 3}H reaction were obtained with two well-resolved peaks. The energy resolution of the sum spectrum was 8.8%. The primary experimental results confirmed the 4H-SiC sandwich neutron spectrometer's feasibility. -- Highlights: ► Sandwich neutron spectrometer employing 4H-SiC as a detecting material has been developed for the first time. ► {sup 6}LiF neutron converter has been deposited on the surface of 4H-SiC Schottky diode. ► Preliminary testing results obtained with the 4H-SiC sandwich neutron spectrometer are presented.

Application of semiconductor MOSFET and pin diode dosimeters to epithermal neutron beam dose distribution measurements in phantoms

International Nuclear Information System (INIS)

Carolan, M.G.; Wallace, S.A.; Allen, B.J.; Rosenfeld, A.B.; Mathur, J.N.

1996-01-01

For any clinical application of Boron Neutron Capture Therapy (BNCT) fast and accurate dose calculations will be required for treatment planning. Such calculations are also necessary for the planning and interpretation of results from pre-clinical and clinical trials where the speed of calculation is not so critical. A dose calculation system based on the MCNP Monte Carlo Neutron transport code has been developed by Wallace. This system takes image data from CT scans and constructs a voxel based geometrical model for input into MCNP. To validate the calculations, a number of phantoms were constructed and exposed in the HB11 epithermal neutron beam at the HFR of the CEC Joint Research Centre in Petten. The doses recorded by arrays of PIN diode neutron dosimeters and MOSFET gamma dosimeters in these phantoms were compared with the calculated results from the MCNP dose planning system. Initial results have been reported elsewhere. Poster 197. (author)

Radiation effects in semiconductor laser diode arrays

International Nuclear Information System (INIS)

Carson, R.F.

1988-01-01

The effects of radiation events are important for many of the present and future applications that involve optoelectronic components. Laser diodes show a strong resistance to degradation by gamma rays, prompt x-rays and (to a lesser extent), neutrons. This is due to the short carrier lifetime that is associated with stimulated emission and the high current injection conditions that are present in these devices. Radiation-resistant properties should carry over to many of the more recently developed devices such as multi-stripe array and broad area laser diodes. There are, however, additional considerations for radiation tolerance that are introduced by these devices. Arrays and other high power laser diodes have larger active region volumes than lower power single stripe devices. In addition, evanescent field coupling between stripes, the material quality available from newer MOCVD epitaxial growth techniques, and stripe definition methods may all influence the radiation tolerance of the high power laser diode devices. Radiation tests have been conducted on various GaAs-GaAlAs laser diode array and broad area devices. Tests involving total gamma dose have indicated that high power laser diodes and arrays have small degradations in light power output with current input after 4 MRad(Si) of radiation from a Co 60 source. Additional test results involving flash x-rays indicate that high power diode lasers and arrays are tolerant to 10 12 rads(Si)/sec, when observed on microsecond or millisecond time scales. High power diode laser devices were also irradiated with neutrons to a fluence of 10 14 neutrons/cm 2 with some degradation of threshold current level

Microstructured silicon neutron detectors for security applications

International Nuclear Information System (INIS)

Esteban, S; Fleta, C; Jumilla, C; Pellegrini, G; Quirion, D; Rodriguez, J; Lozano, M; Guardiola, C

2014-01-01

In this paper we present the design and performance of a perforated thermal neutron silicon detector with a 6 LiF neutron converter. This device was manufactured within the REWARD project workplace whose aim is to develop and enhance technologies for the detection of nuclear and radiological materials. The sensor perforated structure results in a higher efficiency than that obtained with an equivalent planar sensor. The detectors were tested in a thermal neutron beam at the nuclear reactor at the Instituto Superior Técnico in Lisbon and the intrinsic detection efficiency for thermal neutrons and the gamma sensitivity were obtained. The Geant4 Monte Carlo code was used to simulate the experimental conditions, i.e. thermal neutron beam and the whole detector geometry. An intrinsic thermal neutron detection efficiency of 8.6%±0.4% with a discrimination setting of 450 keV was measured

Typhoid Intestinal Perforation: 24 Perforations in One Patient

African Journals Online (AJOL)

Intestinal perforation is a common cause of peritonitis necessitating emergency surgical intervention. Perforation ... Mortality rates of typhoid intestinal perforation (TIP) cases are ... may be obscured clinical features with resultant delays in.

A novel wide range, real-time neutron fluence monitor based on commercial off the shelf gallium arsenide light emitting diodes

Energy Technology Data Exchange (ETDEWEB)

Mukherjee, B., E-mail: bhaskar.mukherjee@uk-essen.de [Westdeutsches Protonentherapiezentrum Essen (WPE) gGmbH, Hufelandstrasse 55, D-45147 Essen (Germany); Hentschel, R. [Strahlenklinik, University Hospital Essen (Germany); Lambert, J. [Westdeutsches Protonentherapiezentrum Essen (WPE) gGmbH, Hufelandstrasse 55, D-45147 Essen (Germany); Deya, W. [Strahlenklinik, University Hospital Essen (Germany); Farr, J. [Westdeutsches Protonentherapiezentrum Essen (WPE) gGmbH, Hufelandstrasse 55, D-45147 Essen (Germany)

2011-10-01

Displacement damage produced by high-energy neutrons in gallium arsenide (GaAs) light emitting diodes (LED) results in the reduction of light output. Based on this principle we have developed a simple, cost effective, neutron detector using commercial off the shelf (COTS) GaAs-LED for the assessment of neutron fluence and KERMA at critical locations in the vicinity of the 230 MeV proton therapy cyclotron operated by Westdeutsches Protonentherapiezentrum Essen (WPE). The LED detector response (mV) was found to be linear within the neutron fluence range of 3.0x10{sup 8}-1.0x10{sup 11} neutron cm{sup -2}. The response of the LED detector was proportional to neutron induced displacement damage in LED; hence, by using the differential KERMA coefficient of neutrons in GaAs, we have rescaled the calibration curve for two mono-energetic sources, i.e. 1 MeV neutrons and 14 MeV neutrons generated by D+T fusion reaction. In this paper we present the principle of the real-time GaAs-LED based neutron fluence monitor as mentioned above. The device was calibrated using fast neutrons produced by bombarding a thick beryllium target with 14 MeV deuterons from a TCC CV 28 medical cyclotron of the Strahlenklinik University Hospital Essen.

Note: Coincidence measurements of 3He and neutrons from a compact D-D neutron generator

Science.gov (United States)

Ji, Q.; Lin, C.-J.; Tindall, C.; Garcia-Sciveres, M.; Schenkel, T.; Ludewigt, B. A.

2017-05-01

Tagging of neutrons (2.45 MeV) with their associated 3He particles from deuterium-deuterium (D-D) fusion reactions has been demonstrated in a compact neutron generator setup enabled by a high brightness, microwave-driven ion source with a high fraction of deuterons. Energy spectra with well separated peaks of the D-D fusion reaction products, 3He, tritons, and protons, were measured with a silicon PIN diode. The neutrons were detected using a liquid scintillator detector with pulse shape discrimination. By correlating the 3He detection events with the neutron detection in time, we demonstrated the tagging of emitted neutrons with 3He particles detected with a Si PIN diode detector mounted inside the neutron generator vacuum vessel.

Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery.

Science.gov (United States)

Hamerschmidt, Rogerio; Saab, Stephanie Sbizera; Carvalho, Bettina; Carmo, Carolina do

2018-04-01

Introduction  Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective  To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method  Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results  Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion  Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.

Solid state neutron dosimeter for space applications. Final Report

International Nuclear Information System (INIS)

Entine, G.; Nagargar, V.; Sharif, D.

1990-08-01

Personnel engaged in space flight are exposed to significant flux of high energy neutrons arising from both primary and secondary sources of ionizing radiation. Presently, there exist no compact neutron sensor capable of being integrated in a flight instrument to provide real time measurement of this radiation flux. A proposal was made to construct such an instrument using special PIN silicon diode which has the property of being insensitive to the other forms of ionizing radiation. Studies were performed to determine the design and construction of a better reading system to allow the PIN diode to be read with high precision. The physics of the device was studied, especially with respect to those factors which affect the sensitivity and reproducibility of the neutron response. This information was then used to develop methods to achieve high sensitivity at low neutron doses. The feasibility was shown of enhancing the PIN diode sensitivity to make possible the measurement of the low doses of neutrons encountered in space flights. The new PIN diode will make possible the development of a very compact, accurate, personal neutron dosimeter

Characterization of proton and neutron irradiated low resistivity p-on-n magnetic Czochralski ministrip sensors and diodes

International Nuclear Information System (INIS)

Pacifico, Nicola; Dolenc Kittelmann, Irena; Fahrer, Manuel; Moll, Michael; Militaru, Otilia

2011-01-01

Transient Current Technique (TCT) and Charge Collection Efficiency (CCE) measurements were performed on low resistivity (280Ωcm) n-bulk, p-readout magnetic Czochralski ministrip sensors and diodes. The detectors were irradiated with neutrons and 24 GeV/c protons up to a total NIEL equivalent fluence of 8×10 15 /cm 2 . The study was addressed to assess the radiation tolerance of the detectors up to fluences expected in the next generations of High Energy Physics experiments. The charge collection efficiency after irradiation was found to be much higher than for standard FZ silicon p-in-n sensors. The underlying physics of this remarkable result was investigated by performing Edge-TCT measurements on one of the neutron irradiated ministrip sensors to extract detailed informations about the field and efficiency profiles of the detector.

Experimental and simulation studies of neutron-induced single-event burnout in SiC power diodes

Science.gov (United States)

Shoji, Tomoyuki; Nishida, Shuichi; Hamada, Kimimori; Tadano, Hiroshi

2014-01-01

Neutron-induced single-event burnouts (SEBs) of silicon carbide (SiC) power diodes have been investigated by white neutron irradiation experiments and transient device simulations. It was confirmed that a rapid increase in lattice temperature leads to formation of crown-shaped aluminum and cracks inside the device owing to expansion stress when the maximum lattice temperature reaches the sublimation temperature. SEB device simulation indicated that the peak lattice temperature is located in the vicinity of the n-/n+ interface and anode contact, and that the positions correspond to a hammock-like electric field distribution caused by the space charge effect. Moreover, the locations of the simulated peak lattice temperature agree closely with the positions of the observed destruction traces. Furthermore, it was theoretically demonstrated that the period of temperature increase of a SiC power device is two orders of magnitude less than that of a Si power device, using a thermal diffusion equation.

Pedicled perforator flaps

DEFF Research Database (Denmark)

Demirtas, Yener; Ozturk, Nuray; Kelahmetoglu, Osman

2009-01-01

Described in this study is a surgical concept that supports the "consider and use a pedicled perforator flap whenever possible and indicated" approach to reconstruct a particular skin defect. The operation is entirely free-style; the only principle is to obtain a pedicled perforator flap...... to reconstruct the defect. The perforators are marked with a hand-held Doppler probe and multiple flaps are designed. The appropriate flap is elevated after identifying the perforator(s). Dissection of the perforator(s) or complete incision of the flap margins are not mandatory if the flap is mobilized...... adequately to cover the defect. Defects measuring 3 x 3 cm up to 20 x 20 cm at diverse locations were successfully reconstructed in 20 of 21 patients with 26 flaps. Pedicled perforator flaps offer us reliable and satisfactory results of reconstruction at different anatomic territories of the body. It sounds...

Admittance studies of neutron-irradiated silicon p+-n diodes

International Nuclear Information System (INIS)

Tokuda, Y.; Usami, A.

1977-01-01

Defects introduced in n-type silicon by neutron irradiation were investigated by measuring the conductance (G) and the capacitance (C) of p + -n diodes. The method of the determination of the energy level, capture cross section, and concentration for each defect from the G-T and C-T curves for various frequencies was presented. Assuming that capture cross sections are independent of temperature, the energy levels of E/sub c/-0.15 eV, E/sub c/-0.22 eV, and E/sub c/-0.39 eV were obtained. For these defects, the calculated values of the electron capture cross section were 2.6 x 10 -14 , 3.7 x 10 -15 , and 2.0 x 10 -14 cm 2 , respectively. The introduction rate of defects for E/sub c/-0.39 eV was twice that for E/sub c/-0.22 eV which was twice that for E/sub c/-0.15 eV. Comparing with other published data, the energy levels of E/sub c/-0.15 eV and E/sub c/-0.39 eV were found to be correlated with the A center and the divacancy, respectively

Nanosecond neutron generator

International Nuclear Information System (INIS)

Lobov, S.I.; Pavlovskaya, N.G.; Pukhov, S.P.

1991-01-01

High-voltage nanosecond neutron generator for obtaining neutrons in D-T reaction is described. Yield of 6x10 6 neutron/pulse was generated in a sealed gas-filled diode with a target on the cathode by accelerating pulse voltage of approximately 0.5 MV and length at half-height of 0.5 ns and deuterium pressure of 6x10 -2 Torr. Ways of increasing neutron yield and possibilities of creating generators of nanosecond neutron pulses with great service life are considered

Radiation resistant quench protection diodes for the LHC

International Nuclear Information System (INIS)

Hagedorn, D.; Coull, L.

1994-01-01

The quench protection diodes for the proposed Large Hadron Collider at CERN will be located inside the He-II vessel of the short straight section of one half cell, where they could be exposed to a radiation dose of about 50 kGy and a total neutron fluence of about 10 15 n/cm 2 over 10 years at temperatures of about 2 K. To investigate the influence of irradiation on the electrical characteristics of the diodes, newly developed diodes of thin base region of the diffusion type and of the epitaxial type have been submitted to irradiation tests at liquid nitrogen temperature in a target area of the SPS accelerator at CERN. The degradation of the electrical characteristics of the diodes for a radiation dose up to about 20 kGy and neutron fluence of up to about 5 10 14 n/cm 2 and the effect of carrier injection and thermal annealing after irradiation have been measured. The test results show that only the thin base diodes of the epitaxial type are really radiation resistant. A compromise must be found between required blocking characteristics and radiation resistance. Annealing by carrier injection and occasional warm up to room temperature can extend the service life of irradiated diodes quite substantially

Characterization of proton and neutron irradiated low resistivity p-on-n magnetic Czochralski ministrip sensors and diodes

Energy Technology Data Exchange (ETDEWEB)

Pacifico, Nicola, E-mail: nicola.pacifico@cern.ch [CERN, Geneva (Switzerland); Dolenc Kittelmann, Irena; Fahrer, Manuel; Moll, Michael [CERN, Geneva (Switzerland); Militaru, Otilia [UCL, Louvain (Belgium)

2011-12-01

Transient Current Technique (TCT) and Charge Collection Efficiency (CCE) measurements were performed on low resistivity (280{Omega}cm) n-bulk, p-readout magnetic Czochralski ministrip sensors and diodes. The detectors were irradiated with neutrons and 24 GeV/c protons up to a total NIEL equivalent fluence of 8 Multiplication-Sign 10{sup 15}/cm{sup 2}. The study was addressed to assess the radiation tolerance of the detectors up to fluences expected in the next generations of High Energy Physics experiments. The charge collection efficiency after irradiation was found to be much higher than for standard FZ silicon p-in-n sensors. The underlying physics of this remarkable result was investigated by performing Edge-TCT measurements on one of the neutron irradiated ministrip sensors to extract detailed informations about the field and efficiency profiles of the detector.

Sensitive silicon PIN-diode dosimeter for fast neutrons and method to control and increase its sensitivity

International Nuclear Information System (INIS)

Swinehart, P.R.; Swartz, J.M.

1978-01-01

With the personnel dosimeter, applicable e.g. in medicine, a dose of 0.1 rad for neutrons with an energy greater than 10 keV can be detected. In the range between 0.1 and 20 rad sensitivity is increased to 5 mV/rad. This sensitivity can be achieved by distributing the mass of the semiconductor material of the diode or equal to four times the reciprocal base width. Appropriate dimensions are 750 μm for the edge length of the end surface resp. diameter and 750 μm up to 5000 μm for the base width. (DG) [de

Application of low-cost Gallium Arsenide light-emitting-diodes as kerma dosemeter and fluence monitor for high-energy neutrons

International Nuclear Information System (INIS)

Mukherjee, B.; Simrock, S.; Khachan, J.; Rybka, D.; Romaniuk, R.

2007-01-01

Displacement damage (DD) caused by fast neutrons in unbiased Gallium Arsenide (GaAs) light emitting diodes (LED) resulted in a reduction of the light output. On the other hand, a similar type of LED irradiated with gamma rays from a 60 Co source up to a dose level in excess of 1.0 kGy (1.0 x 10 5 rad) was found to show no significant drop of the light emission. This phenomenon was used to develop a low cost passive fluence monitor and kinetic energy released per unit mass dosemeter for accelerator-produced neutrons. These LED-dosemeters were used to assess the integrated fluence of photoneutrons, which were contaminated with a strong Bremsstrahlung gamma-background generated by the 730 MeV superconducting electron linac driving the free electron laser in Hamburg (FLASH) at Deutsches Elektronen-Synchrotron. The applications of GaAs LED as a routine neutron fluence monitor and DD precursor for the electronic components located in high-energy accelerator environment are highlighted. (authors)

Differentiating perforated from non-perforated appendicitis on contrast-enhanced magnetic resonance imaging

International Nuclear Information System (INIS)

Rosenbaum, Daniel G.; Kovanlikaya, Arzu; Askin, Gulce; Beneck, Debra M.

2017-01-01

The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation. Appendiceal diameter and the following 10 MRI findings were assessed: appendiceal restricted diffusion, wall defect, appendicolith, periappendiceal free fluid, remote free fluid, restricted diffusion within free fluid, abscess, peritoneal enhancement, ileocecal wall thickening and ileus. Two-sample t-test and chi-square tests were used to analyze continuous and discrete data, respectively. Sensitivity and specificity for individual MRI findings were calculated and optimal thresholds for measures of accuracy were selected. Seventy-seven patients (mean age: 12.2 years) with appendicitis were included, of whom 22 had perforation. The perforated group had a larger mean appendiceal diameter and mean number of MRI findings than the non-perforated group (12.3 mm vs. 8.6 mm; 5.0 vs. 2.0, respectively). Abscess, wall defect and restricted diffusion within free fluid had the greatest specificity for perforation (1.00, 1.00 and 0.96, respectively) but low sensitivity (0.36, 0.25 and 0.32, respectively). The receiver operator characteristic curve for total number of MRI findings had an area under the curve of 0.92, with an optimal threshold of 3.5. A threshold of any 4 findings had the best ability to accurately discriminate between perforated and non-perforated cases, with a sensitivity of 82% and specificity of 85%. Contrast-enhanced MRI can differentiate perforated from non-perforated appendicitis. The presence of multiple findings increases diagnostic accuracy, with a threshold of any four findings optimally discriminating between

Differentiating perforated from non-perforated appendicitis on contrast-enhanced magnetic resonance imaging.

Science.gov (United States)

Rosenbaum, Daniel G; Askin, Gulce; Beneck, Debra M; Kovanlikaya, Arzu

2017-10-01

The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation. Appendiceal diameter and the following 10 MRI findings were assessed: appendiceal restricted diffusion, wall defect, appendicolith, periappendiceal free fluid, remote free fluid, restricted diffusion within free fluid, abscess, peritoneal enhancement, ileocecal wall thickening and ileus. Two-sample t-test and chi-square tests were used to analyze continuous and discrete data, respectively. Sensitivity and specificity for individual MRI findings were calculated and optimal thresholds for measures of accuracy were selected. Seventy-seven patients (mean age: 12.2 years) with appendicitis were included, of whom 22 had perforation. The perforated group had a larger mean appendiceal diameter and mean number of MRI findings than the non-perforated group (12.3 mm vs. 8.6 mm; 5.0 vs. 2.0, respectively). Abscess, wall defect and restricted diffusion within free fluid had the greatest specificity for perforation (1.00, 1.00 and 0.96, respectively) but low sensitivity (0.36, 0.25 and 0.32, respectively). The receiver operator characteristic curve for total number of MRI findings had an area under the curve of 0.92, with an optimal threshold of 3.5. A threshold of any 4 findings had the best ability to accurately discriminate between perforated and non-perforated cases, with a sensitivity of 82% and specificity of 85%. Contrast-enhanced MRI can differentiate perforated from non-perforated appendicitis. The presence of multiple findings increases diagnostic accuracy, with a threshold of any four findings optimally discriminating between

Differentiating perforated from non-perforated appendicitis on contrast-enhanced magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

Rosenbaum, Daniel G.; Kovanlikaya, Arzu [New York-Presbyterian Hospital/Weill Cornell Medicine, Division of Pediatric Radiology, New York, NY (United States); Askin, Gulce [Weill Cornell Medical College, Division of Biostatistics and Epidemiology, New York, NY (United States); Beneck, Debra M. [New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Pathology, New York, NY (United States)

2017-10-15

The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation. Appendiceal diameter and the following 10 MRI findings were assessed: appendiceal restricted diffusion, wall defect, appendicolith, periappendiceal free fluid, remote free fluid, restricted diffusion within free fluid, abscess, peritoneal enhancement, ileocecal wall thickening and ileus. Two-sample t-test and chi-square tests were used to analyze continuous and discrete data, respectively. Sensitivity and specificity for individual MRI findings were calculated and optimal thresholds for measures of accuracy were selected. Seventy-seven patients (mean age: 12.2 years) with appendicitis were included, of whom 22 had perforation. The perforated group had a larger mean appendiceal diameter and mean number of MRI findings than the non-perforated group (12.3 mm vs. 8.6 mm; 5.0 vs. 2.0, respectively). Abscess, wall defect and restricted diffusion within free fluid had the greatest specificity for perforation (1.00, 1.00 and 0.96, respectively) but low sensitivity (0.36, 0.25 and 0.32, respectively). The receiver operator characteristic curve for total number of MRI findings had an area under the curve of 0.92, with an optimal threshold of 3.5. A threshold of any 4 findings had the best ability to accurately discriminate between perforated and non-perforated cases, with a sensitivity of 82% and specificity of 85%. Contrast-enhanced MRI can differentiate perforated from non-perforated appendicitis. The presence of multiple findings increases diagnostic accuracy, with a threshold of any four findings optimally discriminating between

Spontaneous external gallbladder perforation

International Nuclear Information System (INIS)

Noeldge, G.; Wimmer, B.; Kirchner, R.

1981-01-01

Spontaneous perforation of the gallbladder is one complication of cholelithiasis. There is a greater occurence of free perforation in the peritoneal cavity with bilary pertonitis, followed by the perforation into the stomach, small intestine and colon. A single case of the nowadays rare spontaneous perforation in and through the abdominal wall will be reported. Spontaneous gallbladder perforation appears nearly asymptomatic in its clinical course because of absent biliary peritonitis. (orig.) [de

The Versatile Modiolus Perforator Flap

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Thomsen, Jorn Bo

2016-01-01

BACKGROUND: Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our...... experience using freestyle facial perforator flaps, we have located areas where perforators are consistently found. This study is focused on a particular perforator lateral to the angle of the mouth; the modiolus and the versatile modiolus perforator flap. METHODS: A cohort case series of 14 modiolus...... perforator flap reconstructions in 14 patients and a color Doppler ultrasonography localization of the modiolus perforator in 10 volunteers. RESULTS: All 14 flaps were successfully used to reconstruct the defects involved, and the location of the perforator was at the level of the modiolus as predicted...

Ultrafast photoconductor detector-laser-diode transmitter

International Nuclear Information System (INIS)

Wang, C.L.; Davis, B.A.; Davies, T.J.; Nelson, M.A.; Thomas, M.C.; Zagarino, P.A.

1987-01-01

We report the results of an experiment in which we used an ultrafast, photoconductive, radiation detector to drive a fast laser-diode transmitter. When we irradiated the neutron-damaged Cr-doped GaAs detector with 17-MeV electron beams, the temporal response was measured to be less than 30 ps. The pulses from this detector modulated a fast GaAlAs laser diode to transmit the laser output through 30- and 1100-m optical fibers. Preliminary results indicate that 50- and 80-ps time resolutions, respectively, are obtainable with these fibers. We are now working to integrate the photoconductive detector and the laser diode transmitter into a single chip

Salmonella intestinal perforation: (27 perforations in one patient, 14 perforations in another Are the goal posts changing?

Directory of Open Access Journals (Sweden)

Adeniran J

2005-01-01

Full Text Available The pathology of salmonellosis after a faeco-oral transmission was first clearly described by Jenner in 1850. Over the years, the pathological manifestations in different tissues of the body have been described. The ileum is however mostly involved leading to enlarged Peyer′s patches, ulceration, and sometimes bleeding and perforation. Efforts at control have largely been improvement in public water supply, safe disposal of waste, and general public health measures. Despite these measures, intestinal perforation from salmonellosis remains the commonest cause of emergency operation in children above 3 years. The incidence continues to rise, so also the mortality, despite new antibiotics and improvement in facilities in the hospitals. Even more disturbing is that we now see more perforations per patient, and more involvement of the colon. Three recently managed patients with multiple ileal/colonic perforations were reviewed. Presenting problems, delay in referral, choice of antibiotics and postoperative complications were noted. One patient had 27 perforations and another 14 perforations. Both survived. Is salmonella changing? Are our patients changing? Is the environment changing? Are the goal posts changing? This article details our recent experience with this dreadful disease, reviews the new literature and makes suggestions for the way forwards.

Investigation on the Acoustic Absorption of Flexible Micro-Perforated Panel with Ultra-Micro Perforations

Science.gov (United States)

Li, Guoxin; Tang, Xiaoning; Zhang, Xiaoxiao; Qian, Y. J.; Kong, Deyi

2017-11-01

Flexible micro-perforated panel has unique advantages in noise reduction due to its good flexibility compared with traditional rigid micro-perforated panel. In this paper, flexible micro-perforated panel was prepared by computer numerical control (CNC) milling machine. Three kinds of plastics including polyvinylchloride (PVC), polyethylene terephthalate (PET), and polyimide (PI) were taken as the matrix materials to prepare flexible micro-perforated panel. It has been found that flexible micro-perforated panel made of PET possessing good porosity and proper density, elastic modulus and poisson ratio exhibited the best acoustic absorption properties. The effects of various structural parameters including perforation diameter, perforation ratio, thickness and air gap have also been investigated, which would be helpful to the optimization of acoustic absorption properties.

Conducting Polymers for Neutron Detection

International Nuclear Information System (INIS)

Clare Kimblin; Kirk Miller; Bob Vogel; Bill Quam; Harry McHugh; Glen Anthony; Steve Jones; Mike Grover

2007-01-01

Conjugated polymers have emerged as an attractive technology for large-area electronic applications. As organic semiconductors, they can be used to make large-area arrays of diodes or transistors using fabrication techniques developed for polymer coatings, such as spraying and screen-printing. We have demonstrated both neutron and alpha detection using diodes made from conjugated polymers and have done preliminary work to integrate a boron carbide layer into the conventional polymer device structure to capture thermal neutrons. The polymer devices appear to be insensitive to gamma rays, due to their small physical thickness and low atomic number

Ultrafast photoconductive detector-laser-diode transmitter

International Nuclear Information System (INIS)

Wang, C.L.; Davies, T.J.; Nelson, M.A.; Thomas, M.C.; Zagarino, P.A.; Davis, B.A.

1987-01-01

The authors report the results of an experiment in which they used an ultrafast, photoconductive, radiation detector to drive a fast laser-diode transmitter. When they irradiated the neutron-damaged Cr-doped Ga/As detector with 17-MeV electron beams, the temporal response of was measured to be less than 30 ps. The pulses from this detector modulated a fast GaAlAs laser diode to transmit the laser output through 30- and 1100-m optical fibers. Preliminary results indicate that 50- and 80-ps time resolutions, respectively, are obtainable with these fibers. They are now working to integrate the photoconductive detector and the laser diode transmitter into a single chip

Differentiation of Acute Perforated from Non-Perforated Appendicitis: Usefulness of High-Resolution Ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Choi, Gyu Chang [Dept. of Radiology, Gumi Hospital, Soonchunhyang University College of Medicine, Gumi (Korea, Republic of)

2011-07-15

To evaluate the usefulness of high-resolution ultrasonography (US) for the differentiation of acute perforated appendicitis from non-perforated appendicitis. The high-resolution US features in 96 patients (49 males, 47 females; mean age, 33.8 years; age range, 4-80 years) with pathologically proven acute appendicitis were evaluated. The following US findings were evaluated for differentiation of acute perforated appendicitis from non-perforated appendicitis: circumferential loss of the echogenic submucosal layer, periappendiceal fluid collection, disruption of the serosal layer, asymmetrical wall thickening, maximum overall diameter > 10.5 mm, and the presence of appendicoliths. The sensitivity and specificity of the US features in the diagnosis of acute perforated appendicitis were calculated. All of the US findings, except for appendicoliths, were significantly more common in the acute perforated appendicitis group (p < 0.001). The sensitivity of circumferential loss of the echogenic submucosal layer, periappendiceal fluid collection, disruption of the serosal layer, asymmetrical wall thickening, maximum overall diameter > 10.5 mm, and the presence of appendicoliths was 85.4, 73.2, 68.3, 70.7, 80.5, and 36.6%, respectively, while the specificity was 65.5, 89.1, 96.4, 98.2, 81.8, and 80.0%, respectively. High-resolution US was found to be useful for differentiating acute perforated appendicitis from non-perforated appendicitis.

Nontraumatic terminal ileal perforation

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Wani Rauf A

2006-03-01

Full Text Available Abstract Background There is still confusion and controversy over the diagnosis and optimal surgical treatment of non traumatic terminal ileal perforation-a cause of obscure peritonitis. Methods This study was a prospective study aimed at evaluating the clinical profile, etiology and optimal surgical management of patients with nontraumatic terminal ileal perforation. Results There were 79 cases of nontraumatic terminal ileal perforation; the causes for perforation were enteric fever(62%, nonspecific inflammation(26%, obstruction(6%, tuberculosis(4% and radiation enteritis (1%. Simple closure of the perforation (49% and end to side ileotransverse anastomosis(42% were the mainstay of the surgical management. Conclusion Terminal ileal perforation should be suspected in all cases of peritonitis especially in developing countries and surgical treatment should be optimized taking various accounts like etiology, delay in surgery and operative findings into consideration to reduce the incidence of deadly complications like fecal fistula.

Dual-sided microstructured semiconductor neutron detectors (DSMSNDs)

International Nuclear Information System (INIS)

Fronk, Ryan G.; Bellinger, Steven L.; Henson, Luke C.; Ochs, Taylor R.; Smith, Colten T.; Kenneth Shultis, J.; McGregor, Douglas S.

2015-01-01

Microstructured semiconductor neutron detectors (MSNDs) have in recent years received much interest as high-efficiency replacements for thin-film-coated thermal neutron detectors. The basic device structure of the MSND involves micro-sized trenches that are etched into a vertically-oriented pvn-junction diode that are backfilled with a neutron converting material. Neutrons absorbed within the converting material induce fission of the parent nucleus, producing a pair of energetic charged-particle reaction products that can be counted by the diode. The MSND deep-etched microstructures produce good neutron-absorption and reaction-product counting efficiencies, offering a 10× improvement in intrinsic thermal neutron detection efficiency over thin-film-coated devices. Performance of present-day MSNDs are nearing theoretical limits; streaming paths between the conversion-material backfilled trenches, allow a considerable fraction of neutrons to pass undetected through the device. Dual-sided microstructured semiconductor neutron detectors (DSMSNDs) have been developed that utilize a complementary second set of trenches on the back-side of the device to count streaming neutrons. DSMSND devices are theoretically capable of greater than 80% intrinsic thermal neutron detection efficiency for a 1-mm thick device. The first such prototype DSMSNDs, presented here, have achieved 29.48±0.29% nearly 2× better than MSNDs with similar microstructure dimensions.

A silicon diode for fast neutron dosimetry

International Nuclear Information System (INIS)

Anon.

1983-01-01

The effect of fast neutrons on both animate and inanimate objects, including human beings, can be extremely serious and cumulative. There is thus a need for a small, simple and cheap component which will provide a permanent or semi-permanent record of the accumulated fast neutron dose

Temperature driven annealing of perforations in bicellar model membranes.

Science.gov (United States)

Nieh, Mu-Ping; Raghunathan, V A; Pabst, Georg; Harroun, Thad; Nagashima, Kazuomi; Morales, Hannah; Katsaras, John; Macdonald, Peter

2011-04-19

Bicellar model membranes composed of 1,2-dimyristoylphosphatidylcholine (DMPC) and 1,2-dihexanoylphosphatidylcholine (DHPC), with a DMPC/DHPC molar ratio of 5, and doped with the negatively charged lipid 1,2-dimyristoylphosphatidylglycerol (DMPG), at DMPG/DMPC molar ratios of 0.02 or 0.1, were examined using small angle neutron scattering (SANS), (31)P NMR, and (1)H pulsed field gradient (PFG) diffusion NMR with the goal of understanding temperature effects on the DHPC-dependent perforations in these self-assembled membrane mimetics. Over the temperature range studied via SANS (300-330 K), these bicellar lipid mixtures exhibited a well-ordered lamellar phase. The interlamellar spacing d increased with increasing temperature, in direct contrast to the decrease in d observed upon increasing temperature with otherwise identical lipid mixtures lacking DHPC. (31)P NMR measurements on magnetically aligned bicellar mixtures of identical composition indicated a progressive migration of DHPC from regions of high curvature into planar regions with increasing temperature, and in accord with the "mixed bicelle model" (Triba, M. N.; Warschawski, D. E.; Devaux, P. E. Biophys. J.2005, 88, 1887-1901). Parallel PFG diffusion NMR measurements of transbilayer water diffusion, where the observed diffusion is dependent on the fractional surface area of lamellar perforations, showed that transbilayer water diffusion decreased with increasing temperature. A model is proposed consistent with the SANS, (31)P NMR, and PFG diffusion NMR data, wherein increasing temperature drives the progressive migration of DHPC out of high-curvature regions, consequently decreasing the fractional volume of lamellar perforations, so that water occupying these perforations redistributes into the interlamellar volume, thereby increasing the interlamellar spacing. © 2011 American Chemical Society

Reactive perforating collagenosis

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Yadav Mukesh

2009-01-01

Full Text Available Reactive perforating collagenosis is a rare cutaneous disorder of unknown etiology. We hereby describe a case of acquired reactive perforating collagenosis in a patient of diabetes and chronic renal failure.

Combining rhinoplasty with septal perforation repair.

Science.gov (United States)

Foda, Hossam M T; Magdy, Emad A

2006-11-01

A combined septal perforation repair and rhinoplasty was performed in 80 patients presenting with septal perforations (size 1 to 5 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. Complete closure of the perforation was achieved in 90% of perforations of size up to 3.5 cm and in only 70% of perforations that were larger than 3.5 cm. Cosmetically, 95% were very satisfied with their aesthetic result. The external rhinoplasty approach proved to be very helpful in the process of septal perforation repair especially in large and posteriorly located perforations and in cases where the caudal septal cartilage was previously resected. Our results show that septal perforation repair can be safely combined with rhinoplasty and that some of the routine rhinoplasty maneuvers, such as medial osteotomies and dorsal lowering, could even facilitate the process of septal perforation repair.

Advanced research capabilities for neutron science and technology: Neutron polarizers for neutron scattering

International Nuclear Information System (INIS)

Penttila, S.I.; Fitzsimmons, M.R.; Delheij, P.J.

1998-01-01

The authors describe work on the development of polarized gaseous 3 He cells, which are intended for use as neutron polarizers. Laser diode arrays polarize Rb vapor in a sample cell and the 3 He is polarized via collisions. They describe development and tests of such a system at LANSCE

Spectrum of Perforation Peritonitis

Science.gov (United States)

Chakma, Sujit M.; Singh, Rahul L.; Parmekar, Mahadev V.; Singh, K.H. Gojen; Kapa, Buru; Sharatchandra, K.H.; Longkumer, Amenla T.; Rudrappa, Santhosh

2013-01-01

Introduction: Perforation peritonitis mostly results from the perforation of a diseased viscus. Other causes of perforation include abdominal trauma, ingestion of sharp foreign body and iatrogenic perforation. The diagnosis is mainly based on clinical grounds. Plain abdominal X-rays (erect) may reveal dilated and oedematous intestines with pneumoperitoneum. Ultrasound and CT scan may diagnose up to 72% and 82% of perforation respectively. The present study was carried out to study various etiological factors, modes of clinical presentation, morbidity and mortality patterns of perforation peritonitis presented in the RIMS hospital, Imphal, India. Material and Methods: The study was conducted from September 2010 to August 2012 on 490 cases of perforation peritonitis admitted and treated in the Department of Surgery. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Results: A total of 490 patients of perforation peritonitis were included in the study, with mean age of 48.28 years. 54.29% patients were below 50 years and 45.71% patients were above 50 years. There were 54.29% male patients and 45.71% female patients. Only 30% patients presented within 24 hours of onset of symptoms, 31.43% patients presented between 24 to 72 hours and 38.57% patients presented 72 hours after the onset of symptoms. Mean duration of presentation was 54.7 hours. Overall 469 patients were treated surgically and 21 patients were managed conservatively. Overall morbidity and mortality recorded in this study were 52.24% and 10% respectively. PMID:24392388

Perforations during contrast enema

International Nuclear Information System (INIS)

Vogel, H.; Steinkamp, U.; Grabbe, E.; Allgemeines Krankenhaus Ochsenzoll, Hamburg

1983-01-01

During contrast enema, perforation into the retroperitoneal space can be differentiated from perforation into the peritoneum and perforation into the intestinal wall associated with formation of barium granulomas or submucosal spreading of the contrast medium. Other special forms are perforation with contrast medium embolism of diverticula; of the processus vermiformis; penetration of contrast medium into fistulous systems and from the operated areas. Risk factors are: balloon catheter, intestinal tubes with a hard tip, preternatural anus, excessive enema pressure, contrast medium additions, preceding manipulations, intestinal diseases, advanced age and delegation of manipulations to assistants and unskilled staff. Children are particularly at risk. (orig.) [de

Study on the ion diode with a laser-plasma anode

International Nuclear Information System (INIS)

Bykovskij, Yu.A.; Kozyrev, Yu.P.; Kozlovskij, K.I.; Tsybin, A.S.; Shikanov, A.E.

1981-01-01

Results of investigation into a pulsed ion diode with magnetic electron isolation (DMI) using a laser ion source are stated. The investigations were carried on by measurement of current characteristics and neutron diode yield for different parameters of laser radiation, isolating magnetic field and DMI geometry. approximately equal to 150 A current of accelerated ions has been generated at a density of approximately equal to 10 A/cm 2 and approximately 1 μs pulse duration when using isolating magnetic field having inductance of up to 10 kGs and laser radiation energy of up to 1 J (power density > or approximately 10 9 W/cm 2 ). Current diode efficiency constituted approximately 50 %. Neutron yield amounted to approximately 10 7 neutr/pulse (D(d, n)He 3 reaction) at an optimal value of inductance of isolating magnetic field. Frequency regime of DMI operation with pulse repetition of up to 10 Hz has been realized [ru

The freestyle pedicle perforator flap

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Jackson, Ian T; Westvik, Tormod S

2015-01-01

BACKGROUND: Perforating vessels are a consistent anatomical finding and well described in the current literature. Any skin flap can be raised on a subcutaneous pedicle as long as it contains at least one supplying perforator. Perforator flaps have been interlinked with microsurgery and generally...... not widely performed by the general plastic surgeons. The aim of this paper is to present the simplicity of pedicled perforator flap reconstruction of moderate-sized defects of the extremities and torso. METHODS: We retrospectively reviewed the charts of 34 patients reconstructed using 34 freestyle pedicled...... perforator flaps for moderate-sized defects of the truncus and extremities. We registered indications, flap size and localization, success rate, and complications. Most importantly, we describe a simple approach to the design of freestyle pedicled perforator flaps and elaborate on technical aspects...

Study on photon sensitivity of silicon diodes related to materials used for shielding

International Nuclear Information System (INIS)

Moiseev, T.

1999-01-01

Large area silicon diodes used in electronic neutron dosemeters have a significant over-response to X- and gamma-rays, highly non-linear at photon energies below 200 keV. This over-response to photons is proportional to the diode's active area and strongly affects the neutron sensitivity of such dosemeters. Since silicon diodes are sensitive to light and electromagnetic fields, most diode detector assemblies are provided with a shielding, sometimes also used as radiation filter. In this paper, the influence of materials covering the diode's active area is investigated using the MCNP-4A code by estimating the photon induced pulses in a typical silicon wafer (300 μm thickness and 1 cm diameter) when provided with a front case cover. There have been simulated small-size diode front covers made of several materials with low neutron interaction cross-sections like aluminium, TEFLON, iron and lead. The estimated number of induced pulses in the silicon wafer is calculated for each type of shielding at normal photon incidence for several photon energies from 9.8 keV up to 1.15 MeV and compared with that in a bare silicon wafer. The simulated pulse height spectra show the origin of the photon-induced pulses in silicon for each material used as protective cover: the photoelectric effect for low Z front case materials at low-energy incident photons (up to about 65 keV) and the Compton and build-up effects for high Z case materials at higher photon energies. A simple means to lower and flatten the photon response of silicon diodes over an extended X- and gamma rays energy range is proposed by designing a composed photon filter. (author)

Study on Photon Sensitivity of Silicon Diodes Related to Materials Used for Shielding

International Nuclear Information System (INIS)

Moiseev, T.

2000-01-01

Large area Silicon diodes used in electronic neutron dosemeters have a significant over-response to X and gamma rays, highly non-linear at photon energies below 200 keV. This over-response to photons is proportional to the diodes active area and strongly affects the neutron sensitivity of such dosemeters. Since Silicon diodes are sensitive to light and electromagnetic fields, most diode detector assemblies are provided with a shielding, sometimes also used as radiation filter. In this paper, the influence of materials covering the diode's active area is investigated using the MCNP-4A code by estimating the photon induced pulses in a typical silicon wafer (300 μm thickness and 1 cm diameter) when provided with a front case cover. There have been simulated small-size diode front covers made of several materials with low neutron interaction cross-sections like aluminium, TEFLON, iron and lead. The estimated number of induced pulses in the silicon wafer is calculated for each type of shielding at normal photon incidence for several photon energies from 9.8 keV up to 1.15 MeV and compared with that in a bare silicon wafer. The simulated pulse height spectra show the origin of the photon induced pulses in silicon for each material used as protective cover: the photoelectric effect for low Z front case materials at low energy incident photons (up to about 65 keV) and the Compton and build-up effects for high Z case materials at higher photon energies. A simple means to lower and flatten the photon response of silicon diodes over an extended X and gamma rays energy range is proposed by designing a composed photon filter. (author)

CT in acute perforated sigmoid diverticulitis

International Nuclear Information System (INIS)

Lohrmann, Christian; Ghanem, Nadir; Pache, Gregor; Makowiec, Frank; Kotter, Elmar; Langer, Mathias

2005-01-01

Background: To assess the value of computed tomography (CT) in patients with acute perforated sigmoid diverticulitis in correlation with the Hinchey classification of perforated diverticular disease. Methods: Thirty patients with acute perforated sigmoid diverticulitis underwent computed tomography prior to surgery. Computed tomography scans were compared with the surgical and histopathological reports, utilizing the Hinchey classification. Results: In 28 of the 30 (93%) patients examined, the Hinchey stage was correctly determined by means of computed tomography. One patient with Hinchey stage IV was falsely classified as Hinchey stage III, and one patient with Hinchey stage III as Hinchey stage II. Computed tomography revealed 12 out of 14 (86%) patients with perforation sites and 3 out of 3 (100%) patients with contained perforation. In one of 17 (6%) patients with surgically or histopathologically proven perforation or contained perforation, a bowel wall discontinuity was revealed by computed tomography. In 6 of the 17 (35%) patients with surgical or histopathological perforation or contained perforation, extraluminal contrast material was detected by computed tomography. Conclusions: Computed tomography is a valuable imaging tool for determining the degree of acute perforated sigmoid diverticulitis, by means of which patients can be stratified according to the severity of the disease; furthermore, this tool is of assistance in surgical planning

High-Resolution Ultrasonography (US) of Appendiceal Specimens: Differentiation of Acute Non-perforated Appendicitis from Perforated Appendicitis

Energy Technology Data Exchange (ETDEWEB)

Choi, Gyo Chang; Kim, Suk; Im, Han Hyeok; Lee, Sang Jin; Yang, Seung Boo; Lee, Seung Woo; Kim, Il Young [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Lee, Hae Kyung [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kwon, Kui Hyang; Shin, Hyung Chul [Soonchunhyang University, College of Medicine, Seoul (Korea, Republic of)

2007-09-15

To analyze surgical specimens from patients with acute non-perforated and perforated appendicitis using high-resolution ultrasonography (US), and to correlate the US features with the pathologic findings. One hundred and six surgical appendix specimens obtained from patients with suspected acute appendicitis were evaluated. The following US features were evaluated for differentiating acute non-perforated appendicitis from perforated appendicitis: circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, the sum of opposing walls {>=} 9 mm and the presence of appendicoliths. The sensitivity and specificity of the US findings for diagnosing perforated appendicitis were determined. All US features were detected significantly more often in the perforated appendicitis group of specimens. The disruption of the serosal layer was the most significant independent predictor of perforation (p < .001). The sensitivity for circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, wall thickness {>=} 9 mm, and the presence of appendicoliths individually was 84.6%, 69.2%, 61.5%, 73.1% and 46.2%, respectively. The specificity for all of these findings was 86.3%, 98.7%, 95.0%, 85.0% and 85.0%, respectively. High-resolution US of appendiceal specimens was very useful for differentiating acute non-perforated from perforated appendicitis

Management of biliary perforation in children

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Mirza Bilal

2010-01-01

Full Text Available Background: To study the aetiology, management and outcome of biliary perforations in paediatric age group. Patients and Methods: In a retrospective study, the records of patients presented with biliary peritonitis due to biliary perforations, managed from March 2006 to July 2009, are reviewed. Results: Eight male patients with biliary peritonitis due to biliary perforation were managed. These patients were divided in two groups, A and B. Group A, (n = 3 patients, had common bile duct (CBD perforation, and Group B (n=5 patients had gallbladder perforation. The presenting features were abdominal pain, fever, abdominal distension, vomiting, constipation, jaundice and signs of peritonism. The management of CBD perforations in Group A was by draining the site of perforation and biliary diversion (tube cholecystostomy. In Group B, the gallbladder perforations were managed by tube cholecystostomy in four patients and cholecystectomy in one patient, however, one patient had to be re-explored and cholecystectomy performed due to complete necrosis of gall bladder. There was no mortality in our series. All patients were asymptomatic on regular follow-up. Conclusion: Early optimal management of biliary perforations remarkably improved the very high mortality and morbidity that characterised this condition in the past.

