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  1. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  2. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  3. Favorable results after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E. H.; Herzberg, G.; Merser, Søren

    2013-01-01

    Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non....... The wrists had been reviewed annually and analysis was done on the latest follow-up data. Results 60 patients had been operated (5 bilaterally), 5 wrists had been revised, and 52 were available for follow-up (with the revised cases excluded). The pain scores, QuickDASH scores, ulnar flexion, and supination...... for the whole group were statistically significantly better at follow-up. There were no statistically significant differences between the rheumatoid and the non-rheumatoid patients except for motion, which was better in the non-rheumatoid group. The motion obtained depended on the preoperative motion. Implant...

  4. Hearing results of the total middle ear reconstruction

    Institute of Scientific and Technical Information of China (English)

    DING Yuan-ping; XU An-ting; CHEN Ying

    2005-01-01

    Objective:To evaluate the success of hearing results in total middle ear reconstruction with cartilage ossiculoplasty for the patients with old open- mastoidectomy cavities. Method: A retrospective review of 69 patients who underwent total middle ear reconstruction with cartilage ossiculoplasty was performed. Results: In this series, the successful hearing results were obtained in 61 % of the patients after operation, but 93% of the ears were dry. For patients with stapes, the successful rate was 65%; for patients without stapes,it was 58 %. The mean hearing gain was 10.7dB. Conclusion: Total middle ear reconstruction offers an effective treatment algorithia of hearing reconstruction for patients with old mastoidectomy cavities. 1. Stapes is important for hearing improvement; 2. Staged operation is good for hearing restoration; 3. For a large number of patients with a problematic cavitites, hearing restoration is possible by total middle ear reconstruction.

  5. Preliminary results of an intercomparison of total ozone spectrophotometers

    Science.gov (United States)

    Parsons, C. L.; Gerlach, J. C.; Williams, M. E.; Kerr, J. B.

    1981-01-01

    Preliminary results from an intercomparison of five total ozone spectrophotometers are presented. These are the Dobson spectrophotometer, the USSR M-83 ozonometer, the Canterbury filter photometer, the SenTran Company filter photometer, and the Brewer grating spectrophotometer. The pertinent characteristics of each are described, and conclusions are drawn about the agreement of each instrument's measurements with the Dobson's values over a time period of nearly one year. A discussion of the importance of calibration and long-term stability and reliability is included.

  6. Hardness Results for Total Rainbow Connection of Graphs

    Directory of Open Access Journals (Sweden)

    Chen Lily

    2016-05-01

    Full Text Available A total-colored path is total rainbow if both its edges and internal vertices have distinct colors. The total rainbow connection number of a connected graph G, denoted by trc(G, is the smallest number of colors that are needed in a total-coloring of G in order to make G total rainbow connected, that is, any two vertices of G are connected by a total rainbow path. In this paper, we study the computational complexity of total rainbow connection of graphs. We show that deciding whether a given total-coloring of a graph G makes it total rainbow connected is NP-Complete. We also prove that given a graph G, deciding whether trc(G = 3 is NP-Complete.

  7. HIGH ECCENTRICITY EOQ TOTAL COST FUNCTION YIELDS JIT RESULTs

    Directory of Open Access Journals (Sweden)

    Willian Roach

    2010-06-01

    Full Text Available No estoque de bens perecíveis, o custo de armazenamento H é muito maior do que o previsto na fórmula clássica do lote econômico do pedido (EOQ. Para bens perecíveis, a função custo total no EOQ é um pico e não uma reta horizontal. Esta forma pontiaguda leva o modelo EOQ a produzir entregas just in time (JIT - resultados semelhantes. O efeito pontiagudo (excentricidade da curva de custo total do lote econômico EOQ depende apenas do custo de armazenamento (H e não da demanda anual (D ou do custo do pedido (S. D e S determinam o nível (altura da curva de custo total do estoque (TC, mas não a forma.

  8. First Results from the August 21, 2017, Total Solar Eclipse

    Science.gov (United States)

    Pasachoff, Jay M.

    2017-08-01

    I report on the observations planned and, weather permitting, made from our site in Salem, Oregon, at the August 21, 2017, total solar eclipse. I also give a first report on collaborators' successes, including Megamovie and simultaneous space observations. We also describe our participation in PBS's NOVA on the eclipse that was to be aired on public television on eclipse night. Our eclipse expedition is supported in large part by grants from the Solar Terrestrial Program of the Atmospheric Sciences Division of NSF and by the Committee for Research and Exploration of the National Geographic Society.

  9. Totally implantable hearing system: Five-year hearing results.

    Science.gov (United States)

    Shohet, Jack A; Kraus, Eric M; Catalano, Peter J; Toh, Elizabeth

    2017-04-13

    1) To provide long-term hearing outcome measures of a totally implantable hearing system (implant) and compare to the baseline unaided (BLU) and baseline aided (BLA) conditions, and 2) discuss relevant safety measures. Prospective, nonrandomized, multicenter, single-subject-as-own-control design. Fifty-one subjects with mild to severe sensorineural hearing loss were implanted between 2008 and 2009 and enrolled in this postmarket approval study in the setting of private and hospital-based practices. Forty-nine of these subjects completed the 5-year study, which included annual follow-ups. Primary effectiveness endpoints were speech reception threshold (SRT) and word recognition scores at 50 dB (WRS50s). Secondary effectiveness endpoints were WRSs and the Abbreviated Profile of Hearing Aid Benefit (APHAB) scores. Adverse Device Effects (ADEs) and Serious Adverse Device Effects (SADEs) reported during the study period and a comparison of bone conduction scores are submitted as safety measures. Compared to the BLA condition, 1) SRT scores were improved at every annual follow-up; 2) WRS50s were better in 49%, and the same in 41% at the 5-year follow-up; 3) WRSs were improved by 17% at the 5-year follow-up; and 4) APHAB scores were improved in most subscales at every annual follow-up. There were three SADEs in three subjects and 15 ADEs in 11 subjects. Bone conduction scores increased by 3.7 dB at the 5-year follow-up. Average battery life was 4.9 years. The implant compared favorably to the subjects' hearing aid throughout the 5-year period in all of the areas measured and was found to be safe. 2b Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  10. THE ANALYSIS OF TOTAL EXPENSES AT 1000 LEI TOTAL REVENUES AND OF THE RESULT OF THE GROWTH OF THEIR EFFICIENCY

    Directory of Open Access Journals (Sweden)

    LĂPĂDUŞI MIHAELA LOREDANA

    2013-12-01

    Full Text Available act The analysis of the company’s expenses is mainly important in the management and control activity, because it highlights the way in which are used the resources (material, human, financial and the impact of their allocation on the company’s performances. The optimization of the level of costs or the their reduction, where it is possible, without affecting the quality of the products and working conditions of the activity, represent the primary objectives of the management of companies.[9] Expenses have been and will remain one of the key indicators of a company requiring continuous application of a control and monitoring mechanism because when it comes to expenses we never speak of their growth, but their reduction. This reduction is the main objective of any economic agent that will result in increasing the efficiency of the entire activity. The costs of a company reflect in cash the total consumption of material, human and financial resources used in manufacturing and selling of the products. The level, dynamics and structure of these expenses reflect synthetically the activity of industrial enterprises when using effectively the available resources. The purpose of this article is to analyze synthetically a company's expenses efficiency based on the efficiency ratio of total expenses at 1000 lei total revenues and the purpose of the article results in a set of conclusions that will highlight a number of important issues concerning the role and the importance of the efficiency of total expenses related to total revenue, as well as the result of the growth of the efficiency of total expenses.

  11. One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

    DEFF Research Database (Denmark)

    Damgaard, Sune; Wetterslev, Jørn; Lund, Jens T

    2009-01-01

    AIMS: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR). METHODS AND RESULTS: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional...

  12. Scapular allograft reconstruction after total scapulectomy: surgical technique and functional results

    NARCIS (Netherlands)

    Capanna, R.; Totti, F.; Geest, I.C.M. van der; Muller, D.A.

    2015-01-01

    HYPOTHESIS: Scapular allograft reconstruction after total scapulectomy preserving the rotator cuff muscles is an oncologically safe procedure and results in good functional outcome with a low complication rate. METHODS: The data of 6 patients who underwent scapular allograft reconstruction after a

  13. Total Quality Management Elements and Results in Higher Education Institutions: The Greek Case

    Science.gov (United States)

    Psomas, Evangelos; Antony, Jiju

    2017-01-01

    Purpose: The purpose of this paper is to determine the main total quality management (TQM) elements adopted and the respective results achieved by higher education institutions (HEIs) in Greece. Design/methodology/approach: A research study was designed and carried out in private sector Greek HEIs. Fifteen HEIs were approached through interviews…

  14. Initial Results of Aperture Area Comparisons for Exo-Atmospheric Total Solar Irradiance Measurements

    Science.gov (United States)

    Johnson, B. Carol; Litorja, Maritoni; Fowler, Joel B.; Butler, James J.

    2009-01-01

    In the measurement of exo-atmospheric total solar irradiance (TSI), instrument aperture area is a critical component in converting solar radiant flux to irradiance. In a May 2000 calibration workshop for the Total Irradiance Monitor (TIM) on the Earth Observing System (EOS) Solar Radiation and Climate Experiment (SORCE), the solar irradiance measurement community recommended that NASA and NISI coordinate an aperture area measurement comparison to quantify and validate aperture area uncertainties and their overall effect on TSI uncertainties. From May 2003 to February 2006, apertures from 4 institutions with links to the historical TSI database were measured by NIST and the results were compared to the aperture area determined by each institution. The initial results of these comparisons are presented and preliminary assessments of the participants' uncertainties are discussed.

  15. Activities Contributing to Total Energy Expenditure in the United States: Results from the NHAPS Study

    Directory of Open Access Journals (Sweden)

    Block Gladys

    2004-02-01

    Full Text Available Abstract Background Physical activity is increasingly recognized as an important factor influencing health and disease status. Total energy expenditure, both low-intensity and high-intensity, contributes to maintenance of healthy body weight. This paper presents the results of a quantitative approach to determining the activities that contribute to total energy expenditure in the United States. Methods Data from the National Human Activity Pattern Survey (NHAPS were used. In 1992–1994 the NHAPS sampled 4,185 females and 3,330 males, aged 18 years and over, weighted to be representative of the 48 contiguous United States. A detailed report of each activity performed in the previous 24 hours was obtained. A score was created for each activity, by multiplying duration and intensity for each individual and summing across individuals. This score was then used to rank each activity according to its contribution to total population energy expenditure, for the total sample and separately for each gender, race, age, region, and season. Results This analysis reveals our society to be primarily sedentary; leisure time physical activity contributed only approximately 5% of the population's total energy expenditure. Not counting sleeping, the largest contributor to energy expenditure was "Driving a car", followed by "Office work" and "Watching TV". Household activities accounted for 20.1% and 33.3% of energy expenditure for males and females respectively. Conclusion The information presented in this paper may be useful in identifying common activities that could be appropriate targets for behavioral interventions to increase physical activity.

  16. The Result of the Rehabilitation for the Patients With Total Hip Replacement

    OpenAIRE

    Aykurt, Bilge; Abbasoglu, M. Adnan

    2004-01-01

    A rehabilitation program was applied for the patients with total hip replacement operated in the Clinics of Orthopaedic Surgery and Travmatology at the School of Medicine, Atatürk University. We evaluated 14 cases subsequent to preoperative and postoperative rehabilitation program. We obtained the followng results: 5 cases (%36,0) were excellent, 8 (%57.0 ) good and 1 (%7.0) moderate. The rehabilitation program together with consequents were compared with the literatures.

  17. Long-term results of «Universal» total knee endoprosthesis

    Directory of Open Access Journals (Sweden)

    J. Pilny

    2015-01-01

    Full Text Available The objective - to evaluate long-term results and survival rates of «Universal» condylar knee prosthesis. Material and methods. There were a total of 121 total knee joint replacements in the set with 107 patients aged 71.3 years on average (52-86 years. A total of 115 knees diagnosed with osteoarthritis of the 3-4th degree were indicated for the surgery, and there were 6 patients with the diagnosis of rheumatoid arthritis. Functional outcomes were evaluated using the Knee Society Score (KSS, Results. The assessment of the knee state on a scale KSS average clinical section KSS (knee score was 48.2, and functional (function score - 46,8 points. After surgery, the indices increased to 87.4 points and 85.8 points, respectively. One complication was described during the surgery, namely - the fracture of the medial tibia condyle (0.8%. In the early post-surgery period, peroneal nerve paresis was observed in two patients (1.6%. In the postoperative period, disorders of the wound healing were observed in 6 patients (4.9%, which were healed successfully in a conservative way. In the late post-surgery period, there were infectious complications in the knee joint in 4 knee joints (3.3%. Aseptic loosening was observed in 4 cases out of 117 endoprostheses (3.4%. It always concerned the loosening of tibial component. The loosening of the femoral component was not observed. In the period from the implantation until June 2014, which is 16-22 years after the implantation, there are 16 patients in total surviving, who had a total of 21 implanted endoprostheses. Among them there are no signs of a loosening only in 4 patients (19%; there was an apparent radiolucent line up until 2 mm with a sclerotic rim under the tibial component. All the patients were without clinical symptoms for the loosening. Six female patients (28.5% state troubles in the area of the femoro-patellar joint, where there is a lateralization of the patella, apparent on the X-ray images. Two

  18. Adverse events in total knee arthroplasty: Results of a physician independent survey in 260 patients

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    Kirschner Stephan

    2010-08-01

    Full Text Available Abstract Purpose Identification of all common and potentially avoidable adverse events is crucial to further improve the quality of medical care. The intention of the current study was to evaluate a standardized physician independent survey format on adverse events in total knee arthroplasty. The protocol for reporting adverse drug events following the International Conference of Harmonisation of technical requirements for registration of pharmaceuticals for human use (ICH was adopted for adverse events occurring during surgical interventions. Material and methods Data of a prospective sequential cohort trial introducing a clinical pathway for total knee arthroplasty was analysed. Reporting of adverse events was done by a physician independent study nurse using the modified ICH-Good Clinical Practice (GCP format (Structure and Content of Clinical study reports - E3 in 260 patients. The adverse events were graded to their severity and their potential relation to surgical treatment. Results A total of 55 patients (21% suffered from an adverse event and 16 (6% from a serious adverse event. In 38 patients' one adverse event occurred, 12 patients showed 2 adverse events and 5 patients suffered from a combination of an adverse and a serious adverse event. A serious adverse event alone occurred in 11 patients. The incidence of adverse events (Fisher p = 0.448 and serious adverse (p = 0.126 events showed no significant difference between the two cohorts. The most common adverse events were deep vein thrombosis (8% and 5% followed by wound healing problems (1% and 0% and haematoma (1% and 3%. A wide range of non surgical adverse events were recorded with low incidence levels. Conclusion The use of the modified ICH-GCP format supports standardization of adverse event reporting. Routine assessment of adverse events by a study nurse revealed higher incidence rates of adverse events in total knee arthroplasty. We recommend the implementation of trained

  19. Principles of management and results of treating the fractured femur during and after total hip arthroplasty.

    Science.gov (United States)

    Greidanus, Nelson V; Mitchell, Philip A; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

    2003-01-01

    The management of fractures of the femur during and after total hip arthroplasty can be difficult, and treatment can be fraught with complications. The ideal scenario would be one in which these fractures are prevented. It is important that the surgeon has a through understanding of the principles of managing these fractures and has access to a variety of fixation and prosthetic devices and allograft bone when necessary in order to provide the best treatment. Because periprosthetic fractures range from the very simple (requiring no surgical intervention) to the complex (requiring major revision), a classification system of these fractures aids in understanding both the principles of management and results of treatment.

  20. First Total Reflection X-Ray Fluorescence round-robin test of water samples: Preliminary results

    Science.gov (United States)

    Borgese, Laura; Bilo, Fabjola; Tsuji, Kouichi; Fernández-Ruiz, Ramón; Margui, Eva; Streli, Christina; Pepponi, Giancarlo; Stosnach, Hagen; Yamada, Takashi; Vandenabeele, Peter; Maina, David M.; Gatari, Michael; Shepherd, Keith D.; Towett, Erick K.; Bennun, Leonardo; Custo, Graciela; Vasquez, Cristina; Depero, Laura E.

    2014-11-01

    Total Reflection X-Ray Fluorescence (TXRF) is a mature technique to evaluate quantitatively the elemental composition of liquid samples deposited on clean and well polished reflectors. In this paper the results of the first worldwide TXRF round-robin test of water samples, involving 18 laboratories in 10 countries are presented and discussed. The test was performed within the framework of the VAMAS project, interlaboratory comparison of TXRF spectroscopy for environmental analysis, whose aim is to develop guidelines and a standard methodology for biological and environmental analysis by means of the TXRF analytical technique.

  1. Results of porous-coated anatomic and duracon total knee arthroplasty.

    Science.gov (United States)

    Pennington, Jonathon; Quinlan, John; Doyle, Terry; Bayan, Ali; Theis, Jean-Claude

    2010-12-01

    The Duracon total knee replacement and its forerunner the Porous-Coated Anatomic (PCA) knee system have been associated with good results. This study reviews a series of 181 knee replacements performed with these systems by seven general orthopedic surgeons with follow-up to a mean of 6.7 years. The mean Knee Society knee and function scores were 72 and 68. The mean Western Ontario and MacMaster Universities Osteoarthritis Index score was 76, and the mean 12-Item Short-Form Health Survey result was 55. A mean flexion of 104 degrees was recorded, and 93.8% of patients rated their satisfaction as good to excellent. Fifty-five percent of patients had minor radiographic lucencies-these were of questionable clinical significance. Seven patients required revision. These knee systems used in a relatively low-volume general unit provide consistent results comparable with those from larger arthroplasty units.

  2. Metal on metal hip resurfacing versus uncemented custom total hip replacement - early results

    Directory of Open Access Journals (Sweden)

    Muirhead-Allwood Sarah K

    2010-02-01

    Full Text Available Abstract Introduction There is no current consensus on the most appropriate prosthesis for treating symptomatic osteoarthritis (OA of the hip in young, active patients. Modern metal on metal hip resurfacing arthroplasty (HR has gained popularity as it is theoretically more stable, bone conserving and easier to revise than total hip arthroplasty. Early results of metal on metal resurfacing have been encouraging. We have compared two well matched cohorts of patients with regard to function, pain relief and patient satisfaction. Methods This prospective study compares 2 cohorts of young, active patients treated with hip resurfacing (137 patients, 141 hips and custom uncemented (CADCAM stems (134 patients, 141 hips. All procedures were performed by a single surgeon. Outcome measures included Oxford, WOMAC and Harris hip scores as well as an activity score. Statistical analysis was performed using the unpaired student's t-test. Results One hundred and thirty four and 137 patients were included in the hip replacement and resurfacing groups respectively. The mean age of these patients was 54.6 years. The mean duration of follow up for the hip resurfacing group was 19.2 months compared to 13.4 months for the total hip replacement group. Pre operative oxford, Harris and WOMAC scores in the THA group were 41.1, 46.4 and 50.9 respectively while the post operative scores were 14.8, 95.8 and 5.0. In the HR group, pre- operative scores were 37.0, 54.1 and 45.9 respectively compared to 15.0, 96.8 and 6.1 post operatively. The degree of improvement was similar in both groups. Conclusion There was no significant clinical difference between the patients treated with hip resurfacing and total hip arthroplasty in the short term.

  3. Acoustic monitoring (RFM of total hip arthroplasty results of a cadaver study

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    Unger AC

    2009-06-01

    Full Text Available Abstract Introduction At present there are no reliable non-traumatic and non-invasive methods to analyse the healing process and loosening status after total hip replacement. Therefore early as well as late loosening of prosthesis and interface component problems are difficult to be found or diagnosed at any time. Methods In a cadaver study the potential application of Resonance Frequency Monitoring (RFM will be evaluated as a non-invasive and non-traumatic method to monitor loosening and interface problems in hip replacement. In a 65 year old female cadaver different stability scenarios for a total hip replacement (shaft, head/modular head and cup, ESKA, Luebeck, Germany are simulated in cemented and cement less prosthesis and then analysed with RFM. The types of stability vary from secure/press-fit to interface-shaft disruption. Results The RFM shows in cemented as well as cement less prosthesis significant intra-individual differences in the spectral measurements with a high dynamic (20 dB difference corresponding to the factor 100 (10000%, regarding the simulated status of stability in the prosthesis system. Conclusion The results of the study demonstrate RFM as a highly sensitive non-invasive and non-traumatic method to support the application of RFM as a hip prosthesis monitoring procedure. The data obtained shows the possibility to use RFM for osteointegration surveillance and early detection of interface problems, but will require further evaluation in clinical and experimental studies.

  4. Preliminary results of the solar corona spectroscopic observation of 9th March 2016 Total Solar Eclipse

    Science.gov (United States)

    Sungging Mumpuni, Emanuel; Zamzam Nurzaman, Muhamad; Suryana, Nana

    2016-11-01

    Spectroscopy observation of solar corona has been carried out from 9th March 2016 Total Solar Eclipse expedition in Maba, East Halmahera. Due to limitation by the weather condition during the observation, the obtained data were not favorable. Because of the low signal to noise ratio, the wavelength calibration was not straightforward. To obtain the optimum results, steps for data reduction were performed as the following: selecting the finest data, extracting the 1D spectrum from 2D spectrum, and calibrating spectrum wavelength (including careful interpolation). In this preliminary result, we discuss the instrumentation, the data under investigation, the extraction process of spectrum, and the polynomial interpolation that has been used for extracting information from our data.

  5. Some results from the second iteration of total-system performance assessment for Yucca Mountain

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, M.L. [Sandia National Labs., Albuquerque, NM (United States)

    1994-12-31

    The second preliminary total-system performance assessment for the potential radioactive-waste-repository site at Yucca Mountain has recently been completed. This paper summarizes results for nominal aqueous and gaseous releases using the composite-porosity flow model. The results are found to be sensitive to the type of unsaturated-zone flow, to percolation flux and climate change, to saturated-zone dilution, to container-wetting processes and container-corrosion processes, to fuel-matrix alteration rate and radionuclide solubilities (especially for {sup 237}Np), and to bulk permeability and retardation of gases {sup 14}C. There are areas that should be given priority in the site-characterization program. Specific recommendations are given in the full report of the study.

  6. Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Birthe Margrethe

    2003-01-01

    To compare total abdominal hysterectomy and subtotal abdominal hysterectomy performed for benign uterine diseases.......To compare total abdominal hysterectomy and subtotal abdominal hysterectomy performed for benign uterine diseases....

  7. Computer navigation results in less severe flexion contracture following total knee arthroplasty.

    Science.gov (United States)

    Bin Abd Razak, Hamid Rahmatullah; Yeo Jin, Seng; Chong Chi, Hwei

    2014-12-01

    We compared postoperative flexion contracture in navigated total knee arthroplasty (TKA) versus conventional TKA. Two groups (Group 1: conventional, Group 2: navigated) of 235 consecutive patients matched for age and gender were retrospectively compared. Range of motion, mechanical axes, Knee Society Scores, Oxford Knee Scores and Short Form-36® (SF-36) scores were collected prospectively and compared preoperatively and at 2years following TKA. At 2years, patients who underwent navigated TKA averaged significantly lesser flexion contracture of 1 degree compared to 6 degrees in patients who underwent conventional TKA. There were a significantly larger proportion of outliers in the conventional group. Computer navigation results in less severe flexion contracture and less frequent flexion contracture of more than 5 degrees as compared to conventional techniques. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Compartment syndrome following total knee arthroplasty: clinical results of late fasciotomy.

    Science.gov (United States)

    Park, Cheol-Hee; Lee, Seung-Hyuk; Kang, Dong-Geun; Cho, Kye-Youl; Lee, Sang-Hak; Kim, Kang-Il

    2014-09-01

    Compartment syndrome after total knee arthroplasty (TKA) is a rare complication. Because of its rarity, it may be overlooked and misdiagnosed as peroneal nerve palsy or deep vein thrombosis. This misdiagnosis could have a profound impact on the patient's outcome. We report a case of a 77-year-old female who developed unilateral compartment syndrome in the calf after staged bilateral TKA at an outside clinic. The patient presented with medical complications related to compartment syndrome: rhabdomyolysis and myoglobinuria, which caused acute renal failure. Thus, we performed late fasciotomy one week after symptom onset to debride necrotic tissue and salvage the compartment. In the discussion section, we will discuss risk factors for compartment syndrome after TKA, results of late fasciotomy and other indications for surgical treatment of compartment syndrome.

  9. First Total Reflection X-Ray Fluorescence round-robin test of water samples: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Borgese, Laura; Bilo, Fabjola [Chemistry for Technologies Laboratory, University of Brescia, Brescia (Italy); Tsuji, Kouichi [Graduate School of Engineering, Osaka City University, Osaka (Japan); Fernández-Ruiz, Ramón [Servicio Interdepartamental de Investigación (SIdI), Laboratorio de TXRF, Universidad Autónoma de Madrid, Madrid (Spain); Margui, Eva [Department of Chemistry, University of Girona, Girona (Spain); Streli, Christina [TU Wien, Atominstitut,Radiation Physics, Vienna (Austria); Pepponi, Giancarlo [Fondazione Bruno Kessler, Povo, Trento (Italy); Stosnach, Hagen [Bruker Nano GmbH, Berlin (Germany); Yamada, Takashi [Rigaku Corporation, Takatsuki, Osaka (Japan); Vandenabeele, Peter [Department of Archaeology, Ghent University, Ghent (Belgium); Maina, David M.; Gatari, Michael [Institute of Nuclear Science and Technology, University of Nairobi, Nairobi (Kenya); Shepherd, Keith D.; Towett, Erick K. [World Agroforestry Centre (ICRAF), Nairobi (Kenya); Bennun, Leonardo [Laboratorio de Física Aplicada, Departamento de Física, Universidad de Concepción (Chile); Custo, Graciela; Vasquez, Cristina [Gerencia Química, Laboratorio B025, Centro Atómico Constituyentes, San Martín (Argentina); Depero, Laura E., E-mail: laura.depero@unibs.it [Chemistry for Technologies Laboratory, University of Brescia, Brescia (Italy)

    2014-11-01

    Total Reflection X-Ray Fluorescence (TXRF) is a mature technique to evaluate quantitatively the elemental composition of liquid samples deposited on clean and well polished reflectors. In this paper the results of the first worldwide TXRF round-robin test of water samples, involving 18 laboratories in 10 countries are presented and discussed. The test was performed within the framework of the VAMAS project, interlaboratory comparison of TXRF spectroscopy for environmental analysis, whose aim is to develop guidelines and a standard methodology for biological and environmental analysis by means of the TXRF analytical technique. - Highlights: • The discussion of the first worldwide TXRF round-robin test of water samples (18 laboratories of 10 countries) is reported. • Drinking, waste, and desalinated water samples were tested. • Data dispersion sources were identified: sample concentration, preparation, fitting procedure, and quantification. • The protocol for TXRF analysis of drinking water is proposed.

  10. Affect of surgical approaches on functional results of total hip arthroplasty in early postoperative period

    Directory of Open Access Journals (Sweden)

    D. V. Andreyev

    2013-01-01

    Full Text Available Minimally invasive approaches implies a less soft tissue damage and, therefore, more rapid recovery of the patient in the early postoperative period. The present study is a comparison of minimally invasive and standard approaches using biomechanical analysis of standing and walking patients before and after total hip arthroplasty, as well as an analysis of clinical outcomes in the early postoperative period. Fifty patients undergoing primary total hip arthroplasty using a minimally invasive and conventional techniques were divided into three groups. The first group consisted of patients operated on using the MIS AL (modified minimally invasive approach Watson-Jones (n = 17, the second - MDM (minimally invasive approach to the modified Mueller (n = 16 and in the third - with the use of transgluteal conventional approach by Harding (n = 17. The estimation of biomechanical parameters in static and dynamic patients before surgery and at 8-10 days after surgery. Also assessed clinical outcome postoperative visual analogue scale (VAS and Harris scale on day 10, 6 and 12 weeks and 1 year. When comparing the three groups of patients stabilometry best results were observed in groups of minimally invasive approaches MIS AL and MDM. When comparing the three groups significantly better (a moderate increase in the duration of the step, rolling the contralateral limb and a slight increase in the duration of the step the operated limb by increasing the duration of the roll-over were identified in the minimally invasive group MIS AL and MDM. In assessing the scale of Harris in the early postoperative period, higher rates were observed in groups of minimally invasive approaches. A year after the operation functional results become similar in all groups.

  11. [Periprosthetic Femoral Fractures after Total Hip Replacement: Our Results and Treatment Complications].

    Science.gov (United States)

    Pavelka, T; Salášek, M; Weisová, D

    2017-01-01

    PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). The Vancouver classification was used to grade the fractures. The cohort included 31 patients with type B1 fracture, 25 patients with type B2 fracture, 8 patients with type B3 fracture, and 19 patients with type C fracture. Altogether 80 patients underwent a surgery, 3 patients with non-displaced type B1 fracture were treated conservatively. The mechanism of injury was a simple fall in 75 % of primary endoprostheses and in 56% of revision endoprostheses. The average time to fracture was 7.6 years in primary implant and 3.6 years in revision endoprosthesis. In fractures with a well-fixed stem (type B1 and C) plate osteosynthesis was used. In case of a comminution zone, osteosynthesis was followed by spongioplasty. In patients with a loose stem (type B2 and B3), the fracture was treated with a revision uncemented stem. In two cases a combination of a revision stem and a massive corticocancellous bone graft was used. The evaluation was performed using the Harris Hip Score and the minimum follow-up from the surgery was 3 years. RESULTS In the group of patients with type B1 fracture, 28 patients were treated surgically. An excellent result was achieved in 22 patients (84%), in 4 patients (16%) the result was very good. The remaining 2 patients failed to meet the requirement of the minimum follow-up of 3 years. In the group of patients with type B2 fractures, composed of 25 patients, the femoral component was replaced with a revision uncemented stem with cerclage wires or titanium tapes or

  12. [Surgical treatment of secondary hyperparathyroidism in chronic kidney failure. Results of total parathyroidectomy with parathyroid autotransplantation].

    Science.gov (United States)

    Courant, O; Letessier, E; Moutel, M G; Hamy, A; Paineau, J; Visset, J

    1993-01-01

    Between 1978 and 1990, 68 patients, operated on for secondary hyperparathyroidism (HPT), received a forearm intramuscular free autologous parathyroid graft (37 women and 31 men--mean age: 43 +/- 16 years). The transplantation (Wells technique) was performed in the same time as the total parathyroidectomy and the remaining parathyroid material after surgical resection was cryopreserved. The results were evaluated in term of clinical and/or radiological and/or biological response respectively 3 or 5.5 years later, depending of the realisation of a renal transplantation (n = 27) or not. Four patients were lost to follow-up and 4 died post-operatively, including a wrong diagnosis (60 patients evaluated). Mortality rate was 12% (5 cases out of 7 related to chronic renal insufficiency). In 3 patients (5%) the transplanted gland had to be removed because of recurrent HPT (1 graft hyperplasia; 2 wrong diagnosis: 1 cervical gland left over and 1 aluminium intoxication). Second cervicotomy was performed in 3 cases (5%) for remaining cervical parathyroid gland (2 cases) and false-positive Tallium-Technetium scan (1 case). Overall results were good or very good in 51 cases (85%). A review of the literature indicate that subtotal parathyroidectomy in not superior to the Wells technique and the latter remain the landmark technique in the authors' hands in order to treat secondary HPT.

  13. Results of total laryngectomy as treatment for locally advanced hypopharyngeal cancer.

    Science.gov (United States)

    García-Cabo Herrero, Patricia; Fernández-Vañes, Laura; López Álvarez, Fernando; Álvarez Marcos, César; Llorente, José Luis; Rodrigo, Juan Pablo

    2017-01-19

    Total laryngectomy (TL), with eventual postoperative radiotherapy, has proven to be effective in treating cases of locally advanced hypopharyngeal cancer. The aim of this study was to analyse the oncological outcomes of this procedure in patients with hypopharyngeal cancer classified T3 and T4. We studied 59 patients (33 T3 and 26 T4a) with primary squamous cell carcinoma of the hypopharynx treated with TL from 1998 to 2012. Mean age was 61 years with a male predominance (96.6%). All the patients were smokers and 96% consumed alcohol. Unilateral selective neck dissection (ND) was performed in 12 patients, unilateral radical ND in 11 patients, bilateral selective ND in 20 patients and radical ND plus selective ND in 14 patients. 66% of the patients received postoperative radiotherapy. Lymph node metastases occurred in 81% of the patients and extranodal invasion in 56% of them. 29% of the patients had loco-regional recurrence, 17% developed distant metastases, and 25% a second primary tumour. The 5-year disease-specific survival was 46%. TL extended to pharynx (with eventual postoperative radiotherapy) offers good oncological results in terms of loco-regional control and survival in locally advanced hypopharyngeal cancer, so organ preservation protocols should achieve similar oncological results to those shown by TL. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  14. Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study

    Directory of Open Access Journals (Sweden)

    Efe Turgay

    2011-01-01

    Full Text Available Abstract Background Navigation was introduced into total knee arthroplasty (TKA to improve accuracy of component position, function and survival of implants. This study was designed to assess the outcome of navigated TKA in comparison with conventional implantation with the focus on rotational component position and clinical mid-term results. Methods In a prospectively randomized single-blinded approach, 90 patients with primary gonarthrosis were assigned to three different groups. Thirty patients each were assigned to NexGen LPS without and with navigation (groups 1 and 2, and 30 patients to navigation with the Stryker Scorpio PS (group 3. The navigation system used was the imageless Stryker KneeTrac, version 1.0. Clinical outcome was assessed by a blinded observer applying the Knee Society Score (KSS and a visual analogue scale (VAS for pain. CT scans and radiographs were conducted prior to and 12 weeks after index surgery. Results Seventy-nine patients were available for clinical evaluation at 3 ± 0.4 years follow-up. Four implants had to be revised for early loosening or infection (4.4%. Four patients had died and three patients were not able to follow the invitation for clinical assessment. Functional results in the KSS were significantly lower after navigated TKA. Operation time and incisions with navigation were significantly longer. Significantly less radiological outliers with navigation were found for coronal alignment of the femur, only. Conclusion In this series, no beneficial effect for navigation in TKA could be shown assessing clinical data, as functional results in the presented series seemed to be lower after first generation navigated TKA. The clinical mid- to long-term value of navigation remains to be evaluated in larger patient series or meta-analyses at longer follow-up. Trial registration number DRKS 00000430

  15. In vivo dosimetry for total body irradiation: five-year results and technique comparison.

    Science.gov (United States)

    Patel, Reshma P; Warry, Alison J; Eaton, David J; Collis, Christopher H; Rosenberg, Ivan

    2014-07-08

    The aim of this work is to establish if the new CT-based total body irradiation (TBI) planning techniques used at University College London Hospital (UCLH) and Royal Free Hospital (RFH) are comparable to the previous technique at the Middlesex Hospital (MXH) by analyzing predicted and measured diode results. TBI aims to deliver a homogeneous dose to the entire body, typically using extended SSD fields with beam modulation to limit doses to organs at risk. In vivo dosimetry is used to verify the accuracy of delivered doses. In 2005, when the Middlesex Hospital was decommissioned and merged with UCLH, both UCLH and the RFH introduced updated CT-planned TBI techniques, based on the old MXH technique. More CT slices and in vivo measurement points were used by both; UCLH introduced a beam modulation technique using MLC segments, while RFH updated to a combination of lead compensators and bolus. Semiconductor diodes were used to measure entrance and exit doses in several anatomical locations along the entire body. Diode results from both centers for over five years of treatments were analyzed and compared to the previous MXH technique for accuracy and precision of delivered doses. The most stable location was the field center with standard deviations of 4.1% (MXH), 3.7% (UCLH), and 1.7% (RFH). The least stable position was the ankles. Mean variation with fraction number was within 1.5% for all three techniques. In vivo dosimetry can be used to verify complex modulated CT-planned TBI, and demonstrate improvements and limitations in techniques. The results show that the new UCLH technique is no worse than the previous MXH one and comparable to the current RFH technique.

  16. Effect of posterior condylar offset on clinical results after posterior-stabilized total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Jian-Tao Wang; Yu Zhang; Qing Liu; Qiang He; Dong-Liang Zhang; Ying Zhang; Ji-Xuan Xiao

    2015-01-01

    Purpose:To determine the effect of the posterior condylar offset (PCO) on clinical results after total knee arthroplasty (TKA) using a high-flex posterior-stabilized (PS) fixed-bearing prosthesis.Methods:We prospectively studied the clinical and radiographic materials of 89 consecutive female patients (89 knees),who had undergone primary TKAs for end-stage osteoarthritis.All operations were performed by a single senior surgeon or under his supervision using the same operative technique.Based on the corrected PCO change,we divided all cases into two groups:group A (corrected PCO change ≥0 mm,58 knees) and group B (corrected PCO change <0 mm,31 knees).One-year postoperatively,clinical and radiographic variables from the two groups were compared by independent t-test.The associations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation.Results:One-year postoperatively,the Knee Society Scores,the Western Ontario and McMaster Universities Osteoarthritis Index,non-weight-bearing active and passive range of knee flexion,flexion contracture,extensor lag,and their improvements had no statistical differences between the two groups (all p > 0.05).The corrected PCO change was not significantly correlated with the improvement of any clinical variable (all p > 0.05).Group A demonstrated greater flexion than group B during active weight bearing (p < 0.05).Conclusions:Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA,while it has no benefit to non-weight-bearing knee flexion or any other clinical result.

  17. Clinical results with the Resolute zotarolimus-eluting stent in total coronary occlusions

    DEFF Research Database (Denmark)

    Kelbæk, Henning; Holmvang, Lene; Richardt, Gert

    2015-01-01

    and results: Patients were divided into three groups: chronic TO (CTO; n=256), non-chronic TO (n=292), and no occlusion (n=2,941). Clinical and safety outcomes assessed through two years included target lesion failure (TLF: cardiac death, target vessel myocardial infarction, and clinically driven target...... lesion revascularisation) and Academic Research Consortium definite or probable stent thrombosis. The rate of TLF at two years was not significantly different among patients in the CTO (9.1%), TO (9.8%), and no occlusion (10.4%) groups (log-rank p=0.800); neither were the components of TLF. Definite...... or probable stent thrombosis occurred more frequently in the TO group (2.8% vs. 1.2% in the CTO and 1.1% in the group with no occlusion, p=0.027). There were 10 late and six very late stent thrombosis events. Conclusions: Apart from a higher rate of stent thrombosis in patients with TO, patients with totally...

  18. Results of aperture area comparisons for exo-atmospheric total solar irradiance measurements.

    Science.gov (United States)

    Johnson, B Carol; Litorja, Maritoni; Fowler, Joel B; Shirley, Eric L; Barnes, Robert A; Butler, James J

    2013-11-20

    Exo-atmospheric solar irradiance measurements made by the solar irradiance community since 1978 have incorporated limiting apertures with diameters measured by a number of metrology laboratories using a variety of techniques. Knowledge of the aperture area is a critical component in the conversion of radiant flux measurements to solar irradiance. A National Aeronautics and Space Administration (NASA) Earth Observing System (EOS) sponsored international comparison of aperture area measurements of limiting apertures provided by solar irradiance researchers was performed, the effort being executed by the National Institute of Standards and Technology (NIST) in coordination with the EOS Project Science Office. Apertures that had institutional heritage with historical solar irradiance measurements were measured using the absolute aperture measurement facility at NIST. The measurement technique employed noncontact video microscopy using high-accuracy translation stages. We have quantified the differences between the participating institutions' aperture area measurements and find no evidence to support the hypothesis that preflight aperture area measurements were the root cause of discrepancies in long-term total solar irradiance satellite measurements. Another result is the assessment of uncertainties assigned to methods used by participants. We find that uncertainties assigned to a participant's values may be underestimated.

  19. Early Results of Autologous Cultivated Limbal Stem Cell Transplantation in Total Limbal Stem Cell Deficiency

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Javadi

    2008-12-01

    Full Text Available

    PURPOSE: To report the early results of transplantation of autologous limbal stem cells cultivated on amniotic membrane (AM in patients with total unilateral limbal stem cell deficiency (LSCD. METHODS: Four eyes of 4 patients with total unilateral LSCD confirmed with impression cytology underwent transplantation of autologous limbal stem cell cultivated on AM. At each follow up visit, a complete eye examination with special attention to recurrence or regression of vascularization, corneal opacification, and epithelial defect healing was performed. Digital imaging was performed at each follow up visit. Impression cytology was repeated in all cases after surgery. RESULTS: The patients were followed for 5-13 months. Visual acuity improved in all cases. Decrease in corneal opacification and vascularization was obvious in 3 cases with coverage of the cornea with corneal epithelium. Sectoral conjunctivalization was evident in these 3 cases, however the corneas were ready for transplantation. The procedure failed in one case with total corneal conjunctivalization. CONCLUSION: Transplantation of autologous stem cells cultivated on AM seems to be an effective way for total LSCD. More definite judgment needs longer follow up together with long-term results of corneal transplantation in these patients.

  1. Compendium of Current Total Ionizing Dose and Displacement Damage Results from NASA GSFC and NEPP

    Science.gov (United States)

    Topper, Alyson D.; Campola, Michael J.; Chen, Dakai; Casey, Megan C.; Yau, Ka-Yen; Label, Kenneth A.; Cochran, Donna J.; O'Bryan, Martha V.

    2017-01-01

    Total ionizing dose and displacement damage testing was performed to characterize and determine the suitability of candidate electronics for NASA space utilization. Devices tested include opto-electronics, digital, analog, linear bipolar devices, and hybrid devices.