Early Management Experience of Perforation after ERCP

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Guohua Li

2012-01-01

Full Text Available Background and Aim. Perforation after endoscopic retrograde cholangiopancreatography (ERCP is a rare complication, but it is associated with significant mortality. This study evaluated the early management experience of these perforations. Patients and Methods. Between November 2003 and December 2011, a total of 8504 ERCPs were performed at our regional endoscopy center. Sixteen perforations (0.45% were identified and retrospectively reviewed. Results. Nine of these 16 patients with perforations were periampullary, 3 duodenal, 1 gastric fundus, and 3 patients had a perforation of an afferent limb of a Billroth II anastomosis. All patients with perforations were recognized during ERCP by X-ray and managed immediately. One patient with duodenal perforation and three patients with afferent limb perforation received surgery, others received medical conservative treatment which included suturing lesion, endoscopic nasobiliary drainage (ENBD, endoscopic retrograde pancreatic duct drainage (ERPD, gastrointestinal decompression, fasting, broad-spectrum antibiotics, and so on. All patients with perforation recovered successfully. Conclusions. We found that: (1 the diagnosis of perforation during ERCP may be easy, but you must pay attention to it. (2 Most retroperitoneal perforations can recover with only medical conservative treatment in early phase. (3 Most peritoneal perforations need surgery unless you can close the lesion up under endoscopy in early phase.

The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation.

Science.gov (United States)

Surapaneni, Sushama; S, Rajkumar; Reddy A, Vijaya Bhaskar

2013-05-01

To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011. This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation -operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation.

Pulsed Neutron log application in accurate fluid contact determination and remedial action planning

International Nuclear Information System (INIS)

Kalu, I.; Mukerji, P.

2002-01-01

A common application of pulsed neutron logging in the Niger Delta is saturation monitoring when run in carbon-oxygen (CO) mode. Recently, one such log was run across a reservoir to confirm the position of the oil-water contact on a well that was producing at very high water cut on the short string of a dual string producer. Material balance calculations had predicted an oil-water contact about 5ft from the deepest perforations and so a water shut-off operation had been planned. The interpreted log however showed that the OWC was about 30ft from the perforation and it also showed fluid movement in the borehole in front of the perforations. A production log was subsequently run which identified a tubing leak and confirmed the crossflow of water from the long string into the short string detected on the pulsed neutron log. The proposed water shut-off treatment was aborted based on the interpretation and resulted in substantial savings

Electron trap annealing in neutron transmutation doped silicon

DEFF Research Database (Denmark)

Guldberg, J.

1977-01-01

Silicon doped by neutron transmutation to 1.2×1014 phosphorus atoms/cm3 was investigated with deep level transient spectroscopy using evaporated Au/n-Si diodes. Seven bulk electron traps were identified which appear after 30 min N2 anneal at temperatures between 425 and 725 °C. Five of these anne......Silicon doped by neutron transmutation to 1.2×1014 phosphorus atoms/cm3 was investigated with deep level transient spectroscopy using evaporated Au/n-Si diodes. Seven bulk electron traps were identified which appear after 30 min N2 anneal at temperatures between 425 and 725 °C. Five...

Automatic dosimeter for kerma measurement based on commercial PIN photo diodes

International Nuclear Information System (INIS)

Kushpil, V.; Kushpil, S.; Huna, Z.

2011-01-01

A new automatic dosimeter for measurement of radiation dose from neutron and ionization radiation is presented. The dosimeter (kerma meter) uses commercial PIN diodes with long base as its active element. Later it provides a maximal dependence of the minority carriers life time versus absorbed dose. The characteristics of the dosimeter were measured for several types of commercial diodes. Device can be useful in many environmental or industrial applications. (authors)

Influence of irradiation on defects creation in pin diode structure

International Nuclear Information System (INIS)

Sopko, V.; Dammer, J.; Sopko, B.; Chren, D.

2012-01-01

In this paper the manufacture of type S1 PIN diodes and radiation defect induce by fast neutrons were studied. A shift from VV"- to VV (neutral) is observed in neutron irradiated diodes. From the results obtained, an explanation that clearly offers itself is that the nature of the defects produced by irradiation of material exhibiting N type conductivity is different from those for type P material. Given that the experiments were conducted with the same material, i.e., the dopant present in the material remained unchanged, it can be stated that simply by changing the type of conductivity with increasing dose, a different kind of defects is produced, having different activation energies in the forbidden band. All these results are consistent with the ongoing RD 50 experiments at CERN.

Scoring system for differentiating perforated and non-perforated pediatric appendicitis.

Science.gov (United States)

Blumfield, Einat; Yang, Daniel; Grossman, Joshua

2017-10-01

Appendicitis is the most common indication for emergency pediatric surgery and its most significant complication is perforation. Perforated appendicitis (PA) may be managed conservatively, whereas non-perforated appendicitis (NP) is managed surgically. Recent studies have shown that ultrasound (US) is effective for differentiating between PA and NP, and does not expose pediatric patients to ionizing radiation. The purpose of this study is to enhance the accuracy of differentiation with a novel scoring system based on clinical, laboratory, and US findings. This retrospective study included 243 patients aged 2-17 years who presented between 2006 and 2013 with surgically proven appendicitis, of whom 60 had perforation. Clinical and laboratory data were collected and US images evaluated by a pediatric radiologist. To create the scoring system, point values were assigned to each parameter. A randomly selected training sample of 137 subjects was used to create a scoring prediction model. The model was tested on the remaining 106 patients. Scores of ≥6, ≥11, and ≥15 yielded specificities of 64, 91, and 99%, and sensitivities of 96, 61, and 29%, respectively (p < 0.001). We have designed a scoring system incorporating clinical, laboratory, and sonographic findings which can differentiate PA from NP with high specificity.

Dimensional changes of alginate impression by using perforated and non-perforated ring trays

Directory of Open Access Journals (Sweden)

Sumadhi Sastrodihardjo

2010-03-01

Full Text Available Dimensional changes are a common occurrence in impressions, either during or after impression taking. It produces a difference in the dimensions of the object and the model, which leads to the restoration being ill-fitted. Several causal factors have been proposed such as friction between the impression material and the teeth, the bulk of the impression material, the type of impression materials used, the impression technique, the pouring time and many others. The exact causal factor is still unknown and the dimensional change mechanism is still poorly understood. The objective of this research was to investigate the role of the perforation on the ring trays in producing dimensional changes in the impression by using perforated and non-perforated ring trays. Alginate impressions were made on the frustum of cone metal master die with a 7.08 mm base diameter, 7.03 mm top diameter and 9.23 mm height using perforated and non-perforated ring trays with 9.40 mm in diameter and 14.17 mm in height. The dimensional change was determined by comparing the dimension of the dental stone die and its metal master die. The results showed that the percentage of dimensional changes that occurred by using perforated ring tray were (+ 0.56±0.40 on the top area, (- 3.54±2.92 on base area and (+ 1.54±0.83 in height, respectively. As compared to using non-perforated ring trays, the percentage of dimensional changes that occurred were (- 0.49±0.49 on top area, (- 8.76±3.95 on base area and (+ 1.19±0.71 in height, respectively. There was a significant difference in the direction of the dimensional changes on both the top areas, but not in the base areas and height.

The development of a spectrometer for 14 MeV neutrons from fusion

International Nuclear Information System (INIS)

Aronsson, D.

1991-01-01

A spectrometer for 14 MeV neutrons, to be used for fusion plasma diagnostics at JET, was developed. The spectrometer utilizes neutron scattering in a polyethylene foil with the detection of the scattered neutron and its associated recoil proton. For the detection of 12 MeV protons we have tested silicon surface barrier detectors, lithium-drifted silicon detectors and high purity germanium detectors. The lithium-drifted detectors were finally selected for use in the spectrometer. The lithium-drifted silicon diodes have also been used for direct spectrometry, utilizing the neutron induced charged particle reactions in silicon. The methods used for the energy calibration and the timing calibration of the diodes, both during the installation of the spectrometer and during operation, are described. The detection of 2 MeV neutrons is done by fast plastic scintillators. Since the neutron generator which was used to test the detectors supplies 14 MeV or 2.5 MeV neutrons only, a neutron energy converter has to be constructed to study the detectors at other neutron energies. In the actual spectrometer an array of scintillation neutron detectors is used. A method of calibrating such an array of detectors with a gamma source was elaborated and is also described here. The result of the calibration is a set of parameters than can be used to determine the high voltage settings and the discriminator levels that are needed to achieve homogeneous sensitivity for all the detectors of the array. The energy scale itself was then calibrated by using gamma sources of various energies. To test the spectrometer as a whole at a neutron generator, a test bed was constructed. A lithium-drifted silicon diode was used to measure the neutron flux and the neutron energy resolution in the test bed. (au)

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly.

Science.gov (United States)

Shin, Dong Hyuk; Cho, Young Suk; Kim, Yoon Sung; Ahn, Hee Cheol; Oh, Young Taeck; Park, Sang O; Won, Moo-Ho; Cho, Jun Hwi; Kim, Young Myeong; Seo, Jeong Yeol; Lee, Young Hwan

2018-01-01

Delta neutrophil index (DNI) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24-month period. Sixty-nine of the 108 patients (median, IQR: 72, 67-77 years) were allocated to the perforated appendicitis group (63.9%) and 39 to the non-perforated appendicitis group (36.1%). WBC, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and DNI were significantly higher in the perforated group. In multiple logistic regression analyses, initial DNI was the only independent marker that can significantly predict the presence of perforation in multiple regression [odds ratio 9.38, 95% confidence interval (2.51-35.00), P=.001]. Receiver operator characteristic curve analysis showed that DNI is a good predictor for the presence of appendiceal perforation at an optimal cut-off for DNI being 1.4% (sensitivity 67.7%, specificity 90.0%, AUC 0.807). Clinicians can reliably differentiate acute perforated appendicitis from non-perforated appendicitis by DNI level of 1.4 or more in elderly patients. © 2017 Wiley Periodicals, Inc.

CT findings of exophageal perforation

Energy Technology Data Exchange (ETDEWEB)

Heo, Jeong Nam; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Hahm, Chang Kok [Hanyang University College of Medicine, Seoul (Korea, Republic of)

2002-09-01

To determine which CT findings are useful for the early disgnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5, age; 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic. Two chest radiologists unaware of the clinical findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n-4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air of fluid collection, focal defect of the esophageal wall, and esophageal wall thickening.

CT findings of exophageal perforation

International Nuclear Information System (INIS)

Heo, Jeong Nam; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Hahm, Chang Kok

2002-01-01

To determine which CT findings are useful for the early disgnosis of esophageal perforation, and on the basis of these findings, to assess the accuracy of prediction of the perforation site. A review of medical records indicated that between January 1995 and December 2001, 36 patients with esophageal perforation were admitted to our hospital. Thirteen of these [M:F=8:5, age; 28-69 (mean, 52.4) years], who had undergone CT chest scanning, were included in this study. The causes of esophageal perforation were trauma (n=5), infectious diseases (n=4), Boerhaave syndrome (n=1), lung cancer (n=1), esophageal cancer (n=1), and idiopathic. Two chest radiologists unaware of the clinical findings reviewed the CT scans and predicted whether the upper or lower esophagus was perforated. The most common CT finding was extraluminal air at the posterior mediastinum (n=11), while other findings included pulmonary consolidation (n=10), pleural effusion (n=7), discontinuity of the esophageal wall (n=6) and subcutaneous emphysema (n=4), fluid collection around the esophagus (n-4), esophageal wall thickening (n=4), pneumothorax (n=2), and lung abscess (n=2). The perforation site was accurately predicted in 76.9% of cases (10/13). The CT findings which help the diagnosis of esophageal perforation, and prediction of the sites at which it occurs, are extraluminal air of fluid collection, focal defect of the esophageal wall, and esophageal wall thickening

Current management of peptic ulcer perforations

International Nuclear Information System (INIS)

Menakuru, S.R.

2004-01-01

Perforation is a life-threatening complication of peptic ulcer disease. Smoking and use of non-steroidal anti-inflammatory drugs are important risk factors for perforation. Diagnosis is made clinically and confirmed by the presence of pneumoperitoneum on radiographs. Nonoperative management is successful in patients identified to have a spontaneously sealed perforation proven by water-soluble contrast gastroduodenogram. Operative management consists of the time-honoured practice of mental patch closure, but now this can be done by laparoscopic methods. The practice of addition of acid-reducing procedures is currently being debated though it continues to be recommended in good-risk patients. Laparoscopic approaches to closure of duodenal perforation are now being applied widely and may become the gold standard in the future especially in patients with < 10 mm perforation size presenting within the first 24 hours of onset of pain. The role of Helicobacter pylori in duodenal ulcer perforation is controversial and more studies are needed to answer this question though recent indirect evidence suggests that eradicating H pylori may reduce the necessity for adding acid reducing procedures and the associated morbidity. Perforation is a life-threatening complication of peptic ulcer disease. The management of peptic ulcer disease has evolved over the decades, due to advances in operative techniques, bacteriology and pharmacology. While the recognition of the role of Helicobacter pylori (H. pylori) in peptic ulceration has resulted in a paradigm shift in the management of uncomplicated peptic ulcers, debate continues about the appropriate management of perforated duodenal bulb and prepyloric ulcers. A new dimension has been added to this controversy by the advent of laparoscopic techniques for closing the perforation. A Medline search of all articles dealing with the management of peptic ulcer perforation published after 1985 was undertaken. The short listed articles were

Glove Perforations During Interventional Radiological Procedures

International Nuclear Information System (INIS)

Leena, R. V.; Shyamkumar, N. K.

2010-01-01

Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

Helicobacter pylori in gastroduodenal perforation

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Bharat B Dogra

2014-01-01

Full Text Available Background:peptic ulcers were earlier believed to be caused by dietary factors, gastric acid, and stress. However, in 1983, Warren and Marshall identified the correlation between Helicobacter pylori (H. pylori and peptic ulcers. It is now well established that most of the peptic ulcers occur as a result of H. pylori infection. But the co-relation between perforated peptic ulcer and H. pylori infection is not yet fully established. Aims and objectives : to study the prevalence of H. pylori infection in patients with perforated peptic ulcer. Materials and methods: this was a prospective study carried out in all cases of perforated peptic ulcer reporting in surgical wards of a medical college during 2008-2010. A total of 50 cases, presenting as acute perforation of duodenum and stomach during this period, formed the study group. After resuscitation, all the cases were subjected to emergency exploratory laparotomy. The exact site of perforation was identified, biopsy was taken from the ulcer margin from 2-3 sites and the tissue was sent for H. pylori culture and histopathological examination. Simple closure of perforation, omentoplasty, thorough peritoneal lavage and drainage was carried out. Results: out of the 50 cases of perforated peptic ulcer, 38 happened to be males, and only 12 were females. The age of the patients ranged from 20 to 70 years. All the patients underwent only emergency laparotomy. As many as 46 cases (92% turned out to be positive for H. pylori and only four cases (8% were negative for this infection. Postoperatively, patients who were found to be positive for H. pylori were put on anti-H. pylori treatment. Conclusion: there was a high prevalence of H. pylori infection in patients with perforated gastroduodenal ulcers.

Spectrum of perforation peritonitis in delhi: 77 cases experience.

Science.gov (United States)

Yadav, Dinesh; Garg, Puneet K

2013-04-01

Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

The management of large perforations of duodenal ulcers

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Sharma Rajeev

2005-06-01

Full Text Available Abstract Background Duodenal ulcer perforations are a common surgical emergency, but literature is silent on the exact definition, incidence, management and complications of large perforations of duodenal ulcers. Methods The case files of 162 patients who underwent emergency laparotomy for duodenal ulcer perforations over a period of three years (2001 – 2003 were retrospectively reviewed and sorted into groups based on the size of the perforations – one group was defined as 'small 'perforations (less than 1 cm in diameter, another 'large' (when the perforation was more than 1 cm but less than 3 cms, and the third, 'giant'(when the perforation exceeded 3 cm. These groups of patients were then compared with each other in regard to the patient particulars, duration of symptoms, surgery performed and the outcome. Results A total of 40 patients were identified to have duodenal ulcer perforations more than 1 cm in size, thus accounting for nearly 25 % of all duodenal ulcer perforations operated during this period. These patients had a significantly higher incidence of leak, morbidity and mortality when compared to those with smaller perforations. Conclusion There are three distinct types of perforations of duodenal ulcers that are encountered in clinical practice. The first, are the 'small' perforations that are easy to manage and have low morbidity and mortality. The second are the 'large' perforations, that are also not uncommon, and omental patch closure gives the best results even in this subset of patients. The word 'giant' should be reserved for perforations that exceed 3 cms in diameter, and these are extremely uncommon.

Novel semiconducting boron carbide/pyridine polymers for neutron detection at zero bias

Energy Technology Data Exchange (ETDEWEB)

Echeverria, Elena; Enders, A.; Dowben, P.A. [University of Nebraska-Lincoln, Department of Physics and Astronomy, Lincoln, NE (United States); James, Robinson; Chiluwal, Umesh; Gapfizi, Richard; Tae, Jae-Do; Driver, M. Sky; Kelber, Jeffry A. [University of North Texas, Department of Chemistry, Denton, TX (United States); Pasquale, Frank L. [University of North Texas, Department of Chemistry, Denton, TX (United States); Lam Research Corporation, PECVD Business Unit, Tualatin, OR (United States); Colon Santana, Juan A. [Center for Energy Sciences Research, Lincoln, NE (United States)

2014-09-19

Thin films containing aromatic pyridine moieties bonded to boron, in the partially dehydrogenated boron-rich icosahedra (B{sub 10}C{sub 2}H{sub X}), prove to be an effective material for neutron detection applications when deposited on n-doped (100) silicon substrates. The characteristic I-V curves for the heterojunction diodes exhibit strong rectification and largely unperturbed normalized reverse bias leakage currents with increasing pyridine content. The neutron capture generated pulses from these heterojunction diodes were obtained at zero bias voltage although without the signatures of complete electron-hole collection. These results suggest that modifications to boron carbide may result in better neutron voltaic materials. (orig.)

Laparoscopic pyloroplasty for perforated peptic ulcer.

Science.gov (United States)

Grišin, Edvard; Mikalauskas, Saulius; Poškus, Tomas; Jotautas, Valdemaras; Strupas, Kęstutis

2017-09-01

Peptic ulcer is a common disease affecting millions of people every year. Despite improved understanding and treatment of the disease, the number of patients admitted with duodenal peptic ulcer perforation has not decreased. Deaths from peptic ulcer disease overcome other common emergency situations. Laparoscopic repair of the perforated peptic ulcer (PPU) is the gold standard approach for simple perforation. However, in patients with large perforated chronic ulcers laparotomy with pyloroplasty is the standard treatment. It is generally accepted to perform open surgery in PPU emergencies because of the greater knowledge and experience gathered over the past decades and less potential harm for the patient or surgical complications. We present a case of successful laparoscopic pyloroplasty of a perforated duodenal ulcer with stenosis.

Magnetic discharge accelerating diode for the gas-filled pulsed neutron generators based on inertial confinement of ions

International Nuclear Information System (INIS)

Kozlovskij, K I; Shikanov, A E; Vovchenko, E D; Shatokhin, V L; Isaev, A A; Martynenko, A S

2016-01-01

The paper deals with magnetic discharge diode module with inertial electrostatic ions confinement for the gas-filled pulsed neutron generators. The basis of the design is geometry with the central hollow cathode surrounded by the outer cylindrical anode and electrodes made of permanent magnets. The induction magnitude about 0.1-0.4 T in the central region of the discharge volume ensures the confinement of electrons in the space of hollow (virtual) cathode and leads to space charge compensation of accelerated ions in the centre. The research results of different excitation modes in pulsed high-voltage discharge are presented. The stable form of the volume discharge preserveing the shape and amplitude of the pulse current in the pressure range of 10 -3 -10 -1 Torr and at the accelerating voltage up to 200 kV was observed. (paper)

CLINICAL STUDY OF DUODENAL PERFORATION

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Sambasiva Rao

2016-04-01

Full Text Available BACKGROUND The duodenal injury can pose a formidable challenge to the surgeon and failure to manage it properly may have devastating results. Over the centuries, there was little to offer the patient of acute abdomen beyond cupping, purgation and enemas, all of which did more harm than good. It was not until 1884 that Mikulicz made an attempt to repair a perforation. Recent statistics indicate roughly 10% of population develop gastric or duodenal ulcer in life time. Roughly 1-3% of population above the age of 20 years have some degree of peptic ulcer activity during any annual period. A detailed history with regards to the signs and symptoms of the patient, a meticulous examination, radiological and biochemical investigations help to arrive at a correct preoperative diagnosis. In this study, a sincere effort has been put to understand the demographic patterns, to understand the underlying aetiology and to understand the effectiveness of the standard methods of investigation and treatment in use today. METHODS This is a 24 months prospective study i.e., from September 2011 to September 2013 carried out at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. The study included the patients presenting to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation to emergency ward with signs and symptoms of hollow viscus perforation. The sample size included 30 cases of duodenal perforation. RESULTS Duodenal ulcer perforation commonly occurs in the age group of 30-60 years, but it can occur in any age group. Majority of the patients were male. Smoking and alcohol consumption were risk factors in most cases (53.3% for the causation of duodenal ulcer perforation. Sudden onset of abdominal pain, situated at epigastrium and right hypochondrium was a constant symptom (100%. Vomiting, constipation and fever were not so common. CONCLUSION The emergency surgical management for perforated duodenal ulcer is by

Reliability of semiconductor and gas-filled diodes for over-voltage protection exposed to ionizing radiation

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Stanković Koviljka

2009-01-01

Full Text Available The wide-spread use of semiconductor and gas-filled diodes for non-linear over-voltage protection results in a variety of possible working conditions. It is therefore essential to have a thorough insight into their reliability in exploitation environments which imply exposure to ionizing radiation. The aim of this paper is to investigate the influence of irradiation on over-voltage diode characteristics by exposing the diodes to californium-252 combined neutron/gamma radiation field. The irradiation of semiconductor over-voltage diodes causes severe degradation of their protection characteristics. On the other hand, gas-filled over-voltage diodes exhibit a temporal improvement of performance. The results are presented with the accompanying theoretical interpretations of the observed changes in over-voltage diode behaviour, based on the interaction of radiation with materials constituting the diodes.

A perforated diverticulum in Cushing's disease

OpenAIRE

de Havenon, Adam; Ehrenkranz, Joel

2011-01-01

We report a case of perforated colonic diverticulum in Cushing's disease. Although perforated diverticuli have been described in patients with Cushing's syndrome secondary to exogenous glucocorticoids, this complication has not been described in patients with Cushing's disease. Patients with hypercortisolism, from either exogenous or endogenous sources, should be monitored for diverticular perforation.

CLINICAL STUDY AND MANAGEMENT OF BENIGN GASTROINTESTINAL PERFORATIONS

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Kishan

2016-05-01

Full Text Available INTRODUCTION Peritonitis due to gastrointestinal perforation is one of the commonest surgical emergencies encountered by a general surgeon. (1,2 Mortality and morbidity is still very high despite early diagnosis and intensive management. This study is aimed to find common causes of perforations, its presentations, mode of investigations and treatment done and outcome of patients. METHODS Case records of all patients, in exclusion and inclusion criteria, who were admitted in emergency surgical ward with suspected GI perforation and peritonitis were included in study and diagnosis confirmed by either investigations preoperatively or by laparotomy and results analysed over a period of 16 months. RESULTS GI perforations due to benign causes are most common causes of peritonitis, of which gastroduodenal perforations are commonest followed by appendicular perforation closely followed by infective perforations. CONCLUSION Benign causes of upper gastroduodenal perforations are common causes of peritonitis (2,3. Mortality increases with delay in presentation and treatment. Abdominal signs like guarding rigidity are present in majority of cases. X-ray erect abdomen was effective in detecting perforation in majority of cases. Surgery is the treatment in all cases of perforation.

Perforated peptic ulcer

DEFF Research Database (Denmark)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M

2015-01-01

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter...... need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research....

Influence of nuclear cross section data at efficiency calculation of the 3He semiconductor neutron spectrometer

International Nuclear Information System (INIS)

Avdic, S.; Pesic, M.

1992-01-01

The ORTEC 580 Neutron Spectrometer system contains a detector unit in diode coincidence arrangement for measurement of fast neutron spectrum in the energy range from 1 MeV to 14 MeV. Numerical code HE3 for computation of semiconductor 3 He detector efficiency in a collimated neutron beam is based on analytical method in infinite diode approximation and Monte Carlo method for real spectrometer geometry. Calculations are performed in the first collision approximation in the detector active volume including evaluation of correction factors. Accuracy of relative detector efficiency calculation is improved by using neutron cross section from nuclear library ENDF/B-6. (author)

Optimization of geometrical characteristics of perforated plates

International Nuclear Information System (INIS)

Radisavljevic, Igor; Balos, Sebastian; Nikacevic, Milutin; Sidjanin, Leposava

2013-01-01

Highlights: ► Perforated plate are tested against 12.7 mm API projectile. ► Perforations similar to the projectile diameter offer more efficient core fracture. ► Larger perforations gave a more efficient core fragmentation. ► SEM microscopy analysis has shown a ductile fracture mode at impact point. - Abstract: In this paper, an attempt was made to design effective non-homogenous armor in form of perforated plate mounted at close distance from basic armor plate. Perforated plate with three perforation diameters: 9, 10 and 11 mm, two ligaments length: 3.5 and 4.5 mm ligaments, set at 0° and 28° angles, were combined to 13 mm basic plate and tested against 12.7 mm API ammunition. It has been shown that larger perforations gave a more efficient core fragmentation, while angled specimens were the only ones that offer full protection against five API shots when the perforated plate was placed at 100 mm from the basic plate. Perforations that are similar in size to the penetrating core diameter offer a more efficient core fracture, leading to a faster fragment separation. This may enable a smaller distance between the add-on perforated and basic plate to be used. Scanning electron microscopy analysis has shown a ductile fracture mode at impact point, with hardness values on plate basic level. On the other hand, a brittle fracture mode with a rise in local hardness measured near impact point is a result of intensive high speed plastic deformation produced by bending stresses. A drop in local hardness measured near impact point, may be the result of intensive cracking that occur due to repeated projectile impact

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

Science.gov (United States)

Masood, Irfan; Majid, Zain; Rafiq, Ali; Rind, Waqas; Zia, Aisha; Raza, Sajjad

2015-01-01

Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before. PMID:26798540

Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

Science.gov (United States)

Yoo, Ri Na; Kye, Bong-Hyeon; Kim, Gun; Kim, Hyung Jin; Cho, Hyeon-Min

2017-10-01

Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

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Irfan Masood

2015-01-01

Full Text Available Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90% perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.

STUDY OF CLINICAL OUTCOMES OF SUBFASCIAL PERFORATOR LIGATION SURGERY IN PERFORATOR INCOMPETENCE

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Vasuki Rajam

2017-02-01

Full Text Available BACKGROUND Chronic venous insufficiency presents with a spectrum of clinical features ranging from pain or heaviness of affected limbs to non-healing ulcers over the lower limbs and usually require some form of surgical intervention, performing direct perforator vein division preferably by subfascial endoscopic perforator ligation surgery for perforator incompetence, as despite aggressive conservative therapy including compression, lifestyle modification and venotonic medications which are of high cost treatment with increased risk of increasing symptoms. MATERIALS AND METHODS A prospective longitudinal clinical study of 30 patients selected by systematic sampling method from November 2014 to September 2015 at our institution was conducted to determine the results of subfascial endoscopic perforator vein surgery (SEPS in perforator incompetence. RESULTS For venous clinical severity scoring pre operatively and after 3 weeks post-surgery, the mean for VCSS pre-operatively was 6.66 and a standard deviation of 2.399. The T value was calculated and was found to be 4.9321 and p value of 0.00001(p value less than 0.05 is significant. Similarly for the cases with active ulcer, the size assessment pre-operatively and post-SEPS was again analysed using student t test and the mean ulcer size prior to surgery was found to be 3.3 and standard deviation of 1.984. The T value was calculated and was found to be 1.789009 and a p value of 0.04 (p value less than 0.05 is significant. CONCLUSION Our study concluded that favourable and significant ulcer healing rate with improvement and reduction in clinical severity suggests that SEPS plays an important role in surgical management of advanced stages of venous insufficiency.

The effect of incremental gamma-ray doses and incremental neutron fluences upon the performance of self-biased sup 1 sup 0 B-coated high-purity epitaxial GaAs thermal neutron detectors

CERN Document Server

Gersch, H K; Simpson, P A

2002-01-01

High-purity epitaxial GaAs sup 1 sup 0 B-coated thermal neutron detectors advantageously operate at room temperature without externally applied voltage. Sample detectors were systematically irradiated at fixed grid locations near the core of a 2 MW research reactor to determine their operational neutron dose threshold. Reactor pool locations were assigned so that fast and thermal neutron fluxes to the devices were similar. Neutron fluences ranged between 10 sup 1 sup 1 and 10 sup 1 sup 4 n/cm sup 2. GaAs detectors were exposed to exponential fluences of base ten. Ten detector designs were irradiated and studied, differentiated between p-i-n diodes and Schottky barrier diodes. The irradiated sup 1 sup 0 B-coated detectors were tested for neutron detection sensitivity in a thermalized neutron beam. Little damage was observed for detectors irradiated at neutron fluences of 10 sup 1 sup 2 n/cm sup 2 and below, but signals noticeably degraded at fluences of 10 sup 1 sup 3 n/cm sup 2. Catastrophic damage was appare...

Tricholithobezoar Causing Gastric Perforation

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Juliana Santos Valenciano

2012-01-01

Full Text Available A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.

Clinical applications of the superior epigastric artery perforator (SEAP) flap: anatomical studies and preoperative perforator mapping with multidetector CT.

Science.gov (United States)

Hamdi, Moustapha; Van Landuyt, Koenraad; Ulens, Sara; Van Hedent, Eddy; Roche, Nathalie; Monstrey, Stan

2009-09-01

Pedicled superior epigastric artery perforator (SEAP) flaps can be raised to cover challenging thoracic defects. We present an anatomical study based on multidetector computerized tomography (MDCT) scan findings of the SEA perforators in addition to the first reported clinical series of SEAP flaps in anterior chest wall reconstruction. (a) In the CT scan study, images of a group of 20 patients who underwent MDCT scan analysis were used to visualise bilaterally the location of musculocutaneous SEAP. X- and Y-axes were used as landmarks to localise the perforators. The X-axis is a horizontal line at the junction of sternum and xyphoid (JCX) and the Y-axis is at the midline. (b) In the clinical study, seven pedicled SEAP flaps were performed in another group of patients. MDCT images revealed totally 157 perforators with a mean of 7.85 perforators per patient. The dominant perforators (137 perforators) were mainly localised in an area between 1.5 and 6.5 cm from the X-axis on both sides and between 3 and 16 cm below the Y-axis. The calibre of these dominant perforators was judged as 'good' to 'very good' in 82.5% of the cases. The average dimension of the flap was 21.7x6.7 cm. All flaps were based on one perforator. Mean harvesting time was 110 min. There were no flap losses. Minor tip necrosis occurred in two flaps. One of them was treated with excision and primary closure. Our clinical experience indicates that the SEAP flap provides a novel and useful approach for reconstruction of anterior chest wall defects. CT-based imaging allows for anatomical assessment of the perforators of the superior epigastric artery (SEA).

Testing of high current by-pass diodes for the LHC magnet quench protection

International Nuclear Information System (INIS)

Berland, V.; Hagedorn, D.; Rodriguez-Mateos, F.

1996-01-01

Within the framework of the Large Hadron Collider (LHC) R and D program, CERN is performing experiments to establish the current carrying capability of irradiated diodes at liquid Helium temperatures for the superconducting magnet protection. Even if the diodes are degraded by radiation dose and neutron fluence, they must be able to support the by-pass current during a magnet quench and the de-excitation of the superconducting magnet ring. During this discharge, the current in the diode reaches a maximum value up to 13 kA and decreased with an exponential time constant of 100 s. Two sets of 75 mm wafer diameter epitaxial diodes, one irradiated and one non-irradiated, were submitted to this experiment. The irradiated diodes have been exposed to radiation in the accelerator environment up to 20 kGy and then annealed at room temperature. After the radiation exposure the diodes had shown a degradation of forward voltage of 50% which reduced to about 14% after the thermal annealing. During the long duration high current tests, one of the diodes was destroyed and the other two irradiated diodes showed a different behavior compared with non-irradiated diodes

Research on the Perforating Algorithm Based on STL Files

Science.gov (United States)

Yuchuan, Han; Xianfeng, Zhu; Yunrui, Bai; Zhiwen, Wu

2018-04-01

In the process of making medical personalized external fixation brace, the 3D data file should be perforated to increase the air permeability and reduce the weight. In this paper, a perforating algorithm for 3D STL file is proposed, which can perforate holes, hollow characters and engrave decorative patterns on STL files. The perforating process is composed of three steps. Firstly, make the imaginary space surface intersect with the STL model, and reconstruct triangles at the intersection. Secondly, delete the triangular facets inside the space surface and make a hole on the STL model. Thirdly, triangulate the inner surface of the hole, and thus realize the perforating. Choose the simple space equations such as cylindrical and rectangular prism equations as perforating equations can perforate round holes and rectangular holes. Through the combination of different holes, lettering, perforating decorative patterns and other perforated results can be accomplished. At last, an external fixation brace and an individual pen container were perforated holes using the algorithm, and the expected results were reached, which proved the algorithm is feasible.

Water distribution in an orchard irrigated by perforated distributors in stony ground

International Nuclear Information System (INIS)

Decroix, M.; Marcesse, J.; Normand, M.

1975-01-01

In the context of new irrigation techniques the Compagnie Nationale d'Amenagement du Bas-Rhone et du Languedoc (B.Rh.L.) has developed a process of localized irrigation by perforated distributors. Conditions were defined for the optimum use of this process, especially the distribution of water in the ground. The study was carried out in a peach orchard in stony ground. The neutronic method was used to measure the soil moisture content. Because of the heterogeneous stone size distribution it was necessary for the specific humidity determination to take into account the dry apparent density. This parameter was measured by gammametry [fr

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience.

Science.gov (United States)

Afridi, Shahida Parveen; Malik, Faiza; Ur-Rahman, Shafiq; Shamim, Shahid; Samo, Khursheed A

2008-11-08

Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK) Pakistan, from 1st September 2005 - 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6%) and gastric ulcer 1.3%. followed by small bowel tuberculosis (21%) and typhoid (17%). large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%). Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%). The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular. Malignant perforations are least common in our setup.

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

Directory of Open Access Journals (Sweden)

Ur-Rahman Shafiq

2008-11-01

Full Text Available Abstract Background Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. Methods A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK Pakistan, from 1st September 2005 – 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. Results The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6% and gastric ulcer 1.3%. followed by small bowel tuberculosis (21% and typhoid (17%. large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%. Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%. Conclusion The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular

The Los Alamos Intense Neutron Source

International Nuclear Information System (INIS)

Nebel, R.A.; Barnes, D.C.; Bollman, R.; Eden, G.; Morrison, L.; Pickrell, M.M.; Reass, W.

1997-01-01

The Intense Neutron Source (INS) is an Inertial Electrostatic Confinement (IEC) fusion device presently under construction at Los Alamos National Laboratory. It is designed to produce 10 11 neutrons per second steady-state using D-T fuel. Phase 1 operation of this device will be as a standard three grid IEC ion focus device. Expected performance has been predicted by scaling from a previous IEC device. Phase 2 operation of this device will utilize a new operating scheme, the Periodically Oscillating Plasma Sphere (POPS). This scheme is related to both the Spherical Reflect Diode and the Oscillating Penning Trap. With this type of operation the authors hope to improve plasma neutron production to about 10 13 neutrons/second

Colonic perforation following endoscopic retrograde ...

African Journals Online (AJOL)

She developed severe upper abdominal pain after the ... non-surgical management of pancreatitis and associated complications, colonic perforation should be considered in patients who deteriorate ... To our knowledge this is the first case of a secure pre-operative diagnosis of colonic perforation due to to pancreatitis.

Laminated Amorphous Silicon Neutron Detector (pre-print)

International Nuclear Information System (INIS)

McHugh, Harry; Branz, Howard; Stradins, Paul; Xu, Yueqin

2009-01-01

An internal R and D project was conducted at the Special Technologies Laboratory (STL) of National Security Technologies, LLC (NSTec), to determine the feasibility of developing a multi-layer boron-10 based thermal neutron detector using the amorphous silicon (AS) technology currently employed in the manufacture of liquid crystal displays. The boron-10 neutron reaction produces an alpha that can be readily detected. A single layer detector, limited to an approximately 2-micron-thick layer of boron, has a theoretical sensitivity of about 3%; hence a thin multi-layer device with high sensitivity can theoretically be manufactured from single layer detectors. Working with National Renewable Energy Laboratory (NREL), an AS PiN diode alpha detector was developed and tested. The PiN diode was deposited on a boron-10 coated substrate. Testing confirmed that the neutron sensitivity was nearly equal to the theoretical value of 3%. However, adhesion problems with the boron-10 coating prevented successful development of a prototype detector. Future efforts will include boron deposition work and development of integrated AS signal processing circuitry.

Radiologic Study of Meniscus Perforations in the Temporomandibular Joint

International Nuclear Information System (INIS)

Kim, Kee Duck; Park, Chang Seo

1990-01-01

Thirty-nine patients (forty-four joints) who had been diagnosed as having meniscus perforation of the temporomandibular joint by inferior joint space arthrography and had been treated by surgical procedures were evaluated retrospectively. Information of clinical findings, arthrotomographic findings and surgical findings was collected on a standardized form and evaluated. The results were as follows: 1. On the 34 patients of 38 joints which were surgically confirmed perforation of meniscus or its attachments of the temporomandibular joint, there were 29 females and 5 males (5.8:1). The average age was 36 years (range 17 to 70). 2. The common clinical findings of group that had meniscus displacement without reduction and with perforation were pain on the affected joint and limitation of mouth opening. In the group showing meniscus displacement with reduction and with perforation the common clinical findings were pain and clicking on the affected joint. 3. 32 joints (84.2%) were arthrotomographically anterior meniscus displacement without reduction and with perforation, 6 joints (15.8%) showed anterior meniscus displacement with reduction and with perforation. 4. Joints categorized arthrotomographically as having meniscus displacement without reduction and with perforation were less likely to have full translation of the condyle in comparison with the normal or meniscus displacement with reduction and with perforation groups (p<0.05) 5. The arthrographic findings of 44 joints having meniscus perforation were compared with surgical findings, there were 6 false positive findings of meniscus perforation, the reliability of arthrographic findings of meniscus perforation was a 86.4% correlation with surgical findings. 6. On the site of perforations of 38 joints which were surgically confirmed perforation of meniscus or its attachments, twenty-three of perforations (60.5%) were in location at the junction of the meniscus and posterior attachment, fourteen (36.9%) were

Isolated jejunal perforation following blunt abdominal trauma

Directory of Open Access Journals (Sweden)

Ahmet Pergel

2012-09-01

Full Text Available Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare. These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often inadequate for diagnosing this subsetof trauma. For an accurate and timely diagnosis, thepossibility of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta 28-year-old man with isolated jejunal perforation followingblunt abdominal trauma.Key words: Blunt abdominal trauma, isolated jejunal perforation,early diagnosis

Perforated peptic ulcer.

Science.gov (United States)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M; Bingener, Juliane; Møller, Morten H; Ohene-Yeboah, Michael; Søreide, Jon Arne

2015-09-26

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are common causes, demographic differences in age, sex, perforation location, and underlying causes exist between countries, and mortality rates also vary. Clinical prediction rules are used, but accuracy varies with study population. Early surgery, either by laparoscopic or open repair, and proper sepsis management are essential for good outcome. Selected patients can be managed non-operatively or with novel endoscopic approaches, but validation of such methods in trials is needed. Quality of care, sepsis care bundles, and postoperative monitoring need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Saphenous perforator flap].

Science.gov (United States)

Winkel, R; Tajsic, N; Husum, H; Schlageter, M; Hanebuth, G; Hoffmann, R

2013-04-01

Replacement of full thickness soft tissue defects in the lower leg and ankle, appropriate to the defect and following the course of blood vessels feeding the skin of a distally hinged fasciocutaneous flap most reliably based on the individual anatomy of distal perforators of the posterior tibial artery. Full thickness soft tissue defects, up to 12 cm in length and up to 8 cm in width. Sufficient vascularization of the foot required, in osteomyelitis, and when joints, fractures, implants and tendons are exposed and when a split skin graft, a local flap, a suralis perforator flap or a free flap is not indicated. For patients, in whom a 1-2 h operation is not possible; necessity of angioplasty; decollement or scars around the distal perforators of the posterior tibial artery; local infection or necrosis of soft tissues and/or bone, which cannot be totally excised. Radical debridement; flap dissection without tourniquet; microdissection; design of the flap on the skin: pivot point ~ 10 cm (6-14 cm) proximal of the tip of the medial malleolus; base ~ 5 cm in width, between the course of the saphenous nerve and of the great saphenous vein and the Achilles tendon; adipofascial pedicle up to 15 cm in length sited over the septum between soleus and flexor digitorum muscles, following the course of the saphenous nerve, with a central skin stripe, which expands into a proximal skin island; skin island is outlined similar to the defect, but larger by 1 to 2 cm, surrounded by an adipofascial border: adjustment of the planning as well as of the elevation of these flaps according to the individual position and the caliber of perforators requires in each case the search for a perforator at the estimated pivot point. Delay of transposition, if the division of more than one perforator proximal to the pivot point obviously diminishes circulation. No "tunnelling "of the pedicle; defects of skin due to the elevation of the flap are replaced by split and meshed skin grafts or temporary

Perforated marginal ulcers after laparoscopic gastric bypass.

Science.gov (United States)

Felix, Edward L; Kettelle, John; Mobley, Elijah; Swartz, Daniel

2008-10-01

Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors' center was conducted to determine the incidence of PMU and whether any causative factors were present. A prospectively kept database of all patients at the authors' bariatric center was retrospectively reviewed. The complete records of patients with a PMU were examined individually for accuracy and analyzed for treatment, outcome, and possible underlying causes of the marginal perforation. Between April 1999 and August 2007, 1% of the patients (35/3,430) undergoing laparoscopic gastric bypass experienced one or more perforated marginal ulcers 3 to 70 months (median, 18 months) after LRYGB. The patients with and without perforation were not significantly different in terms of mean age (37 vs 41 years), weight (286 vs 287 lb), body mass index (BMI) (46 vs 47), or female gender (89% vs 83%). Of the patients with perforations, 2 (6%) were taking steroids, 10 (29%) were receiving nonsteroidal antiinflammatory drugs (NSAIDs) at the time of the perforation, 18 (51%) were actively smoking, and 6 of the smokers also were taking NSAIDs. Eleven of the patients (31%) who perforated did not have at least one of these possible risk factors, but 4 (36%) of the 11 patients in this group had been treated after bypass for a marginal ulcer. Only 7 (20%) of the 35 patients who had laparoscopic bypass, or 7 (0.2%) in the entire group of 3,430 patients, perforated without any warning. There were no deaths, but three patients reperforated. The incidence of a marginal ulcer perforating after LRYGB was significant (>1%) and appeared to be related to smoking or the use of NSAIDs or steroids. Because only 0.2% of all patients acutely perforated without some risk factor or warning, long-term ulcer prophylaxis or treatment may be necessary

Imaging gastrointestinal perforation in pediatric blunt abdominal trauma

International Nuclear Information System (INIS)

Jamieson, D.H.; Babyn, P.S.; Pearl, R.

1996-01-01

Objective. To assess the role of imaging, in particular CT, in the early detection of GI perforation. Subjects and methods. In a 10-year period, 43 patients with surgically confirmed GI perforation were identified from hospital records; 22 of these had preoperative CT evaluation. Medical records and radiology were retrospectively reviewed and CT studies were particularly assessed for extraluminal air, free intraperitoneal fluid, bowel wall thickening, bowel wall enhancement, and bowel dilatation. During the study period an additional 12 trauma patients were identified who had CT studies demonstrating the above findings, but who had hypovolemic shock bowel or nondisrupting bowel injury without perforation evident. Results. Extraluminal air was demonstrated in 47 % of the imaged perforations. There was one false-positive extraluminal air. Perforation was confirmed in patients who had all five of the above CT findings, but this was the case for only 18 % of patients with perforation. One or more of the five specified CT findings were present in all CT studies reviewed. No false-negative CT study was performed in the study period. Conclusion. Separating nondisrupting bowel injury from perforation is diagnostically difficult; however, CT remains a good modality for assessing GI perforation in pediatric blunt trauma, but it cannot replace diligent and repeated clinical evaluation of all potential perforation victims. (orig.). With 4 figs., 1 tab

Digital neutron dosimeter

International Nuclear Information System (INIS)

Ramondetta, P.W.; Groeber, E.O.Jr.

1978-01-01

Design features for a portable battery-operated neutron dosimeter are described. The system employs a 50-mil PIN detector diode, whose forward voltage increases with exposure to fast neutrons. Because this change is permanent and cumulative, the system is able to integrate small doses (from 0 to 1000 rad) over long periods of time. The system is temperature compensated over its operating range of -40 C to +52C. Display accuracies of +-20 rad for readings below 100 rad and +-20% for readings above 100 rad are maintained throughout the range. Temperature correction is performed digitally after an initial analog-to-digital conversion of both the forward diode voltage and the ambient temperature. System flexibility is promoted with the use of a replaceable ROM for the final voltage-to-dose conversion table. This digital approach to temperature compensation, combined with the extensive use of CMOS circuitry, suggests the use of custom large-scale integration as a means of further reducing system weight and size. This possibility, as well as others, is discussed as a means of reducing system size. Test and evaluation results are also included. (author)

Development of a new deuterium-deuterium (D-D) neutron generator for prompt gamma-ray neutron activation analysis.

Science.gov (United States)

Bergaoui, K; Reguigui, N; Gary, C K; Brown, C; Cremer, J T; Vainionpaa, J H; Piestrup, M A

2014-12-01

A new deuterium-deuterium (D-D) neutron generator has been developed by Adelphi Technology for prompt gamma neutron activation analysis (PGNAA), neutron activation analysis (NAA), and fast neutron radiography. The generator makes an excellent fast, intermediate, and thermal neutron source for laboratories and industrial applications that require the safe production of neutrons, a small footprint, low cost, and small regulatory burden. The generator has three major components: a Radio Frequency Induction Ion Source, a Secondary Electron Shroud, and a Diode Accelerator Structure and Target. Monoenergetic neutrons (2.5MeV) are produced with a yield of 10(10)n/s using 25-50mA of deuterium ion beam current and 125kV of acceleration voltage. The present study characterizes the performance of the neutron generator with respect to neutron yield, neutron production efficiency, and the ionic current as a function of the acceleration voltage at various RF powers. In addition the Monte Carlo N-Particle Transport (MCNP) simulation code was used to optimize the setup with respect to thermal flux and radiation protection. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experimental perforation of tubing with a hydraulic sand jet

Energy Technology Data Exchange (ETDEWEB)

Semenov, Yu V

1970-01-01

A series of field tests has shown that perforation with a hydraulic sand jet improves the quality of well completion. The sand jet does not crack the cement sheath or the casing, and the perforations are larger and deeper than perforations formed by explosive charges. Fluid circulation during sand jet perforation can safely be stopped for at least 10 min. Water containing a surfactant can be used as a sand carrier. Sand jet perforation allows successful completion of wells cased by 2 tubing strings. Sand jet perforation can be used to clean the borehole well and to remove foreign objects from the well.

A measurement of the response to fast neutrons of several materials dosemeters

International Nuclear Information System (INIS)

Jones, L.T.; Kitching, S.J.; Lewis, T.A.; Playle, T.S.