  2. Does improved instrumentation result in better component alignment in total knee arthroplasty?

    Directory of Open Access Journals (Sweden)

    Mo Hassaballa

    2011-03-01

    Full Text Available Accurate component alignment and joint line reproduction in total knee replacement (TKR is crucial for successful clinical outcome. Advances in instrumentation and better understanding of the biomechanics can help to achieve better three dimensional alignments of TKR components and joint line restoration. We compared the accuracy of component alignment and joint line restoration with the use of 2 different TKR instrumentation kits (an older Gobot and a newer Xcelerate. Retrospective study of 150 consecutive patients undergoing primary TKR had their pre and post-operative x-rays reviewed. Seventy-five patients (group A had their TKR using the older instrumentation kit (Gobot and 75 (group B had the newer version (Xcelerate. The positioning of the prosthesis components were assessed using the American Knee society radiographic evaluation method and the joint line position using the Figgie’s method. The results from the two groups were statistically compared. There was a significantly greater elevation of the joint line position in TKRs done with the Gobot instrumentation (mean 4.49 mm vs. 2.71 mm in group B, P=0.03, and significant differences in the mean tibial component angle cTCA (group A 88.6º, group B 90.1º, P=0.04 and the mean Q angle (group A 6.28º valgus, group B 8.45º valgus, P=0.04. Use of the newer Xcelerate instrumentation was associated with better restoration of joint line position, however the femoral component flexion and posterior slope of the tibial component ere found to be above the desired level. Hence the overall differences between the two groups were found to be small.

  3. Results of a 5-Week Schedule of Modern Total Skin Electron Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Morris, Stephen Lloyd, E-mail: stephen.morris@gstt.nhs.uk [St Johns Institute of Dermatology, Guys and St Thomas Hospital, London (United Kingdom); McGovern, Mark; Bayne, Sally; Wain, Mary; Child, Fiona; Whittaker, Sean [St Johns Institute of Dermatology, Guys and St Thomas Hospital, London (United Kingdom)

    2013-08-01

    Purpose: To report the outcomes of a 5-week schedule of total skin electron beam radiation therapy (TSEB) for mycosis fungoides (MF). Methods: Over 5 years, 41 patients with confirmed MF were treated with a modern TSEB technique delivering 30 Gy in 20 fractions over 5 weeks to the whole skin surface. Data were collected prospectively and entered into the skin tumor unit research database. Skin modified skin weighted assessment tool score data were collected to determine response, duration of response, survival, and toxicity. The outcomes were analyzed according to the patient's stage before TSEB, prognostic factors, and adjuvant treatments. Results: Seventeen patients were stage 1B, 19 were stage IIB, 3 were stage III, and 2 were stage IV. The overall response rate was 95%, with a complete response rate of 51%. Seventy-six percent of patients had relapsed at median follow-up of 18 months. The median time to relapse was 12 months, to systemic therapy was 15 months, and to modified skin weighted assessment tool progression above baseline was 44 months. The complete response rate was 59% in stage IB and 47% in stage IIB patients. The median time to skin relapse was longer in stage IB compared with stage IIB, 18 months versus 9 months. The median time to systemic therapy was longer in stage IB compared with stage IIB, >56 months versus 8 months. The median overall survival was 35 months: >56 months for stage IB, 25 months for stage IIB, 46 months for stage III, and 23.5 months for stage IV. Fifteen patients received adjuvant psoralen + ultraviolet A treatment with no difference seen in the time to relapse. Conclusions: This 5-week schedule of TSEB for MF has a high response rate with comparable duration of response to other regimens. Future studies are needed to find adjuvant and combination treatments to improve the duration of response.

  4. Factors associated with the frequency of initial total mastectomy: results of a multi-institutional study.

    Science.gov (United States)

    Feigelson, Heather Spencer; James, Ted A; Single, Richard M; Onitilo, Adedayo A; Aiello Bowles, Erin J; Barney, Tom; Bakerman, Jordan E; McCahill, Laurence E

    2013-05-01

    Several previous studies have reported conflicting data on recent trends in use of initial total mastectomy (TM); the factors that contribute to TM variation are not entirely clear. Using a multi-institution database, we analyzed how practice, patient, and tumor characteristics contributed to variation in TM for invasive breast cancer. We collected detailed clinical and pathologic data about breast cancer diagnosis, initial, and subsequent breast cancer operations performed on all female patients from 4 participating institutions from 2003 to 2008. We limited this analysis to 2,384 incident cases of invasive breast cancer, stages I to III, and excluded patients with clinical indications for mastectomy. Predictors of initial TM were identified with univariate analyses and random effects multivariable logistic regression models. Initial TM was performed on 397 (16.7%) eligible patients. Use of preoperative MRI more than doubled the rate of TM (odds ratio [OR] = 2.44; 95% CI, 1.58-3.77; p < 0.0001). Increasing tumor size, high nuclear grade, and age were also associated with increased rates of initial TM. Differences by age and ethnicity were observed, and significant variation in the frequency of TM was seen at the individual surgeon level (p < 0.001). Our results were similar when restricted to tumors <20 mm. We identified factors associated with initial TM, including preoperative MRI and individual surgeon, that contribute to the current debate about variation in use of TM for the management of breast cancer. Additional evaluation of patient understanding of surgical options and outcomes in breast cancer and the impact of the surgeon provider is warranted. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Feasibility of transanal endoscopic total mesorectal excision for rectal cancer: results of a pilot study

    Science.gov (United States)

    Oh, Jae Hwan; Park, Sung Chan; Kim, Min Jung; Park, Byung Kwan; Hyun, Jong Hee; Chang, Hee Jin; Han, Kyung Su

    2016-01-01

    Purpose To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. Methods This study enrolled 12 patients with clinically node negative rectal cancer located 4–12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027). Results The 12 patients included 7 males and 5 females, of median age 59 years and median body mass index 24.2 kg/m2. Tumors were located on average 6.7 cm from the anal verge. Four patients (33.3%) received preoperative chemoradiotherapy. Median operating time was 195 minutes and median blood loss was 50 mL. There were no intraoperative complications and no conversions to open surgery. TME was complete or nearly complete in 11 patients (91.7%). Median distal resection and circumferential resection margins were 18.5 mm and 10 mm, respectively. Median number of harvested lymph nodes was 15. Median length of hospital stay was 9 days. There were no postoperative deaths. Six patients experienced minor postoperative complications, including urinary dysfunction in 2, transient ileus in 3, and wound abscess in 1. Conclusion This pilot study showed that high-quality TME was possible in most patients without serious complications. Transanal TME for patients with rectal cancer may be feasible and safe, but further investigations are necessary to evaluate its long-term functional and oncologic outcomes and to clarify its indications. PMID:27757396

  6. Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich) liner.

    Science.gov (United States)

    Wang, Tao; Sun, Jun-Ying; Zha, Guo-Chun; Dong, Sheng-Jie; Zhao, Xi-Jiang

    2016-01-01

    Ceramic-on-ceramic (COC) couplings are an attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. However, the material in total hip arthroplasty (THA) remains one of the major concern regarding the risk of fracture. The present study aims at reporting the fracture rate of bearings in a series of COC THAs with the use of a sandwich liner and attempt to detect the relative risk factors, the possible cause and assess the clinical results. We retrospectively evaluated 153 patients (163 hips) using the sandwich liner COC THA between 2001 and 2009. Patient assessment was based on demographic factors, including age, weight, gender and body-mass index (BMI). All patients were evaluated clinically and radiographically or using computed tomography viz-a-viz dislocation, osteolysis, periprosthetic fracture, infection, loosening and implant fracture. Three ceramic sandwich liners fracture (1.84%) were observed at an average of 7.3 years' followup. The factors which were found to be non-significant to the ceramic liner fracture, included age (P = 0.205), weight (P = 0.241), gender (P = 0.553), BMI (P = 0.736), inclination (P = 0.199) and anteversion (P = 0.223). The overall survival was 91.4% at 12-year with revision as the endpoint. Other complications included osteolysis in 4 (2.45%), dislocation in one and periprosthetic fracture in one. In no hip aseptic loosening of the implants was seen. Our experience with the ceramic-polyethylene sandwich liner acetabular component has been disappointing because of the high rate of fracture and osteolyis. We have discontinued the use of this device and recommend the same.

  7. Monte Carlo simulation applied in total reflection x-ray fluorescence: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Meira, Luiza L. C.; Inocente, Guilherme F.; Vieira, Leticia D.; Mesa, Joel [Departamento de Fisica e Biofisica - Instituto de Biociencias de Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (Brazil)

    2013-05-06

    The X-ray Fluorescence (XRF) analysis is a technique for the qualitative and quantitative determination of chemical constituents in a sample. This method is based on detection of the characteristic radiation intensities emitted by the elements of the sample, when properly excited. A variant of this technique is the Total Reflection X-ray Fluorescence (TXRF) that utilizes electromagnetic radiation as excitation source. In total reflection of X-ray, the angle of refraction of the incident beam tends to zero and the refracted beam is tangent to the sample support interface. Thus, there is a minimum angle of incidence at which no refracted beam exists and all incident radiation undergoes total reflection. In this study, we evaluated the influence of the energy variation of the beam of incident x-rays, using the MCNPX code (Monte Carlo NParticle) based on Monte Carlo method.

  8. Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Lee, Y K; Ha, Y C; Yoo, J-I; Jo, W L; Kim, K-C; Koo, K H

    2017-06-01

    We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  9. Harmonic analysis of total electron contents time series: methodology and results

    NARCIS (Netherlands)

    Amiri-Simkooei, A.R.; Asgari, J.

    2011-01-01

    In an attempt to model regular variations of the ionosphere, the least-squares harmonic estimation is applied to the time series of the total electron contents (TEC) provided by the JPL analysis center. Multivariate and modulated harmonic estimation spectra are introduced and estimated for the serie

  10. Long-term results with the Kudo type 3 total elbow arthroplasty

    DEFF Research Database (Denmark)

    Thillemann, Theis Muncholm; Olsen, Bo Sanderhoff; Johannsen, Hans Viggo;

    2012-01-01

    From 1992 to 1993, 17 elbows were replaced with the unlinked Kudo type 3 total elbow arthroplasty in 16 patients with arthritic joint destruction. Of these elbows, 8 were available for clinical examination after a mean of 9.5 years. Of the 17 elbow implants, 5 were revised: 2 because of loosening...

  11. Total cysto-prostatectomy: Technique description and results in 2 dogs.

    Science.gov (United States)

    Bacon, Nicholas; Souza, Carlos H de M; Franz, Sarah

    2016-02-01

    We describe a novel technique for total cysto-prostatectomy, followed by uretero-urethral anastomosis in 2 dogs. The technique was successful and was performed without pubic osteotomy. Post-operative urinary tract infections may be a potentially serious event.

  12. Result of bilateral total hip replacement in the treatment of a child with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Владимир Евгеньевич Басков

    2015-12-01

    Full Text Available Total hip replacement in children is performed according to very limited and compelling indications. The principal of such a treatment is the complete and irreversible destruction of the hip joint accompanied by a permanent loss of function of the lower limb. Hip replacement in children with cerebral palsy is a very rare method of treatment. According to observations from the Turner Institute, it was performed in only 2% of all replacement cases. After the placement of an artificial joint, the atherogenic component of the contractures disappears and improves the motor activity of patients. In this paper, a 3-year follow-up of the bilateral total hip replacement in a child with cerebral palsy and bilateral secondary stage III coxarthrosis is presented.

  13. Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project

    OpenAIRE

    Best, A. J.; Fender, D.; Harper, W. M.; McCaskie, A. W.; Oliver, K; Gregg, P J

    1999-01-01

    As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. ...

  14. [Prophylactic total thyroidectomy in childhood for multiple endocrine neoplasia type 2A: preliminary results].

    Science.gov (United States)

    Arts, C H; Bax, N M; Jansen, M; Lips, C J; Vroom, T M; van Vroonhoven, T J

    1999-01-09

    Evaluation of prophylactic total thyroidectomy in childhood in case of MEN2A gene carriership. Retrospective. Prophylactic thyroidectomy was performed in 14 MEN2A gene carriers (7 boys, 7 girls; median age 9.1 year (range: 4.8-14.7)), in June 1993-July 1997 at the department Pediatric Surgery of the Wilhelmina Children's Hospital in Utrecht, the Netherlands. Median time between genetic investigation and operation was 5.5 months (range: 2-35). Lymph node dissection was not performed. The parathyroids were identified and left untouched as far as possible, autotransplantation was performed twice because of doubt about viability. Outpatient follow-up took place every 3-6 months. One patient (13.4 year) showed macroscopic, the other 13 microscopic multifocal medullary thyroid carcinoma, 11 bilateral and 3 unilateral. In 1 child (6.2 year) neuroinvasive growth existed already. Surgical sections were free of tumour. After the operation temporary hoarseness occurred once, temporary hypocalcaemia three times and permanent hypoparathyroidism twice; after autotransplantation no hypocalcaemia occurred. Median follow-up was 3.2 year (range: 1 month-4.0 year). Mild psychological problems were observed in 4 patients, psychiatric problems in 1. Prophylactic total thyroidectomy during the first decade is recommended. Additional lymph node dissection and total parathyroidectomy are unnecessary than. In order to prevent postoperative hypoparathyroidism, autotransplantation of at least one parathyroid is advisable.

  15. Total Hip Arthroplasty Complicated by a Gluteal Hematoma Resulting in Acute Foot Drop.

    Science.gov (United States)

    Khattar, Nicolas K; Parry, Phillip V; Agarwal, Nitin; George, Hope K; Kretz, Eric S; Larkin, Timothy M; Gruen, Gary S; Abla, Adnan A

    2016-01-01

    Total hip arthroplasty is a prevalent orthopedic intervention in the United States. Massive postoperative hematomas are a rare albeit serious complication of the procedure. Sequelae of these hematomas can include lower extremity paralysis from compression of the sciatic nerve. A 66-year-old woman taking aspirin and clopidogrel for coronary stents presented with a complete foot drop, paresthesias, and lower extremity pain 10 days after a total hip arthroplasty. The patient was initially seen by a neurology service at another hospital and thought to have lateral recess stenosis. At the authors' center, magnetic resonance imaging of the lumbar spine failed to show lateral recess stenosis. Urgent pelvic computed tomography showed a large hematoma and raised suspicion of sciatic nerve compression. Hip magnetic resonance imaging showed a right gluteal hematoma compressing the sciatic nerve. The patient was then taken to the operating room for the clot to be evacuated and was later referred for rehabilitation. Massive hematomas after total hip arthroplasty are an important consideration in the differential diagnosis of nontraumatic acute foot drop. Prompt diagnosis may correlate with improved neurological outcome and help reduce overall morbidity.

  16. Five- to 8-year results of the uncemented Duracon total knee arthroplasty system.

    Science.gov (United States)

    Chana, Rishi; Shenava, Yatish; Nicholl, Alison P; Lusted, Felicity J; Skinner, Paul W; Gibb, Paul A

    2008-08-01

    We report prospective clinical and radiographic outcomes of a series of 219 hydroxyapatite-coated Duracon (Stryker Howmedica Osteonics Corporation, Kalamazoo, Mich) total knee arthroplasties with a follow-up of 5 to 8 years. Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and SF-12 Health Status Questionnaire were used. Analysis of fluoroscopic radiographs was performed with the American Knee Society Score. All living patients (186 knees) were followed up. Twenty-eight patients (30 knees) had died. The preoperative Knee Society Score of 43.8 increased to 77.1 and the preoperative Function score of 20.3 increased to 63.4. WOMAC scores showed marked improvement (pain, 250 preoperatively to 157; stiffness, 115 preoperatively to 56; and function, 910 preoperatively to 588). There was no radiographic evidence of loosening or migration. Gaps visible at the bone-implant interface healed over the first year. Three prostheses were revised, 2 for deep infection and 1 for tibial tray subsidence. A survivorship of 98.6% has been achieved at 8 years. This intermediate-term study with 100% follow-up at 8 years demonstrates excellent clinical and radiographic outcomes. It is our opinion that these are comparable to the gold standard cemented total knee arthroplasties and may have advantages over other uncoated cementless designs.

  17. Long-term Results of Primary Total Knee Arthroplasty with and without Patellar Resurfacing

    Directory of Open Access Journals (Sweden)

    Park,Se-Jin

    2010-10-01

    Full Text Available Among patients that underwent total knee arthroplasty from June, 1990 to January, 1999, 61 cases (44 patients that could be followed for more than 10 years were included in this study. The patients were divided into a patellar retention group and a patellar resurfacing group, and were compared with regard to their clinical and radiological outcomes. In patients undergoing primary TKA, a selective patellar resurfacing protocol was used. The indications for patellar retention were a small patella, nearly normal articular cartilage, minimal preoperative patellofemoral pain, poor patellar bone quality, and young patient age. When patellar retention was performed, osteophytes of the patella were removed and marginal electrocauterization was carried out. There were 25 cases (20 patients in the patellar retention group and 36 cases (29 patients in the patellar resurfacing group. The mean follow-up period was 140.7 months in the patellar retention group and 149.0 months in the patellar resurfacing group. The selective patellar resurfacing with total knee arthroplasty had a favorable outcome;there were a significant difference noted between the 2 groups in the functional scores, which showed better outcomes in the patellar resurfacing group than in the patellar retention group.

  18. QUALITY MANAGEMENT AND INTEGRATED TOTAL QUALITY IN SPANISH MINING: RESULTS OF AN EMPIRICAL STUDY

    Directory of Open Access Journals (Sweden)

    CARMEN ESCANCIANO

    2012-01-01

    Full Text Available En este artículo se presentan y analizan los resultados de un estudio empírico realizado en España entre empresas mineras certificadas ISO 9001. El objetivo perseguido es doble: en primer lugar, reflexionar sobre la situación de la gestión de calidad en la minería española; en segundo término, valorar en qué medida la posesión de un sistema de gestión de calidad constituye un pilar a partir del cual iniciar la andadura hacia la calidad total integrada con otros sistemas de gestión tan importantes en este sector industrial como el de la gestión ambiental o la gestión de la seguridad y salud laboral.

  19. Percutaneous laser thermal angioplasty: initial clinical results with a laser probe in total peripheral artery occlusions.

    Science.gov (United States)

    Cumberland, D C; Sanborn, T A; Tayler, D I; Moore, D J; Welsh, C L; Greenfield, A J; Guben, J K; Ryan, T J

    1986-06-28

    A metal-tipped laser fibre was used during percutaneous angioplasty of femoral/popliteal or iliac artery occlusions in 56 patients. Primary success was achieved in 50 (89%) of these total occlusions, providing a channel for subsequent balloon dilatation. Before the procedure, 18 lesions had been judged untreatable by conventional angioplasty and four of the six failures were in these. Complications directly attributable to the laser probe were one case of vessel perforation and two cases of entry into vessel walls; these had no sequelae. Other acute complications were a distal thrombosis in a non-heparinised patient, requiring local streptokinase treatment, and two reocclusions and one transient peripheral embolic episode in the first 24 hours. The laser probe technique has potential for increasing the proportion of patients suitable for angioplasty.

  20. Mitigating effects of hUCB-MSCs on the hematopoietic syndrome resulting from total body irradiation.

    Science.gov (United States)

    Shim, Sehwan; Lee, Seung Bum; Lee, Jong-geol; Jang, Won-Suk; Lee, Sun-Joo; Park, Sunhoo; Lee, Seung-Sook

    2013-04-01

    This study evaluated the clinical and pathologic effects of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in the recovery from total body irradiation by comparing it with the effects of granulocyte-colony stimulating factor (G-CSF), an efficacious drug in the treatment of acute bone marrow radiation syndrome. BALB/c mice were treated with G-CSF or hUCB-MSCs after they were irradiated with 7 Gy cobalt-60 γ-rays. Circulating blood counts, histopathologic changes in the bone marrow, and plasma level of Flt-3L and transforming growth factor (TGF-β1) were monitored in the postirradiation period. Hematologic analysis revealed that the peripheral leukocyte counts were markedly increased in the hUCB-MSCs-treated group, whereas G-CSF-treated mice did not recover significantly. Moreover, differential counts showed that hUCB-MSC treatment has regenerative effects on white blood cells, lymphocytes, and monocytes compared with the irradiated group. Treatment with hUCB-MSCs or G-CSF significantly increased immunoreactivity of Ki-67 until 3 weeks after total body irradiation. However, at 3 weeks, the number of Ki-67 immunoreactive cells significantly increased in the hUCB-MSCs-treated group compared with the G-CSF-treated group. Furthermore, hUCB-MSC treatment significantly modulated plasma levels of the hematopoietic cytokines Flt-3L and TGF-β1, whereas G-CSF treatment failed to decrease the plasma Flt-3L levels at 2 weeks after irradiation. Based on the differences in circulating blood cell reconstitution and cell density of bone marrow, the authors suggest that MSC treatment is superior to G-CSF treatment for hematopoietic reconstitution following sublethal dose radiation exposure.

  1. Long-term results of low dose total body irradiation for advanced non-Hodgkin lymphoma.

    Science.gov (United States)

    Lybeert, M L; Meerwaldt, J H; Deneve, W

    1987-08-01

    Sixty-eight patients received fractionated low dose total body irradiation (LTBI) as treatment for non-Hodgkin lymphoma (NHL) at the Rotterdamsch Radio-Therapeutisch Instituut (RRTI) in the period 1973-1979. Ninety percent (61/68) of these patients had advanced disease (Stage III + IV). According to current malignancy grade classifications, 34 patients had low grade NHL, 10 intermediate, and 19 high grade. In 5 cases no exact grading was possible. LTBI was given 3 times a week, midline dose 0.1 Gy, using 6 or 25 MeV photons to a mean total dose of 1.78 Gy. Initial response rate for low, intermediate, and high grade NHL was resp. 84, 42, and 40%. The main prognostic factor for survival and recurrence-free survival (RFS) was malignancy grade. Probability of uncorrected survival at 10 years for low, intermediate, and high grade was resp. 34, 0 and 0%. Probability of RFS at 10 years was resp. 19, 0, and 0%. Neither stage nor sex had any influence on survival. Age was reversely correlated with survival, but was not correlated with RFS. Influence of prior therapy (18 patients) on survival and RFS was separately analyzed. Neither survival nor RFS of unfavorable histologic type NHL (high and intermediate grade) was influenced. On the other hand patients with a favorable histologic type NHL (low grade) had a significantly (p less than 0.05) better RFS if they received LTBI as initial treatment, but survival was not significantly influenced. RFS at 5 and 10 years of patients who received LTBI as first treatment was respectively 32% and 27%. No treatment related complications were noted. Subsequent chemotherapy in case of relapse was not hampered by previous LTBI. The high response rate and extended RFS, without maintenance therapy, makes LTBI a preferable first line treatment for patients with advanced stage low grade NHL.

  2. Design rationale and biomechanics of Maverick Total Disc arthroplasty with early clinical results.

    Science.gov (United States)

    Mathews, Hallett H; Lehuec, Jean-Charles; Friesem, Tai; Zdeblick, Thomas; Eisermann, Lukas

    2004-01-01

    This paper reviews the design criteria, biomechanical and biological (wear and safety) testing of this chrome cobalt metal-on-metal, ball and socket design prosthesis. The surgical technique and early clinical results of the initial implantations are also reviewed. Initial results of 7 Maverick implantations showed all 7 patients attaining a 15 point Oswestry improvement within 3 months after implantation. This early result in a small sample is significantly quicker in recovery and improvement when compared to the historical control of the LT cage with Infuse IDE study. Longer term results and more careful study are needed of this interesting and optimistic finding.

  3. Death resulting from overzealous total parenteral nutrition: the refeeding syndrome revisited.

    Science.gov (United States)

    Miller, Sarah J

    2008-01-01

    Commentary is provided on the pivotal paper by Weinsier and Krumdieck from 1981 describing 2 patients who developed profound and fatal refeeding syndrome following initiation of aggressive total parenteral nutrition. This classic description was among the first to describe the overwhelming cardiovascular and pulmonary manifestations that can accompany parenteral refeeding with carbohydrate in chronically malnourished patients. The syndrome has also been described with oral and enteral nutrition. One of the hallmarks of the syndrome is hypophosphatemia. Since 1981, dosing schemes for addressing hypophosphatemia have been refined. Other manifestations of the syndrome include other electrolyte abnormalities such as hypokalemia and hypomagnesemia, hyperglycemia, fluid and sodium retention, and neurologic and hematologic complications. Case reports of refeeding syndrome continue to be published, particularly in the anorexia nervosa population. Stressed, critically ill patients may be at risk of refeeding following short periods of fasting; hypophosphatemia is commonly encountered in this situation. It behooves the current nutrition support practitioner to keep in mind the types of patients at risk of refeeding syndrome and to approach refeeding of such patients with caution and careful monitoring.

  4. Return to work after total hip and knee arthroplasty: results from a clinical study.

    Science.gov (United States)

    Tilbury, C; Leichtenberg, C S; Tordoir, R L; Holtslag, M J; Verdegaal, S H M; Kroon, H M; Nelissen, R G H H; Vliet Vlieland, T P M

    2015-12-01

    The aim of this study was to measure return to work and duration until return to work in patients undergoing total hip or knee arthroplasty (THA or TKA). This prospective study included patients under 65 years of age, undergoing THA or TKA, who provided information on their work status preoperatively (paid work yes/no and working hours) and 1 year thereafter (paid work yes/no, working hours and time until return to work). Seventy-one THA and 64 TKA patients had a paid job preoperatively. The employment rates 1 year postoperatively were 64/71 (90 %) after THA and 53/64 (83 %) after TKA. Of those who returned to work, 9/64 (14 %) of THA patients and 10/53 (19 %) of TKA patients worked less hours than preoperatively [mean decrease of 16 (SD 11.5) and 14 (SD 13.0) hours, respectively]. The mean time to return to work was 12.5 (SD 7.6) and 12.9 (SD 8.0) weeks in THA and TKA, respectively. The majority of working patients who underwent THA or TKA returned to work, after approximately 12 weeks. A considerable proportion of the patients returning to work worked less hours than preoperatively. More research into patients who do not return or decrease their working hours is needed.

  5. Trochanteric osteotomies in revision total hip arthroplasty: contemporary techniques and results.

    Science.gov (United States)

    Jando, Victor T; Greidanus, Nelson V; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

    2005-01-01

    Revision total hip arthroplasty (THA) presents several challenges to the orthopaedic surgeon and typically requires the use of a more extensile surgical approach. Osteotomy of the greater trochanter can be considered as the ultimate extensile exposure in revision THA. The methods of trochanteric osteotomy can be categorized into three types: the standard trochanteric osteotomy, the trochanteric slide, and the extended trochanteric osteotomy. Although the standard osteotomy and trochanteric slide osteotomy provide excellent acetabular exposure, in the revision setting they are frequently associated with an unacceptably high rate of nonunion and proximal migration of the trochanteric fragment. The extended trochanteric osteotomy (ETO) has increased in popularity as the number and complexity of revision THAs continue to increase. Two commonly used techniques are the ETO via a posterolateral approach or via a modified direct lateral approach. Both techniques provide wide exposure of the acetabulum, facilitate femoral component exposure and removal, aid in canal preparation and femoral reconstruction, and allow for correction of proximal femoral deformity. The osteotomy fragment is easily secured and may be advanced distally to achieve proper tensioning of the abductors. Recent literature demonstrates that the ETO has a relatively low rate of nonunion and is associated with fewer intraoperative femoral fractures or cortical perforations, as well as decreased surgical time.

  6. Cementless Gustilo-Kyle and BIAS total hip arthroplasty: 2- to 5-year results.

    Science.gov (United States)

    Kienapfel, H; Martell, J; Rosenberg, A; Galante, J

    1991-01-01

    We conducted extensive radiographic and clinical examination of 58 cementless total hip arthroplasties. Forty BIAS femoral stems had heads made of Co-base F 75 alloy and 18 Gustilo-Kyle femoral stems had Ti6A14V alloy heads. The cross-sectional geometry and location of the porous coating pads of the two stem types was identical, the BIAS component being slightly shorter. At the last follow-up, 27.8% of the Gustilo-Kyle femoral components and 2.5% of the BIAS femoral components were unstable. None of the acetabular components in the BIAS group as against 38.9% of the acetabular components in the Gustilo-Kyle group demonstrated wear of more than 1 mm. All unstable components which did not suffer intraoperative fracture had also acetabular wear of more than 1 mm. The only case with endosteal erosion was seen in a patient with an unstable implant displaying the most extensive wear. Nonparametric statistical analysis showed that the patients with Ti6A14V/polyethylene bearing surfaces had a statistically significantly higher extent of wear and a statistically significant higher incidence of femoral component loosening than patients with CrCoMo/polyethylene bearing surfaces.

  7. Long-term results of total body irradiation in adults with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone; Zich, Alexander; Budach, Volker; Jahn, Ulrich; Neumann, Oliver [Charite University Medicine, Department of Radiation Oncology, Berlin (Germany); Martus, Peter [University Tuebingen, Institute of Clinical Epidemiology and Applied Biostatistics, Tuebingen (Germany); Arnold, Renate [Charite University Medicine, Campus CVK, Department of Hematology and Oncology, Bone Marrow Transplant Unit, Berlin (Germany)

    2014-05-15

    The aim of this chart review of adult patients treated for acute lymphoblastic leukemia (ALL) with total body irradiation (TBI) was to evaluate early and late toxicity and long-term outcome. A total of 110 adult patients (34 ± 12 years) with ALL underwent TBI (6 fractions of 2 Gy for a total of 12 Gy) as a part of the treatment regimen before transplantation. Treatment-related toxicity, mortality, and hematologic outcome are reported. Mean follow-up was 70 months. The 2- and 5-year leukemia-free survival rates were 78 and 72 %, respectively. In all, 29 % (32/110) patients suffered from medullary recurrence after a median time of 7 months. Gender was the only statistically significant prognostic factor in terms of overall survival in favor of female patients. Treatment-related mortality and overall survival after 2 and 5 years were 16 and 22 %, and 60 and 52.7 %, respectively. The most frequent late reaction wascGVHD of the skin (n = 33, 30 %). In addition, 15.5 % (17/110 patients) suffered pulmonary symptoms, and 6 patients developed lung fibrosis. Eyes were frequently affected by the radiation (31/110 = 28 %); 12 of 110 patients (11 %) presented with symptoms from osteoporosis, 5 of 110 patients (4.5 %) developed hypothyreosis and 2 patients diabetes mellitus. Of the male patients, 11 % reported erectile dysfunction or loss of libido, while 2 of 36 women reported menopausal syndrome at the mean time of 28 months after treatment with requirement for substitution. No women became pregnant after treatment. No acute or late cardiac toxicities were documented in our patients. No secondary malignancies were documented. Although hematologic outcome was in the upper range of that reported in the literature, treatment-related mortality (TRM) and medullary recurrences remain a challenge. Sophisticated radiation techniques allow for decreasing toxicity to certain organs and/or dose escalation to the bone marrow in highly selected patients in order to improve therapeutic

  8. THE ORDER OF CALCULATION OF THE TOTAL FINANCIAL RESULT OF THE ACCOUNTING REPORTING OF THE ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Bashkatov V. V.

    2014-01-01

    Full Text Available The changes which have happened in the structure and the contents of accounting reports are presented in the article, and the procedure of payments indicator "Cumu-lative financial result of the period" is considered in detail

  9. Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance.

    Science.gov (United States)

    Siepe, Christoph J; Wiechert, Karsten; Khattab, Mohamed F; Korge, Andreas; Mayer, H Michael

    2007-07-01

    Despite the increasing popularity of total lumbar disc replacement (TDR) in predominantly young and active patients, no previous study has addressed possibilities, limitations and potential risks regarding athletic performance following TDR. Mechanical concerns remain and the implant's resilience as regards its load-bearing capacity during sporting activities is unknown. Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9-50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity. Due to the young age of the patients and significant load increase exerted during athletic activities, persisting concerns regarding the future behaviour of the implant remain and will require longer follow-up, modified investigation techniques and larger patient cohorts.

  10. Compendium of Single-Event Latchup and Total Ionizing Dose Test Results of Commercial Analog to Digital Converters

    Science.gov (United States)

    Irom, Farokh; Agarwal, Shri G.

    2012-01-01

    This paper reports single-event latchup and total dose results for a variety of analog to digital converters targeted for possible use in NASA spacecraft's. The compendium covers devices tested over the last 15 years.

  11. Some influences of approximate values for velocity, density and total temperature sensitivities on hot wire anemometer results

    Science.gov (United States)

    Stainback, P. C.

    1986-01-01

    There is a renewed interest in hot wire anemometry at transonic speeds. Recent results were published which indicate that at transonic speeds a heated wire is sensitive only to mass flow and total temperature, results similar to those obtained for supersonic flows. Other results were obtained to show that the sensitivity is a function of velocity, density, and total temperature, results in agreement with many of those obtained in the 1950s. An analysis of anemometry results was made to evaluate possible errors when various assumptions were made concerning the sensitivity of a heated wire to fluid flow variables.

  12. Long-term survival and radiological results of the Duracon™ total knee arthroplasty

    OpenAIRE

    Bachmann, Matthias; Bolliger, Lilianna; Ilchmann, Thomas; Clauss, Martin

    2013-01-01

    Purpose The aim of this study was to analyse the long-term (>ten years) survival rate and radiological results of the Duracon TKA. Methods Between 1992 and 1999 159 Duracon TKA were implanted at our institution. A Kaplan-Meier survival analysis for the endpoints exchange, addition or removal of any component for any reason, revision due to aseptic loosening and mechanical failure was performed. Radiological long-term (>ten years) follow-up (FU) analysis was performed according to the Knee Soc...

  13. Determination of total transformer losses resulting from a semirotating flux excitation

    Energy Technology Data Exchange (ETDEWEB)

    Adly, A.A. [Cairo Univ., Giza (Egypt)

    1995-11-01

    Theoretical and experimental studies have shown that hysteresis losses in a magnetic material subject to an applied rotating field decreases considerably as the field amplitude drives the magnetization into saturation. Recently, low core loss transformers operating with semirotating flux excitation have been proposed. The purpose of this paper is to present an analytical investigation of the overall iron and copper losses of such transformers. In this analysis, core magnetic properties are accurately represented and simulated using vector Preisach models. A sample design for a 110 V, 165 VA single-phase transformer with semirotating flux excitation is given and quantitative analytical results are used as a guide to determine its optimum operating conditions.

  14. Effect of Gender and Preoperative Diagnosis on Results of Revision Total Knee Arthroplasty

    Science.gov (United States)

    Pun, Stephanie Y.

    2008-01-01

    Recent studies question an effect of gender on outcome of primary TKA. We questioned whether the results of revision TKA were affected by gender. We separated 67 revision TKAs by gender and preoperative diagnosis into four groups (arthrofibrosis, infection, instability, and wear and loosening). Each revision TKA was individually matched by age and gender to two primary TKAs. Postoperative Knee Society pain and function scores after revision TKA were lower than for primary TKA for both females and males. However, postoperative Knee Society pain and function scores were similar in males and females. Postoperative pain and function scores were lower for all revision groups compared with primary TKA, except for pain and function scores after revision for instability. Postoperative pain and function scores were higher for instability and wear or loosening than for arthrofibrosis. Our data suggest the results of revision TKA are affected by preoperative diagnosis but not gender. Level of Evidence: Level III, retrospective matched cohort study. See Guidelines for Authors for a complete description of levels of evidence. PMID:18726656

  15. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  16. Clinical results of Maverick lumbar total disc replacement: two-year prospective follow-up.

    Science.gov (United States)

    Le Huec, J C; Mathews, H; Basso, Y; Aunoble, S; Hoste, D; Bley, B; Friesem, T

    2005-07-01

    Disc prosthesis is the new treatment for degenerative disc disease in the lumbar spine. Key to assessing the interest in this new motion technique is evaluating the results in terms of functional and radiologic outcomes. This prospective study reports the outcome of 64 Maverick devices implanted between January 2002 and November 2003. The degree of improvement was equivalent to that obtained with anterior fusion cages using the mini-invasive technique. Radiographic follow-up in this series showed a degree of mobility close to normal. The technique is safe because the intra- and postoperative complication rate is low. The Oswestry score improved for 75% of patients. This improvement is significantly correlated with facet arthrosis and muscle fatty degeneration.

  17. Prescription trajectories and effect of total hip arthroplasty on the use of analgesics, hypnotics, antidepressants, and anxiolytics: results from a population of total hip arthroplasty patients.

    Science.gov (United States)

    Blågestad, Tone; Nordhus, Inger H; Grønli, Janne; Engesæter, Lars B; Ruths, Sabine; Ranhoff, Anette H; Bjorvatn, Bjørn; Pallesen, Ståle

    2016-03-01

    Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, this study sought to investigate redeemed medications in a complete population (N = 39,688) undergoing THA in 2005 to 2011. User rates and redeemed drug volume of analgesics (nonsteroid anti-inflammatory drugs (NSAIDs), opioids, and nonopioids) and psychotropics (hypnotics, anxiolytics, and antidepressants) were calculated for 4 quarters before and 4 quarters after surgery. We analysed preoperative prescription trends (Q1 vs Q4), postoperative prescription (Q4 vs Q5), and long-term effect of surgery (Q4 vs Q8). Before surgery, use of all drug groups increased from Q1 to Q4. Use of opioids, nonopioids, and hypnotics dramatically increased from Q4 to Q5. Long-term (Q4 vs Q8) surgery reduced prescriptions of analgesics, hypnotics, and anxiolytics, but not antidepressants. Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms.

  18. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk : Results from the EPIC cohort study

    NARCIS (Netherlands)

    Sanikini, Harinakshi; Dik, Vincent K.; Siersema, Peter D.; Bhoo-Pathy, Nirmala; Uiterwaal, Cuno S. P. M.; Peeters, Petra H. M.; Alez, Carlos A. Gonz; Zamora-Ros, Raul; Overvad, Kim; Nneland, Anne Tj; Roswall, Nina; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Kuehn, Tilman; Katzke, Verena; Boeing, Heiner; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Tumino, Rosario; Panico, Salvatore; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Huerta, Jose Maria; Sanchez-Cantalejo, Emilio; Barricarte, Aurelio; Sonestedt, Emily; Wallstrom, Peter; Nilsson, Lena Maria; Johansson, Ingegerd; Bradbury, Kathryn E.; Khaw, Kay-Tee; Wareham, Nick; Huybrechts, Inge; Freisling, Heinz; Cross, Amanda J.; Riboli, Elio; Bueno-de-Mesquita, H. B(as)

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and hi

  19. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: results from the EPIC cohort study

    NARCIS (Netherlands)

    Sanikini, H.; Dik, V.K.; Siersema, P.D.; Bhoo-Pathy, N.; Uiterwaal, C.S.; Peeters, P.H.M.; Gonzalez, C.A.; Zamora-Ros, R.; Overvad, K.; Tjonneland, A.; Roswall, N.; Boutron-Ruault, M.C.; Fagherazzi, G.; Racine, A.; Kuhn, T.; Katzke, V.; Boeing, H.; Trichopoulou, A.; Trichopoulos, D.; Lagiou, P.; Palli, D.; Grioni, S.; Vineis, P.; Tumino, R.; Panico, S.; Weiderpass, E.; Skeie, G.; Braaten, T.; Huerta, J.M.; Sanchez-Cantalejo, E.; Barricarte, A.; Sonestedt, E.; Wallstrom, P.; Nilsson, L.M.; Johansson, I.; Bradbury, K.E.; Khaw, K.T.; Wareham, N.; Huybrechts, I.; Freisling, H.; Cross, A.J.; Riboli, E.; Bueno-de-Mesquita, H.B.

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and hi

  20. SRS 2010 Vegetation Inventory GeoStatistical Mapping Results for Custom Reaction Intensity and Total Dead Fuels.

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Lloyd A. [Leading Solutions, LLC.; Paresol, Bernard [U.S. Department of Agriculture, Forest Service, Pacific Northwest Research Station, Portland, OR.

    2014-09-01

    This report of the geostatistical analysis results of the fire fuels response variables, custom reaction intensity and total dead fuels is but a part of an SRS 2010 vegetation inventory project. For detailed description of project, theory and background including sample design, methods, and results please refer to USDA Forest Service Savannah River Site internal report “SRS 2010 Vegetation Inventory GeoStatistical Mapping Report”, (Edwards & Parresol 2013).

  1. Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

    Science.gov (United States)

    Kinlaw, Dennis C.; Eads, Jeannette

    1992-01-01

    It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

  2. Resultados da artroplastia total do cotovelo Bi-Contact®: estudo multicêntrico Results from Bi-Contact® total elbow arthroplasty: multicenter study

    Directory of Open Access Journals (Sweden)

    Eduardo Benegas

    2011-10-01

    Full Text Available OBJETIVO: Descrever a experiência inicial de quatro serviços ortopédicos com a artroplastia total do cotovelo (ATC Bi-Contact® relatando os resultados e complicações do procedimento. MÉTODOS: Estudo retrospectivo, através da análise de prontuários, de pacientes submetidos à ATC primária com modelo de prótese desenvolvido junto ao IOT-HCFMUSP. Foram avaliados 46 cotovelos (45 pacientes operados de 2000 a 2009 em quatro serviços ortopédicos. RESULTADOS: A maioria dos pacientes era do sexo feminino (74% e a mediana da idade foi de 62,5 anos. Os diagnósticos encontrados foram sequela de trauma (47,83%, artrite reumatóide (32,61%, osteoartrose primária (8,7%, fraturas agudas (6,52% e ossificação heterotópica (2,17%. A mediana do tempo de acompanhamento foi de 2,08 anos (0,25-9. O procedimento melhorou significativamente a dor e o arco de movimento. Foi evidenciada a presença de pelo menos uma complicação em 69,57% dos casos, sendo as principais infecção (28,26%, necessidade de revisão (28,26%, fratura intraoperatória (15,22% e soltura asséptica (15,22%. CONCLUSÃO: A ATC do tipo Bi-Contact® propiciou uma melhora significativa na dor e no arco de movimento na presente série. O índice de complicação é alto, sendo as mais frequentes infecção, soltura asséptica e fratura intraoperatória.OBJECTIVE: To describe the initial experience of four orthopedic clinics from using Bi-Contact® total elbow arthroplasty (TEA, reporting the results and complications of the procedure. METHODS: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMUSP. Forty-six elbows (45 patients that were operated at four orthopedic clinics between 2000 and 2009 were evaluated. RESULTS: The majority of the patients were female (74%, and the median age was 62.5 years. The diagnoses encountered were trauma sequelae (47

  3. Resultados de artroplastia total de joelho com e sem implante de recapeamento (resurfacing patelar Results of total knee replacement with/without resurfacing of the patella

    Directory of Open Access Journals (Sweden)

    Abdul Khan

    2012-01-01

    Full Text Available OBJETIVO: Estudar a diferença de dor, estalido e crepitação patelofemoral no pós-operatório em pacientes com ou sem recapeamento patelar após 5 anos, os quais tinham dor patelofemoral antes da cirurgia. Estudar a incidência de dor, estalido e crepitação patelofemoral depois de pateloplastia em ambos os grupos. MÉTODOS: Revisão retrospectiva de 765 pacientes submetidos a artroplastia total do joelho (ATJ com ou sem recapeamento patelar. Os pacientes foram perguntados sobre dor pré e pós-operatória, 5 anos depois da cirurgia. Foram examinados por enfermeiro especializado 5 anos, após a cirurgia para verificar estalidos ou crepitação patelofemoral (PF. RESULTADOS: 688 pacientes (89,9% tinham dor PF pré-operatória. De 688 pacientes, 449 tinham recapeamento patelar (R e 239 não tinham (NR. Trinta e seis pacientes do grupo NR tinham pateloplastia. A incidência de dor PF pós-operatória foi 13,3% no grupo R e 13,6% no grupo NR. A incidência de estalido PF pós-operatório no grupo R foi 10,4% e apenas 1,3% no grupo NR (estatisticamente significante, p OBJECTIVE: To study the difference of post-op patellofemoral pain, clunk and crepitus in patients with/without resurfacing at 5 years who had pre-op patellofemoral pain. To study the incidence of post-operative patellofemoral pain, clunk and crepitus following patelloplasty in both the groups. METHODS: Retrospective review of 765 patients who had total knee replacement with/without resurfacing.Patients were asked about both pre-operative pain and also post-operative pain 5 years after the operation. Patients were examined by a specialist nurse at 5 years post-operatively to check for any patellofemoral clunk/crepitus. RESULTS: 688 patients (89.9% had preoperative PF pain. Of 688 patients, 449 had patellar resurfacing and 239 had not (NR. Thirty-six patients from the NR group had patelloplasty. The incidence of postoperative PF pain was 13.3% in the R group and 13.6% in the NR group

  4. Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years.

    Science.gov (United States)

    Pailhé, Régis; Reina, Nicolas; Cavaignac, Etienne; Sharma, Akash; Lafontan, Valérie; Laffosse, Jean-Michel; Chiron, Philippe

    2013-01-01

    There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d'Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom(®) (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing(®) (Smith & Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001). In group 1 we observed 6 complications only concerned males with Durom(®) implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

  5. Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years

    Directory of Open Access Journals (Sweden)

    Régis Pailhé

    2013-07-01

    Full Text Available There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS and Postel-Merle d’Aubigné (MDA score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1 [100 Durom® (Zimmer Inc., Warsaw, IN, USA and 42 Birmingham Hip Resurfacing® (Smith & Nephew, Memphis, TN, USA] and 278 patients with total hip arthroplasty (group 2. The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001. In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time.

  6. Comparison of total Hg results in sediment samples from Rio Grande reservoir determine by NAA and CV AAS

    Energy Technology Data Exchange (ETDEWEB)

    Franklin, Robson L., E-mail: robsonf@cetesbnet.sp.gov.br [Centro Tecnologico de Saneamento Basico (ELAI/CETESB), SP, Sao Paulo (Brazil). Laboratorio de Quimica Inorganica; Bevilacqua, Jose Eduardo [Centro Tecnologico de Saneamento Basico (CETESB), SP, Sao Paulo (Brazil). UNIFIEO - Centro Universitario FIEO; Favaro, Deborah I.T., E-mail: defavaro@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Laboratorio de Analise por Ativacao Neutronica (LAN/CRPq)

    2011-07-01

    The Rio Grande reservoir is located in the Metropolitan area of Sao Paulo and it is used for recreation purposes and as source water for drinking water production. During the last decades has been detected mercury contamination in the sediments of this reservoir, mainly in the eastern part, near the main affluent of the reservoir, in the Rio Grande da Serra and Ribeirao Pires counties. In the present study bottom sediment samples were collected in four different sites into four sampling campaigns during the period of September 2008 to January 2010. The samples were dried at room temperature, ground and passed through a 2 mm sieve. Total Hg determination in the sediment samples was carried out by two different analytical techniques: neutron activation analysis (NAA) and cold vapor atomic absorption spectrometry (CV AAS). The methodology validation, in terms of precision and accuracy, was performed by reference materials, and presented a recovery of 83 to 108%. The total Hg results obtained by both analytical techniques ranged from 3 to 71 mg kg-1 and were considered similar by statistical analysis, even though NAA technique furnishes the total concentration while CV AAS using the 3015 digestion procedure characterizes only the bioavailable Hg. These results confirm that both analytical techniques were suitable to detect the Hg concentration levels in the Rio Grande sediments studied. The Hg levels in the sediment of the Rio Grande reservoir confirm the anthropogenic origin for this element in this ecosystem. (author)

  7. Certain Results of Measurements of Characteristics of Stratospheric Aerosol Layer and Total Ozone Content at Siberian Lidar Station in Tomsk

    Directory of Open Access Journals (Sweden)

    Nevzorov Aleksey

    2016-01-01

    Full Text Available We consider the results of long-term remote optical monitoring, obtained at the Siberian Lidar Station of Institute of Atmospheric Optics, Siberian Branch, Russian Academy of Sciences in Tomsk (56.5°N, 85.0°E. The scattering characteristics of stratospheric aerosol layer, obtained according to data of lidar measurements since 1986, are presented. We analyze the trends of changes in the total ozone (TO content over Tomsk for the period 1996-2013 according to data of spectrophotometric measurements with employment of Total Ozone Mapping Spectrometer (TOMS data for the period 1979-1994. We determined the periods of elevated content of stratospheric aerosol over Tomsk aftera series of explosive eruptions of volcanoes of Pacific Ring of Fire and Iceland in 2006-2011. Since the second half of 1990s, we record an increasing TO trend, equaling 0.65 DU/yr for the period 1996-2013.

  8. Certain Results of Measurements of Characteristics of Stratospheric Aerosol Layer and Total Ozone Content at Siberian Lidar Station in Tomsk

    Science.gov (United States)

    Nevzorov, Aleksey; Bazhenov, Oleg; Burlakov, Vladimir; Dolgii, Sergey

    2016-06-01

    We consider the results of long-term remote optical monitoring, obtained at the Siberian Lidar Station of Institute of Atmospheric Optics, Siberian Branch, Russian Academy of Sciences in Tomsk (56.5°N, 85.0°E). The scattering characteristics of stratospheric aerosol layer, obtained according to data of lidar measurements since 1986, are presented. We analyze the trends of changes in the total ozone (TO) content over Tomsk for the period 1996-2013 according to data of spectrophotometric measurements with employment of Total Ozone Mapping Spectrometer (TOMS) data for the period 1979-1994. We determined the periods of elevated content of stratospheric aerosol over Tomsk aftera series of explosive eruptions of volcanoes of Pacific Ring of Fire and Iceland in 2006-2011. Since the second half of 1990s, we record an increasing TO trend, equaling 0.65 DU/yr for the period 1996-2013.

  9. An Attempted Substitute Study of Total Skin Electron Therapy Technique by Using Helical Photon Tomotherapy with Helical Irradiation of the Total Skin Treatment: A Phantom Result

    Directory of Open Access Journals (Sweden)

    Chi-Ta Lin

    2013-01-01

    Full Text Available An anthropomorphic phantom was used to investigate a treatment technique and analyze the dose distributions for helical irradiation of the total skin (HITS by helical tomotherapy (HT. Hypothetical bolus of thicknesses of 0, 10, and 15 mm was added around the phantom body to account for the dose homogeneity and setup uncertainty. A central core structure was assigned as a “complete block” to force the dose tangential delivery. HITS technique with prescribed dose (Dp of 36 Gy in 36 fractions was generated. The radiochromic EBT2 films were used for the dose measurements. The target region with 95.0% of the Dp received by more than 95% of the PTV was obtained. The calculated mean doses for the organs at risk (OARs were 4.69, 3.10, 3.20, and 2.94 Gy for the lung, heart, liver, and kidneys, respectively. The measurement doses on a phantom surface for a plan with 10 mm hypothetical bolus and bolus thicknesses of 0, 1, 2, and 3 mm are 89.5%, 111.4%, 116.9%, and 117.7% of Dp, respectively. HITS can provide an accurate and uniform treatment dose in the skin with limited doses to OARs and is safe to replace a total skin electron beam regimen.

  10. Eliminating patellofemoral complications in total knee arthroplasty: clinical and radiographic results of 121 consecutive cases using the Duracon system.

    Science.gov (United States)

    Mont, M A; Yoon, T R; Krackow, K A; Hungerford, D S

    1999-06-01

    This study reports the minimum 5-year follow-up of our experience with the Duracon Total Knee Arthroplasty System. A total of 121 consecutive total knee replacements using the Duracon system (Howmedica, Rutherford, NJ) were performed in 104 patients. Three patients died before the 5-year follow-up and were excluded from the final evaluation. The remaining 118 knees (101 patients) were assessed at a mean follow-up of 65 months (range, 60-80 months). The knee diagnoses were osteoarthritis in 97 patients, rheumatoid arthritis in 2 patients, osteonecrosis in 1 patient, and pigmented villonodular synovitis in 1 patient. The mean age was 70 years (range, 28-85 years). There were no reoperations for aseptic loosening, and there have been no reoperations for patellofemoral problems. At final follow-up evaluation, 112 knees (96%) had good or excellent results, and 6 knees (4%) had poor clinical results or went on to revision. For the surviving knees, the preoperative Knee Society objective score improved from a mean of 52 points (range, 20-72 points) to a final follow-up mean of 94 points (range, 66-100 points). Five knees needed reoperations: 2 knees in 1 patient because of acute hematogenous infection at 12 months, 1 knee because of a supracondylar femur fracture, 1 because of a patellar tendon rupture, and 1 to increase polyethylene thickness because of instability. The lack of aseptic loosening at the minimum 5-year follow-up compares favorably with any cemented or cementless series of knee replacement. The almost complete absence of patellofemoral complications in this series also indicates that the design changes, with particular attention to the trochlea design and patellofemoral contact throughout full flexion, have achieved their intended purpose. The results are encouraging at midterm, awaiting true long-term (15-20 years) follow-up.

  11. Surgical and pathomorphological results of total mesorectumectomy by using waterjet dissection technique in patients with rectal cancer

    Directory of Open Access Journals (Sweden)

    D. V. Sidorov

    2016-01-01

    Full Text Available Background. The paper presents our own experience of using a waterjet dissector ERBEJET2® in the course of surgical interventions for colorectal cancer. This experience is unique for Russia.Materials and methods. Waterjet dissection method associated with total  mesorectumectomy was used by us in 20 patients suffering from rectal cancer. An average age of patients was 59.2 ± 13.9 years. In all the patients surgeries were performed for adenogenic colorectal cancer, morphologically verified at the preoperative stage. Resected preparations were studied on morphological level. For comparison, two control groups of 20 patients were selected, in which the rectum mobilization was performed by using monopolar coagulator and harmonic scalpel. The studied groups were matched by gender, age, location and the tumor extent. All the surgeries were performed by one surgical team.Results. Results of the study demonstrated advantages of waterjet dissection when performing total mesorectumectomy due to a minimum depth of tissue damage on the lateral margin of resection.Conclusion. Waterjet dissectors have taken their place in the extensive list of tools used when performing surgical interventions for colorectal cancer, that allows to expect an improvement of functional and oncological results of the surgical treatment.

  12. Clinical outcome of successful percutaneous coronary intervention for chronic total occlusion: results from the multicenter Korean Chronic Total Occlusion (K-CTO) registry.

    Science.gov (United States)

    Kim, Byeong-Keuk; Shin, Sanghoon; Shin, Dong-Ho; Hong, Myeong-Ki; Gwon, Hyeon-Cheol; Kim, Hyo-Soo; Yu, Cheol Woong; Park, Hun Sik; Chae, In-Ho; Rha, Seung-Woon; Lee, Seung-Hwan; Kim, Moo-Hyun; Hur, Seung-Ho; Jang, Yangsoo

    2014-06-01

    To investigate the impact of the success or failure of chronic total occlusion (CTO) interventions on the clinical outcomes in the current drug-eluting stent (DES) era. The impact of the successful CTO intervention on long-term clinical outcomes still remains unclear. Between 2007 and 2009, a total of 2568 patients with CTO were followed in a multicenter Korean CTO registry. Of these, successful recanalization with DESs occurred in 2045 patients (successful CTO group), whereas failure occurred in 523 patients (failed CTO group). The occurrence of the composite of cardiac death and myocardial infarction (MI) was compared between the successful CTO and failed CTO groups. During follow-up (median duration, 729 days), the occurrence of cardiac death or MI was significantly lower in the successful CTO group than in the failed CTO group (1.7% vs 3.3%; hazard ratio, 0.50; 95% confidence interval, 0.28-0.91; P=.02) and the cumulative occurrence in the successful CTO group was also significantly lower than in the failed CTO group (1.7% vs 3.0%; P=.03) by the Kaplan-Meier method. The successful CTO group had a significantly lower need for bypass surgery than the failed CTO group (0.2% vs 2.5%; PCTO (odds ratio, 0.51; 95% CI, 0.29-0.92) was significantly predictive of the occurrence of cardiac death or MI, together with age and left ventricular ejection fraction CTO intervention with DESs compared to failed CTO intervention was associated with lower event rates during follow-up.

  13. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: results from the EPIC cohort study.

    Science.gov (United States)

    Sanikini, Harinakshi; Dik, Vincent K; Siersema, Peter D; Bhoo-Pathy, Nirmala; Uiterwaal, Cuno S P M; Peeters, Petra H M; González, Carlos A; Zamora-Ros, Raul; Overvad, Kim; Tjønneland, Anne; Roswall, Nina; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Kühn, Tilman; Katzke, Verena; Boeing, Heiner; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Tumino, Rosario; Panico, Salvatore; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Huerta, José María; Sánchez-Cantalejo, Emilio; Barricarte, Aurelio; Sonestedt, Emily; Wallstrom, Peter; Nilsson, Lena Maria; Johansson, Ingegerd; Bradbury, Kathryn E; Khaw, Kay-Tee; Wareham, Nick; Huybrechts, Inge; Freisling, Heinz; Cross, Amanda J; Riboli, Elio; Bueno-de-Mesquita, H B

    2015-03-15

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and histological type in the European Prospective Investigation into Cancer and Nutrition study. Coffee and tea consumption were assessed by dietary questionnaires at baseline. Adjusted hazard ratios (HRs) were calculated using Cox regression models. During 11.6 years of follow up, 683 gastric adenocarcinoma cases were identified among 477,312 participants. We found no significant association between overall gastric cancer risk and consumption of total coffee (HR 1.09, 95%-confidence intervals [CI]: 0.84-1.43; quartile 4 vs. non/quartile 1), caffeinated coffee (HR 1.14, 95%-CI: 0.82-1.59; quartile 4 vs. non/quartile 1), decaffeinated coffee (HR 1.07, 95%-CI: 0.75-1.53; tertile 3 vs. non/tertile 1) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100 mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive association was observed between gastric cardia cancer risk and caffeinated coffee consumption (HR 1.98, 95%-CI: 1.16-3.36, p-trend=0.06; quartile 3 vs. non/quartile 1) and per increment of 100 mL/day (HR 1.09, 95%-CI: 1.04-1.14). In conclusion, consumption of total, caffeinated and decaffeinated coffee and tea is not associated with overall gastric cancer risk. However, total and caffeinated coffee consumption may be associated with an increased risk of gastric cardia cancer. Further prospective studies are needed to rule out chance or confounding. © 2014 UICC.

  14. Results from three years of the world's largest interlaboratory comparison for total mercury and methylmercury: Method performance and best practices

    Science.gov (United States)

    Creswell, J. E.; Engel, V.; Carter, A.; Davies, C.

    2013-12-01

    Brooks Rand Instruments has conducted the world's largest interlaboratory comparison study for total mercury and methylmercury in natural waters annually for three years. Each year, roughly 50 laboratories registered to participate and the majority of participants submitted results. Each laboratory was assigned a performance score based on the distance between its results and the consensus mean, as well as the precision of its replicate analyses. Participants were also asked to provide detailed data on their analytical methodology and equipment. We used the methodology data and performance scores to assess the performance of the various methods reported and equipment used. Although the majority of methods in use show no systematic trend toward poor analytical performance, there are noteworthy exceptions. We present results from each of the three years of the interlaboratory comparison exercise, as well as aggregated method performance data. We compare the methods used in this study to methods from other published interlaboratory comparison studies and present a list of recommended best practices. Our goals in creating a list of best practices are to maximize participation, ensure inclusiveness, minimize non-response bias, guarantee high data quality, and promote transparency of analysis. We seek to create a standardized methodology for interlaboratory comparison exercises for total mercury and methylmercury analysis in water, which will lead to more directly comparable results between studies. We show that in most cases, the coefficient of variation between labs measuring replicates of the same sample is greater than 20% after the removal of outlying data points (e.g. Figure 1). It is difficult to make comparisons between studies and ecosystems with such a high variability between labs. We highlight the need for regular participation in interlaboratory comparison studies and continuous analytical method improvement in order to ensure accurate data. Figure 1

  15. [Total reverse shoulder replacement. Evaluation of the clinical results and complications in a series of 52 cases].

    Science.gov (United States)

    Cáceres-Sánchez, L; Mesa-Mateo, A; Barrionuevo-Sánchez, F J; García-Benítez, B; Expósito-Triano, S

    2015-01-01

    To evaluate the clinical results and analyse the complications of total reverse shoulder replacement performed in our centre over an 8 year period. A retrospective study was conducted on 50 patients (52 shoulders), with a mean age of 70.15 years (range 51 to 84 years) between December 2004 and December 2012, who received a total reverse shoulder replacement, all performed by the same surgeon. The results have been evaluated according to clinical data, radiography study, a satisfaction scale, and the Constant scale, with a minimum follow-up of 16 months. Five of the cases (9.62%) had been intervened due to fractures of the proximal end of the humerus, 6 cases (11.53%) as surgical consequence of a prosthesis revision, 10 cases (19.23%) due to fracture sequelae, and 30 cases (59.62%) were patients with arthropathy due to a massive fracture of the rotator cuff. After a mean follow up of 35.78 months (range, 16-82), satisfactory clinical results were obtained in 80% of cases, with a mean preoperative Constant of 27.7 points, and reaching 67.1 points 12 months after the operation. On the visual analogue scale, 8.25 points were obtained before the surgery, which decreased to 2.25 points 12 months later. The complications rate was 15.38%, which were due to an intra-operative fracture (1.92%), deep infection (3.84%), instability (3.84%), and early mechanical loosening (3.84%). Scapular notching was observed in the radiographic study in 9 (17.3%) cases. After the results obtained, it could be said that total reverse shoulder replacement achieved encouraging results in the short term for the treatment of glenohumeral arthrosis and massive tears of the rotary cuff. On analysing our series, it can be seen that the complications rate is much higher when it is used to treat fracture sequelae in which there is a loss of proximal humerus bone stock. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  16. Porous tantalum uncemented acetabular shells in revision total hip replacement: two to four year clinical and radiographic results.

    Science.gov (United States)

    Kim, W Y; Greidanus, N V; Duncan, C P; Masri, B A; Garbuz, D S

    2008-01-01

    In cementless revision total hip arthroplasty (THA), achieving initial implant stability and maximising host bone contact is key to the success of reconstruction. Porous tantalum acetabular shells may represent an improvement from conventional porous coated uncemented cups in revision acetabular reconstruction associated with severe acetabular bone defects. We reviewed the results of 46 acetabular revisions with Paprosky 2 and 3 acetabular bone defects done with a hemispheric, tantalum acetabular shell and multiple supplementary screws. At a mean follow-up of 40 (24-51) months, one acetabular shell had been revised in a patient with a Paprosky 3B defect. Cementless acetabular revision with the tantalum acetabular shell demonstrated excellent early clinical and radiographic results and warrants further evaluation in revision acetabular reconstruction associated with severe acetabular bone defects.

  17. Total protein concentration and diagnostic test results for gray wolf (Canis lupus) serum using Nobuto filter paper strips

    Science.gov (United States)

    Jara, Rocio F.; Sepúlveda, Carolina; Ip, Hon S.; Samuel, Michael D.

    2015-01-01

    Nobuto filter paper strips are widely used for storing blood-serum samples, but the recovery of proteins from these strips following rehydration is unknown. Poor recovery of proteins could reduce the concentration of antibodies and antigens and reduce the sensitivity of diagnostic assays. We compared the protein concentration, and its association with test sensitivity, of eluted Nobuto strip samples with paired sera. We collected and froze serum from five gray wolves (Canis lupus) for 8 mo. When thawed, we used a spectrophotometer (absorbance 280 nm) to determine the serum protein concentration for paired sera and Nobuto eluates for each animal in 2-fold serial dilutions. Total protein concentration was similar for both sample storage methods (Nobuto eluates and control sera), except for the undiluted samples in which Nobuto eluates had higher total protein concentrations. Both sample storage methods appear to produce similar results using the SNAP® 4Dx® Test to detect antibodies against pathogens causing Lyme disease, anaplasmosis, and ehrlichiosis as well as antigen for canine heartworm disease.

  18. First results from the NASA WB-57 airborne observations of the Great American 2017 Total Solar Eclipse

    Science.gov (United States)

    Caspi, Amir; Tsang, Constantine; DeForest, Craig; Seaton, Daniel B.; Bryans, Paul; Tomczyk, Steven; Burkepile, Joan; Judge, Phil; DeLuca, Edward E.; Golub, Leon; Gallagher, Peter T.; Zhukov, Andrei; West, Matthew; Durda, Daniel D.; Steffl, Andrew J.

    2017-08-01

    Total solar eclipses present rare opportunities to study the complex solar corona, down to altitudes of just a few percent of a solar radius above the surface, using ground-based and airborne observatories that would otherwise be dominated by the intense solar disk and high sky brightness. Studying the corona is critical to gaining a better understanding of physical processes that occur on other stars and astrophysical objects, as well as understanding the dominant driver of space weather that affects human assets at Earth and elsewhere. For example, it is still poorly understood how the corona is heated to temperatures of 1-2 MK globally and up to 5-10 MK above active regions, while the underlying chromosphere is 100 times cooler; numerous theories abound, but are difficult to constrain due to the limited sensitivities and cadences of prior measurements. The origins and stability of coronal fans, and the extent of their reach to the middle and outer corona, are also not well known, limited in large part by sensitivities and fields of view of existing observations.Airborne observations during the eclipse provide unique advantages; by flying in the stratosphere at altitudes of 50 kft or higher, they avoid all weather, the seeing quality is enormously improved, and additional wavelengths such as near-IR also become available due to significantly reduced water absorption. For an eclipse, an airborne observatory can also follow the shadow, increasing the total observing time by 50% or more.We present the first results from airborne observations of the 2017 Great American Total Solar Eclipse using two of NASA's WB-57 research aircraft, each equipped with two 8.7" telescopes feeding high-sensitivity visible (green-line) and near-IR (3-5 µm) cameras operating at high cadence (30 Hz) with ~3 arcsec/pixel platescale and ±3 R_sun fields of view. The aircraft will fly along the eclipse path, separated by ~90 km, to observe a summed ~8 minutes of totality in both visible and

  19. A Cannulated Tri-Tapered Femoral Stem for Total Hip Arthroplasty: Clinical and Radiological Results at Ten Years.

    Science.gov (United States)

    Rajakulendran, Karthig; Strambi, Francesco; Ruggeri, Riccardo; Field, Richard E

    2015-10-01

    We report the ten-year clinical and radiological outcomes of a novel cannulated, tri-tapered femoral stem, used in primary total hip arthroplasty (110 stems in 98 patients). At ten years, two Tri-taper stems had been revised for infection and dislocation. The mean Oxford Hip Score improved from 13.46 pre-operatively, to 37.04. Radiological analysis revealed radiolucent lines in 57 cases, but none exceeded 2 mm thickness. Stem subsidence was identified in 63 cases, with mean distal tip migration of 3.8 mm. Survivorship with revision for aseptic loosening as the end point was 100% at 10 years. Stem survival with revision for any cause was 98.2% (95% CI, 92.9% to 99.5%). The ten-year results of the Tri-taper stem are comparable to other polished, tapered femoral stems. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Reconstruction of a deficient patella in revision total knee arthroplasty: results of a new surgical technique using transcortical wiring.

    Science.gov (United States)

    Seo, Jai-Gon; Moon, Young-Wan; Lee, Byung-Hoon; Kim, Sang-Min

    2015-02-01

    This study aimed to report the results of a novel surgical technique for the reconstruction of a deficient patella during revision total knee arthroplasty (TKA). Twenty-eight patients (30 knees) with a deficient patella were treated with an onlay-type prosthesis and bone-augmenting procedure, using acrylic bone cement and transcortical wiring. The technique was indicated when the thickness of remnant patella was less than 8mm with variable amounts of the peripheral rim. Mean follow-up period was 36.6months (range, 24 to 55months).The respective mean Knee Society scores for knee and function improved from 34.2 and 23 points, preoperatively to 73.5 and 61 points, at final follow-up. One patient experienced patellar fracture 1week after surgery. There were no complications associated with implanted hardware. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Three- to five-year results with the cementless Harris-Galante acetabular component used in hybrid total hip arthroplasty.

    Science.gov (United States)

    Kienapfel, H; Pitzer, W; Griss, P

    1992-01-01

    In this paper we present our 3- to 5-year results after hybrid total hip replacement using the cementless porous coated Harris-Galante acetabular component and the cemented Griss femoral component in 39 patients with 40 implantations. Postoperatively, mild to moderate pain was experienced by 16.1% of patients, mostly following hard activity. A slight to moderate limp occurred in 24.2%. All patients were able to walk more than 1000 m. Full-time use of support was required by 2.8%. The postoperative range of motion was increased in 93.9%. Radiographically, none of the acetabular or femoral components had to be classified as unstable. Only one acetabular component displayed complete (i.e., along all interface zones) radiolucency and was therefore classified as possibly unstable.

  2. Modular stem fixed-bearing total ankle replacement: prospective results of 23 consecutive cases with 3-year follow-up.

    Science.gov (United States)

    Brigido, Stephen A; Galli, Melissa M; Bleazey, Scott T; Protzman, Nicole M

    2014-01-01

    In the present report, the 3-year outcomes of 23 consecutive patients treated with a modular stem fixed-bearing total ankle replacement are described. Pain, functional impairment, and disability were assessed annually using a visual analog scale. Complications and additional procedures also were recorded. Compared with preoperative pain (8.4 ± 1.4), functional impairment (8.7 ± 2.3), and disability (3.0 ± 2.5), there were statistically significant postoperative improvements at 1 year (pain, 2.6 ± 1.6; functional impairment, 3.1 ± 2.1; disability, 0.9 ± 1.2), 2 years (pain, 1.5 ± 1.3; functional impairment, 1.9 ± 1.4; disability, 0.6 ± 1.4), and 3 years (pain, 1.3 ± 1.3; functional impairment, 1.9 ± 1.9; disability, 0.4 ± 0.9; p ≤ .001). Pain, function, and disability significantly improved postoperatively from 1 to 2 years (p ≤ .008) and from 1 to 3 years (p ≤ .008). The reductions in pain, functional impairment, and disability were maintained from 2 to 3 years (p ≥ .08). Nine complications (39.1%) were encountered: 1 deep infection, 2 pulmonary embolisms, 3 wounds, 1 ectopic bone formation, 1 stiff joint, and 1 talar subsidence. In the 3-year follow-up period, 3 patients (13.0%) required additional procedures after the immediate postoperative phase. Our results have demonstrated that modular stem fixed-bearing prostheses can be implanted in a predictable and consistent fashion with resultant improvements in pain, function, and disability. Future studies evaluating the clinical outcomes after modular stem fixed-bearing total ankle replacement are warranted.

  3. The results of knee manipulation for stiffness after total knee arthroplasty with or without an intra-articular steroid injection

    Directory of Open Access Journals (Sweden)

    Sharma Vineet

    2008-01-01

    Full Text Available Background: Stiffness after total knee arthroplasty (TKA requiring manipulation has a reported incidence of 1.3-54%. The purpose of this study was to compare the incidence of stiffness warranting manipulation using two different pain management protocols. We also studied the effect of an intra-articular injection of local anesthetic and steroid given at the time of manipulation on the range-of-motion (ROM at last follow-up. Materials and Methods: A total of 286 TKAs (248 patients between January 2002 and December 2003 were compared to a second group of 292 TKAs (251 patients between January 2004 and March 2006. The first group received patient-controlled analgesia (PCA for postoperative pain management. The second group had a peri-articular injection of a steroid-containing local anesthetic at the time of surgery, but no postoperative PCA. All patients undergoing manipulation in the second group also received a similar intra-articular injection at the time of manipulation as well. Only patients with minimum 12 months follow-up after manipulation were included in the study. Results: The overall incidence of stiffness requiring manipulation in both groups was similar at 2.4% and 2.1%, respectively ( P = 0.1. The end results of manipulation with and without injection showed a significantly higher final ROM in patients who had had an injection at the time of manipulation ( P = 0.001. The difference was due to the fact that patients who had an injection lost no motion from that achieved at the time of manipulation. Conclusion: We were unable to demonstrate a significant reduction in the incidence of stiffness after TKA using a modern pain management protocol. However, injection of a local anesthetic and steroid at the time of manipulation did have a significant influence on preserving the ROM that was obtained at the time of manipulation.

  4. Description and primary results of Total Solar Irradiance Monitor, a solar-pointing instrument on an Earth observing satellite

    Science.gov (United States)

    Wang, Hongrui; Fang, Wei; Li, Huiduan

    2015-04-01

    Solar driving mechanism for Earth climate has been a controversial problem for centuries. Long-time data of solar activity is required by the investigations of the solar driving mechanism, such as Total Solar Irradiance (TSI) record. Three Total Solar Irradiance Monitors (TSIM) have been developed by Changchun Institute of Optics, Fine Mechanics and Physics for China Meteorological Administration to maintain continuities of TSI data series which lasted for nearly 4 decades.The newest TSIM has recorded TSI daily with accurate solar pointing on the FY-3C meteorological satellite since Oct 2013. TSIM/FY-3C has a pointing system for automatic solar tracking, onboard the satellite designed mainly for Earth observing. Most payloads of FY-3C are developed for observation of land, ocean and atmosphere. Consequently, the FY-3C satellite is a nadir-pointing spacecraft with its z axis to be pointed at the center of the Earth. Previous TSIMs onboard the FY-3A and FY-3B satellites had no pointing system, solar observations were only performed when the sun swept through field-of-view of the instruments. And TSI measurements are influenced inevitably by the solar pointing errors. Corrections of the solar pointing errors were complex. The problem is now removed by TSIM/FY-3C.TSIM/FY-3C follows the sun accurately by itself using its pointing system based on scheme of visual servo control. The pointing system is consisted of a radiometer package, two motors for solar tracking, a sun sensor and etc. TSIM/FY-3C has made daily observations of TSI for more than one year, with nearly zero solar pointing errors. Short time-scale variations in TSI detected by TSIM/FY-3C are nearly the same with VIRGO/SOHO and TIM/SORCE.Instrument details, primary results of solar pointing control, solar observations and etc will be given in the presentation.

  5. Revision of partial knee to total knee arthroplasty with use of patient-specific instruments results in acceptable femoral rotation.

    Science.gov (United States)

    Schotanus, Martijn G M; Thijs, Elke; Boonen, B; Kerens, B; Jong, B; Kort, Nanne P

    2017-08-07

    Patient-specific instruments (PSI) were initially developed for the alignment of both total knee- (TKA) and partial knee arthroplasty (PKA). We hypothesize that CT-based PSI for PKA-to-TKA revision surgery can restore biomechanical limb alignment and prosthetic component positioning in vivo as calculated pre-operatively, resulting in a limited percentages of outliers. An imaging analysis was performed using CT-based 3D measurement methods based on a pre- and post-revision CT scan. Imaging data were gathered on 10 patients who were operated for PKA-to-TKA revision with the use of PSI based on CT imaging. The planned femur and tibia component position in vivo were compared with the pre-revision planned component position. Outliers were defined as deviations >3.0° from pre-revision planned position for the individual implant components. Adjustments (e.g. resection level and implant size) during surgery were recorded. The HKA axis was restored accurately in all patients with a mean post-operative HKA axis of 178.1° (1.4°). Five femoral (2 varus, 2 internal rotation and 1 extension) and 14 tibial guides (2 varus, 6 anterior slope, 3 internal rotation and 3 external rotation) on a total of 60 outcome measures were identified as outliers. During surgery, an intraoperative tibial resection of 2 mm extra was performed in three patients. In 80 and 70% for, respectively, the femur and tibia, the surgeon-planned size was implanted during surgery. All patient-specific guides fitted well in all patients. No intraoperative or post-operative complications related to surgery were registered. This study introduced a unique new concept regarding PSI, PKA-to-TKA revision surgery. Based on the results, we were unable to fully confirm our hypothesis. PSI as a "new" tool for PKA-to-TKA revision surgery appears to be an accurate tool for the alignment of the TKA femur component. The tibial guide seems more susceptible to errors, resulting in a substantial percentage of outliers

  6. Our Results in Patients with Inguinal Hernia in Whom Total Extraperitoneal Preperitoneal (Tepp Method Has Been Used

    Directory of Open Access Journals (Sweden)

    Akgün Çelik

    2012-12-01

    Full Text Available Aim: TEPP (Total extraperitoneal preperitoneal inguinal hernia repair is a laparoscopic technique. In this study, we aimed to evaluate the clinical outcomes of TEPP. Methods: Hospital records of 130 patients who underwent TEPP in Bezm-i Alem Valide Sultan Gureba Training and Research Hospital between January 2005 and January 2010 were retrospectively evaluated. Demographic characteristics, length of hospital stay, return to an active life, complications, and recurrence rates were determined. Results: The mean age was 41 years and 85% of the patients were male. Most of the patients had inguinal hernia type 3B according to Nyhus classification (92. Seven patients had 3C and, type 3A was found in 22 patients. Of the 130 patients, 9 had recurrence. The mean duration of surgery was 30 minutes and the mean length of hospital stay was 1.2 days. The most common complication was accumulation of fluid in the scrotum (24 patients. Major vascular injury, organ injury, and wound infection were not detected. There was no recurrence during 3-60-month-follow-up. Conclusion: Return to an active life, duration of surgery, complication rates, and cosmetic results in TEPP were better than that in other techniques. (The Me di cal Bul le tin of Ha se ki 2012; 50: 119-21

  7. Clinicopathological characteristics of patients with amyotrophic lateral sclerosis resulting in a totally locked-in state (communication Stage V).

    Science.gov (United States)

    Hayashi, Kentaro; Mochizuki, Yoko; Takeuchi, Ryoko; Shimizu, Toshio; Nagao, Masahiro; Watabe, Kazuhiko; Arai, Nobutaka; Oyanagi, Kiyomitsu; Onodera, Osamu; Hayashi, Masaharu; Takahashi, Hitoshi; Kakita, Akiyoshi; Isozaki, Eiji

    2016-09-30

    In the present study, we performed a comprehensive analysis to clarify the clinicopathological characteristics of patients with amyotrophic lateral sclerosis (ALS) that had progressed to result in a totally locked-in state (communication Stage V), in which all voluntary movements are lost and communication is impossible. In 11 patients, six had phosphorylated TAR DNA-binding protein 43 (pTDP-43)-immunoreactive (ir) neuronal cytoplasmic inclusions (NCI), two had fused in sarcoma (FUS)-ir NCI, and three had copper/zinc superoxide dismutase (SOD1)-ir NCI. The time from ALS onset to the need for tracheostomy invasive ventilation was less than 24 months in ten patients. Regardless of accumulated protein, all the patients showed common lesions in the pallido-nigro-luysian system, brainstem reticular formation, and cerebellar efferent system, in addition to motor neurons. In patients with pTDP-43-ir NCI, patients with NCI in the hippocampal dentate granule neurons (DG) showed a neuronal loss in the cerebral cortex, and patients without NCI in DG showed a preserved cerebral cortex. By contrast, in patients with FUS-ir NCI, patients with NCI in DG showed a preserved cerebral cortex and patients without NCI in DG showed marked cerebral degeneration. The cerebral cortex of patients with SOD1-ir NCI was preserved. Together, these findings suggest that lesions of the cerebrum are probably not necessary for progression to Stage V. In conclusion, patients with ALS that had progressed to result in communication Stage V showed rapidly-progressed symptoms, and their common lesions could cause the manifestations of communication Stage V.

  8. Loss of albumin and megalin binding to renal cubilin in rats results in albuminuria after total body irradiation.

    Science.gov (United States)

    Yammani, Raghunatha R; Sharma, Mukut; Seetharam, Shakuntla; Moulder, John E; Dahms, Nancy M; Seetharam, Bellur

    2002-08-01

    The role of the renal apical brush-border membrane (BBM) endocytic receptors cubilin and megalin in the onset of albuminuria in rats exposed to a single dose of total body irradiation (TBI) has been investigated. Albuminuria was evident as immunoblot (IB) analysis of the urine samples from TBI rats revealed excretion of large amounts of albumin. IB analysis of the BBM proteins did not reveal any significant changes in cubilin or megalin levels, but (125)I-albumin binding to BBM from TBI rats declined by 80% with a fivefold decrease (from 0.5 to 2.5 microM) in the affinity for albumin. IB analysis of cubilin from the BBM demonstrated a 75% loss when purified using albumin, but not intrinsic factor (IF)-cobalamin (Cbl) ligand affinity chromatography. Immunoprecipitation (IP) of Triton X-100 extract of the BBM with antiserum to cubilin followed by IB of the immune complex with an antiserum to megalin revealed a 75% loss of association between megalin and cubilin. IP studies with antiserum to cubilin or megalin and IB with antiserum to the cation-independent mannose 6-phosphate/insulin-like growth factor II-receptor (CIMPR) revealed that CIMPR interacted with both cubilin and megalin. In addition, TBI did not disrupt the association of CIMPR with either cubilin or megalin in BBM. These results suggest that albuminuria noted in TBI rats is due to selective loss of albumin and megalin, but not CIMPR or IF-Cbl binding by cubilin. Furthermore, these results also suggest that albumin and IF-Cbl binding to cubilin occur at distinct sites and that in the rat renal BBM, CIMPR interacts with both cubilin and megalin.

  9. Comparision of Fixed-Bearing and Mobile-Bearing Total Knee Arthroplasties: Short-Term Clinical Results

    Directory of Open Access Journals (Sweden)

    Burak Kaymaz

    2015-05-01

    Full Text Available Introduction: Mobile-bearing knee replacements were introduced as an alternative to fixed-bearing prosthesis to decrease the wear. Despite theoretical advantages of mobile bearings prosthesis, it is still controversial whether there is any clinically significant difference between the patients treated with fixed and mobile bearing prosthesis. The aim of this study is to compare the short-term clinical outcomes of fixed  versus mobile-bearing prosthesises.Methodology: Patients who were diagnosed as grade 4 gonartrosis and operated for total knee arthroplasty between years 2010-2014 were evaluated and 33 patients (40 knees were included in the study. From hospital medical and radiological databases, age and gender of the patients, duration of operation, number of blood tranfusions postoperatively and pre-operative range of motions (ROM of the operated knees were recorded and all the patients were assessed with  Knee Society Knee Score. Results:  Twenty-two knees (12 female, 10 male were present in fixed bearing group (Group I and 18 knees (13 female, 5 male were present in mobile bearing group (Group II. There was no statistically significant difference between the groups in terms of pre-operative range of motions (ROM, post-operative range of motions (ROM, number of blood transfusions. Knee Society Knee Score was 167.7±23.4 in Group I and 178.1±22.4 in Group II. Mobile bearing prosthesis group was found to have better knee score and this difference was near to statistically significance (p=0.055.Conclusions: Clinical outcomes of mobile bearing prosthesis seems to be better in short-term follow-up but long-term results should also be investigated before recommending the mobile bearing prosthesises.

  10. Scanning imaging absorption spectrometer for atmospheric chartography carbon monoxide total columns: statistical evaluation and comparison with chemistry transport model results

    NARCIS (Netherlands)

    de Laat, A.T.J.; Gloudemans, A.M.S.; Aben, I.; Krol, M.C.; Meirink, J.F.; van der Werf, G.R.; Schrijver, H.

    2007-01-01

    This paper presents a detailed statistical analysis of one year (September 2003 to August 2004) of global Scanning Imaging Absorption Spectrometer for Atmospheric Chartography (SCIAMACHY) carbon monoxide (CO) total column retrievals from the Iterative Maximum Likelihood Method (IMLM) algorithm, vers

  11. Scanning Imaging Absorption Spectrometer for Atmospheric Chartography carbon monoxide total columns: Statistical evaluation and comparison with chemistry transport model results

    NARCIS (Netherlands)

    Laat, de A.T.J.; Gloudemans, A.M.S.; Aben, I.; Krol, M.C.; Meirink, J.F.; Werf, van der G.R.; Schrijver, H.

    2007-01-01

    This paper presents a detailed statistical analysis of one year (September 2003 to August 2004) of global Scanning Imaging Absorption Spectrometer for Atmospheric Chartography (SCIAMACHY) carbon monoxide (CO) total column retrievals from the Iterative Maximum Likelihood Method (IMLM) algorithm, vers

  12. Clinical Utility of the J-CTO Score in Coronary Chronic Total Occlusion Interventions: Results from a Multicenter Registry

    Science.gov (United States)

    Christopoulos, Georgios; Wyman, R. Michael; Alaswad, Khaldoon; Karmpaliotis, Dimitri; Lombardi, William; Grantham, J. Aaron; Yeh, Robert W.; Jaffer, Farouc A.; Cipher, Daisha J.; Rangan, Bavana V.; Christakopoulos, Georgios E.; Kypreos, Megan A.; Lembo, Nicholas; Kandzari, David; Garcia, Santiago; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

    2015-01-01

    Background The performance of the J-CTO score in predicting success and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods and Results We examined the records of 650 consecutive patients who underwent CTO PCI between 2011 and 2014 at six experienced centers in the United States. Six hundred and fifty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO≥3). The impact of the J-CTO score on technical success and procedure time was evaluated with univariable logistic and linear regression, respectively. The performance of the logistic regression model was assessed with the Hosmer-Lemeshow statistic and receiver operator characteristic curves. Antegrade wiring techniques were used more frequently in easy lesions (97%) than very difficult lesions (58%), whereas the retrograde approach became less frequent with increased lesion difficulty (41% for very difficult lesions vs. 13% for easy lesions). The logistic regression model for technical success demonstrated satisfactory calibration and discrimination (p for Hosmer-Lemeshow=0.743 and area under curve=0.705). The J-CTO score was associated with a two-fold increase in the odds of technical failure (odds ratio 2.04, 95% confidence interval [95% CI] 1.52-2.80, pCTO score (regression coefficient 22.33, 95% CI 17.45-27.22, pCTO score was strongly associated with final success and efficiency in this study, supporting its expanded use in CTO interventions. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02061436. PMID:26162857

  13. [Results of total laryngectomy as treatment for locally advanced laryngeal cancer in the organ-preservation era].