1986-07-01

The response to fast neutrons was measured for three types of materials testing dosemeters: fast neutron dosimetry silicon diodes; beryllia, alumina and calcium fluoride TLDs; graphite walled ionisation chambers. The calibrations were made using a 3MW positive ion accelerator. The arrangement of the target, beam monitor and devices is described, and the measured fast neutron sensitivities are presented. (UK)

Perforated Sigmoid Diverticular Disease: a Management Protocol

Science.gov (United States)

Moin, Thajammul

2008-01-01

Background: To develop an evidence-based protocol for the management of perforated sigmoid diverticular disease. Methods: A search of the literature was undertaken. All publications pertaining to perforated sigmoid diverticular disease were analyzed and then categorized according to their level of evidence. Recommendations were then made on the basis of this. Results: Multiple case reports suggest that primary closure of perforation of sigmoid diverticula is safe in the absence of peritoneal contamination. Conclusions: A 2-stage laparoscopic approach incorporating the principles of damage limitation surgery may be a safe strategy in the management of perforated diverticular disease. PMID:18435896

Perforator anatomy of the ulnar forearm fasciocutaneous flap.

Science.gov (United States)

Mathy, Jon A; Moaveni, Zachary; Tan, Swee T

2012-08-01

The ulnar forearm fasciocutaneous flap (UFFF) is a favourable alternative to the radial forearm flap when thin and pliable tissue is required. The precise anatomy of the cutaneous perforators of UFFF has not been previously reported. The position of cutaneous perforators>0.5 mm was recorded while raising 52 consecutive free UFFFs in 51 patients at our Centre. Three (6%) UFFFs in two patients demonstrated direct cutaneous supply through a superficial ulnar artery, a known anatomic variance. There was no cutaneous perforator>0.5 mm in one flap. Among the remaining 48 dissections, an average of 3 (range, 1-6) cutaneous perforators were identified. Ninety-four percent of these forearms demonstrated at least one perforator>0.5 mm within 3 cm, and all had at least one perforator within 6 cm of the midpoint of the forearm. Proximal perforators were more likely to be musculo-cutaneous through the edge of flexor carpi ulnaris or flexor digitorum superficialis, while mid- to distal perforators were septo-cutaneous. UFFF skin paddle designed to overlie an area within 3 cm of the midpoint between the medial epicondyle and the pisiform is most likely to include at least one cutaneous perforator from the ulnar artery, without a need for intra-operative skin island adjustment. This novel anatomic finding and other practical generalisations are discussed to facilitate successful elevation of UFFF. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Perforated gastric carcinoma in a young-age patient

Directory of Open Access Journals (Sweden)

Feng-Hsu Wu

2018-06-01

Full Text Available Perforation is a rare complication of gastric carcinoma, and it occurs in less than 5% of all gastric carcinoma cases and in less than 1% within all acute abdomen cases. The diagnosis of malignancy is usually not validated preoperatively. In previous reported English literature, all patients with perforated gastric cancer have the feature of old age. This feature might be able to guide the surgeon to impress the differential diagnosis of malignancy before or during the emergent operation of gastric perforation.This 32-year-old male patient suffered from sudden onset of epigastric pain. We performed emergent operation under the impression of hollow organ perforation. The postoperative pathologic report of gastric ulcer revealed gastric carcinoma. We performed second-stage operation of total gastrectomy with D2 lymphadenectomy smoothly 7 days later. As we know, this is the youngest patient having the condition of perforated gastric carcinoma reported in the literature. This case reminds us that it is possible for perforated gastric carcinoma to occur in young-age patients. Keywords: Gastric cancer, Acute abdomen, Gastric perforation

PERFORATED PEPTIC ULCER: A CLINICAL ANALYSIS AND OUTCOME

OpenAIRE

Bijit

2016-01-01

BACKGROUND The incidence of perforated peptic ulcer is approximately 7-10 cases per one lakh population per year. Perforation is seen in about 7% of patients hospitalized for peptic ulcer disease. Peptic ulcer perforation, which can be gastric/duodenal perforation can be a serious life-threatening condition if not detected early and treated urgently. Peptic ulcer disease has decreased considerably worldwide with the advent of potent anti-ulcer medicines, but its complication l...

Design and operation of a 2-D thin-film semiconductor neutron detector array for use as a beamport monitor

International Nuclear Information System (INIS)

Unruh, Troy C.; Bellinger, Steven L.; Huddleston, David E.; McNeil, Walter J.; Patterson, Eric; Sobering, Tim J.; McGregor, Douglas S.

2009-01-01

Silicon-based diodes coated with a thin film of neutron reactive materials have been shown to produce excellent low-efficiency neutron detectors. This work employs the same technology, but groups 25 equally sized and spaced diodes on a single 29 mm by 29 mm substrate. A 5x5 array was fabricated and coated with a thin film of 6 LiF for use as a low-efficiency neutron beam monitor. The 5x5 neutron detector array is coupled to an array of amplifiers, allowing the response to be interpreted using a LabVIEW FPGA. The 5x5 array has been characterized in a diffracted neutron beam. This work is a part of on-going research to develop various designs of high- and low-efficiency semiconductor neutron detectors.

Perforated membrane-type acoustic metamaterials

International Nuclear Information System (INIS)

Langfeldt, F.; Kemsies, H.; Gleine, W.; Estorff, O. von

2017-01-01

This letter introduces a modified design of membrane-type acoustic metamaterials (MAMs) with a ring mass and a perforation so that an airflow through the membrane is enabled. Simplified analytical investigations of the perforated MAM (PMAM) indicate that the perforation introduces a second anti-resonance, where the effective surface mass density of the PMAM is much higher than the static value. The theoretical results are validated using impedance tube measurements, indicating good agreement between the theoretical predictions and the measured data. The anti-resonances yield high low-frequency sound transmission loss values with peak values over 25 dB higher than the corresponding mass-law. - Highlights: • A new membrane-type acoustic metamaterial exhibiting negative density is presented. • The metamaterial design contains a ring mass with a perforation through the membrane. • The sound transmission loss exhibits narrow-band peaks much higher than the mass-law. • The emergence of the peaks is explained using a simple theoretical model. • Impedance tube measurements are used to validate the theoretical predictions.

Perforated membrane-type acoustic metamaterials

Energy Technology Data Exchange (ETDEWEB)

Langfeldt, F., E-mail: Felix.Langfeldt@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Kemsies, H., E-mail: Hannes.Kemsies@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Gleine, W., E-mail: Wolfgang.Gleine@haw-hamburg.de [Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, Berliner Tor 9, D-20099 Hamburg (Germany); Estorff, O. von, E-mail: estorff@tu-harburg.de [Institute of Modelling and Computation, Hamburg University of Technology, Denickestr. 17, D-21073 Hamburg (Germany)

2017-04-25

This letter introduces a modified design of membrane-type acoustic metamaterials (MAMs) with a ring mass and a perforation so that an airflow through the membrane is enabled. Simplified analytical investigations of the perforated MAM (PMAM) indicate that the perforation introduces a second anti-resonance, where the effective surface mass density of the PMAM is much higher than the static value. The theoretical results are validated using impedance tube measurements, indicating good agreement between the theoretical predictions and the measured data. The anti-resonances yield high low-frequency sound transmission loss values with peak values over 25 dB higher than the corresponding mass-law. - Highlights: • A new membrane-type acoustic metamaterial exhibiting negative density is presented. • The metamaterial design contains a ring mass with a perforation through the membrane. • The sound transmission loss exhibits narrow-band peaks much higher than the mass-law. • The emergence of the peaks is explained using a simple theoretical model. • Impedance tube measurements are used to validate the theoretical predictions.

Oriented cluster perforating technology and its application in horizontal wells

Directory of Open Access Journals (Sweden)

Huabin Chen

2016-11-01

Full Text Available An oriented cluster perforating technology, which integrates both advantages of cluster and oriented perforating, will help solve a series of technical complexities in horizontal well drilling. For realizing its better application in oil and gas development, a series of technologies were developed including perforator self-weight eccentricity, matching of the electronic selective module codes with the surface program control, axial centralized contact signal transmission, and post-perforation intercluster sealing insulation. In this way, the following functions could be realized, such as cable-transmission horizontal well perforator self-weight orientation, dynamic signal transmission, reliable addressing & selective perforation and post-perforation intercluster sealing. The combined perforation and bridge plug or the multi-cluster perforation can be fulfilled in one trip of perforation string. As a result, the horizontal-well oriented cluster perforating technology based on cable conveying was developed. This technology was successfully applied in unconventional gas reservoir exploitation, such as shale gas and coalbed methane, with accurate orientation, reliable selective perforation and satisfactory inter-cluster sealing. The horizontal-well oriented cluster perforating technology benefits the orientation of horizontal well drilling with a definite target and direction, which provides a powerful support for the subsequent reservoir stimulation. It also promotes the fracturing fluid to sweep the principal pay zones to the maximum extent. Moreover, it is conductive to the formation of complex fracture networks in the reservoirs, making quality and efficient development of unconventional gas reservoirs possible.

The value of CT in detecting pathologic bowel perforation

International Nuclear Information System (INIS)

Chang, Jong Wun; Shin, Joo Yong; Kim, Hong; Rhee, Chang Soo; Lee, Sung Moon; Joo, Yang Goo; Suh, Soo Jhi

1997-01-01

To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers. two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for 1) diagnosis of bowel perforation, 2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and 3) complications and their extent. CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases(7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.=20

Duodenal perforation during percutaneous nephrolithotomy (PCNL ...

African Journals Online (AJOL)

A. Bansal

2016-06-03

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

External perforated window Solar Screens: The effect of screen depth and perforation ratio on energy performance in extreme desert environments

KAUST Repository

Sherif, A.

2012-09-01

In hot arid desert environments, the solar radiation passing through windows increases the cooling loads and the energy consumption of buildings. Shading of windows can reduce these loads. Unlike the woven solar screens, wooden solar screens have a thickness that provides selective shading properties. Perforated wooden solar screens were traditionally used for windows shading. Developing modern types of these shading systems can lead to significant energy savings. The paper addresses the influence of changing the perforation percentage and depth of these screens on the annual energy loads, hence defining the optimum depth/perforation configurations for various window orientations. Series of experiments were performed using the EnergyPlus simulation software for a typical residential building in the Kharga Oasis, located in the Egyptian desert. A range of perforation percentages and depths were tested. Conclusions prove that external fixed deep perforated solar screens could effectively achieve energy savings up to 30% of the total energy consumption in the West and South orientations. Optimum range of depths and perforation percentages were recommended. These are: 80-90% perforation rate and 1:1 depth/opening width ratio. These lighter and deeper solar screen configurations were found to be more efficient in energy consumption in comparison with the traditional ones. © 2012 Elsevier B.V. All rights reserved.

Intestinal perforation by an ingested foreign body*

Science.gov (United States)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F. S.; de Castro, Francisco Gomes; Miller, Wagner Peitl; de Lima, Raphael Rodrigues; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

Objective To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. PMID:27818542

Intestinal perforation by an ingested foreign body

International Nuclear Information System (INIS)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F.S.; Castro, Francisco Gomes de; Miller, Wagner Peitl; Lima, Raphael Rodrigues de; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. (author)

Intestinal perforation by an ingested foreign body.

Science.gov (United States)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F S; de Castro, Francisco Gomes; Miller, Wagner Peitl; de Lima, Raphael Rodrigues; Tazima, Leandro; Geraldo, Jamylle

2016-01-01

To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation.

Intestinal perforation by an ingested foreign body

Energy Technology Data Exchange (ETDEWEB)

Nicolodi, Gabriel Cleve; Trippia, Cesar Rodrigo; Caboclo, Maria Fernanda F.S.; Castro, Francisco Gomes de; Miller, Wagner Peitl; Lima, Raphael Rodrigues de; Tazima, Leandro; Geraldo, Jamylle, E-mail: gabrielnicolodi@gmail.com [Hospital Sao Vicente - Funef, Curitiba, PR (Brazil)

2016-09-15

Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases), increased density of mesenteric fat (in all four cases), identification of the foreign body passing through the intestinal wall (in three cases), and gas in the peritoneal cavity (in one case). Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation. (author)

Intestinal perforation by an ingested foreign body

Directory of Open Access Journals (Sweden)

Gabriel Cleve Nicolodi

Full Text Available Abstract Objective: To identify the computed tomography findings suggestive of intestinal perforation by an ingested foreign body. Materials and Methods: This was a retrospective study of four cases of surgically proven intestinal perforation by a foreign body, comparing the computed tomography findings with those described in the literature. Results: None of the patients reported having ingested a foreign body, all were over 60 years of age, three of the four patients used a dental prosthesis, and all of the foreign bodies were elongated and sharp. In all four patients, there were findings indicative of acute abdomen. None of the foreign bodies were identified on conventional X-rays. The computed tomography findings suggestive of perforation were thickening of the intestinal walls (in all four cases, increased density of mesenteric fat (in all four cases, identification of the foreign body passing through the intestinal wall (in three cases, and gas in the peritoneal cavity (in one case. Conclusion: In cases of foreign body ingestion, intestinal perforation is more common when the foreign body is elongated and sharp. Although patients typically do not report having ingested such foreign bodies, the scenario should be suspected in elderly individuals who use dental prostheses. A computed tomography scan can detect foreign bodies, locate perforations, and guide treatment. The findings that suggest perforation are thickening of the intestinal walls, increased mesenteric fat density, and, less frequently, gas in the peritoneal cavity, often restricted to the point of perforation.

Neurodevelopmental outcome after neonatal perforator stroke

NARCIS (Netherlands)

Ecury-Goossen, Ginette M; van der Haer, Marit; Smit, Liesbeth S; Feijen-Roon, Monique; Lequin, Maarten; de Jonge, Rogier C J; Govaert, Paul; Dudink, Jeroen

AIM: To assess outcome after neonatal perforator stroke in the largest cohort to date. METHOD: Survivors from a cohort of children diagnosed with neonatal perforator stroke using cranial ultrasound or magnetic resonance imaging were eligible for inclusion. Recovery and Recurrence Questionnaire

Duodenal perforation: an unusual complication of sickle cell anemia.

Science.gov (United States)

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.

The value of CT in detecting pathologic bowel perforation

Energy Technology Data Exchange (ETDEWEB)

Chang, Jong Wun; Shin, Joo Yong; Kim, Hong; Rhee, Chang Soo; Lee, Sung Moon; Joo, Yang Goo; Suh, Soo Jhi [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of)

1997-10-01

To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers. two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for (1) diagnosis of bowel perforation, (2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and (3) complications and their extent. CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases(7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.=20.

Laparoscopic treatment of perforated appendicitis

Science.gov (United States)

Lin, Heng-Fu; Lai, Hong-Shiee; Lai, I-Rue

2014-01-01

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis. PMID:25339821

DETERMINATION OF THE TEMPERATURE DISTRIBUTION THE PERFORATED FINS UNDER

Directory of Open Access Journals (Sweden)

Aziz7 M. Mhamuad

2015-02-01

Full Text Available This work treats the problem of heat transfer for perforated fins under natural convection. The temperature distribution is examined for an array of rectangular fins (15 fins with uniform cross-sectional area (100x270 mm embedded with various vertical body perforations that extend through the fin thickness. The patterns of perforations include 18 circular perforations (holes. Experiments were carried out in an experimental facility that was specifically design and constructed for this purpose. The heat transfer rate and the coefficient of heat transfer increases with perforation diameter increased. 

Perforated peptic ulcer: How to improve outcome?

DEFF Research Database (Denmark)

Møller, Morten Hylander; Adamsen, Sven; Wøjdemann, Morten

2008-01-01

Despite the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased...... with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evidential status. Only a few randomized, controlled trials have been published...... to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment Udgivelsesdato: 2008/8/27...

Fast track pathway for perforated appendicitis.

Science.gov (United States)

Frazee, Richard; Abernathy, Stephen; Davis, Matthew; Isbell, Travis; Regner, Justin; Smith, Randall

2017-04-01

Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis. Interval appendectomy was excluded. Patients were treated initially with intravenous antibiotics and transitioned to oral antibiotics and dismissed when medically stable and tolerating oral intake. A retrospective review of patients managed on the fast track pathway was undertaken to analyze length of stay, morbidity, and readmissions. Thirty-four males and twenty-one females with an average age of 46.8 years underwent laparoscopic appendectomy for perforated appendicitis between January 2013 and December 2014. Pre-existing comorbidities included hypertension 42%, diabetes mellitus 11%, COPD 5% and heart disease 2%. No patient had conversion to open appendectomy. Average length of stay was 2.67 days and ranged from 1 to 12 days (median 2 days). Postoperative morbidity was 20% and included abscess (6 patients), prolonged ileus (3 patients), pneumonia (1 patient), and congestive heart failure (1 patient). Five patients were readmitted for abscess (3 patients), congestive heart failure (1 patient), and pneumonia (1 patient). A fast track pathway for perforated appendicitis produced shorter length of stay and acceptable postoperative morbidity and readmission. This offers the potential for significant cost savings over current national practice patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

Thermally stimulated current method applied to highly irradiated silicon diodes

CERN Document Server

Pintilie, I; Pintilie, I; Moll, Michael; Fretwurst, E; Lindström, G

2002-01-01

We propose an improved method for the analysis of Thermally Stimulated Currents (TSC) measured on highly irradiated silicon diodes. The proposed TSC formula for the evaluation of a set of TSC spectra obtained with different reverse biases leads not only to the concentration of electron and hole traps visible in the spectra but also gives an estimation for the concentration of defects which not give rise to a peak in the 30-220 K TSC temperature range (very shallow or very deep levels). The method is applied to a diode irradiated with a neutron fluence of phi sub n =1.82x10 sup 1 sup 3 n/cm sup 2.

The Heidelberg Appendicitis Score Predicts Perforated Appendicitis in Children.

Science.gov (United States)

Boettcher, Michael; Günther, Patrick; Breil, Thomas

2017-10-01

In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis. In 2 years, 157 children suffered from appendicitis. Perforation occurred in 47 (29.9%) of the patients. C-reactive protein (CRP) levels higher than 20 mg/dL ( P = .037) and free abdominal fluid on ultrasonography ( P = .031) are the most important features to differentiate perforated from simple appendicitis. Moreover, all children with perforation had a positive Heidelberg Appendicitis Score (HAS). A negative HAS excludes perforation in all cases (negative predictive value = 100%). Perforated appendicitis can be ruled out by the HAS. In a cohort with right-sided abdominal pain, perforation should be considered in children with high CRP levels and free fluids or abscess formation on ultrasound.

Medicolegal aspects of iatrogenic root perforations

DEFF Research Database (Denmark)

Tsesis, I; Rosen, E; Bjørndal, L

2014-01-01

AIM: To retrospectively analyze the medico-legal aspects of iatrogenic root perforations (IRP) that occurred during endodontic treatments. METHODOLOGY: A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of IRP following root canal...... treatment (p root perforation is a complication of root canal treatment and may result in tooth extraction...... and in legal actions against the treating practitioner. Mandibular molars are more prone to medico-legal claims related to root perforations. The patient should be informed of the risks during RCT and should get information on alternative treatments and their risks and prognosis...

Spontaneous ileal perforation complicating low anorectal malformation

Directory of Open Access Journals (Sweden)

TiJesuni Olatunji

2015-01-01

Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

Premixed Combustion of Coconut Oil on Perforated Burner

Directory of Open Access Journals (Sweden)

I.K.G. Wirawan

2013-10-01

Full Text Available Coconut oil premixed combustion behavior has been studied experimentally on perforated burner with equivalence ratio (φ varied from very lean until very rich. The results showed that burning of glycerol needs large number of air so that the laminar burning velocity (SL is the highest at very lean mixture and the flame is in the form of individual Bunsen flame on each of the perforated plate hole. As φ is increased the  SL decreases and the secondary Bunsen flame with open tip occurs from φ =0.54 at the downstream of perforated flame. The perforated flame disappears at φ = 0.66 while the secondary Bunsen flame still exist with SL increases following that of hexadecane flame trend and then extinct when the equivalence ratio reaches one or more. Surrounding ambient air intervention makes SL decreases, shifts lower flammability limit into richer mixture, and performs triple and cellular flames. The glycerol diffusion flame radiation burned fatty acids that perform cellular islands on perforated hole.  Without glycerol, laminar flame velocity becomes higher and more stable as perforated flame at higher φ. At rich mixture the Bunsen flame becomes unstable and performs petal cellular around the cone flame front. Keywords: cellular flame; glycerol; perforated flame;secondary Bunsen flame with open tip; triple flame

Microvascular anatomy of the cerebellar parafloccular perforating space.

Science.gov (United States)

Sosa, Pablo; Dujovny, Manuel; Onyekachi, Ibe; Sockwell, Noressia; Cremaschi, Fabián; Savastano, Luis E

2016-02-01

The cerebellopontine angle is a common site for tumor growth and vascular pathologies requiring surgical manipulations that jeopardize cranial nerve integrity and cerebellar and brainstem perfusion. To date, a detailed study of vessels perforating the cisternal surface of the middle cerebellar peduncle-namely, the paraflocculus or parafloccular perforating space-has yet to be published. In this report, the perforating vessels of the anterior inferior cerebellar artery (AICA) in the parafloccular space, or on the cisternal surface of the middle cerebellar peduncle, are described to elucidate their relevance pertaining to microsurgery and the different pathologies that occur at the cerebellopontine angle. Fourteen cadaveric cerebellopontine cisterns (CPCs) were studied. Anatomical dissections and analysis of the perforating arteries of the AICA and posterior inferior cerebellar artery at the parafloccular space were recorded using direct visualization by surgical microscope, optical histology, and scanning electron microscope. A comprehensive review of the English-language and Spanish-language literature was also performed, and findings related to anatomy, histology, physiology, neurology, neuroradiology, microsurgery, and endovascular surgery pertaining to the cerebellar flocculus or parafloccular spaces are summarized. A total of 298 perforating arteries were found in the dissected specimens, with a minimum of 15 to a maximum of 26 vessels per parafloccular perforating space. The average outer diameter of the cisternal portion of the perforating arteries was 0.11 ± 0.042 mm (mean ± SD) and the average length was 2.84 ± 1.2 mm. Detailed schematics and the surgical anatomy of the perforating vessels at the CPC and their clinical relevance are reported. The parafloccular space is a key entry point for many perforating vessels toward the middle cerebellar peduncle and lateral brainstem, and it must be respected and protected during surgical approaches to the

A Novel Perforator Flap Training Model Using a Chicken Leg.

Science.gov (United States)

Cifuentes, Ignacio J; Yañez, Ricardo A; Salisbury, Maria C; Rodriguez, José R; Varas, Julian E; Dagnino, Bruno L

2016-04-01

Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

Esophageal perforation

Science.gov (United States)

... esophagus into the space around the lungs. Collapsed lung. X-rays taken after you drink a non-harmful dye can help pinpoint the location of the perforation. You may also have chest CT scan look for an abscess in the chest or esophageal cancer.

[Iatrogen perforation of the rectum after colon radiography].

Science.gov (United States)

Eggum, R; Kressner, U; Haffner, J

1998-05-10

Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment.

High power pulsed neutron source for electronuclear installation

Energy Technology Data Exchange (ETDEWEB)

Korenev, S.A.; Puzynin, I.V.; Samoilov, V.N.; Sissakian, A.N. [Joint Inst. for Nuclear Research, Dubna (Russian Federation)

1997-09-01

The pulsed neutron source based on the reaction T(d,n)He is described in this report. The source consists of pulsed a pulsed Arkad`ev-Marx generator and a vacuum diode with explosive ion emission. 9 refs., 3 figs.

Experimental characterization of semiconductor-based thermal neutron detectors

Energy Technology Data Exchange (ETDEWEB)

Bedogni, R., E-mail: roberto.bedogni@lnf.infn.it [IFNF—LNF, via E. Fermi n. 40, 00044 Frascati, Roma (Italy); Bortot, D.; Pola, A.; Introini, M.V.; Lorenzoli, M. [Politecnico di Milano, Dipartimento di Energia, via La Masa 34, 20156 Milano (Italy); INFN—Milano, Via Celoria 16, 20133 Milano (Italy); Gómez-Ros, J.M. [IFNF—LNF, via E. Fermi n. 40, 00044 Frascati, Roma (Italy); CIEMAT, Av. Complutense 40, 28040 Madrid (Spain); Sacco, D. [IFNF—LNF, via E. Fermi n. 40, 00044 Frascati, Roma (Italy); INAIL—DIT, Via di Fontana Candida 1, 00040 Monteporzio Catone (Italy); Esposito, A.; Gentile, A.; Buonomo, B. [IFNF—LNF, via E. Fermi n. 40, 00044 Frascati, Roma (Italy); Palomba, M.; Grossi, A. [ENEA Triga RC-1C.R. Casaccia, via Anguillarese 301, 00060 S. Maria di Galeria, Roma (Italy)

2015-04-21

In the framework of NESCOFI@BTF and NEURAPID projects, active thermal neutron detectors were manufactured by depositing appropriate thickness of {sup 6}LiF on commercially available windowless p–i–n diodes. Detectors with different radiator thickness, ranging from 5 to 62 μm, were manufactured by evaporation-based deposition technique and exposed to known values of thermal neutron fluence in two thermal neutron facilities exhibiting different irradiation geometries. The following properties of the detector response were investigated and presented in this work: thickness dependence, impact of parasitic effects (photons and epithermal neutrons), linearity, isotropy, and radiation damage following exposure to large fluence (in the order of 10{sup 12} cm{sup −2})

Studies of defects in neutron-irradiated p-type silicon by admittance measurements of n+-p diodes

International Nuclear Information System (INIS)

Tokuda, Y.; Usami, A.

1978-01-01

Defects introduced in p-type silicon by neutron irradiation were studied by measuring the admittance of n + -p diodes. It was shown that the energy levels and capture cross sections estimated from the temperature dependence of the admittance had some uncertainty due to the temperature dependence of the concentration of free carriers in the bulk and the high-frequency-junction capacitance. So, we presented the method of determination of the energy levels, capture cross sections, and concentrations of defects from the frequency dependence of the admittance. This method consists of the measurements of G/ω and C as a function of frequency. From this method, assuming that capture cross sections are independent of temperature, the energy levels of E/sub v/+0.16 and E/sub v/+0.36 eV were obtained. For these defects, the calculated values of the hole capture cross section were 2.4 x 10 -14 and 3.7 x 10 -14 cm 2 , respectively. Comparing with other published data, the energy level of E/sub v/+0.36 eV was found to be correlated with the divacancy

Perforated duodenal ulcer: an unusual complication of gastroenteritis.

OpenAIRE

Wilson, J M; Darby, C R

1990-01-01

A 7 year old boy was admitted to hospital with gastroenteritis, which was complicated by an acute perforated duodenal ulcer. After oversewing of the perforation he made an uncomplicated recovery. Peptic ulceration is under-diagnosed in childhood and this leads to delay in diagnosis and appropriate management. Ulceration is associated with severe illness and viral infections, but perforation is rare.

Iatrogen perforation of the rectum following barium enema

International Nuclear Information System (INIS)

Eggum, R.; Kressner, U.; Haffner, J.

1998-01-01

Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment. 10 refs., 1 fig

Target injection and engagement for neutron generation at 1 Hz

International Nuclear Information System (INIS)

Komeda, Osamu; Mori, Yoshitaka; Nishimura, Yasuhiko

2013-01-01

Target injection is a key technology to realizing inertial fusion energy. Here we present the first demonstration of target injection and neutron generation. We injected more than 600 spherical deuterated polystyrene (C 8 D 8 ) bead targets during 10 minutes at 1 Hz. After the targets fell for a distance of 18 cm, we applied the synchronized laser-diode-pumped ultra-intense laser HAMA and successfully generated neutrons repeatedly. The result is a step toward fusion power and also suggests possible industrial neutron sources. (author)

Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

Science.gov (United States)

Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

2015-07-01

Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

Acquired perforating dermatosis in a patient with chronic renal failure.

Science.gov (United States)

Fernandes, Karen de Almeida Pinto; Lima, Lourenço de Azevedo; Guedes, Juliana Chaves Ruiz; Lima, Ricardo Barbosa; D'Acri, Antônio Macedo; Martins, Carlos José

2016-01-01

Perforating dermatoses are a group of skin diseases characterized by transepidermal elimination of dermal material. The disease is divided into two groups: the primary group and the secondary group. The classical or primary perforating dermatoses are subdivided into four types according to the eliminated dermal materials: Kyrle disease, perforating reactive collagenosis, elastosis perforans serpiginosa, and perforating folliculitis. The secondary form is known as acquired perforating dermatosis. The term was proposed in 1989 by Rapini to designate the perforating dermatoses affecting adult patients with systemic disease, regardless of the dermal materials eliminated. This report describes a case of the disease with elimination of collagen and elastic fibers in a patient with chronic renal failure.

Idiopathic gastric perforation in an asplenic infant | Olsen | African ...

African Journals Online (AJOL)

Introduction: The cause of idiopathic gastric perforations in neonates remains unknown. Perforations of the abdominal oesophagus, stomach and duodenum in infants and children are the rarest type of intestinal perforations. There are 21 reported cases of an idiopathic gastric rupture in nonneonates. Case Report: A ...

Radiation effects on breakdown in silicon multiguarded diodes

International Nuclear Information System (INIS)

Bisello, D.; Da Rold, M.; Franzin, L.; Wheadon, R.

1996-01-01

The authors have investigated the current-voltage characteristics of silicon PIN diodes with a number of different multiguard structures. These structures were designed to increase the overall device breakdown voltage. The same measurements were carried out after gamma irradiation at different doses and neutron irradiation at fluences beyond type-inversion. This study is a first step towards defining guard structures optimized for operation in high-radiation environments such as those expected at the LHC

CORRELATION BETWEEN TYMPANIC MEMBRANE PERFORATION AND HEARING LOSS

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Lidija RISTOVSKA

2016-04-01

Full Text Available Introduction: Perforation of the tympanic membrane primarily results from middle ear infections, trauma or iatrogenic causes. The perforation causes conductive hearing loss by reducing the surface area available for sound transmission to the ossicular chain. Objective: The objective was to analyze the characteristics of tympanic membrane perforations in relation to hearing loss and to determine the type and degree of hearing loss. Materials and methods: We analyzed audiometric, otoscopic findings and medical reports of 218 patients, 114 males (52.3% and 104 females (47.7%, aged 9 to 75 years (mean age of 47.9 years, examined during the period of November 2012 to October 2015. For statistical data analysis we used Chi-square test with level of significance p<0.05. Results: Most of the patients had unilateral perforations (89% with right ear predominance and involvement of two quadrants of pars tensa (37.2%. Mean air-bone gap was 23.9 dB. The largest air-bone gap was at frequency of 250 Hz. Most of the patients (73.1% had mixed hearing loss (p=0.032, and average hearing thresholds from 21 to 40 dB. Conclusion: Mean air-bone gap is largest at the lower frequencies, and decreases as frequency increases. Size of the perforation has effect on hearing loss. Mean air-bone gap increases with increasing size of the perforation. There is no big difference between the mean air-bone gap in posterior versus anterior perforations.

Gallbladder perforation complicating typhoid fever: report of two cases.

Science.gov (United States)

Gali, B M; Ali, N; Agbese, G O; Duna, V D; Dawha, S D; Ismai, G I; Mohammed, M

2011-01-01

Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy. Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records. The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi. Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.

Silicon photo-multiplier radiation hardness tests with a beam controlled neutron source

International Nuclear Information System (INIS)

Angelone, M.; Pillon, M.; Faccini, R.; Pinci, D.; Baldini, W.; Calabrese, R.; Cibinetto, G.; Cotta Ramusino, A.; Malaguti, R.; Pozzati, M.

2010-01-01

Radiation hardness tests were performed at the Frascati Neutron Generator on silicon Photo-Multipliers that were made of semiconductor photon detectors built from a square matrix of avalanche photo-diodes on a silicon substrate. Several samples from different manufacturers have been irradiated, integrating up to 7x10 10 1-MeV-equivalent neutrons per cm 2 . Detector performance was recorded during the neutron irradiation, and a gradual deterioration of their properties began after an integrated fluence of the order of 10 8 1-MeV-equivalent neutrons per cm 2 was reached.

Shorting time of magnetically insulated reflex-ion diodes from the neutral-atom charge-exchange mechanism

International Nuclear Information System (INIS)

Strobel, G.

1981-10-01

In a magnetically insulated diode, collision-free electrons return to the cathode and no electron current is present at the anode. Electron transport to the anode is studied in this paper. Steady-state space-charge-limited flow is assumed initially. Breakdown of ion flow occurs when static neutral atoms at the anode undergo charge exchange, which results in neutral atoms drifting across the diode. These are subsequently ionized by reflexing ions producing electrons trapped in Larmor orbits throughout the diode. These electrons drift to the anode via ionization and inelastic collisions with other neutral atoms. Model calculations compare the effects of foil and mesh cathodes. Steady-state space-charge-limited ion current densities are calculated. The neutral atom density at the cathode is determined as a function of time. The shorting time of the diode is scaled versus the electrode separation d, the diode potential V 0 , the magnetic field, and the initial concentration of static neutron atoms

Hyperbilirubinemia as a predictor for appendiceal perforation

DEFF Research Database (Denmark)

Burcharth, J; Pommergaard, H C; Rosenberg, J

2013-01-01

Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum bilirubin may be a useful marker for appendiceal perforation. The purpose of this systematic review was to evaluate studies investigating elevated serum...

Sigmoid Colonic Perforation with Faecal Peritonitis due to Faecaloma

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Ibrahim Khalil

2014-09-01

Full Text Available Colon perforation is an uncommon event usually caused by malignancy, diverticular disease, amoebic colitis, steroid therapy, trauma and ulcerative colitis, but stercoral perforation is very rare. Severe chronic constipation is considered to be the main causative factor in development of stercoral perforation of colon. Sometimes it can also produce catastrophic complications like colonic obstruction, faecal peritonitis and septicaemia. We report a rare case of sigmoid colonic perforation with faecal peritonitis and pneumoperitonium due to faecaloma which was diagnosed after exploratory laparotomy.

Peptic ulcer perforation

African Journals Online (AJOL)

FinePrint

2015-06-01

Jun 1, 2015 ... Peptic ulcer perforation is one of the surgical complications of peptic ulcer ... Treatment can be operative or non-operative followed by proton .... chronic gastritis without evidence of ... inhibits pancreatic bicarbonate secretion.

Perforated peptic ulcer following gastric bypass for obesity.

Science.gov (United States)

Macgregor, A M; Pickens, N E; Thoburn, E K

1999-03-01

Peptic ulcer in the excluded segment of a gastric bypass performed in the management of morbid obesity has only rarely been reported in the literature. The purpose of this study is to review our experience with the condition in a series of 4300 patients who underwent gastric-restrictive surgery between 1978 and 1997. Eleven patients presented with acute perforation of a peptic ulcer in the excluded gastric segment. Nine ulcers were duodenal, one was gastric, and one patient had both gastric and duodenal perforations. The time between primary gastric-restrictive surgery and ulcer perforation varied from 20 days to 12 years. All patients presented with upper abdominal pain. The classical radiological sign of perforated peptic ulcer, free air under the diaphragm, did not occur in any patient. Nine patients were initially treated by primary closure of the perforation with subsequent definitive ulcer therapy by vagotomy, pyloroplasty, or gastrectomy. One case, initially treated elsewhere, was managed by placement of a Malecot catheter through the duodenal perforation, gastrostomy, and peritoneal drainage. One recent case remains symptom-free on H2 blockers after simple closure. There was no mortality. Six cases were previously reported in the literature with a 33 per cent mortality rate.

Stercoral perforation in a 17-year old.

LENUS (Irish Health Repository)

McHugh, S

2012-02-01

INTRODUCTION: Stercoral perforation is a rare cause of perforation. This is the first reported case where a partial eating disorder (ED) is the primary causative differential. CASE PRESENTATION: We present the case of a 17-year-old girl who presented to her local Emergency Department with a 24-h history of left-sided abdominal pain. She subsequently deteriorated and a computed tomography scan of her abdomen showed gross distension of the large bowel with a sigmoid perforation. She underwent total colectomy with end ileostomy. Histology reported stercoral perforation but normal bowel ganglia. While an inpatient she was reviewed by the Psychiatric team who were concerned she was suffering from a partial ED. CONCLUSION: This case highlights the importance of a multidisciplinary approach in optimally treating patients such as these. Aggressive medical management with involvement of a psychiatric team and dietetics addresses any underlying causative psychiatric issues and helps prevent recurrence.

Stercoral perforation in a 17-year old.

LENUS (Irish Health Repository)

McHugh, S

2009-04-02

INTRODUCTION: Stercoral perforation is a rare cause of perforation. This is the first reported case where a partial eating disorder (ED) is the primary causative differential. CASE PRESENTATION: We present the case of a 17-year-old girl who presented to her local Emergency Department with a 24-h history of left-sided abdominal pain. She subsequently deteriorated and a computed tomography scan of her abdomen showed gross distension of the large bowel with a sigmoid perforation. She underwent total colectomy with end ileostomy. Histology reported stercoral perforation but normal bowel ganglia. While an inpatient she was reviewed by the Psychiatric team who were concerned she was suffering from a partial ED. CONCLUSION: This case highlights the importance of a multidisciplinary approach in optimally treating patients such as these. Aggressive medical management with involvement of a psychiatric team and dietetics addresses any underlying causative psychiatric issues and helps prevent recurrence.

Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction

Directory of Open Access Journals (Sweden)

Khanna Rahul

2006-09-01

Full Text Available Abstract Background Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel.

Energy Analysis of Solar Collector With perforated Absorber Plate

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Ammar A. Farhan

2017-09-01

Full Text Available The thermal performance of three solar collectors with 3, 6 mm and without perforation absorber plate was assessed experimentally. The experimental tests were implemented in Baghdad during the January and February 2017. Five values of airflow rates range between 0.01 – 0.1 m3/s were used through the test with a constant airflow rate during the test day. The variation of the following parameters air temperature difference, useful energy, absorber plate temperature, and collector efficiency was recorded every 15 minutes. The experimental data reports that the increases the number of absorber plate perforations with a small diameter is more efficient rather than increasing the hole diameter of the absorber plate with decreasing the perforation numbers. Maximum air temperature difference throughout the solar collector with 3, 6 mm perforations and without perforations are 17, 15, and 12 oC, respectively. Also, it can be concluded that the energy gained from the solar collector with 3 mm perforation absorber plate is 28.2 % more than the energy gained from solar collector without holes per day for 0.1 m3/s airflow rate. The maximum values of the thermal performance curves are 0.67, 0.64, and 0.56 for the solar collector with 3, 6 mm, and without perforations, respectively.

Arrangement for formation perforating and fracturing

Energy Technology Data Exchange (ETDEWEB)

Belyaev, B M; Vitsenii, E M; Zheltov, Yu P; Nikolaev, S I

1962-03-06

An arrangement for perforating and hydraulic fracturing, to be lowered on a wire line, consists of a chamber with a shaped charge, a head and a nozzle. This arrangement enables carrying out, simultaneously, the operations of perforating and fracturing. The device may be equipped with separate sections with shaped charges and a powder chamber in which powder charges are placed, designed to be ignited in sequence by slow- acting electric igniters. For controlling the gas pressure and strengthening the arrangement in the zone of perforation, the device is equipped with rubber seals which release the ring elements under pressure of explosive gas. Between the walls of the casing and the rubber seals is an annular space through the gas escapes.

Intraabdominal contamination after gallbladder perforation during laparoscopic cholecystectomy and its complications.

Science.gov (United States)

Kimura, T; Goto, H; Takeuchi, Y; Yoshida, M; Kobayashi, T; Sakuramachi, S; Harada, Y

1996-09-01

Gallbladder perforation often occurs during laparoscopic cholecystectomy. The frequency and causes of gallbladder perforation as well as the relevant clinical background factors were investigated in 110 patients undergoing laparoscopic cholecystectomy. We also evaluated intraperitoneal contamination by bacteria and gallstones at the time of gallbladder perforation and investigated whether perforation caused early or late postoperative complications. Intraoperative gallbladder perforation occurred in 29 of the 110 patients (26.3%). It was caused by injury with an electric knife during dissection of the gallbladder bed, injury during gallbladder retraction with grasping forceps, injury during gallbladder extraction from the abdomen, and slippage of cystic duct clips (potentially causing bile and stone spillage). Perforation was more frequent in patients with positive bile cultures and in those with pigment stones (p gallbladder perforation is sometimes unavoidable during laparoscopic cholecystectomy, the risk of severe complications appears to be minimized by early closure of perforation, retrieval of as many of the spilled stones as possible, and intraperitoneal lavage.

MRI of perforated gall bladder

International Nuclear Information System (INIS)

Sood, B.; Jain, M.; Khandelwal, N.; Singh, P.; Suri, S.

2002-01-01

Gall bladder perforation is a dreaded complication of acute cholecystitis that, if not diagnosed early in the course, might have a poor prognosis. Both CT and ultrasonography have been used until now extensively for the diagnosis of acute cholecystitis, but diagnosis of perforation is always difficult. Magnetic resonance, by its superior soft tissue resolution and multiplanar capability, is a better modality and should fare better than ultrasonography and CT, as demonstrated in our case. Magnetic resonance imaging demonstrates the wall of the gall bladder and defects to a much better advantage and more convincingly. In addition, MR colangiopancreatography images demonstrate the biliary tree better than other modalities. We suggest that in the case of acute cholecystitis, if perforation is suspected and CT and ultrasonography are not conclusive, MR should be the modality of choice. It can be used as a first line of investigation; however, it might not be cost-effective. Copyright (2002) Blackwell Science Pty Ltd

Optimization of the process of steel strip perforation and nickel platting for the purpose of elimination of trichloroethylene from the cleaning process of perforated steel strip

Directory of Open Access Journals (Sweden)

Petrović Aleksandra B.

2009-01-01

Full Text Available In the production of pocket type electrodes for Ni-Cd batteries perforation of proper steel strips and then nickel platting of perforated steel strips were made. In the nickel platting process, the organic solvent, trichloroethylene, has previously been used for cleaning. Due to the carcinogenic nature of trichloroethylene and the many operations previously required during cleaning, it was considered to do cleaning of perforated steel strips without use of the mentioned organic solvent. In the purpose of elimination of trichloroethylene from the cleaning process of perforated steel strips, the tests of perforation of steel strips with use of oils of different viscosity were made. It was shown that there was no dysfunction during the work of the perforation plants, meaning there was no additional heating of the strips, deterring of the steel filings, nor excessive wearing of the perforation apparatus. The perforation percent was the same irrelevant of the viscosity of the used oil. Before being perforated using the oils with different viscosity, the nickel platting steel strips were cleaned in different degreasers (based on NaOH as well as on KOH. It was shown that efficient cleaning without the use of trichloroethylene is possible with the use of oil with smaller viscosity in the perforated steel strips process and the degreaser based on KOH in the cleaning process, before nickel platting. It also appeared that the alkali degreaser based on KOH was more efficient, bath corrections were made less often and the working period of the baths was longer, which all in summary means less quantity of chemicals needed for degreasing of perforated steel strips.

Fouling Resilient Perforated Feed Spacers for Membrane Filtration

KAUST Repository

Kerdi, Sarah

2018-04-24

The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50% - 61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L.m-2.h-1 and 6.6 L.m-2.h-1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those observed with

Fouling resilient perforated feed spacers for membrane filtration.

Science.gov (United States)

Kerdi, Sarah; Qamar, Adnan; Vrouwenvelder, Johannes S; Ghaffour, Noreddine

2018-04-24

The improvement of feed spacers with optimal geometry remains a key challenge for spiral-wound membrane systems in water treatment due to their impact on the hydrodynamic performance and fouling development. In this work, novel spacer designs are proposed by intrinsically modifying cylindrical filaments through perforations. Three symmetric perforated spacers (1-Hole, 2-Hole, and 3-Hole) were in-house 3D-printed and experimentally evaluated in terms of permeate flux, feed channel pressure drop and membrane fouling. Spacer performance is characterized and compared with standard no perforated (0-Hole) design under constant feed pressure and constant feed flow rate. Perforations in the spacer filaments resulted in significantly lowering the net pressure drop across the spacer filled channel. The 3-Hole spacer was found to have the lowest pressure drop (50%-61%) compared to 0-Hole spacer for various average flow velocities. Regarding permeate flux production, the 0-Hole spacer produced 5.7 L m -2 .h -1 and 6.6 L m -2 .h -1 steady state flux for constant pressure and constant feed flow rate, respectively. The 1-Hole spacer was found to be the most efficient among the perforated spacers with 75% and 23% increase in permeate production at constant pressure and constant feed flow, respectively. Furthermore, membrane surface of 1-Hole spacer was found to be cleanest in terms of fouling, contributing to maintain higher permeate flux production. Hydrodynamic understanding of these perforated spacers is also quantified by performing Direct Numerical Simulation (DNS). The performance enhancement of these perforated spacers is attributed to the formation of micro-jets in the spacer cell that aided in producing enough unsteadiness/turbulence to clean the membrane surface and mitigate fouling phenomena. In the case of 1-Hole spacer, the unsteadiness intensity at the outlet of micro-jets and the shear stress fluctuations created inside the cells are higher than those

A new Recoil Proton Telescope for energy and fluence measurement of fast neutron fields

Energy Technology Data Exchange (ETDEWEB)

Lebreton, Lena; Bachaalany, Mario [IRSN / LMDN (Institut de Radioprotection et de Surete nucleaire / Laboratoire de Metrologie et de dosimetrie des neutrons), Cadarache Bat.159, 13115 Saint Paul-lez-Durance, (France); Husson, Daniel; Higueret, Stephane [IPHC / RaMsEs (Institut Pluridisciplinaire Hubert Curien / Radioprotection et Mesures Environnementales), 23 rue du loess - BP28, 67037 Strasbourg cedex 2, (France)

2015-07-01

The spectrometer ATHENA (Accurate Telescope for High Energy Neutron metrology Applications), is being developed at the IRSN / LMDN (Institut de Radioprotection et de Surete nucleaire / Laboratoire de Metrologie et de dosimetrie des neutrons) and aims at characterizing energy and fluence of fast neutron fields. The detector is a Recoil Proton Telescope and measures neutron fields in the range of 5 to 20 MeV. This telescope is intended to become a primary standard for both energy and fluence measurements. The neutron detection is achieved by a polyethylene radiator for n-p conversion, three 50{sub m} thick silicon sensors that use CMOS technology for the proton tracking and a 3 mm thick silicon diode to measure the residual proton energy. This first prototype used CMOS sensors called MIMOSTAR, initially developed for heavy ion physics. The use of CMOS sensors and silicon diode increases the intrinsic efficiency of the detector by a factor of ten compared with conventional designs. The first prototype has already been done and was a successful study giving the results it offered in terms of energy and fluence measurements. For mono energetic beams going from 5 to 19 MeV, the telescope offered an energy resolution between 5 and 11% and fluence difference going from 5 to 7% compared to other home standards. A second and final prototype of the detector is being designed. It will hold upgraded CMOS sensors called FastPixN. These CMOS sensors are supposed to run 400 times faster than the older version and therefore give the telescope the ability to support neutron flux in the order of 107 to 108cm{sup 2}:s{sup 1}. The first prototypes results showed that a 50 m pixel size is enough for a precise scattering angle reconstruction. Simulations using MCNPX and GEANT4 are already in place for further improvements. A DeltaE diode will replace the third CMOS sensor and will be installed right before the silicon diode for a better recoil proton selection. The final prototype with

Nasal Septum Perforation due to Methamphetamine abuse

Directory of Open Access Journals (Sweden)

Mehdi Bakhshaee

2012-07-01

Full Text Available Introduction: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. Case Report: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. Conclusions: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.

Spectrum of perforation peritonitis in India--review of 504 consecutive cases.

Science.gov (United States)

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-09-05

Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high. In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Spectrum of perforation peritonitis in India-review of 504 consecutive cases

Directory of Open Access Journals (Sweden)

Sharma Rajeev

2006-09-01

Full Text Available Abstract Background/objective Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH, Chandigarh. Methods Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. Results The most common cause of perforation in our series was perforated duodenal ulcer (289 cases followed by appendicitis (59 cases, gastrointestinal perforation due to blunt trauma abdomen (45 cases, typhoid fever (41 cases and tuberculosis (20 cases. Despite delay in seeking medical treatment (53%, the overall mortality (10% was favourably comparable with other published series though the overall morbidity (50% was unusually high. Conclusion In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Silicon Photo-Multiplier Radiation Hardness Tests with a White Neutron Beam

International Nuclear Information System (INIS)

Montanari, A.; Tosi, N.; Pietropaolo, A.; Andreotti, M.; Baldini, W.; Calabrese, R.; Cibinetto, G.; Luppi, E.; Cotta Ramusino, A.; Malaguti, R.; Santoro, V.; Tellarini, G.; Tomassetti, L.; De Donato, C.; Reali, E.

2013-06-01

We report radiation hardness tests performed, with a white neutron beam, at the Geel Electron Linear Accelerator in Belgium on silicon Photo-Multipliers. These are semiconductor photon detectors made of a square matrix of Geiger-Mode Avalanche photo-diodes on a silicon substrate. Several samples from different manufacturers have been irradiated integrating up to about 6.2 x 10 9 1-MeV-equivalent neutrons per cm 2 . (authors)

Contact lens rehabilitation following repaired corneal perforations

Science.gov (United States)

Titiyal, Jeewan S; Sinha, Rajesh; Sharma, Namrata; Sreenivas, V; Vajpayee, Rasik B

2006-01-01

Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60%) required aphakic contact lenses. The best corrected visual acuity (BCVA) of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25%) eyes with spectacle correction and 37 (92.5%) eyes with the use of contact lens (p < 0.001). The best-corrected visual acuity with spectacles was 0.20 ± 0.13 while the same with contact lens was 0.58 ± 0.26. All the patients showed an improvement of ≥ 2 lines over spectacles in the snellen's acuity chart with contact lens. Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries. PMID:16536877

Frequency of wound infection in non-perforated appendicitis with use of single dose perforative antibiotics

International Nuclear Information System (INIS)

Ali, K.; Latif, H.; Ahmad, S.

2015-01-01

Antibiotics are used both pre and post-operatively in acute appendicitis for preventing wound infection. It has been observed that the routine use of post-operative antibiotics is not necessary in cases of non-perforated appendicitis as only prophylactic antibiotics are sufficient to prevent wound infection. The aim of this study was to see the frequency of wound infection in non-perforated appendicitis with single dose preoperative antibiotics only. Method: This observational study was conducted at the Department of Surgery, Ayub Medical College, Abbottabad from May to November 2014. A total of 121 patients with non-perforated appendicitis were included in the study. Only single dose preoperative antibiotics were used. The patients were followed for wound infection till 8th post-operative day. Results: 121 patients, 56(46.28%) male and 65(53.72%) female were included in the study. The mean age of patients was 27.41 ± 7.12 years with an age range of 18 to 45 years. In the entire series, 7(5.78%) patients developed wound infection. The infection was minor which settled with conservative therapy. Prophylactic antibiotics were found efficacious in 114(94.21%) patients. There was no significant association between wound infection and age and gender. Conclusion: Single dose preoperative antibiotics were found effective in controlling post-operative wound infection without the need of extending the antibiotics to post-operative period in cases of non-perforated appendicitis. (author)

Preoperative chest x-ray findings in peptic ulcer perforation

Energy Technology Data Exchange (ETDEWEB)

Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J. [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

1981-12-15

This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings.

Preoperative chest x-ray findings in peptic ulcer perforation

International Nuclear Information System (INIS)

Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J.

1981-01-01

This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings

Prediction of inelastic behavior and creep-fatigue life of perforated plates

International Nuclear Information System (INIS)

Igari, Toshihide; Setoguchi, Katsuya; Nakano, Shohki; Nomura, Shinichi

1991-01-01

Prediction methods of macroscopic and local stress-strain behavior of perforated plates in plastic and creep regime which are proposed by the authors are applied to the inelastic analysis and creep-fatigue life prediction of perforated cylinder subjected to cyclic thermal stress. Stress-strain behavior of perforated cylinder is analyzed by modeling the perforated portion to cylinder with equivalent-solid-plate properties. Creep-fatigue lives at around a hole of perforated plates are predicted by using the local stress-strain behavior and are compared with experimentally observed lives. (author)

Primary Closure versus Gastric Resection for Perforated Gastric

African Journals Online (AJOL)

Perforated gastric ulcer is one of the most life‑threatening complications of peptic ulcer disease with high .... tubes were removed and oral nutrition resumed. The .... surgical approach for perforated gastric cancer: One‑stage vs. two‑stage ...

Study on Dynamic Response of Downhole Tools under Perforation Impact Load

Directory of Open Access Journals (Sweden)

Liu Jun

2017-01-01

Full Text Available A model of a multibody system is established to investigate the dynamic response of an oil tube-shock absorber-perforating gun system in downhole perforation-test joint operation. In the model, the oil tube and perforating gun are modeled as elastic rods and the shock absorber is modeled as single particle system with damping and a spring. Two force continuity conditions are used to simulate the interactions among the three components. The perforation impact load is determined by an experiment of underwater explosion of perforating bullets. Using the model, the effects of charge quantity of perforating bullet, the number of shock absorbers, and the length of oil tube on the dynamic response of oil tube and packer are investigated. On this basis, a basic principle of the combination design of shock absorber and oil tube is proposed to improve the mechanical state of downhole tools. The study results can provide theoretical support for the design of downhole perforation-test joint operation.

Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms

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Yoshinobu Yamamoto

2017-01-01

Full Text Available Background. Delayed perforation is a rare but severe complication of endoscopic submucosal dissection (ESD for early gastric neoplasm (EGN. The aim of this study was to clarify clinical factors related to delayed perforation after ESD. Methods. A total of 1158 consecutive patients with 1199 EGNs underwent ESD at our hospital between January 2000 and December 2015. Univariate analysis was used to identify clinicopathological factors related to delayed perforation. Moreover, duration of cautery needed for hemostasis was measured by comparison between perforated and nonperforated points in patients with delayed perforation. Results. Delayed perforation occurred in 5 of 1158 consecutive patients with 1199 EGNs who underwent ESD (0.42%. All cases were diagnosed within 24 h after ESD and recovered with conservative management. On univariate analysis, location in the upper stomach was the factor most significantly associated with delayed perforation (P<0.01. Duration of cautery needed for hemostasis was significantly longer at perforated points (9 s than at nonperforated points (3.5 s in five patients. Conclusions. Location in the upper stomach was the risk factor most prominently associated with delayed perforation after ESD for EGNs. In addition, delayed perforation appears associated with excessive electrocautery for hemostasis.

Clinicopathological Analysis of Factors Related to Colorectal Tumor Perforation

OpenAIRE

Medina-Arana, Vicente; Martínez-Riera, Antonio; Delgado-Plasencia, Luciano; Rodríguez-González, Diana; Bravo-Gutiérrez, Alberto; Álvarez-Argüelles, Hugo; Alarcó-Hernández, Antonio; Salido-Ruiz, Eduardo; Fernández-Peralta, Antonia M.; González-Aguilera, Juan J.

2015-01-01

Abstract Colorectal tumor perforation is a life-threatening complication of this disease. However, little is known about the anatomopathological factors or pathophysiologic mechanisms involved. Pathological and immunohistochemical analysis of factors related with tumoral neo-angiogenesis, which could influence tumor perforation are assessed in this study. A retrospective study of patients with perforated colon tumors (Group P) and T4a nonperforated (controls) was conducted between 2001 and 20...

Predictors of appendiceal perforation in an equal access system.

Science.gov (United States)

Walker, Avery; Hatch, Quinton; Drake, Thurston; Nelson, Daniel W; Fitzpatrick, Emilie; Bingham, Jason; Black, George; Maykel, Justin A; Steele, Scott R

2014-07-01

Discrepancies in socioeconomic factors have been associated with higher rates of perforated appendicitis. As an equal-access health care system theoretically removes these barriers, we aimed to determine if remaining differences in demographics, education, and pay result in disparate outcomes in the rate of perforated appendicitis. All patients undergoing appendectomy for acute appendicitis (November 2004-October 2009) at a tertiary care equal access institution were categorized by demographics and perioperative data. Rank of the sponsor was used as a surrogate for economic status. A multivariate logistic regression model was performed to determine patient and clinical characteristics associated with perforated appendicitis. A total of 680 patients (mean age 30±16 y; 37% female) were included. The majority were Caucasian (56.4% [n=384]; African Americans 5.6% [n=38]; Asians 1.9% [n=13]; and other 48.9% [n=245]) and enlisted (87.2%). Overall, 6.4% presented with perforation, with rates of 6.6%, 5.8%, and 6.7% (P=0.96) for officers, enlisted soldiers, and contractors, respectively. There was no difference in perforation when stratified by junior or senior status for either officers or enlisted (9.3% junior versus 4.40% senior officers, P=0.273; 6.60% junior versus 5.50% senior enlisted, P=0.369). On multivariate analysis, parameters such as leukocytosis and temperature, as well as race and rank were not associated with perforation (P=0.7). Only age had a correlation, with individuals aged 66-75 y having higher perforation rates (odds ratio, 1.04; 95% confidence interval, 1.02-1.05; P<0.001). In an equal-access health care system, older age, not socioeconomic factors, correlated with increased appendiceal perforation rates. Published by Elsevier Inc.

Behavior of the future LHC magnet protection diodes irradiated in a nuclear reactor at 4.6 K with intermediate annealing

International Nuclear Information System (INIS)

Berland, V.; Hagedorn, D.; Gerstenberg, H.

1996-01-01

In the framework of the LHC project at CERN, the effects of radiation on the electrical characteristics of epitaxial diodes for superconducting magnet protection were studied. The diodes were exposed to an irradiation dose up to 50 kGy and a neutron fluence of 10 15 n/cm 2 with intermediate thermal annealing each 10 kGy dose steps in the Technical University of Munich reactor at 4.6 K

Irradiation of quench protection diodes at cryogenic temperatures in a nuclear research reactor

International Nuclear Information System (INIS)

Hagedorn, D.; Schoenbacher, H.; Gerstenberg, H.

1996-01-01

Within the framework of the Large Hadron Collider (LHC) R ampersand D programme, CERN and the Department of Physics E21 of the Technical University Munich have established a collaboration to carry out irradiation experiments at liquid helium and liquid nitrogen temperatures on epitaxial diodes for the superconducting magnet protection. Small diode samples of 10 mm wafer diameter from two different manufacturers were submitted to doses of up 50 kGy and neutron fluences up to 1015 n/cm 2 and the degradation of the electrical characteristics was measured versus dose. During irradiation the diodes were submitted to current pulse annealing and after irradiation to thermal annealing. After exposure some diodes show a degradation in forward voltage drop of up to 600 % which, however, can be reduced to about 15 % - 20 % by thermal annealing. The degradation at liquid helium temperature is very similar to the degradation at liquid nitrogen temperature. These degradations of electrical characteristics during the short term irradiation in a nuclear reactor are compared with degradations during long term irradiation in an accelerator environment at liquid nitrogen temperature

Influence of operating microscope in the sealing of cervical perforations.

Science.gov (United States)

Schmidt, Bruna Schwingel; Zaccara, Ivana Maria; Reis Só, Marcus Vinícius; Kuga, Milton Carlos; Palma-Dibb, Regina Guenka; Kopper, Patrícia Maria Poli

2016-01-01

Accidental root canal perforations are among the main complications of endodontic treatment. This study evaluated the influence of operating microscope (OM) in the marginal adaptation of mineral trioxide aggregate (MTA) (Angelus(®)) and glass ionomer (Vitremer) inserted into cervical perforations. Perforations were made in the cervical third of the buccal wall of the root canal in mandibular incisors. Next, the teeth were divided into four groups (N = 10): MG - MTA without OM; VG - Vitremer without OM; MOMG - MTA with OM; VOMG - Vitremer with OM. The perforations were sealed according to the group and the teeth were prepared for analysis by confocal laser scanning microscope. Images of perforation region (1,024×) were made and the gap presented by the materials was measured using the Image J program. LEXT OLS4100 three dimensional (3D) measuring laser microscope measured the volumetric misfit. Data of gap were analyzed by Kruskal-Wallis and Dunn's tests. Analysis of variance (ANOVA) and Tukey's tests compared the volumetric misfits. The results showed lower volume and gap in the interface dentin/material in VOMG compared to the other groups (P < 0.05). The use of OM improved the quality of cervical perforations sealed with Vitremer, being indicated in clinical situations of iatrogenic cervical perforations.

Laparoscopic Primary Colorrhaphy for Acute Iatrogenic Perforations during Colonoscopy

Directory of Open Access Journals (Sweden)

Eric M. Haas

2013-01-01

Full Text Available Purpose. We present our experience with laparoscopic colorrhaphy as definitive surgical modality for the management of colonoscopic perforations. Methods. Over a 17-month period, we assessed the outcomes of consecutive patients presenting with acute colonoscopic perforations. Patient characteristics and perioperative parameters were tabulated. Postoperative outcomes were evaluated within 30 days following discharge. Results. Five female patients with a mean age of 71.4 ± 9.7 years (range: 58–83, mean BMI of 26.4 ± 3.4 kg/m2 (range: 21.3–30.9, and median ASA score of 2 (range: 2-3 presented with acute colonoscopic perforations. All perforations were successfully managed through laparoscopic colorrhaphy within 24 hours of development. The perforations were secondary to direct trauma (n=3 or thermal injury (n=2 and were localized to the sigmoid (n=4 or cecum (n=1. None of the patients required surgical resection, diversion, or conversion to an open procedure. No intra- or postoperative complications were encountered. The mean length of hospital stay was 3.8 ± 0.8 days (range: 3–5. There were no readmissions or reoperations. Conclusion. Acute colonoscopic perforations can be safely managed via laparoscopic primary repair without requiring resection or diversion. Early recognition and intervention are essential for successful outcomes.

Properties of the photodiode PiN as neutron detector

International Nuclear Information System (INIS)

Adamiec, G.; Iniguez, M.P.; Lorente, A.; Gallego, E.; Voytchev, M.

2005-01-01

The photodiode can be used to measure the ambient dose equivalent for an Am-Be source, as well placed in a paraffin sphere with LiF 6 converter as nude with a PE converter. The ratio between the counting rate and the ambient dose equivalent is linear in the two cases. The sensitivity of the diode with the converter 6 LiF is evaluated to 8.4 shocks by micro sievert by square centimeter of active surface of diode. The photodiode with the PE converter has a sensitivity lower of 2.1 shocks by micro sievert by square centimeter (for the Am-Be source) of active surface of diode. About the disadvantages, the disadvantage of photodiode inside the paraffin sphere is its size and weight; the disadvantage of the diode with the PE converter is its sensitivity to the orientation of the neutron flux and the necessity to calibrate for the source type. (N.C.)

Esophageal Perforation due to Transesophageal Echocardiogram: New Endoscopic Clip Treatment

Directory of Open Access Journals (Sweden)

John Robotis

2014-07-01

Full Text Available Esophageal perforation due to transesophageal echocardiogram (TEE during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC® clip (Ovesco Endoscopy, Tübingen, Germany. The perforation was successfully sealed. The patient remained on intravenous antibiotics, proton pump inhibitors and parenteral nutrition for few days, followed by enteral feeding. She was discharged fully recovered 3 months later. We clearly demonstrate an effective, less invasive treatment of an esophageal perforation with a new endoscopic clip.

Perforated duodenal diverticulum caused by Bezoar: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Dept. of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

2013-11-15

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

Duodenal perforation: an unusual complication of sickle cell anemia

OpenAIRE

Acıpayam, Can; Aldıç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; Aşkar, Hasan; Dorum, Bayram Ali

2014-01-01

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presente...

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

OpenAIRE

Yadav, Dinesh; Garg, Puneet K.

2012-01-01

Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 co...

Perforated duodenal diverticulum caused by Bezoar: A case report

International Nuclear Information System (INIS)

Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae

2013-01-01

Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

Perforated peptic ulcer

Science.gov (United States)

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M.; Bingener, Juliane; Møller, Morten H.; Ohene-Yeboah, Michael; Søreide, Jon Arne

2015-01-01

Summary Perforated peptic ulcer (PPU) is a frequent emergency condition worldwide with associated mortality up to 30%. A paucity of studies on PPU limits the knowledge base for clinical decision-making, but a few randomised trials are available. While Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are frequent causes of PPU, demographic differences in age, gender, perforation location and aetiology exist between countries, as do mortality rates. Clinical prediction rules are used, but accuracy varies with study population. Early surgery, either by laparoscopic or open repair, and proper sepsis management are essential for good outcome. Selected patients can perhaps be managed non-operatively or with novel endoscopic approaches, but validation in trials is needed. Quality of care, sepsis care-bundles and postoperative monitoring need further evaluation. Adequate trials with low risk of bias are urgently needed for better evidence. Here we summarize the evidence for PPU management and identify directions for future clinical research. PMID:26460663

Surgical management of perforated duodenal ulcer: the changing scene.

Science.gov (United States)

Plummer, J M; McFarlane, M E C; Newnham

2004-12-01

To determine the management of perforated duodenal ulcer at the University Hospital of the West Indies (UHWI) in this era of Helicobacter pylori, the medical records of all patients seen at the UHWI during the period July 1997 to June 2002 with an intra-operative diagnosis of perforated peptic ulcer were reviewed The records were analyzed for the following: age, gender, duration of symptoms, non-steroidal anti-inflammatory drug (NSAID) use, smoking status, operative repair duration of hospitalization, Helicobacter pylori status and medical therapy, peri-operative complications, mortality and recurrence. Ninety per cent of the cases were males. All females in whom perforation occurred were age 50 years and older compared to males where 58% of cases presented before age 50 years. Perforations in acute ulcers occurred in 80% of cases. The majority of patients were male smokers. Non-steroidal anti-inflammatory drug use was also an important risk factor in elderly females. Simple surgical closure and standard triple therapy antibiotics to eradicate Helicobacter pylori was the most common treatment offered. Mortality was one per cent and follow-up poor but 11% of patients had documented recurrent peptic ulceration. In this study population, perforated duodenal ulcer occured overwhelmingly in males less than 50 years of age. There is a trend towards exclusive simple surgical closure and H pylori eradication at the UHWI for patients with perforated duodenal ulcer but this needs to be supported by documentation of H pylori prevalence in the population of patients presenting with perforated peptic ulcers.

Factors related to persisting perforations after ventilation tube insertion.

Science.gov (United States)

O'Connell Ferster, Ashley P; Tanner, April Michelle; Karikari, Kodjo; Roberts, Christopher; Wiltz, Derek; Carr, Michele M

2016-02-01

Over a million ventilation tubes are placed annually in the United States, making this one of the most commonly performed procedures in the field of medicine. Certain factors increase the risk of persistent tympanic membrane perforation following the extrusion of short term ventilation tubes. Persistent perforations may fail to heal on their own, necessitating surgical closure to avoid conductive hearing loss. It is important to detect factors that may predict children who are at increased risk for persistent perforations. This study was a retrospective chart review that involved 757 patients between 2003 and 2008. The patients studied were within the age of 2 months-17 years, and all had short term tubes placed. The chart data also included demographic information, comorbidities, and information related to tube insertion and follow-up care. Chi-square, t-test, and multivariate logistic regression were conducted to compare variables between patients with perforations and those without. Data from 757 patients was analyzed, showing that perforation rate is associated with rhinorrhea, operative tube removal, aural polyps, and otorrhea (OR 1.72, 8.16, 4.69, and 1.72 respectively). The absence of otorrhea decreased the likelihood of TM perforations and no significant differences were found in gender, total number of sets of tubes, type of tube, use of nasal steroids, adenoidectomy, or nasal congestion. Our findings suggest that children with rhinorrhea, otorrhea, aural polyps, or prolonged intubation requiring operative tube removal should be identified clinically as children at risk of persisting perforation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Common Bile Duct Perforation Due to Tuberculosis: A Case Report

OpenAIRE

Razman Jarmin; Shaharin Shaharuddin

2004-01-01

A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

A 1,470 nm diode laser in stapedotomy: Mechanical, thermal, and acoustic effects.

Science.gov (United States)

Koenraads, Simone P C; de Boorder, Tjeerd; Grolman, Wilko; Kamalski, Digna M A

2017-08-01

Multiple laser systems have been investigated for their use in stapes surgery in patients with otosclerosis. The diode 1,470 nm laser used in this study is an attractive laser system because it is easily transported and relatively inexpensive in use. This wavelength has relative high absorption in water. This study aimed to investigate the mechanical, thermal, and acoustic effects of the diode 1,470 nm laser on a stapes in an inner ear model. Experiments were performed in an inner ear model including fresh frozen human stapes. High-speed imaging with frame rates up to 2,000 frames per second (f/s) was used to visualize the effects in the vestibule during fenestration of the footplate. A special high-speed color Schlieren technique was used to study thermal effects. The sound produced by perforation was recorded by a hydrophone. Single pulse settings of the diode 1,470 nm laser were 100 ms, 3 W. Diode 1,470 nm laser fenestration showed mechanical effects with small vapor bubbles and pressure waves pushed into the vestibule. Thermal imaging visualized an increase temperature underneath the stapes footplate. Acoustic effects were limited, but larger sounds levels were reached when vaporization bubbles arise and explode in the vestibule. The diode 1,470 nm laser highly absorbs in perilymph and is capable of forming a clear fenestration in the stapes. An overlapping laser pulse will increase the risk of vapor bubbles, pressure waves, and heating the vestibule. As long as we do not know the possible damage of these effects to the inner ear function, it seems advisable to use the laser with less potential harm. Lasers Surg. Med. 49:619-624, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Spectrum of perforation peritonitis in India-review of 504 consecutive cases

OpenAIRE

Jhobta, Rajender Singh; Attri, Ashok Kumar; Kaushik, Robin; Sharma, Rajeev; Jhobta, Anupam

2006-01-01

Abstract Background/objective Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. Methods Five hundred and four consecutive cases of perforation peritonitis over a period of five years were r...

Diaphragmatic eventration complicated by gastric volvulus with perforation

OpenAIRE

Gupta, V; Chandra, A; Gupta, P

2012-01-01

Eventration of the diaphragm with gastric volvulus is uncommon. Gastric perforation in these cases is rare and usually associated with acute gastric volvulus with strangulation. We describe a case of diaphragmatic eventration with chronic gastric volvulus with gastric perforation without strangulation in an elderly man.

Common Bile Duct Perforation Due to Tuberculosis: A Case Report

Directory of Open Access Journals (Sweden)

Razman Jarmin

2004-10-01

Full Text Available A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

Science.gov (United States)

Sivaram, P; Sreekumar, A

2018-04-01

Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation. This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed. Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm 2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay. An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.

Jejunal Diverticular Perforation due to Enterolith

Directory of Open Access Journals (Sweden)

Ronaldo Nonose

2011-08-01

Full Text Available Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

Sonographic templates of newborn perforator stroke.

Science.gov (United States)

Abels, Lyanne; Lequin, Maarten; Govaert, Paul

2006-07-01

Many paediatric strokes occur in the perinatal period. Improvement in neuroimaging has increased detection in newborns with neurological symptoms. To define sonographic templates of neonatal stroke in the territory of perforators of the anterior choroidal artery (AChA) and the anterior (ACA), middle (MCA) and posterior (PCA) cerebral arteries. In 24 neonates with perforator stroke, we retrospectively studied antenatal and perinatal events. Brain sonography was performed with an 8.5-MHz probe. Only hyperechoic lesions in the thalamus and/or striatum and/or centrum semiovale were included. MRI was obtained using a 1.5-T machine. We detected 28 perforator strokes in 24 infants (6 preterm): 5 MCA medial striate, 8 MCA lateral striate, 3 MCA centrum semiovale, 4 ACA Heubner's, 5 PCA thalamic arteries, 1 AChA, and 2 hypothalamic perforators. We attributed clinical seizures to stroke in two infants only. Catheter-related embolism (certain in three, possible in six others) and birth trauma (two) were probable causes. Specific conditions were found in six others. Only one infant (in nine evaluated) had an increased prothrombotic risk (fII mutation). In describing the lesions, we focused on the templates of infarction as seen in a parasagittal US sweep. Infarcts were confirmed by MRI in 21 patients. Our study showed that infarct topography can be evaluated reliably with brain sonography. This is important given the asymptomatic character of most lesions.

Sen perforation af tyndtarm efter laparoskopisk gastrisk bypass

DEFF Research Database (Denmark)

Spanager, Lene; Sigild, Ulf Henrik; Neuenschwander, Anders Ulrich

2010-01-01

We present two cases in which the patients were admitted to a local hospital with acute abdominal pain four or five months after having undergone laparoscopic gastric bypass. In both cases, operation revealed a perforation of the small bowel close to the distal anastomosis. In the first case......, a massive constipation of the small bowel was most likely a contributing factor. In the second case, the cause was a kink of the entero-entero anastomosis leading to obstruction and finally perforation of the biliary limp. Late perforations are among the rarely reported complications associated with gastric...

Equivalent Young's Modulus of Perforated Shell with Square Penetration Pattern

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Jo; Ryu, Yong Ho [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2011-05-15

The analysis of a plate or shell perforated with a large number of holes, by finite element method for instance, was a very costly and time-consuming technique which solves only one particular problem. But it is possible to model the perforated plate or shell and to analyze it and it is no more time-consuming theses days due to the rapid development of the computer and software. However, if a perforated plate or shell is submerged in fluid it is almost impossible to model and analyze it as is and the fluid at the same time, which is needed to investigate the effect of the fluid structure interaction. The simplest way to avoid time consuming and costly analysis of perforated plate or shell submerged in fluid is to replace the perforated plate or shell by an equivalent solid one considering weakening effect of holes. Many authors have proposed experimental or theoretical method to solve this problem for the plate. Slot and O'Donnell determined the effective elastic constants for the thick perforated plates by equating strains in the equivalent solid material to the average strains in the perforated material. O'Donnell also presented those of thin perforated plates. These results are implemented in Article A-8000 of Appendix A to the ASME code Section III, which contains a method of analysis for flat perforated plates when subjected to directly applied loads or loadings resulting from structural interaction with adjacent members. Unfortunately the effective elastic constants for the perforated shell are not found in any references. Therefore in this study the modal characteristics of the perforated shell are investigated and the equivalent material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies

Perforated pyloroduodenal peptic ulcer and sonography.

Science.gov (United States)

Kuzmich, Siarhei; Harvey, Chris J; Fascia, Daniel T M; Kuzmich, Tatsiana; Neriman, Deena; Basit, Rizwan; Tan, Kai Lee

2012-11-01

The purpose of this article is to illustrate the spectrum of sonographic findings in perforated pyloroduodenal peptic ulcer and discuss the potential role of sonography in the diagnosis. Although sonography is not the first-line investigation of choice in suspected perforated peptic ulcer, understanding of the characteristic appearances seen during general abdominal sonography may aid the reader in the diagnosis of this important and sometimes overlooked cause of nonspecific abdominal pain. This may shorten time to the diagnosis and ultimate surgical management.

Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

Directory of Open Access Journals (Sweden)

Loabat Geranpayeh

2006-01-01

Full Text Available Spontaneous perforation of the uterus is rare, its incidence being about 0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

Risk of surgical glove perforation in oral and maxillofacial surgery.

Science.gov (United States)

Kuroyanagi, N; Nagao, T; Sakuma, H; Miyachi, H; Ochiai, S; Kimura, Y; Fukano, H; Shimozato, K

2012-08-01

Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Perforated peptic ulcer associated with abdominal compartment syndrome.

Science.gov (United States)

Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

2008-11-01

Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation.

Perforated peptic ulcer in an infant.

Science.gov (United States)

Feng, C Y; Hsu, W M; Chen, Y

2001-02-01

We describe a case of perforated peptic ulcer (PPU) in a 9-month-old boy. Abdominal distension was the first clinical sign of PPU. Before he developed abdominal distension, the patient had suffered from an upper respiratory tract infection with fever for about 2 weeks, which was treated intermittently with ibuprofen. A plain abdominal radiograph revealed pneumoperitoneum with a football sign. At laparotomy, a 0.8-cm perforated hole was found over the prepyloric area. Simple closure with omental patching was performed after debridement of the perforation. Pathologic examination showed chronic peptic ulcer with Helicobacter pylori infection. The postoperative course and outcome were satisfactory. The stress of underlying disease, use of ibuprofen, blood type (A), and H. pylori infection might have contributed to the development of PPU in this patient. PPU in infancy is rare and has a high mortality rate; early recognition and prompt surgical intervention are key to successful management.

A case report of esophageal perforation: Complication of nasogastric tube placement

Science.gov (United States)

Isik, Arda; Firat, Deniz; Peker, Kemal; Sayar, Ilyas; Idiz, Oguz; Soytürk, Mehmet

2014-01-01

Patient: Male, 70 Final Diagnosis: Esophageal perforation Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Esophageal perforation is a well-defined and severe clinical condition. There are several etiologies of esophagus perforation. Case Report: We report the case of a 70-year-old Caucasian man who underwent an emergency cholecystectomy due to acute cholecystitis. Two days after surgery, his condition deteriorated. Thorax computerized tomography revealed an esophageal perforation. Conclusions: Esophageal perforation due to nasogastric application is relatively rare but the consequences are potentially serious. The anatomy of the upper gastrointestinal system should be understood by all healthcare professionals involved in the treatment. PMID:24803977

Low-energy plasma-cathode electron gun with a perforated emission electrode

Science.gov (United States)

Burdovitsin, Victor; Kazakov, Andrey; Medovnik, Alexander; Oks, Efim; Tyunkov, Andrey

2017-11-01

We describe research of influence of the geometric parameters of perforated electrode on emission parameters of a plasma cathode electron gun generating continuous electron beams at gas pressure 5-6 Pa. It is shown, that the emission current increases with increasing the hole diameters and decreasing the thickness of the perforated emission electrode. Plasma-cathode gun with perforated electron can provide electron extraction with an efficiency of up to 72 %. It is shown, that the current-voltage characteristic of the electron gun with a perforated emission electrode differs from that of similar guns with fine mesh grid electrode. The plasma-cathode electron gun with perforated emission electrode is used for electron beam welding and sintering.

Study of an integrated electronic monitor for neutron beams

International Nuclear Information System (INIS)

Barelaud, B.; Nexon-Mokhtari, F.; Barrau, C.; Decossac, J.L.; Vareille, J.C.; Sarrabayrouse, G.

1994-01-01

Many neutron beams monitors in 10 keV - 50 keV range are perturbed by gamma radiation impact. This new monitor uses two silicon (junction) diodes operating coincidence detection, combined with an electronic threshold to eliminate gamma background noise. The results and analyses presented here only concern feasibility studies. (D.L.)

Perforate on CHO cell membranes induced by electromagnetic ...

African Journals Online (AJOL)

STORAGESEVER

2009-06-17

Jun 17, 2009 ... Key words: Electromagnetic pulse (EMP), atomic force microscope, CHO cell, cell membrane. INTRODUCTION .... of perforation ranges from 390 to 660 nm and the depth is. 392.95 nm. ... cell membrane perforations increased when both the field intensity and ..... Melatonin and a spin-trap compound block.

Perforated appendicitis: Risk factors and outcomes of management ...

African Journals Online (AJOL)

The case files of patients with perforated appendicitis were analysed in relation to age, sex, clinical presentation, management and outcome of management. The aim was to detect the main factors that contributed to the perforation of the appendix in these patients and assess the effectiveness of the treatment offered.

Neutron generator ion source pulser

International Nuclear Information System (INIS)

Peelman, H.E.

1987-01-01

This patent describes, for use with a pulsed neutron generator in a logging tool lowered in a borehole, a pulsed high voltage source having an output terminal adapted to be connected to pulse neutron generator. The power supply comprises: (a) high voltage supply means; (b) field effect transistor means comprising at least a pair of field effect transistors serially connected between the high voltage supply means and ground; (c) an output terminal between the two transistors of the field effect transistor means, the output terminal adapted to be connected by a conductor to provide pulsed high voltage to a neutron generator; (d) control pulse forming means connected to the gates of the respective two transistors, the pulse forming means forming control pulses selectively switching the transistors off and on in timed sequence to thereby connect the output terminal to the high voltage supply means, and (e) diode means connected to the gates of the transistors to limit gate voltage for operation of the transistors

Development of polarized {sup 3}He filter for polarized neutron experiment

Energy Technology Data Exchange (ETDEWEB)

Sakai, K.; Sato, H.; Yoshimi, A.; Asahi, K. [Tokyo Inst. of Tech. (Japan). Faculty of Science; Masuda, Y.; Muto, S.; Ishimoto, S.; Morimoto, K.

1996-08-01

A high-pressure polarized {sup 3}He gas cell, pumped with two diode lasers, has been developed at KEK for use as a polarizer and a spin analyzer for low energy neutrons. The polarization attained of {sup 3}He was determined through the measurement of the transmission of the unpolarized neutrons through the {sup 3}He cell. So far we obtained P{sub He}=18% at 10 atm and P{sub He}=12% at 20 atm. (author)

A new avalanche photo diode based readout for the crystal barrel calorimeter

Energy Technology Data Exchange (ETDEWEB)

Urban, Martin [Helmholtz-Institut fuer Strahlen- und Kernphysik, Nussallee 14-16, 53115 Bonn (Germany); Collaboration: CBELSA/TAPS-Collaboration

2015-07-01

The CBELSA/TAPS experiment at ELSA has proven successful in the measurement of double polarization observables in meson photoproduction off protons and neutrons. To be able to measure purely neutral reactions on a polarized neutron target with high efficiency, the main calorimeter consisting of 1320 CsI(Tl) crystals has to be integrated into the first level trigger. Key requirement to achieve this goal is an exchange of the existing PIN photo diode by a new avalanche photo diode (APD) readout. The main advantage of the new readout system is that it will provide timing information which allows a fast trigger signal. The energy resolution will remain compatible to the previous system. Besides the development of automated test routines for the front end electronics, the characterization of all APDs was successfully accomplished in Bonn. After tests with a 3 x 3 CsI(Tl) crystal matrix at the tagged photon beam facilities at ELSA and MAMI the first half of the Crystal Barrel was upgraded in 2014. This talk shows the result of the latest test measurements including the gain stabilization of the new APD readout electronics and presents the progress of the ongoing upgrade.

Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction

DEFF Research Database (Denmark)

Gunnarsson, Gudjon Leifur; Tei, Troels; Thomsen, Jørn Bo

2016-01-01

Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstr......Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap...

Optimizing time management after perforation by colonoscopy results in better outcome for the patients.

Science.gov (United States)

Rumstadt, Bernhard; Schilling, Dieter

2008-01-01

Perforation during colonoscopy is a rare but severe complication. The aim of this study was to assess the time management and laparoscopic therapy of this complication and to evaluate patient outcomes. A retrospective analysis was done on 15 patients operated for a perforation from colonoscopy between January 2000 and December 2006. Three perforations occurred during diagnostic and 12 perforations during interventional colonoscopy. Two perforations occurred as transmural thermal injury to the colon wall. Peritonitis was found in 4 cases and significantly correlated with the mean time between perforation and operation. Twelve perforations were oversewn laparoscopically and 3 perforations were oversewn by laparotomy. After laparoscopic treatment, hospital stay was significantly shorter than after laparotomy. One patient had a postoperative wound infection, mortality was 0%. Laparoscopic oversewing is a safe and effective method in the treatment of perforation from colonoscopy. Optimizing the time range between perforation and laparoscopic therapy results in a better outcome for the patients.

Bladder perforations in children

African Journals Online (AJOL)

2014-11-20

Nov 20, 2014 ... Mean recovery time for patients was 15 days. ... fracture.[1,2] Isolated bladder perforations are rare, and they .... PA, perineal injury, pelvic fracture. Trauma .... Lower genitourinary injury and pelvic fractures in pediatric patients.

Traumatic oesophageal perforation due to haematoma

DEFF Research Database (Denmark)

Grønhøj Larsen, Christian; Brandt, Bodil

2014-01-01

. Three explanations postulated to be the cause for late perforation which might be due to esophageal wall ischemia from pressure built up between the hematoma, azygos vein and the lower part of thoracic trachea; or could be an immediate rupture walled-off until the patient became symptomatic......; or the intramural hematoma gradually lysed and causing late perforation. CONCLUSION: Although extremely rare, an oesophageal haematoma and late complications must be considered in patients on anti-coagulant therapy following blunt thoracic trauma and complaining only of chest pain....

Semiconductor dosimetry system for gamma and neutron radiation

International Nuclear Information System (INIS)

Savic, Z.; Pavlovic, Z.

1995-01-01

The semiconductor dosimetry system for gamma and neutron radiation based on pMOS transistor and PIN diode is described. It is intended for tactical or accidental personal dosimetry. The production steps are given. The temperature, dose and time (fading) response are reported. Hardware and software requirements which are needed for obtaining the desired measurement error are pointed. (author)

Nano-honeycomb structured transparent electrode for enhanced light extraction from organic light-emitting diodes

Energy Technology Data Exchange (ETDEWEB)

Shi, Xiao-Bo; Qian, Min; Wang, Zhao-Kui, E-mail: zkwang@suda.edu.cn, E-mail: lsliao@suda.edu.cn; Liao, Liang-Sheng, E-mail: zkwang@suda.edu.cn, E-mail: lsliao@suda.edu.cn [Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Institute of Functional Nano and Soft Materials (FUNSOM), and Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, Jiangsu 215123 (China)

2015-06-01

A universal nano-sphere lithography method has been developed to fabricate nano-structured transparent electrode, such as indium tin oxide (ITO), for light extraction from organic light-emitting diodes (OLEDs). Perforated SiO{sub 2} film made from a monolayer colloidal crystal of polystyrene spheres and tetraethyl orthosilicate sol-gel is used as a template. Ordered nano-honeycomb pits on the ITO electrode surface are obtained by chemical etching. The proposed method can be utilized to form large-area nano-structured ITO electrode. More than two folds' enhancement in both current efficiency and power efficiency has been achieved in a red phosphorescent OLED which was fabricated on the nano-structured ITO substrate.

Perforation of the Esophagus Secondary to Insertion of Covered Wallstent Endoprostheses

International Nuclear Information System (INIS)

Farrugia, Mark; Morgan, Robert A.; Latham, Jennifer A.; Glynos, Michael; Mason, Robert C.; Adam, Andreas

1997-01-01

Perforation of the esophagus is a very rare complication of metallic esophageal stent insertion. Two cases are presented in which esophageal perforations were caused by the sharp ends of metallic stents impinging on the esophageal wall. In retrospect, both perforations might have been prevented by additional stent insertion

The US findings of acute nonperforated and perforated appendicitis in children

International Nuclear Information System (INIS)

Bae, Jun Gi; Lee, Young Seok; Jung, Yoon Ho; Kim, Ji Hye; Lee, Woon Ki; Lee, Tae Hoon

1996-01-01

To analyse and interpret different sonographic findings in acute nonperforated and appendicitis. In 46 cases of acute appendicitis in children(26 girls, 20 boys) proven by surgery, sonographic findings were reviewed retrospectively. The findings of nonperforated and perforated appendicitis were analysed, focusing on the size, shape and echogenicity of the appendix, echo patterns of periappendiceal abscesses, mesenteric lymphadenopathy, and the prevalence of appendicolith. A noncompressible distended appendix was present in 18 of 21 patients with nonperforated appendicitis and in 13 of 25 patients with perforation. In 18 patients with nonperforated appendicitis, the average diameter of distended appendix was 8.6 mm ; target appearance was noted in 16 patients and loss of echogenic submucosa in two. In 13 patients with perforated appendicitis, the average diameter of appendix was 9.1 mm ; target appearance was noted in four patients and loss of echogenic submucosa in nine. Periappendiceal abscesses were present in 21 of 25 cases of perforated appendicitis, and the echogenicity of abscesses was mixed in 12 patients, hypoechogenic in eight, and hyperechogenic in one. Mesenteric lymphadenopathy was present in two of 21 patients with nonperforated appendicitis and in four of 25 with perforation. Appendicolith was detected on sonography in three of 25 patients with perforated appendicitis, but was found in seven patients during surgery. One patients with perforated appendicitis also had right side hydronephrosis. Sonographically false-negative results were obtained in six cases. A sonographic examination was useful to differenciate perforated and nonperforated appendicitis in children. Loss of echogenic submucosa in the distended appendix and periappendiceal abscess formation were important findings in diagnosis of perforated appendicitis

Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma

International Nuclear Information System (INIS)

Chen Haiyan; Ma Xiumei; Ye Ming; Hou Yanli; Xie Huaying; Bai Yongrui

2014-01-01

The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0-3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ≤ 70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose > 100 Gy (biologically effective dose -10 ), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor. (author)

A CLINICAL STUDY ON PATIENTS WITH DUODENAL ULCER PERFORATION

Directory of Open Access Journals (Sweden)

Kishore Babu

2016-03-01

Full Text Available INTRODUCTION Perforated duodenal ulcer, the most catastrophic complication was Associated with high mortality in the past due to late presentation of the patients, delay in surgery and lack of antibiotics. Various authors state that the incidence of peptic ulcer disease and perforation has been declining for the past 3 decades. Because of advances in the medical therapy of peptic ulcer with a wide range of drugs the management of peptic ulcer disease has been changing and the role of surgery has been declining. Perforation is usually seen in 3rd and 4th decades with a male preponderance and the epidemiological trend is not the same worldwide. Incidence is slightly declining in western countries. The present study has been done during the period between 2013 and 2014 in S. V. R. R. Government general hospital Tirupati. AIMS AND OBJECTIVES The aim of the present study is to analyze the probable factors for increase in incidence of duodenal ulcer perforation, with particular emphasis on assessment of impact of H2 receptor antagonists and Proton Pump inhibitors on the incidence of perforation. STUDY SETTING S. V. Medical College, Department of General Surgery, Tirupati. STUDY PERIOD Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2013 to October 2014. INCLUSION CRITERIA Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have peritonitis due to duodenal ulcer perforation. EXCLUSION CRITERIA Patients with peritonitis due causes other than duodenal ulcer. STUDY METHOD Prospective Observational study among the selected patients. Total numbers of peptic ulcer cases that were admitted in this hospital and treated either medically or surgically were noted. The details of their clinical history and findings, investigation reports, operative findings, post-operative complications were recorded. Simple closure was performed for all the

Jejunal perforation by swallowed ibuprofen caplet | Njoku | Nigerian ...

African Journals Online (AJOL)

We present a case of jejunal perforation caused by an unusual foreign body, an ibuprofen caplet in its blister packing believed to be the first of its kind, perforation of the intestine caused by an ingested medication. The patient eventually developed an enterocutaneous fistula through the weak wall of a preexisting incisional ...

Study of an integrated electronic monitor for neutron beams

Energy Technology Data Exchange (ETDEWEB)

Barelaud, B.; Nexon-Mokhtari, F.; Barrau, C.; Decossac, J.L.; Vareille, J.C. [Limoges Univ., 87 (France); Sarrabayrouse, G. [Centre National de la Recherche Scientifique (CNRS), 31 - Toulouse (France). Lab. d`Automatique et d`Analyse des Systemes

1994-12-31

Many neutron beams monitors in 10 keV - 50 keV range are perturbed by gamma radiation impact. This new monitor uses two silicon (junction) diodes operating coincidence detection, combined with an electronic threshold to eliminate gamma background noise. The results and analyses presented here only concern feasibility studies. (D.L.). 11 refs.

Cause rare d'une perforation de la cloison nasale

Science.gov (United States)

Jahidi, Ali; Hemmaoui, Bouchaïb; Itoua, Wulfran Rosaire; Errami, Noureddine; Benariba, Fouad

2014-01-01

Les perforations de la cloison nasale constituent une pathologie fréquente en ORL. Leurs causes sont multiples et restent dominées par les traumatismes chirurgicaux. Les étiologies infectieuses et notamment la tuberculose sont rares. Nous présentons le cas d'une patiente ayant bénéficié d'une méatotomie bilatérale et chez laquelle une perforation de la cloison nasale a été découverte lors d'un examen systématique à un an de son intervention. D'abord considérée comme une complication de la chirurgie, la biopsie des berges de la perforation a permis de déterminer son origine tuberculeuse. La présentation clinique des perforations de la cloison nasale n'est pas spécifique. Elles sont souvent asymptomatiques et de découverte fortuite. Les traumatismes notamment chirurgicaux sont le plus siuvent en cause. L′orogine tuberculeuse resta très rare. Le diagnostic de certitude de tuberculose repose sur la biopsie des berges de cette perforation. Le but de ce travail est de mettre en avant l'intérêt de la biopsie dans le diagnostic de la tuberculose de la cloison nasale. Cette biopsie doit être systématique même en cas d'antécédents de chirurgie endonasale qui est le plus souvent en cause dans les perforations de la cloison nasale. PMID:24932334

Reconstruction of pressure sores with perforator-based propeller flaps.

Science.gov (United States)

Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

2011-03-01

Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

Small bowel perforation due to fish bone: A case report

Directory of Open Access Journals (Sweden)

Huseyin Pulat

2015-09-01

Full Text Available Accidental ingestion of foreign bodies are a common condition in clinical practice. However, small bowel perforation which dues to ingestion foreign bodies has been rarely seen. In this article, we report a case of small bowel perforation which dues to ingestion foreign body. A 80-year-old female patient, presenting with complaints of acute abdomen, was admitted to the emergency department. She denied abdominal pain, nausea and vomiting. The patient had tenderness and defense on the right lower quadrant. Contrast enhanced abdominal computed tomography has been used on the patient's diagnosis. This revealed small bowel perforation due to the ingestion of foreign body. The patient was operated emergency. A microperforation due to fish bone was detected on the terminal ileum. The patient underwent debridement and primary repair. The patient was discharged postoperative 7th day without problem. Bowel perforation due to the ingestion of foreign bodies should be considered in the differential diagnosis of acute abdomen. Keywords: Foreign body, Small intestine, Perforation

Perforated Duodenal Ulcer in a Young Child: An Uncommon Condition

Directory of Open Access Journals (Sweden)

Rohit Prasad Yadav

2009-04-01

Full Text Available Duodenal ulcer is an uncommonly diagnosed entity in children. H. pyloriinfection, blood group ‘O’ or secondary to medications like non steroidal anti-infl ammatory drugs (NSAID and corticosteroids or physiological stress in burns, head injury and mucosal ischemia are implicated as risk factors for their causation. The diagnosis is usually overlooked because of vague and variable symptoms and remote index of suspicion accounted for their low incidence in children. Undiagnosed or mistreated perforations may carry high morbidity and mortality. We report a successfully treated 41/2 year old male child who presented with features of perforation peritonitis and was incidentally found to have a perforated duodenal ulcer. Key Words: duodenal ulcer, laparotomy, perforation

Perforated choledochal cyst in a Jehovah's Witness patient.