    Science.gov (United States)

    Rodrigo, Juan P; López, Fernando; Llorente, José L; Álvarez-Marcos, César; Suárez, Carlos

    2015-01-01

    Total laryngectomy (TL) and postoperative radiotherapy (RT), when indicated, have proven to be effective in treating cases of locally advanced laryngeal cancer. The aim of this study was to analyse the oncological outcomes of this procedure in patients with laryngeal cancer classified T3 and T4a. We studied 80 patients (51 T3 and 29 T4a) with primary squamous cell carcinoma of the larynx who underwent TL between 1998 and 2006. Bilateral neck dissection was performed in 54 patients, unilateral in 11, and central in 4. Twenty patients (25%) received postoperative radiotherapy. Mean age was 64 years with a male predominance (97%). As for habits, 96% were smokers and 89% consumed alcohol. Lymph node metastases occurred in 44% of patients and extracapsular invasion in 37% of them. All cases had tumour-free margins. In all, 25% of patients had loco-regional recurrence and 5% developed distant metastases. The 5-year disease-specific survival was 72% and 5-year overall survival was 55%. Variables associated with decreased disease-specific survival were T4 classification (P=.068), N2-N3 classifications (P=.005), extracapsular invasion (P=.018) and stage iv disease (P=.009). On multivariate analysis, the only variable associated with decreased disease-specific survival was the presence of N2-N3 nodal metastases (P=.008). TL is an effective treatment for the management of patients with locally advanced laryngeal cancer. Organ preservation protocols should achieve similar oncological results to those obtained with TL. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  14. Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement. Results of a prospective study in 462 hips

    Energy Technology Data Exchange (ETDEWEB)

    Koelbl, O.; Seufert, J.; Pohl, F.; Flentje, M. [Univ. Wuerzburg (Germany). Klinik and Poliklinik for Radiotherapy; Tauscher, A.; Springorum, H.W. [Caritas Hospital, Bad Mergentheim (Germany). Orthopedic Clinic; Lehmann, H. [Caritas Hospital, Bad Mergentheim (Germany). Inst. of Radiology

    2003-11-01

    Background: The effectiveness of pre- or postoperative radiotherapy for prevention of heterotopic ossification (HO) following total hip replacement (THR) has already been demonstrated in the past. Thereby, in most studies using preoperative radiotherapy patients were irradiated < 6 h before surgery. The purpose of this prospective study was to analyze the effectiveness of preoperative irradiation on the evening before surgery and to identify risk factors for HO in a homogeneous collective of patients. Patients and Methods: From July 1997 to July 2001, 416 patients (462 hips; 235 males, 227 females) received preoperative radiotherapy of the hip on the evening before surgery with a 7-Gy single fraction. The patients' median age was 67.1 years. The most frequent indication for radiotherapy was hypertrophic osteoarthritis (383 hips, 82.9%). Treatment results were assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). The analysis of radiographs was performed according to the Brooker score. Results: The overall incidence of HO was 18.1% (n = 84), Brooker score 1 12.3% (n = 57), score 2 3.9% (n = 18), score 3 1.5% (n = 7), and score 4 0.4% (n = 2). Sex, body height, hypertrophic osteoarthritis of higher degree, size of the femoral component of the prosthesis, previous ipsi- or contralateral HO, and short course of nonsteroidal anti-inflammatory drug (diclofenac) therapy significantly influenced the HO rate in univariate analysis. In multivariate analysis, an interdependence of prosthesis size, sex and patient's height was found. From these three variables, only prosthesis size was statistically significant in multivariate analysis. The cumulative dose of diclofenac ({<=} 300 mg or > 300 mg) within the first 7 postoperative days and previous ipsi- or contralateral HO influenced the incidence of HO in multivariate analysis. Conclusion: Preoperative radiotherapy on the evening before surgery is an effective treatment

  15. Worldwide experience with a totally subcutaneous implantable defibrillator: Early results from the EFFORTLESS S-ICD registry

    NARCIS (Netherlands)

    P.D. Lambiase (Pier); C.S. Barr (Craig); D.A.M.J. Theuns (Dominic); R.E. Knops (Reinoud); P. Neuzil (Petr); J.B. Johansen (Jens); A.M. Hood (Margaret); S.S. Pedersen (Susanne); S. Kääb (Stefan); F.D. Murgatroyd (Francis); H.L. Reeve (Helen); N. Carter (Nathan); L. Boersma (Lucas)

    2014-01-01

    textabstractAims The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large inte

  16. The EFQM Model as a framework for total quality management in healthcare : Results of a longitudinal quantitative study

    NARCIS (Netherlands)

    van Schoten, Steffie; de Blok, Carolien; Spreeuwenberg, Peter; Groenewegen, Petrus; Wagner, Cordula

    2016-01-01

    Purpose – To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as

  17. Worldwide experience with a totally subcutaneous implantable defibrillator: Early results from the EFFORTLESS S-ICD registry

    NARCIS (Netherlands)

    P.D. Lambiase (Pier); C.S. Barr (Craig); D.A.M.J. Theuns (Dominic); R.E. Knops (Reinoud); P. Neuzil (Petr); J.B. Johansen (Jens); A.M. Hood (Margaret); S.S. Pedersen (Susanne); S. Kääb (Stefan); F.D. Murgatroyd (Francis); H.L. Reeve (Helen); N. Carter (Nathan); L. Boersma (Lucas)

    2014-01-01

    textabstractAims The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large

  18. Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Victor J; Ortiz, Jorge G; Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio; Biller, José

    2017-05-26

    Cerebral small vessel disease (SVD) is inversely associated with cognitive performance. However, whether the total SVD score is a better predictor of poor cognitive performance than individual signatures of SVD is inconclusive. We aimed to estimate the combined and independent predictive power of these MRI findings. Atahualpa residents aged ≥60 years underwent brain MRI. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). The presence of moderate-to-severe white matter hyperintensities, deep cerebral microbleeds, lacunar infarcts, and >10 enlarged perivascular spaces was added for estimating the total SVD score ranging from 0 to 4 points. Montreal Cognitive Assessment predictive models were fitted to assess how well the total SVD score or each of its components predicts cognitive performance. Of 351 eligible candidates, 331 (94%) were included. The total SVD score was 0 points in 202 individuals (61%), 1 point in 67 (20%), 2 points in 40 (12%), 3 points in 15 (5%), and 4 points in seven (2%). A generalized lineal model showed an inverse relationship between the total SVD score and the MoCA (p = 0.015). The proportion of variance in the MoCA score explained by the SVD score was 32.8% (R(2)  = 0.328). This predictive power was similar for white matter hyperintensities (R(2)  = 0.306), microbleeds (R(2)  = 0.313), lacunar infarcts (R(2)  = 0.323), and perivascular spaces (R(2)  = 0.313). This study shows a significant association between the SVD score and worse cognitive performance. The SVD score is a predictor of poor cognitive performance. This predictive power is not better than that of isolated neuroimaging signatures of SVD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  19. “Remotion” Total Wrist Arthroplasty: Preliminary Results of a Prospective International Multicenter Study of 215 Cases

    DEFF Research Database (Denmark)

    Herzberg, Guillaume; Boeckstyns, Michel Ernest Henri; Sorensen, Allan Ibsen

    2012-01-01

    preoperative and postoperative reports of "ReMotion" TWA at regular intervals. The cases of 7 centers with more than 15 inclusions were considered for this article. A total of 215 wrists were included. In the rheumatoid arthritis (RA; 129 wrists) and nonrheumatoid arthritis (non-RA; 86 wrists) groups......, there were respectively 5 and 6% complications requiring implant revision with a survival rate of 96 and 92%, respectively, at an average follow-up of 4 years. Within the whole series, only one dislocation was observed in one non-RA wrist. A total of 112 wrists (75 rheumatoid and 37 nonrheumatoid) had more...... than 2 years of follow-up (minimum: 2 years, maximum: 8 years). In rheumatoid and non-RA group, visual analog scale (VAS) pain score improved by 48 and 54 points, respectively, and QuickDASH score improved by 20 and 21 points, respectively, with no statistical differences. Average postoperative arc...

  20. The predictive value of total serum IgE for a positive allergen specific IgE result

    OpenAIRE

    2004-01-01

    Background: Measurement of total serum IgE and allergen specific IgE is often requested to assess possible allergy. As public awareness increases, so do requests for allergy assessment; unless there is a clear “allergen suspect” in the history, several allergen specific IgE requests may be made. This increases the likelihood of detecting borderline increases in allergen specific IgE of uncertain relevance, and has important cost implications for the service.

  1. Clinical, roentgenographic, and scintigraphic results after interruption of the superior lateral genicular artery during total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ritter, M.A.; Keating, E.M.; Faris, P.M. (Center for Hip and Knee Surgery, Mooresville, IN (USA))

    1989-11-01

    Forty-eight patients treated by primary bilateral simultaneous total knee arthroplasty, in which one knee had a lateral release and the other did not, were evaluated clinically and roentgenographically from one to 12 years postoperatively. Thirty of these patients also had a technetium-99 bone scan. Mean clinical scores at the last follow-up examination were 90 for both groups. Roentgenographically, there were no subluxations, dislocations, or fractures in either group. There were two metal-backed patellae (one in each group) with signs of polyethylene wear and developed debris. Bone scans showed no difference between the two groups and no signs of osteonecrosis of the patella.

  2. New Study Results the Secondary Settlement for Vertical Total Stress on Highway Construction built on Soft Ground in the Mekong Delta

    CERN Document Server

    Van, Hung Pham

    2012-01-01

    Today, to calculate secondary settlement for vertical total stress by the analytic formula, we often use the formula of Raymond and Wahls (1976) This formula does not reflect that the secondary settlement for vertical total stress depends on the magnitude of the vertical total stress which impact sinkage in soft soil, and changes with depth and preconsolidation pressure. As a result, soft soil creep, resulted from the soft soil's vertical total stress, under road and highway at different depths will be different. The problems were solved in this article.

  3. Revision total hip and knee arthroplasty implant identification: implications for use of Unique Device Identification 2012 AAHKS member survey results.

    Science.gov (United States)

    Wilson, Natalia A; Jehn, Megan; York, Sally; Davis, Charles M

    2014-02-01

    FDA's Unique Device Identification (UDI) Rule will mandate manufacturers to assign unique identifiers to their marketed devices. UDI use is expected to improve implant documentation and identification. A 2012 American Association of Hip and Knee Surgeons membership survey explored revision total hip and knee arthroplasty implant identification processes. 87% of surgeons reported regularly using at least 3 methods to identify failed implants pre-operatively. Median surgeon identification time was 20 min; median staff time was 30 min. 10% of implants could not be identified pre-operatively. 2% could not be identified intra-operatively. UDI in TJA registry and UDI in EMR were indicated practices to best support implant identification and save time. FDA's UDI rule sets the foundation for UDI use in patient care settings as standard practice for implant documentation. © 2013.

  4. Results of hematopoietic stem cell transplantation after treatment with different high-dose total-body irradiation regimens in five Dutch centers

    NARCIS (Netherlands)

    van Kempen-Harteveld, M. Loes; Brand, Ronald; Kal, Henk B.; Verdonck, Leo F.; Hofman, Pieter; Schattenberg, Anton V.; van der Maazen, Richard W.; Cornelissen, Jan J.; Eijkenboom, Wil M. H.; van der Lelie, Johannes P.; Oldenburger, Foppe; Barge, Renee M.; van Biezen, Anja; Vossen, Jaak M. J. J.; Noordijk, Evert M.; Struikmans, Henk

    2008-01-01

    Purpose: To evaluate results of high-dose total-body irradiation (TBI) regimens for hematopoietic stem cell transplantation. Methods and Materials: A total of 1,032 patients underwent TBI in one or two fractions before autologous or allogeneic hematologic stem cell transplantation for acute leukemia

  5. Results of hematopoietic stem cell transplantation after treatment with different high-dose total-body irradiation regimens in five Dutch centers.

    NARCIS (Netherlands)

    Kempen-Harteveld, ML van; Brand, R.; Kal, H.B.; Verdonck, L.F.; Hofman, P.; Schattenberg, A.V.M.B.; Maazen, R.W.M. van der; Cornelissen, J.J.L.M.; Eijkenboom, W.M.H.; Lelie, JP van der; Oldenburger, F.; Barge, R.M.; Biezen, A. van; Vossen, J.M.J.J.; Noordijk, E.M.; Struikmans, H.

    2008-01-01

    PURPOSE: To evaluate results of high-dose total-body irradiation (TBI) regimens for hematopoietic stem cell transplantation. METHODS AND MATERIALS: A total of 1,032 patients underwent TBI in one or two fractions before autologous or allogeneic hematologic stem cell transplantation for acute leukemia

  6. Intravascular ultrasound guidance of percutaneous coronary intervention in ostial chronic total occlusions: a description of the technique and procedural results.

    Science.gov (United States)

    Ryan, Nicola; Gonzalo, Nieves; Dingli, Philip; Cruz, Oscar Vedia; Jiménez-Quevedo, Pilar; Nombela-Franco, Luis; Nuñez-Gil, Ivan; Trigo, María Del; Salinas, Pablo; Macaya, Carlos; Fernandez-Ortiz, Antonio; Escaned, Javier

    2017-02-14

    Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution. CTO operators with extensive IVUS experience in non-CTO cases carried out all procedures. Procedural and outcome data was prospectively entered into the institutional database and a retrospective analysis of clinical, angiographic and technical data performed. 17 (77%) of the 22 procedures were successful. The mean age was 59.8 ± 11.5 years, and 90.9% were male. The most commonly attempted lesions were located in the left anterior descending 36.4% (Soon et al. in J Intervent Cardiol 20(5):359-366, 2007) and Circumflex artery (LCx) 31.8% (Mollet et al. in Am J Cardiol 95(2):240-243, 2005). Mean JCTO score was 3.09 ± 0.75 (3.06 ± 0.68, 3.17 ± 0.98 in the successful and failed groups respectively p = 0.35). The mean contrast volume was 378.7 ml ± 114.7 (389.9 ml ± 130.5, 349.2 ml ± 52.2 p = 0.3 in the successful and failed groups respectively). There was no death, coronary artery bypass grafting or myocardial infarction requiring intervention in this series. When the success rates were analyzed taking into account the date of adoption of this technique, the learning curve had no significant impact on CTO-PCI success. This series describes a good success rate in IVUS guided stumpless wiring of CTOs in consecutive patients with this complex anatomical scenario.

  7. Physical activity and return to work after fast-track total hip replacement with or without supervised rehabilitation. Results from a randomized controlled trial

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Mechlenburg, Inger; Søballe, Kjeld

    Background Total hip replacement (THR) results in pain reduction and functional improvements. However, it is suggested that these improvements are not followed by increases in physical activity level and return to usual activities postoperatively. Furthermore, it is unknown whether supervised...

  8. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    DEFF Research Database (Denmark)

    Klit, Jakob

    2014-01-01

    BACKGROUND: Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma...... bilateral THA, and 44 HR. The study groups received a paper-format questionnaire within one month before surgery and at three, six, and 12 months postoperatively. RESULTS: Study I showed a high willingness to undergo PAO again with the experience and knowledge they have today and improvements were seen...... in younger patients cannot be expected to change the patient's relation to work or annual income. Patients stay sexually active after THA, and female patients experiences positive changes. CONCLUSION: Based on the findings in this thesis PAO patients are satisfied with the outcome at medium to long...

  9. [Long-term results of mobilization by bone resection in patients with post-traumatic total stiffness and ankylosis of the elbow. Study and results of 39 operations].

    Science.gov (United States)

    Baciu, C C; Dobre, I; Mîrsu, F; Duma, A

    1990-01-01

    Thirty patients with post-traumatic stiffness and ankylosis of the elbow were treated operatively at the Colentina Clinical Hospital, from 1970-1986. They were treated by 39 surgical mobilisation using Ollier technique. In eleven patients with a persisting functional amplitude of the prono-supination, the resections have been effected on the distal end of the humerus and on the olecranon, and in nineteen with a limited prono-supination too, it was added a resection of the radial head. The mobilisations were realised without interposition. At follow-up the patients were evaluated after 1 to 8 years, using the pre- and post- operative Rocher's indices and the Kerboull's classification. The flexion-extension was improved by 55 per cent, the pronation by 55.3 per cent and the supination also with 55.3 per cent. The results plead for the maintaining of this type of surgical treatment for the treatment of post-traumatic stiffnesses and ankyloses of the elbow, though there are not complete satisfactory, especially for the joint stability.

  10. Application of SCIAMACHY and MOPITT CO total column measurements to evaluate model results over biomass burning regions and Eastern China

    Directory of Open Access Journals (Sweden)

    C. Liu

    2011-01-01

    Full Text Available We developed a new CO vertical column density product from near IR observations of the SCIAMACHY instrument onboard ENVISAT. For the correction of a temporally and spatially variable offset of the CO vertical column densities we apply a normalisation procedure based on coincident MOPITT (version 4 observations over the oceans. The resulting normalised SCIAMACHY CO data are well suited for the investigation of the CO distribution over continents, where important emission sources are located. We use only SCIAMACHY observations for effective cloud fractions below 20%. Since the remaining effects of clouds can still be large (up to 100%, we applied a cloud correction scheme which explicitly considers the cloud fraction, cloud top height and surface albedo of individual observations. We compared our new SCIAMACHY CO data set, and also observations from the MOPITT instrument, to the results from three global atmospheric chemistry models (MATCH, EMAC at low and high resolution, and GEOS-Chem; the focus of this comparison is on regions with strong CO emissions (from biomass burning or anthropogenic sources. The comparison indicates that over most of these regions the seasonal cycle is generally captured well but the simulated CO vertical column densities are systematically smaller than those from the satellite observations, in particular with respect to SCIAMACHY observations. Because of the high sensitivity of the SCIAMACHY observations to the lowest part of the atmosphere, this indicates that especially close to the surface the model simulations systematically underestimate the true atmospheric CO concentrations, probably caused by an underestimation of CO emissions by current emission inventories. For some biomass burning regions, however, such as Central Africa in July–August, model results are also found to be higher than the satellite observations.

  11. Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up.

    Science.gov (United States)

    Unwin, Olivia; Hassaballa, Mohammed; Murray, James; Harries, William; Porteous, Andrew

    2017-03-01

    MIS TKA has been shown to offer a reduced in-patient stay, but no clinical difference at two years. Whilst there may be a benefit from earlier discharge, we need to ensure that there are no detrimental effects in the medium and long-term following MIS-TKA. To report the mid-term result from a prospective randomised controlled trial (RCT) comparing MIS-TKA with standard approach for TKA. Using knee score questionnaires, we collected patient reported outcome measures (PROMs) regarding pain and function. Sixty-six patients (from an eligible cohort of 83 patients) completed the mid-term postal follow-up. There was no significant difference between groups for change in score from pre-operative to final follow-up in all three PROMs. Mean MIS and standard group improvement was: AKSS 53 and 51 (p=0.7644), OKS 15 and 16 (p=0.2341) or WOMAC 15 and 15 (p=0.9900) respectively. Both groups showed improvement in pain and function with no significant difference between groups. There was no difference between groups for revision due to malalignment at a mean six year follow-up. In addition to the early benefits regarding hospital stay and complications, we have found that at a mean of six years there was no increase in malalignment, pain or function with MIS techniques. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Results of total lung irradiation and chemotherapy in comparison with partial lung irradiation in metastatic undifferentiated soft tissue sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, N.; Fuerst, G.; Pape, H.; Bannach, B.; Schmitt, G.; Molls, M.

    1988-07-01

    The poor prognosis of patients with unresectable pulmonary metastases of soft tissue sarcoma is well known. In order to evaluate the beneficial effect of radiotherapy, we have treated 44 patients with pulmonary metastases of grade 3 soft tissue sarcoma from 1980 to 1986. In 36 patients the treatment volume was restricted to the single metastases up to a dose of 50 to 60 (9 to 10 Gy/week). The survival rate at one year was 18% and at two years 6%. Eight patients were treated with a combined regimen, consisting of cisplatin and ifosfamide with simultaneous whole lung irradiation. Irradiation was performed with 8 or 16 MV photons at a hyperfractionation of 2x0,8 Gy/day (8 Gy/week). After a dose of 12 Gy, the single metastases were boosted up to 50 to 60 Gy, with a second course of chemotherapy. In six of eight patients complete remissions were achieved, one patient showed a partial remission. The survival rate at 27 months was 50%. The patients with partial remission died from pulmonary progression at 23 months. One patient died after twelve months from a loco-regional recurrence in the tonsillar fossa without evidence of pulmonary disease. Side effects included alopecia and moderate bone marrow suppression approximately twelve days after each chemotherapy cycle. Pulmonary fibrosis was observed only at the high dose volume without impairment of respiratory function. From these observations the conclusion is drawn that whole lung irradiation simultaneously with cisplatin and ifosfamide chemotherapy provides good palliative results without relevant morbidity in patients with high grade unresectable pulmonary metastases of soft tissue sarcomas.

  13. The relationship of walking intensity to total and cause-specific mortality. Results from the National Walkers' Health Study.

    Directory of Open Access Journals (Sweden)

    Paul T Williams

    Full Text Available PURPOSE: Test whether: 1 walking intensity predicts mortality when adjusted for walking energy expenditure, and 2 slow walking pace (≥24-minute mile identifies subjects at substantially elevated risk for mortality. METHODS: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. RESULTS: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10(-5, cardiovascular diseases (2.4% increase, P=0.001, 637 deaths, ischemic heart disease (2.8% increase, P=0.003, 336 deaths, heart failure (6.5% increase, P=0.001, 36 deaths, hypertensive heart disease (6.2% increase, P=0.01, 31 deaths, diabetes (6.3% increase, P=0.004, 32 deaths, and dementia (6.6% increase, P=0.0004, 44 deaths. Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001, cardiovascular diseases (43.9% increased risk, P=0.03, and dementia (5.0-fold increased risk, P=0.0002 even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET-hours per week. CONCLUSIONS: The risk for mortality: 1 decreases in association with walking intensity, and 2 increases substantially in association for walking pace ≥24 minute mile (equivalent to <400 m during a six-minute walk test even among subjects who exercise regularly.

  14. [Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50

    NARCIS (Netherlands)

    Busch, V.J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2007-01-01

    OBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was i

  15. "To whom do the results of this trial apply?" External validity of a randomized controlled trial involving 130 patients scheduled for primary total hip replacement

    DEFF Research Database (Denmark)

    Petersen, Mette K; Andersen, Karen Vestergaard; Andersen, Niels T

    2007-01-01

    , but they should at least allow patients and clinicians to judge to whom trial results can reasonably be applied. We assessed the external validity of an RCT investigating the efficacy of a fast-track program after total hip replacement. METHODS: 130 patients were identified as potential participants.18 patients...

  16. Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry

    NARCIS (Netherlands)

    Wees, P.J. van der; Wammes, J.J.G.; Akkermans, R.P.; Koetsenruijter, J.; Westert, G.P.; Kampen, A. van; Hannink, G.J.; Waal Malefijt, M.C. de; Schreurs, B.W.

    2017-01-01

    BACKGROUND: Patient-Reported Outcome (PRO) measurement is a method for measuring perceptions of patients on their health and quality of life. The aim of this paper is to present the results of PRO measurements in total hip and knee replacement as routinely collected during 20 years of surgery in a

  17. Total energy cycle assessment of electric and conventional vehicles: an energy and environmental analysis. Volume 3: appendix E to technical report, comprehensive EVTECA results tables

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    This report compares the energy use, oil use and emissions of electric vehicles (EVs) with those of conventional, gasoline-powered vehicles (CVs) over the total life cycle of the vehicles. The various stages included in the vehicles` life cycles include vehicle manufacture, fuel production, and vehicle operation. Disposal is not included. An inventory of the air emissions associated with each stage of the life cycle is estimated. Water pollutants and solid wastes are reported for individual processes, but no comprehensive inventory is developed. Volume III presents the results of the total energy cycle model runs, which are summarized in Volume I.

  18. Effect of different doses of aerobic exercise on total white blood cell (WBC and WBC subfraction number in postmenopausal women: results from DREW.

    Directory of Open Access Journals (Sweden)

    Neil M Johannsen

    Full Text Available BACKGROUND: Elevated total white blood cell (WBC count is associated with an increased risk of coronary heart disease and death. Aerobic exercise is associated with lower total WBC, neutrophil, and monocyte counts. However, no studies have evaluated the effect of the amount of aerobic exercise (dose on total WBC and WBC subfraction counts. PURPOSE: To examine the effects of 3 different doses of aerobic exercise on changes in total WBC and WBC subfraction counts and independent effects of changes in fitness, adiposity, markers of inflammation (IL-6, TNF-α, C-reactive protein, fasting glucose metabolism, and adiponectin. METHODS: Data from 390 sedentary, overweight/obese postmenopausal women from the DREW study were used in these analyses. Women were randomized to a non-exercise control group or one of 3 exercise groups: energy expenditure of 4, 8, or 12 kcal kg(-1⋅week(-1 (KKW for 6 months at an intensity of 50% VO2peak. RESULTS: A dose-dependent decrease in total WBC counts (trend P = 0.002 was observed with a significant decrease in the 12KKW group (-163.1±140.0 cells/µL; mean±95%CI compared with the control (138.6±144.7 cells/µL. A similar response was seen in the neutrophil subfraction (trend P = 0.001 with a significant decrease in the 12KKW group (-152.6±115.1 cells/µL compared with both the control and 4KKW groups (96.4±119.0 and 21.9±95.3 cells/µL, respectively and in the 8KKW group (-102.4±125.0 cells/µL compared with the control. When divided into high/low baseline WBC categories (median split, a dose-dependent decrease in both total WBCs (P = 0.003 and neutrophils (P<0.001 was observed in women with high baseline WBC counts. The effects of exercise dose on total WBC and neutrophil counts persisted after accounting for significant independent effects of change in waist circumference and IL-6. CONCLUSION: Aerobic exercise training reduces total WBC and neutrophil counts, in a dose-dependent manner, in

  19. Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old. A concise follow-up of previous reports.

    Science.gov (United States)

    Warth, Lucian C; Callaghan, John J; Liu, Steve S; Klaassen, Alison L; Goetz, Devon D; Johnston, Richard C

    2014-11-05

    We report the updated results for a previously described cohort of patients who were less than fifty years old at the time of the index Charnley total hip arthroplasty with cement. The original cohort consisted of ninety-three consecutive hips in sixty-nine patients. The patients were followed for a minimum of thirty-five years after surgery or until death. At the latest follow-up evaluation, there were forty-one total hip replacements (44%) in thirty-two living patients. Thirty-four (37%) of the ninety-three total hip replacements in the original cohort had been revised or removed. Twenty acetabular (22%) and seven femoral (8%) components had been revised for aseptic loosening. Since the twenty-five-year follow-up, the average six-minute-walk distance decreased from 395 m to 171 m, and this decrease correlated with increasing comorbidity. This study demonstrates the durability of cemented total hip replacements in a young patient population. Although 63% (fifty-nine) of the ninety-three original hip replacements were functioning at the latest follow-up or at the time of death, a significant decrease in activity level was seen over time (p < 0.001). Of the forty-one original implants in the patients who were alive at the time of the thirty-five-year follow-up, only 46% (nineteen) were retained. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  20. Artroplastia total do joelho com o apoio tibial móvel: avaliação dos resultados a médio prazo Total knee arthroplasty with a mobile tibial bearing: medium-term follow-up results

    Directory of Open Access Journals (Sweden)

    Luiz Gabriel Betoni Guglielmetti

    2010-01-01

    Full Text Available OBJETIVO: Avaliações dos resultados a médio prazo da aplicação da prótese com apoio tibial móvel. MÉTODOS: Noventa e seis pacientes (107 joelhos foram submetidos a artroplastia total do joelho realizada com um modelo de prótese com mobilidade rotatória no componente tibial. Os pacientes foram avaliados após um seguimento médio de 52,7 meses - desvio padrão 21,94 (mínimo de 24 meses e máximo de 120 meses, através do protocolo de avaliação "Knee Society Clinical Rating System" (KSCRS, com uma média de 78,22 pontos. RESULTADOS: Entre as complicações transoperatórias e pós operatórias imediatas ocorreram uma deiscência de sutura, com cura espontânea, duas fraturas de patela, uma fratura do côndilo medial do fêmur, três paresias do nervo fibular lateral e uma distrofia nervosa simpático reflexa. As complicações tardias foram uma fratura da patela, uma fratura distal do fêmur, quatro solturas assépticas e quatro infecções profundas, que necessitaram de revisão. CONCLUSÃO: Excluindo-se os casos que necessitaram de uma revisão, por soltura séptica ou asséptica, os autores concluem serem bons os resultados clínicos e funcionais obtidos com a prótese com o apoio tibial móvel num seguimento a médio prazo.OBJECTIVE: Evaluation of mid-term follow up results of the application of a total knee replacement with a mobile tibial bearing design. METHODS: Ninety six patients (107 knees were submitted to total knee Arthroplasty, performed with a model of prosthesis with rotating mobility in the tibial component. The patients were evaluated after a mean follow-up of 52.7 months - standard deviation 21.94 (minimum 24 months and maximum 120 months through the Knee Society Clinical Rating System (KSCRS, with a mean outcome of 78.22 points. RESULTS: The complications that occurred immediately after or during the surgery included: one wound dehiscence with spontaneous healing, two patellar fractures, one fracture of the medial

  1. Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years old: results after 12-years follow-up.

    Science.gov (United States)

    Faldini, Cesare; Miscione, Maria Teresa; Chehrassan, Mohammadreza; Acri, Francesco; Pungetti, Camilla; d'Amato, Michele; Luciani, Deianira; Giannini, Sandro

    2011-12-01

    Congenital hip dysplasia may lead to severe acetabular and femoral abnormalities that can make total hip arthroplasty a challenging procedure. We assessed a series of patients affected by developmental hip dysplasia treated with total hip arthroplasty using cementless tapered stem and here we report the outcomes at long-term follow-up. Twenty-eight patients (24 women and 4 men) aged between 44 and 50 years (mean 47 years) were observed. Clinical evaluation was rated with the Harris Hip Score. Radiographic evaluation consisted in standard anteroposterior and axial view radiographs of the hip. According to Crowe's classification, 16 hips presented dysplasia grade 1, 14 grade 2, and 4 grade 3. All patients were treated with total hip arthroplasty using a cementless tapered stem (Wagner Cone Prosthesis). Six patients were operated bilaterally, with a totally of 34 hips operated. After surgery, the patients were clinically and radiographically checked at 3, 6, and 12 months and yearly thereafter until an average follow-up of 12 years (range 10-14 years). Average Harris Hip Score was 56 ± 9 (range 45-69) preoperatively, 90 ± 9 (range 81-100) 12 months after surgery, and 91 ± 8 (range 83-100) at last follow-up. Radiographic evaluation demonstrated excellent osteointegration of the implants. Signs of bone resorption were present in 6 hips, nevertheless no evidence of loosening was observed and none of the implants has been revised. Even in dysplasic femur, the tapered stem allowed adequate stability and orientation of the implant. We consider tapered stem a suitable option for total hip arthroplasty in developmental hip dysplasia, also in case of young patients, thanks to the favourable long-term results.

  2. Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

    Directory of Open Access Journals (Sweden)

    Tunc Oktenoglu

    2013-01-01

    Full Text Available Study Design. Prospective clinical study. Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease. Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery. Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group. The mean age of the patients in total disc prosthesis group was 37,32 years. The mean age of the patients in posterior dynamic transpedicular stabilization was 43,08. Clinical (VAS and Oswestry and radiological evaluations (lumbar lordosis and segmental lordosis angles of the patients were carried out prior to the operation and 3, 12, and 24 months after the operation. We compared the average duration of surgery, blood loss during the surgery and the length of hospital stay of both groups. Results. Both techniques offered significant improvements in clinical parameters. There was no significant change in radiologic evaluations after the surgery for both techniques. Conclusion. Both dynamic systems provided spine stability. However, the posterior dynamic system had a slight advantage over anterior disc prosthesis because of its convenient application and fewer possible complications.

  3. Total knee arthroplasties performed with a mini-incision or a standard incision. Similar results at six months follow-up

    Directory of Open Access Journals (Sweden)

    Noriega-Fernandez Alfonso

    2010-02-01

    Full Text Available Abstract Background Minimal invasion surgery (MIS is a recent technique recommended for Total knee arthroplasty (TKA but demands an effort of the surgeons and the learning curve may be long. Methods Twenty six MIS-TKA were matched to 36 standard TKA with respect to age, sex, body mass index or preoperative score. All patients suffered from knee osteoarthritis, which had not improved with medical treatment and which presented a less than 10° deformity in the coronal and sagittal radiographic projections. At six months after the surgery a specific questionnaire was completed as well as the KSS (Knee Society rating scale, the generic short-form health questionnaire (SF-12 and a visual analogue scale (VAS. Results The MIS technique required more time of surgery (p Conclusions Minimal invasion surgery in total knee arthroplasty showed no improvement over a standard approach.

  4. Butter increased total and LDL cholesterol compared with olive oil but resulted in higher HDL cholesterol compared with a habitual diet

    DEFF Research Database (Denmark)

    Engel, Sara; Tholstrup, Tine

    2015-01-01

    , moderate olive oil intake, and a habitual diet on blood lipids, high-sensitivity C-reactive protein (hsCRP), glucose, and insulin. DESIGN: The study was a controlled, double-blinded, randomized 2 × 5-wk crossover dietary intervention study with a 14-d run-in period during which subjects consumed...... their habitual diets. The study included 47 healthy men and women (mean ± SD total cholesterol: 5.22 ± 0.90 mmol/L) who substituted a part of their habitual diets with 4.5% of energy from butter or refined olive oil. RESULTS: Study subjects were 70% women with a mean age and body mass index (in kg/m(2)) of 40.......4 y and 23.5, respectively. Butter intake increased total cholesterol and LDL cholesterol more than did olive oil intake (P

  5. Patient-based outcome analysis is important to determine the success of total knee arthroplasty: result of a focus group discussion

    Directory of Open Access Journals (Sweden)

    Zacharia B

    2016-05-01

    Full Text Available Balaji Zacharia, Manu Paul, Mohammed Thanveeruddin Sherule Department of Orthopedics, Government Medical College, Kozhikode, Kerala, India Background: Total knee replacement (TKR results in an excellent outcome in terms of pain relief. The reporting of outcomes was traditionally focused on implant survivorship and objective outcomes such as range of motion, knee stability, and radiographic alignment. However, patients and doctors had differing perceptions of all domains of outcome, especially subjective quality of life domains such as emotions and social functioning. In this study, we tried to find out the expectations of Indian patients regarding TKR and assess the level of satisfaction among our patients from their view point using focus group discussion (FGD, and whether these expectations have an impact on outcomes and patient satisfaction. Materials and methods: This study was conducted in the Department of Orthopedics, Government Medical College, Kozhikode, Kerala, India, in November 2014. Patients between the ages 60 and 65 years who met inclusion criteria were selected. A total of 50 patients were selected for FGDs. Among them, 42 patients participated in FGD. The remaining eight did not appear for the discussion. A total of four FGD sessions were conducted. Results and discussion: It was found that there is a discrepancy between the satisfaction levels of patient and surgeon. There is a difference in satisfaction level achieved depending on socioeconomic, geographic, and cultural characteristics. Conclusion: Newer methods of TKR outcome assessment combining radiological outcome, surgeon-based assessment, and patient satisfaction based on their socioeconomic status and cultural characteristics should be developed for different populations. Keywords: focus group discussion, total knee arthroplasty, patient-specific objectives

  6. Special aspects of wrist arthritis management for SLAC and SNAC wrists using midcarpal arthrodesis: results of bilateral operations and conversion to total arthrodesis.

    Science.gov (United States)

    Gohritz, Andreas; Gohla, Thomas; Stutz, Nicolas; Moser, Veith; Koch, Hilmar; Krimmer, Hermann; Lanz, Ulrich

    2005-01-01

    Although midcarpal wrist arthrodesis is recognized as a standard procedure to treat scapholuate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) of the wrist, little has been reported about patients with bilateral involvement and the number, cause, and results of failed cases requiring conversion to total wrist arthrodesis. This study investigated the results of 20 patients with bilateral procedures and of 22 patients who underwent total wrist fusion after failed midcarpal arthrodesis out of an overall group of 907 patients treated by this method during a 12-year period. Of these, 16 bilateral and 20 converted cases were reexamined after an average of 48 months and 42 months, respectively. Patients after bilateral midcarpal arthrodesis experienced a pain reduction by an average of 54% of the preoperative pain values at rest and by 56% at stress on the visual analog scale (scale range: 0 to 100) and from intolerable (3.7) to pain only during stress (1.9) on the verbal scale (scale range: I to 4). A mean arc of wrist extension and flexion of 53 degrees on the right and 49 of the left wrist was preserved. The mean DASH score was 45 points and 70% of the patients felt impaired only during certain activities. Total arthrodesis reduced pain in 18 of 20 reexamined wrists by 67% of the previous values after the failed partial arthrodesis at rest and by 46% at stress on the visual analog scale andfrom intolerable pain (3.7) to pain only during stress (2.1) on the verbal scale. Seven of the 20 reexamined patients noted complete pain relief at rest and two also under stress conditions. The DASH score averaged 39 points. A mean Krimmer score of 46 points and a mean Buck-Gramcko and Lohman evaluation of 6 points represented a satisfactory result. Grip strength of the operated hand averaged 53% of the opposite side. Subjectively, 30% felt impaired only during certain activities, 55%felt considerably and 15% strongly limited in daily life. However, all but

  7. Patient-based outcome analysis is important to determine the success of total knee arthroplasty: result of a focus group discussion.

    Science.gov (United States)

    Zacharia, Balaji; Paul, Manu; Thanveeruddin Sherule, Mohammed

    2016-01-01

    Total knee replacement (TKR) results in an excellent outcome in terms of pain relief. The reporting of outcomes was traditionally focused on implant survivorship and objective outcomes such as range of motion, knee stability, and radiographic alignment. However, patients and doctors had differing perceptions of all domains of outcome, especially subjective quality of life domains such as emotions and social functioning. In this study, we tried to find out the expectations of Indian patients regarding TKR and assess the level of satisfaction among our patients from their view point using focus group discussion (FGD), and whether these expectations have an impact on outcomes and patient satisfaction. This study was conducted in the Department of Orthopedics, Government Medical College, Kozhikode, Kerala, India, in November 2014. Patients between the ages 60 and 65 years who met inclusion criteria were selected. A total of 50 patients were selected for FGDs. Among them, 42 patients participated in FGD. The remaining eight did not appear for the discussion. A total of four FGD sessions were conducted. It was found that there is a discrepancy between the satisfaction levels of patient and surgeon. There is a difference in satisfaction level achieved depending on socioeconomic, geographic, and cultural characteristics. Newer methods of TKR outcome assessment combining radiological outcome, surgeon-based assessment, and patient satisfaction based on their socioeconomic status and cultural characteristics should be developed for different populations.

  8. Laparoscopic Totally Extraperitoneal Groin Hernia Repair Using a Self-Gripping Mesh: Clinical Results of 235 Primary and Recurrent Groin Hernias.

    Science.gov (United States)

    Ozmen, John; Choi, Vincent; Hepburn, Kirsten; Hawkins, Will; Loi, Ken

    2015-11-01

    Compared with open surgery, laparoscopic groin hernia repair has been shown to significantly reduce postoperative pain. However, chronic pain remains a problem with the laparoscopic approach, affecting approximately 10% of patients. The purpose of this study was to evaluate clinical outcomes following the use of Parietex ProGrip™ (Covidien, Dublin, Ireland) self-gripping mesh during laparoscopic totally extraperitoneal groin hernia repair. Data were collected prospectively from 145 male and 15 female patients with 235 inguinal hernias. All patients underwent repair by the laparoscopic totally extraperitoneal approach using Parietex ProGrip mesh. During follow-up ranging from 5 to 24 months, complications, pain score, patient satisfaction, and recurrence were analyzed. All patients were discharged on the day of surgery or the next morning. There were no immediate complications or returns to the operating room. Delayed postoperative complications included minor bruising to the genital region (3 cases), hematoma/seroma (1 case), and wound infection (1 case). The mean follow-up was 15 months, at which time there were no reports of hernia recurrence and 99% of patients were satisfied with their hernia repair. One patient (0.63%) reported severe pain (numeric rating scale score of >7), and 4 patients (2.5%) reported intermittent mild pain on exertion. The results of this study suggest that the use of a self-gripping mesh during the laparoscopic totally extraperitoneal approach is a promising and effective technique for repairing both primary and recurrent inguinal hernias.

  9. Mid-term results of third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty: a ten-year minimum follow-up.

    Science.gov (United States)

    Yeung, Eric; Bott, Paul Thornton; Chana, Rishi; Jackson, Mark P; Holloway, Ian; Walter, William L; Zicat, Bernard A; Walter, William K

    2012-01-18

    Alumina ceramic-on-ceramic bearings have gained popularity in hip arthroplasty because of their properties of low wear and chemical inertness. In a previous study, we reported the excellent clinical results in a series of cementless ceramic-on-ceramic primary total hip arthroplasties at a minimum of five years of follow-up. The purpose of the present study was to determine the results in the same patient cohort at a minimum of ten years of follow-up. A series of 301 consecutive primary cementless total hip arthroplasties was assessed clinically and radiographically. Clinical information was available for 244 hips in 227 surviving patients at a minimum of ten years of follow-up, and radiographic information was available for 184 hips in 172 patients. Twenty-six (9.2%) of the patients had died of an unrelated cause and eight (2.7%) had undergone revision arthroplasty by the time of the latest follow-up. The average Harris hip score was 94 points, with 95% (232) of the patients having an excellent or good result and psoas tendinitis, and a repeat revision in one of the patients with psoas tendinitis due to acetabular osteolysis. The overall survival rate of the implants was 98% (95% confidence interval, 94.2% to 99.6%) at ten years with revision for any reason as the end point. The patients in our series had a good implant survival rate, good function, a low implant wear rate as reported in the previous study, and no further radiographic evidence of failure at ten years after cementless primary total hip arthroplasty with alumina ceramic-on-ceramic bearings.