Science.gov (United States)

Jones, V S; Philip, C

2007-07-01

Perforation is a rare presentation of a choledochal cyst. The case reported is a 9-month-old female baby with a perforated choledochal cyst. Being a Jehovah's Witness, blood tranfusion was refused. Apart from highlighting this social dilemma, the suitability of a cystojejunostomy as a temporary measure in the above scenario is evaluated and discussed.

Gastric Perforation by Ingested Rabbit Bone Fragment

Directory of Open Access Journals (Sweden)

Giulio Gambaracci

2016-04-01

Full Text Available The majority of accidentally ingested foreign bodies is excreted from the gastrointestinal (GI tract without any complications. Sometimes sharp foreign bodies – like chicken and fish bones – can lead to intestinal perforation and may present insidiously with a wide range of symptoms and, consequently, different diagnoses. We report the case of a 59-year-old woman presenting with fever and a 1-month history of vague abdominal pain. Computed tomography (CT showed the presence of a hyperdense linear image close to the gastric antrum surrounded by a fluid collection and free peritoneal air. At laparotomy, a 4-cm rabbit bone fragment covered in inflamed tissue was detected next to a gastric wall perforation. Rabbit bone fragment ingestion, even if rarely reported, should not be underestimated as a possible cause of GI tract perforation.

A rare manifestation of perforated diverticulitis: parastomal subcutaneous abscess.

NARCIS (Netherlands)

Peters, J.H.; Bleichrodt, R.P.; Goor, H. van

2003-01-01

Perforation is a serious complication of diverticular disease. The sigmoid is the main affected anatomic site of perforated diverticulitis and sigmoid resection followed either by Hartmann procedure or primary anastomosis are the standard surgical approaches. Surgery, however, does not cure

Study on modal characteristics of perforated shell using effective Young's modulus

International Nuclear Information System (INIS)

Jhung, Myung Jo; Yu, Seon Oh

2011-01-01

Research highlights: → The effective Young's modulus of perforated shell is proposed for modal analysis. → The penetration pattern is almost negligible for effective elastic constants. → The frequency of perforated shell decreases significantly due to the hole effect. - Abstract: For the perforated cylindrical shell submerged in fluid, it is almost impossible to develop a finite element model due to the necessity of the fine meshing of the shell and the fluid at the same time. This necessitates the use of solid shell with effective material properties. Unfortunately the effective elastic constants are not found in any references even though the ASME code is suggesting those for perforated plate. Therefore in this study the effective material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies.

Delayed Diagnosis of Pharyngeal Perforation following Exploding Tyre Blast Barotrauma

Directory of Open Access Journals (Sweden)

Samantha M. Field

2014-01-01

Full Text Available Introduction. Pharyngoesophageal perforation secondary to barotrauma is a rare phenomenon that can have serious complications if identified late. It is challenging to detect due to nonspecific symptoms. We present a case in which detection proved difficult leading to delayed diagnosis. Case Report. A 27-year-old mechanic presented with haemoptysis, dysphonia, and odynophagia after a car tyre exploded in his face. Flexible nasoendoscopy (FNE revealed blood in the pharynx, thought to represent mucosal haemorrhage. Initial treatment consisted of IV dexamethasone and antibiotics. After 3 days, odynophagia persisted prompting a CT scan. This revealed a defect in the posterior hypopharynx and surgical emphysema in the deep neck tissues. Contrast swallow confirmed posterior hypopharyngeal leak. NG feeding was commenced until repeated contrast swallow confirmed resolution of the defect. Discussion. Prompt nonsurgical management of pharyngoesophageal perforation has good outcomes but untreated perforation can have serious complications. FNE should be performed routinely, but only a contrast swallow can diagnose a functional perforation. Clinicians should have a high index of clinical suspicion when patients present with barotrauma and odynophagia. Patients should be kept nil by mouth until perforation has been excluded. Conclusion. When faced with cases of facial barotrauma, clinicians should have a low threshold for further imaging to exclude pharyngoesophageal perforation.

Laparoscopic lavage for perforated diverticulitis with purulent peritonitis

DEFF Research Database (Denmark)

Thornell, Anders; Angenete, Eva; Bisgaard, Thue

2016-01-01

Background: Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. Objective: To compare laparoscopic...... lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. Design: Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287) Setting: 9 hospitals in Sweden and Denmark. Patients: Patients who have...... confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. Intervention: Randomization between laparoscopic lavage and the Hartmann procedure. Measurements: Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key...

A final report for Gallium arsenide P-I-N detectors for high-sensitivity imaging of thermal neutrons

CERN Document Server

Vernon, S M

1999-01-01

This SBIR Phase I developed neutron detectors made FR-om gallium arsenide (GaAs) p-type/ intrinsic/n-type (P-I-N) diodes grown by metalorganic chemical vapor deposition (MOCVD) onto semi-insulating (S1) bulk GaAs wafers. A layer of isotonically enriched boron-10 evaporated onto the FR-ont surface serves to convert incoming neutrons into lithium ions and a 1.47 MeV alpha particle which creates electron-hole pairs that are detected by the GaAs diode. Various thicknesses of ''intrinsic'' (I) undoped GaAs were tested, as was use of a back-surface field (BSF) formed FR-om a layer of Al sub x Ga sub 1 sub - sub x As. Schottky-barrier diodes formed FR-om the same structures without the p+ GaAs top layer were tested as a comparison. After mesa etching and application of contacts, devices were tested in visible light before application of the boron coating. Internal quantum efficiency (IQE) of the best diode near the GaAs bandedge is over 90%. The lowest dark current measured is 1 x 10 sup - sup 1 sup 2 amps at -1 V o...

Transmural coil embolization—alternative technique for management of arterial perforation during subintimal angioplasty

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Karthikeyan Damodharan

2016-01-01

Full Text Available Subintimal angioplasty of lower limb arterial occlusion carries a relatively higher risk of vessel perforation compared to transluminal angioplasty. Vessel perforation is a potentially life threatening complication which requires prompt recognition and management. They are usually managed by endovascular techniques such as low-pressure balloon tamponade, covered stents, and coil embolization of the ruptured artery. We describe a technique of treating vessel perforation following balloon angioplasty. Patient developed a large perforation of the proximal superficial femoral artery (SFA after balloon inflation during subintimal angioplasty of complete SFA occlusion. Following failure of balloon tamponade in sealing the perforation, we successfully treated it by deploying an embolization coil at the site of perforation through the vessel wall followed by balloon tamponade. Our technique could be a useful relatively inexpensive alternative treatment option in the management of vessel perforation compared to covered stents.

External perforated Solar Screens for daylighting in residential desert buildings: Identification of minimum perforation percentages

KAUST Repository

Sherif, Ahmed

2012-06-01

The desert climate is endowed by clear sky conditions, providing an excellent opportunity for optimum utilization of natural light in daylighting building indoor spaces. However, the sunny conditions of the desert skies, in countries like Egypt and Saudi Arabia, result in the admittance of direct solar radiation, which leads to thermal discomfort and the incidence of undesired glare. One type of shading systems that is used to permit daylight while controlling solar penetration is " Solar Screens" Very little research work addressed different design aspects of external Solar Screens and their influence on daylighting performance, especially in desert conditions, although these screens proved their effectiveness in controlling solar radiation in traditional buildings throughout history.This paper reports on the outcomes of an investigation that studied the influence of perforation percentage of Solar Screens on daylighting performance in a typical residential living room of a building in a desert location. The objective was to identify minimum perforation percentage of screen openings that provides adequate illuminance levels in design-specific cases and all-year-round.Research work was divided into three stages. Stage one focused on the analysis of daylighting illuminance levels in specific dates and times, while the second stage was built on the results of the first stage, and addressed year round performance using Dynamic Daylight Performance Metrics (DDPMs). The third stage addressed the possibility of incidence of glare in specific cases where illuminance levels where found very high in some specific points during the analysis of first stage. The research examined the daylighting performance in an indoor space with a number of assumed fixed experimentation parameters that were chosen to represent the principal features of a typical residential living room located in a desert environment setting.Stage one experiments demonstrated that the screens fulfilled the

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

OpenAIRE

Ur-Rahman Shafiq; Malik Faiza; Afridi Shahida; Shamim Shahid; Samo Khursheed A

2008-01-01

Abstract Background Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. Methods ...

Radiation Resistance and Life Time Estimates at Cryogenic Temperatures of Series Produced By-Pass Diodes for the LHC Magnet Protection

Science.gov (United States)

Denz, R.; Gharib, A.; Hagedorn, D.

2004-06-01

For the protection of the LHC superconducting magnets about 2100 specially developed by-pass diodes have been manufactured in industry and more than one thousand of these diodes have been mounted into stacks and tested in liquid helium. By-pass diode samples, taken from the series production, have been submitted to irradiation tests at cryogenic temperatures together with some prototype diodes up to an accumulated dose of about 2 kGy and neutron fluences up to about 3.0 1013 n cm-2 with and without intermediate warm up to 300 K. The device characteristics of the diodes under forward bias and reverse bias have been measured at 77 K and ambient versus dose and the results are presented. Using a thermo-electrical model and new estimates for the expected dose in the LHC, the expected lifetime of the by-pass diodes has been estimated for various positions in the LHC arcs. It turns out that for all of the by-pass diodes across the arc elements the radiation resistance is largely sufficient. In the dispersion suppresser regions of the LHC, on a few diodes annual annealing during the shut down of the LHC must be applied or those diodes may need to be replaced after some time.

CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

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Venkata Anantha Lakshmi Manabala

2016-06-01

Full Text Available INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS This is a prospective study done in our hospital where 110 cases of peritonitis due to appendicular perforation were selected for our study. All the cases where peritonitis was due to appendicular perforation at laparotomy were included. The study period was from January 2014 to December 2015. The cases of peritonitis due to other causes like duodenal, gastric, enteric perforation were excluded. Patients with acute abdominal emergency with clinical diagnosis of peritonitis were examined carefully with detailed history and clinical examination. Necessary investigations were done and patients taken up for emergency surgery. CONCLUSIONS Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. Age incidence of appendicular perforation is maximum in the age group of 21–30 years. Next common age group is 31–40 yrs. Incidence is more in males. Male to female ratio is 2.4:1. Pain abdomen, vomiting, fever and anorexia were common symptoms in all the patients. Majority of the patients came late to the hospital accounting for the cause of perforation and subsequent mortality and morbidity.

The research progress of acute small bowel perforation

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Rudolf Schiessel

2015-08-01

Full Text Available This article reviews the various aetiologies of small bowel perforations and their management. In addition to the well-known aetiologies such as trauma, inflammation and circulatory disorders, several new causes of small bowel perforation have been described in recent years. The spectrum reaches from iatrogenic perforations during laparoscopic surgery or enteroscopies to drug-induced perforations with new anticancer agents. The management of small bowel perforations requires a concept consisting of the safe revision of the leaking bowel and the treatment of the peritonitis. Depending on the local situation and the condition of the patient, several treatment options are available. The surgical management of the bowel leak can range from a simple primary closure to a delayed restoration of bowel continuity. When the condition of the bowel or patient is frail, the risk of a failure of a closure or anastomosis is too high, and the exteriorization of the bowel defect as a primary measure is a safe option. The treatment of the peritonitis is also dependent on the condition of the patient and the local situation. Early stages of peritonitis can be treated by a simple peritoneal lavage, either performed by laparoscopy or laparotomy. Severe forms of peritonitis with multi-organ failure and an abdominal compartment syndrome need repeated peritoneal revisions. In such cases, the abdomen can only be closed temporarily. Different technical options are available in order to overcome the difficult care of these patients.

Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

Science.gov (United States)

Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

2012-09-21

To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital. No procedure-related mortalities occurred. Performing closure with endoscopic clipping reduced the C-reactive protein (CRP) titers. The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping

Perforated peptic ulcer in southeastern Taiwan.

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Li, Chin-Hsien; Chang, Wen-Hsiung; Shih, Shou-Chuan; Lin, Shee-Chan; Bair, Ming-Jong

2010-09-01

No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.

Case report: Stercoral sigmoid colonic perforation with fecal peritonitis

International Nuclear Information System (INIS)

Sharma, Monika; Agrawal, Anjali

2010-01-01

Chronic constipation can lead to fecal impaction. It can also rarely lead to catastrophic complications like perforation, colonic obstruction, and fecal peritonitis. We report a rare case of stercoral sigmoid colonic perforation with fecal peritonitis and pneumoperitoneum, which was diagnosed on preoperative CT scan

Generalized multiscale finite element methods for problems in perforated heterogeneous domains

KAUST Repository

Chung, Eric T.

2015-06-08

Complex processes in perforated domains occur in many real-world applications. These problems are typically characterized by physical processes in domains with multiple scales. Moreover, these problems are intrinsically multiscale and their discretizations can yield very large linear or nonlinear systems. In this paper, we investigate multiscale approaches that attempt to solve such problems on a coarse grid by constructing multiscale basis functions in each coarse grid, where the coarse grid can contain many perforations. In particular, we are interested in cases when there is no scale separation and the perforations can have different sizes. In this regard, we mention some earlier pioneering works, where the authors develop multiscale finite element methods. In our paper, we follow Generalized Multiscale Finite Element Method (GMsFEM) and develop a multiscale procedure where we identify multiscale basis functions in each coarse block using snapshot space and local spectral problems. We show that with a few basis functions in each coarse block, one can approximate the solution, where each coarse block can contain many small inclusions. We apply our general concept to (1) Laplace equation in perforated domains; (2) elasticity equation in perforated domains; and (3) Stokes equations in perforated domains. Numerical results are presented for these problems using two types of heterogeneous perforated domains. The analysis of the proposed methods will be presented elsewhere. © 2015 Taylor & Francis

Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality.

Science.gov (United States)

Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Kumar, Anjay; Mishra, Kiran; Mohanty, Debajyoti; Agrawal, Vivek

2013-01-01

Invasive colonic amoebiasis presents primarily with dysentery; colonic perforation occurs rarely. Cases of amoebic colonic perforations have been reported sporadically over the past 20 years. A retrospective study was done in the surgical unit of a tertiary care hospital in North India. The case records of those patients were reviewed who underwent exploratory laparotomy from January 2011 to September 2012 and were diagnosed with amoebic colonic perforation on histopathological examination. Details concerning the clinical presentation, investigations, intraoperative findings, operative procedures, and postoperative outcomes were retrieved. Amongst, a total of 186 emergency exploratory laparotomies carried out during the study, 15 patients of amoebic colonic perforation were identified. The median age of the patients was 42 years (IQR 32.0-58.0) and the male to female ratio was 13:2. Previous history of colitis was present in only 1 patient. The preoperative diagnosis was perforation peritonitis in 12 patients; and intussusception, intestinal obstruction and ruptured liver abscess in 1 patient each. Ten patients had single perforation while 5 had multiple colonic perforations. All the patients except one had perforations in the right colon. Bowel resection was performed depending upon the site and extent of the colon involved-right hemicolectomy (8), limited ileocolic resection (6) and sigmoidectomy (1). Bowel continuity could be restored only in 2 of the 15 patients and a stoma was constructed in the remaining 13 patients. The overall mortality rate was found to be 40% (6/15). Amoebic colonic perforation is associated with unusually high mortality.

[Laparoscopic surgery for perforated peptic ulcer].

Science.gov (United States)

Yasuda, Kazuhiro; Kitano, Seigo

2004-03-01

Laparoscopic surgery has become the treatment of choice for the management of perforated peptic ulcer. The advantages of laparoscopic repair for perforated peptic ulcer include less pain, a short hospital stay, and an early return to normal activity. Although the operation time of laparoscopic surgery is significantly longer than that of open surgery, laparoscopic technique is safe, feasible, and with morbidity and mortality comparable to that of the conventional open technique. To benefit from the advantages offered by minimally invasive laparoscopic technique, further study will need to determine whether laparoscopic surgery is safe in patients with generalized peritonitis or sepsis.

Perforated Meckel's diverticulum in omphalocele

OpenAIRE

Jin, Hanna; Han, Ji-Won; Oh, Chaeyoun; Kim, Hyun-Young; Jung, Sung-Eun

2017-01-01

Meckel's diverticulum is a rare condition in neonates with reports of concurrent Meckel's diverticulum and omphalocele being few. Herein, we present a case of omphalocele associated with perforated Meckel's diverticulum.

Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report.

Science.gov (United States)

Schwenter, Frank; Gervaz, Pascal; de Saussure, Philippe; McKee, Thomas; Morel, Philippe

2009-01-13

In Crohn's disease, the extension of active terminal ileitis into a Meckel's diverticulum is possible, but usually has no impact on clinical decision-making. We describe an original surgical approach in a young woman presenting with a combination of perforated Meckel's diverticulitis and active Crohn's ileitis. We report the case of a 22-year-old woman with Crohn's disease, who was admitted for abdominal pain, fever and diarrhoea. CT scan demonstrated active inflammation of the terminal ileum, as well as a fluid collection in the right iliac fossa, suggesting intestinal perforation. Laparoscopy was performed and revealed, in addition to extensive ileitis, a 3 x 3 cm abscess in connection with perforated Meckel's diverticulitis. It was therefore possible to avoid ileocaecal resection by only performing Meckel's diverticulectomy; pathological examination of the surgical specimen revealed the presence of transmural inflammation with granulomas and perforation of the diverticulum at its extremity. Crohn's disease of the ileum may be responsible for Meckel's diverticulitis and cause perforation which, in this case, proved to be a blessing in disguise and spared the patient an extensive small bowel resection.

Electrical effects of transient neutron irradiation of silicon devices

International Nuclear Information System (INIS)

Hjalmarson, H.P.; Pease, R.L.; Van Ginhoven, R.M.; Schultz, P.A.; Modine, N.A.

2007-01-01

The key effects of combined transient neutron and ionizing radiation on silicon diodes and bipolar junctions transistors are described. The results show that interstitial defect reactions dominate the annealing effects in the first stage of annealing for certain devices. Furthermore, the results show that oxide trapped charge can influence the effects of bulk silicon displacement damage for particular devices

A Five-Year Review of Perforated Peptic Ulcer Disease in Irrua, Nigeria.

Science.gov (United States)

Dongo, A E; Uhunmwagho, O; Kesieme, E B; Eluehike, S U; Alufohai, E F

2017-01-01

Peptic ulcer perforation is a common cause of emergency admission and surgery. This is the first study that documents the presentation and outcome of management in Irrua, Nigeria. This is a prospective study of all patients operated on for perforated peptic ulcer between April 1, 2010, and March 31, 2015. A structured questionnaire containing patients' demographics, operation findings, and outcome was filled upon discharge or death. There were 104 patients. 81 males and 23 females (M : F = 3.5 : 1). The age range was between 17 years and 95 years. The mean age was 48.99 years ± SD 16.1 years. The ratio of gastric to duodenal perforation was 1.88 : 1. Perforation was the first sign of peptic ulcer disease in 62 (59.6%). Pneumoperitoneum was detectable with plain radiographs in 95 (91%) patients. 72 (69.2%) had Graham's Omentopexy. Death rate was 17.3%. We note that gastric perforation is a far commoner disease in our environment. Perforation is often the first sign of peptic ulcer disease. We identify fasting amongst Christians as a risk factor for perforation.

Spontaneous perforation of sigmoid colon in a child with acute lymphoblastic leukemia

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Miolski Jelena

2017-01-01

Full Text Available Introduction. Perforation of the sigmoid colon is rare in children and its descriptions in medical literature are infrequent. Case Outline. In a 13-year-old boy with acute lymphoblastic leukemia, a ten-month course of chemotherapy was accompanied by many complications: parasitic infestation (Enterobius vermicularis, lung candidiasis, esophageal candidiasis, steroid diabetes, anaphylactoid reaction to L-asparaginase, febrile neutropenia, mucositis, anemia, thrombocytopenia, enterocolitis, and respiratory distress syndrome. During reinduction treatment, consisting of dexamethasone, vincristine, doxorubicin, and crisantaspase, he complained of abdominal pain and, upon radiographic examination, was found to have pneumoperitoneum. Because of suspicion of abdominal hollow organ perforation, he was subjected to explorative laparotomy, which yielded the diagnosis of perforation of the sigmoid colon. Conclusion. After an extensive review of the published reports on sigmoid perforation, all associated conditions that could possibly induce perforation – such as Hirschsprung’s disease or foreign body – were systematically excluded in our patient. Although typhlitis was the first diagnostic hypothesis, this was excluded by intraoperative findings, histopathology, and perforation site. To the best of our knowledge, this is the first report of a spontaneous perforation of the sigmoid colon in a child with acute lymphoblastic leukemia.

Laparoscopic management of duodenal ulcer perforation: is it advantageous?

Science.gov (United States)

Palanivelu, C; Jani, Kalpesh; Senthilnathan, P

2007-01-01

Surgery is the mainstay of treatment of patients with peptic duodenal perforation. With the advent of minimal access techniques, laparoscopy is being used for the treatment of this condition. Retrospective analysis of 120 consecutive patients (mean age 44.5 years; 111 men) with duodenal ulcer perforation who had undergone laparoscopic surgery. 87 patients had history of tobacco consumption, 12 were chronic NSAID users, 72 had Helicobacter pylori infection and 36 had a co-morbid condition. The mean time to surgery from onset of symptoms was 28.4 hours. The median operating time was 46 minutes. All patients underwent laparoscopic closure of the perforation with Graham's patch omentopexy; 12 patients underwent additional definitive ulcer surgery. The morbidity rate was 7.5%; no patient needed conversion to open surgery or died. The mean postoperative hospital stay was 5.8 days. Results of laparoscopic management of perforated peptic ulcer are encouraging, with no conversion to open surgery, low morbidity and no mortality.

Corneal perforation after conductive keratoplasty with previous refractive surgery.

Science.gov (United States)

Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

2003-12-01

A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

An Experimentally Validated Numerical Modeling Technique for Perforated Plate Heat Exchangers.

Science.gov (United States)

White, M J; Nellis, G F; Kelin, S A; Zhu, W; Gianchandani, Y

2010-11-01

Cryogenic and high-temperature systems often require compact heat exchangers with a high resistance to axial conduction in order to control the heat transfer induced by axial temperature differences. One attractive design for such applications is a perforated plate heat exchanger that utilizes high conductivity perforated plates to provide the stream-to-stream heat transfer and low conductivity spacers to prevent axial conduction between the perforated plates. This paper presents a numerical model of a perforated plate heat exchanger that accounts for axial conduction, external parasitic heat loads, variable fluid and material properties, and conduction to and from the ends of the heat exchanger. The numerical model is validated by experimentally testing several perforated plate heat exchangers that are fabricated using microelectromechanical systems based manufacturing methods. This type of heat exchanger was investigated for potential use in a cryosurgical probe. One of these heat exchangers included perforated plates with integrated platinum resistance thermometers. These plates provided in situ measurements of the internal temperature distribution in addition to the temperature, pressure, and flow rate measured at the inlet and exit ports of the device. The platinum wires were deposited between the fluid passages on the perforated plate and are used to measure the temperature at the interface between the wall material and the flowing fluid. The experimental testing demonstrates the ability of the numerical model to accurately predict both the overall performance and the internal temperature distribution of perforated plate heat exchangers over a range of geometry and operating conditions. The parameters that were varied include the axial length, temperature range, mass flow rate, and working fluid.

The posterolateral mid-forearm perforator flap: anatomical study and clinical application.

Science.gov (United States)

Zhuang, Yue-Hong; Lin, Jian; Fu, Fei-Huan; Cai, Zhen-De; Huang, Hui-Mei; Zheng, He-Ping

2013-11-01

Defects sustained at the distal forearm are common and pedicled perforator flaps have unique advantages in resurfacing it. The purpose of this study is to reappraise the anatomy of the perforator in the posterolateral aspect of the mid-forearm and present our clinical experience on using perforator flaps based on it for reconstruction of defects in the distal forearm. This study was divided into anatomical study and clinical application. In the anatomical study, 30 preserved upper limbs were used. Clinically, 11 patients with defects at the forearm underwent reconstruction with the posterolateral mid-forearm perforator flaps. The defects, ranging from 4.5 × 2.5 cm to 10.5 × 4.5 cm, were located at the dorsal aspect of the distal forearm in 6 cases and at the volar aspect of the distal forearm in 5 cases. Three patterns of the perforator were observed in the posterolateral aspect of the mid-forearm, which originated from the posterior interosseous artery, the proximal segment of the radial artery or the radial recurrent artery, and the middle segment of the radial artery, respectively. The perforator was located 11.8 ± 0.2 cm to 15.8 ± 0.4 cm inferior to the lateral humeral epicondyle. Clinically, flaps in 8 cases survived uneventfully, while the other 3 cases suffered mild marginal epidermal necrosis, which was cured with continuous dress changing. The location of the perforator at the posterolateral aspect of the mid-forearm is consistent; the posterolateral mid-forearm perforator flap is particularly suitable to cover defects in the distal one-third of the forearm. Copyright © 2013 Wiley Periodicals, Inc.

Three-dimensional numerical simulation of wave interaction with perforated quasi-ellipse caisson

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Yong-xue Wang

2011-03-01

Full Text Available The finite difference method and the volume of fluid (VOF method were used to develop a three-dimensional numerical model to study wave interaction with a perforated caisson. The partial cell method was adopted to solve this type of problem for the first time. The validity of the present model, with and without the presence of caisson structures, was examined by comparing the model results with experimental data. Then, the numerical model was used to investigate the effects of various wave and structure parameters on the wave force and wave runup of the perforated quasi-ellipse caisson. Compared with the solid quasi-ellipse caisson, the wave force on the perforated quasi-ellipse caisson is significantly reduced with increasing porosity of the perforated quasi-ellipse caisson. Furthermore, the perforated quasi-ellipse caisson can also reduce the wave runup, and it tends to decrease with the increase of the porosity of the perforated quasi-ellipse caisson and the relative wave height.

Peritonitis by jejunal ulcer perforation in a child: a case report

Directory of Open Access Journals (Sweden)

Ndèye Aby Ndoye

2017-01-01

Full Text Available Ulcer perforation is a rare cause of peritonitis in children. The cases reported in the literature are caused by peptic ulcer. We report on a case of peritonitis caused by jejunal ulcer perforation, discovered in a girl's abdomen during an acute surgical procedure. The treatment consisted of a resection of the perforation followed by an end-to-end anastomosis. Postoperative period was uneventful.

Single center experience in laparoscopic treatment of gallbladder perforation.

Science.gov (United States)

Sahbaz, Nuri Alper; Peker, Kivanc Derya; Kabuli, Hamit Ahmet; Gumusoglu, Alpen Yahya; Alis, Halil

2017-12-01

Gallbladder perforation (GBP) is a rare disease with potential mortality. Previous series have reported an incidence of approximately 2-11% and it still continues to be a significant problem for surgeons. To present our clinical experience with gallbladder perforation. The records of 2754 patients who received surgical treatment for cholelithiasis between 2010 and 2016 were reviewed retrospectively. One hundred thirty-three patients had gallbladder perforation. Age, gender, time from the onset of symptoms, diagnostic procedures, surgical treatment, morbidity and mortality rates were evaluated. 15.78% of patients had a body mass index > 35. 6.76% had chronic obstructive pulmonary disease, 6.76% had cardiac disease, 10.52% had diabetes and 4.51% had sepsis. American Society of Anesthesiology scores were I in 54.13%, II in 35.33%, III in 6.01% and IV in 4.51% of the patients. 27.81% of patients were diagnosed during surgery. The perforation site was the gallbladder fundus in 69.17%, body in 17.30%, Hartman's pouch in 10.53% and cystic duct in 3% of patients. Treatment modalities were laparoscopic cholecystectomy in 82.71%, open cholecystectomy in 3%, percutaneous drainage catheters + laparoscopic cholecystectomy in 3%, laparoscopic cholecystectomy + fistula repair in 10.53% and open cholecystectomy + fistula repair in 0.75% of patients. Mean length of hospital stay was 1.69 days. Mortality and morbidity rates were 8.27% and 10.52%, respectively. Histopathology results were acute cholecystitis in 69.93%, chronic cholecystitis in 20.30% and acute exacerbation over chronic cholecystitis in 9.77% of patients. Appropriate classification and management of perforated cholecystitis is essential. Laparoscopic cholecystectomy is a safe and feasible method to decrease morbidity in gallbladder perforations.

Perforated peptic ulcer - an update.

Science.gov (United States)

Chung, Kin Tong; Shelat, Vishalkumar G

2017-01-27

Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported. In this review we have summarized the current evidence on PPU to update readers. This literature review includes the most updated information such as common causes, clinical features, diagnostic methods, non-operative and operative management, post-operative complications and different scoring systems of PPU. With the advancement of medical technology, PUD can now be treated with medications instead of elective surgery. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU. Erect chest radiograph may miss 15% of cases with air under the diaphragm in patients with bowel perforation. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard. Laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer.

Perforated peptic ulcer - an update

Science.gov (United States)

Chung, Kin Tong; Shelat, Vishalkumar G

2017-01-01

Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported. In this review we have summarized the current evidence on PPU to update readers. This literature review includes the most updated information such as common causes, clinical features, diagnostic methods, non-operative and operative management, post-operative complications and different scoring systems of PPU. With the advancement of medical technology, PUD can now be treated with medications instead of elective surgery. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU. Erect chest radiograph may miss 15% of cases with air under the diaphragm in patients with bowel perforation. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard. Laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer. PMID:28138363

Medical image of the week: eosphageal perforation

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Bilal J

2015-04-01

Full Text Available No abstract available. Article truncated after 150 words. A 74 year old man with a past medical history of esophageal strictures status post dilatation, coronary artery disease status post CABG, and atrial fibrillation presented to hospital with complaints of severe chest pain that began after the consumption of tortilla chips one hour prior to presentation. Electrocardiogram and cardiac enzymes were not consistent with acute coronary syndrome. Chest X-ray was consistent with a widened mediastinal silhouette. Contrast esophogram was negative for extra luminal extravasation. CT scan of the chest with oral contrast demonstrated thickening of the mid-thoracic esophagus with an extra-luminal focus of gas in the mediastinum along with fluid along the inferior aspect of the esophagus (Figures 1 and 2. These findings were concerning for esophageal perforation. The patient was taken to the operating room for endoscopy which showed micro perforation in mid-esophagus. Esophageal perforation remains a highly morbid condition. Mortality rates are based predominantly on time of ...

Dosimetric properties of the fast neutron therapy beams at TAMVEC

International Nuclear Information System (INIS)

Almond, P.R.; Smith, A.R.; Smathers, J.R.; Otte, V.A.

1975-01-01

In October 1972, M.D. Anderson Hospital and Tumor Institute of the University of Texas System Cancer Center initiated a clinical trial of fast neutron radiotherapy using the cyclotron at Texas A and M University. Initially, the study used neutrons produced by bombarding beryllium with 16 MeV deuterons, but since March, 1973, neutrons from 50 MeV deuterons have been used. The dosimetric properties of the 30 MeV beams have also been measured for comparison with the neutron beams from D-T generators. The three beams are compared in terms of dose rate, skin sparing, depth dose and field flatness. Isodose curves for treatment planning were generated using the decrement line method and compared to curves measured by a computer controlled isodose plotter. This system was also used to measure the isodose curves for wedge fields. Dosimetry checks on various patients were made using silicon diodes as in vivo fast neutron dosimeters

Use of Computed Tomography to Determine Perforation in Patients With Acute Appendicitis.

Science.gov (United States)

Gaskill, Cameron E; Simianu, Vlad V; Carnell, Jonathan; Hippe, Daniel S; Bhargava, Puneet; Flum, David R; Davidson, Giana H

Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined. The purpose of this study was to assess the preoperative diagnostic accuracy of CT in determining appendiceal perforation in patients operated for acute appendicitis. We performed a retrospective review of pathology and radiology reports from consecutive patients who presented to the emergency department with suspicion for acute appendicitis between January 2012 and May 2015. CT scans were re-reviewed by abdominal imaging fellowship-trained radiologists using standardized criteria, and the radiologists were blinded to pathology and surgical findings. Radiologists specifically noted presence or absence of periappendiceal gas, abscess, appendicolith, fat stranding, and bowel wall thickening. The overall radiologic impression as well as these specific imaging findings was compared to results of pathology and operative reports. Pathology reports were considered the standard for diagnostic accuracy. Eighty-nine patients (65% male, average age of 34 years) presenting with right lower quadrant pain underwent CT imaging and prompt appendectomy. Final pathology reported perforation in 48% (n = 43) of cases. Radiologic diagnosis of perforation was reported in 9% (n = 8), correctly identifying perforation in 37.5% (n = 3), and incorrectly reporting perforation in 62.5% of nonperforated cases per pathology. Radiology missed 93% (n = 40) of perforations postoperatively diagnosed

Perforated Meckel's diverticulum in omphalocele

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Hanna Jin

2017-02-01

Full Text Available Meckel's diverticulum is a rare condition in neonates with reports of concurrent Meckel's diverticulum and omphalocele being few. Herein, we present a case of omphalocele associated with perforated Meckel's diverticulum.

Vitrectomy in double-perforation gunshot injury

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Abd El Alim Mohamed A

2013-11-01

Full Text Available Ahmed Abd El Alim MohamedOphthalmology department, Ain Shams University, Cairo, EgyptObjective: This study sought to evaluate the result of pars plana vitrectomy in patients with gunshot wounds involving double perforation.Methods: This was a retrospective, noncomparative, interventional case series.Results: Eighteen patients (18 eyes with double-perforation gunshot injuries were treated from February 2010 to March 2012. The group included 16 men (88% and two women (11%; the mean age was 24 (15–33 years. In each case, vitrectomy was scheduled 1–6 weeks after repair of the entrance site. Associated retinal detachments were observed in two eyes (11%, retinal incarceration was observed surrounding the exit site in three eyes (16%, and retention of an intraocular foreign body was observed in two cases. After a follow-up period of 8 ± 2 months, two eyes (11% had achieved visual acuity (VA of 0.5, nine eyes (50% had achieved VA between 0.5 and 0.1, and seven eyes (38% had achieved VA between 0.1 and hand movement. The main reasons for functional failure (VA 0.1 to hand movement were macular dragging (due to fibrosis at the exit site near the macula in seven cases (38%, submacular hemorrhage in four cases (22%, and epimacular fibrosis in five cases (27%. All cases developed postoperative exotropia. One case (5% developed postoperative hemorrhage. No cases exhibited signs of postoperative redetachment.Conclusion: The outcome of pars plana vitrectomy in cases with double perforations is variable. Factors including the surgeon's skill level, the time to surgery, and the efficacy of the intraocular tamponade affect the postoperative outcome.Keywords: pars plana vitrectomy, gunshot injury, double perforation

Lack of utility of measuring serum bilirubin concentration in distinguishing perforation status of pediatric appendicitis.

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Bonadio, William; Bruno, Santina; Attaway, David; Dharmar, Logesh; Tam, Derek; Homel, Peter

2017-06-01

Pediatric appendicitis is a common, potentially serious condition. Determining perforation status is crucial to planning effective management. Determine the efficacy of serum total bilirubin concentration [STBC] in distinguishing perforation status in children with appendicitis. Retrospective review of 257 cases of appendicitis who received abdominal CT scan and measurement of STBC. There were 109 with perforation vs 148 without perforation. Although elevated STBC was significantly more common in those with [36%] vs without perforation [22%], the mean difference in elevated values between groups [0.1mg/dL] was clinically insignificant. Higher degrees of hyperbilirubinemia [>2mg/dL] were rarely encountered [5%]. Predictive values for elevated STBC in distinguishing perforation outcome were imprecise [sensitivity 38.5%, specificity 78.4%, PPV 56.8%, NPV 63.4%]. ROC curve analysis of multiple clinical and other laboratory factors for predicting perforation status was unenhanced by adding the STBC variable. Specific analysis of those with perforated appendicitis and percutaneously-drained intra-abdominal abscess which was culture-positive for Escherichia coli showed an identical rate of STBC elevation compared to all with perforation. The routine measurement of STBC does not accurately distinguish perforation status in children with appendicitis, nor discern infecting organism in those with perforation and intra-abdominal abscess. Copyright © 2017 Elsevier Inc. All rights reserved.

An unusual cause of duodenal perforation due to a lollipop stick

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Mi Jin Kim

2013-04-01

Full Text Available Children have a natural tendency to explore objects with their mouths; this can result in the swallowing of foreign objects. Most ingested foreign bodies pass uneventfully through the gastrointestinal tract.However, some foreign bodies cause obstruction or perforation of the gastrointestinal tract, requiring surgical intervention. Perforation of the gastrointestinal tract may be associated with considerable morbidity and mortality. The most common sites of intestinal foreign body perforation are the ileocecal and rectosigmoid regions. Foreign body perforation of the duodenum is relatively uncommon. We report the first Korean case of duodenal perforation by an ingested 8-cm lollipop stick. Lollipops are popular with the children and fairly accessible to them, as most parents are not aware of their potential harm. Pediatric clinicians should be aware of the risks associated with lollipop stick ingestion. Our report also describes the feasibility and safety of laparoscopic diagnosis and management of pediatric patients with peritonitis induced by the ingestion of foreign bodies.

Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets

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Sojung Han

2017-05-01

Full Text Available Gastrointestinal (GI leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggest that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.

Changing trend in emergency surgery for perforated duodenal ulcer

International Nuclear Information System (INIS)

Gurteyik, E.

2003-01-01

Objective: To evaluate changes in the emergency surgery of the duodenal ulcer. Subjects and Methods: Hospital records of 523 surgically treated patients, with duodenal ulcer perforation, during the period of 25 years 91975-1999) in the same surgical department, was retrospectively analysed. Changing aspects of emergency surgery of peptic ulcer disease, in the recent period, were determined in respect to number of operations per year and in the choice of operative methods. Results: The average number of patients and emergency operations per year was 21. No significant change was observed during the study period. Elective operations gradually decreased in the last ten years, and none was performed in the last 4 years. On the other hand, 226 emergency interventions for duodenal ulcer perforation were performed in the last ten years and 84 interventions in the last 4 years. Definitive anti-ulcer surgery was performed in 42% of patients between 1985 and 1994. Simple closure of the perforation plus treatment with proton pump inhibitors and with anti-Helicobacter pylori medication was the method in 80% during the last year. Conclusion: Emergency surgery for perforated duodenal ulcer preserves its steady rate despite disappearance of elective operations after tremendous progress in medical control of peptic ulcer disease. There is an obvious return from definitive anti-ulcer surgery to simple closure of the perforation followed by antisecretory and antibacterial medications in the recent years. (author)

Gastric cancer perforation: experience from a tertiary care hospital.

Science.gov (United States)

Kandel, Bishnu Prasad; Singh, Yogendra; Singh, Keshav Prasad; Khakurel, Mahesh

2013-01-01

Gastric cancer perforation can occurs in advanced stage of the disease and is often associated with a high morbidity and mortality. Peritonitis due to perforation needs emergency laparotomy and different surgical procedures can be performed for definitive treatment. Surgical procedures largely depend on the stage of the disease and general condition of the patient. This study was carried out to evaluate the outcome and role of different surgical procedures in gastric cancer perforation. Medical record of patients with gastric perforation, who were treated during ten years period, was reviewed retrospectively. Data regarding clinical presentation, surgical procedures, staging and survival of patients were obtained. Features suggestive of diffuse peritonitis were evident in all cases. The majority of the patients underwent emergency surgery except one who died during resuscitation. The majority of patients were in stage III and stage IV. Surgical procedure includes simple closure and omental patch in five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patients and Devine's antral exclusion in one patient. Surgical site infection was the most common (45.5%) postoperative complication. Four patients died within one month of the surgery. Three patients who underwent gastrectomy survived for one year and one patient survived for five years. Although gastric cancer perforation usually occurs in advanced stage of the disease, curative resection should be considered as far as possible.

Rare occupational cause of nasal septum perforation: Nickel exposure

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Ertugrul Cagri Bolek

2017-10-01

Full Text Available Many etiologies are held accountable for nasal septum perforations. Topical nasal drug usage, previous surgeries, trauma, nose picking, squamous cell carcinoma, some rheumatological disorders such as granulomatosis with polyangiitis (Wegener granulomatosis, some infectious diseases such as syphilis and leprosy are among the causes of the perforations. Occupational heavy metal exposures by inhalation rarely may also cause nasal septum perforation. Here, we present a 29-year-old patient without any known diseases, who is a worker at a metallic coating and nickel-plating factory, referred for investigation of his nasal cartilage septum perforation from an otorhinolaryngology clinic. The patient questioning, physical examination and laboratory assessment about rheumatic and infectious diseases were negative. There was a metallic smell in the breath during the physical examination. The analysis showed serum nickel level at 31 μg/l and urine nickel at 18 μg/l (84.11 μg/g creatinine. Other possible serum and urine heavy metal levels were within normal ranges. Nickel exposure is usually together with other heavy metals (chromium or cadmium, it is rarely alone. Nickel ingested by inhalation usually leads to respiratory problems such as reduced olfactory acuity, ulcers, septum perforation or tumors of the nasal sinuses. This case demonstrates the importance of occupational anamnesis and awareness of diagnosis. Int J Occup Med Environ Health 2017;30(6:963–967

Duodenal perforation precipitated by scrub typhus

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Raghunath Rajat

2015-01-01

Full Text Available Scrub typhus is an acute febrile illness usually presenting with fever, myalgia, headache, and a pathognomonic eschar. Severe infection may lead to multiple organ failure and death. Gastrointestinal tract involvement in the form of gastric mucosal erosions and ulcerations owing to vasculitis resulting in gastrointestinal bleeding is common. This process may worsen a pre-existent asymptomatic peptic ulcer, causing duodenal perforation, and present as an acute abdomen requiring surgical exploration. We report the case of a patient with no previous symptoms or risk factors for a duodenal ulcer, who presented with an acute duodenal perforation, probably precipitated by scrub typhus infection.

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

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Lingling Yu

2016-01-01

Full Text Available We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n=10 and nonperforated NEC group (n=47. We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (all P<0.05. Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (all P<0.05. Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis.

14 MeV calibration of JET neutron detectors—phase 1: calibration and characterization of the neutron source

Science.gov (United States)

Batistoni, P.; Popovichev, S.; Cufar, A.; Ghani, Z.; Giacomelli, L.; Jednorog, S.; Klix, A.; Lilley, S.; Laszynska, E.; Loreti, S.; Packer, L.; Peacock, A.; Pillon, M.; Price, R.; Rebai, M.; Rigamonti, D.; Roberts, N.; Tardocchi, M.; Thomas, D.; Contributors, JET

2018-02-01

In view of the planned DT operations at JET, a calibration of the JET neutron monitors at 14 MeV neutron energy is needed using a 14 MeV neutron generator deployed inside the vacuum vessel by the JET remote handling system. The target accuracy of this calibration is  ±10% as also required by ITER, where a precise neutron yield measurement is important, e.g. for tritium accountancy. To achieve this accuracy, the 14 MeV neutron generator selected as the calibration source has been fully characterised and calibrated prior to the in-vessel calibration of the JET monitors. This paper describes the measurements performed using different types of neutron detectors, spectrometers, calibrated long counters and activation foils which allowed us to obtain the neutron emission rate and the anisotropy of the neutron generator, i.e. the neutron flux and energy spectrum dependence on emission angle, and to derive the absolute emission rate in 4π sr. The use of high resolution diamond spectrometers made it possible to resolve the complex features of the neutron energy spectra resulting from the mixed D/T beam ions reacting with the D/T nuclei present in the neutron generator target. As the neutron generator is not a stable neutron source, several monitoring detectors were attached to it by means of an ad hoc mechanical structure to continuously monitor the neutron emission rate during the in-vessel calibration. These monitoring detectors, two diamond diodes and activation foils, have been calibrated in terms of neutrons/counts within  ±5% total uncertainty. A neutron source routine has been developed, able to produce the neutron spectra resulting from all possible reactions occurring with the D/T ions in the beam impinging on the Ti D/T target. The neutron energy spectra calculated by combining the source routine with a MCNP model of the neutron generator have been validated by the measurements. These numerical tools will be key in analysing the results from the in

Risk factors for reintervention after surgery for perforated gastroduodenal ulcer

DEFF Research Database (Denmark)

Hasselager, R B; Lohse, N; Duch, P

2016-01-01

BACKGROUND: Perforated gastroduodenal ulcer carries a high mortality rate. Need for reintervention after surgical repair is associated with worse outcome, but knowledge on risk factors for reintervention is limited. The aim was to identify prognostic risk factors for reintervention after perforated...... gastroduodenal ulcer in a nationwide cohort. METHODS: All patients treated surgically for perforated gastroduodenal ulcer in Denmark between 2003 and 2014 were included using data from the Danish Clinical Register of Emergency Surgery. Potential risk factors for reintervention were assessed, and their crude...... and adjusted associations calculated by the competing risks subdistribution hazards approach. RESULTS: A total of 4086 patients underwent surgery for perforated gastroduodenal ulcer during the study interval. Median age was 71·1 (i.q.r. 59·6-81·0) years and the overall 90-day mortality rate was 30·8 per cent...

Posterior perforation of gastric ulcer: a rare surgical emergency ...

African Journals Online (AJOL)

BACKGROUND:Gastric ulcer perforation is a rare surgical emergency.Posterior gastric ulcer is even rarer and usually has a delayed presentation with attendant greater morbidity and mortality. AIM:To report a case of posterior perforation of gastric ulcer and review the literature. CASE REPORT:A 65yr old driver was seen in ...

ASSESSMENT OF SEVERITY OF PERFORATED PERITONITIS USING MODIFIED APACHE II SCORE

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L. Rajeswar Reddy

2016-06-01

Full Text Available Acute generalised peritonitis from gastrointestinal hollow viscus perforation is a potentially life threatening condition. It is a common surgical emergency in many general surgical units in the developing countries and it is often associated with high morbidity and mortality. Grading the severity of acute peritonitis has assisted in no small way in decision making and has improved therapy in the management of severely ill patients. Empirically based risk assessment for important clinical events has been extremely useful in evaluating new therapies, in monitoring resources for effective use and improving quality of care. MATERIAL AND METHODS A prospective survey of patients with acute generalised peritonitis due to gastrointestinal perforation was carried out in general surgical wards of KIMS Hospital, Amalapuram during the period starting from July 2013-November 2016. The study population consisted of 50 consecutive patients who had laparotomy during the study period for acute peritonitis due to gastrointestinal perforation, after diagnostic conformation. RESULT AND DISCUSSION The most common cause of peritonitis in our study was perforated duodenal ulcer (31 cases, followed by appendicular perforation (7 cases, followed by stomach perforation (7 cases. Despite delay in seeking treatment, the overall mortality rate (14% was favourably comparable with other published series.

Computer modeling characterization, and applications of Gallium Arsenide Gunn diodes in radiation environments

Energy Technology Data Exchange (ETDEWEB)

El- Basit, Wafaa Abd; El-Ghanam, Safaa Mohamed; Kamh, Sanaa Abd El-Tawab [Electronics Research Laboratory, Physics Department, Faculty of Women for Arts, Science and Education, Ain-Shams University, Cairo (Egypt); Abdel-Maksood, Ashraf Mosleh; Soliman, Fouad Abd El-Moniem Saad [Nuclear Materials Authority, Cairo (Egypt)

2016-10-15

The present paper reports on a trial to shed further light on the characterization, applications, and operation of radar speed guns or Gunn diodes on different radiation environments of neutron or γ fields. To this end, theoretical and experimental investigations of microwave oscillating system for outer-space applications were carried out. Radiation effects on the transient parameters and electrical properties of the proposed devices have been studied in detail with the application of computer programming. Also, the oscillation parameters, power characteristics, and bias current were plotted under the influence of different γ and neutron irradiation levels. Finally, shelf or oven annealing processes were shown to be satisfactory techniques to recover the initial characteristics of the irradiated devices.