  10. Mid-term results of ReCap/Magnum/Taperloc metal-on-metal total hip arthroplasty with mean follow-up of 7.1 years.

    Science.gov (United States)

    Koutalos, Antonios A; Kourtis, Aristotelis; Clarke, Ian C; Smith, Evert J

    2017-05-12

    Despite enthusiasm for metal-on-metal bearings, disappointing short- to mid-term outcomes has all but halted the use of this bearing articulation. This review presents mid-term results for the ReCap Magnum total hip replacement. This prospective study evaluated 79 ReCap/Magnum/Taperloc total hip replacements with mean follow-up of 7.1 (range 3.7-9.2) years. 43 were female and 36 male. Metal ions were measured and radiographic measurement included a 'margin of safety' angle to quantify risk of edge loading. When a clinical suspicion of adverse reaction to metal debris was present, patients had metal artefact reduction sequence MRI. Harris Hip Score and Oxford Hip Score evaluated functional outcome and SF-12 and EQ-5L-5D assessed quality of life at final follow-up. 7 hips were revised indicating 91.1% survivorship at 7.1 years. Postoperative Harris Hip Score and Oxford Hip Score significantly improved. Females and symptomatic patients predicted increased metal ions. Margin of safety correlated with postoperative Oxford Hip Score. Symptomatic hips and positive MRI showed reduced survivorship. Compared to more traditional bearings like metal or ceramic on polyethylene the overall outcome of this ReCap/Magnum/Taperloc study cohort is modest. It is felt that further failures will occur in this group therefore cautious interpretation of the results is justified given the potential for reduced survival outcomes.

  11. Methods and Techniques Used to Convey Total System Performance Assessment Analyses and Results for Site Recommendation at Yucca Mountain, Nevada, USA

    Energy Technology Data Exchange (ETDEWEB)

    P. D. Mattie; J. A. McNeish; D. S. Sevougian; R. W. Andrews

    2001-04-13

    Total System Performance Assessment (TSPA) is used as a key decision-making tool for the potential geologic repository for high level radioactive waste at Yucca Mountain, Nevada, USA. Because of the complexity and uncertainty involved in a post-closure performance assessment, an important goal is to produce a transparent document describing the assumptions, the intermediate steps, the results, and the conclusions of the analyses. An important objective for a TSPA analysis is to illustrate confidence in performance projections of the potential repository given a complex system of interconnected process models, data, and abstractions. The methods and techniques used for the recent TSPA analyses demonstrate an effective process to portray complex models and results with transparency and credibility.

  12. Methods and Techniques Used to Convey Total System Performance Assessment Analyses and Results for Site Recommendation at Yucca Mountain, Nevada, USA

    Energy Technology Data Exchange (ETDEWEB)

    Mattie, Patrick D.; McNeish, Jerry A.; Sevougian, S. David [Duke Engineering and Services, Las Vegas, NV (United States); Andrews, Robert W. [Bechtel SAIC Company, Las Vegas, NV (United States)

    2001-07-01

    Total System Performance Assessment (TSPA) is used as a key decision-making tool for the potential geologic repository of high level radioactive waste at Yucca Mountain, Nevada USA. Because of the complexity and uncertainty involved in a post-closure performance assessment, an important goal is to produce a transparent document describing the assumptions, the intermediate steps, the results, and the conclusions of the analyses. An important objective for a TSPA analysis is to illustrate confidence in performance projections of the potential repository given a complex system of interconnected process models, data, and abstractions. The methods and techniques used for the recent TSPA analyses demonstrate an effective process to portray complex models and results with transparency and credibility.

  13. Dietary exposure to dioxins and dioxin-like PCBs of Hong Kong adults: results of the first Hong Kong Total Diet Study.

    Science.gov (United States)

    Wong, Waiky W K; Yip, Yiu-chung; Choi, Koon-kay; Ho, Y Y; Xiao, Ying

    2013-01-01

    Dioxins and dioxin-like polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) covered by the Stockholm Convention on POPs. To assess the associated health risk of the Hong Kong population, the dietary exposure of the Hong Kong population and various age-gender subgroups to dioxins and dioxin-like PCBs was estimated in the first Hong Kong Total Diet Study (TDS), where food samples were collected and prepared "as consumed". A total of 142 composite food samples, mainly foods of animal origin and their products and oily food, were analysed for polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) and dioxin-like PCBs by the high-resolution gas chromatograph/high-resolution mass spectrometer (HRGC/HRMS) system. Dietary exposures were estimated by combining the analytical results with the food consumption data of Hong Kong adults. The mean and 95th percentile exposures to dioxins and dioxin-like PCBs of the Hong Kong population were 21.9 and 59.7 pg toxic equivalent (TEQ) kg⁻¹ body weight (bw) month⁻¹ respectively, which amounted to 31.3% and 85.2% of the provisional tolerable monthly intake (PTMI). The main dietary source of dioxins and dioxin-like PCBs was "Fish and seafood and their products" (61.9% of the total exposure), followed by "Meat, poultry and game and their products" (20.0%) and "Mixed dishes" (6.95%). The study findings suggest that the Hong Kong population is unlikely to experience the major undesirable health effects of dioxins and dioxin-like PCBs.

  14. Dietary exposure to polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls of the French population: Results of the second French Total Diet Study.

    Science.gov (United States)

    Sirot, Véronique; Tard, Alexandra; Venisseau, Anaïs; Brosseaud, Aline; Marchand, Philippe; Le Bizec, Bruno; Leblanc, Jean-Charles

    2012-07-01

    Polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) bioaccumulate through the food chain and are therefore of public health concern. Exposure to these compounds was assessed in the second French Total Diet Study (TDS). Food samples (n=583) were collected to be representative of the whole diet of the population, prepared as consumed, and analyzed. Contamination data were combined with national individual food consumption data. Mean exposure (95th percentile) to PCDD/F+DL-PCBs was assessed to be 0.57 (1.29) pg TEQ(WHO-98) (kg bw)(-1) d(-1) in the adult population and 0.89 (2.02) pg TEQ(WHO-98) (kg bw)(-1) d(-1) in the child and teenager population. Less than 4% of the population exceeded the health-based guidance value for PCDD/F+DL-PCBs. Mean exposure (95th percentile) to the six indicator PCBs (PCB 28, 52, 101, 138, 153, 180) was estimated at 2.71 (7.90) ng (kg bw)(-1) d(-1) in the adult population and 3.77 (11.7) ng (kg bw)(-1) d(-1) in the child and teenager population. Only 2.6% of the adults [CI(95%): 1.9; 3.3] and 6.5% of the children and teenagers [5.2; 7.8] exceeded the health-based guidance value for total PCBs. These results show that the contamination levels in food and therefore the exposure of the general French population to PCDD/Fs and PCBs have declined (by a factor of 3.2 for PCDD/F+DL-PCBs and about three for total PCBs) since the last evaluation, which was conducted using another methodology in 2005 and 2007, and show the efficiency of the European risk management measures which came into force after these evaluations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Dietary exposure of the Hong Kong adult population to polybrominated diphenyl ethers (PBDEs): results of the first Hong Kong Total Diet Study.

    Science.gov (United States)

    Chen, M Y Y; Wong, W W K; Choi, K K; Yip, Y C; Ho, Y Y; Xiao, Y

    2013-01-01

    Polybrominated diphenyl ethers (PBDEs) are a group of industrial chemicals that are persistent and can bioaccumulate. In the first Hong Kong Total Diet Study, the dietary exposure of Hong Kong adults to PBDEs was estimated to assess the associated health risks. Food samples, which represented the Hong Kong people's diet, were collected and prepared in table-ready form for analysis. Concentrations of PBDEs were determined in 142 composite samples. The dietary exposures were estimated by combining the analytical results with the local food consumption data of the adults. The mean and 95th percentile of dietary PBDEs exposures of the Hong Kong people were 1.34 and 2.90 ng kg(-1) body weight day(-1), respectively. The main dietary source of PBDEs was "fish and seafood and their products", which contributed 27.3% of the total exposure, followed by "meat, poultry and game and their products" (20.7%), "cereals and their products" (15.9%), and "fats and oils" (15.9%). The large margins of exposure (MOE) (>2.5) calculated following the European Food Safety Authority (EFSA) approach for four important congeners, BDE-47, BDE-99, BDE-153 and BDE-209, indicate that the estimated dietary exposures are unlikely to be a significant health concern.

  16. Occult hernias and bilateral endoscopic total extraperitoneal inguinal hernia repair: is there a need for prophylactic repair? : Results of endoscopic extraperitoneal repair over a period of 10 years.

    Science.gov (United States)

    Saggar, V R; Sarangi, R

    2007-02-01

    An advantage of the endoscopic total extraperitoneal approach over the conventional hernia repair is detection of an unsuspected, asymptomatic hernia on the contralateral side. A high incidence of occult contralateral hernias has been reported in the literature. However, few studies have examined the incidence of development of a hernia on the healthy side evaluated previously during an endoscopic unilateral hernia repair. This study aims to evaluate the incidence of development of a contralateral hernia after a previous bilateral exploration. The need for a prophylactic contralateral repair is also addressed. We retrospectively reviewed the results of 822 endoscopic total extraperitoneal inguinal hernia repairs done in 634 patients over a period of 10 years from May 1993 to 2003. Incidence of hernia undetected clinically and during previous contralateral repair was assessed over a follow up period ranging from 10 to 82 months. About 7.97% of bilateral hernias were clinically occult hernias. Only 1.12% of unilateral hernia repairs (who had undergone a contralateral evaluation at surgery) subsequently developed a hernia on the other side. The endoscopic approach to inguinal hernia repair is an excellent tool to detect and treat occult contralateral hernias. The incidence of hernia occurring at the contralateral side after a previous bilateral exploration is low, hence a prophylactic repair on the contralateral side is not recommended on a routine basis.

  17. The calibration and initial results of the HeI D3 line flash spectrum obtained during the 2008 total solar eclipse

    Institute of Scientific and Technical Information of China (English)

    LI Hui; ZHOU TuanHui; LI JingWei; SHEN JinHua; JI HaiSheng; NI HouKun; ZHANG HaiYing; ZHANG YaNan; LIU HongRui; DENG YuanYong; WANG DongGuang; DU QiuSheng

    2009-01-01

    The flash spectra in the Hel D3 line were obtained during the 2008 total solar eclipse. This paper describes the instrument and the calibration of the obtained flash spectrum, and presents our initial results.The average integrated intensity is E_(ave)=8.13×10~(13)erg·cm~(-1)·s~(-1)·ster~(-1)ath=1100km,which confirms that the Hel D3 emission is negatively correlated with the solar activity. The surface brightness reaches a maximum of F_(ave)=8.25×10~5 erg·cm~(-2)·s~(-1)·ster(-1) at about h≈(1290±75) km and then decreases exponentially with height when h > 1800 km with an exponential index β= 1.63×10~(-8)cm~(-1).

  18. The calibration and initial results of the HeI D3 line flash spectrum obtained during the 2008 total solar eclipse

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The flash spectra in the HeI D3 line were obtained during the 2008 total solar eclipse. This paper describes the instrument and the calibration of the obtained flash spectrum, and presents our initial results. The average integrated intensity is Eave = 8.13×1013 erg·cm-1· s-1·ster-1 at h = 1100 km, which confirms that the HeI D3 emission is negatively correlated with the solar activity. The surface brightness reaches a maximum of F ave = 8.25×105 erg·cm-2·s-1·ster-1 at about h ≈ (1290 ± 75) km and then decreases exponentially with height when h >1800 km with an exponential index β = 1.63×10-8 cm-1.

  19. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement: two-year results from a randomised study.

    Science.gov (United States)

    Penny, J O; Brixen, K; Varmarken, J E; Ovesen, O; Overgaard, S

    2012-08-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into two groups to receive either a resurfacing or a THR and were followed for two years. One patient's resurfacing subsequently failed, leaving 19 patients in each group. Resurfaced replacements maintained proximal femoral BMD and, compared with THR, had an increased bone mineral density in Gruen zones 2, 3, 6, and particularly zone 7, with a gain of 7.5% (95% confidence interval (CI) 2.6 to 12.5) compared with a loss of 14.6% (95% CI 7.6 to 21.6). Resurfacing replacements maintained the BMD of the medial femoral neck and increased that in the lateral zones between 12.8% (95% CI 4.3 to 21.4) and 25.9% (95% CI 7.1 to 44.6). On the acetabular side, BMD was similar in every zone at each point in time. The mean BMD of all acetabular regions in the resurfaced group was reduced to 96.2% (95% CI 93.7 to 98.6) and for the total hip replacement group to 97.6% (95% CI 93.7 to 101.5) (p = 0.4863). A mean total loss of 3.7% (95% CI 1.0 to 6.5) and 4.9% (95% CI 0.8 to 9.0) of BMD was found above the acetabular component in W1 and 10.2% (95% CI 0.9 to 19.4) and 9.1% (95% CI 3.8 to 14.4) medial to the implant in W2 for resurfaced replacements and THRs respectively. Resurfacing resulted in a mean loss of BMD of 6.7% (95% CI 0.7 to 12.7) in W3 but the BMD inferior to the acetabular component was maintained in both groups. These results suggest that the ability of a resurfacing hip replacement to preserve BMD only applies to the femoral side.

  20. Fourth-generation ceramic-on-ceramic total hip arthroplasty in patients of 55 years or younger: short-term results and complications analysis

    Institute of Scientific and Technical Information of China (English)

    Wang Weiguo; Guo Wanshou; Yue Debo; Shi Zhencai; Zhang Nianfei; Liu Zhaohui; Sun Wei

    2014-01-01

    Background The incidence of total hip replacement in the younger and more active patients is ever increasing.The ceramic-on-ceramic (COC) bearing was developed to reduce wear debris-induced osteolysis and loosening and to improve the longevity of hip arthroplasties.Few studies have reported the clinical results and complications of the new zirconia-toughened ceramic total hip arthroplasty (THA).Methods A consecutive series of 132 young patients (177 hips) that underwent primary cementless THAs between January 2010 and December 2012 were included in this study.These arthroplasties all had fourth-generation COC bearings performed through a posterolateral approach.The average age was (41.8±8.3) years (ranging from 22 to 55 years),and the mean follow-up period was (24.5±9.4) months (ranging from 12 to 47 months).The results were evaluated both clinically and radiographically.Harris hip score (HHS) was determined before surgery and at the time of each follow-up.Presence of postoperative groin or thigh pain and squeaking were recorded.Other complications such as dislocations,periprosthetic fractures,and ceramic components fractures were diagnosed and treated in emergency.Results The average HHSs improved from preoperative 60.3±10.7 (ranging from 29 to 76) to 91.0±5.1 (ranging from 74 to 100) at the final follow-up (t=-45.064,P <0.05),and 97.7% of cases were scored as excellent and good results.At the last follow-up,incidental inguinal pain was found in three hips (1.7%) and thigh pain in 11 hips (6.2%).Radiographs showed a high rate of new bone formation around the acetabular and stem components.No obvious osteolysis or prosthesis loosening was detected.Complications occurred in six hips (3.4%):posterior dislocation in two hips (1.1%),periprosthetic femoral fracture in one hip (0.6%),asymptomatic squeaking in two hips (1.1%),and ceramic liner fracture in one hip (0.6%).Conclusions The fourth-generation COC THA showed excellent clinical results in

  1. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  2. Enhancing sucrose synthase activity in transgenic potato (Solanum tuberosum L.) tubers results in increased levels of starch, ADPglucose and UDPglucose and total yield.

    Science.gov (United States)

    Baroja-Fernández, Edurne; Muñoz, Francisco José; Montero, Manuel; Etxeberria, Ed; Sesma, María Teresa; Ovecka, Miroslav; Bahaji, Abdellatif; Ezquer, Ignacio; Li, Jun; Prat, Salomé; Pozueta-Romero, Javier

    2009-09-01

    Sucrose synthase (SuSy) is a highly regulated cytosolic enzyme that catalyzes the conversion of sucrose and a nucleoside diphosphate into the corresponding nucleoside diphosphate glucose and fructose. To determine the impact of SuSy activity in starch metabolism and yield in potato (Solanum tuberosum L.) tubers we measured sugar levels and enzyme activities in tubers of SuSy-overexpressing potato plants grown in greenhouse and open field conditions. We also transcriptionally characterized tubers of SuSy-overexpressing and -antisensed potato plants. SuSy-overexpressing tubers exhibited a substantial increase in starch, UDPglucose and ADPglucose content when compared with controls. Tuber dry weight, starch content per plant and total yield of SuSy-overexpressing tubers increased significantly over those of control plants. In contrast, activities of enzymes directly involved in starch metabolism in SuSy-overexpressing tubers were normal when compared with controls. Transcriptomic analyses using POCI arrays and the MapMan software revealed that changes in SuSy activity affect the expression of genes involved in multiple biological processes, but not that of genes directly involved in starch metabolism. These analyses also revealed a reverse correlation between the expressions of acid invertase and SuSy-encoding genes, indicating that the balance between SuSy- and acid invertase-mediated sucrolytic pathways is a major determinant of starch accumulation in potato tubers. Results presented in this work show that SuSy strongly determines the intracellular levels of UDPglucose, ADPglucose and starch, and total yield in potato tubers. We also show that enhancement of SuSy activity represents a useful strategy for increasing starch accumulation and yield in potato tubers.

  3. Assessment of Total Suspended Sediment Distribution under Varying Tidal Conditions in Deep Bay: Initial Results from HJ-1A/1B Satellite CCD Images

    Directory of Open Access Journals (Sweden)

    Liqiao Tian

    2014-10-01

    Full Text Available Using Deep Bay in China as an example, an effective method for the retrieval of total suspended sediment (TSS concentration using HJ-1A/1B satellite images is proposed. The factors driving the variation of the TSS spatial distribution are also discussed. Two field surveys, conducted on August 29 and October 26, 2012, showed that there was a strong linear relationship (R2 = 0.9623 between field-surveyed OBS (optical backscatter measurements (5-31NTU and laboratory-analyzed TSS concentrations (9.89–35.58 mg/L. The COST image-based atmospheric correction procedure and the pseudo-invariant features (PIF method were combined to remove the atmospheric effects from the total radiance measurements obtained with different CCDs onboard the HJ-1A/1B satellites. Then, a simple and practical retrieval model was established based on the relationship between the satellite-corrected reflectance band ratio of band 3 and band 2 (Rrs3/Rrs2 and in-situ TSS measurements. The R2 of the regression relationship was 0.807, and the mean relative error (MRE was 12.78%, as determined through in-situ data validation. Finally, the influences of tide cycles, wind factors (direction and speed and other factors on the variation of the TSS spatial pattern observed from HJ-1A/1B satellite images from September through November of 2008 are discussed. The results show that HJ-1A/1B satellite CCD images can be used to estimate TSS concentrations under different tides in the study area over synoptic scales without using simultaneous in-situ atmospheric parameters and spectrum data. These findings provide strong informational support for numerical simulation studies on the combined influence of tide cycles and other associated hydrologic elements in Deep Bay.

  4. Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up

    Institute of Scientific and Technical Information of China (English)

    Chen-Yi Ye; De-Ting Xue; Shuai Jiang; Rong-Xin He

    2016-01-01

    Background:The application of second-generation constrained condylar knee (CCK) prostheses has not been widely studied.This retrospective study was carried out to evaluate the clinical and radiographic outcomes of a second-generation CCK prosthesis for complex primary or revision total knee arthroplasty (TKA).Methods:In total,51 consecutive TKAs (47 patients) were performed between June 2003 and June 2013 using second-generation modular CCK prostheses.The follow-up was conducted at 3rd day,1st,6th,and 12th months postoperatively and later annually.Anteroposterior (AP),lateral,skyline,and long-standing AP radiographs of the affected knees were taken.The Hospital for Special Surgery (HSS) Knee Score,the Knee Society Knee Score (KSKS),the Knee Society Function Score (KSFS),and range of motion (ROM) were also recorded.Heteroscedastic two-tailed Student's t-tests were used to compare the HSS score and the Knee Society score between primary and revision TKAs.A value ofP < 0.05 was considered statistically significant.Results:Four knees (two patients) were lost to follow-up,and 47 knees (31 primary TKAs and 16 revision TKAs) had a mean follow-up time of 5.5 years.The mean HSS score improved from 51.1 ± 15.0 preoperatively to 85.3 ± 8.4 points at the final follow-up (P < 0.05).Similar results were observed in terms of the KSKS and KSFS,which improved from 26.0 ± 13.0 to 80.0 ± 12.2 and from 40.0 ± 15.0 to 85.0 ± 9.3 points,respectively (P < 0.05).No significant difference in the HSS,KSKS,KSFS,or ROM was found between primary and revision TKAs (P> 0.05).Two complications were observed in the revision TKA group (one intraoperative distal femur fracture and one recurrence of infection) while one complication (infection) was observed in the primary TKA group.No prosthesis loosening,joint dislocation,patella problems,tibial fracture,or nerve injury were observed.Radiolucent lines were observed in 4% of the knees without progressive osteolysis

  5. Fourth-generation ceramic-on-ceramic total hip arthroplasty in patients of 55 years or younger: short-term results and complications analysis.

    Science.gov (United States)

    Wang, Weiguo; Guo, Wanshou; Yue, Debo; Shi, Zhencai; Zhang, Nianfei; Liu, Zhaohui; Sun, Wei; Wang, Bailiang; Li, Zirong

    2014-01-01

    The incidence of total hip replacement in the younger and more active patients is ever increasing. The ceramic-on-ceramic (COC) bearing was developed to reduce wear debris-induced osteolysis and loosening and to improve the longevity of hip arthroplasties. Few studies have reported the clinical results and complications of the new zirconia-toughened ceramic total hip arthroplasty (THA). A consecutive series of 132 young patients (177 hips) that underwent primary cementless THAs between January 2010 and December 2012 were included in this study. These arthroplasties all had fourth-generation COC bearings performed through a posterolateral approach. The average age was (41.8 ± 8.3) years (ranging from 22 to 55 years), and the mean follow-up period was (24.5 ± 9.4) months (ranging from 12 to 47 months). The results were evaluated both clinically and radiographically. Harris hip score (HHS) was determined before surgery and at the time of each follow-up. Presence of postoperative groin or thigh pain and squeaking were recorded. Other complications such as dislocations, periprosthetic fractures, and ceramic components fractures were diagnosed and treated in emergency. The average HHSs improved from preoperative 60.3 ± 10.7 (ranging from 29 to 76) to 91.0 ± 5.1 (ranging from 74 to 100) at the final follow-up (t = 45.064, P acetabular and stem components. No obvious osteolysis or prosthesis loosening was detected. Complications occurred in six hips (3.4%): posterior dislocation in two hips (1.1%), periprosthetic femoral fracture in one hip (0.6%), asymptomatic squeaking in two hips (1.1%), and ceramic liner fracture in one hip (0.6%). The fourth-generation COC THA showed excellent clinical results in younger active patients with no osteolysis-related prosthesis failure at a short-term follow-up study. Surgeons should still be aware of the potential risks of complications such as dislocation, periprosthetic fracture, squeaking, and ceramic components fracture.

  6. Determination of trace elements in planktonic microcrustaceans using total reflection X-ray fluorescence (TXRF): First results from two Chilean lakes

    Energy Technology Data Exchange (ETDEWEB)

    Woelfl, Stefan; Mercado, Susana; Villalobos, Lorena [Instituto de Zoologia, Universidad Austral de Chile, Casilla 567, Valdivia (Chile); Mages, Margarete; Ovari, Mihaly [Department of Inland Water Research Magdeburg, UFZ Centre for Environmental Research Leipzig-Halle, Brueckstrasse 3a, 39114, Magdeburg (Germany); Encina, Francisco [Escuela de Ciencias Ambientales, Facultad de Ciencias, Universidad Catolica de Temuco, Montt 056, Temuco (Chile)

    2004-02-01

    First results are described from the application of a recently developed dry method for determination of elements in single specimens of freshwater microcrustaceans, using total reflection X-ray fluorescence spectrometry (TXRF). This method is a powerful, non-destructive technique for quantifying the trace element content of minute biological samples with a dry weight of 3-50 {mu}g. Three different freshwater microcrustaceans were sampled, from the natural, uncontaminated Lake Laja and from the artificial Rapel reservoir which is slightly contaminated by drainage water from a copper mine. Single specimens of Daphnia pulex, Bosmina chilensis, and Ceriodaphnia dubia were prepared using a modification of the dry method and measured by TXRF. The results showed that both As, Mn, Fe, Ni, Zn, and Cu content and the bioaccumulation of these metals were usually significantly different between the microcrustaceans from the two lakes. The largest difference was found for Cu which was eight times more concentrated in the two microcrustaceans from Rapel reservoir than it was in D. pulex from Lake Laja. (orig.)

  7. Results of the cementless Plasmacup in revision total hip arthroplasty: a retrospective study of 72 cases with an average follow-up of eight years

    Directory of Open Access Journals (Sweden)

    Fuchs-Winkelmann Susanne

    2010-05-01

    Full Text Available Abstract Background There are multiple revision implant systems currently available for socket revision in revision total hip arthroplasty. Up until now, not all of these systems have been followed up with regards to their long-term use as a revision implantation. For the first time, this study presents the hemispherical porous-coated socket Plasmacup SC, produced by Aesculap, Tuttlingen, Germany, and the clinical and radiological mid-term results of this revision cup implant. Methods Over a period of ten years the Plasmacup SC press-fit-cup was used as a revision implant in 72 consecutive aseptic cases which were included in this retrospective study. The mean follow-up period was 8 years. Bone graft transplantation was performed in 32% of all cases. In 90%, the cup was fixed with additional screws. The follow-up radiographs were analysed with regards to cup migration, osteointegration and osteolysis in the DeLee zones using a computer aided program taking the teardrop figure as a main point of reference. For clinical evaluation the Harris-Hip-Score and the WOMAC-Score were utilized. Results At the follow up examination, the mean Harris-Hip-Score was 83.5 points and the mean WOMAC-Score 34.7 points. 93% of all patients were satisfied with the result of the operation. No aseptic cup loosening could be observed and only one cup had to be removed due to infection. No significant longitudinal or transversal cup migration could be observed. Conclusion Aesculap's Plasmacup SC is suitable as a cementless cup revision implant. There is stable cup osteointegration, post press-fit implantation, even in the case of major acetabular bone defects.

  8. An increased total resected lymph node count benefits survival following pancreas invasive intraductal papillary mucinous neoplasms resection: an analysis using the surveillance, epidemiology, and end result registry database.

    Directory of Open Access Journals (Sweden)

    Wenming Wu

    Full Text Available BACKGROUND: The therapeutic effect of lymph node dissection for pancreas invasive intraductal papillary mucinous neoplasms (IPMN remains unclear. The study investigated whether cancer-specific survival (CSS and overall survival (OS rates among invasive IPMN patients improve when more lymph nodes are harvested during surgery. STUDY DESIGN: The study cohort was retrieved from the Surveillance, Epidemiology, and End Results (SEER database. The lymph node count was categorized into quartiles. The relationship between lymph node count and survival was analyzed using Kaplan-Meier curves and a Cox proportional-hazards model. The stage migration was assessed by Chi-square tests. Propensity score matching (PSM was used to minimize confounding variables between groups. RESULTS: In total, 1,080 patients with resected invasive IPMNs from 1992 to 2011 were included. Univariate and multivariate Cox models indicated that an increased lymph node count independently improves survival. The Kaplan-Meier and log-rank tests identified 16 nodes as an optimal cut-off value that yielded a significant survival benefit for all invasive IPMN patients. The stage migration effect existed in this cohort. After PSM, the 5-year CSS increased from 36% to 47%, and the median survival rate increased from 30 months to 40 months by increasing the lymph node count to over 16, alone. The 5-year OS rate also provided additional support for this result. CONCLUSION: Increased lymph node counts were associated with improved survival in invasive IPMN patients. One cut-off value of lymph node count was 16 for this improvement.

  9. Clinical results of Hi-tech Knee II total knee arthroplasty in patients with rheumatoid athritis: 5- to 12-year follow-up

    Directory of Open Access Journals (Sweden)

    Yamanaka Hajime

    2012-02-01

    Full Text Available Abstract Background Total knee arthroplasty (TKA is a common form of treatment to relieve pain and improve function in cases of rheumatoid arthritis (RA. Good clinical outcomes have been reported with a variety of TKA prostheses. The cementless Hi-Tech Knee II cruciate-retaining (CR-type prosthesis, which has 6 fins at the anterior of the femoral component, posterior cruciate ligament (PCL retention, flat-on-flat surface component geometry, all-polyethylene patella, strong initial fixation by the center screw of the tibial base plate, 10 layers of titanium alloy fiber mesh, and direct compression molded ultra high molecular weight polyethylene (UHMWPE, is appropriate for TKA in the Japanese knee. The present study was performed to evaluate the clinical results of primary TKA in RA using the cementless Hi-Tech Knee II CR-type prosthesis. Materials and methods We performed 32 consecutive primary TKAs using cementless Hi-Tech Knee II CR-type prosthesis in 31 RA patients. The average follow-up period was 8 years 3 months. Clinical evaluations were performed according to the American Knee Society (KS system, knee score, function score, radiographic evaluation, and complications. Results The mean postoperative maximum flexion angle was 115.6°, and the KS knee score and function score improved to 88 and 70 after surgery, respectively. Complications, such as infection, occurred in 1 patient and revision surgery was performed. There were no cases of loosening in this cohort, and prosthesis survival rate was 96.9% at 12 years postoperatively. Conclusion These results suggest that TKA using the cementless Hi-Tech Knee II CR-type prosthesis is a very effective form of treatment in RA patients at 5 to 12 years postoperatively. Further long-term follow-up studies are required to determine the ultimate utility of this type of prosthesis.

  10. Mid-term results of total ankle arthroplasty in developmental dysplasia of ankle%踝关节发育不良的人工关节置换术

    Institute of Scientific and Technical Information of China (English)

    毛宾尧; 王毳; 李新春; 司全明

    2012-01-01

    目的 研究人工踝关节置换治疗发育性踝关节不良的中期疗效.方法 自1997年10月~2010年12月,人工踝关节置换治疗踝关节疾患66例中踝关节发育不良6例,男5例,女1例,年龄44.5 ~59岁,平均52.7岁.幼儿时有外伤史4例,不明2例,病程5 ~11年.结果 6例6踝获6~11年随访,平均8年4个月.术前、后踝关节功能采用Kofoed评价法,术前踝关节功能平均36分(30 ~40分)4例,17分(0~29)2例;术后优(85~ 100分)3例,良(75 ~ 84分)3例,均无疼痛.仅1例作了步态分析,术前跛行步态(站立相超过58%),术后正常步态(站立相15% ~45%周期内).结论 人工踝关节置换治疗踝关节发育不良具有良好疗效.%Objective To investigate mid-term results of total ankle replacement in treatment for developmental dysplasia of the ankle.Methods From October 1997 to December 2010,total ankle replacement was performed in 66 cases with ankle disorders,in which six patients were developmental dysplasia of the ankle.There were five males and one female.Their age ranged from 44.5 to 59 years,average 52.7 years.There was tramatic history in four of the six patients.Results Six ankles were followed up for a mean time of eight years and four months,ranging from six to 11 years.The ankle function was evaluated by Kofoed's system in six patients and gait analysis system was only performed in one patient pre- and postoperatively.The ankle function score of preoperation was 36 ( 30 - 40) in four cases,and 17 (0 -29) in one.The score of postoperation was excellent (85 - 100) in three cases,good (75 - 84) in three cases.All patients were painless completely.According to gait analysis scanning system,the patient was preoperatively lame ( in standing phase > 55% ),but had normal gait ( in standing phase 15%- 45% ) after operation.Conclusions Total ankle replacement is a good method for improvement of the developmental dysplasia of the ankle.

  11. Poly(2-methacryloyloxyethyl phosphorylcholine)-grafted highly cross-linked polyethylene liner in primary total hip replacement: one-year results of a prospective cohort study.

    Science.gov (United States)

    Takatori, Yoshio; Moro, Toru; Kamogawa, Morihide; Oda, Hiromi; Morimoto, Shuhei; Umeyama, Takashige; Minami, Manabu; Sugimoto, Hideharu; Nakamura, Shigeru; Karita, Tatsuro; Kim, Juntaku; Koyama, Yurie; Ito, Hideya; Kawaguchi, Hiroshi; Nakamura, Kozo

    2013-06-01

    To control particle-induced osteolysis in total hip replacement (THR), we developed a new technique to graft poly(2-methacryloyloxyethyl phosphorylcholine) onto the surface of polyethylene liners. A prospective cohort study was conducted to investigate the clinical safety of this novel bearing surface. Between April 2007 and September 2008, we recruited a prospective consecutive series of 80 patients in five participating hospitals. These patients received a cementless THR; a 26-mm-diameter cobalt-chromium-molybdenum alloy ball and a poly(2-methacryloyloxyethyl phosphorylcholine)-grafted cross-linked polyethylene liner were used for the bearing couplings. These individuals were followed a year postoperatively. An evaluation of clinical performance was conducted through an assessment of hip joint function based on the evaluation chart authorized by the Japanese Orthopaedic Association. No patients were lost to follow-up. No adverse events were found to be correlated with the implanted liners. The average hip joint function score improved from 43.2 preoperatively to 91.7 postoperatively at 1 year. There was no implant migration nor periprosthetic osteolysis detected on radiographic analysis. On the basis of our results, we conclude that poly(2-methacryloyloxyethyl phosphorylcholine)-grafted cross-linked polyethylene liners are a safe implant option for hip replacement surgery for short-term clinical use.

  12. Result of verifying controllability of the total adaptive generation controller for brushless exciter; Brushless reijikiyo hatsudenki saiteki seigyo hoshiki no seigyosei kensho kekka

    Energy Technology Data Exchange (ETDEWEB)

    Morioka, Y. [Kansai Electric Power Co. Inc., Osaka (Japan)

    1998-11-10

    Discussions were given on effects of the total adaptive generation controller (STAGEC) for a brushless exciter. The STAGEC unifies exciting and speed governing systems, and uses the optimal regulator theory as a multi-input and multi-output system. Therefore, it requires a numerical model for objects to be controlled, and considered the control lagging. In addition, as an evaluation function to express a parameter for its optimizing performance, such a function was used as the one minimizing deviation from the targeted value of active power and terminal voltage similarly to conventional AVR and governors, in consideration of practical application of the system. The advanced performance system analyzer (APSA) was used to verify the system controllability by simulating the Kiso and Kansai trunk line. Generators other than those in the regular power transmission systems were paralleled as required. Installing the brushless TAGEC increased the critical transmission power by 40 to 45 MW (10 to 12%), and installing it on both generators increased the power by 50 MW (13%). These results reveal that the transmission capacity can be improved greater than with conventional brushless AVRs with PSS, and the capacity can be further increased by synergetic effect provided by the system if it is installed on a multiple number of generators. (NEDO)

  13. Electron Temperatures and Flow Speeds of the Low Solar Corona: MACS Results from the Total Solar Eclipse of 29 March 2006 in Libya

    Science.gov (United States)

    Reginald, Nelson L.; Davila, Joseph M.; SaintCyr, O.; Rabin, Douglas M.; Guhathakurta, Madhulika; Hassler, Donald M.; Gashut, Hadi

    2011-01-01

    An experiment was conducted in conjunction with the total solar eclipse on 29 March 2006 in Libya to measure both the electron temperature and its flow speed simultaneously at multiple locations in the low solar corona by measuring the visible K-coronal spectrum. Coronal model spectra incorporating the effects of electron temperature and its flow speed were matched with the measured K-coronal spectra to interpret the observations. Results show electron temperatures of (1.10 +/- 0.05) MK, (0.70 +/- 0.08) MK, and (0.98 +/- 0.12) MK, at 1.1 Solar Radius from Sun center in the solar north, east and west, respectively, and (0.93 +/- 0.12) MK, at 1.2 Solar Radius from Sun center in the solar west. The corresponding outflow speeds obtained from the spectral fit are (103 +/- 92) km/s, (0 + 10) km/s, (0+10) km/s, and (0+10) km/s. Since the observations were taken only at 1.1 Solar Radius and 1.2 Solar Radius from Sun center, these speeds, consistent with zero outflow, are in agreement with expectations and provide additional confirmation that the spectral fitting method is working. The electron temperature at 1.1 Solar Radius from Sun center is larger at the north (polar region) than the east and west (equatorial region).

  14. Electron Temperatures and Flow Speeds of the Low Solar Corona: MACS Results from the Total Solar Eclipse of 29 March 2006 in Libya

    Science.gov (United States)

    Reginald, Nelson L.; Davila, Joseph M.; SaintCyr, O.; Rabin, Douglas M.; Guhathakurta, Madhulika; Hassler, Donald M.; Gashut, Hadi

    2011-01-01

    An experiment was conducted in conjunction with the total solar eclipse on 29 March 2006 in Libya to measure both the electron temperature and its flow speed simultaneously at multiple locations in the low solar corona by measuring the visible K-coronal spectrum. Coronal model spectra incorporating the effects of electron temperature and its flow speed were matched with the measured K-coronal spectra to interpret the observations. Results show electron temperatures of (1.10 +/- 0.05) MK, (0.70 +/- 0.08) MK, and (0.98 +/- 0.12) MK, at 1.1 Solar Radius from Sun center in the solar north, east and west, respectively, and (0.93 +/- 0.12) MK, at 1.2 Solar Radius from Sun center in the solar west. The corresponding outflow speeds obtained from the spectral fit are (103 +/- 92) km/s, (0 + 10) km/s, (0+10) km/s, and (0+10) km/s. Since the observations were taken only at 1.1 Solar Radius and 1.2 Solar Radius from Sun center, these speeds, consistent with zero outflow, are in agreement with expectations and provide additional confirmation that the spectral fitting method is working. The electron temperature at 1.1 Solar Radius from Sun center is larger at the north (polar region) than the east and west (equatorial region).

  15. Safety and Effectiveness of Everolimus-Eluting Stents in Chronic Total Coronary Occlusion Revascularization: Results From the EXPERT CTO Multicenter Trial (Evaluation of the XIENCE Coronary Stent, Performance, and Technique in Chronic Total Occlusions).

    Science.gov (United States)

    Kandzari, David E; Kini, Annapoorna S; Karmpaliotis, Dimitri; Moses, Jeffrey W; Tummala, Pradyumna E; Grantham, J Aaron; Orr, Charles; Lombardi, William; Nicholson, William J; Lembo, Nicholas J; Popma, Jeffrey J; Wang, Jin; Larracas, Cristina; Rutledge, David R

    2015-05-01

    This study sought to evaluate procedural and clinical outcomes among patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using contemporary methods and everolimus-eluting stents (EES). Limited studies have detailed the procedural and late-term safety and efficacy of CTO revascularization among multiple centers applying modern techniques and with newer-generation drug-eluting stents. Among 20 centers, 250 consecutive patients were enrolled for attempted CTO PCI. Procedural and in-hospital clinical outcomes were examined in addition to the 1-year primary endpoint of death, myocardial infarction, and target lesion revascularization (major adverse cardiac events [MACE]). Demographic, lesion, and procedural characteristics included prior bypass surgery: 9.9%; diabetes: 40.1%; lesion length: 36.1 ± 18.5 mm; and stent length: 51.7 ± 27.2 mm. Procedural success, defined as guidewire recanalization with no in-hospital MACE, was 96.4%. Success with antegrade-only methods was 97.9% and 86.2% by retrograde/combined methods, respectively. Compared with a pre-specified performance goal derived from 6 prior CTO drug-eluting stent trials (1-year MACE: 24.4%), treatment with EES was associated with significantly lower composite adverse events for both intent-to-treat (18.5%, 1-sided upper confidence interval: 23.4%, p = 0.025) and per-protocol populations (8.2%, 1-sided upper confidence interval: 12.3%, p CTO PCI in a patient population with high lesion complexity. (EXPERT CTO: Evaluation of the XIENCE PRIME LL and XIENCE Nano Everolimus Eluting Coronary Stent Coronary Stents, Performance, and Technique in Chronic Total Occlusions; NCT01435031). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Compendium of Current Total Ionizing Dose and Displacement Damage Results from NASA Goddard Space Flight Center and Selected NASA Electronic Parts and Packaging Program

    Science.gov (United States)

    Topper, Alyson D.; Campola, Michael J.; Chen, Dakai; Casey, Megan C.; Yau, Ka-Yen; Cochran, Donna J.; LaBel, Kenneth A.; Ladbury, Raymond L.; Lauenstein, Jean-Marie; Mondy, Timothy K.; hide

    2017-01-01

    Total ionizing dose and displacement damage testing was performed to characterize and determine the suitability of candidate electronics for NASA space utilization. Devices tested include optoelectronics, digital, analog, linear bipolar devices, and hybrid devices.

  17. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    1993-01-01

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of distri

  18. Holding thermal receipt paper and eating food after using hand sanitizer results in high serum bioactive and urine total levels of bisphenol A (BPA.

    Directory of Open Access Journals (Sweden)

    Annette M Hormann

    Full Text Available Bisphenol A (BPA is an endocrine disrupting environmental contaminant used in a wide variety of products, and BPA metabolites are found in almost everyone's urine, suggesting widespread exposure from multiple sources. Regulatory agencies estimate that virtually all BPA exposure is from food and beverage packaging. However, free BPA is applied to the outer layer of thermal receipt paper present in very high (∼20 mg BPA/g paper quantities as a print developer. Not taken into account when considering thermal paper as a source of BPA exposure is that some commonly used hand sanitizers, as well as other skin care products, contain mixtures of dermal penetration enhancing chemicals that can increase by up to 100 fold the dermal absorption of lipophilic compounds such as BPA. We found that when men and women held thermal receipt paper immediately after using a hand sanitizer with penetration enhancing chemicals, significant free BPA was transferred to their hands and then to French fries that were eaten, and the combination of dermal and oral BPA absorption led to a rapid and dramatic average maximum increase (Cmax in unconjugated (bioactive BPA of ∼7 ng/mL in serum and ∼20 µg total BPA/g creatinine in urine within 90 min. The default method used by regulatory agencies to test for hazards posed by chemicals is intra-gastric gavage. For BPA this approach results in less than 1% of the administered dose being bioavailable in blood. It also ignores dermal absorption as well as sublingual absorption in the mouth that both bypass first-pass liver metabolism. The elevated levels of BPA that we observed due to holding thermal paper after using a product containing dermal penetration enhancing chemicals have been related to an increased risk for a wide range of developmental abnormalities as well as diseases in adults.

  19. Holding Thermal Receipt Paper and Eating Food after Using Hand Sanitizer Results in High Serum Bioactive and Urine Total Levels of Bisphenol A (BPA)

    Science.gov (United States)

    Hormann, Annette M.; vom Saal, Frederick S.; Nagel, Susan C.; Stahlhut, Richard W.; Moyer, Carol L.; Ellersieck, Mark R.; Welshons, Wade V.; Toutain, Pierre-Louis; Taylor, Julia A.

    2014-01-01

    Bisphenol A (BPA) is an endocrine disrupting environmental contaminant used in a wide variety of products, and BPA metabolites are found in almost everyone’s urine, suggesting widespread exposure from multiple sources. Regulatory agencies estimate that virtually all BPA exposure is from food and beverage packaging. However, free BPA is applied to the outer layer of thermal receipt paper present in very high (∼20 mg BPA/g paper) quantities as a print developer. Not taken into account when considering thermal paper as a source of BPA exposure is that some commonly used hand sanitizers, as well as other skin care products, contain mixtures of dermal penetration enhancing chemicals that can increase by up to 100 fold the dermal absorption of lipophilic compounds such as BPA. We found that when men and women held thermal receipt paper immediately after using a hand sanitizer with penetration enhancing chemicals, significant free BPA was transferred to their hands and then to French fries that were eaten, and the combination of dermal and oral BPA absorption led to a rapid and dramatic average maximum increase (Cmax) in unconjugated (bioactive) BPA of ∼7 ng/mL in serum and ∼20 µg total BPA/g creatinine in urine within 90 min. The default method used by regulatory agencies to test for hazards posed by chemicals is intra-gastric gavage. For BPA this approach results in less than 1% of the administered dose being bioavailable in blood. It also ignores dermal absorption as well as sublingual absorption in the mouth that both bypass first-pass liver metabolism. The elevated levels of BPA that we observed due to holding thermal paper after using a product containing dermal penetration enhancing chemicals have been related to an increased risk for a wide range of developmental abnormalities as well as diseases in adults. PMID:25337790

  20. Prevalence of colorectal cancer and its precursor lesions in symptomatic and asymptomatic patients undergoing total colonoscopy: results of a large prospective, multicenter, controlled endoscopy study.

    Science.gov (United States)

    Blumenstein, Irina; Tacke, Wolfgang; Bock, Herbert; Filmann, Natalie; Lieber, Elena; Zeuzem, Stefan; Trojan, Jörg; Herrmann, Eva; Schröder, Oliver

    2013-05-01

    Colorectal cancer (CRC) is the second most common cancer in Germany. Screening colonoscopies have been offered in Germany since 2002. However, validation of screening programs for CRC relies on estimates up to date. The aim of this study was to analyze the influence of the risk factor tumor-suspicious symptoms on the prevalence of CRC and its precursor lesions in patients at least 55 years of age undergoing colonoscopy in comparison with an age-matched and sex-matched control population undergoing screening colonoscopy. Multicenter, prospective, controlled colonoscopy study. Integrated care program of 49 gastroenterological practices in collaboration with a health insurance company and the screening colonoscopy program in Hesse, Germany. In total, 1075 symptomatic and 5375 asymptomatic participants were matched for age and sex (1 : 5) from 1 October 2008 to 30 September 2010. Detection of CRC and its precursor lesions. Overall, the prevalence of CRC was significantly equivalent in both the symptomatic (n=13/1075, 1.21%) and the control group [n=55/5375, 1.02%, 95% confidence interval (CI) for the difference: [-0.46%, 0.83%], P=0.0002, equivalence test with δ=1.5%], respectively. Advanced adenomas were observed in significantly fewer symptomatic patients (61/1075, 5.67%) compared with 432/5375 matched asymptomatic screening participants (8.03%, 95% CI for the difference: [-3.98%, -0.74%], P=0.0094, difference test). Finally, polyps were found significantly less often in symptomatic patients (n=269/1075, 25.0%) than in matched screening participants (n=1807/5375, 33.6%, 95% CI for the difference: [-11.53%, -5.66%], P<0.0001, difference test). The results underline the importance of screening the symptom-free population at least 55 years of age to prevent CRC.

  1. First-Generation Versus Second-Generation Drug-Eluting Stents in Coronary Chronic Total Occlusions: Two-Year Results of a Multicenter Registry

    Science.gov (United States)

    Yu, Cheol Woong; Kim, Je Sang; Lee, Hyun Jong; Choi, Rak Kyeong; Kim, Tae Hoon; Jang, Ho Joon; Choi, Young Jin; Roh, Young Moo; Shim, Won-Heum; Song, Young Bin; Hahn, Joo-Yong; Choi, Jin-Ho; Lee, Sang Hoon; Gwon, Hyeon-Cheol; Choi, Seung-Hyuk

    2016-01-01

    Background Limited data are available regarding the long-term clinical outcomes of second-generation drug-eluting stents (DES) versus first-generation DES in patients with coronary chronic total occlusion (CTO) who undergo percutaneous coronary intervention (PCI). The aim of this study was to compare the clinical outcomes of second-generation DES with those of first-generation DES for the treatment of CTO. Methods and Results Between March 2003 and February 2012, 1,006 consecutive patients with CTO who underwent successful PCI using either first-generation DES (n = 557) or second-generation DES (n = 449) were enrolled in a multicenter, observational registry. Propensity-score matching was also performed. The primary outcome was cardiac death over a 2-year follow-up period. No significant differences were observed between the two groups regarding the incidence of cardiac death (first-generation DES versus second-generation DES; 2.5% vs 2.0%; hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.37 to 1.98; p = 0.72) or major adverse cardiac events (MACE, 11.8% vs 11.4%; HR: 1.00; 95% CI: 0.67 to 1.50; p = 0.99). After propensity score matching, the incidences of cardiac death (HR: 0.86; 95% CI: 0.35 to 2.06; p = 0.86) and MACE (HR: 0.93; 95% CI: 0.63 to 1.37; p = 0.71) were still similar in both groups. Furthermore, no significant differences were observed between sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting, and everolimus-eluting stents regarding the incidence of cardiac death or MACE. Conclusion This study shows that the efficacy of second-generation DES is comparable to that of first-generation DES for treatment of CTO over 2 years of follow-up. PMID:27314589

  2. Prótesis total de rodilla en pacientes con enfermedad de Parkinson. Resultados preliminares. [Total ­knee­ arthroplasty­ in­ Parkinson’s ­disease­ patients. Preliminary results.

    Directory of Open Access Journals (Sweden)

    Juan P. Bonifacio

    2014-06-01

    Full Text Available In­tro­duc­ción: La enfermedad de Parkinson es un trastorno neurodegenerativo progresivo y crónico, con una incidencia aproximada de 31/100.000 habitantes en la Argentina. El objetivo de este estudio fue analizar un grupo de pacientes con enfermedad de Parkinson sometidos a artroplastia total de rodilla. Materiales­ y ­Métodos:­ Entre 2009 y 2011, se evaluó a 11 pacientes (edad promedio 68 años, rango 65-80 con enfermedad de Parkinson que fueron operados por artrosis de rodilla con prótesis cementadas estabilizadas a posteriori. Todos fueron evaluados con la escala analógica visual para el dolor, el Knee Society Scoring, el WOMAC y el grado de satisfacción subjetiva. El grado de afectación de la enfermedad de Parkinson se determinó con la escala modificada de Hoehn y Yahr. Se registraron las complicaciones. Resultados: El seguimiento promedio fue de 2 años (rango 1-3. Las evaluaciones para dolor y funcionales arrojaron los siguientes resultados: la escala analógica visual para el dolor mejoró 3 puntos promedio; KSS dolor 37/74; KSS funcional 36/51, WOMAC 67/31. El grado de satisfacción de los pacientes fue de bueno a excelente en 7 casos. La escala modificada de Hoehn y Yahr fue de 1,5 puntos en el preoperatorio y de 2,6 puntos en el posoperatorio. Hubo 6 complicaciones: dos síndromes confusionales, una trombosis venosa profunda, una luxación protésica y dos prótesis dolorosas. Conclusión:­ La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es un procedimiento que mejora los resultados funcionales y el dolor, pero provoca mayores complicaciones que en la población general.

  3. Midterm results of cementless primary total hip arthroplasty%生物型初次全髋关节置换术的中期随访结果

    Institute of Scientific and Technical Information of China (English)

    何平; 龚翰; 陈东峰; 卢伟杰

    2016-01-01

    目的:探讨生物型固定的全髋关节置换术中髋臼假体的中期临床疗效。方法回顾性分析紫金县人民医院骨科与广州医科大学附属第一医院骨科自2002年1月至2010年9月收治的194例(206髋)生物型全髋关节置换术病例,排除合并髋关节感染、恶性肿瘤、患肢神经肌肉疾病者,随访时间5~13年,平均8.9年,临床观察髋关节功能评分( Harris评分)、并发症、影像学检查评估假体稳定性,组间比较采用配对样本t检验,计量资料对比采用卡方检验,假体生存率采用Kaplan-Meier方法进行分析,以无菌性松动导致的假体翻修作为随访终点。结果共116例(126髋)获得完整随访。 Harris评分由术前的(50.3±13.2)分提高至末次随访时的(96.4±5.1)分,差异有统计学意义(t =3.124,P<0.001)。其中术后并发症包括无菌性松动(7例7髋)、脱位(3例3髋)、深静脉血栓(1例1髋)、异位骨化(11例11髋),手术部位浅表感染(3例3髋)。以无菌性松动导致的假体翻修作为随访终点,髋臼假体13年累计生存率为88%,股骨假体13年累计生存率为100%。结论全髋关节置换术生物型髋关节假体的中期生存率满意,并发症少,临床结果好。%Objective To evaluate the clinical and radiographic results of cementless primary total hip arthroplasty (THA) by a midterm follow-up.Methods A series of 194 patients (206 hips) who had undergone cementless primary THA from January 2002 to September 2010 were involved in this retrospective study .Those patients with history of hip infection , malignant tumor or neuromuscular diseases were excluded.The mean follow-up time was 8.9 years (range,5-13 years).Clinical outcomes were evaluated based on the Harris score .Complications were recorded and components loosening was assessed in the anterior posterior and lateral X-ray examinations of the hips .Paired T

  4. A new bipolar blood sealing system embedded in perioperative strategies vs. a conventional regimen for total knee arthroplasty: results of a matched-pair study

    Directory of Open Access Journals (Sweden)

    Pfeiffer, Michael

    2005-12-01

    Full Text Available From a prospective matched-pair study in 40 patients it can be concluded that the use of a new bipolar sealer system for electrocoagulation is effective in Total Knee Arthroplasty in reducing the visible total blood loss until drain removal on day two after surgery by more than 28% as compared to a conventional regimen. Together with shed blood autotransfusion, it reduced homologous blood transfusions by a factor of five. No complications occurred. The system can be recommended for use in knee surgery during, after opening, and without use of a tourniquet. It bears additional potential for further applications in orthopaedic surgery.

  5. Influence of preoperative nucleus pulposus status and radiculopathy on outcomes in mono-segmental lumbar total disc replacement: results from a nationwide registry

    Directory of Open Access Journals (Sweden)

    Zweig Thomas

    2011-12-01

    Full Text Available Abstract Background Currently, herniated nucleus pulposus (HNP with radiculopathy and other preconditions are regarded as relative or absolute contraindications for lumbar total disc replacement (TDR. In Switzerland it is left to the surgeon's discretion when to operate. The present study is based on the dataset of SWISSspine, a governmentally mandated health technology assessment registry. We hypothesized that preoperative nucleus pulposus status and presence or absence of radiculopathy has an influence on clinical outcomes in patients treated with mono-segmental lumbar TDR. Methods Between March 2005 and April 2009, 416 patients underwent mono-segmental lumbar TDR, which was documented in a prospective observational multicenter mode. The data collection consisted of perioperative and follow-up data (physician based and clinical outcomes (NASS, EQ-5D. Patients were divided into four groups according to their preoperative status: 1 group degenerative disc disease ("DDD": 160 patients without HNP and no radiculopathy, classic precondition for TDR; 2 group "HNP-No radiculopathy": 68 patients with HNP but without radiculopathy; 3 group "Stenosis": 73 patients without HNP but with radiculopathy, and 4 group "HNP-Radiculopathy": 132 patients with HNP and radiculopathy. The groups were compared regarding preoperative patient characteristics and pre- and postoperative VAS and EQ-5D scores using general linear modeling. Results Demographics in all four groups were comparable. Regarding the improvement of quality of life (EQ-5D there were no differences across the four groups. For the two main groups DDD and HNP-Radiculopathy no differences were found in the adjusted postoperative back- and leg pain alleviation levels, in the stenosis group back- and leg pain relief were lower. Conclusions Despite higher preoperative leg pain levels, outcomes in lumbar TDR patients with HNP and radiculopathy were similar to outcomes in patients with the classic

  6. Two or three machined vs roughened surface dental implants loaded immediately supporting total fixed prostheses: 1-year results from a randomised controlled trial.

    Science.gov (United States)

    Cannizzaro, Gioacchino; Gastaldi, Giorgio; Gherlone, Enrico; Vinci, Raffaele; Loi, Ignazio; Trullenque-Eriksson, Anna; Esposito, Marco

    2017-01-01

    To compare implants with machined vs roughened surfaces placed flapless in totally edentulous jaws and immediately restored with metal-resin screw-retained cross-arch prostheses. Mandibles were rehabilitated with two implants (Fixed-on-2 or Fo2) and maxillae with three implants (Fixed-on-3 or Fo3). Forty edentulous or to be rendered edentulous patients (20 in the mandible and 20 in the maxilla) were randomised to the machined group (20 patients: 10 mandibles and 10 maxillae) and to the roughened group (20 patients: 10 mandibles and 10 maxillae) according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 60 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading. Flaps were raised in four patients from the machined group. Four prostheses on machined implants and three on roughened implants were delayed for loading because a sufficient insertion torque was not obtained. There were no dropouts 1 year after loading. Two maxillary machined implants were lost in two patients (difference in proportions = 0.10; 95% CI = -0.03 to 0.23; P (Fisher's exact test) = 0.487); one maxillary Fo3 prosthesis on machined implants and one mandibular Fo2 prosthesis on roughened implants had to be remade (difference in proportions = 0; 95% CI = -0.14 to 0.14; P (Fisher's exact test) = 1.000). Five patients with machined implants had six complications vs seven patients who had eight complications at roughened implants (difference in proportions = -0.10; 95% CI = -0.38 to 0.18; P (Fisher's exact test) = 0.731). There were no statistically significant differences for implant failures, prosthetic failures or complications between groups. There were no statistically significant differences for marginal peri-implant bone levels between the two groups (estimate of the difference = -0.06 mm; 95% CI = -0.23 to 0.10; P (ANCOVA) = 0.445), with

  7. Favourable results of a new intraoperative and postoperative filtered autologous blood re-transfusion system in total hip arthroplasty : A randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger G.; Swierstra, Martzen J.; Ohanis, David; Rolink, Rob; Kollen, Boudewijn J.; Verheyen, Cees C. P. M.

    2014-01-01

    A new intraoperative filtered salvaged blood re-transfusion system has been developed for primary total hip arthroplasty (THA) that filters and re-transfuses the blood that is lost during THA. This system is intended to increase postoperative haemoglobin (Hb) levels, reduce perioperative net blood l

  8. Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.

    2014-01-01

    Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have detriment

  9. Early feeding after total laryngectomy results in shorter hospital stay without increased risk of complications : a retrospective case-control study

    NARCIS (Netherlands)

    Serbanescu-Kele, C. M. C.; Halmos, G. B.; Wedman, J.; van der Laan, B. F. A. M.; Plaat, B. E. C.

    2015-01-01

    Objectives: To evaluate the effects of a reduced nil per os (NPO) period after total laryngectomy (TLE) on general and wound-related post-operative complications, swallowing function and duration of hospital stay. Design, setting and participants: In a retrospective case-control study in 71 patients

  10. Total dietary fiber intakes in the US population are related to whole grain consumption: results from the National Health and Nutrition Examination Survey 2009 to 2010.

    Science.gov (United States)

    Reicks, Marla; Jonnalagadda, Satya; Albertson, Ann M; Joshi, Nandan

    2014-03-01

    Whole grain (WG) foods have been shown to reduce chronic disease risk and overweight. Total dietary fiber is associated with WG and its health benefits. The purpose was to determine whether associations exist between WG intake (no-WG intake, 0 ounce equivalent [oz eq]; low, >0-dietary fiber intake among Americans 2 years and older. One-day food intake data from the US National Health and Nutrition Examination Survey 2009 to 2010 (n = 9042) showed that only 2.9% and 7.7% of children/adolescents (2-18 years) and adults (≥19 years) consumed at least 3 WG oz eq/d, respectively. For children/adolescents and adults, individuals in the high WG intake group were 59 and 76 times more likely to fall in the third fiber tertile, respectively, compared with those with no-WG intake. Total dietary fiber intake from food sources varied by WG intake group for children/adolescents and adults with more total dietary fiber consumed from ready-to-eat (RTE) and hot cereals and yeast breads/rolls in the high WG intake group compared with the no-WG intake group. Major WG sources for children/adolescents and adults included yeast bread/rolls (24% and 27%, respectively), RTE cereals (25% and 20%, respectively), and oatmeal (12% and 21%, respectively). Among those with the highest WG intake, WG RTE cereal with no added bran was the greatest contributor to total dietary fiber compared with other RTE cereal types. Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.

  11. Biochemical response after 3-D conformal radiotherapy of localized prostate cancer to a total dose of 66 Gy. 4 year results

    Energy Technology Data Exchange (ETDEWEB)

    Wachter-Gerstner, N.; Wachter, S.; Goldner, G.; Nechvile, E.; Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, AKH Wien (Austria)

    2002-10-01

    Background: Since the introduction of 3-D conformal radiotherapy (CRT) doses of {<=}70 Gy have been used in many European countries. In this analysis, the impact of a short-term neoadjuvant hormonal treatment in combination with CRT to a moderate dose level of 66 Gy was examined. Patients and methods: From January 1994 to February 1999 397 patients were treated for carcinoma of the prostate. In 279 patients a definitive curative treatment (T1=38, T2=165, T3=50, Tx=11) with or without androgen deprivation was performed. 164 patients with radiotherapy of the prostate{+-}seminal vesicles to a total dose of 66 Gy (n=109) alone or in combination with a short-term hormonal treatment (n=55) were included in this analysis. Biochemical relapse was defined as three rising PSA values or reintroduction of hormonal treatment. A low-risk subgroup was defined for patients with maximum serum PSA level {<=}10 and ct{<=}2 and G{<=}2, all other patients were summarized as high-risk patients. Results: The median follow-up of alive patients was 40 months (12-72 months). There was a total of 29/164 deaths, two were cause-specific and 27 were considered unrelated to prostate cancer. The 4-year rates of no biochemical evidence of disease for all patients was 58%. For the high-risk group the 4-year rates could be improved with borderline significance from 35% to 66% (p=0.057) by additional neoadjuvant hormonal treatment. In contrast for the low-risk group no significant improvement was observed: 73% and 82%, respectively (p=0.5). Conclusion: Especially in high-risk patients doses <70 Gy for radiotherapy alone seem not to be sufficient for curative treatment. Additional hormonal treatment and doses >70 Gy should be considered. As a consequence of our earlier analysis a prospective multicenter treatment optimization protocol has been initiated in 1999. The protocol includes a risk-adapted dose increase from 70 Gy in low-risk patients to 74 Gy in high-risk patients including short

  12. Initial In-flight Results: The Total Solar Irradiance Monitor on the FY-3C Satellite, an Instrument with a Pointing System

    Science.gov (United States)

    Wang, Hongrui; Qi, Jin; Li, Huiduan; Fang, Wei

    2017-01-01

    The total solar irradiance (TSI) has been recorded daily since October 2013 by the Total Solar Irradiance Monitor (TSIM) onboard the FY-3C satellite, which is mainly designed for Earth observation. The TSIM has a pointing system to perform solar tracking using a sun sensor. The TSI is measured by two electrical substitution radiometers with traceability to the World Radiation Reference. The TSI value measured with the TSIM on 2 October 2013 is 1364.88 W m^{-2} with an uncertainty of 1.08 W m^{-2}. Short-term TSI variations recorded with the TSIM show good agreement with SOHO/VIRGO and SORCE/TIM. The data quality and accuracy of FY-3C/TSIM are much better than its predecessors on the FY-3A and FY-3B satellites, which operated in a scanning mode.

  13. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

    Science.gov (United States)

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y

    2008-09-01

    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  14. Total fistulectomy with simple closure of the internal opening in the management of complex cryptoglandular fistulas: long-term results and functional outcome.

    Science.gov (United States)

    Tobisch, Alexander; Stelzner, Sigmar; Hellmich, Gunter; Jackisch, Thomas; Witzigmann, Helmut

    2012-07-01

    Total fistulectomy with simple closure of the internal opening has been used for the management of complex anal fistulas. This approach involves complete removal of the fistula tract and closure of the internal opening with sutures. This study aimed to report long-term outcomes in patients with complex cryptoglandular fistulas who undergo this procedure. This is a retrospective review of a prospectively collected consecutive series. This study was conducted at a community-based hospital with a specialized colorectal unit. : Patients included in this study had cryptoglandular fistulas and underwent total fistulectomy with simple closure of the internal opening between 1997 and 2007. The main outcome measures were success rate and postoperative continence (Cleveland Clinic Florida Fecal Incontinence Scale). Treatment was considered successful if the external opening was closed and no drainage was present at the last follow-up. Success was achieved in 187 (74%) patients with a median follow-up time of 70 (range, 14-141) months. Patients with posterior transsphincteric or suprasphincteric fistulas had a higher success rate than those with other types of fistulas (82% vs 67%;p = 0.014), and patients for whom the procedure failed were significantly younger than those for whom the procedure was a success (mean, 45 vs 50 years; p = 0.010). Of 160 patients with success who had no previous surgery, 89 (56%) had normal continence postoperatively (CCF-FI score = 0). The limitations of this study include its retrospective nature, the potential for selection bias, and the lack of preoperative continence scores. Total fistulectomy with simple closure of the internal opening is effective for the long-term closure of complex cryptoglandular fistulas.However, this procedure may affect continence despite its sphincter-sparing quality. Nonetheless, the high success rate in patients with posterior transsphincteric or suprasphincteric fistulas renders this procedure a reasonable option

  15. Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database

    DEFF Research Database (Denmark)

    Mäkelä, Keijo T; Matilainen, Markus; Pulkkinen, Pekka

    2014-01-01

    Background and purpose An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA...... database with the Finnish data included. Material and methods 438,733 THRs performed during the period 1995-2011 in Sweden, Denmark, Norway, and Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities with 95% confidence interval (CI). Cox multiple regression...

  16. Total encephalic irradiation with complementary dose: preliminary results and prognostic factors; Irradiation encephalique en totalite avec complement de dose: resultats preliminaires et facteurs pronostiques

    Energy Technology Data Exchange (ETDEWEB)

    Assouline, A.; Kzrisch, C. [CHU d' Amiens, 80 (France); Assouline, A.; Levy, A.; Chargari, C.; Lamproglou, I.; Mazeron, J.J. [CHU Pitie Salpetriere, 75 - Paris (France); Chargari, C. [Hopital d' instruction des armees du Val-de-Grace, 75 - Paris (France)

    2010-10-15

    The authors report an assessment study of prognostic factors of global survival and of the benefit of a complementary dose delivered by a conventional linear accelerator for brain metastases after a total encephalic irradiation. This study is based on data from 250 patients treated in Amiens hospital for secondary brain metastases of a lung or breast cancer and melanoma. Five prognostic factors have been studied: type of primitive tumour, gender, number of metastases, surgical resection of metastases, and improvement of neurological symptoms after radiotherapy. An analysis is performed on a subgroup to determine whether a complementary dose would improve survival in the group of patients presenting less than three metastases. Short communication

  17. Recanalization strategy for chronic total occlusions with tapered and stiff-tip guidewire. The results of CTO new techniQUE for STandard procedure (CONQUEST) trial.

    Science.gov (United States)

    Mitsudo, Kazuaki; Yamashita, Takehiro; Asakura, Yasushi; Muramatsu, Toshiya; Doi, Osamu; Shibata, Yoshisato; Morino, Yoshihiro

    2008-11-01

    The success rate of percutaneous coronary intervention (PCI) for chronic total coronary occlusion (CTO) lesions varies depending on the guidewire manipulation skills of the operator. The standardization of guidewire technique is very important. A new technique with a new tapered wire (Conquest, Confianza Pro) was tested to verify effectiveness for higher initial success rates and standardization of PCI for CTO. A prospective, multicenter registry was conducted at 6 investigational sites. In the CONQUEST trial, The CTO lesions were treated by using an intermediate guidewire to cross the lesion. If it did not cross, the guidewire was changed to the Conquest guidewire. If it did not cross, "seesaw-wiring" or the "parallel-wire technique" was performed. The primary endpoint was the initial procedural success rate. A total of 110 patients representing 116 CTO lesions were treated from July 2003 through March 2004. The procedural success rate was 86.2% on the first try, and 88.8% on the second try, respectively. The guidewire success rate on the second try was 90.5% during the hospital stay; no deaths, or acute myocardial infarctions were confirmed. Two patients deteriorated into tamponade, and surgical or percutaneous drainage was performed in each patient without any sequelae. A guidewire technique in PCI for CTOs that starts with the intermediate guidewire and moves to the Confianza Pro tapered guidewire, either alone or by performing a see-saw or parallel-wire technique, can achieve a high initial success rate with an acceptably low major complication rate.

  18. [Use of fish oil lipid emulsions in hospitalized patients under 18 years old with abnormal results in liver tests associated with total parental nutrition].

    Science.gov (United States)

    Giraldo Villa, Adriana; Henao Roldan, Catherine; García Loboguerrero, Fanny; Martínez Volkmar, María Isabel; Contreras Ramírez, Mónica María; Ruiz Navas, Patricia

    2014-04-01

    Introducción: La Nutricion Parental Total (NPT) prolongada esta asociada con complicaciones potencialmente mortales en la poblacion pediatrica como lo es la colestasis. Dentro del soporte nutricional, la fuente de acidos grasos, el contenido de fitoesteroles y la dosis de lipidos se han relacionado con el desarrollo de esta complicacion. Objetivo: Describir el comportamiento de las pruebas hepaticas en pacientes pediatricos con NPT en quienes se uso lipidos a base de acidos grasos omega 3 (omegavenR). Métodos: Estudio retrospectivo, en menores de 18 anos con tratamiento intravenoso por minimo 8 dias con acidos grasos omega 3. Los pacientes fueron inicialmente clasificados en dos grupos: colestasis y alteracion de pruebas hepaticas. Se evaluo el comportamiento de la transaminasa glutamico oxalacetica (TGO), transaminasa glutamico piruvica (TGP), bilirrubina total (BT), bilirrubina directa, gama glutamil transferasa (GGT) y fosfatasa alcalina (FA) antes y despues del tratamiento con omegaven R. Resultados: 33 pacientes cumplieron los criterios de inclusion. Al finalizar la administracion de omegavenR, 82,4% de los pacientes que presentaron inicialmente colestasis mostraron resolucion o mejoria. En el grupo de pacientes con alteracion de pruebas hepaticas 18,8% progresaron a colestasis. Conclusiones: Nuestro estudio sugiere que el uso de omegaven R en pacientes pediatricos con NPT y BD ≥ 2 mg/dL, parece revertir o mejorar la colestasis, mientras que en pacientes con alteracion de pruebas hepaticas aun no se tiene claro su efecto.

  19. High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial

    Energy Technology Data Exchange (ETDEWEB)

    Treskes, K.; Bos, S.A.; Sierink, J.C.; Luitse, J.S.K.; Goslings, J.C. [Academic Medical Center, Trauma Unit, Department of Surgery, Amsterdam (Netherlands); Beenen, L.F.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Edwards, M.J.R. [Radboud University Medical Center, Department of Trauma and emergency surgery, Nijmegen (Netherlands); Beuker, B.J.A. [University Medical Center Groningen, Trauma Unit, Department of Surgery, Groningen (Netherlands); Muradin, G.S.R. [University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); Hohmann, J. [University of Basel Hospital, Department of Radiology and Nuclear Medicine, Basel (Switzerland); Hollmann, M.W. [Academic Medical Center, Department of Anaesthesiology, Amsterdam (Netherlands); Dijkgraaf, M.G.W. [Academic Medical Center, Clinical Research Unit, Amsterdam (Netherlands); Collaboration: REACT-2 study group

    2017-06-15

    To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning. Trauma patients from five trauma centres were randomized between April 2011 and January 2014 to TBCT imaging or STWU consisting of conventional imaging with selective CT scanning. Incidental findings were divided into three categories: 1) major finding, may cause mortality; 2) moderate finding, may cause morbidity; and 3) minor finding, hardly relevant. Generalized estimating equations were applied to assess differences in incidental findings. In total, 1083 patients were enrolled, of which 541 patients (49.9 %) were randomized for TBCT and 542 patients (50.1 %) for STWU. Major findings were detected in 23 patients (4.3 %) in the TBCT group compared to 9 patients (1.7 %) in the STWU group (adjusted rate ratio 2.851; 95%CI 1.337-6.077; p < 0.007). Findings of moderate relevance were detected in 120 patients (22.2 %) in the TBCT group compared to 86 patients (15.9 %) in the STWU group (adjusted rate ratio 1.421; 95%CI 1.088-1.854; p < 0.010). Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning. (orig.)

  20. Radioimmunoscintigraphy of recurrent, metastatic, or occult colorectal cancer with technetium 99m-labeled totally human monoclonal antibody 88BV59: results of pivotal, phase III multicenter studies.

    Science.gov (United States)

    Serafini, A N; Klein, J L; Wolff, B G; Baum, R; Chetanneau, A; Pecking, A; Fischman, A J; Hoover, H C; Wynant, G E; Subramanian, R; Goroff, D K; Hanna, M G

    1998-05-01

    To assess the performance and potential clinical impact of a totally human monoclonal antibody, 88BV59 (HumaSPECT) (INTRACEL, Corp, Rockville, MD), in 202 assessable presurgical patients with recurrent, metastatic, or occult colorectal cancer. 88BV59, labeled with technetium Tc 99m (99mTc) (HumaSPECT-Tc), was injected intravenously, and planar and single photon emission tomography (SPECT) images were obtained 14 to 20 hours postinjection. Surgical and pathologic verification of tumor were used as the standard against which the performance of HumaSPECT-Tc imaging and computed tomography (CT) analysis were evaluated. All patients entered onto the recurrent disease study had at least one tumor site defined on CT. The sensitivity of HumaSPECT-Tc in those CT-positive patients was 87%. The specificity of HumaSPECT-Tc was 57% compared with 17% for CT and the difference was statistically significant (P HAHA) response (90 ng/mL) at 9 weeks postinfusion was observed. HumaSPECT-Tc can provide important and accurate information about the presence and location of disease in patients with a high clinical suspicion of metastatic or recurrent colorectal cancer and either positive (known disease) or negative (occult disease) CT scans.

  1. Cementless Total Hip Arthroplasty With a High Hip Center for Hartofilakidis Type B Developmental Dysplasia of the Hip: Results of Midterm Follow-Up.

    Science.gov (United States)

    Chen, Min; Luo, Zheng-Liang; Wu, Ke-Rong; Zhang, Xiao-Qi; Ling, Xiao-Dong; Shang, Xi-Fu

    2016-05-01

    Acetabular reconstruction in adults with Hartofilakidis type B developmental dysplasia of the hip is a major technical challenge. The purpose of this retrospective study was to evaluate hip function and radiographic outcomes regarding high hip center at midterm follow-up. From January 1, 2007 to December 31, 2009, 37 patients who had Hartofilakidis type B developmental dysplasia of the hip underwent a primary total hip arthroplasty using a high hip center technique. Functional, radiographic, and survivorship outcomes were evaluated. Of the 37 patients, 31 patients (83.8%) were available for the mean follow-up of 6.1 years (range, 1.5-7.6 years). Thirty-one cementless cups were located at an average vertical distance of 38.1 ± 3.3 mm and at a mean horizontal distance of 35.5 ± 3.4 mm. The mean ratio of the height of the hip center was 2.4% (range, 2.0%-2.9%). The Harris Hip Scores were improved from 50.3 points (range, 38-63 points) preoperatively to 92.3 points (range, 85-100 points) at the final follow-up (P hip center technique in conjunction with a cementless acetabular component seems to be a valuable alternative to achieve satisfactory midterm outcomes for Hartofilakidis type B developmental dysplasia of the hip. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Total hysterectomy and anterior vaginal wall suspension for concurrent uterine and bladder prolapses: Long-term anatomical results of additional vault and/or posterior compartment prolapse repair

    Directory of Open Access Journals (Sweden)

    Dominic Lee

    2015-03-01

    Conclusion: At long-term follow-up, nearly one in five apical recurrences in these two surgical groups was observed with stable results in the anterior compartment. The posterior compartment required the least surgical intervention.

  3. Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up

    Directory of Open Access Journals (Sweden)

    Chen-Yi Ye

    2016-01-01

    Conclusions: Second-generation modular CCK prostheses are a safe and practical treatment for both primary and revision knees that cannot be balanced. However, further studies focusing on different types of constrained prostheses are required to validate these results.

  4. Total carbon dioxide, hydrographic, and nitrate measurements in the Southwest Pacific during Austral autumn, 1990: Results from NOAA/PMEL CGC-90 cruise

    Energy Technology Data Exchange (ETDEWEB)

    Lamb, M.F.; Feely, R.A. [Pacific Marine Environmental Lab., Seattle, WA (United States); Moore, L. [Atlantic Oceanographic and Meteorological Lab., Miami, FL (United States)] [and others

    1995-10-01

    In support of the National Oceanic and Atmospheric Administration (NOAA) Climate and Global Change (C&GC) Program, Pacific Marine Environmental Laboratory (PMEL) scientists have been measuring the growing burden of greenhouse gases in the thermocline waters of the Pacific Ocean since 1980. Collection of data at a series of hydrographic stations along longitude 170{degrees} W during austral autumn of 1990 was designed to enhance understanding of the increase in the column burden of chlorofluorocarbons and carbon dioxide in the thermocline waters since the last expedition in 1984. This document presents the procedures and methods used to obtain total carbon dioxide (TCO{sub 2}), hydrographic, and nitrate data during the NOAA/PMEL research vessel (R/V) Malcolm Baldrige CGC-90 Cruise. Data were collected along two legs; sampling for Leg 1 began along 170{degrees} W from 15{degrees} S to 60{degrees} S, then angled northwest toward New Zealand across the Western Boundary Current. Leg 2 included a reoccupation of some stations between 30{degrees} S and 15{degrees} S on 170{degrees} W and measurements from 15{degrees} S to 5{degrees} N along 170{degrees} W. The following data report summarizes the TCO{sub 2}, salinity, temperature, and nitrate measurements from 63 stations. The TCO, concentration in seawater samples was measured using a coulometric/extraction system (Models 5011 and 5030, respectively) originated by Ken Johnson. The NOAA/PMEL R/V Malcolm Baldrige CGC-90 Cruise data set is available without charge as a numeric data package (NDP) from the Carbon Dioxide Information Analysis Center. The NDP consists of two oceanographic data files, two FORTRAN 77 data retrieval routine files, a {open_quotes}readme{close_quotes} file, and this printed documentation, which describes the contents and format of all files as well as the procedures and methods used to obtain the data.

  5. Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study.

    Science.gov (United States)

    Bonaccio, Marialaura; Di Castelnuovo, Augusto; De Curtis, Amalia; Costanzo, Simona; Bracone, Francesca; Persichillo, Mariarosaria; Donati, Maria Benedetta; de Gaetano, Giovanni; Iacoviello, Licia

    2015-09-14

    Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4·3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (≤2 times/month) was inversely associated with mortality (multivariable HR=0·68; 95 % CI 0·54, 0·87). At intake ≥8 times/month, a greater protection was observed (HR=0·53; 0·32, 0·90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0·64; 95 % CI 0·44, 0·94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship.

  6. The association between component malalignment and post-operative pain following navigation-assisted total knee arthroplasty: results of a cohort/nested case-control study.

    Science.gov (United States)

    Czurda, Thomas; Fennema, Peter; Baumgartner, Martin; Ritschl, Peter

    2010-07-01

    Previous studies have noted an adverse relationship between implant malalignment during total knee arthroplasty (TKA) and post-operative pain. Although some evidence exists indicating that computer-assisted surgical navigation for TKA can improve the accuracy of component alignment, its impact on clinical outcomes is currently unknown. The dual goals of the present cohort/nested case-control study were to (1) compare self-reported responses to the Western Ontario-McMaster Osteoarthritis Index (WOMAC) questionnaire between computer-assisted TKA (123 patients) using the imageless PiGalileo navigation system and conventional TKA (207 patients) [cohort analysis], and (2) to investigate a potential association between malalignment and post-operative pain in 19 painful knees and 19 asymptomatic knees obtained from the cohort analysis using matched sampling [nested case-control study]. In the cohort analysis, a relevant but non-significant (P = 0.06) difference in the occurrence of chronic pain was observed between the navigated (12%) and conventional arms (20%). Median post-operative WOMAC pain score was 100 (range, 50-100) in the conventional group and 100 (range, 65-100) in the navigated group. However, the Mann-Whitney test revealed a significant difference in favor of the navigated group (P = 0.01). In the nested case-control analysis, radiological outcomes and computer tomography (CT) measurements of femoral rotation were compared between the groups. The CT rotation measurements yielded evidence of a relationship between post-operative pain and incorrect rotational alignment of the femoral component of more than 3 degrees (OR: 7; 95% CI: 1.2-42; P = .033). In conclusion, there was no clinical benefit to computer-assisted navigation; however, a statistically significant relationship was observed between incorrect rotational alignment of the femoral component and symptoms of post-operative pain following TKA.

  7. Total- and monomethyl-mercury and major ions in coastal California fog water: Results from two years of sampling on land and at sea

    Directory of Open Access Journals (Sweden)

    Peter Weiss-Penzias

    2016-04-01

    Full Text Available Abstract Marine fog water samples were collected over two summers (2014–2015 with active strand collectors (CASCC at eight coastal sites from Humboldt to Monterey counties in California, USA, and on four ocean cruises along the California coastline in order to investigate mercury (Hg cycling at the ocean-atmosphere-land interface. The mean concentration of monomethylmercury (MMHg in fog water across terrestrial sites for both years was 1.6 ± 1.9 ng L-1 (<0.01–10.4 ng L-1, N = 149, which corresponds to 5.7% (2.0–10.8% of total Hg (HgT in fog. Rain water samples from three sites had mean MMHg concentrations of 0.20 ± 0.12 ng L-1 (N = 5 corresponding to 1.4% of HgT. Fog water samples collected at sea had MMHg concentrations of 0.08 ± 0.15 ng L-1 (N = 14 corresponding to 0.4% of HgT. Significantly higher MMHg concentrations in fog were observed at terrestrial sites next to the ocean relative to a site 40 kilometers inland, and the mean difference was 1.6 ng L-1. Using a rate constant for photo-demethylation of MMHg of -0.022 h-1 based on previous demethylation experiments and a coastal-inland fog transport time of 12 hours, a mean difference of only 0.5 ng L-1 of MMHg was predicted between coastal and inland sites, indicating other unknown source and/or sink pathways are important for MMHg in fog. Fog water deposition to a standard passive 1.00 m2 fog collector at six terrestrial sites averaged 0.10 ± 0.07 L m-2 d-1, which was ∼2% of typical rainwater deposition in this area. Mean air-surface fog water fluxes of MMHg and HgT were then calculated to be 34 ± 40 ng m-2 y-1 and 546 ± 581 ng m-2 y-1, respectively. These correspond to 33% and 13% of the rain fluxes, respectively.

  8. Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population.

    Science.gov (United States)

    Friedman, Susan M; Mendelson, Daniel A; Kates, Stephen L; McCann, Robert M

    2008-07-01

    Hip fractures in older adults are a common event, leading to substantial morbidity and mortality. Hip fractures have been previously described as a "geriatric, rather than orthopedic disease." Patients with this condition have a high prevalence of comorbidity and a high risk of complications from surgery, and for this reason, geriatricians may be well suited to improve outcomes of care. Co-management of hip fracture patients by orthopedic surgeons and geriatricians has led to better outcomes in other countries but has rarely been described in the United States. This article describes a co-managed Geriatric Fracture Center program that has resulted in lower-than-predicted length of stay and readmission rates, with short time to surgery, low complication rates, and low mortality. This program is based on the principles of early evaluation of patients, ongoing co-management, protocol-driven geriatric-focused care, and early discharge planning. This is a potentially replicable model of care that uses the expertise of geriatricians to optimize the management of a common and serious condition.

  9. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  10. Transverse target-spin asymmetry associated with deeply virtual Compton scattering on the proton and a resulting model-dependent constraint on the total angular momentum of quarks in the nucleon

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Zhenyu

    2007-02-15

    In this thesis we report on the rst results on the transverse target-spin asymmetry associated with deeply virtual Compton scattering on the proton. It is shown that this asymmetry can provide one of the rare possibilities to access the Generalized Parton Distribution (GPD) E of the nucleon, and thus, through models for E, also to the total angular momentum of u and d quarks in the nucleon. The measurement was performed using the 27.6 GeV positron beam of the HERA storage ring and the transversely polarized hydrogen target of the HERMES experiment at DESY. The two leading azimuthal amplitudes of the asymmetry are extracted from the HERMES 2002-2004 data, corresponding to an integrated luminosity of 65.3 pb.1. By comparing the results obtained at HERMES and theoretical predictions based on a phenomenological model of GPDs, we obtain a model-dependent constraint on the total angular momentum of quarks in the nucleon. (orig.)

  11. Metal ion levels in large-diameter total hip and resurfacing hip arthroplasty-Preliminary results of a prospective five year study after two years of follow-up

    Directory of Open Access Journals (Sweden)

    Maurer-Ertl W

    2012-04-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. Methods The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively. Results The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p  Discussion In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.