Dual detector neutron lifetime log: theory and practical applications

International Nuclear Information System (INIS)

Serpas, C.J.; Wichmann, P.A.; Fertl, W.H.; DeVries, M.R.; Rndall, R.R.

1977-01-01

The Neutron Lifetime Log instrumentation has continued to evolve and now is equipped with dual detectors for increased ease in gas detection and also a ratio response for a simultaneous porosity determination. A good deal of experimentation was involved to minimize both lithology and salinity effects on the porosity indication. This paper contains a discussion of the theory and concepts related to the application of the Dual Detector Neutron Lifetime Log (DNLL). It is important to note that with these advances the recording of thermal neutron capture cross section (Σ) remains consistent with the past measurements of earlier generations of instruments as the most accurate determination of this parameter. A number of field examples of the newly logged results are shown. These field cases include Dual Detector NLL's run thru the drill strings of highly deviated holes when difficulties were encountered in getting conventional open hole logs to bottom, logs thru open perforations and hot radioactive zones, comparisons of the large and small diameter instruments, logs with anomalous fluids in the annulus, logs thru multiple casing strings, and a number of other examples

Diode pumped solid state laser by two diodes

International Nuclear Information System (INIS)

Li Mingzhong; Zhang Xiaomin; Liang Yue; Man Yongzai; Zhou Pizhang

1995-01-01

A Nd: YLF laser is pumped by home-made quantum well diode lasers. Datum of laser output energy 60 μJ and peak power 120 mw are observed at wavelength 1.047 μm. On the same pumping condition, the output power synchronously pumped by two diodes is higher than the total output power pumped by two diodes separately. The fluctuation is <3%. The results agree with theoretical analysis

Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

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Toshihiro Kitai

2014-01-01

Full Text Available Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

An investigation of the damaged zone created by perforating

International Nuclear Information System (INIS)

Pucknell, J.K.; Behrmann, L.A.

1991-01-01

This paper reports on underbalance perforation flow experiments performed on reservoir and outcrop sandstones to investigate the perforation damaged zone. Cores from several different formations were perforated under reservoir conditions. After perforating, the cores were examined using CAT scans (Computer Aided tomography), thin sections and mercury porosimetry. In conjunction with these measurements, permeabilities in the damaged zone were measured using a minipermeameter and radial flow permeameter or were estimated from pore size distribution. The density and porosity of the damaged zone (at least for saturated rocks) is essentially the same as that in the undamaged rock. The damaged zone is not compacted, contrary to suggestions made in earlier work. However, the creation of this zone involves the destruction of large pores. The volume lost from these pores is replaced by microfractures created when rock grains are fractured by penetration of the shaped charge jet. This reduction in the average pore size causes a reduction in the permeability with the damaged zone. Although direct measurement of this permeability was made difficult by naturally occurring permeability variations, unambiguous measurements were obtained

Costs of treating bleeding and perforated peptic ulcers in The Netherlands.

Science.gov (United States)

de Leest, Helena; van Dieten, Hiske; van Tulder, Maurits; Lems, Willem F; Dijkmans, Ben A C; Boers, Maarten

2004-04-01

Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs includes perforations and bleeds. Several preventive strategies are being tested for cost-effectiveness, but little is known about the costs of the complications they are trying to prevent. We estimated the direct costs of hospital treatment of bleeding and perforated ulcers in a university hospital, from data in discharge letters and the hospital management information system. Eligible patients had been treated in the VU University Medical Center between January 1997 and August 2000 for an ulcer bleed or perforation (International Classification of Diseases code 531-4). Resource use comprised hospitalization days and diagnostic and therapeutic interventions. Insurance claim prices determined the costs from the payers' perspective. In a secondary analysis we excluded resource use that was clearly related to the treatment of comorbid illness. Fifty-three patients with a bleeding (n = 35) or perforated ulcer (n = 15) or both (n = 3) were studied, including 14 with comorbidity; 22 complications occurred in the stomach, 29 in the duodenum, one in both stomach and duodenum, and one after partial gastrectomy. A simultaneous bleed and perforation was most expensive (26,000 euro), followed by perforation (19,000 euro) and bleeding (12,000 euro). A bleed in the duodenum was more expensive than in the stomach (13,000 euro vs 10,000 euro), while the opposite was seen for perforations (13,000 euro vs 21,000 euro). Comorbidity increased costs substantially: even after correction for procedures unrelated to the ulcer complication, comorbidity more than doubled the costs of treatment. Treatment of complicated ulcers is expensive, especially in patients with comorbid conditions.

Perforated Gastric Ulcer Associated with Anti-Angiogenic Therapy

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Diogo Libânio

2017-08-01

Full Text Available Anti-angiogenic therapy with bevacizumab, an inhibitor of vascular endothelial growth factor, is commonly used in metastatic colorectal cancer and is rarely associated with gastrointestinal perforation, perforation being more frequent in the primary tumor site or at the anastomotic level. We present the case of a 64-year-old male with stage IV rectal adenocarcinoma who was on palliative chemotherapy with FOLFOX and bevacizumab. After the 4th chemotherapy cycle, our patient started fever and epigastric pain. He was hemodynamically stable, and signs of peritoneal irritation were absent. There were no alterations in the abdominal X-ray, and C-reactive protein was markedly elevated. A CT scan revealed a de novo thickness in the gastric antrum. Upper digestive endoscopy showed an ulcerated 40-mm lesion in the angulus, with a 20-mm orifice communicating with an exsudative cavity revested by the omentum. A conservative approach was decided including fasting, broad-spectrum intravenous antibiotics, and proton-pump inhibitors. Subsequent gastroduodenal series showed no contrast extravasation, allowing the resumption of oral nutrition. Esophagogastroduodenoscopy after 8 weeks showed perforation closure. Biopsies did not show neoplastic cells or Heliobacter pylori infection. Although the success in the conservative management of perforation allowing the maintenance of palliative chemotherapy (without bevacizumab, the patient died after 4 months due to liver failure. The reported case shows an uncommon endoscopic finding due to a rare complication of anti-angiogenic therapy. Additionally, it reminds clinicians that a history of gastroduodenal ulcers should be actively sought before starting anti-angiogenic treatment and that suspicion for perforation should be high in these cases.

RPL-SC dosimetric system for measuring gamma and neutron irradiation in case of emergency

International Nuclear Information System (INIS)

Khristova, M. G.

1993-01-01

A RPL-SC dosimetric system is designed based on radiophotoluminescence (RPL) and on the effect of fast neutron bombardment of silicon semiconductor (SC) diodes. The experimental prototype consists of a computerized automatic measurement system and an individual dosimetric cassette accommodating RPL and SC detectors. The equipment includes: a device for measurement of the direct voltage of Si diodes and the RPL light emitted by RPL detectors; a compartment with dosimetric cassettes to be measured; a manipulator with three positions executing automatic measurement of cassettes; a computer and a printer. The system operates in both manual and automatic modes. In the manual mode each step of the manipulator is set up by the operator who changes the ranges after they have been filled to capacity and registers the results. In the automatic mode the whole process of maintaining the supply and control voltage, of manipulator's operation, measuring, data recording and data processing are controlled by a specially designed computer programme. Main technical parameters: 1) Measurement range of absorbed dose: gamma rays - 10 -3 to 10 2 Gy; thermal neutrons - 10 -3 to 10 2 Gy; fast neutrons - 10 to 30 Gy. 2) Energy range: gamma rays - 0.04 to 1.25 MeV; thermal neutrons - 0.024 eV; fast neutrons - 0.3 to 14 MeV. 3) Relative measurement error - ±15% 4) Recurrent measurement of one and the same dose. 5) Measurement time of 1 detector - 15 sec. (author)

DIANE, a simulation code for the interaction of neutrons with living tissues. Application to low doses of fast neutrons on human tumoral cells; DIANE, un code de simulation de l'interaction des neutrons avec la matiere vivante. Applications aux faibles doses de neutrons rapides sur des cellules tumorales humaines

Energy Technology Data Exchange (ETDEWEB)

Nenot, M.L

2003-07-15

Our work deals with the irradiation of cells and living tissues by 14 MeV neutrons at very low doses (a few 10{sup -2} Gy). Such experiments require an accurate knowledge of the values of neutron dose rates and fluences at the level of cell cultures. We have performed measurements of fluence rates through an activation method applied to gold and copper foils. The fluence rate is deduced from the gamma rays emitted by the irradiated foils. Neutron doses and dose rates have been measured through varied methods: PIN diodes, ionization tissue equivalent chambers, and Geiger-Mueller counters. We have designed the DIANE code to simulate the impact of energetic neutrons on cells. This code can be used with isolated cells or macroscopic tissues, it takes into account the roles of the ionisation electrons produced by recoil nuclei entering the cell. This point is all the more important since recent works have highlighted the impact of very low energy electrons on DNA. (A.C.)

SU-E-T-75: Commissioning Optically Stimulated Luminescence Dosimeters for Fast Neutron Therapy

Energy Technology Data Exchange (ETDEWEB)

Young, L [UniversityWashington, Seattle, WA (United States); Yang, F; Sandison, G [University of Washington, Seattle, WA (United States); Woodworth, D [University of California, Santa Barbara, Santa Barbara, CA (United States); McCormick, Z [University of Nevada - Reno, Reno, Nevada (United States)

2014-06-01

Purpose: Fast neutrons therapy used at the University of Washington is clinically proven to be more effective than photon therapy in treating salivary gland and other cancers. A nanodot optically stimulated luminescence (OSL) system was chosen to be commissioned for patient in vivo dosimetry for neutron therapy. The OSL-based radiation detectors are not susceptible to radiation damage caused by neutrons compared to diodes or MOSFET systems. Methods: An In-Light microStar OSL system was commissioned for in vivo use by radiating Landauer nanodots with neutrons generated from 50.0 MeV protons accelerated onto a beryllium target. The OSLs were calibrated the depth of maximum dose in solid water localized to 150 cm SAD isocenter in a 10.3 cm square field. Linearity was tested over a typical clinical dose fractionation range i.e. 0 to 150 neutron-cGy. Correction factors for transient signal fading, trap depletion, gantry angle, field size, and wedge factor dependencies were also evaluated. The OSLs were photo-bleached between radiations using a tungsten-halogen lamp. Results: Landauer sensitivity factors published for each nanodot are valid for measuring photon and electron doses but do not apply for neutron irradiation. Individually calculated nanodot calibration factors exhibited a 2–5% improvement over calibration factors computed by the microStar InLight software. Transient fading effects had a significant impact on neutron dose reading accuracy compared to photon and electron in vivo dosimetry. Greater accuracy can be achieved by calibrating and reading each dosimeter within 1–2 hours after irradiation. No additional OSL correction factors were needed for field size, gantry angle, or wedge factors in solid water phantom measurements. Conclusion: OSL detectors are a useful for neutron beam in vivo dosimetry verification. Dosimetric accuracy comparable to conventional diode systems can be achieved. Accounting for transient fading effects during the neutron beam

Conservative Management of Colonoscopic Perforation: A Case Report.

Science.gov (United States)

Parsa, Hossein; Miroliaee, Arash; Doagoo, Zafar; Sina, Saeed

2017-07-01

Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored. Serial abdominal examinations were performed to rule out peritonitis. After transferring to surgery ward in the day 4, liquid diet started slowly, and she was ambulated. At the day 8, she was discharged with the good clinical condition. Conservative management of the patients with early diagnosis of perforation and no signs and symptoms of peritonitis or sepsis could be the modality of choice.

Primary tubercular caecal perforation: a rare clinical entity

Directory of Open Access Journals (Sweden)

Moses Sonia

2010-03-01

Full Text Available Abstract Background Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon. Case presentation We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum. Conclusions We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.

Review of current neutron detection systems for emergency response

Science.gov (United States)

Mukhopadhyay, Sanjoy; Maurer, Richard; Guss, Paul; Kruschwitz, Craig

2014-09-01

Neutron detectors are used in a myriad of applications—from safeguarding special nuclear materials (SNM) to determining lattice spacing in soft materials. The transformational changes taking place in neutron detection and imaging techniques in the last few years are largely being driven by the global shortage of helium-3 (3He). This article reviews the status of neutron sensors used specifically for SNM detection in radiological emergency response. These neutron detectors must be highly efficient, be rugged, have fast electronics to measure neutron multiplicity, and be capable of measuring direction of the neutron sources and possibly image them with high spatial resolution. Neutron detection is an indirect physical process: neutrons react with nuclei in materials to initiate the release of one or more charged particles that produce electric signals that can be processed by the detection system. Therefore, neutron detection requires conversion materials as active elements of the detection system; these materials may include boron-10 (10B), lithium-6 (6Li), and gadollinium-157 (157Gd), to name a few, but the number of materials available for neutron detection is limited. However, in recent years, pulse-shape-discriminating plastic scintillators, scintillators made of helium-4 (4He) under high pressure, pillar and trench semiconductor diodes, and exotic semiconductor neutron detectors made from uranium oxide and other materials have widely expanded the parameter space in neutron detection methodology. In this article we will pay special attention to semiconductor-based neutron sensors. Modern microfabricated nanotubes covered inside with neutron converter materials and with very high aspect ratios for better charge transport will be discussed.

Perforated peptic ulcer in Tikur Anbessa Hospital: a review of 74 cases.

Science.gov (United States)

Ersumo, Tessema; W/Meskel, Yidnekachew; Kotisso, Berhanu

2005-01-01

Little is known on the pattern of perforated peptic ulcer in Ethiopia. To evaluate the early, outcome of management, a five-year retrospective analysis of 74 operated cases of perforated peptic ulcer was undertaken. Perforated peptic ulcer accounted for 3.4% of the adult emergency surgical procedures. The mean age was 32.6 years, with a male to female ratio of 7.2 to 1.0. Fifty-six percent of the cases were unmarried. In nearly 22.0% of the patients, no previous history of peptic ulcer disease was documented. Delay in diagnosis was noted in 95% of the cases. Most patients had duodenal ulcer perforation, and about 78% had purulent peritonitis at laparotomy. Fourteen died in hospital. Early presentation of patients to surgical care facilities may reduce morbidity and mortality in cases of peptic ulcer perforation.

Design of diode electron gun for 250 kW CW klystron

International Nuclear Information System (INIS)

Prasad, M.; Pande, S.A.; Hannurkar, P.R.

2005-01-01

A 250 kW CW klystron at frequencies 350 MHz and 700 MHz is being developed at Centre for Advanced Technology. These klystrons are required for forthcoming project like 100 MeV proton Linac for Spallation Neutron Source (SNS) as a main rf sources. In order to develop klystrons, we have designed the diode electron gun, which delivers more than 10 A beam current at 50 kV. This paper describes the simulation results of electron gun with computer code EGUN. (author)

Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

Directory of Open Access Journals (Sweden)

Mehrotra Sandeep

2009-01-01

Full Text Available Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

DIANE, a simulation code for the interaction of neutrons with living tissues. Application to low doses of fast neutrons on human tumoral cells

International Nuclear Information System (INIS)

Nenot, M.L.

2003-07-01

Our work deals with the irradiation of cells and living tissues by 14 MeV neutrons at very low doses (a few 10 -2 Gy). Such experiments require an accurate knowledge of the values of neutron dose rates and fluences at the level of cell cultures. We have performed measurements of fluence rates through an activation method applied to gold and copper foils. The fluence rate is deduced from the gamma rays emitted by the irradiated foils. Neutron doses and dose rates have been measured through varied methods: PIN diodes, ionization tissue equivalent chambers, and Geiger-Mueller counters. We have designed the DIANE code to simulate the impact of energetic neutrons on cells. This code can be used with isolated cells or macroscopic tissues, it takes into account the roles of the ionisation electrons produced by recoil nuclei entering the cell. This point is all the more important since recent works have highlighted the impact of very low energy electrons on DNA. (A.C.)

Rare occupational cause of nasal septum perforation: Nickel exposure.

Science.gov (United States)

Bolek, Ertugrul Cagri; Erden, Abdulsamet; Kulekci, Cagri; Kalyoncu, Umut; Karadag, Omer

2017-10-06

Many etiologies are held accountable for nasal septum perforations. Topical nasal drug usage, previous surgeries, trauma, nose picking, squamous cell carcinoma, some rheumatological disorders such as granulomatosis with polyangiitis (Wegener granulomatosis), some infectious diseases such as syphilis and leprosy are among the causes of the perforations. Occupational heavy metal exposures by inhalation rarely may also cause nasal septum perforation. Here, we present a 29-year-old patient without any known diseases, who is a worker at a metallic coating and nickel-plating factory, referred for investigation of his nasal cartilage septum perforation from an otorhinolaryngology clinic. The patient questioning, physical examination and laboratory assessment about rheumatic and infectious diseases were negative. There was a metallic smell in the breath during the physical examination. The analysis showed serum nickel level at 31 μg/l and urine nickel at 18 μg/l (84.11 μg/g creatinine). Other possible serum and urine heavy metal levels were within normal ranges. Nickel exposure is usually together with other heavy metals (chromium or cadmium), it is rarely alone. Nickel ingested by inhalation usually leads to respiratory problems such as reduced olfactory acuity, ulcers, septum perforation or tumors of the nasal sinuses. This case demonstrates the importance of occupational anamnesis and awareness of diagnosis. Int J Occup Med Environ Health 2017;30(6):963-967. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Diagnosing perforated appendicitis in pediatric patients: a new model.

Science.gov (United States)

van den Bogaard, Veerle A B; Euser, Sjoerd M; van der Ploeg, Tjeerd; de Korte, Niels; Sanders, Dave G M; de Winter, Derek; Vergroesen, Diederik; van Groningen, Krijn; de Winter, Peter

2016-03-01

Studies have investigated sensitivity and specificity of symptoms and tests for diagnosing appendicitis in children. Less is known with regard to the predictive value of these symptoms and tests with respect to the severity of appendicitis. The aim of this study was to determine the predictive value of patient's characteristics and tests for discriminating between perforated and nonperforated appendicitis in children. Pediatric patients who underwent an appendectomy at Spaarne Hospital Hoofddorp, the Netherlands, between January 1, 2009 and December 31, 2013, were included. Baseline patient's characteristics, history, physical examination, laboratory data and results of ultrasounds were collected. Univariate and multivariate logistic regressions were used to determine predictors of perforation. In total, 375 patients were included in this study of which 97 children (25.9%) had significant signs of perforation. Univariate analysis showed that age, duration of complaints, temperature, vomiting, CRP, WBC, different findings on ultrasound and the diameter of the appendix were good predictors of a perforated appendicitis. The final multivariate prediction model included temperature, CRP, clearly visible appendix and free fluids on ultrasound and diameter of the appendix and resulted in an area under the curve (AUC) of 0.91 showing sensitivity and specificity of respectively 85.2% and 81.2%. This prediction model can be used for identification of 'high-risk' children for a perforated appendicitis and might be helpful to prevent complications and longer hospitalization by bringing these children to theater earlier. Copyright © 2016 Elsevier Inc. All rights reserved.

Using perforators as recipient vessels (supermicrosurgery) for free flap reconstruction of the knee region.

Science.gov (United States)

Hong, Joon Pio; Koshima, Isao

2010-03-01

The purpose of this article is to evaluate the feasibility of a perforator as a recipient vessel to reconstruct soft tissue defects of the knee region.From December of 2006 to August of 2008, total of 25 patients underwent reconstructive procedure using either an anterolateral thigh or an upper medial thigh perforator flap. The flaps were anastomosed in a perforator to perforator manner using supermicrosurgery technique.Minimum of 3 perforators were traced around the knee defect. All flaps survived attached to a recipient perforator with artery diameter ranging from 0.4 to 0.9 mm and accompanying veins ranging from 0.4 to 1.2 mm. This approach allowed reduction in time for pedicle and recipient vessel dissection and minimized the trauma involved during isolation of the vessels.Using the perforator as recipient vessel allows an increase in selection for choice of recipient. By using a perforator as recipient, less time is consumed to secure the vessel, does not need long pedicles for flap, is not bound by the condition of major arteries, and minimizes any risk for major vessel injury while having acceptable flap survival.

The diode pump: its application to nuclear particle counting and to the detection of rapid neutronic power excursions in atomic piles (1962); La pompe a diodes, son application au comptage de particules nucleaires et a la detection des excursions rapides de puissance neutronique d'une pile atomique (1962)

Energy Technology Data Exchange (ETDEWEB)

Nicolo, G [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1962-05-15

This work deals in particular with three applications of an electronic device whose principle is based on that of the diode pump. 1- Linear response circuit 2- Logarithmic response circuit 3- Detection of neutronic power excursions in atomic piles using a circuit or a combination of several circuits of the linear response type. Each of the applications has been studied theoretically and experimentally. Finally, the detection of rapid power excursions is extensively discussed with reference to the many methods available, emphasis being laid on the rapidity of the electronic response. (author) [French] Cet ouvrage traite plus particulierement de trois applications d'un dispositif electronique dont le principe de fonctionnement est base sur celui de la pompe a diodes. 1- Circuit a reponse lineaire 2- Circuit a reponse logarithmique 3- Detection des excursions de puissance neutronique d'une pile atomique a l'aide d'un circuit ou d'une association de plusieurs circuits a reponse lineaire. Chacune des applications fait l'objet d'une etude theorique et experimentale. Enfin, la detection des excursions rapides de puissance est tres largement discutee a travers plusieurs methodes, notamment sur la partie concernant la rapidite de reponse de l'electronique. (auteur)

Typhoid ileal perforation: a 13-year experience

Directory of Open Access Journals (Sweden)

Poras Chaudhary

2015-07-01

Full Text Available Typhoid fever is endemic in many developing countries with a high rate of complications. Aim of this study is to analyse epidemiological features, clinical presentations, complications and therapeutic outcomes of enteric perforation peritonitis diagnosed and treated in our hospital. Records of total number of 646 patients, who presented with perforation peritonitis due to enteric fever in the surgical emergency unit of Dr Ram Manohar Lohia hospital, New Delhi between January 2001 and December 2013, were reviewed retrospectively. Descriptive statistics was used to analyze the data. Out of 646 patients, 62 (9.59% presented in shock. Stomal, peristomal, local and systemic complications were high in these patients. Primary closure was done in 212 (33.12 patients, primary ileostomy was created in 410 (64.06 patients, and resection and anastomosis was done in 24 (3.75 patients. Thirteen patients (2.01% died of typhoid intestinal perforation. To prevent complications of typhoid fever, in addition to control sanitation, it is also important to control quackery and malpractices. Awareness and education about the disease, its nature and complications will also be of great help.

Influence of delays on perforation risk in adults with acute appendicitis.

LENUS (Irish Health Repository)

Kearney, D

2012-02-03

PURPOSE: This study analyzed whether prehospital or in-hospital delay was the more significant influence on perforation rates for acute appendicitis and whether any clinical feature designated patients requiring higher surgical priority. METHODS: A retrospective analysis was conducted over one year at a tertiary referral hospital without a dedicated emergency surgical theater. Admission notes, theater logbook, and the Hospital Inpatient Enquiry system were reviewed to identify the characteristics and clinical course of patients aged greater than 16 years who were operated upon for histologically confirmed acute appendicitis. RESULTS: One hundred and fifteen patients were studied. The overall perforation rate was 17 percent. The mean duration of symptoms prior to hospital presentation was 38.1 hours with the mean in-hospital waiting time prior to operation being 23.4 hours. Although body temperature on presentation was significantly greater in patients found to have perforated appendicitis (P < 0.05), only patient heart rate at presentation and overall duration of symptoms, but not in-hospital waiting time, independently predicted perforation by stepwise linear regression modeling. CONCLUSION: In-hospital delay was not an independent predictor of perforation in adults with acute appendicitis although delays may contribute if patients are left to wait unduly. Tachycardia at presentation may be a quantifiable feature of those more likely to have perforation and who should be given higher surgical priority.

[Reconstruction of ankle and foot with combination of free perforator flaps and skin graft].

Science.gov (United States)

Yin, Lu; Gong, Ketong; Yin, Zhonggang; Zhang, Bo; Xu, Jianhua

2017-03-01

To evaluate the clinical outcomes of free perforator flaps combined with skin graft for reconstruction of ankle and foot soft tissue defects. Between June 2014 and October 2015, 20 cases of ankle and foot soft tissue defects were treated. There were 16 males and 4 females, aged from 19 to 61 years (mean, 43.3 years). Injury was caused by traffic accident in 7 cases, by crashing in 9 cases, and machine twist in 4 cases. The locations were the ankle in 6 cases, the heel in 3 cases, the dorsum pedis in 4 cases, and the plantar forefoot in 7 cases of avulsion injury after toes amputation. The size of wound ranged from 15 cm×10 cm to 27 cm×18 cm. The time from injury to treatment was from 11 to 52 days (mean, 27 days). The anterolateral thigh perforator flap was used in 11 cases, thoracodorsal antery perforator flap in 3 cases, medial sural artery perforator flap in 4 cases, deep inferior epigastric perforator flap in 1 case, and anteromedial thigh perforator flap in 1 case, including 5 chimeric perforator flaps, 5 polyfoliate perforator flaps, 3 flow-through perforator flaps, and 3 conjoined perforator flaps. The size of the perforator flap ranged from 10.0 cm×6.5 cm to 36.0 cm×8.0 cm, the size of skin graft from 5 cm×3 cm to 18 cm×12 cm. Venous crisis occurred in 2 flaps which survived after symptomatic treatment; 18 flaps survived successfully and skin grafting healed well. The follow-up time ranged 4-18 months (mean, 8.3 months). The flaps had good appearance, texture and color, without infection. The patients could walk normally and do daily activities. Only linear scars were observed at the donor sites. Free perforator flap can be used to reconstruct defects in the ankle and foot, especially in the weight-bearing area of the plantar forefoot. A combination of free perforator flap and skin graft is ideal in reconstruction of great soft tissue defects in the ankle and foot.

Perforation in a patient with stercoral colitis and diverticulosis: who did it?

Directory of Open Access Journals (Sweden)

Vijaya R. Bhatt

2014-02-01

Full Text Available Stercoral colitis with perforation of the colon is an uncommon, yet life-threatening cause of the acute abdomen. No one defining symptom exists for stercoral colitis; it may present asymptomatically or with vague symptoms. Diagnostic delay may result in perforation of the colon resulting in complications, even death. Moreover, stercoral perforation of the colon can also present with localized left lower quadrant abdominal pain masquerading as diverticulitis. Diverticular diseases and stercoral colitis share similar pathophysiology; furthermore, they may coexist, further complicating the diagnostic dilemma. The ability to decide the cause of perforation in a patient with both stercoral colitis and diverticulosis has not been discussed. We, therefore, report this case of stercoral perforation in a patient with diverticulosis and include a discussion of the epidemiology, clinical presentation, and a review of helpful diagnostic clues for a rapid differentiation to allow for accurate diagnosis and treatment.

[An Analysis of Perforated Gastric Cancer with Acute Peritonitis in Our Hospital].

Science.gov (United States)

Adachi, Shinichi; Endo, Shunji; Chinen, Yoshinao; Itakura, Hiroaki; Takayama, Hirotoshi; Tsuda, Yujiro; Ueda, Masami; Nakashima, Shinsuke; Ohta, Katsuya; Ikenaga, Masakazu; Yamada, Terumasa

2018-01-01

Perforated gastric cancer is relatively rare and the incidence is reported about 1% of all the cases of gastric cancer. We retrospectively analyzed the clinical data of the consecutive 12 patients with perforated gastric cancer who underwent operation in our hospital between January 2005 and December 2016. There were 5 men and 7 women, with an average age of 65.8 years old(34-87). Perforated gastric cancer occurred in the region U(1 cases), M(6 cases), L(5 cases). There were 11 cases with distant metastasis. We could successfully diagnosed as perforated gastric cancer in 8 cases before emergency operation. Gastrectomy was performed in 5 cases. However, the curative resection was performed only 1 case. Prognosis of perforated gastric cancer is poor. We considered as an appropriate two-step surgical strategy that the first step of surgery is an acute peritonitis treatment followed by radical gastrectomy with lymphadenectomy.

Preoperative CT angiography reduces surgery time in perforator flap reconstruction

NARCIS (Netherlands)

Smit, Jeroen M.; Dimopoulou, Angeliki; Liss, Anders G.; Zeebregts, Clark J.; Kildal, Morten; Whitaker, Iain S.; Magnusson, Anders; Acosta, Rafael

The use of perforator flaps in breast reconstructions has increased considerably in the past decade. A disadvantage of the perforator flap is difficult dissection, which results in a longer procedure. During spring 2006, we introduced CT angiography (CTA) as part of the diagnostic work-up in

Perforation af rectum med faekal peritonitis efter staplet haemorideoperation

DEFF Research Database (Denmark)

Beuke, Anna-Christina; Pedersen, Mark Ellebaek; Qvist, Niels

2008-01-01

Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors.......Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors....

Critical impact energy for the perforation of metallic plates

International Nuclear Information System (INIS)

Aly, S.Y.; Li, Q.M.

2008-01-01

This paper investigates the empirical formulae used in engineering practice to predict the critical perforation energy of metallic plates struck by rigid projectiles in the sub-ordnance regime. Main factors affecting the critical perforation energy are identified and valid conditions for each empirical formula are compared. Dimensional analysis is conducted to show the dependence of the non-dimensional critical impact energy on other influential non-dimensional numbers. Available empirical formulae are re-expressed in non-dimensional forms. A modified Jowett/AEA equation is proposed to predict the critical perforation energy of a flat-ended short projectile. The present work increases the confidence of using these empirical formulae and can be regarded as a quick guide for ballistic protection design of metallic shields and steel armour plates

A Case Report of Stercoraceous Perforation of the Cecum due to Scybalum

Directory of Open Access Journals (Sweden)

HR Khorshidi

2006-10-01

Introduction & Objective: Non-traumatic colon perforations are usually caused by malignancy, diverticulum and colitis. Stercoraceous perforation of the colon has rarely been reported in the literature. This lesion is assumed to be produced by the pressure from a hard scybalum resulting in a perforated ulcer with necrotic edges. We report a case of stercoraceous perforation of the cecum due to scybalum. Case: We report a 50-year-old man who had a severe abdominal pain from 3 days ago and had peritonitis in physical exam. He was admitted in Mars, 2005 at Mobasher Kashani Hospital in Hamadan and he was parapelegic from 8 months ago due to trauma in his medical history and then he had severe and chronic constipation that necessitated the use of cathartic drugs. We operated him with diagnosis of peritonitis, and perforation of cecum due to scybalum was seen and right hemicolectomy and colostomy and ileostomy was done. Conclusion: The most common site of colon perforation due to scybalum is rectosigmoid area and cecal perforation is a rare area in the literature. It is presented with peritonitis in old patients that have chronic constipation. It is difficult to diagnose this lesion preoperatively. This lesion was only 11% correctly diagnosed before operation and should be always suspected when a patient with chronic constipation suffers from sudden abdominal pain. Resection and colostomy is the treatment of choice in most situations.

Surgical management of perforated peptic ulcer disease.

Science.gov (United States)

Sweeney, K J; Faolain, M O; Gannon, D; Gorey, T F; Kerin, M J

2006-01-01

Surgery for perforated peptic ulcer disease is one of the most common emergency procedures carried out in the western world. The role of postoperative empiric Helicobacter Pylori eradication therapy is controversial. The clinical, operative and postoperative surveillance details of 84 consecutive patients who underwent surgery for perforated peptic ulcer were reviewed. All patients underwent omentopexy +/- simple closure followed by proton pump therapy. Patients were followed-up for an average of 44 +/- 19 months. Females were older than male patients (59 +/- 20 vs. 46 + 17 years; pperforated peptic ulcer is associated with a significant perioperative mortality rate. Elderly female patients are particularly at risk.

Non-operative management of perforated peptic ulcer

International Nuclear Information System (INIS)

Rahman, M.M.; Ahsan, H.N.; Hossain, M.D.

2003-01-01

Objective: The aim of this study was to see the morbidity and mortality in peptic ulcer perforation cases by non-operative management in selected cases. Results: In the selected 54 patients, male: female were 49:05. Nine had history of NSAID intake. There was no mortality. Morbidity analysis showed that three had hepatic abscess, four had pelvic abscess, six took prolonged time for improvement, in two cases conservative treatment had to be abandoned and laparotomy was done in the same hospital admission. Conclusion: Non-operative procedure is a safe and effective measure for the management of perforated peptic ulcer in selected cases. (author)

Acute spontaneous gastric perforation in neonates: A report of three ...

African Journals Online (AJOL)

Gastric perforation in neonates is a rare, serious and life-threatening problem. The precise aetiology is obscure in most cases. By virtue of its high mortality rate, it requires prompt recognition and surgical intervention. We report three cases of neonatal gastric perforation managed by early resuscitation and primary repair.

Perforated gastric and duodenal ulcers in an urban African population

African Journals Online (AJOL)

Background: Perforations of the stomach and duodenum are frequent causes of acute generalized peritonitis in our environment. This is a prospective study of 331 cases of gastric and duodenal perforations. Study design: A consecutive series of adult patients admitted and treated for acute generalized peritonitis due to ...

The "stamp method" : a new treatment for perforated peptic ulcer?

NARCIS (Netherlands)

Bertleff, M.J.O.E.; Liem, RSB; Robinson, PH; Bonjer, HJ; Lange, J. F.; Bartels, H.; van der Werf, J.F.A.

Background: The aim of this study was to develop a simple method for closure of a perforated peptic ulcer, making it more accessible for laparoscopic surgery. Methods: An experimental pilot study was performed using five male Wistar rats. The perforation was closed by a bioabsorbable patch made of

Percutaneous drainage in conservative therapy for perforated gastroduodenal ulcers.

Science.gov (United States)

Oida, Takatsugu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

2012-01-01

The management of peptic ulcers has dramatically changed and the incidence of elective surgery for gastroduodenal peptic ulcers has markedly decreased; hence, the incidence of emergency surgery for perforated peptic ulcers has slightly increased. In select cases, conservative therapy can be used as an alternative for treating perforated gastroduodenal ulcers. In this study, we evaluated the efficacy of percutaneous abdominal drainage for the conservative treatment of perforated gastroduodenal ulcers. We retrospectively studied 51 patients who had undergone conservative therapy for perforated gastroduodenal ulcers. These patients were divided into 2 groups on the basis of the initial treatment with conservative therapy with or without percutaneous drainage: group PD included patients who had undergone percutaneous drainage and group NPD, patients who had undergone non-percutaneous drainage. In the PD group, 14.3% (n=3) of the patients did not respond to conservative therapy, while this value was 43.3% (n=13) in the NPD group. The 2 groups differed significantly with respect to conversion from conservative therapy to surgery (pperforated gastroduodenal ulcers should be performed only in the case of patients meeting the required criteria; its combination with percutaneous intraperitoneal drainage is effective as initial conservative therapy.

Influence of perforation erosion on multiple growing hydraulic fractures in multi-stage fracturing

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Yongming Li

2018-02-01

Full Text Available In multi-stage hydraulic fracturing, the limited-entry method is widely used to promote uniform growth of multiple fractures. However, this method's effectiveness may be lost because the perforations will be eroded gradually during the fracturing period. In order to study the influence of perforation erosion on multiple growing hydraulic fractures, we combined the solid–fluid coupled model of hydraulic fracture growth with an empirical model of perforation erosion to implement numerical simulation. The simulations show clearly that the erosion of perforation will significantly deteriorate the non-uniform growth of multiple fractures. Based on the numerical model, we also studied the influences of proppant concentration and injection rates on perforation erosion in multi-stage hydraulic fracturing. The results indicate that the initial erosion rates become higher with the rising proppant concentration, but the growth of multiple hydraulic fractures is not sensitive to the varied proppant concentration. In addition, higher injection rates are beneficial significantly to the limited-entry design, leading to more uniform growth of fractures. Thus, in multi-stage hydraulic fracturing enough high injection rates are proposed to keep uniform growths. Keywords: Unconventional oil and gas reservoir, Horizontal well, Perforation friction, Perforation erosion, Multi-stage hydraulic fracturing, Numerical simulation, Mathematic model, Uniform growth of fractures

Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

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Nikhil Ranjan

2015-01-01

Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

Intraoperative Tumor Perforation is Associated with Decreased 5-Year Survival in Colon Cancer

DEFF Research Database (Denmark)

Bundgaard, N S; Bendtsen, V O; Ingeholm, P

2017-01-01

BACKGROUND: It is a widely held belief that intraoperative tumor perforation in colon cancer impairs survival and causes local recurrence, although the prognostic importance remains unclear. AIM: The aim of this study was to assess the effect of unintended intraoperative tumor perforation...... on postoperative mortality and long-term survival. MATERIAL AND METHODS: This national cohort study was based on data from a prospectively maintained nationwide colorectal cancer database. We included 16,517 colon cancer patients who were resected with curative intent from 2001 to 2012. RESULTS: Intraoperative...... tumor perforation produced a significantly impaired 5-year survival of 40% compared to 64% in non-perforated colon cancer. Intraoperative tumor perforation was an independent risk factor for death, hazard ratio 1.63 (95% confidence interval: 1.4-1.94), with a significantly increased 90-day postoperative...

Study on modal characteristics of perforated shell using effective Young's modulus

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Jo, E-mail: mjj@kins.re.kr [Korea Institute of Nuclear Safety, 19 Guseong-dong, Yuseong-gu, Daejeon 305-338 (Korea, Republic of); Yu, Seon Oh [Korea Institute of Nuclear Safety, 19 Guseong-dong, Yuseong-gu, Daejeon 305-338 (Korea, Republic of)

2011-06-15

Research highlights: > The effective Young's modulus of perforated shell is proposed for modal analysis. > The penetration pattern is almost negligible for effective elastic constants. > The frequency of perforated shell decreases significantly due to the hole effect. - Abstract: For the perforated cylindrical shell submerged in fluid, it is almost impossible to develop a finite element model due to the necessity of the fine meshing of the shell and the fluid at the same time. This necessitates the use of solid shell with effective material properties. Unfortunately the effective elastic constants are not found in any references even though the ASME code is suggesting those for perforated plate. Therefore in this study the effective material properties of perforated shell are suggested by performing several finite element analyses with respect to the ligament efficiencies.

Charge collection and space charge distribution in neutron-irradiated epitaxial silicon detectors

International Nuclear Information System (INIS)

Poehlsen, Thomas

2010-04-01

In this work epitaxial n-type silicon diodes with a thickness of 100 μm and 150 μm are investigated. After neutron irradiation with fluences between 10 14 cm -2 and 4 x 10 15 cm -2 annealing studies were performed. CV-IV curves were taken and the depletion voltage was determined for different annealing times. All investigated diodes with neutron fluences greater than 2 x 10 14 cm -2 showed type inversion due to irradiation. Measurements with the transient current technique (TCT) using a pulsed laser were performed to investigate charge collection effects for temperatures of -40 C, -10 C and 20 C. The charge correction method was used to determine the effective trapping time τ eff . Inconsistencies of the results could be explained by assuming field dependent trapping times. A simulation of charge collection could be used to determine the field dependent trapping time τ eff (E) and the space charge distribution in the detector bulk. Assuming a linear field dependence of the trapping times and a linear space charge distribution the data could be described. Indications of charge multiplication were seen in the irradiated 100 μm thick diodes for all investigated fluences at voltages above 800 V. The space charge distribution extracted from TCT measurements was compared to the results of the CV measurements and showed good agreement. (orig.)

Malrotation with midgut volvulus associated with perforated ileal duplication

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Anand Pandey

2013-01-01

Full Text Available Duplication of the alimentary tract is an important surgical condition. It may occur anywhere in the gastrointestinal tract. An important complication of this entity is perforation of the normal or abnormal gut. Malrotation with midgut volvulus can be a surgical emergency. We present a patient, who presented as malrotation with midgut volvulus associated with perforated ileal duplication. The patient was successfully managed.

Spontaneous bile duct perforation in an infant, managed with simple ...

African Journals Online (AJOL)

Spontaneous bile duct perforation is a very rare but important cause of surgical jaundice in pediatric patients and one of the most common causes of surgical jaundice during infancy after biliary atresia. Preoperative diagnosis may not be possible in most of the cases. The exact cause of the perforation remains unclear.

Experience with Acute Perforated Duodenal Ulcer in a West African ...

African Journals Online (AJOL)

Plain chest x-rays demonstrated gas under the diaphragm in 21(65.6%) of the patients. After adequate resuscitation, all the patients underwent laparotomy where the abdomen was explored, the diagnosis of perforated duodenal ulcer was confirmed and 29(70.7%) had simple closure of the perforation with omentum (after ...

Ceramic microsieves: influence of perforation shape and distribution on flow resistance and membrane strength

NARCIS (Netherlands)

Kuiper, S.; Brink, R.; Nijdam, W.; Krijnen, Gijsbertus J.M.; Elwenspoek, Michael Curt

2002-01-01

Ceramic microsieves with slit-shaped perforations were compared to sieves with circular-shaped perforations, regarding flow resistance and membrane strength. Destructive tests show that the highest strength is obtained if the perforations are placed in a non-alternating pattern. Especially for

Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.

Science.gov (United States)

Banaszkiewicz, Zbigniew; Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

2014-01-01

Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates.

Coaxial foilless diode

OpenAIRE

Long Kong; QingXiang Liu; XiangQiang Li; ShaoMeng Wang

2014-01-01

A kind of coaxial foilless diode is proposed in this paper, with the structure model and operating principle of the diode are given. The current-voltage relation of the coaxial foilless diode and the effects of structure parameters on the relation are studied by simulation. By solving the electron motion equation, the beam deviation characteristic in the presence of external magnetic field in transmission process is analyzed, and the relationship between transverse misalignment with diode par...

Comparison of proton microbeam and gamma irradiation for the radiation hardness testing of silicon PIN diodes

Science.gov (United States)

Jakšić, M.; Grilj, V.; Skukan, N.; Majer, M.; Jung, H. K.; Kim, J. Y.; Lee, N. H.

2013-09-01

Simple and cost-effective solutions using Si PIN diodes as detectors are presently utilized in various radiation-related applications in which excessive exposure to radiation degrades their charge transport properties. One of the conventional methods for the radiation hardness testing of such devices is time-consuming irradiation with electron beam or gamma-ray irradiation facilities, high-energy proton accelerators, or with neutrons from research reactors. Recently, for the purpose of radiation hardness testing, a much faster nuclear microprobe based approach utilizing proton irradiation has been developed. To compare the two different irradiation techniques, silicon PIN diodes have been irradiated with a Co-60 gamma radiation source and with a 6 MeV proton microbeam. The signal degradation in the silicon PIN diodes for both irradiation conditions has been probed by the IBIC (ion beam induced charge) technique, which can precisely monitor changes in charge collection efficiency. The results presented are reviewed on the basis of displacement damage calculations and NIEL (non-ionizing energy loss) concept.

Acoustic Liner Drag: Measurements on Novel Facesheet Perforate Geometries

Science.gov (United States)

Howerton, Brian M.; Jones, Michael G.

2016-01-01

Interest in characterization of the aerodynamic drag of acoustic liners has increased in the past several years. This paper details experiments in the NASA Langley Grazing Flow Impedance Tube to quantify the relative drag of several perforate-over-honeycomb liner configurations at flow speeds of centerline flow Mach number equals 0.3 and 0.5. Various perforate geometries and orientations are investigated to determine their resistance factors using a static pressure drop approach. Comparison of these resistance factors gives a relative measurement of liner drag. For these same flow conditions, acoustic measurements are performed with tonal excitation from 400 to 3000 hertz at source sound pressure levels of 140 and 150 decibels. Educed impedance and attenuation spectra are used to determine the impact of variations in perforate geometry on acoustic performance.

Congenital Infantile Fibrosarcoma Causing Intestinal Perforation in a Newborn

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Margarita Kaiser

2017-01-01

Full Text Available Congenital infantile fibrosarcoma (CIF is a rare malignant mesenchymal tumor and only 14 cases have been reported with gastrointestinal manifestation. We report about a female newborn delivered per emergency cesarean section at 34 weeks of gestation. Postnatally, she rapidly developed an acute abdomen and sonographic evidence of intestinal perforation requiring laparotomy on the first day of life. A perforated 2 × 3 cm sized spherical tumorous structure of the jejunum was identified. Due to unknown histopathology at this point and unclear resectional margins, she received a temporary ileostomy, which was closed two months later. Histopathology revealed a congenital intestinal fibrosarcoma without the characteristic ETV6-NTRK3 fusion transcript. In conclusion, this rare tumor must be considered as differential diagnosis of intestinal perforations in newborns.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation.

Science.gov (United States)

Limmer, Alexandra M; Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation

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Alexandra M. Limmer

2017-01-01

Full Text Available Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient’s caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.

Perforated duodenal ulcer -a rare cause of acute abdomen in pregnancy.

Science.gov (United States)

Goel, Bharti; Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

2014-09-01

Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind while dealing with cases of acute abdomen in pregnancy and to proceed with multidisciplinary approach for better feto-maternal outcome.

Method for improving the electrostatics perforation pattern using power controlled discharges

Energy Technology Data Exchange (ETDEWEB)

Garzon, C; Miranda, E; GarcIa-Garcia, J [Departament d' Enginyeria Electronica, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain); Martinez-Cisneros, C; Alonso, J, E-mail: carolina.garzon@uab.cat [Departament de Quimica Analitica, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain)

2011-06-23

The aims of this work are to show the influence of adding a series resistance at the output of a discharge generator circuit and to point out that this component can be used to control the spark energy in electrostatic perforation systems. Analysis of the experimental results reveals that there exists a close connection between the resistor value and the obtained perforation pattern both in hole density and size. The use of a series resistor has a strong influence on the material porosity, which is an important industrial parameter for assessing the pattern perforation quality.

Abdominal wall perforation in a patient with recurrent epithelial ovarian cancer after bevacizumab treatment

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Efnan Algin

2016-08-01

Full Text Available Bowel perforation is a rare but well-described complication of bevacizumab, a VEGF monoclonal antibody. However, bevacizumab associated abdominal wall perforation is a more serious complication. In here, a patient with recurrent epithelial ovarian cancer developing both bowel and abdominal wall perforation after bevacizumab treatment is reported with review of the literature to point out the clinical significance of this rare complication. To our knowledge, this is the first case with bevacizumab associated abdominal wall perforation.

Spontaneous neonatal gastrointestinal perforation: surgical or ...

African Journals Online (AJOL)

... cases of spontaneous gastrointestinal perforation in neonates at the University of Benin Teaching Hospital, Benin City. The perinatal stress factors were caesarian delivery, prematurity and fetal distress due to prolonged obstructed labour.

Bowel perforation in type IV vascular Ehlers-Danlos syndrome. A systematic review.