  12. Results of total knee arthroplasty after high tibial osteotomy%胫骨高位截骨术后全膝关节置换的疗效分析

    Institute of Scientific and Technical Information of China (English)

    印度新德里利物浦骨科医院

    2008-01-01

    [目的]目前采用胫骨高位截骨术治疗膝关节内侧间室骨性关节炎已在临床广泛开展,对于其中预后不佳者可采用全膝关节置换,本文对其临床效果进行分析.[方法]对38例胫骨高位截骨术后接受全膝关节置换术患者进行回顾分析.术后随访时间平均8年,对其中期疗效进行评估.[结果]特种外科住院评分由术前平均39分提高到术后平均86.5分.优良率达87%.[结论]与未接受过胫骨高位截骨术患者相比,胫骨高位截骨术后接受全膝关节置换的中期疗效令人满意.%[Objective] High tibial osteotomy is a well accepted procedure for medial compartment osteoarthritis of knees.Over time its results deteriorate and some patients were reoperated with a total knee arthroplasty.To evaluate the results of total knee arthroplasty after a high tibial osteotomy.[Method] Thirty-eight knees were evaluated retrospectively for the results of a total knee arthroplasty after a high tibial osteotomy.They were followed up for an average of 8 years and the mid terra results assessed.[Result] The average Hospital for special surgery score increased to 86.5 points from 39 points pre-operatively.There were 87% excellent and good results.[Conclusion] Mid term results of total knee arthroplasty after hish tibial osteotomy are excellent and are comparable to those without a tibial osteotomy.

  13. Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Sun Zhuoyu

    2012-03-01

    Full Text Available Abstract Background Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL and Ontario (ON, Canada. Methods Incident colorectal cancer cases (n = 1760 were identified from population-based cancer registries in the provinces of ON (1997-2000 and NL (1999-2003. Controls (n = 2481 were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ, personal history questionnaire (PHQ, and food frequency questionnaire (FFQ were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Results Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p-trend = 0.02, 5th versus 1st quintile, whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p-trend = 0.06, 5th versus 1st quintile, carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p-trend = 0.05, 5th versus 1st quintile and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p-trend = 0.04, 5th versus 1st quintile. Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. Conclusion This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

  14. Which factors will affect the medium-term results of total hip arthroplasty?%谁在影响着人工全髋关节置换后的中期疗效?☆

    Institute of Scientific and Technical Information of China (English)

    陈明; 勘武生; 方真华; 郑琼; 徐敏超

    2013-01-01

      背景:人工全髋关节置换后患者生活质量受多方面因素的影响,分析与置换后疗效相关的影响因素,以便采取针对性措施进行干预。  目的:探讨影响初次人工全髋关节置换疗效的相关因素。  方法:对352例初次行人工全髋关节置换患者的临床资料进行回顾性分析,根据髋关节 Harris 评分,设定影响评分的相关因素,通过卡方检验和 Spearman 等级相关分析评估各因素与初次人工全髋关节置换疗效之间的关系。并将文章结果与相关研究结果进行对比分析。  结果与结论:初次人工全髋关节置换时患者年龄、体质量指数、髋关节旋转中心、股骨偏心距和置换后康复训练对中期疗效影响明显。置换前诊断、手术入路、患者性别、假体类型等对置换后效果影响不明显。关节外科医师只有对这些影响因素给予充分的重视,正确预防、科学处理影响关节功能恢复的各种因素,将是提高患者满意度的前提条件。%BACKGROUND: Life quality of patients after total hip arthroplasty wil affected by various factors, and the factors that can affect the treatment effect after replacement should be analyzed in order to take the specific measures to intervene. OBJECTIVE: To investigate the relative factors that affect the treatment effect of initial total hip arthroplasty. METHODS: The clinical data of 352 patients treated with initial total hip arthroplasty were retrospectively analyzed, and the factors that affect the scoring were determined according to the Harris score. The relationship between various factors and the treatment of total hip arthroplasty was evaluated and analyzed through chi-square test and Spearman classification. Comparative analysis was performed to compare the results of relative articles and researches. RESULTS AND CONCLUSION: Age, body mass index, hip rotation center, femoral eccentricity and post

  15. Does the use of laminar flow and space suits reduce early deep infection after total hip and knee replacement?: the ten-year results of the New Zealand Joint Registry.

    Science.gov (United States)

    Hooper, G J; Rothwell, A G; Frampton, C; Wyatt, M C

    2011-01-01

    We have investigated whether the use of laminar-flow theatres and space suits reduced the rate of revision for early deep infection after total hip (THR) and knee (TKR) replacement by reviewing the results of the New Zealand Joint Registry at ten years. Of the 51 485 primary THRs and 36 826 primary TKRs analysed, laminar-flow theatres were used in 35.5% and space suits in 23.5%. For THR there was a significant increase in early infection in those procedures performed with the use of a space suit compared with those without (p space suit (p space suit (p space suits were used in those theatres (p deep infection has not been reduced by using laminar flow and space suits. Our results question the rationale for their increasing use in routine joint replacement, where the added cost to the health system seems to be unjustified.

  16. Rotational total skin and total nodal radiotherapy in mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Bamberg, M.; Molls, M.; Langrock, J.; Muskalla, K.; Quast, U.

    1987-04-01

    The following report describes our technique of rotational total skin radiotherapy with electrons (TSER). We present stage related treatment results. Furthermore our first experiences with the combination of TSER and total nodal irradiation (TNI) are communicated.

  17. The preoperative serum ratio of total prostate specific antigen (PSA to free testosterone (FT, PSA/FT index ratio, and prostate cancer. Results in 220 patients undergoing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Antonio B. Porcaro

    2016-03-01

    Full Text Available Objectives: To evaluate associations of preoperative total prostate specific antigen (PSA to free testosterone (FT, the PSA/FT index ratio, with features of pathology prostate cancer (PCA and to investigate its prognostic potential in clustering the PCA population. Patients and methods: After excluding criteria, the records of 220 patients who underwent radical prostatectomy (RP were retrospectively reviewed. Serum samples of PSA, total testosterone (TT and FT were collected at 8.00 A.M., one month after biopsies and before RP. The PSA/FT ratio was computed in the population of patients who were clustered in groups according to ranking intervals of the PSA/FT ratio which identified at least 4 clusters which were coded as A, B, C, and D. The independent associations of the PSA/FT index ratio were assessed by statistical methods and a two-sided P < 0.05 was considered to indicate statistical significance. Results: TT correlated to FT which was a significant predictor of PSA in the population of patients who were subsequently clustered, according to increasing interval values of the PSA/FT index ratio, in groups that showed a stronger linear association of FT with PSA. The PSA/FT index ratio significantly associated with pathology features of prostate cancer such as pathology Gleason score (pGS, invasion of the seminal vesicles (pT3b, proportion of positive cores (P+ and proportion of cancer involving the volume of the prostate. In the population of patients, TT, PSA/FT index ratio and P+ independently associated with pGS ≥ 7 and pT3b; moreover, the odds ratio (OR of the PSA/FT index ratio resulted 9.11 which was stronger than TT (OR = 1.11 and P+ (OR = 8.84. In the PCA population, TT, PSA/FT index ratio and P+ also independently associated with pT3b PCA; interestingly, the OR of PSA/FT index resulted 54.91 which was stronger than TT (OR = 1.31 and P+ (26.43. Conclusions: Preoperative PSA/FT index ratio is an independent strong factor which

  18. 不同类型公共场所环境空气细菌总数的监测结果分析%Analysis of monitoring results of different types of public environmental air-total bacterial count

    Institute of Scientific and Technical Information of China (English)

    李晓莉

    2014-01-01

    Objective To investigate the monitoring results of different types of public environmental air total bacterial count. Methods 254 samples were selected in our hospital in 2012 January -2013 year in December from different public places to col-lect, the total number of bacteria in the air of the environment. Results Shopping malls, public transport waiting room, waiting room of hospital air bacterial count qualified rate reached 100%, cultural entertainment and qualified rate was 85.5%, the hair-dressing industry 97.6%, hotel of 65.8%. Different types of public environmental air bacteria are statistically significant difference (P<0.05). Conclusion Understanding the different types of public environmental air bacteria, strengthen the management, to im-prove the public plays an important role in environmental treatment.%目的:探讨不同类型公共场所环境空气细菌总数的监测结果。方法选取我中心2012年1月-2013年12月自不同公共场所所采集到的254份样品,对其环境空气细菌总数进行分析。结果商场、公共交通等候室、医院候诊室环境空气细菌总数合格率达到100%,文化娱乐场所合格率85.5%,理发美容业97.6%,旅店业65.8%。不同类型公共场所环境空气细菌总数存在明显统计学差异性(P<0.05)。结论了解不同类型公共场所环境空气细菌总数,加强其管理,对于提高公共场所环境治疗具有重要作用。

  19. Restricted total stability and total attractivity

    Directory of Open Access Journals (Sweden)

    Giuseppe Zappala'

    2006-08-01

    Full Text Available In this paper the new concepts of restricted total stability and total attractivity is formulated. For this purpose the classical theory of Malkin with suitable changes and the theory of limiting equations, introduced by Sell developed by Artstein and Andreev, are used. Significant examples are presented.

  20. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  1. 对血培养实施全面质量控制前后结果分析%Analysis on results before and after implementing total quality control on blood culture

    Institute of Scientific and Technical Information of China (English)

    朱中华; 张茂海; 张桂花

    2016-01-01

    目的:通过对血培养实施全面质量控制措施,观察血培养实施前、后的结果变化。方法对进行质量控制措施前一年的血培养结果与进行质量控制措施后1年的结果进行比较分析。结果对血培养进行质量控制措施后,血培养的阳性率升高2.4%、污染率下降8.6%。结论通过对血培养实施全面质量控制可提高血培养阳性率、降低血培养污染率。污染菌的判定,一定结合实验室检查资料和患者临床情况。确保为临床提供准确、有效的抗菌药物。%Objective To observe the changes of the blood culture results before and after implementing the quality control on blood culture .Methods The blood culture results in 1 year before implementing the quality control and in 1 year after implementing the quality control were performed the contrastive analysis .Results After implementing the quality control on blood culture ,the positive rate of blood culture was elevated by 2 .4% and the pollution rate was decreased by 8 .6% after the quality control .Conclu‐sion Implementing the total quality control on blood culture can improve the positive rate of blood culture and reduces the pollu‐tion rate of blood culture .The determination of contamination bacteria must combine the laboratory detection data with the clinical situation for ensuring to provide accurate and effective antimicrobial agents for clinic .

  2. Medium-term results of two-staged revision surgery for infected total hip arthroplasty%二期翻修治疗人工全髋关节置换术后感染的中期疗效评估

    Institute of Scientific and Technical Information of China (English)

    顾文骏; 吴海山; 吴宇黎; 李晓华; 赵辉; 王波; 符培亮

    2012-01-01

    目的 对全髋关节置换术后感染行二期翻修术治疗的患者进行中期的随访,并进行疗效评估.方法 自2004年1月~2007年12月,本组采用二期翻修术治疗人工髋关节术后感染22例(22髋).一期手术彻底清创,取出感染假体,置入抗生素骨水泥间隔器;二期手术植入骨水泥型或非骨水泥型假体.以感染复发率、疼痛评分(VAS评分)、髋关节功能评分(Harris评分)评估术后疗效.结果 平均随访周期为(6.6±1.8)年(5~8年),22例患者均未发现感染复发、假体松动和脱位等.治疗前VAS评分平均为7.2分(5~9.1分),一期手术后VAS评分平均为3.8分(1.2~5.3分),最后一次随访时VAS评分平均为1.2分(0~3.2分).治疗前Harris评分平均为36.4分(20~49分),一期手术后Harris评分平均为56.3分(40~66分),最后随访时Harris评分平均为84.2分(72~93分).结论 使用抗生素骨水泥间隔器二期翻修术中期随访控制感染效果显著,为全髋置换术后感染提供了有效治疗途径.%Objective To discuss the medium-term results of two-staged revision surgery for the treatment of infected total hip arthroplasty. Methods 22 patients (22 hips) were enrolled in this study between January, 2004 and December, 2007. The treatment protocol consisted of a two-stage surgery with removal of infected components, insertion of an antibiotic impregnated cement spacer and re-implantation of an uncemented or cemented prosthesis. Patients were assessed for infection recurrence, pain (visual analog scale [ VAS] ) and hip joint function ( Harris Hip score). Results The average duration of follow-up was (6. 6 ±1.8) ( range, 5-8 ) years; all 22 hips were successfully converted to prosthesis in an average time of 4. 2 months after spacer implantation. There was no case of recurrent prosthetic infection. No patient had required revision for aseptic loosening or dislocation on the femoral side. The mean VAS pain score improved from 7. 2 ( range

  3. 旋转铰链膝假体在全膝关节置换翻修术后的临床效果%Clinical results of rotating hinged knee prosthesis in total knee arthroplasty revison

    Institute of Scientific and Technical Information of China (English)

    黄菲; 郑秋坚

    2016-01-01

    Objective To explore the clinical results of rotating hinged knee prosthesis in total knee arthroplasty ( TKA) revision. Methods A retrospective analysis was carried out on the clinical data of 10 patients ( 10 knees ) with severe knee deformity from department of orthopedics , Guangdong General Hospital .These patients received rotating hinged knee prosthesis for total knee arthroplasty revison because of aseptic loosening or infection and were followed up between October 2008 and May 2013.All the cases adopted first-stage revision or debridement and the home-made antibiotic polymethyl methacrylate ( PMMA) were used in the first stage treatment; the rotating hinged knee prosthesis was used in the second-stage revision.The patients were followed up after the revision , and evaluated by hospital for special surgery ( HSS) knee score and range of motion . Results The patients were followed up from 2 to 57 months with an average time of 29 months.All the ten cases healed well without lower limb phlebothrombosis or pulmonary infection . Clinical evaluation showed that the mean HSS knee score improved from 37 points preoperatively to 85 points postoperatively , and the mean range of motion increased from 65°to 93°. Conclusion In this study the knee function could be improved by the rotating hinged knee prosthesis than other prostheses .%目的:探讨使用旋转铰链膝假体进行全膝关节置换( TKA)术后翻修的临床效果。方法回顾性分析2008年10月至2013年5月,广东省人民医院骨科行人工TKA术后翻修且进行随访的重度膝关节畸形患者,其中采用旋转铰链型膝关节假体为10例(10膝)。收治的10例(10膝) TKA术后因假体松动或膝关节感染而需行全膝关节翻修的患者,采用一期翻修或一期清创加自制含抗生素骨水泥植入,可旋转绞链膝假体二期翻修方法治疗。术后进行随访并采用膝关节协会评分(HSS)及膝关节活动度评估膝关节

  4. Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

    Science.gov (United States)

    Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung; Kim, Young-Baeg; Kim, Du Hwan

    2017-01-01

    Objective To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2–7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were 8.6±2.3 and 8.4±2.0, and lower level motion values were 8.4±2.2 and 8.3±1.9. Preoperative and postoperative FSU heights were 37.0±2.1 and 37.1±1.8. In the group B, upper level adjacent segment motion values were 8.1±2.6 and 8.2±2.8, and lower level motion values were 6.5±3.3 and 6.3±3.1. FSU heights were 37.1±2.0 and 36.2±1.8. The postoperative FSU motion and height changes were significant (p<0.05). The patient’s satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient’s biomechanical characteristics and economic status should be understood and treated using the optimal procedure. PMID:28061490

  5. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  6. Early clinical results of electromagnetic navigation assisted total knee arthroplasty%电磁导航辅助全膝关节置换术的早期临床结果

    Institute of Scientific and Technical Information of China (English)

    崔文权; 姜文学; 元礼渊; 齐志明; 毕伟; 韩亚洲

    2013-01-01

    Objective To retrospectively evaluate the accuracy of postoperative prosthesis implantation and reconstruction of lower limb alignment after total knee arthroplasty ( TKA ) using an electromagnetic ( EM ) navigation system, and to investigate the technical characteristics and early clinical results of EM navigation assisted TKA. Methods The data of 64 initial consecutive patients ( 100 knees ) who underwent primary TKA using an EM navigation system from July 2006 to February 2007 were retrospectively studied. There were 7 males and 57 females, whose mean age was 66.9 years old ( range; 57-79 years ). The navigation time, tourniquet time, blood loss and drainage flow in 48h were observed after the operation. The mechanical axis angle of the lower extremity, the coronal inclination angle of femoral and tibial prostheses and the sagittal inclination angle of femoral prostheses (α,βandγangles ) were measured based on X-rays before the operation and at the 3rd month after the operation. Varus was expressed as positive (+) and valgus negative (-). The knee function was evaluated using the Knee Society Score ( KSS ) before the operation and at the 3rd month after the operation, and the knee joint flexion and extension range of motion ( ROM ) and complications were also recorded. Results The navigation time was ( 10±2 ) min for each knee, and the tourniquet time was ( 93±9 ) min. The blood loss and drainage flow in 48 h were ( 483±55 ) ml. The preoperative and postoperative mechanical axis angles were (+8.07±6.69 ) ° and (+1.20±1.92 ) ° respectively, and statistically significant differences were found between them ( P0.05 ). No complications such as infection, injuries of nerves and blood vessels, bone fractures, deep venous thrombosis of the lower extremity and so on were found. Conclusions The EM navigation system is safe and reliable. With the EM navigation system in TKA, optimal prosthesis position and lower limb alignment and good early clinical results can

  7. Metal ion levels and functional results following resurfacing hip arthroplasty versus conventional small-diameter metal-on-metal total hip arthroplasty; a 3 to 5year follow-up of a randomized controlled trial

    NARCIS (Netherlands)

    Bisseling, P.; Smolders, J.M.; Hol, A.; Susante, J.L.C. van

    2015-01-01

    We present an update of a randomized controlled trial on 71 patients (<65 years) who received either a resurfacing hip arthroplasty (RHA) (n=38) or cementless 28-mm metal-on-metal (MoM) total hip arthroplasty (THA) (n=33). Metal ion levels and functional outcome scores were analyzed with a mean f

  8. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study

    NARCIS (Netherlands)

    Bisseling, P.; Wit, B.W. de; Hol, A.M.; Gorp, M.J. van; Kampen, A. van; Susante, J.L. van

    2015-01-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patien

  9. Pseudotumour incidence, cobalt levels and clinical outcome after large head metal-on-metal and conventional metal-on-polyethylene total hip arthroplasty MID-TERM RESULTS OF A RANDOMISED CONTROLLED TRIAL

    NARCIS (Netherlands)

    van der Veen, H. C.; Reininga, I. H. F.; Zijlstra, W. P.; Boomsma, M. F.; Bulstra, S. K.; van Raay, J. J. A. M.

    2015-01-01

    We compared the incidence of pseudotumours after large head metal-on-metal (MoM) total hip arthroplasty (THA) with that after conventional metal-on-polyethylene (MoP) THA and assessed the predisposing factors to pseudotumour formation. From a previous randomised controlled trial which compared large

  10. 人工关节在踝关节残障中的应用及随访%The application and followed-up result with total ankle arthroplasty and autografing for ankle disabled persons

    Institute of Scientific and Technical Information of China (English)

    毛宾尧; 王毳; 李新春; 司全明

    2011-01-01

    [目的]观察植骨人工踝关节置换治疗踝关节病损的中远期疗效.[方法]自1998年10月~ 2008年12月,植骨人工踝关节置换治疗踝关节损伤性关节炎56例(其中伴距骨体顶部局限性坏死2例和胫骨骨折并小腿筋膜间室综合征广泛肌切除后距下关节融合1例),类风关1例.男35例,女22例;平均年龄54.7岁(28~68岁).[结果]本组57例获平均6年9个月随访(2年10个月~10年3个月).术前、术后踝关节功能采用Kofoed评价法和步态分析,术前踝关节功能62分(60 ~75)13例,47分(30 ~ 60)27例,16分(0~29)17例.术后效果优(85 ~100分)39例,良(75~84分)14例,差(60~74分)1例.优良率98.3%.术前、术后疗效按Kofoed评价以统计学分析,P<0.01具有显著意义.术前步态49例均为跛行步态(负重相>55%);术后正常步态(15% ~45%周期内)24例,轻微跛行(站立相45%~55%)22例,跛行(负重相>55%)3例.未行步态分析8例.术前、术后步态分析两组数据的统计学分析P<0.05,有统计学意义.X线检查显示植骨部与假体间固定良好,植骨成活.[结论]植骨人工踝关节置换对改善创伤性踝关节炎等疾患的功能有良好疗效.%[Objective]To study the therapetic results of the ankle arthroplasty with autografing in treatment of ankle traumatic osteoarthritis for ankle disabled persons. [ Method ] Sinee October, 1998 to December,2008, total ankle replacement with autografing was emplayed to treat 56 cases of traumatic osteoarthritis ( among two local necrosis of the talus, and one occurred after ankle and subtalar joint arthrodesis for tibial fracture and osteofascial compartment syndrome). There were 35 men and 22 women. Their ages ranged from 28 to 68 years,averaging 54. 7 years. [ Result] In this grop,57 patiens were followed up for a mean time of 6 years and 9 months(2 years and 10 months to 10 years and 3 months). The ankle function was evaluated by Ko-foeds system and gait

  11. Weak Total Resolvability In Graphs

    Directory of Open Access Journals (Sweden)

    Casel Katrin

    2016-02-01

    Full Text Available A vertex v ∈ V (G is said to distinguish two vertices x, y ∈ V (G of a graph G if the distance from v to x is di erent from the distance from v to y. A set W ⊆ V (G is a total resolving set for a graph G if for every pair of vertices x, y ∈ V (G, there exists some vertex w ∈ W − {x, y} which distinguishes x and y, while W is a weak total resolving set if for every x ∈ V (G−W and y ∈ W, there exists some w ∈ W −{y} which distinguishes x and y. A weak total resolving set of minimum cardinality is called a weak total metric basis of G and its cardinality the weak total metric dimension of G. Our main contributions are the following ones: (a Graphs with small and large weak total metric bases are characterised. (b We explore the (tight relation to independent 2-domination. (c We introduce a new graph parameter, called weak total adjacency dimension and present results that are analogous to those presented for weak total dimension. (d For trees, we derive a characterisation of the weak total (adjacency metric dimension. Also, exact figures for our parameters are presented for (generalised fans and wheels. (e We show that for Cartesian product graphs, the weak total (adjacency metric dimension is usually pretty small. (f The weak total (adjacency dimension is studied for lexicographic products of graphs.

  12. Qualidade total do produto Products total quality

    Directory of Open Access Journals (Sweden)

    Henrique Silveira de Almeida

    1992-06-01

    Full Text Available O texto aborda o conceito de qualidade total do produto, seus determinantes, bem como as dimensões que compõem essa qualidade. Parte-se do pressuposto de que a qualidade do produto deve ser avaliada pela satisfação total do consumidor. Para o consumidor a qualidade do produto envolve pelo menos as seguintes dimensões: a qualidade do produto em si; a qualidade do produto ao longo do tempo; a qualidade dos serviços associados ao uso do produto; e o custo do ciclo de vida do produto. O trabalho procura detalhar e discutir cada uma dessas dimensões da qualidade, tendo em vista a satisfação do consumidor.The paper concerns to the concept of product's total quality, its determinants, and the dimensions wich constitute this quality. We admit that product quality should be evaluated via consumer's total satisfaction. Product quality for consumers includes at least the following dimensions: the product quality per se; the performance of product quality over time; the quality of services related to the use of the product; and the product lifecycle costs. This study seeks to specify and to discuss each of these quality dimensions related to consumer's satisfaction.

  13. Total abdominal colectomy

    Science.gov (United States)

    ... the rectum. This can cause an infection or abscess. Scarring of the connection between the small intestine ... More Crohn disease Ileostomy Total proctocolectomy and ileal - anal pouch Total proctocolectomy with ileostomy Ulcerative colitis Patient ...

  14. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  15. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  16. A New Approach to Determine the Total Airborne N Input into the Soil/Plant System Using 15N Isotope Dilution (ITNI: Results for Agricultural Areas in Central Germany

    Directory of Open Access Journals (Sweden)

    Rolf W.B. Russow

    2001-01-01

    Full Text Available The atmospheric deposition of nitrogen (N in the environment is of great concern due to its impact on natural ecosystems including affecting vegetation, reducing biodiversity, increasing tree growth in forests, and the eutrophication of aquatic systems. Taking into account the average annual N emission into the atmosphere in Germany of about 2 million t N (ammonia/ammonium, NOx, and assuming homogeneous distribution throughout Germany, an average N deposition of 45 kg/ha x year can be calculated. Such high atmospheric N deposition could be confirmed by N balances from long-term field experiments in Central Germany (e.g., the Static Fertilization Experiment in Bad Lauchstädt. By contrast, estimates by standard methods indicate a deposition of only about 30 kg N/ha x year. This is because the standard methods are using wet-only or bulk collectors, which fail to take into account gaseous deposition and the direct uptake of atmospheric N by aerial plant parts. Therefore, a new system was developed using 15N isotope dilution methodology to measure the actual total atmospheric N input into a soil/plant system (Integrated Total Nitrogen Input, ITNI. A soil/plant system is labeled with [15N]ammonium-[15N]nitrate and the total input of airborne N is calculated from the dilution of this tracer by N from the atmosphere. An average annual deposition of 64 ± 11 kg/ha x year from 1994–2000 was measured with the ITNI system at the Bad Lauchst?dt research farm in the dry belt of Central Germany. Measurements in 1999/2000 at three other sites in Central Germany produced deposition rates of about 60 kg/ha x year. These data clearly show that the total atmospheric N deposition into the soil/plant system determined by the newly developed ITNI system significantly exceeds that obtained from standard wet-only and bulk collectors. The higher atmospheric N depositions found closely match those postulated from the N balances of long-term agricultural field

  17. Updated of the events tree of total loss of power at the site, SBO, taking into account the results of stress tests and methodological updates, convolution, and hydraulic power recovery from model RCPs; Actualizacion del arbol de sucesos de perdida total de suministro electro en el emplazamiento, SBO, teniendo en cuenta los resultados de los estres tests y actualizaciones metodologicas, convolucion, recuperacion desde centrales hidraulicas y modelo de sellos de las RCPs

    Energy Technology Data Exchange (ETDEWEB)

    Lopez Lorenzo, M. A.; Perez Martin, F.

    2013-07-01

    In this paper, is described a tree of events to an accident loss total power at the site (SBO) considering, first the results of stress tests arising from the Fukushima accident and moreover, various methodological updates related to this initiating event.

  18. Reemplazo total de cadera

    OpenAIRE

    Sánchez Vergel, Alfredo; Fundación Valle de Lili

    2002-01-01

    Definición/Tipos de prótesis/ ¿Qué pacientes se podrían beneficiar de un reemplazo total de cadera?/Artrosis de cadera/Tipos de artrosis de cadera/Alternativas al reemplazo total de cadera/Preguntas frecuentes sobre el reemplazo total de cadera.

  19. Reemplazo total de cadera

    OpenAIRE

    Sánchez Vergel, Alfredo; Fundación Valle de Lili

    2002-01-01

    Definición/Tipos de prótesis/ ¿Qué pacientes se podrían beneficiar de un reemplazo total de cadera?/Artrosis de cadera/Tipos de artrosis de cadera/Alternativas al reemplazo total de cadera/Preguntas frecuentes sobre el reemplazo total de cadera.

  20. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  1. Total organic carbon analyzer

    Science.gov (United States)

    Godec, Richard G.; Kosenka, Paul P.; Smith, Brian D.; Hutte, Richard S.; Webb, Johanna V.; Sauer, Richard L.

    The development and testing of a breadboard version of a highly sensitive total-organic-carbon (TOC) analyzer are reported. Attention is given to the system components including the CO2 sensor, oxidation reactor, acidification module, and the sample-inlet system. Research is reported for an experimental reagentless oxidation reactor, and good results are reported for linearity, sensitivity, and selectivity in the CO2 sensor. The TOC analyzer is developed with gravity-independent components and is designed for minimal additions of chemical reagents. The reagentless oxidation reactor is based on electrolysis and UV photolysis and is shown to be potentially useful. The stability of the breadboard instrument is shown to be good on a day-to-day basis, and the analyzer is capable of 5 sample analyses per day for a period of about 80 days. The instrument can provide accurate TOC and TIC measurements over a concentration range of 20 ppb to 50 ppm C.

  2. Rango de movilidad y resultados funcionales en tres diseños diferentes de artroplastia de rodilla primaria. Estudio Comparativo. [Range of motion and functional results in three different designs of total knee arthroplasty].

    Directory of Open Access Journals (Sweden)

    Juan Pablo Bonifacio

    2016-11-01

    Full Text Available Introducción: El objetivo de este trabajo  fue analizar los resultados funcionales y el rango de movi­miento entre tres grupos de pacientes con ar­troplastia total de rodilla: dos utilizando prótesis de alta flexión y el otro con un diseño convencional. Materiales y Métodos: 64 pacientes fueron operados con prótesis total de rodilla  Zimmer NexGen®, y 34 pacientes operados con Optetrack ®  de alta flexión. Luego de la exclusión de pacientes;  22 pacientes  (grupo A fueron tratados con diseño de alta flexión de Zimmer, 21 pacientes (grupo B tratados con prótesis Zimmer convencional, y 25 pacientes (Grupo C con artroplastia  Optetrack® PS. La evaluación funcional se realizó con el Knee Society Score, el Western Ontario and McMaster Universities osteoathritis index y la escala analógica visual. Resultados:  En el posoperatorio, el promedio de flexión máxima del grupo A subió de 99° a 113º, con un aumento promedio de 14º, en el grupo B de 106° a 118º con una ganancia promedio de 12º y en el grupo C de 110° a 111° siendo la ganancia de 1°. Los resultados funcionales evaluados con KSS y el WOMAC presentaron mejorías en los tres grupos. Conclusión: Las evaluaciones clínicas funcionales son favorables en los tres diseños  evaluados. Este estudio muestra que no hay diferencias significativas en la flexión final lograda, y resultados funcionales entre los dos primeros diseños entre sí, si siendo estos significativamente superiores al diseño del tercer grupo luego de un año de seguimiento.  Palabras Claves: Prótesis total de rodilla, prótesis de alta flexión, prótesis convencionales, rango de movilidad

  3. Metal ion levels and functional results following resurfacing hip arthroplasty versus conventional small-diameter metal-on-metal total hip arthroplasty; a 3 to 5year follow-up of a randomized controlled trial.

    Science.gov (United States)

    Bisseling, Pepijn; Smolders, José M H; Hol, Annemiek; van Susante, Job L C

    2015-01-01

    We present an update of a randomized controlled trial on 71 patients (resurfacing hip arthroplasty (RHA) (n=38) or cementless 28-mm metal-on-metal (MoM) total hip arthroplasty (THA) (n=33). Metal ion levels and functional outcome scores were analyzed with a mean follow-up of 58 months (SD 8.1). No clear shifts in relatively good outcome was encountered between RHA and THA. Metal ion levels appear to equalize between groups after 3 years. Median cobalt and chromium remained below 1.3 μg/L throughout follow-up in both groups. Six revisions were performed, of which three for pseudotumor formation (one THA, two RHA). In conclusion there were no clinical differences between the two groups and metal ion levels were lower than other series remained low, however, pseudotumor formation was not eliminated.

  4. Angiographic and clinical comparisons of intravascular ultrasound- versus angiography-guided drug-eluting stent implantation for patients with chronic total occlusion lesions: two-year results from a randomised AIR-CTO study.

    Science.gov (United States)

    Tian, Nai-Liang; Gami, Sandeep-Kumar; Ye, Fei; Zhang, Jun-Jie; Liu, Zhi-Zhong; Lin, Song; Ge, Zhen; Shan, Shou-Jie; You, Wei; Chen, Liang; Zhang, Yao-Jun; Mintz, Gary; Chen, Shao-Liang

    2015-04-01

    This study sought to compare angiographic endpoints at one-year follow-up after a drug-eluting stent implantation guided by either intravascular ultrasound (IVUS) or angiography in patients with chronic total occlusion (CTO) lesions. Patients with at least one CTO lesion recanalised successfully were randomly assigned to the IVUS-guided or the angiography-guided group. The use of IVUS for penetration of the true lumen and optimisation of stent expansion was only done in the IVUS-guided group. The primary endpoint was in-stent late lumen loss (LLL) at one-year follow-up. A total of 230 patients with CTO lesions after successful recanalisation were enrolled and followed with office visits or telephone contact up to 24 months. In-stent LLL in the IVUS-guided group was significantly lower compared to the angiography-guided group at one-year follow-up (0.28±0.48 mm vs. 0.46±0.68 mm, p=0.025), with a significant difference in restenosis of the "in-true-lumen" stent between the two groups (3.9% vs.13.7%, p=0.021). The minimal lumen diameter and minimal stent cross-section area significantly and negatively correlated with LLL (all pCTO lesion was associated with less LLL and a lower incidence of "in-true-lumen" stent restenosis. Additional study is required to identify the clinical benefit of the IVUS-guided procedure for CTO lesions. [ChiCTR-TRC-10000996].

  5. 全膝人工关节股骨假体屈曲对疗效的影响:1年随访结果%Effect of femoral component flexion in total knee arthroplasty One-year follow-up results One-year follow-up results

    Institute of Scientific and Technical Information of China (English)

    张洪美; 张志强; 孙钢; 赵铁军; 顾力军; 陈卫衡; 尹天; 刘道兵; 张淳; 谢斌

    2008-01-01

    BACKGROUND:The majority of people do not believe that the femoral component flexion in total knee arthroplasty affect or affect little postoperative function and it is the only that the radiographic films is not satisfactory.So it has not caused people's enollgh attention.But the femoral component flexion affects the results of total knee arthroplasty obviously.OnJECTIVE:To investigate the curative effects of femoral component installed in the position of flexion during the operative procedure of total knee arthroplasty(123 knees)on the follow up results in 78 patients.DESIGN:Grouping contrast observation.SETTlNG:First Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Cllinese Medicine.PARTlCIPANTS:123 knees(78 patients)were given total knee arthroplasty in the First Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Chinese Medicine from October 2001 to June 2004.Seventeen(13.8%,15 patients)knees were found with femoral component flexion(FCF),in which there were 5 male cases and 10 female cases,aged from 47 to 81 years old.106(63 patients)knees were found without FCF,in which there were 22 male cases and 41 female cases,aged from 47 to 79 years old.METHODS:Total knee arthroplasties about their HSS rating scores,ranges of motion and flexion contractures werecompared in the two groups before operation and after operation,and the degrees of the FCF angle and the distances of femoral component flexion were measured.MAIN OUTCOME MEASURES:①Femoral Drostllesis flexion measurement;②HSS scores and activity:③femoral prosthesis flexion angle and distance buckling;④adverse events and side effects.RESULTS:Follow up lasted for one year above.①The degrees of flexion of femoral components were from 7°to 19°(average 11.3°)and the distance of flexion was from 2 mm to 4 mm(average 2.6 mln)in those 17 knees of total knee arthroplasty.②Differences in HSS rating scores and range of motion were not statistically

  6. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Posterior hip approach yields better functional results vis-à-vis anterolateral approach in total hip arthroplasty for patients with severe hip dysplasia: A prospective randomized controlled clinical study.

    Science.gov (United States)

    Çatma, Faruk Mehmet; Öztürk, Alper; Ünlü, Serhan; Ersan, Önder; Altay, Murat

    2017-01-01

    We aimed to compare functional outcomes of two common hip approaches for patients with severe hip dysplasia in total hip replacement (THR) surgery. Seventy hips of 68 patients randomized into two groups with regard to hip approach as posterior (group I) and anterolateral (group II). All patients underwent THR surgery with femoral shortening osteotomy. The groups were compared for operation time, preoperative and 6 months after abductor muscle strengths (AMSs), gait disorders, union time of the osteotomied site and dislocation rates. There were two early dislocations in group I, and two early and one late dislocations in group II. No significant difference was observed regarding hip dislocations. Mean union time of the osteotomied site was 113.9 ± 51 days in group I while 111.1 ± 29.3 days in group II ( p = 0.774). Six months after surgery, group I had higher AMS than group II ( p dysplasia of hip is a challenging procedure, and posterior approach provides better functional outcomes regarding gait and AMSs.

  8. Revision Total Elbow Arthroplasty.

    Science.gov (United States)

    Ramirez, Miguel A; Cheung, Emilie V; Murthi, Anand M

    2017-08-01

    Despite recent technologic advances, total elbow arthroplasty has complication rates higher than that of total joint arthroplasty in other joints. With new antirheumatic treatments, the population receiving total elbow arthroplasty has shifted from patients with rheumatoid arthritis to those with posttraumatic arthritis, further compounding the high complication rate. The most common reasons for revision include infection, aseptic loosening, fracture, and component failure. Common mechanisms of total elbow arthroplasty failure include infection, aseptic loosening, fracture, component failure, and instability. Tension band fixation, allograft struts with cerclage wire, and/or plate and screw constructs can be used for fracture stabilization.

  9. Totalization Data Exchange (TDEX)

    Data.gov (United States)

    Social Security Administration — The Totalization Data Exchange (TDEX) process is an exchange between SSA and its foreign country partners to identify deaths of beneficiaries residing abroad. The...

  10. Effect of sepsis on calcium uptake and content in skeletal muscle and regulation in vitro by calcium of total and myofibrillar protein breakdown in control and septic muscle: Results from a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Benson, D.W.; Hasselgren, P.O.; Hiyama, D.T.; James, J.H.; Li, S.; Rigel, D.F.; Fischer, J.E.

    1989-07-01

    Because high calcium concentration in vitro stimulates muscle proteolysis, calcium has been implicated in the pathogenesis of increased muscle breakdown in different catabolic conditions. Protein breakdown in skeletal muscle is increased during sepsis, but the effect of sepsis on muscle calcium uptake and content is not known. In this study the influence of sepsis, induced in rats by cecal ligation and puncture, on muscle calcium uptake and content was studied. Sixteen hours after cecal ligation and puncture or sham operation, calcium content of the extensor digitorum longus (EDL) and soleus (SOL) muscles was determined with an atomic absorption spectrometer. Calcium uptake was measured in intact SOL muscles incubated in the presence of calcium 45 (45Ca) for between 1 and 120 minutes. Total and myofibrillar protein breakdown was determined in SOL muscles, incubated in the presence of different calcium concentrations (0; 2.5; 5.0 mmol/L), and measured as release into the incubation medium of tyrosine and 3-methylhistidine (3-MH), respectively. Calcium content was increased by 51% (p less than 0.001) during sepsis in SOL and by 10% (p less than 0.05) in EDL muscle. There was no difference in 45Ca uptake between control and septic muscles during the early phase (1 to 5 minutes) of incubation. During more extended incubation (30 to 120 minutes), muscles from septic rats took up significantly more 45Ca than control muscles (p less than 0.05). Tyrosine release by incubated SOL muscles from control and septic rats was increased when calcium was added to the incubation medium, and at a calcium concentration of 2.5 mmol/L, the increase in tyrosine release was greater in septic than in control muscle. Addition of calcium to the incubation medium did not affect 3-MH release in control or septic muscle.

  11. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study.

    Science.gov (United States)

    Bisseling, P; de Wit, B W K; Hol, A M; van Gorp, M J; van Kampen, A; van Susante, J L C

    2015-09-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patients with a 32 mm ceramic-on-polyethylene (CoP) THA (n = 33, 18 males; median age 63 years, 38 to 71) were cross-sectionally screened with metal artefact reducing sequence-MRI (MARS-MRI) for pseudotumour formation at a median of 55 months (23 to 72) post-operatively. MRIs were scored by consensus according to three different classification systems for pseudotumour formation. Clinical scores were available for all patients and metal ion levels for MoM bearing patients. Periprosthetic lesions with a median volume of 16 mL (1.5 to 35.9) were diagnosed in six patients in the RHA group (17%), one in the MoM THA group (4%) and six in the CoP group (18%). The classification systems revealed no clear differences between the groups. Solid lesions (n = 3) were exclusively encountered in the RHA group. Two patients in the RHA group and one in the MoM THA group underwent a revision for pseudotumour formation. There was no statistically significant relationship between clinical scoring, metal ion levels and periprosthetic lesions in any of the groups. Periprosthetic fluid collections are seen on MARS-MRI after conventional CoP THA and RHA and may reflect a soft-tissue collection or effusion. Currently available MRI classification systems seem to score these collections as pseudotumours, causing an-overestimatation of the incidence of pseudotumours.

  12. Breakup of New Orleans Households after Hurricane Katrina

    Science.gov (United States)

    Rendall, Michael S.

    2011-01-01

    Theory and evidence on disaster-induced population displacement have focused on individual and population-subgroup characteristics. Less is known about impacts on households. I estimate excess incidence of household breakup resulting from Hurricane Katrina by comparing a probability sample of pre-Katrina New Orleans resident adult household heads…

  13. Strictness and Totality Analysis

    DEFF Research Database (Denmark)

    Solberg, K. L.; Nielson, Hanne Riis; Nielson, Flemming

    1998-01-01

    We define a novel inference system for strictness and totality analysis for the simply-typed lazy lambda-calculus with constants and fixpoints. Strictness information identifies those terms that definitely denote bottom (i.e. do not evaluate to WHNF) whereas totality information identifies those ...

  14. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat...