Science.gov (United States)

El Masri, H; Loong, T-H; Meurette, G; Podevin, J; Zinzindohoue, F; Lehur, P-A

2018-05-01

Spontaneous gastrointestinal (GI) perforation is a well-known complication occurring in patients suffering from Type IV vascular Ehlers-Danlos syndrome (EDS IV). The aim of the present study was to review the current literature on spontaneous GI perforation in EDS IV and illustrate the surgical management and outcome when possible. A systematic review of all the published data on EDS IV patients with spontaneous GI perforation between January 2000 and December 2015 was conducted using three major databases PUBMED, EMBASE, and Cochrane Central Register of Controlled Trails. References of the selected articles were screened to avoid missing main articles. Twenty-seven published case reports and four retrospective studies, including 31 and 527 cases, respectively, matched the search criteria. A case from our institution was added. Mean age was 26 years (range 6-64 years). The most frequent site of perforation was the colon, particularly the sigmoid, followed by small bowel, upper rectum, and finally stomach. The majority of cases were initially managed with Hartmann's procedure. In recurrent perforations, total colectomy was performed. The reperforation rate was considerably higher in the "partial colectomy with anastomosis" group than in the Hartmann group. Colonic perforation is the most common spontaneous GI perforation in EDS IV patients. An unexpected fragility of the tissues should raise the possibility of a connective tissue disorder and prompt further investigation with eventual management of these high-risk patients with a multidisciplinary team approach in dedicated centres. In the emergency setting, a Hartmann procedure should be performed.

Anatomical study of the popliteal artery perforator-based propeller flap and its clinical application.

Science.gov (United States)

Onishi, Tadanobu; Shimizu, Takamasa; Omokawa, Shohei; Sananpanich, Kanit; Kido, Akira; Mahakkanukrauh, Pasuk; Tanaka, Yasuhito

2018-05-30

There is lack of anatomical information regarding cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. We aimed to evaluate the anatomical basis of popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate our experience utilizing this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery. We investigated the number, location, length, and diameter of cutaneous perforators of the popliteal artery. Based on the results, we treated three cases with a large soft tissue defect around the knee using popliteal artery perforator-based propeller flap. We found a mean of 1.9 cutaneous perforators arising from the popliteal artery with a mean pedicle length of 6 cm and a mean arterial internal diameter of 0.9 mm, which were located at an average of 4 cm proximal to the bicondylar line. The most distal perforator consistently arose along the small saphenous vein and connected proximally with concomitant artery of the posterior femoral cutaneous nerve, forming a connection with perforating arteries of the profunda femoris artery. A mean of 4.5 cutaneous perforators branched from the arterial connection sites. All clinical cases healed without any complications. The popliteal artery perforator-based propeller flap is reliable for reconstruction of soft tissue defects around the knee. The flap should include the deep fascia and concomitant artery along with the posterior femoral cutaneous nerve for maintaining the blood supply.

Perfuração de Luvas durante Cirurgias Ginecológicas Glove Perforation during Gynecologic Surgeries

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Eddie Fernando Candido Murta

2000-05-01

Full Text Available Objetivo: analisar a incidência de perfuração de luvas cirúrgicas durante atos operatórios ginecológicos. Métodos: estudo prospectivo de 454 luvas usadas em 65 procedimentos utilizando-se o método de pressão de água. Resultados: do total de 454 luvas examinadas, foram verificadas perfurações em 54 (11,9%, sendo estatisticamente significativo o maior número de perfurações em comparação ao grupo controle, uma (1,7% em 60 analisadas (pPurpose: to analyze the frequency of glove perforation during gynecologic surgeries. Methods: a prospective study of 454 gloves used in 65 surgeries by the water pressure method. Results: of a total of 454 gloves, 54 (11.9% had perforations. Comparison with the control group showed p<0.05 (chi² test, 1 (1.7% perforation in 60 gloves tested. Of the total of gloves used in 65 surgeries, 29 (44.6% had perforations, 44 (81% had one perforation and 10 (19% had more than one perforation. The two most common sites of perforations were the index finger, 20 (29.5% and the thumb, 14 (25.9%. Perforation was predominant in the left hand (72.1%. The surgeons were the members of the team with the greatest number of glove perforations. Total hysterectomy was the most frequent surgery in which glove perforations occurred (50% of the cases. Conclusion: the glove perforations occurred with relatively high frequency during gynecologic surgeries. The index finger of the left hand proved to be the most affected region. Among the members of the team, the highest percentage of glove perforations occurred in those of the surgeons. Total hysterectomy had the highest perforation rate.

Right ventricular perforation by a passive-fixation pacemaker lead two weeks after implantation

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Azeem S. Sheikh, BSc, MBBS, FCPS, MRCP

2014-12-01

Full Text Available Myocardial perforation is a rare complication of permanent pacemaker implantation. While most of the perforations occur at the time of implantation or within the first 24 h, delayed myocardial perforations are very rare. The clinical course is extremely variable with some patients presenting completely asymptomatic, while others can develop cardiac tamponade and haemodynamic instability. We report an unusual case of a subacute ventricular perforation caused by a passive-fixation lead two weeks after implantation and we successfully managed to extract the lead under local anaesthesia, without the patient undergoing surgery, as recommended in the previously published reports.

Simulation of a silicon neutron detector coated with TiB2 absorber

International Nuclear Information System (INIS)

Krapohl, D; Nilsson, H-E; Petersson, S; Slavicek, T; Thungström, G; Pospisil, S

2012-01-01

Neutron radiation cannot be directly detected in semiconductor detectors and therefore needs converter layers. Planar clean-room processing can be used in the manufacturing process of semiconductor detectors with metal layers to produce a cost-effective device. We used the Geant4 Monte-Carlo toolkit to simulate the performance of a semiconductor neutron detector. A silicon photo-diode was coated with vapour deposited titanium, aluminium thin films and a titaniumdiboride (TiB 2 ) neutron absorber layer. The neutron capture reaction 10B(n, alpha)7Li is taken advantage of to create charged particles that can be counted. Boron-10 has a natural abundance of about SI 19.8%. The emitted alpha particles are absorbed in the underlying silicon detector. We varied the thickness of the converter layer and ran the simulation with a thermal neutron source in order to find the best efficiency of the TiB 2 converter layer and optimize the clean room process.

Photothermal IR spectroscopy with perforated membrane micromechanical resonators

DEFF Research Database (Denmark)

Kurek, Maksymilian

-IR method. In order to overcome them, string resonators were replaced by membranes. A reliable sampling technique was maintained by adding perforation to membranes and thereby essentially getting membrane porous filters. Membranes gave also access to fully integrated magnetic transduction that allowed...... for significant shrinkage and simplification of the system. An analytical model of a locally heated membrane was developed and confirmed through FEM simulations. Then, low stress silicon nitride perforated membranes were fabricated and characterized using two different experimental setups that employed optical...

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

Energy Technology Data Exchange (ETDEWEB)

Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Geerlings, Mirjam I. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Luijten, Peter R. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

2009-12-15

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

International Nuclear Information System (INIS)

Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M.; Zwanenburg, Jaco J.M.; Geerlings, Mirjam I.; Luijten, Peter R.

2009-01-01

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study.

Science.gov (United States)

Conijn, Mandy M A; Hendrikse, Jeroen; Zwanenburg, Jaco J M; Takahara, Taro; Geerlings, Mirjam I; Mali, Willem P Th M; Luijten, Peter R

2009-12-01

The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries.

Fatal Gastrointestinal Perforations in sudden death cases in Last 10 ...

African Journals Online (AJOL)

Pathology unit of University Malaya, Kuala Lumpur in the year 2006 by reviewing the autopsy reports. There were 61 cases of GIT perforation out of 5579 autopsies conducted during a period of ten years (1996-2005). The incidence rate of fatal gastrointestinal perforation was 1.09% during this period. Out of these 61 cases, ...

Management of a Small Paracentral Corneal Perforation Using Iatrogenic Iris Incarceration and Tissue Adhesive

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Akira Kobayashi

2012-07-01

Full Text Available Background: Surgical intervention for corneal perforation is indicated when the anterior chamber does not reform within a short period of time. Herein, we report the successful management of a small paracentral corneal perforation using autologous iris incarceration and tissue adhesive. Case: A 41-year-old man developed a small paracentral corneal perforation (0.5 mm in size in the right eye, while the treating physician attempted to remove the residual rust ring after removal of a piece of metallic foreign body. Observations: The eye was initially managed with a bandage soft contact lens to ameliorate the aqueous leakage; however, without success. Iatrogenic iris incarceration of the wound was first induced, followed by application of cyanoacrylate tissue adhesive to the perforated site. As a result, the anterior chamber was immediately reformed and maintained. Complete corneal epithelialization of the perforation was achieved in 2 months without visual compromises. Conclusions: Cyanoacrylate tissue adhesive with iatrogenic incarceration of the autologous iris was effective in treating this type of small corneal perforation. This technique is simple and potentially useful for small paracentral corneal perforations outside the visual axis and without good apposition.

[Operative laparoscopy in the management of perforated peptic ulcer].

Science.gov (United States)

Schirru, Angelo; Cavaliere, Davide; Caristo, Ilario; Bianchi, Massimo; Cosce, Umberto; Mariani, Federica; Scarimbolo, Monica; Cavaliere, Paolo

2004-01-01

The aim of this retrospective study was to assess the feasibility, safety and efficacy of the laparoscopic approach in the management of perforated peptic ulcers. From January 1997 to December 2002, all patients referred to our community hospital for abdominal surgical emergencies were routinely managed by laparoscopic surgery. A review was carried out on 39 consecutive patients suffering from perforated peptic ulcers with or without generalised peritonitis. The study population comprised 24 male and 15 female patients, aged 30 to 94 years (mean age: 62 +/- 18). Laparoscopic repair was attempted in all patients. Laparoscopy afforded the correct diagnosis in all cases. Laparoscopic peritoneal washout (irrigation and suction of the entire abdominal cavity) with simple suture of the perforation proved successful in 34 patients. An additional omental patching was performed in 15 of these cases. Conversion to conventional open surgery was necessary in 5 patients. The morbidity and mortality rates were 13% and 10%, respectively. The mean operative time was 77 minutes (range: 40-120) and the mean hospital stay 9 days (range: 3-22). Laparoscopic repair of perforated ulcers is technically feasible but requires sound experience in laparoscopic abdominal emergencies. This study shows that the mini-invasive procedure is safe and effective, offering a valid alternative to traditional laparotomy.

Primary Report of Totally Tubeless Percutaneous Nephrolithotomy Despite Pelvi-calyceal Perforations.

Science.gov (United States)

Aghamir, Seyed Mohammad Kazem; Salavati, Alborz; Hamidi, Morteza; FallahNejad, Asghar

2017-07-02

Nephrostomy tube insertion and/or a ureteral stent placement is advised when pelvi-calyceal perforations are encountered during percutaneous nephrolithotomy (PNL) nevertheless totally tubeless PNL is a possible exit strategy in percutaneous renal surgery therefore case series on the short term clinical outcomes of noninvasive management of iatrogenic pelvicalyceal perforations encountered during PNL is presented. During retrospective analysis of 1271 PNL procedures, 25 incidents of accidental ureteral catheter/ jj stent dislodgement during first 24 post-operative hours were identified in patient who had pelvi calyceal perforations and had no nephrostomy tube (tubeless). Thirteen patients could not be re-stented nor a nephrostomytube could have been placed for them mainly due to patient refusal or comorbid conditions. The main outcome was rate of successful noninvasive management. Eighteen Patients bearing mucosal tears (grade I trauma) or visible peri-pelvic fat (grade II) successfully recovered without need for ureteral stenting or nephrostomy (72.0%). In seven (28.0%) cases of extension of the perforation into the peri-pelvic fat (grade III), either nephrostomy insertion or JJ stenting was needed for resolution of fever and urinoma. The major limitation was the necessity to exclude patients and manage them in the standard fashion according to clinical guidelines. Iatrogenic perforations of the collecting system are quite diverse in terms of severity that result in different natural histories and not all might need urinary diversion via nephrostomy or ureteral stenting.Low grade perforations may be successfully managed in totally tubeless fashion nevertheless further prospective investigations seem warranted.

Management of nontraumatic corneal perforation with tectonic drape patch and cyanoacrylate glue.

Science.gov (United States)

Khalifa, Yousuf M; Bailony, M Rami; Bloomer, Michele M; Killingsworth, Daniel; Jeng, Bennie H

2010-10-01

To report a case of nontraumatic corneal perforation managed with a tectonic drape patch. Interventional case report. A 60-year-old patient with a corneal scar in his left eye likely secondary to herpes simplex virus interstitial keratitis underwent laser peripheral iridotomy for narrow angles. He developed progressive thinning of the cornea overlying the scar that led to a descemetocele and then ultimately a 1.2- × 1.7-mm perforation. Intraoperatively, several attempts were made to seal the perforation with cyanoacrylate glue, but the wound continued to leak. Sterile plastic drape that was on the surgical field was fashioned into a 2-mm-diameter patch, and the peripheral edge of the tectonic drape patch was glued over the perforation, successfully sealing the cornea. One week later, the drape patch was intact without leak, and a penetrating keratoplasty was carried out without complication. Tectonic drape patch technique for nontraumatic corneal perforations in which there is tissue loss is a viable temporizing option when cyanoacrylate glue alone fails and when there is no corneal tissue or amniotic membrane available to close the wound.

Perforation and bacterial contamination of microscope covers in lumbar spinal decompressive surgery.

Science.gov (United States)

Osterhoff, Georg; Spirig, José; Klasen, Jürgen; Kuster, Stefan P; Zinkernagel, Annelies S; Sax, Hugo; Min, Kan

2014-01-01

To determine the integrity of microscope covers and bacterial contamination at the end of lumbar spinal decompressive surgery. A prospective study of 25 consecutive lumbar spinal decompressions with the use of a surgical microscope was performed. For detection of perforations, the microscope covers were filled with water at the end of surgery and the presence of water leakage in 3 zones (objective, ocular and control panel) was examined. For detection of bacterial contamination, swabs were taken from the covers at the same locations before and after surgery. Among the 25 covers, 1 (4%) perforation was observed and no association between perforation and bacterial contamination was seen; 3 (4%) of 75 smears from the 25 covers showed post-operative bacterial contamination, i.e. 2 in the ocular zone and 1 in the optical zone, without a cover perforation. The incidence of microscope cover perforation was very low and was not shown to be associated with bacterial contamination. External sources of bacterial contamination seem to outweigh the problem of contamination due to failure of cover integrity. © 2014 S. Karger AG, Basel.

Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients

International Nuclear Information System (INIS)

Grassi, Roberto; Romano, Stefania; Pinto, Antonio; Romano, Luigia

2004-01-01

Introduction: Gastro-duodenal perforations may be suspected in patients with history of ulceration, who present with acute pain and abdominal wall rigidity, but radiological findings in these cases may be unable to confirm a clinical diagnosis. The aim of our study was to report our experience in the diagnosis of gastro-duodenal perforation by conventional radiography, US and CT examinations. Material and methods: We retrospectively reviewed medical records of 166 consecutive patients who presented in the last 2 years to our institutions with symptoms of acute abdomen and submitted to surgery at the Emergency Unit of the ''A.Cardarelli'' Hospital of Naples with a surgical finding of perforated gastro-duodenal ulcer. The evidence of free intraperitoneal air on abdominal plain film was considered as a direct or suggestive finding of perforation. Evidence of intraperitoneal free fluid and/or reduced intestinal peristalsis at sonographic examination were considered indirect signs of gastro-duodenal perforation. Evidence of free peritoneal gas at CT was considered as a direct evidence of gastro-duodenal perforation. Results: Twenty patients underwent immediate surgery with no preoperative imaging evaluation, in 10 of them the site of perforation was found in a juxta-pyloric region and in the others at level of duodenum. In 146 patients submitted to serial radiological investigations before surgery, the site of perforation was in 56 (38.3%) duodenal, in 52 (35.6%) juxta-pyloric, in 28 (19.1%) gastric and in 10 (6.8%) pyloric. The cause of perforation was in all cases gastric or duodenal ulceration, in seven cases involving pancreatic parenchyma. In 110 (75.4%) patients with direct findings of perforation, in 94 cases (85.5%) the correct diagnosis was established on abdominal plain film, in two (1.8%) with radiographic and sonographic examinations and in 14 (12.7%) on CT findings. In 36 (24,6%) patients with no direct findings of perforation, only 24 (16,4%) of them

Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients

Energy Technology Data Exchange (ETDEWEB)

Grassi, Roberto; Romano, Stefania E-mail: stefromano@libero.it; Pinto, Antonio; Romano, Luigia

2004-04-01

Introduction: Gastro-duodenal perforations may be suspected in patients with history of ulceration, who present with acute pain and abdominal wall rigidity, but radiological findings in these cases may be unable to confirm a clinical diagnosis. The aim of our study was to report our experience in the diagnosis of gastro-duodenal perforation by conventional radiography, US and CT examinations. Material and methods: We retrospectively reviewed medical records of 166 consecutive patients who presented in the last 2 years to our institutions with symptoms of acute abdomen and submitted to surgery at the Emergency Unit of the ''A.Cardarelli'' Hospital of Naples with a surgical finding of perforated gastro-duodenal ulcer. The evidence of free intraperitoneal air on abdominal plain film was considered as a direct or suggestive finding of perforation. Evidence of intraperitoneal free fluid and/or reduced intestinal peristalsis at sonographic examination were considered indirect signs of gastro-duodenal perforation. Evidence of free peritoneal gas at CT was considered as a direct evidence of gastro-duodenal perforation. Results: Twenty patients underwent immediate surgery with no preoperative imaging evaluation, in 10 of them the site of perforation was found in a juxta-pyloric region and in the others at level of duodenum. In 146 patients submitted to serial radiological investigations before surgery, the site of perforation was in 56 (38.3%) duodenal, in 52 (35.6%) juxta-pyloric, in 28 (19.1%) gastric and in 10 (6.8%) pyloric. The cause of perforation was in all cases gastric or duodenal ulceration, in seven cases involving pancreatic parenchyma. In 110 (75.4%) patients with direct findings of perforation, in 94 cases (85.5%) the correct diagnosis was established on abdominal plain film, in two (1.8%) with radiographic and sonographic examinations and in 14 (12.7%) on CT findings. In 36 (24,6%) patients with no direct findings of perforation, only 24

Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage.

Science.gov (United States)

Wang, Yu-Chun; Hsieh, Chi-Hsun; Fu, Chih-Yuan; Yeh, Chun-Chieh; Wu, Shih-Chi; Chen, Ray-Jade

2012-05-01

With recent advances in radiologic diagnostic procedures, the use of diagnostic peritoneal lavage (DPL) has markedly declined. In this study, we reviewed data to reevaluate the role of DPL in the diagnosis of hollow organ perforation in patients with blunt abdominal trauma. Adult patients who had sustained blunt abdominal trauma and who were hemodynamically stable after initial resuscitation underwent an abdominal computed tomographic (CT) scan. Diagnostic peritoneal lavage was performed for patients who were indicated to receive nonoperative management and where hollow organ perforation could not be ruled out. During a 60-month period, 64 patients who had received abdominal CT scanning underwent DPL. Nineteen patients were diagnosed as having a positive DPL based on cell count ratio of 1 or higher. There were 4 patients who sustained small bowel perforation. The sensitivity and specificity of the cell count ratio for a hollow organ perforation in this study were 100% and 75%, respectively. No missed hollow organ perforations were detected. For patients with blunt abdominal trauma and hemoperitoneum who plan to receive nonoperative management, DPL is still a useful tool to exclude hollow organ perforation that is undetected by CT. Copyright © 2012 Elsevier Inc. All rights reserved.

Combined esophageal injury complicated by progression to a second perforation: a case report

Directory of Open Access Journals (Sweden)

Krieg Andreas

2009-09-01

Full Text Available Abstract Introduction Intramural dissection of the esophagus is a rare disorder characterized by a lesion between the submucosa and mucosa dividing the esophagus into a false and true lumen. The etiology of esophageal dissection remains uncertain but it affects predominantly women in their seventies and eighties. Symptoms may include uncharacteristic ones such as retrosternal pain, odynophagia or dysphagia. Conservative management is thought to be adequate and surgery should only be performed if complications such as abscess formation or perforation appear. Here we report the case and surgical management of a combined esophageal perforation and dissection. Case presentation We report the case of a combined esophageal perforation and dissection in a 45-year-old Caucasian woman with a history of relapsing periods of dysphagia since her childhood. The clinical course in this patient was complicated by progression to a second perforation, which made a definitive surgical management by esophagectomy necessary. Conclusion To the best of our knowledge, this is the first reported case of a combined esophageal perforation and dissection complicated by progression to a second perforation. This emphasizes that cautious and intensive observation is necessary in patients with esophageal dissection.

Oral antibiotics for perforated appendicitis is not recommended

DEFF Research Database (Denmark)

Alamili, Mahdi; Gögenur, Ismail; Rosenberg, Jacob

2010-01-01

In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this paper...... was to give an overview of studies on acute perforated appendicitis with postoperative oral antibiotics. Five studies were found in a database search covering the 1966-2009 period. There is no evidence to support a conversion of the postoperative antibiotic regimen from intravenous to oral administration...

Perforated Peptic Ulcer: new insights

NARCIS (Netherlands)

M.J.O.E. Bertleff (Marietta)

2011-01-01

textabstractMuch has been written on perforated peptic ulcer (PPU) during the last hundred years. In 1500, when necropsies were first allowed, often a small hole was found in the anterior wall of the stomach, giving an explanation for symptoms of acute abdominal pain, nausea, vomiting which often

Repair of an Endoscopic Retrograde Cholangiopancreatography-Related Large Duodenal Perforation Using Double Endoscopic Band Ligation and Endoclipping

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Keunmo Kim

2017-03-01

Full Text Available Endoscopic closure techniques have been introduced for the repair of duodenal wall perforations that occur during endoscopic retrograde cholangiopancreatography (ERCP. We report a case of successful repair of a large duodenal wall perforation by using double endoscopic band ligation (EBL and an endoclip. Lateral duodenal wall perforation occurred during ERCP in a 93-year-old woman with acute calculous cholangitis. We switched to a forward endoscope that had a transparent band apparatus. A 2.0-cm oval-shaped perforation was found at the lateral duodenal wall. We repaired the perforation by sequentially performing double EBL and endoclipping. The first EBL was performed at the proximal edge of the perforation orifice, and two-thirds of the perforation were repaired. The second EBL, which also included the contents covered under the first EBL, repaired the defect almost completely. Finally, to account for the possible presence of a residual perforation, an endoclip was applied at the distal end of the perforation. The detection and closure of the perforation were completed within 10 minutes. We suggest that double EBL is an effective method for closure.

Comparative research of finite element methods for perforated structures of nuclear power plant primary equipment

International Nuclear Information System (INIS)

Xiong Guangming; Deng Xiaoyun; Jin Ting

2013-01-01

Many perforated structures are used for nuclear power plant primary equipment, and they are complex, and have various forms. In order to explore the analysis and evaluation method, this paper used finite element method and equivalent analytic method to do the comparative analysis of perforated structures. The paper considered the main influence factors (including perforated forms, arrangements, and etc.), obtaining the systematic analysis methods of perforated structures. (authors)

The Effect of Perforation on the Dynamics of a Flexible Panel

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A. Putra

2014-01-01

Full Text Available Introduction of holes into plate-like structures is commonly found as one of the practical noise control measures to reduce sound radiation. However, perforation also reduces the panel stiffness and hence increases its vibration. The discussion on this effect is lacking and hence this paper discusses the dynamics of a perforated panel from the results obtained from Finite Element (FE model. Different hole geometries and arrangement are simulated to investigate their effect on the plate mobility. In general, it is found that increasing the perforation ratio increases the plate mobility. For a fixed perforation ratio, the mobility increases at high frequency (above 1 kHz for a smaller hole density in the plate. The plate with holes concentrated at the middle shows the largest increase of vibration around the plate centre compared to those uniformly distributed or away from the middle and concentrated at the plate edges. This is because as the hole separation becomes smaller, the reduction of the global stiffness around the mid area of the plate becomes greater. This also corresponds to the finding here that the mobility is greater at the vicinity of the hole. Different conditions of the plate edges are found to give consistent trend of the effect of perforation.

Vinorelbine induced perforation of a metastatic gastric lesion.

Science.gov (United States)

Mullally, W J; O'Súilleabháin, C B; Brady, C; O'Reilly, S

2017-08-01

Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637-641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review. A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler's sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma. Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071-1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91-92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761-1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma. This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted

The new generations of power components will depend on neutron and/or electron bombardment techniques

International Nuclear Information System (INIS)

Lilen, H.

1976-01-01

Neutron and electron bombardment techniques for materials doping, newly introduced in the fabrication of power semiconductor components: diodes, transistors, thyristors, and triacs are briefly outlined. A neutron bombardment of high purity silicon results in a short-lived 31 Si isotope (from 30 Si) decaying into 31 P. The phosphorus with its five peripheral electrons induces a negative doping (N), and the neutron technique gives a homogeneous doping. Furthermore, silicon bombardment with 1 to 2MeV electrons induces micro-ruptures in the lattice, that act as recombination traps reducing carrier lifetimes. Consequently, gold diffusion techniques can be replaced by electron bombardment with a gain in controlling carrier lifetimes [fr

Mesenchymal stem cell-laden hybrid scaffold for regenerating subacute tympanic membrane perforation

Energy Technology Data Exchange (ETDEWEB)

Jang, Chul Ho, E-mail: chulsavio@hanmail.net [Department of Otolaryngology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Ahn, SeungHyun [Department of Biomechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon (Korea, Republic of); Lee, Jae Whi; Lee, Byeong Ha [School of Information and Communications, Gwangju Institute of Science and Technology, Gwangju (Korea, Republic of); Lee, Hyeongjin [Department of Biomechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon (Korea, Republic of); Kim, GeunHyung, E-mail: gkimbme@skku.edu [Department of Biomechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon (Korea, Republic of)

2017-03-01

Tympanic membrane (TM) perforation is one of the most common otology complications. To date, there has not been reported TM regeneration using bioprinted scaffold. The purpose of this study was to evaluate the efficacy and feasibility of bioprinted polycaprolactone/collagen/alginate-mesenchymal stem cell (PCAMSC) scaffolds for the regeneration of subacute TM perforation. Sprague-Dawley rats were used in an animal model of subacute TM perforation. In the experimental group (n = 7), bioprinted 3D PCAMSC scaffold was placed on the perforation. The control group (n = 7) were treated with polycaprolactone/collagen/alginate (PCA) scaffold. Healing time, acoustic-mechanical properties, and morphological analysis were performed by otoendoscopy, auditory brainstem response (ABR), single-point laser doppler vibrometer (LDV), optical coherence tomography (OCT), and light microscopic evaluation. The closure of the TM perforation was achieved in 100% of the experimental group vs. 72% of the control group, and this difference was statistically significant (p < 0.05). The ABR threshold at all frequencies of the experimental group was recovered to the normal level compared to the control group. TM vibration velocity in the experimental group recovered similar to the normal control level. The difference are very small and they are not statistically significant below 1 kHz (p = 0.074). By OCT and light microscopic examination, regenerated TM of the experimental group showed thickened fibrous and mucosal layer. In contrast, the control group showed well regenerated but less thickened than experimental group. From these results, the cell-laden PCAMSC scaffold offers a significant advantage in the TM regeneration in a rat subacute TM perforation model. It may offer attractive opportunities in the conservative clinical treatment. - Highlights: • MSCs-laden scaffold was fabricated using a centrifugal spinning and cell-printing process. • The cell-laden scaffold showed the outstanding

Mesenchymal stem cell-laden hybrid scaffold for regenerating subacute tympanic membrane perforation

International Nuclear Information System (INIS)

Jang, Chul Ho; Ahn, SeungHyun; Lee, Jae Whi; Lee, Byeong Ha; Lee, Hyeongjin; Kim, GeunHyung

2017-01-01

Tympanic membrane (TM) perforation is one of the most common otology complications. To date, there has not been reported TM regeneration using bioprinted scaffold. The purpose of this study was to evaluate the efficacy and feasibility of bioprinted polycaprolactone/collagen/alginate-mesenchymal stem cell (PCAMSC) scaffolds for the regeneration of subacute TM perforation. Sprague-Dawley rats were used in an animal model of subacute TM perforation. In the experimental group (n = 7), bioprinted 3D PCAMSC scaffold was placed on the perforation. The control group (n = 7) were treated with polycaprolactone/collagen/alginate (PCA) scaffold. Healing time, acoustic-mechanical properties, and morphological analysis were performed by otoendoscopy, auditory brainstem response (ABR), single-point laser doppler vibrometer (LDV), optical coherence tomography (OCT), and light microscopic evaluation. The closure of the TM perforation was achieved in 100% of the experimental group vs. 72% of the control group, and this difference was statistically significant (p < 0.05). The ABR threshold at all frequencies of the experimental group was recovered to the normal level compared to the control group. TM vibration velocity in the experimental group recovered similar to the normal control level. The difference are very small and they are not statistically significant below 1 kHz (p = 0.074). By OCT and light microscopic examination, regenerated TM of the experimental group showed thickened fibrous and mucosal layer. In contrast, the control group showed well regenerated but less thickened than experimental group. From these results, the cell-laden PCAMSC scaffold offers a significant advantage in the TM regeneration in a rat subacute TM perforation model. It may offer attractive opportunities in the conservative clinical treatment. - Highlights: • MSCs-laden scaffold was fabricated using a centrifugal spinning and cell-printing process. • The cell-laden scaffold showed the outstanding

Numerical Simulations of Pillar Structured Solid State Thermal Neutron Detector Efficiency and Gamma Discrimination

Energy Technology Data Exchange (ETDEWEB)

Conway, A; Wang, T; Deo, N; Cheung, C; Nikolic, R

2008-06-24

This work reports numerical simulations of a novel three-dimensionally integrated, {sup 10}boron ({sup 10}B) and silicon p+, intrinsic, n+ (PIN) diode micropillar array for thermal neutron detection. The inter-digitated device structure has a high probability of interaction between the Si PIN pillars and the charged particles (alpha and {sup 7}Li) created from the neutron - {sup 10}B reaction. In this work, the effect of both the 3-D geometry (including pillar diameter, separation and height) and energy loss mechanisms are investigated via simulations to predict the neutron detection efficiency and gamma discrimination of this structure. The simulation results are demonstrated to compare well with the measurement results. This indicates that upon scaling the pillar height, a high efficiency thermal neutron detector is possible.

A compact spin-exchange optical pumping system for 3He polarization based on a solenoid coil, a VBG laser diode, and a cosine theta RF coil

Science.gov (United States)

Lee, Sungman; Kim, Jongyul; Moon, Myung Kook; Lee, Kye Hong; Lee, Seung Wook; Ino, Takashi; Skoy, Vadim R.; Lee, Manwoo; Kim, Guinyun

2013-02-01

For use as a neutron spin polarizer or analyzer in the neutron beam lines of the HANARO (High-flux Advanced Neutron Application ReactOr) nuclear research reactor, a 3He polarizer was designed based on both a compact solenoid coil and a VBG (volume Bragg grating) diode laser with a narrow spectral linewidth of 25 GHz. The nuclear magnetic resonance (NMR) signal was measured and analyzed using both a built-in cosine radio-frequency (RF) coil and a pick-up coil. Using a neutron transmission measurement, we estimated the polarization ratio of the 3He cell as 18% for an optical pumping time of 8 hours.

Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement

Directory of Open Access Journals (Sweden)

Hamid Shokoohi

2016-04-01

Full Text Available Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS, peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or “dirty” free fluid as well as evidence of free air, and may expedite patient management.

Acute abdominal compartment syndrome complicating a colonoscopic perforation: a case report

Directory of Open Access Journals (Sweden)

Souadka Amine

2012-02-01

Full Text Available Abstract Introduction A perforation occurring during colonoscopy is an extremely rare complication that may be difficult to diagnose. It can be responsible for acute abdominal compartment syndrome, a potentially lethal complex pathological state in which an acute increase in intra-abdominal pressure may provoke the failure of several organ systems. Case presentation We report a case of acute abdominal compartment syndrome after perforation of the bowel during a colonoscopy in a 60-year-old North African man with rectal cancer, resulting in respiratory distress, cyanosis and cardiac arrest. Our patient was treated by needle decompression after the failure of cardiopulmonary resuscitation. An emergency laparotomy with anterior resection, including the perforated sigmoid colon, was then performed followed by immediate anastomosis. Our patient remains alive and free of disease three years later. Conclusion Acute abdominal compartment syndrome is a rare disease that may occasionally occur after a colonoscopic perforation. It should be kept in mind during colonoscopy, especially considering its simple salvage treatment.

Triggering Mechanism for Neutron Induced Single-Event Burnout in Power Devices

Science.gov (United States)

Shoji, Tomoyuki; Nishida, Shuichi; Hamada, Kimimori

2013-04-01

Cosmic ray neutrons can trigger catastrophic failures in power devices. It has been reported that parasitic transistor action causes single-event burnout (SEB) in power metal-oxide-semiconductor field-effect transistors (MOSFETs) and insulated gate bipolar transistors (IGBTs). However, power diodes do not have an inherent parasitic transistor. In this paper, we describe the mechanism triggering SEB in power diodes for the first time using transient device simulation. Initially, generated electron-hole pairs created by incident recoil ions generate transient current, which increases the electron density in the vicinity of the n-/n+ boundary. The space charge effect of the carriers leads to an increase in the strength of the electric field at the n-/n+ boundary. Finally, the onset of impact ionization at the n-/n+ boundary can trigger SEB. Furthermore, this failure is closely related to diode secondary breakdown. It was clarified that the impact ionization at the n-/n+ boundary is a key point of the mechanism triggering SEB in power devices.

Characteristics of GaAs MESFET inverters exposed to high energy neutrons

International Nuclear Information System (INIS)

Bloss, W.L.; Yamada, W.E.; Young, A.M.; Janousek, B.K.

1988-01-01

GaAs MESFET circuits have been exposed to high energy neutrons with fluences ranging from 1x10/sup 14/ n/cm/sup 2/ to 2x10/sup 15/ m/cm/sup 2/. Discrete transistors, inverters, and ring oscillators were characterized at each fluence. While the MESFETs exhibit significant threshold voltage shifts and transconductance and saturation current degradation over this range of neutron fluences, the authors have observed improvement in the DC characteristics of Schottky Diode FET Logic (SDFL) inverters. This unusual result has been successfully simulated using device parameters extracted from FETs damaged by exposure to high energy neutrons. Although the decrease in device transconductance results in an increase in inverter gate delay, as reflected in ring oscillator frequency measurements, the authors conclude that GaAs ICs fabricated from this logic family will remain functional after exposure to extreme neutron fluences. This is a consequence of the observed improvement in inverter noise margin evident in both measured and simulated circuit performance

Improved productivity justifies world record underbalanced perforating operation

Energy Technology Data Exchange (ETDEWEB)

Johnson, A. M.; Bakker, E. R. [NAM B.V. (Netherlands); Hungerford, K.

1998-12-31

To achieve vertical connectivity with all the layers, and thus long term sustained productivity in a highly stratified reservoir, a one run underbalanced perforating operation was considered necessary. Due to coiled tube limitations in this deep (5136 m along hole, 3700 m true vertical depth, with a maximum deviation of 89 degrees), high pressure well a hydraulic workover unit (HWU) was selected to deploy and retrieve the guns. The operation is considered a world record since this is the longest section (total gross interval of 1026 m perforated) of guns conveyed, fired underbalanced and deployed out of a live well. It is concluded that the improved productivity more than justified the additional time, effort and expenditure; considering the full life cycle of the well it is readily apparent that the operation was an economic and technical success. Details of the considerations leading to the perforating technique selection, the planning and the execution of the operation, and the validation of the technique in terms of productivity gains, are provided. 13 refs., 7 figs.

Subacute right ventricle perforation by pacemaker lead presenting with left hemothorax and shock.

Science.gov (United States)

Nichols, Julianne; Berger, Natalie; Joseph, Praveen; Datta, Debapriya

2015-01-01

Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT) of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

Coaxial foilless diode

Energy Technology Data Exchange (ETDEWEB)

Kong, Long; Liu, QingXiang; Li, XiangQiang; Wang, ShaoMeng [College of Physical Science and Technology, Southwest Jiaotong University, Chengdu 610031 (China)

2014-05-15

A kind of coaxial foilless diode is proposed in this paper, with the structure model and operating principle of the diode are given. The current-voltage relation of the coaxial foilless diode and the effects of structure parameters on the relation are studied by simulation. By solving the electron motion equation, the beam deviation characteristic in the presence of external magnetic field in transmission process is analyzed, and the relationship between transverse misalignment with diode parameters is obtained. These results should be of interest to the area of generation and propagation of radial beam for application of generating high power microwaves.

Percutaneous Emergency Needle Caecostomy for Prevention of Caecal Perforation

OpenAIRE

Limmer, Alexandra M.; Clement, Zackariah

2017-01-01

Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was ...

Evaluation of risk factors for mortality in perforated peptic ulcer in ...

African Journals Online (AJOL)

Objective: To assess the risk factor that influence mortality from perforated peptic ulcer. Design: Retrospective study. Setting: Ankara Numune Teaching and Research Hospital, Ankara, Turkey. Subjects: A total of 342 patients with perforated peptic ulcer disease were identified from April 1997 to January 2004. Data for the ...

Premixed Combustion of Kapok (ceiba pentandra seed oil on Perforated Burner

Directory of Open Access Journals (Sweden)

I.K.G. Wirawan

2014-05-01

Full Text Available Availability of fossil fuels in the world decrease gradually due to excessive fuel exploitation. This situations push researcher to look for alternative fuels as a source of renewable energy, one of them is kapok (ceiba pentandra seed oil. The aim this study was to know the behavior of laminar burning velocity, secondary Bunsen flame with open tip, cellular and triple flame. Premixed combustion of kapok seed oil was studied experimentally on perforated burner with equivalence ratio (φ varied from 0.30 until 1.07. The results showed that combustion of glycerol requires a large amount of air so that laminar burning velocity (SL is the highest at very lean mixture (φ =0.36 in the form of individual Bunsen flame on each of the perforated plate hole.  Perforated and secondary Bunsen flame both reached maximum SL similar with that of ethanol and higher than that of hexadecane. Slight increase of φ decreases drastically SL of perforated and secondary Bunsen flame. When the mixture was enriched, secondary Bunsen and perforated flame disappears, and then the flame becomes Bunsen flame with open tip and triple flame (φ = 0.62 to 1.07. Flame was getting stable until the mixture above the stoichiometry. Being isolated from ambient air, the SL of perforated flame, as well as secondary Bunsen flame, becomes equal with non-isolated flame. This shows the decreasing trend of laminar burning velocity while φ is increasing. When the mixture was enriched island (φ = 0.44 to 0.48 and petal (φ = 0.53 to 0.62 cellular flame take place. Flame becomes more unstable when the mixture was changed toward stoichiometry.

The ectopic appendicolith from perforated appendicitis as a cause of tubo-ovarian abscess

International Nuclear Information System (INIS)

Vyas, Rajashree C.; Sides, Corey; Klein, Deborah J.; Reddy, Sireesha Y.; Santos, Mary C.

2008-01-01

Acute appendicitis is a common surgical cause of abdominal pain in the pediatric population. History and physical examination are atypical in up to a third of patients. Known potential complications of untreated or delayed management of acute appendicitis include appendiceal perforation, periappendiceal abscess formation, peritonitis, bowel obstruction and rarely septic thrombosis of mesenteric vessels. We report an unusual complication of perforated appendicitis. A tubo-ovarian abscess developed secondary to appendicolith migration into the right fallopian tube in a patient who had undergone interval laparoscopic appendectomy for perforated appendicitis. The retained appendicolith was visualized within the obstructed and dilated fallopian tube on contrast-enhanced CT. We discuss the CT imaging features of this unusual complication of perforated appendicitis. (orig.)

The ectopic appendicolith from perforated appendicitis as a cause of tubo-ovarian abscess

Energy Technology Data Exchange (ETDEWEB)

Vyas, Rajashree C.; Sides, Corey; Klein, Deborah J. [University of Rochester Medical Center, Rochester, NY (United States); Reddy, Sireesha Y. [University of Rochester, Obstetrics and Gynecology, Rochester, NY (United States); Santos, Mary C. [University of Rochester, Pediatric Surgery, Rochester, NY (United States)

2008-09-15

Acute appendicitis is a common surgical cause of abdominal pain in the pediatric population. History and physical examination are atypical in up to a third of patients. Known potential complications of untreated or delayed management of acute appendicitis include appendiceal perforation, periappendiceal abscess formation, peritonitis, bowel obstruction and rarely septic thrombosis of mesenteric vessels. We report an unusual complication of perforated appendicitis. A tubo-ovarian abscess developed secondary to appendicolith migration into the right fallopian tube in a patient who had undergone interval laparoscopic appendectomy for perforated appendicitis. The retained appendicolith was visualized within the obstructed and dilated fallopian tube on contrast-enhanced CT. We discuss the CT imaging features of this unusual complication of perforated appendicitis. (orig.)

Intestinal volvulus and perforation caused by multiple magnet ingestion: report of a case.

Science.gov (United States)

Ilçe, Zekeriya; Samsum, Hakan; Mammadov, Emil; Celayir, Sinan

2007-01-01

Ingested magnets can cause intestinal fistulas, perforation, and obstruction. There have been reports of magnet ingestion causing intestinal volvulus, but multiple magnet ingestion causing perforation and intestinal volvulus in a child is very unusual. We report the case of a 4-year-old girl, who ingested four magnets she acquired as toys, which caused intestinal volvulus and perforation as a result of pressure necrosis, several days after ingestion. At surgery we repaired two perforations, but additional bowel resection was not required. The patient was discharged on postoperative day 10. If multiple magnet ingestion is suspected in a child, the child must be monitored carefully. If there are signs of obstruction, emergency surgery is mandatory.

Conservative treatment of perforated upper gastrointestinal tract

International Nuclear Information System (INIS)

Naoi, Daishi; Sano, Wataru; Nakata, Yasuyuki; Yano, Kentaro; Suzuki, Takeshi; Chiku, Tsuyoshi; Tashiro, Tsuguhiko

2009-01-01

In order to clarify the validity of indication criteria of the conservative treatment for perforated upper gastrointestinal tract, a retrospective study was carried out. We enrolled 28 patients with perforation of the gastrointestinal tract who were determined to receive conservative treatment at the time of hospitalization from January 2000 to December 2007. When the following criteria were satisfied, we treated the patients by the conservative treatment after informed consent was gained from them and their families: stable condition of vital signs; peritoneal signs localized in the upper abdomen; and no or slight fluid collection at the Douglas' pouch determined by computed tomography. Patients who showed changes for the worse of peritonitis or increased fluid collection during follow-up were promptly converted to surgery. Six patients were converted to surgery, but all of them were discharged very much improved. We compared patient's data of the conservative treatment group and the converted surgery group at the time of consultation. All data were not statistically different between two groups. If all criteria are satisfied, it seemed that we can start conservative treatment for perforated gastrointestinal tract with careful observation and the system of prompt conversion to operation for patients who showed changes for the worse of peritonitis or increased fluid collection. (author)

Colorectal cancer complicated by perforation. Specific features of surgical tactics

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S. N. Shchaeva

2015-01-01

Full Text Available Objective: to assess the immediate results of surgical interventions for colorectal cancer complicated by perforation.Materials and methods. The immediate results of surgical treatment were retrospectively analyzed in 56 patients with colorectal cancer complicated by perforated colon cancer, who had been treated at Smolensk surgical hospitals in 2001 to 2013. Patients with diastatic perforation of the colon in the presence of decompensated obturation intestinal obstruction of tumor genesis were not included into this investigation.Results. The immediate results of uni- and multistage surgical interventions were analyzed in relation to the extent of peritonitis and the stage of colon cancer. More satisfactory immediate results were observed after multistage surgical treatment. Following these interventions, a fatal outcome of disseminated peritonitis in the presence of performed colorectal cancer was recorded in 8 (53.3 % cases whereas after symptomatic surgery there were 11 (67.8 % deaths. A fatal outcome was noted in 1 case (7.7 % after multistage surgery.Discussion. The results of surgical treatment in the patients with perforated colorectal cancer are directly related to the degree of peritonitis and the choice of surgical tactics.

COMPARATIVE ANALYSIS OF PRIMARY REPAIR VERSUS RESECTION AND ANASTOMOSIS IN JEJUNOILEAL PERFORATIONS IN SOUTHERN ODISHA

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Charan Panda

2017-11-01

Full Text Available BACKGROUND Small intestinal perforation remains a major issue in this region of study. Most often, it is caused by either infections due to typhoid, tuberculosis or traumatic due to blunt or penetrating injuries. The mortality reported is related to various factors including age, delayed treatment, sepsis at presentation and inadequate treatment due to lack of resources. Management is therefore complex not only with regards to choose the most suitable surgical treatment, but also as regards an early diagnosis of complications, which is difficult in absence of diagnostic modalities that are often not available. The aim of the study is to compare primary repair versus intestinal resection and anastomosis in case of jejunoileal perforations due to various aetiologies. MATERIALS AND METHODS 60 patients with acute peritonitis underwent emergency laparotomy. Aetiology, number of perforations, size of perforations, site of perforations, surgical procedure undertaken and postoperative complications were recorded. The patients were divided into two groups according to the surgical procedure adapted at laparotomy; primary repair and intestinal resection and anastomosis. Clinical data, intraoperative findings and complications were evaluated and compared. RESULTS 40 out of 60, we found jejunoileal perforations, gastroduodenal in 20 patients. 23 had undergone primary repair and 17 resection and anastomosis. Postoperative complications were compared among both groups in relation to various factors. Conclusion was drawn as to prefer, which surgery in which group of patients. CONCLUSION In our study, detailed analysis of the complication pattern shows primary closure is associated with less number of complications in traumatic cases and resection and anastomosis is associated with lesser complications in infective cases. Primary closure is less complicated for single perforations as compared to multiple perforations. Resection and anastomosis is less

Iatrogenic stomach perforation complicating unrecognized ...

African Journals Online (AJOL)

We report a case of 21-year-old male patient with traumatic diaphragmatic herniation of the stomach that is misdiagnosed as a hemo-pneumothorax with the resulting insertion of a chest tube causing iatrogenic perforation of the stomach and draining of gastric content into the pleural cavity. An emergency thoracotomy was ...

Augmented reality and dynamic infrared thermography for perforator mapping in the anterolateral thigh.

Science.gov (United States)

Cifuentes, Ignacio Javier; Dagnino, Bruno Leonardo; Salisbury, María Carolina; Perez, María Eliana; Ortega, Claudia; Maldonado, Daniela

2018-05-01

Dynamic infrared thermography (DIRT) has been used for the preoperative mapping of cutaneous perforators. This technique has shown a positive correlation with intraoperative findings. Our aim was to evaluate the accuracy of perforator mapping with DIRT and augmented reality using a portable projector. For this purpose, three volunteers had both of their anterolateral thighs assessed for the presence and location of cutaneous perforators using DIRT. The obtained image of these "hotspots" was projected back onto the thigh and the presence of Doppler signals within a 10-cm diameter from the midpoint between the lateral patella and the anterior superior iliac spine was assessed using a handheld Doppler device. Hotspots were identified in all six anterolateral thighs and were successfully projected onto the skin. The median number of perforators identified within the area of interest was 5 (range, 3-8) and the median time needed to identify them was 3.5 minutes (range, 3.3-4.0 minutes). Every hotspot was correlated to a Doppler sound signal. In conclusion, augmented reality can be a reliable method for transferring the location of perforators identified by DIRT onto the thigh, facilitating its assessment and yielding a reliable map of potential perforators for flap raising.

Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction

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Carolyn L. Mulvey, BS

2013-05-01

Conclusions: Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders, perforator number, and flap weight may optimize outcomes.

A shovel with a perforated blade reduces energy expenditure required for digging wet clay.

Science.gov (United States)

Harivanam, Sridhar; Marklin, Richard W; Papanek, Paula E; Cariapa, Vikram

2010-08-01

A shovel with a blade perforated with small holes was tested to see whether a worker would use less whole-body energy to dig wet clay than with a shovel with an opaque blade. A perforated shovel is hypothesized to require less whole-body energy on the basis of adhesion theory; a smaller surface area would require less physical effort to dig and release soil from the blade. The study involved 13 workers from an electric utility who dug wet clay with two 1.5-m long-handled point shovels, which differed only in blade design (perforated and opaque). Oxygen consumption was measured with a portable system while each worker dug wet clay at a self-regulated pace for 10 min. There was no significant difference in number of scoops dug during the 10-min sessions, but workers dug 9.5% more weight of clay with the perforated shovel than with the conventional shovel (404 kg vs. 369 kg, respectively). Furthermore, stable oxygen uptake normalized to weight of participant and to the weight of clay dug revealed that participants expended 11.7% less relative energy per kilogram of clay dug with the perforated shovel. A point shovel with a perforated blade is recommended for digging and shoveling wet clay. However, the extra weight that workers chose to dig with the perforated shovel may increase the loading on the spine and may offset the metabolic advantages. Manual shoveling is a common task, and workers may experience less whole-body and muscle fatigue when using a perforated shovel.

Colorectal cancer with intestinal perforation – a retrospective analysis of treatment outcomes

Science.gov (United States)

Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

2014-01-01

Aim of the study Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. Material and methods A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Results Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). Conclusions In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates. PMID:25784840

A theoretical model describing arterial flow in the DIEP flap related to number and size of perforator vessels.

Science.gov (United States)

Patel, Sameer A; Keller, Alex

2008-11-01

The deep inferior epigastric perforator flap is rapidly becoming a more widely employed method of autologous breast reconstruction. The technical considerations involved in the execution of the flap are many and include the selection of perforators to be incorporated in the flap. We attempt to give a mathematical explanation, based on the physics of flow through vessels and the properties of circuits with multiple resistances in parallel, for the clinical observations which have been arrived at through clinical experience. We compare the system of perforators to a circuit with multiple resistances in parallel. Each of these resistances represents a perforator vessel. In the event that there is only one perforator vessel, this simplifies to a single resistance in series with the capillary bed perfusing the flap. The flow through the flap is optimized by incorporation of the largest diameter perforator. Inclusion of other smaller perforators in addition to the largest diameter perforator will reduce the overall resistance, but this reduction in resistance is dependent on the diameter of the additional perforator and may not be worth the additional trauma of dissection and increased operative time. Incorporating several smaller perforators at the expense of excluding the largest diameter perforator appears to increase the overall resistance, unless the smaller perforators are only slightly smaller. We conclude that the best perfused flap involves use of the largest diameter vessel, that although adding additional perforators will decrease the resistance and increase flow, the magnitude of the benefit depends largely on the calibre of the additional perforator, and that this benefit needs to be weighed against the downside of increased muscle and facial trauma.

Charge collection and space charge distribution in neutron-irradiated epitaxial silicon detectors

Energy Technology Data Exchange (ETDEWEB)

Poehlsen, Thomas

2010-04-15

In this work epitaxial n-type silicon diodes with a thickness of 100 {mu}m and 150 {mu}m are investigated. After neutron irradiation with fluences between 10{sup 14} cm{sup -2} and 4 x 10{sup 15} cm{sup -2} annealing studies were performed. CV-IV curves were taken and the depletion voltage was determined for different annealing times. All investigated diodes with neutron fluences greater than 2 x 10{sup 14} cm{sup -2} showed type inversion due to irradiation. Measurements with the transient current technique (TCT) using a pulsed laser were performed to investigate charge collection effects for temperatures of -40 C, -10 C and 20 C. The charge correction method was used to determine the effective trapping time {tau}{sub eff}. Inconsistencies of the results could be explained by assuming field dependent trapping times. A simulation of charge collection could be used to determine the field dependent trapping time {tau}{sub eff}(E) and the space charge distribution in the detector bulk. Assuming a linear field dependence of the trapping times and a linear space charge distribution the data could be described. Indications of charge multiplication were seen in the irradiated 100 {mu}m thick diodes for all investigated fluences at voltages above 800 V. The space charge distribution extracted from TCT measurements was compared to the results of the CV measurements and showed good agreement. (orig.)

Perforation of dental gloves during prosthodontic treatments as assessed by the conductivity and water inflation tests.

Science.gov (United States)

Nikawa, H; Hamada, T; Tamamoto, M; Abekura, H; Murata, H

1996-01-01

The incidence of latex glove perforation during prosthodontic treatment was investigated on 122 occasions using two methods, a conductivity test and a water inflation test. Latex glove perforation was detected in 38.5% of the treatments by the conductivity test and in 27.9% by the water inflation test. The perforation went unrecognized in 74.7% of the occurrences (35/47 incidents) using the conductivity test and in 64.7% (22/34) when the water inflation test was used. Of the total 55 glove perforations, 21 perforations were detected only by conductivity test, 3 were detected only by the water inflation test, and 31 perforations were detected by both methods, which suggested that the conductivity test is more sensitive than the water inflation test for the detection of glove perforation. The results of this research suggested that even when latex gloves are worn, the risk to prosthodontists of exposure to body fluids remains in four of every six treatments, often without the awareness of the prosthodontist.

Neonatal gastric perforation: a report of 3 cases and literature review ...

African Journals Online (AJOL)

Neonatal gastric perforation (NGP) is an uncommon disease. Historical reports regard the aetiology as spontaneous while the mortality remains high. We present the report of the cases of neonatal gastric perforations who presented to our facility, its diverse aetiology and a review of the literature. Their clinical data including ...

Persistent perforation in non-faeculant diverticular peritonitis--incidence and clinical significance.

LENUS (Irish Health Repository)

O'Leary, D P

2013-02-01

Non-resectional strategies (NRS) have improved outcomes for a sub-group of patients with perforated diverticulitis. NRS are applicable to patients with non-faeculant peritonitis (Hinchey II and III). Success is dependent on the initial perforation sealing, which Hinchey estimated occurred \\'most of the time\\'. An exact percentage remains ill-defined.

Micro direct methanol fuel cell with perforated silicon-plate integrated ionomer membrane

DEFF Research Database (Denmark)

Larsen, Jackie Vincent; Dalslet, Bjarke Thomas; Johansson, Anne-Charlotte Elisabeth Birgitta

2014-01-01

This article describes the fabrication and characterization of a silicon based micro direct methanol fuel cell using a Nafion ionomer membrane integrated into a perforated silicon plate. The focus of this work is to provide a platform for micro- and nanostructuring of a combined current collector...... at a perforation ratio of 40.3%. The presented fuel cells also show a high volumetric peak power density of 2 mW cm−3 in light of the small system volume of 480 μL, while being fully self contained and passively feed....... and catalytic electrode. AC impedance spectroscopy is utilized alongside IV characterization to determine the influence of the plate perforation geometries on the cell performance. It is found that higher ratios of perforation increases peak power density, with the highest achieved being 2.5 mW cm−2...

Properties of a radiation-induced charge multiplication region in epitaxial silicon diodes

CERN Document Server

Lange, Jörn; Fretwurst, Eckhart; Klanner, Robert; Lindström, Gunnar

2010-01-01

Charge multiplication (CM) in p$^+$n epitaxial silicon pad diodes of 75, 100 and 150 $\\upmu$m thickness at high voltages after proton irradiation with 1 MeV neutron equivalent fluences in the order of $10^{16}$ cm$^{-2}$ was studied as an option to overcome the strong trapping of charge carriers in the innermost tracking region of future Super-LHC detectors. Charge collection efficiency (CCE) measurements using the Transient Current Technique (TCT) with radiation of different penetration (670, 830, 1060 nm laser light and $\\alpha$-particles with optional absorbers) were used to locate the CM region close to the p$^+$-implantation. The dependence of CM on material, thickness of the epitaxial layer, annealing and temperature was studied. The collected charge in the CM regime was found to be proportional to the deposited charge, uniform over the diode area and stable over a period of several days. Randomly occurring micro discharges at high voltages turned out to be the largest challenge for operation of the dio...

Comparison of differently viscous iodinated and bariumcontaining contrast agents in the detection of pharyngeal perforation

International Nuclear Information System (INIS)

Keberle, M.; Wittenberg, G.; Trusen, A.; Hahn, D.; Baumgartner, W.

2001-01-01

Purpose: In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Methods: Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. Results: In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous that the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Conclusions: Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose. (orig.) [de

Directional bending wave propagation in periodically perforated plates

DEFF Research Database (Denmark)

Andreassen, Erik; Manktelow, Kevin; Ruzzene, Massimo

2015-01-01

We report on the investigation of wave propagation in a periodically perforated plate. A unit cell with double-C perforations is selected as a test article suitable to investigate two-dimensional dispersion characteristics, group velocities, and internal resonances. A numerical model, formulated...... using Mindlin plate elements, is developed to predict relevant wave characteristics such as dispersion, and group velocity variation as a function of frequency and direction of propagation. Experimental tests are conducted through a scanning laser vibrometer, which provides full wave field information...... for the design of phononic waveguides with directional and internal resonant characteristics....

Perforated ileal duplication cyst with haemorrhagic pseudocyst formation

International Nuclear Information System (INIS)

Hwang, Im Kyung; Kim, Bong Soo; Kim, Heung Chul; Lee, In Sun; Hwang, Woo Chul; Namkung, Sook

2003-01-01

Duplication cysts of the gastrointestinal tract are rare congenital abnormalities. Ectopic gastric mucosa, which can be found in duplications, may cause peptic ulceration, gastrointestinal bleeding or perforation. We report a 1-year-old boy with a perforated ileal duplication cyst with haemorrhagic pseudocyst formation caused by peptic ulceration of the duplication cyst. It presented a snowman-like appearance consisting of a small, thick-walled, true enteric cyst and a large, thin-walled haemorrhagic pseudocyst on US and CT. It is an unusual manifestation of a duplication cyst, which has not been reported in the English language literature. (orig.)

Non-invasive vascular imaging in perforator flap surgery

International Nuclear Information System (INIS)

Saba, Luca; Piga, Mario; Atzeni, Matteo; Ribuffo, Diego; Rozen, Warren Matthew; Alonso-Burgos, Alberto; Bura, Raffaella

2013-01-01

Preoperative imaging using a range of imaging modalities has become increasingly popular for preoperative planning in plastic surgery, in particular in perforator flap surgery. Modalities in this role include ultrasound (US), magnetic resonance angiography (MRA), and computed tomographic angiography (CTA). The evidence for the use of these techniques has been reported in only a handful of studies. In this paper we conducted a non-systematic review of the literature to establish the role for each of these modalities. The role of state-of-the-art vascular imaging as an application in perforator flap surgery is thus offered

Pneumatosis cystoides intestinalis associated with massive free air mimicking perforated diffuse peritonitis.

Science.gov (United States)

Sakurai, Yoichi; Hikichi, Masahiro; Isogaki, Jun; Furuta, Shinpei; Sunagawa, Risaburo; Inaba, Kazuki; Komori, Yoshiyuki; Uyama, Ichiro

2008-11-21

While pneumatosis cystoides intestinalis (PCI) is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.

Mucosal Perforation During Laparoscopic Heller Myotomy Has No Influence on Final Treatment Outcome.

Science.gov (United States)

Salvador, Renato; Spadotto, Lorenzo; Capovilla, Giovanni; Voltarel, Guerrino; Pesenti, Elisa; Longo, Cristina; Cavallin, Francesco; Nicoletti, Loredana; Ruol, Alberto; Valmasoni, Michele; Merigliano, Stefano; Costantini, Mario

2016-12-01

The aims of the study were (a) to examine the final outcome in patients experiencing accidental mucosal perforation during laparoscopic Heller myotomy with Dor fundoplication (LHD) and (b) to evaluate whether perforation episodes might influence the way in which surgeons subsequently approached the LHD procedure. We studied all consecutive patients that underwent LHD between 1992 and 2015. Patients were divided into two main groups: those who experienced an intraoperative mucosal perforation (group P) and those whose LHD was uneventful (group NP). Two additional groups were compared: group A, which consisted of patients operated by a given surgeon immediately before a perforation episode occurred, and group B, which included those operated immediately afterwards. Eight hundred seventy-five patients underwent LHD; a mucosal perforation was detected in 25 patients (2.9 %), which was found unrelated to patients' symptom's score and age, radiological stage, manometric pattern, or the surgeon's experience. The median postoperative symptom score was similar for the two groups as the failure rate: 92 failures in group NP (10.8 %) and 4 in group P (16 %) (p = 0.34); moreover, symptoms recurred in 2 patients of group A (10 %) and 3 patients of group B (15 %) (p = 0.9). Accidental perforation during LHD is infrequent and impossible to predict on the grounds of preoperative therapy or the surgeon's personal experience. Despite a longer surgical procedure and hospital stay, the outcome of LHD is much the same as for patients undergoing uneventful myotomy. A recent mucosal perforation does not influence the surgeon's subsequent performance.

Traumatic tympanic membrane perforations: characteristics and ...

African Journals Online (AJOL)

Objective: To characterize traumatic tympanic membrane perforation (TTMP) in terms of distribution, mechanisms, and outcome of treatment. To assess the factors influencing such outcome. Study design: Prospective analytical study, assessing outcomes post-injuries. Setting: Clinical department of a tertiary referral hospital.

Coaxial foilless diode

Directory of Open Access Journals (Sweden)

Long Kong

2014-05-01

Full Text Available A kind of coaxial foilless diode is proposed in this paper, with the structure model and operating principle of the diode are given. The current-voltage relation of the coaxial foilless diode and the effects of structure parameters on the relation are studied by simulation. By solving the electron motion equation, the beam deviation characteristic in the presence of external magnetic field in transmission process is analyzed, and the relationship between transverse misalignment with diode parameters is obtained. These results should be of interest to the area of generation and propagation of radial beam for application of generating high power microwaves.

Conservative Management of an Epicardial Collateral Perforation During Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention.

Science.gov (United States)

Ngo, Christian; Christopoulos, George; Brilakis, Emmanouil S

2016-01-01

Coronary artery perforation is a highly feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can lead to pericardial effusion, tamponade, and, rarely, emergent cardiac surgery. Perforation of epicardial collaterals during retrograde CTO-PCI may be particularly challenging to treat, as embolization from both sides of the perforation may be required to control the bleeding. However, conservative measures can occasionally be effective. We present a case of epicardial collateral vessel perforation that was managed conservatively with anticoagulation reversal.

Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate

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Antoinette S. Birs

2016-01-01

Full Text Available Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates.

A CLINICAL STUDY TO ANALYSE THE SPECTRUM OF PERITONITIS DUE TO HOLLOW VISCUS PERFORATION

Directory of Open Access Journals (Sweden)

Sai Datta

2015-07-01

Full Text Available Perforation peritonitis is the one of the common abdominal surgical emergency . The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered at K aturi M edical C ollege and H ospital , G untur. A.P. Hundred consec utive cases of perforation peritonitis over a period of 26 months . (June 2010 - July 2012 were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively. The most common type of perforation in our series was per forated duodenal ulcer (56 cases followed by Appendicular (16 cases, Ileal (12 cases, Colonic ( 6 cases, Gastric ( 4 cases, Jejunal (2 cases, Gall bladder (2 cases, Anastomotic ulcer ( 2 cases were reported . Despite delay in seeking medical treatment (32%, the overall mortality (11% , favorably comparable with other published series though the overall morbidity (29% was favorable. In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tr act perforations constitute the majority of cases in India. Mostly males and elderly people are affected due to injudicious usage of NSAIDS, alcohol, smoking. ( 11 Withdrawal from these habits and using of proton pump inhibitors and H - Pylori eradication which warrant early recognition and prompt treatment to avoid serious complications and death.

Investigation of incidence and risk factors for surgical glove perforation in small animal surgery.

Science.gov (United States)

Hayes, Galina M; Reynolds, Deborah; Moens, Noel M M; Singh, Ameet; Oblak, Michelle; Gibson, Thomas W G; Brisson, Brigitte A; Nazarali, Alim; Dewey, Cate

2014-05-01

To identify incidence and risk factors for surgical glove perforation in small animal surgery. Observational cohort study. Surgical gloves (n = 2132) worn in 363 surgical procedures. All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. There is a high incidence of unrecognized glove perforations in small animal surgery. © Copyright 2014 by The American College of Veterinary Surgeons.

Risk factors in patients surgically treated for peptic ulcer perforation

DEFF Research Database (Denmark)

Møller, Morten Hylander; Shah, Kamran; Bendix, Jørgen

2009-01-01

OBJECTIVE: The overall mortality for patients undergoing surgery for perforated peptic ulcer has increased despite improvements in perioperative monitoring and treatment. The objective of this study was to identify and describe perioperative risk factors in order to identify ways of optimizing...... the treatment and to improve the outcome of patients with perforated peptic ulcer. MATERIAL AND METHODS: Three hundred and ninety-eight patients undergoing emergency surgery in four university hospitals in Denmark were included in the study. Information regarding the pre-, intra- and postoperative phases were...... insufficiency upon admission and insufficient postoperative nutrition have been added to the list of independent risk factors for death within 30 days of surgery in patients with peptic ulcer perforation. Finding that shock upon admission, reduced albumin blood levels upon admission, renal insufficiency upon...

Project of the borehole neutron generator for the direct determination of oxygen and carbon by activation method

Science.gov (United States)

Bogdanovich, B. Yu; Vovchenko, E. D.; Iliinskiy, A. V.; Isaev, A. A.; Kozlovskiy, K. I.; Nesterovich, A. V.; Senyukov, V. A.; Shikanov, A. E.

2016-09-01

The paper deals with application features of borehole neutron generator (BNG) based on the vacuum accelerating tube (AT) with laser-plasma ion source for determination of oxygen isotope 16O and carbon isotope 12C by direct activation. The project of pulsed BNG for realization of an activation method in the conditions of natural presence of productive hydrocarbons is offered. The diode system with radial acceleration, magnetic electron insulation and laser-plasma source of deuterons at the anode in a sealed-off vacuum accelerating tube is applied. The permanent NdFeB magnet with induction about 0.5 T for produce the insulating magnetic field in the diode gap is proposed. In the experiments on the model of BNG with the accelerating voltage source (≈350 kV), performed by the scheme of Arkadiev-Marx generator, the output of (d, d) neutrons was ∼107 pulse-1.

Clinical features and outcomes of delayed perforation after endoscopic submucosal dissection for early gastric cancer.

Science.gov (United States)

Hanaoka, N; Uedo, N; Ishihara, R; Higashino, K; Takeuchi, Y; Inoue, T; Chatani, R; Hanafusa, M; Tsujii, Y; Kanzaki, H; Kawada, N; Iishi, H; Tatsuta, M; Tomita, Y; Miyashiro, I; Yano, M

2010-12-01

Perforation is a major complication of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). However, there have been no reports on delayed perforation after ESD for EGC. We aimed to elucidate the incidence and outcomes of delayed perforation after ESD. Clinical courses in 1159 consecutive patients with 1329 EGCs who underwent ESD were investigated. Delayed perforation occurred in six patients (0.45 %). All these patients had complete en bloc resection without intraoperative perforation during ESD. Five of six perforations were located in the upper third of the stomach, while one lesion was found in the middle third. Symptoms of peritoneal irritation with rebound tenderness presented within 24 h after ESD in all cases. One patient did not require surgery because the symptoms were localized, and recovered with conservative antibiotic therapy by nasogastric tube placement. The remaining five patients required emergency surgery. There was no mortality in this case series. © Georg Thieme Verlag KG Stuttgart · New York.

Spontaneous acalculous gallbladder perforation in a man secondary to chemotherapy and radiation: A rare case report.

Science.gov (United States)

Zhang, Jungang; Shen, Guoliang; Shi, Ying; Zhang, Chengwu; Hong, Defei; Jin, Li; Yang, Hongguo; Sun, Wei; Cai, Hanhui; Hu, Zhiming; Wu, Weiding

2018-05-01

Gallbladder perforation is a serious clinical condition and associated with high morbidity and mortality. A definitive diagnosis is contentious before surgery. We herein report a case of perforation of the gallbladder neck secondary to chemotherapy and radiation for nasopharyngeal carcinoma patient. Gallbladder perforation secondary to chemotherapy and radiation. To decrease the mortality associated with gallbladder perforation, Laparoscopic cholecystectomy and peritoneal lavage were performed followed for gallbladder perforation patient because of chemotherapy and radiation. The patient recovered fully without serious complication and discharged on the 10th postoperative day. A pathological examination of the resected gallbladder revealed cholecystitis in the thinning of the neck. Early diagnosis and surgical intervention of gallbladder perforation in relation to asopharyngeal carcinoma chemotherapy and radiation are of prime importance. The laparoscopic procedure is safe and feasible in the selected patients.

Computational analysis of acoustic transmission through periodically perforated interfaces

Directory of Open Access Journals (Sweden)

Rohan E.

2009-06-01

Full Text Available The objective of the paper is to demonstrate the homogenization approach applied to modelling the acoustic transmission on perforated interfaces embedded in the acoustic fluid. We assume a layer, with periodically perforated obstacles, separating two half-spaces filled with the fluid. The homogenization method provides limit transmission conditions which can be prescribed at the homogenized surface representing the "limit" interface. The conditions describe relationship between jump of the acoustic pressures and the transversal acoustic velocity, on introducing the "in-layer pressure" which describes wave propagation in the tangent directions with respect to the interface.This approach may serve as a relevant tool for optimal design of devices aimed at attenuation of the acoustic waves, such as the engine exhaust mufflers or other structures fitted with sieves and grillages. We present numerical examples of wave propagation in a muffler-like structure illustrating viability of the approach when complex 3D geometries of the interface perforation are considered.

A case of radiation enteritis with perforated peritonitis caused by a piece of eggshell

International Nuclear Information System (INIS)

Kitamura, Hirotaka; Maeda, Kazuya; Miyanaga, Tamonn; Doden, Kenji; Hattori, Masakazu; Hashizume, Yasuo

2011-01-01

The patient was a woman in her sixties who had received radiation therapy for cancer of uterine cervix 7 years earlier and had been suffering from diarrhea for these several years. The patient was seen at our emergency clinic because of a 5 hour-history of lower abdominal pain at the beginning of July 2010. An abdominal CT scan showed free air and ascites. A high density structure 1.5 cm in size was identified within the small intestine, but its relation with the perforation was obscure. Emergency operation was done with the most likely diagnosis of intestinal perforation and general peritonitis. When the lower abdomen was opened by midline incision, about 200 ml of cloudy ascites was observed and the ileum became white in color and hard resulting from the radiation therapy. A perforation was identified in the ileum about 15 cm distant from the ileocecal valve, and a 1.5-cm sized thin and hard material was palpated within the intestine at the same portion. Ilececal resection including the perforated portion was performed and functional end-to-end anastomosis was made at a grossly normal area. There was a piece of eggshell 1.5-cm in size in the perforated portion in the resected specimen. From this together with histopathologial findings, perforation of the small intestine caused by a piece of eggshell associated with radiation enteritis was finally diagnosed. Small bowel perforation must be kept in mind as a possible late complication of radiation therapy, however, no cases of small bowel perforation caused by eggshell have been reported so far. This rare case is reported here, with a review of the literature. (author)

Acute mesenteric ischemia and duodenal ulcer perforation: a unique double pathology

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Haruna Lois

2012-10-01

Full Text Available Abstract Background Acute mesenteric ischaemia and duodenal perforation are surgical emergencies with serious consequences. Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%. There are very few reported cases of patients presenting with this dual pathology. Case presentation We report a unique case of a 53 year old Italian lady who presented with acute mesenteric ischaemia and duodenal perforation. This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation. Conclusion Early management in the intensive care unit and appropriate surgical intervention maximised the patient’s chances of survival despite the poor prognosis associated with her dual pathology. The rare pathology of the patient described can be explained by two possible hypotheses: peptic ulcer disease causing duodenal ulceration, which precipitated ischaemic infarction of the small bowel. The second hypothesis is the patient developed a stress related ulcer following ischaemic bowel infarction secondary to arterial thrombosis.

Experimental investigation of the unsteady one-phase flow through perforated plates

International Nuclear Information System (INIS)

Casadei, F.

1982-07-01

The flow of the coolant through the perforated dip-plate during a hypothetical core-disruptive accident in a sodium-cooled fast breeder reactor was simulated in a one-dimensional model. Several experiments with water as fluid and with various perforation ratios of the dip-plate and different initial heights of the fluid head over the dip plate were run. The pressure drop through the dip-plate and the forces acting on the dip-plate and on the upper plug of the reactor vessel in a wide range of the Reynolds and Strouhal numbers were measured. The flow pattern downstreams the perforated plate was filmed with high-speed cameras. The resistance coefficients for the unsteady flow of the coolant through the perforated plate were obtained as a function of the acceleration. The forces acting on the upper plug and their time integral were compared with those acting on the dip-plate. Finally, using the high-speed film pictures the formation of fluid jets downstream the dip-plate was investigated. (orig.) [de

Prediction of inelastic behavior and creep-fatigue life of perforated plates

International Nuclear Information System (INIS)

Igari, Toshihide; Yamauchi, Masafumi; Nomura, Shinichi.

1992-01-01

Prediction methods of macroscopic and local stress-strain behaviors of perforated plates in plastic and creep regime are proposed in this paper, and are applied to the creep-fatigue life prediction of perforated plates. Both equivalent-solid-plate properties corresponding to the macroscopic behavior and the stress-strain concentration around a hole were obtained by assuming the analogy between plasticity and creep and also by extending the authors' proposal in creep condition. The perforated plates which were made of Hastelloy XR were subjected to the strain-controlled cyclic test at 950degC in air in order to experimentally obtain the macroscopic behavior such as the cyclic stress-strain curve and creep-fatigue life around a hole. The results obtained are summarized as follows. (1) The macroscopic behavior of perforated plates including cyclic stress-strain behavior and relaxation is predictable by using the proposed method in this paper. (2) The creep-fatigue life around a hole can be predicted by using the proposed method for stress-strain concentration around a hole. (author)

Case Report: Rectal perforation during CT colonography [version 1; referees: 2 approved

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Marianna Zukiwskyj

2016-03-01

Full Text Available Introduction Computer tomography colonoscopy (CTC is an increasingly prevalent procedure for the investigation of colorectal symptoms, or as a component of colorectal cancer screening.  It is considered a low risk procedure, however colonic perforation is a recognized significant complication.   Case Report We report the case of an 81-year-old female patient who underwent CTC after failed optical colonoscopy as part of routine colorectal cancer screening.  Perforation of the rectum with surrounding pararectal air was confirmed on CTC.  The patient had minimal symptoms and was treated successful non-operatively with bowel rest and antibiotics.   Conclusion Perforation sustained during CTC is an uncommon complication.  The incidence of perforation during CTC is still lower than that during optical colonoscopy.  In the absence of significant abdominal signs and symptoms, this rare complication may be successfully managed non-operatively.

CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

OpenAIRE

Venkata Anantha Lakshmi Manabala; Krishna Mohan Narayanrao

2016-01-01

INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS ...

Subacute Right Ventricle Perforation by Pacemaker Lead Presenting with Left Hemothorax and Shock

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Julianne Nichols

2015-01-01

Full Text Available Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

Segmental resection with primary anastomosis is not always safe in splenic flexure perforation.

Science.gov (United States)

Weledji, Elroy P; Mokake, Martin D; Sinju, Motaze

2016-01-16

Familial adenomatous polyposis (FAP) is caused by a rare mutation of the adenomatous polyposis coli gene on Chromosome 5q. The risk of colorectal cancer in patients with FAP is nearly 100% and intensive endoscopic surveillance or prophylactic colectomy are mandatory. If extensive endoscopic surveillance is chosen, there is a cumulative risk of perforation and bleeding especially after polypectomy. We discussed the problems and options in the management of the late diagnosis of an iatrogenic perforation of the splenic flexure complicating endoscopic surveillance in FAP. We present a 35-year-old black African man with FAP who sustained a splenic flexure perforation following a colonoscopic polypectomy of a suspicious lesion. He underwent a splenic flexure resection and primary anastomosis that dehisced and the patient benefited from an emergency definitive colectomy and ileorectal anastomosis. Resection with primary anastomosis following iatrogenic perforation of the splenic flexure is not safe because of a high chance of anastomotic dehiscence. Following a late diagnosis in an unstable patient exteriorization of the perforation as a stoma is a better option prior to a definitive prophylactic colectomy.

Standard Practice for Ensuring Test Consistency in Neutron-Induced Displacement Damage of Electronic Parts

CERN Document Server

American Society for Testing and Materials. Philadelphia

2007-01-01

1.1 This practice sets forth requirements to ensure consistency in neutron-induced displacement damage testing of silicon and gallium arsenide electronic piece parts. This requires controls on facility, dosimetry, tester, and communications processes that affect the accuracy and reproducibility of these tests. It provides background information on the technical basis for the requirements and additional recommendations on neutron testing. In addition to neutrons, reactors are used to provide gamma-ray pulses of intensities and durations that are not achievable elsewhere. This practice also provides background information and recommendations on gamma-ray testing of electronics using nuclear reactors. 1.2 Methods are presented for ensuring and validating consistency in neutron displacement damage testing of electronic parts such as integrated circuits, transistors, and diodes. The issues identified and the controls set forth in this practice address the characterization and suitability of the radiation environm...

Free vibration analysis of perforated plate with square penetration pattern using equivalent material properties

Energy Technology Data Exchange (ETDEWEB)

Jhung, Myung Ho [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Jeong, Kyeong Hoon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-06-15

In this study, the natural frequencies of the perforated square plate with a square penetration pattern are obtained as a function of ligament efficiency using the commercial finite-element analysis code ANSYS. In addition, they are used to extract the effective modulus of elasticity under an assumption of a constant Poisson's ratio. The effective modulus of elasticity of the fully perforated square plate is applied to the modal analysis of a partially perforated square plate using a homogeneous finite-element analysis model. The natural frequencies and the corresponding mode shapes of the homogeneous model are compared with the results of the detailed finite-element analysis model of the partially perforated square plate to check the validity of the effective modulus of elasticity. In addition, the theoretical method to calculate the natural frequencies of a partially perforated square plate with fixed edges is suggested according to the Rayleigh-Ritz method.

EVALUAT I ON OF VARIOUS PROGNOSTIC FACTORS IN PERFORATIVE PERITONITIS MANAGEMENT

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Sarada

2015-09-01

Full Text Available Peritonitis is one of the major problems confronting the surgeons in day to day practice. Despite many advances in understanding pathophysiology, mortality rate of diffuse suppurative peritonitis remains high. A prospective study, with prior institutional ethics committee approval, involving 100 patients of perforative peritonitis is done to assess the vari ous prognostic factors in management of generalized peritonitis. Role of age, gender, duration, type of perforation, associated systemic factors are studied in relation to morbidity and mortality in the outcome of management of peritonitis. Elderly age, il eal perforations, delay in presentation of more than 24 hours and associated shock on day one are found to have bad prognosis

The use of endoluminal vacuum (E-Vac) therapy in the management of upper gastrointestinal leaks and perforations.

Science.gov (United States)

Smallwood, Nathan R; Fleshman, James W; Leeds, Steven G; Burdick, J S

2016-06-01

Upper intestinal leaks and perforations are associated with high morbidity and mortality rates. Despite the growing experience using endoscopically placed stents, the treatment of these leaks and perforations remain a challenge. Endoluminal vacuum (E-Vac) therapy is a novel treatment that has been successfully used in Germany to treat upper gastrointestinal leaks and perforations. There currently are no reports on its use in the USA. E-Vac therapy was used to treat 11 patients with upper gastrointestinal leaks and perforations from September 2013 to September 2014. Five patients with leaks following sleeve gastrectomy were excluded from this study. A total of six patients were treated with E-Vac therapy; these included: (n = 2) iatrogenic esophageal perforations, (n = 1) iatrogenic esophageal and gastric perforations, (n = 1) iatrogenic gastric perforation, (n = 1) gastric staple line leak following a surgical repair of a traumatic gastric perforation, and (n = 1) esophageal perforation due to an invasive fungal infection. Four patients had failed an initial surgical repair prior to starting E-Vac therapy. All six patients (100 %) had complete closure of their perforation or leak after an average of 35.8 days of E-Vac therapy requiring 7.2 different E-Vac changes. No deaths occurred in the 30 days following E-Vac therapy. One patient died following complete closure of his perforation and transfer to an acute care facility due to an unrelated complication. There were no complications directly related to the use of E-Vac therapy. Only one patient had any symptoms of dysphagia. This patient had severe dysphagia from an esophagogastric anastomotic stricture prior to her iatrogenic perforations. Following E-Vac therapy, her dysphagia had actually improved and she could now tolerate a soft diet. E-Vac therapy is a promising new method in the treatment of upper gastrointestinal leaks and perforations. Current successes need to be validated through future

Perforation of the sinus membrane during sinus floor elevation

DEFF Research Database (Denmark)

von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M

2014-01-01

PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...

Digital-to-analog device for continuous detection of neutron damping decrement in logging

International Nuclear Information System (INIS)

Sokolov, Yu.I.; Zinchenko, A.I.; Rudenko, Eh.L.

1976-01-01

Algorithms are analyzed for a continuous detection of the damping decrement (DD) of the thermal neutron density in time, characterizing absorptive and diffusion properties of a bed; an an automated measuring device has been developed. The design of a digital calculator involving reguired mathematical and logical operations in the DD measurement by the specified algorithms necessitated the use of a system of elements with a diode-transistor RC logic. Following laboratory tests the mock-up of the calculator was subjected to borehole tests as part of the pulsed neutron logging apparatus of the IGN-4 type. A continuous detection of the DD reciprocal with a parallel recording of the differential and integral curves of pulsed neutron-neutron logging has been performed. The borehole tests revealed the efficiency of the new device and the possibility of its use together with the apparatus of the IGN-4 type

Perforated Duodenal Ulcer: Has Anything Changed?

Science.gov (United States)

Koskensalo, Selja; Leppäniemi, Ari

2010-04-01

To assess the current management and outcome of perforated duodenal peptic ulcer managed with open repair, a focused analysis was conducted, excluding gastric, traumatic and iatrogenic perforations. A retrospective study of a 6-year period identified 61 patients. Mean age was 59 (range 19-87) years and 33 (54%) were male. Medical history included nonsteroidal anti-inflammatory drugs in 46%, smoking in 30%, atherosclerosis in 26% and excessive alcohol use in 23%. Generalized abdominal tenderness was recorded in 64% of the cases. The mean (SD) C-reactive protein value was 100 (141) g/l and white blood cell count was 12.8 (7.9) E9/l. Plain abdominal X-ray was positive for air in 87% (41/47) and CT scan in 86% (18/21). Four patients (7%) were operated without radiological imaging. There were 31 patients (51%) with a delay of 24 h or more from the start of symptoms to surgery. The mean (SD) delay from admission to surgery was 9 (3) (range 3-12) h. The treatment consisted of open suture repair in 92%, peritoneal lavage in 92%, external drainage in 80% and nasogastric decompression in 92%. The overall hospital mortality and morbidity rates were 11 and 21%, respectively. The duodenal suture leak rate was 7% and intra-abdominal abscess rate was 2%. The majority of patients with perforated duodenal ulcer can be diagnosed with conventional clinical and radiological methods, and treated according to established surgical principles. The mortality and duodenal morbidity rates have remained unchanged for the last decade. Shortening preoperative delay could improve the prognosis.

Foreign body causing perforation of the appendix in an African boy ...

African Journals Online (AJOL)

Abstract. Foreign bodies in the appendix are a rare but well described clinical entity and may cause perforation. Presented here is the case of a 13yr old Ugandan boy who had features of acute appendicitis, was sent for appendicectomy and during the operation was found to have perforation of the appendix due to a seed.

Case report of idiopathic cecal perforation presenting as acute appendicitis on ultrasound

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Calista Harbaugh

2016-08-01

Full Text Available Cecal perforation is an uncommon phenomenon in a pediatric population. It has been linked to a number of underlying medical conditions, which may result in focal inflammation or relative ischemia including hematologic malignancy, infection, and inflammatory bowel disease. We present an otherwise healthy 16-year-old male diagnosed with acute uncomplicated appendicitis on ultrasound, who was found to have cecal perforation with normal appendix intraoperatively, ultimately requiring ileocectomy. With this report, we aim to present the numerous pathophysiologic etiologies of cecal perforation, and to promote a comprehensive differential diagnosis despite the clinical and radiologic findings consistent with uncomplicated appendicitis.

Bladder perforation owing to a unipolar coagulating device.

Science.gov (United States)

Pakter, J; Budnick, L D

1981-09-15

A report on a patient who sustained a burn and perforation of the urinary bladder from visible sparks emanating from a unipolar coagulating device during the couse of laparoscopic sterilization is presented. It is the first report of urinary bladder burns using a unipolar coagulating device. A 24-year-old woman, gravida 10, para 3, abortus 7, underwent a laparoscopic sterilization with a unipolar coagulating device. As the physician was finishing the coagulation, a spark from the device caused a 1-2 cm burn with a central area of perforation into the urinary bladder. Conservative treatment was recommended, and consisted of Foley catheterization and drainage for 5 days. Initial urine culture revealed Klebsiella species, and oral ampicillin was prescribed. Hematuria was noted throughout the patient's hospitalization, and blood clots were present in the urine on Day 2 postoperation. The patient had no abdominal or flank pain, was afebrile, and had a stable hemoglobin level during the hospital stay. Cystography was performed on Day 5 postoperatively and demonstrated no perforation. Foley catheter was removed. Patient was discharged 2 days later and remains in good health 3 months postoperatively.

Segmental absence of intestinal musculature with metachronous bowel perforations in an infant

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Noboru Oyachi

2018-03-01

Full Text Available Segmental absence of intestinal musculature is a rare condition. A female patient was born at 39 weeks gestational age with birth weight of 2,900 g. The patient was prenatally diagnosed as having segmental bowel distension in the fetal stage. She manifested bilious emesis with abdominal distension at day 1. Although excretion of viscous meconium was observed by gastrografin enema, gastrointestinal perforation developed. Emergency laparotomy and peritoneal drainage was required at that time and further laparotomy was performed on day 15. Multiple perforations were recognized discontinuously from the jejunum to the transverse colon, and jejunostomy was constructed. Additional bowel perforations occurred and re-exploration was required at day 43. We found newly formed small perforations in the proximal jejunum, ileum and the transverse colon and a tube jejunostomy and a colostomy were established. The patient required prolonged TPN management, which induced correlated cholestasis and liver failure, and died at day 143. Pathologic findings showed partial hypoplasia of the intrinsic muscle layer in the small intestine and diagnosed as segmental absence of intestinal musculature. Her disorder was unusual in its presentation, which included prenatal bowel dilatation, metachronous superimposed bowel perforation, and extensive discrete lesions from the jejunum to the transverse colon.

Small bowel perforation without tumor recurrence after radiotherapy for cervical carcinoma: report of seven cases.

Science.gov (United States)

Yamashita, Hideomi; Nakagawa, Keiichi; Tago, Masao; Igaki, Hiroshi; Shiraishi, Kenshirou; Nakamura, Naoki; Sasano, Nakashi; Yamakawa, Sen; Ohtomo, Kuni

2006-04-01

We describe the clinical presentation, evaluation, management and outcome of patients experiencing small bowel perforation following radiation therapy for cervical cancer. A database consisting of 95 Japanese women with stage 0-4 A cervix cancer treated between 1991 and 2004 contained seven patients (7.4%) with small bowel perforation. The median age at the time of perforation was 72.5 years (range 62-78). The median time from completion of radiotherapy to perforation was 6 months (range 2-58). Surgery (one small bowel resection and anastomosis with diversion; six small bowel resection and anastomosis) was performed immediately in all seven patients. One of seven patients died of small bowel perforation (i.e. mortality rate was 14%). Bowel adhesion was detected during the operation in only three cases (43%). Signs of peritonitis were absent in six cases (86%). Severe abdominal pain was seen in all seven patients. The perforation site was ileum in all seven cases. In all patients, pathological changes were compatible with postirradiation injury of the gastrointestinal tract. The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.

Discriminating between simple and perforated appendicitis

NARCIS (Netherlands)

Bröker, Mirelle E. E.; van Lieshout, Esther M. M.; van der Elst, Maarten; Stassen, Laurents P. S.; Schepers, Tim

2012-01-01

Several studies have been performed in order to diagnose an acute appendicitis using history taking and laboratory investigations. The aim of this study was to create a model for the identification of a perforated appendicitis. All consecutive patients who have undergone an appendectomy in the

Infantile perforated appendicitis: A forgotten diagnosis

Directory of Open Access Journals (Sweden)

Katherine W. Gonzalez

2015-04-01

Full Text Available Acute appendicitis in the infant is a rare surgical diagnosis despite its frequency in older patients. The clinical presentation is often vague and can be misleading. We present the successful diagnosis and treatment of a 3 month old female with perforated appendicitis.

Management of perforated peptic ulcer in patients at a teaching hospital.

Science.gov (United States)

Bin-Taleb, Ali K; Razzaq, Riyadh A; Al-Kathiri, Zaki O

2008-02-01

To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU). A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study. A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks. Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.

Anatomical study of terminal peroneal artery perforators and their clinical applications

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Rajendran Purushothaman

2013-01-01

Full Text Available Introduction: Peroneal artery gives off plenty of perforators that pass through fascial septum to supply skin and tenosynovium of peroneal muscles. Aim: The aim of this study was to study the anatomical basis of perforators from terminal part of peroneal artery axiality and to make use of this knowledge in reconstructing defects of posterior heel with the advantage of reducing the morbidity of conventional flaps. Materials and Methods: Our study was conducted at Department of Plastic surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, India. We have carried out eleven cadaver dissections (from six cadavers-four fresh cadavers and two preserved cadavers and delineated all septocutaneous and septosynovial perforators of distal peroneal axis and studied their relation with short saphenous vein (SSV and sural nerve. Using this anatomical knowledge we have fashioned perforator based flaps in 13 patients (three propeller, four V-Y advancement, six tenosynovial flaps for reconstruction of defects over tendo achilles and pericalcaneal region . Results: In all cases, SSV and sural nerve were preserved and donor site was closed primarily. No total flap loss was noted. Conclusion: Perforator based flaps from distal most part of peroneal artery provide a good and reliable method for reconstruction of pericalcaneal and tendo achilles region defects with preservation of SSV and sural nerve. It also avoids contour deformity of the grafted donor site of the classical lateral calcaneal artery axial flap.

Repair of post polypectomy colonic perforation by Endoclip: a case report

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Ahmad Hormati

2015-10-01

Full Text Available A 73-year-old woman was admitted to evaluate for iron deficiency anemia, increased serum creatinine, and ascites. Her colonoscopy revealed a polyp at the junction of sigmoid and descending colon, and after polypectomy, a 6 mm colonic perforation was seen. The perforation was detected by radiography and CT scan; and beside conservative management and antibiotics, her perforation was closed by using Endoclip. The patient was observed and discharged from hospital without any surgery 5 days later, and in follow-up there was no problem regarding perforation. Resumo: Mulher, 73 anos, internada para avaliação para anemia ferropriva, com aumento da creatinina sérica e ascite. A colonoscopia revelou um pólipo na junção dos colos sigmoide e descendente e, em seguida à polipectomia, foi observada uma perfuração de 6 mm no cólon, comprovada por radiografias e tomografia computadorizada. Além do tratamento conservador e da antibioticoterapia, a perfuração foi ocluída com Endoclip. A paciente ficou sob observação e recebeu alta do hospital sem qualquer cirurgia 5 dias mais tarde. Durante o seguimento, não foram observados problemas com relação à perfuração. Keywords: Polypectomy, Colonic perforation, Endoclip, Palavras-chave: Polipectomia, Perfuração de cólon, Endoclip

Marginal ulcer perforation: a single center experience.

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Natarajan, S K; Chua, D; Anbalakan, K; Shelat, V G

2017-10-01

Marginal ulcer (MU) is defined as ulcer on the jejunal side of the gastrojejunostomy (GJ) anastomosis. Most MUs are managed medically but those with complications like bleeding or perforation require intervention. It is recommended that GJ anastomosis be revised in patients with MU perforation (MUP). The aim of this case series is to study the clinical presentation and management of MUP. Three hundred and thirty-two patients who underwent emergency surgery for perforated peptic ulcer at a single center were studied over a period of 5 years. Nine patients (2.7 %) presented with MUP. GJ was previously done for either complicated peptic ulcer (n = 4) or for suspected gastric malignancy (n = 5). Two patients had previously completed H. pylori therapy. None of the patients presented with septic shock. MU was on the jejunal side of GJ in all patients. The median MUP size was 10 mm. Four patients (44.4 %) had omental patch repair, three (33.3 %) had primary closure, and one each had revision of GJ and jejunal serosal patch repair. There were no leaks, intra-abdominal abscess or reoperation and no malignancies. MUP patients do not present with septic shock. Omental patch repair or primary closure is sufficient enough. Revision of Billroth-II-GJ into Roux-en-Y-GJ is not mandatory.

Perforated coins from graves at the Viminacium necropolis of Više Grobalja

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Vojvoda Mirjana D.

2015-01-01

Full Text Available A common problem that occurs when interpreting finds of perforated Roman coins is whether they had been perforated in Roman times or later. Hence, the specimens that originate from an undisturbed archaeological context, as is the case with finds from the Viminacium necropolis of Više Grobalja, are indispensable. A total of 47 perforated coins were discovered: 31 with a single and 16 with three perforations. The analysis of the context of the finds, in some specimens, allows the confident assertion that they had constituted a part of jewellery. [Projekat Ministarstva nauke Republike Srbije, br. 47018: IRS - Viminacium, Roman city and military legion camp - research of the material and non-material culture of inhabitants using the latest technologies of remote detection, geophysics, GIS, digitalisation and 3D visualisation

LaPlace's law revisited: Cecal perforation as an unusual presentation of pancreatic carcinoma

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Cason Frederick D

2007-02-01

Full Text Available Abstract Background Pancreatic cancer is often locally and distally aggressive, but initial presentation as cecal perforation is uncommon. Case presentation We describe a patient presenting with pneumoperitoneum, found at initial exploration to have a cecal perforation believed to be secondary to a large cecal adenoma, after palpation of the remainder of the colon revealed hard stool but no distal obstruction. Postoperatively, however, the patient progressed to large bowel obstruction and upon reexploration, a mass could now be delineated, encompassing the splenic flexure, splenic hilum, and distal pancreas. Histological evaluation determined this was locally invasive pancreatic adenocarcinoma, and therefore the true etiology of the original cecal perforation. Conclusion Any perforation localized to the cecum must be highly suspicious for a distal obstruction, as dictated by the law of LaPlace.

Free vibration analysis of perforated plate with square penetration pattern using equivalent material properties

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Myung Jo Jhung

2015-06-01