  15. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  16. Primary total elbow arthroplasty

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2013-01-01

    Full Text Available Background: Primary total elbow arthroplasty (TEA is a challenging procedure for orthopedic surgeons. It is not performed as frequently as compared to hip or knee arthroplasty. The elbow is a nonweight-bearing joint; however, static loading can create forces up to three times the body weight and dynamic loading up to six times. For elderly patients with deformity and ankylosis of the elbow due to posttraumatic arthritis or rheumatoid arthritis or comminuted fracture distal humerus, arthroplasty is one of the option. The aim of this study is to analyze the role of primary total elbow arthroplasty in cases of crippling deformity of elbow. Materials and Methods: We analyzed 11 cases of TEA, between December 2002 and September 2012. There were 8 females and 3 males. The average age was 40 years (range 30-69 years. The indications for TEA were rheumatoid arthritis, comminuted fracture distal humerus with intraarticular extension, and posttraumatic bony ankylosis of elbow joint. The Baksi sloppy (semi constrained hinge elbow prosthesis was used. Clinico-radiological followup was done at 1 month, 3 months, 6 months, 1 year, and then yearly basis. Results: In the present study, average supination was 70° (range 60-80° and average pronation was 70° (range 60-80°. Average flexion was 135° (range 130-135°. However, in 5 cases, there was loss of 15 to 35° (average 25° of extension (45° out of 11 cases. The mean Mayo elbow performance score was 95.4 points (range 70-100. Arm length discrepancy was only in four patients which was 36% out of 11 cases. Clinico-radiologically all the elbows were stable except in one case and no immediate postoperative complication was noted. Radiolucency or loosening of ulnar stem was seen in 2 cases (18% out of 11 cases, in 1 case it was noted after 5 years and in another after 10 years. In second case, revision arthroplasty was done, in which only ulnar hinge section, hinge screw and lock screw with hexagonal head

  17. Total eclipses of the sun.

    Science.gov (United States)

    Zirker, J B

    1980-12-19

    Total eclipses of the sun offer research opportunities in a variety of sciences. Some of the advances in solar physics resulting from eclipse observations are discussed. Experiments at the total eclipse of 16 February 1980 in India are also described. These included a test of general relativity, studies in coronal physics, investigations of solar prominences, diameter measurements, a search for interplanetary dust, a study of the gravity waves in the earth's atmosphere, and experiments on the biological effects on animals and humans.

  18. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  19. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  20. Total Water Management - slides

    Science.gov (United States)

    Total Water Management (TWM) examines urban water systems in an interconnected manner. It encompasses reducing water demands, increasing water recycling and reuse, creating water supply assets from stormwater management, matching water quality to end-use needs, and achieving envi...

  1. Revised Total Coliform Rule

    Science.gov (United States)

    The Revised Total Coliform Rule (RTCR) aims to increase public health protection through the reduction of potential pathways for fecal contamination in the distribution system of a public water system (PWS).

  2. Total Ecosystem Carbon Stock

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Total ecosystem carbon includes above- and below-ground live plant components (such as leaf, branch, stem and root), dead biomass (such as standing dead wood, down...

  3. Long-term results of total repair of tetralogy of Fallot in adulthood: 35 years follow-up in 104 patients corrected at the age of 18 or older.

    Science.gov (United States)

    Nollert, G; Fischlein, T; Bouterwek, S; Böhmer, C; Dewald, O; Kreuzer, E; Welz, A; Netz, H; Klinner, W; Reichart, B

    1997-08-01

    Long-term survival after surgical repair of tetralogy of Fallot (TOF) is reported to be excellent if the patients are corrected in childhood. However, age at operation has been demonstrated as an important risk-factor. The aim of our study was to investigate whether adult patients also benefit from surgery. From December 1958 to May 1977, 739 patients underwent a correction of their TOF with pulmonary stenosis at our institution. Foreigners (n = 52) and those who moved to a foreign country (n = 13) were excluded from further analysis. Sixteen patients were lost during follow-up (98% complete). Of the remaining patient population (n = 658; mean age: 12.2 +/- 8.6 years; range 2-67 years), 104 patients were 18 years or older at the time of correction. Operative (n = 25) and one-year (n = 8) deaths were excluded for long-term calculations, resulting in a study group of 71 patients. Actuarial 10, 20, 30, and 35-year survival rates were 94%, 93%, 83%, and 72% respectively, and not different from normal life expectancy. The most common cause of death was congestive heart failure (n = 3), followed by myocardial infarction (n = 2) and sudden death (n = 2). Parameters influencing longterm survival could not be detected. At follow-up (mean 27.7 years), more than 80% (n = 48) of the 58 survivors reported themselves to be in NYHA functional class I or II and 95% (n = 55) were in a better condition than before the operation. Repair of tetralogy of Fallot in adulthood shows excellent results with normal life expectancy for the patients.

  4. Total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-05-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen.

  5. Total Energy Monitor

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, S

    2008-08-11

    The total energy monitor (TE) is a thermal sensor that determines the total energy of each FEL pulse based on the temperature rise induced in a silicon wafer upon absorption of the FEL. The TE provides a destructive measurement of the FEL pulse energy in real-time on a pulse-by-pulse basis. As a thermal detector, the TE is expected to suffer least from ultra-fast non-linear effects and to be easy to calibrate. It will therefore primarily be used to cross-calibrate other detectors such as the Gas Detector or the Direct Imager during LCLS commissioning. This document describes the design of the TE and summarizes the considerations and calculations that have led to it. This document summarizes the physics behind the operation of the Total Energy Monitor at LCLS and derives associated engineering specifications.

  6. Algebraic totality, towards completeness

    CERN Document Server

    Tasson, Christine

    2009-01-01

    Finiteness spaces constitute a categorical model of Linear Logic (LL) whose objects can be seen as linearly topologised spaces, (a class of topological vector spaces introduced by Lefschetz in 1942) and morphisms as continuous linear maps. First, we recall definitions of finiteness spaces and describe their basic properties deduced from the general theory of linearly topologised spaces. Then we give an interpretation of LL based on linear algebra. Second, thanks to separation properties, we can introduce an algebraic notion of totality candidate in the framework of linearly topologised spaces: a totality candidate is a closed affine subspace which does not contain 0. We show that finiteness spaces with totality candidates constitute a model of classical LL. Finally, we give a barycentric simply typed lambda-calculus, with booleans ${\\mathcal{B}}$ and a conditional operator, which can be interpreted in this model. We prove completeness at type ${\\mathcal{B}}^n\\to{\\mathcal{B}}$ for every n by an algebraic metho...

  7. [Total temporomandibular joint prostheses].

    Science.gov (United States)

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Clinical aspects of accidents resulting in acute total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Cronkite, E.P.

    1988-01-01

    That the management of whole body radiation injury involves: (1) watchful waiting, (2) observation of the hematologic parameters, (3) use of antibiotics, platelet red cell and possibly granulocyte transfusions, (4) administration of hemopoietic molecular regulators of granulopoiesis, and (5) bone marrow transplantation as the last line of defense. The clinical indication for the preceding will not be discussed, since this will be a subject of later speakers in this conference. Certainly, if a radiation casualty is fortunate enough to have an identical twin, a marrow transplant may be lifesaving and certainly can do no harm to the patient, and there is little risk to the donor.

  9. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  10. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe;

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...

  11. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  12. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  13. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  14. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  15. Total Cost of Ownership

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2007-01-01

    Total Cost of Ownership (TCO), som giver et bud på, hvordan virksomheder kan opnå en bedre indsigt i, hvilke leverandører der forårsager hvilke omkostninger og dermed danne et forbedret beslutningsgrundlag for besparelser i leverandørleddet. I artiklen argumenteres først og fremmest for, hvorfor TCO er...

  16. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    is examined. It is concluded that the risk of developing carcinoma of the cervical stump is low, and no longer a weighty indication for the total in preference to the supravaginal hysterectomy as long as subsequent screening of the cervix is performed. At the same time it is important to inform the women...

  17. Total synthesis of aquatolide

    NARCIS (Netherlands)

    Saya, J.M.; Vos, K.; Klein Nijenhuis, R.A.; van Maarseveen, J.H.; Ingemann, S.; Hiemstra, H.

    2015-01-01

    A total synthesis of the sesquiterpene lactone aquatolide has been accomplished. The central step is an intramolecular [2 + 2]-photocycloaddition of an allene onto an alpha,beta-unsaturated delta-lactone. Other key steps are an intramolecular Horner-Wadsworth-Emmons reaction to close the lactone and

  18. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise. Trea...

  19. Total Synthesis of Naloxone

    Institute of Scientific and Technical Information of China (English)

    HU Wen-Xiang; WANG Jian-Ying; XU Ming

    2003-01-01

    @@ Naloxone (1) is one of the 14-hydroxyl substituted opium antagonists which are valuable medications for treat ment of opiate abuse, opiate overdose, and alcohol addiction. Here, the total synthesis of naloxone was described. We selected 2,6-dihydroxynaphalene (2) as the starting material.

  20. Total Quality Management.

    Science.gov (United States)

    Focus in Change, 1992

    1992-01-01

    The philosophy known as Total Quality Management (TQM) is frequently presented as a way to change and improve public education. This issue of "Focus in Change" examines Deming's original 14 TQM points and their application to education. Myron Tribus lays out the core philosophy of the movement and discusses its possible application to…

  1. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  2. Fusion following failed total ankle replacement.

    Science.gov (United States)

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  3. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation...... by Tim Brown can be compared to considerations by László Moholy-Nagy and Walter Gropuis on the training and education of active and capable citizens. This opens, though, some dilemmas to discuss: To what extend is the capability of creativity then a (pre)condition to be a citizen of the society wished...... for? To which degree should everyone be educated in ’design literacy’ to participate? Total design of participation is an artistic intervention in society and must be discussed in this utopian tradition....

  4. Total Synthesis of (-)-Conolutinine.

    Science.gov (United States)

    Feng, Xiangyang; Jiang, Guangde; Xia, Zilei; Hu, Jiadong; Wan, Xiaolong; Gao, Jin-Ming; Lai, Yisheng; Xie, Weiqing

    2015-09-18

    The first enantioselective synthesis of (-)-conolutinine was achieved in 10 steps. The synthesis featured a catalytic asymmetric bromocyclization of tryptamine to forge the tricycle intermediate. Hydration of an alkene catalyzed by Co(acac)2 was also employed as a key step to diastereoselectively introduce the tertiary alcohol moiety. The absolute configuration of (-)-conolutinine was established to be (2S,5aS,8aS,13aR) based on this asymmetric total synthesis.

  5. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  6. TOTAL PERFORMANCE SCORECARD

    OpenAIRE

    Anca ȘERBAN; Oana DUMITRAȘCU

    2013-01-01

    The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated t...

  7. Total synthesis of teixobactin

    Science.gov (United States)

    Jin, Kang; Sam, Iek Hou; Po, Kathy Hiu Laam; Lin, Du'an; Ghazvini Zadeh, Ebrahim H.; Chen, Sheng; Yuan, Yu; Li, Xuechen

    2016-08-01

    To cope with the global bacterial multidrug resistance, scientific communities have devoted significant efforts to develop novel antibiotics, particularly those with new modes of actions. Teixobactin, recently isolated from uncultured bacteria, is considered as a promising first-in-class drug candidate for clinical development. Herein, we report its total synthesis by a highly convergent Ser ligation approach and this strategy allows us to prepare several analogues of the natural product.

  8. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  9. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  10. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  11. Total Phenolics and Total Flavonoids in Selected Indian Medicinal Plants

    OpenAIRE

    C T Sulaiman; Indira Balachandran

    2012-01-01

    Plant phenolics and flavonoids have a powerful biological activity, which outlines the necessity of their determination. The phenolics and flavonoids content of 20 medicinal plants were determined in the present investigation. The phenolic content was determined by using Folin-Ciocalteu assay. The total flavonoids were measured spectrophotometrically by using the aluminium chloride colorimetric assay. The results showed that the family Mimosaceae is the richest source of phenolics, (Acacia ni...

  12. Total Quality Management

    DEFF Research Database (Denmark)

    Gaarslev, Axel

    1996-01-01

    Contains major results from a Nordic collaborative research program on implementing TQM in the Nordic construction industry.......Contains major results from a Nordic collaborative research program on implementing TQM in the Nordic construction industry....

  13. Total Quality Management

    DEFF Research Database (Denmark)

    Gaarslev, Axel

    1996-01-01

    Contains major results from a Nordic collaborative research program on implementing TQM in the Nordic construction industry.......Contains major results from a Nordic collaborative research program on implementing TQM in the Nordic construction industry....

  14. Identity and total institution

    Directory of Open Access Journals (Sweden)

    Ljubičić Milana

    2015-01-01

    Full Text Available This paper analyses a psychiatric institution resident’s identity (self- construction processes. Our quest was grounded on constructivist theoretical paradigm that sees identity as a manner a person defines oneself in accordance with offered social repertoire. In other words, the total institution milieu offers limited range of identities to its residents. On the other hand, the latter are not just passive subjects that identity is imposed upon. They are able to use a number of adjustment mechanisms to the knowledge about themselves - ranging from symbolic escape to open resistance against the imposed image about them; to obedience, and we were interested to understand the (supposed complex dynamic of identity (re-building in, so-called, special or forensic patients. In order to understand this process and attempting to discover, besides the manifest also the latent layer of the story about self, the local, or personal, identity understanding was examined.

  15. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  16. Multiclass Total Variation Clustering

    Science.gov (United States)

    2014-12-01

    before thresholding) plotted over the fours and nines. Right: Solution f 4 from LSD [1] plotted over the fours and nines. 3.2 Transductive Framework From...of [11] and [3] with default parameters. We used the code available from [19] to test each NMF algorithm. All non-recursive algorithms ( LSD [1], NMFR...significantly improved upon previously reported results of LSD in particular. We allowed each non-recursive algorithm 10000 iterations using initial

  17. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  18. Total light absorption in graphene

    CERN Document Server

    Thongrattanasiri, Sukosin; de Abajo, F Javier Garcia

    2011-01-01

    We demonstrate that 100% light absorption can take place in a single patterned sheet of doped graphene. General analysis shows that a planar array of small lossy particles exhibits full absorption under critical-coupling conditions provided the cross section of each individual particle is comparable to the area of the lattice unit-cell. Specifically, arrays of doped graphene nanodisks display full absorption when supported on a substrate under total internal reflection, and also when lying on a dielectric layer coating a metal. Our results are relevant for infrared light detectors and sources, which can be made tunable via electrostatic doping of graphene.

  19. TQM - Total Quality Management (Bibliography)

    Science.gov (United States)

    1990-05-01

    TOTAL QUALITY MANAGEMENT (BIBLIOORAPHY) PREPARED BY... Total Quality Management (TQM), it is an appropriate time to provide an overview of the literature available on the topic. The Total Quality Management bibliography...Secretary 32 CFR Part 281 Total Quality Management Agency: Office of the Secretary, DOD Action: Proposed rule Summary: This proposed rule establishes

  20. Economie en totale oorlog

    Directory of Open Access Journals (Sweden)

    H.A.M. Klemann

    2004-01-01

    Full Text Available J. Meihuizen, Noodzakelijk kwaad. De bestraffing van economische collaboratie in Nederland na de Tweede WereldoorlogThe economy and full-scale warMeihuizen concludes that the interests of the reconstruction had to take precedence over those of an honourable judicial process, as a result of which cases of economic collaboration seldom reached the courts. This essay argues that Dutch firms could not avoid manufacturing goods for the occupying forces because they were often relatively small-scale in nature and organised along the lines of a family business. If this type of firm refused to fulfil a German order and its competitor was willing to accept it, then it ran the risk of being squeezed out by the competition. This is why, in the Netherlands and elsewhere, as soon as a firm made the transition from a smallscale to a medium-sized family business it was inclined to work all-out for the occupying forces. This had nothing to do with free choice, but rather the will to survive. In addition to this, non-military production, even that which was geared towards keeping the people at home alive and healthy, supported the German war effort. In an economy where all military production is systematically maximized and manufacturing geared towards producing civilian goods is pushed back to a level where it can just about survive, all manufacturing becomes economic collaboration, thereby making the notion redundant. Consequently, the question that should have resounded throughout this study ought to have been whether a legal case could have been made against economic collaboration at all or whether this was doomed to fail from the start.

  1. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  2. Testing EDM of Total Stations

    Directory of Open Access Journals (Sweden)

    Cirbus Ján

    2001-03-01

    Full Text Available The paper is devoted to testing electrooptical distance measuring devices (EDM built in total stations, than can be used for various tasks in the contemporary geodetic works. A rich market offer and availability of these universal measuring systems with satisfying distance range, excellent accuracy and other parameters, make total stations as dominant terrestrial geodetic instruments.For succesfully applying these instruments, above all for relliable distance measurements, the stability of the modulation frequency is the most important pre-condition. In the article, therefore, there are given some methods to verify the modulation frequency stability. In addition, some ways for determining the EDM distance constant and periodical corrections of the phase measuring unit are introduced for 4 types of EDM : LEICA 1700L, TOPCON GTS6A, TOPCON GTS2, C.ZEISS ELTA50. It were also investigated their possibilities for precise distance survey. Values of the determined constants and periodical corrections are presented in Tab. 2.Based on the investigation results of the 4 EDM types and using the values m obtained for different distances S, equations of the a posteriori standard deviations in form : m = (a+b.S were derived too.

  3. EVALUATION OF TOTAL ORGANIC EMISSIONS ANALYSIS METHODS

    Science.gov (United States)

    The rationale and supporting experimental data for revising EPA's 1996 "Guidance for Total Organics" are summarized in this document. It reports the results of reseach and investigation of improvements to the Total Organic Emissions (TOE) guidance used by EPA to measure recovera...

  4. [Proximal and total femur replacement].

    Science.gov (United States)

    Pennekamp, P H; Wirtz, D C; Dürr, H R

    2012-07-01

    Reconstruction of segmental bone defects of the proximal femur following wide tumor resection or revision arthroplasty. Aggressive benign or primary malignant bone tumors of the proximal femur; destructive metastases; massive segmental bone defects of the proximal femur; periprosthetic fractures. Local infection; very short life expectancy (acetabular bone stock. Anterolateral approach. Exposure and detachment of the iliopsoas and gluteus medius muscle from the proximal femur with a sufficient safety margin to the bone; distal transsection of the vastus lateralis/intermedius and rectus femoris muscle according to the extraosseous tumor extension; distal femur osteotomy al least 3 cm beyond the farthest point of tumor extension; in case of total femur replacement, additional lateral arthrotomy of the knee with resection of the ligaments and menisci; reaming of the medullary canal after securing the shaft with a Verbrugge clamp; trial assembly and reduction followed by the definitive implantation of the prosthesis with adjustment of the femoral neck anteversion in 5° increments; soft tissue reconstruction and fixation to an attachment tube covering the prosthesis; in case of total femur replacement, the preparation of the tibia is followed by the coupling of the tibial and femoral components. Infection prophylaxis, 20 kg partial weight bearing, continuous passive motion. A total of 20  patients with proximal femur replacement and 2 patients with total femur replacement implanted between June 2007 and December 2011 were retrospectively reviewed. Three patients had primary malignant bone tumors, while 19 patients underwent resection for metastatic disease. The mean age at surgery was 62.0 ± 18.1 years (18-82 years). Fifteen patients with a mean follow-up of 20.3 ± 17.2 months (4-51 months) were studied. Among the 22 cases, periprosthetic infection occurred in 3 patients (13.6%), dislocation in 2 patients (9.1%). Evaluation of the functional

  5. Total Restrained Bondage in Graphs

    Institute of Scientific and Technical Information of China (English)

    Nader JAFARI RAD; Roslan HASNI; Joanna RACZEK; Lutz VOLKMANN

    2013-01-01

    A subset S of vertices of a graph G with no isolated vertex is a total restrained dominating set if every vertex is adjacent to a vertex in S and every vertex in V(G)-S is also adjacent to a vertex in V(G)-S.The total restrained domination number of G is the minimum cardinality of a total restrained dominating set of G.In this paper we initiate the study of total restrained bondage in graphs.The total restrained bondage number in a graph G with no isolated vertex,is the minimum cardinality of a subset of edges E such that G-E has no isolated vertex and the total restrained domination number of G-E is greater than the total restrained domination number of G.We obtain several properties,exact values and bounds for the total restrained bondage number of a graph.

  6. Generalized gravitational entropy from total derivative action

    Science.gov (United States)

    Dong, Xi; Miao, Rong-Xin

    2015-12-01

    We investigate the generalized gravitational entropy from total derivative terms in the gravitational action. Following the method of Lewkowycz and Maldacena, we find that the generalized gravitational entropy from total derivatives vanishes. We compare our results with the work of Astaneh, Patrushev, and Solodukhin. We find that if total derivatives produced nonzero entropy, the holographic and the field-theoretic universal terms of entanglement entropy would not match. Furthermore, the second law of thermodynamics could be violated if the entropy of total derivatives did not vanish.

  7. Generalized Gravitational Entropy from Total Derivative Action

    CERN Document Server

    Dong, Xi

    2015-01-01

    We investigate the generalized gravitational entropy from total derivative terms in the gravitational action. Following the method of Lewkowycz and Maldacena, we find that the generalized gravitational entropy from total derivatives vanishes. We compare our results with the work of Astaneh, Patrushev, and Solodukhin. We find that if total derivatives produced nonzero entropy, the holographic and the field-theoretic universal terms of entanglement entropy would not match. Furthermore, the second law of thermodynamics could be violated if the entropy of total derivatives did not vanish.

  8. Total synthesis of bryostatin 1.

    Science.gov (United States)

    Keck, Gary E; Poudel, Yam B; Cummins, Thomas J; Rudra, Arnab; Covel, Jonathan A

    2011-02-02

    Bryostatin 1 is a marine natural product that is a very promising lead compound because of the potent biological activity it displays against a variety of human disease states. We describe herein the first total synthesis of this agent. The synthetic route adopted is a highly convergent one in which the preformed, heavily functionalized pyran rings A and C are united by "pyran annulation", the TMSOTf-promoted reaction between a hydroxyallylsilane appended to the A-ring fragment and an aldehyde contained in the C-ring fragment, with concomitant formation of the B ring. Further elaborations of the resulting very highly functionalized intermediate include macrolactonization and selective cleavage of just one of five ester linkages present.

  9. Total quality management implementation guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  10. FY-3气象卫星紫外臭氧总量探测仪辐亮度在轨定标与反演结果分析%Calibration in-orbit and retrieval result study of FY-3 Total Ozone Unit (TOU)

    Institute of Scientific and Technical Information of China (English)

    江芳; 王维和; 王咏梅; 王英鉴

    2012-01-01

    FY-3气象卫星上搭载的紫外臭氧总量探测仪TOU是我国自主开发研制的首台用于全球臭氧总量定量测量的探测仪,自发射以来已成功在轨运行近两年.由于TOU发射前辐亮度定标存在偏差,为了得到高精度的产品,TOU必须进行在轨定标.本文介绍了基于辐射传输模式计算对TOU辐亮度进行在轨道定标的方法,定标过程中用于模拟辐亮度计算的臭氧总量由与TOU观测时刻相近的国外臭氧总量探测仪器MetOp/GOME-2提供.文章将在轨定标后TOU的反演结果与AURA/OMI以及地基的产品进行比较,结果表明,用辐射传输模式对TOU辐亮度进行在轨定标的方法是可行的,反演结果能够真实地反映臭氧的时空分布特性,在全球部分地基观测站所处的位置上对TOU,OMI以及地基的臭氧总量进行比较的结果表明,TOU与OM1的相对偏差均方根约为2.52%,TOU与地基以及OMI与地基观测结果之间的相对偏差均方根分别为4.45%和3.89%.%Ultraviolet Total Ozone Unit (TOU) is one of the main payloads on FY-3 satellite and the first instrument for daily global coverage of total ozone monitoring in China. TOU has been operating in-orbit about two years. Because pre-launch calibration has serious error in high ranges of radiance, an in-orbit calibration method based on radiative transfer model calculation was introduced in the paper, the total ozone column used to calculate the simulation radiance was produced from MetOp/GOME-2. The retrieval results were compared with AURA/OMI global ozone products and ground-based ozone measurement data, the results show that the calibration method is feasible and the spatial and temporal distribution characteristics are consistent with OMI and GOME-2 products. The quantitative comparisons with ground-based measurements and AURA/OMI ozone product were made over 74 stations, the TOU total ozone retrieval has a 2.52% RMS relative error compared with AURA/OMI ozone

  11. Instability following total knee arthroplasty.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  12. Total Quality Management (TQM) Bibliography

    Science.gov (United States)

    1990-04-01

    GTE FIE COPY DTIC c" ECTE 8JUL 25 1990u TOTAL QUALITY MANAGEMENT (TQM) BIBLIOGRAPHY APRIL-1990 Jointly supported by __’__________-_________ Jointly...Arsenal, AL 35898-5241 1I. TITLE (Include Security Classification) TOTAL QUALITY MANAGEMENT (TQM) BIBL IRAPHY APRIL-1990 12. PERSONAL AUTHOR(S) Knott...implementation of the concept of total quality management (TQM). The selected coverage includes books, periodical articles, conference papers and reports. Coded

  13. Totally optimal decision trees for Boolean functions

    KAUST Repository

    Chikalov, Igor

    2016-07-28

    We study decision trees which are totally optimal relative to different sets of complexity parameters for Boolean functions. A totally optimal tree is an optimal tree relative to each parameter from the set simultaneously. We consider the parameters characterizing both time (in the worst- and average-case) and space complexity of decision trees, i.e., depth, total path length (average depth), and number of nodes. We have created tools based on extensions of dynamic programming to study totally optimal trees. These tools are applicable to both exact and approximate decision trees, and allow us to make multi-stage optimization of decision trees relative to different parameters and to count the number of optimal trees. Based on the experimental results we have formulated the following hypotheses (and subsequently proved): for almost all Boolean functions there exist totally optimal decision trees (i) relative to the depth and number of nodes, and (ii) relative to the depth and average depth.

  14. Revision total elbow arthroplasty with the linked Coonrad-Morrey total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis; Belling-Sørensen, Anne Kathrine;

    2013-01-01

    In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs).......In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs)....

  15. TOTAL LAPAROSCOPIC HYSTERECTOMY VERSUS TOTAL ABDOMINAL HYSTERECTOMY: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Virupaksha

    2015-10-01

    Full Text Available BACKGROUND: Hysterectomy is a common gynaecological surgery which can be done by abdominal, vaginal or laparoscopic routes or with robotic assistance. Although there were concerns regarding the safety of laparoscopic surgery, a newer technique when compared with abdominal hysterectomy, it is now being reco gnized as a safe procedure in the hands of an experienced surgeon. AIMS: This study was done to compare the intra - operative and post - operative parameters of abdominal and laparoscopic hysterectomy. SETTINGS AND DESIGN: This study was done at JSS Hospital, Mysore between June 2013 and September 2014. It is a retrospective study . MATERIALS AND METHOD S: Patients admitted in the Department of Obstetrics and Gynaecology at JSS Hospital, JSS University, Mysore, with an indication for total abdominal hysterectomy( TAH or total laparoscopic hysterectomy(TLH for benign pathology from June 2013 to September 2014 were included in the study. Exclusion criteria were suspicion of malignancy, vaginal prolapse higher than first degree and those undergoing laparoscopic assi sted vaginal hysterectomy. Baseline characteristics, intraoperative and postoperative parameters were compared between the two groups. STATISTICAL ANALYSIS : The data were analyzed using independent T test, Chi square test and Mann Whitney test. A p value o f <0 . 05 was accepted as significant. RESULTS: The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with TAH, i.e. 70.44 minutes, with the p value being <0.0001. But the duration of stay in the hospital was shorter for t he women undergoing TLH, mean duration being 3.74 days as opposed to 7.65 days in women undergoing TAH. This difference was also statistically significant with p value being <0.0001. Also, women undergoing TAH required more analgesic doses (mean 3.29 than those undergoing TLH (mean 1.36 and this difference was also statistically significant. CONCLUSION: Although TLH took a

  16. Total Synthesis of Bryostatin 9

    OpenAIRE

    Wender, Paul A.; Schrier, Adam J.

    2011-01-01

    The total synthesis of bryostatin 9 was accomplished using a uniquely step economical and convergent Prins-driven macrocyclization strategy. At 25 linear and 42 total steps, this is currently the most concise and convergent (5 steps post fragment coupling) synthesis of a potent bryostatin.

  17. Total synthesis of bryostatin 9.

    Science.gov (United States)

    Wender, Paul A; Schrier, Adam J

    2011-06-22

    The total synthesis of bryostatin 9 was accomplished using a uniquely step-economical and convergent Prins-driven macrocyclization strategy. At 25 linear and 42 total steps, this is currently the most concise and convergent synthesis of a potent bryostatin.

  18. The total charm cross section

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, R

    2007-09-14

    We assess the theoretical uncertainties on the total charm cross section. We discuss the importance of the quark mass, the scale choice and the parton densities on the estimate of the uncertainty. We conclude that the uncertainty on the total charm cross section is difficult to quantify.

  19. Total parenteral nutrition in children.

    Science.gov (United States)

    Zlotkin, S H; Stallings, V A; Pencharz, P B

    1985-04-01

    This article first focuses on the indications for total parenteral nutrition and the effect of its use on the outcome of various nutrient-depleting diseases in infants and children. This is followed by a discussion of some of the newer nutrient additions to total parenteral nutrition regimens, such as biotin, carnitine, zinc, copper, iron, and others.

  20. Fractionation and determination of total antioxidant capacity, total ...

    African Journals Online (AJOL)

    DEYAKS PLC

    2014-01-29

    Jan 29, 2014 ... components that can scavenge reactive oxygen species. In this study, the total ... Medicinal plants containing active chemical constituents with high antioxidant property play an important role in the prevention of various ...

  1. [Treatment of infected total hip endoprostheses].

    Science.gov (United States)

    Zilkens, K W; Forst, R; Casser, H R

    1989-07-01

    In total hip arthroplasty the most serious complication besides aseptic loosening is infection. The results observed in 42 cases of infected hip arthroplasties are presented. In contrast to early superficial infection, deep infection following total hip replacement is difficult to treat. Depending on the general condition of the patient, a well-defined, adequate treatment is required. In patients at vital risk the provocation of a permanent fistula can be recommended as an alternative method in preference to revision arthroplasty.

  2. Photoproduction total cross section and shower development

    CERN Document Server

    Cornet, F; Grau, A; Pancheri, G; Sciutto, S J

    2015-01-01

    The total photoproduction cross section at ultra-high energies is obtained using a model based on QCD minijets and soft-gluon resummation and the ansatz that infrared gluons limit the rise of total cross sections. This cross section is introduced into the Monte Carlo system AIRES to simulate extended air-showers initiated by cosmic ray photons. The impact of the new photoproduction cross section on common shower observables, especially those related to muon production, is compared with previous results.

  3. Totality eclipses of the Sun

    CERN Document Server

    Littmann, Mark; Willcox, Ken

    2008-01-01

    A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. - ;A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. Totality: Eclipses of the Sun is the best guide and reference book on solar eclipses ever written. It explains: how to observe them; how to photograph and videotape them; why they occur; their history and mythology; and future eclipses - when and where to see them. Totality also tells the remarkable story of how eclipses shocked scientists, revealed the workings of the Sun, and made Einstein famous. And the book shares the experiences and advice of many veteran eclipse observers. Totality: Eclipses of the Sun is profusely ill...

  4. Qualità totale e mobilità totale

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-04-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  5. Total Product Life Cycle (TPLC)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Total Product Life Cycle (TPLC) database integrates premarket and postmarket data about medical devices. It includes information pulled from CDRH databases...

  6. Total Product Life Cycle (TPLC)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Total Product Life Cycle (TPLC) database integrates premarket and postmarket data about medical devices. It includes information pulled from CDRH databases...

  7. Total Quality Management Implementation Plan.

    Science.gov (United States)

    1989-06-01

    E 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM ( Total Quality Management ), Continuous Process Improvement,_________ Depot Operations, Supply Support 16... Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Defense General...Reduction PrOtect (O704.Ot8SL Wasilngton, OC 20503j. .EPORT DATE 3. REPORT TYPE AND DATES COVERED June 19891 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Total

  8. The total synthesis of psymberin.

    Science.gov (United States)

    Huang, Xianhai; Shao, Ning; Palani, Anandan; Aslanian, Robert; Buevich, Alexei

    2007-06-21

    The total synthesis of a new member of the pederin family of natural products, psymberin 1, was accomplished. Using a recently reported novel and efficient PhI(OAc)2 mediated oxidative entry to 2-(N-acylaminal)-substituted tetrahydropyrans as the key step, this total synthesis was executed in a convergent and efficient manner. The longest linear sequence of this synthesis was 22 steps starting from known 6.

  9. Total Quality From The Top

    Science.gov (United States)

    1993-04-01

    product followed. But, according to V. Daniel Hunt, author of Quality in America, "the time bomb ticks silently 1 V. Daniel Hunt. Quality in America...Michael L., Richard K. Lester, and Robert M. Solow . Made In America. Cambridge, MA:MIT Press, 1989. Doyle, Kevin. "Who’s Killing Total Quality?" Incentive...Gatanas, Harry. Lt Col, USA. "Leadership and Total Quality Management." Carlisle Barracks, PA:U.S. Army War College. April 1992. Hunt, V. Daniel

  10. Single-Incision Laparoscopic Total Colectomy

    Science.gov (United States)

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

    2012-01-01

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

  11. Total hip and total knee replacement: preoperative nursing management.

    Science.gov (United States)

    Lucas, Brian

    Total hip replacement (THR) and total knee replacement (TKR) surgery are carried out for the relief of hip or knee pain, usually caused by osteoarthritis. This is the first of two articles on THR and TKR. It will outline the different types of replacement used in lower limb joint replacement surgery. Preparation of patients for surgery requires attention to physical, psychological and social factors and these are explored in detail. The organization of services along the patient pathway to ensure comprehensive preparation is considered and the nursing role highlighted. The second article, to be published in the next issue, will discuss recovery and rehabilitation from THR and TKR surgery.

  12. TOTAL REWARDS MODEL IN ROMANIAN COMPANIES

    Directory of Open Access Journals (Sweden)

    Elena-Sabina HODOR

    2014-04-01

    Full Text Available Total Rewards Management is a subject of major importance for companies, because, by using models for this, firms can achieve their objectives of high performance. In order to analyse a validated total rewards model in Romanian Accounting and Consulting Companies, it is used The WorldatWork Total Rewards Model, which depict what contributes to applicant attraction and employee motivation and retention. Thus, the methodology of the previous survey is adjusted to the local context. The conclusions for the methodological aspects illustrate that the present research involves three strategic steps in order to achieve the objectives presented: the analysis of organizational environment of the companies from the sample, checking if Total Rewards Model proposed in the previous research is applicable for the same romanian companies from the previous survey, the analysing of the differences between results, and, if necessary, the adaptation of the model for Romania.

  13. TOTAL REWARDS MODEL IN ROMANIAN COMPANIES

    Directory of Open Access Journals (Sweden)

    Elena-Sabina HODOR

    2014-04-01

    Full Text Available Total Rewards Management is a subject of major importance for companies, because, by using models for this, firms can achieve their objectives of high performance. In order to analyse a validated total rewards model in Romanian Accounting and Consulting Companies, it is used The WorldatWork Total Rewards Model, which depict what contributes to applicant attraction and employee motivation and retention. Thus, the methodology of the previous survey is adjusted to the local context. The conclusions for the methodological aspects illustrate that the present research involves three strategic steps in order to achieve the objectives presented: the analysis of organizational environment of the companies from the sample, checking if Total Rewards Model proposed in the previous research is applicable for the same romanian companies from the previous survey, the analysing of the differences between results, and, if necessary, the adaptation of the model for Romania.

  14. 单髁置换与全膝关节置换治疗内侧胫股关节炎早中期疗效比较%The Early Results for the Treatment of Medial Compartmental Knee Osteoarthritis:Unicompart-mental Knee Arthroplasty(Oxford Ⅲ)Versus Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    房小文; 薛峰; 盛晓文; 王正飞; 杨兴

    2015-01-01

    Objective To investigate the early resuit of unicompartmental knee arthroplasty( OxfordⅢ)versus total knee arthroplasty for the treatment of medial compartmental knee osteoarthritis. Methods From April 2013 to August 2014,15 ca-ses(16 knee)of medial compartmental knee osteoarthritis were treated by unicompartmental knee arthroplasty(OxfordⅢ),16 cases(16 knee)of medial compartmental knee osteoarthritis were treated by total knee arthroplasty. The UkA group and TkA group hospital for special surgery knee score(HSS)were 57. 25 and 59. 37 respectively;keen Society Score(kSS)were 55. 94 and 56. 47 respectively. Results All the patients′data were collected. By the time of 2 weeks after operation,Patients in the group UkA had better results than group TkA in the range of motion( ROM),kSS,HSS and the operation time. Conclusion With the strict indications selection,UkA for the treatment of medial compartmental knee osteoarthritis is comparable to TkA, and has less time for operation,rapid postoperative recovery than TkA.%目的:比较Oxford Ⅲ代单髁置换( unicompartmental knee arthroplasty,UkA)和全膝关节置换术( total knee artgroplasty,TkA)治疗膝关节内侧胫股关节炎的早期疗效。方法2013年4月至2014年8月我院收治内侧胫股关节炎患者31例32膝,UkA组15例16膝,TkA组16例16膝。术前对UkA组和TkA组患者膝关节的功能评价采用膝关节评分( keen society score,kSS),分别为55.94分和56.47分;美国特种外科医院膝关节评分( hospital for special sur-gery knee score,HSS)分别为57.25分和59.37分;分别进行单髁置换和全膝关节置换。结果两组患者术后2周的功能改善情况UkA组较TkA组好,膝关节活动度更大;两组的手术时间UkA组较TkA组短。结论人工单髁置换治疗膝内侧胫股关节炎是一种行之有效的方法,与全膝置换早期效果类似,但手术时间短,恢复快。

  15. Total 2004 annual report; TOTAL 2004 rapport annuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  16. Solar irradiance, total and spectral; Irradiancia solar, total e espectral

    Energy Technology Data Exchange (ETDEWEB)

    Fraidenraich, Naum [Pernambuco Univ., Recife, PE (Brazil). Centro de Energia Nuclear; Lyra, Francisco [Companhia Hidroeletrica do Sao Francisco (CHESF), Recife, PE (Brazil)

    1995-12-31

    In this chapter some important characteristics concerning solar irradiance are presented, such as: solar constant; spectral irradiance for a zeroed mass of air; solar constant variation according to Earth-Sun distance; solar energy variation on Earth`s surface; atmospheric attenuation of solar energy; and total radiation and spectral irradiation on Earth`s surface. 3 refs., 5 figs., 6 tabs.

  17. Total N, total P and organic matters content in floodplain soils of Xianghai Nature Reserve

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Soil sediment samples of 10 layers with a spacing of 10 cm each were collected in different floodplain zones adjacent to Huolin River in the Xianghai Nature Reserve, and contents of total N, total P and organic matters were analyzed. The results showed that contents of total N, total P and organic matters were generally decreasing with the increase of distance from sample locations to the river channel, and contents of the three items were generally higher in the upper soil layer than that in the lower soil layer. The content variations displayed how flooding functions influenced nutrient matter content variations in floodplain soils since the flood inundation frequencies of the sample locations varied. The correlation analysis displayed that there were remarkable relativities between total N, total P and organic matters within definite spatial distance from the Huolin River channel.

  18. Totally ossified metaplastic spinal meningioma.

    Science.gov (United States)

    Ju, Chang Il; Hida, Kazutoshi; Yamauchi, Tomohiro; Houkin, Kiyohiro

    2013-09-01

    A 61-year-old woman with a very rare case of totally ossified large thoracic spinal metaplastic meningioma, showing progressing myelopathy is presented. Computed tomographic images showed a large totally ossfied intradural round mass occupying the spinal canal on T9-10 level. Magnetic resonance imaging revealed a large T9-10 intradural extramedullary mass that was hypointense to spinal cord on T1- and T2-weighted sequences, partial enhancement was apparent after Gadolinium administration. The spinal cord was severely compressed and displaced toward the right at the level of T9-10. Surgical removal of the tumor was successfully accomplished via the posterior midline approach and the histological diagnosis verified an ossified metaplastic meningioma. The clinical neurological symptoms of patient were improved postoperatively. In this article we discuss the surgical and pathological aspects of rare case of spinal totally ossified metaplastic meningioma.

  19. Qualidade total e cultura organizacional

    OpenAIRE

    Machado, Denise Del Pra Netto

    1996-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Socio-Economico O ambiente dinâmico em que as organizações estão inseridas determina uma constante busca de competitividade. Com a adoção da Qualidade Total, como um processo ofensivo de enfrentamento das exigências de mercado, procura-se uma vantagem competitiva, além da sobrevi-vência organizacional. Com base no referencial teórico-empírico sobre Qualidade Total e Cultura Organizacional, procurou-se verifi-car o efei...

  20. Total Ozone Prediction: Stratospheric Dynamics

    Science.gov (United States)

    Jackman, Charles H.; Kawa, S. Ramdy; Douglass, Anne R.

    2003-01-01

    The correct prediction of total ozone as a function of latitude and season is extremely important for global models. This exercise tests the ability of a particular model to simulate ozone. The ozone production (P) and loss (L) will be specified from a well- established global model and will be used in all GCMs for subsequent prediction of ozone. This is the "B-3 Constrained Run" from M&MII. The exercise mostly tests a model stratospheric dynamics in the prediction of total ozone. The GCM predictions will be compared and contrasted with TOMS measurements.

  1. Stereoselective Total Synthesis of Mycalamides

    Institute of Scientific and Technical Information of China (English)

    Masahiro Toyota

    2005-01-01

    @@ 1Introduction Mycalamides A (1a) and B (1b) are potent antiviral compounds from a New Zealand sponge of the genus Mycale. Apart from their antitumor property, mycalamide A (1a) exhibits immunosuppressive action by blocking T-cell activation in mice and is significantly more potent than FK-506 and cyclosporine A. Because of their intriguing biological activity, unique structures and scarce supply of these natural products, mycalamides A (1a) and B (1b) have attracted considerable attention as target molecules for total synthesis, and total, formal, or partial syntheses of this family of compounds have been reported[1,2].

  2. VOICE REHABILITATION FOLLOWING TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2015-03-01

    Full Text Available Despite continuing advances in surgical management of laryngeal malignancy, total laryngectomy is still the treatment of choice in advanced laryngeal malignancies. Considering the longevity of the patient following total laryngectomy, various measures have been adopted in order to provide voice function to the patient. Significant advancements have taken place in voice rehabilitation of post laryngectomy patients. Advancements in oncological surgical techniques and irradiation techniques have literally cured laryngeal malignancies. Among the various voice rehabilitation techniques available TEP (Tracheo oesophageal puncture is considered to be the gold standard. This article attempts to explore the various voice rehabilitation technique available with primary focus on TEP.

  3. Advances in total scattering analysis

    Energy Technology Data Exchange (ETDEWEB)

    Proffen, Thomas E [Los Alamos National Laboratory; Kim, Hyunjeong [Los Alamos National Laboratory

    2008-01-01

    In recent years the analysis of the total scattering pattern has become an invaluable tool to study disordered crystalline and nanocrystalline materials. Traditional crystallographic structure determination is based on Bragg intensities and yields the long range average atomic structure. By including diffuse scattering into the analysis, the local and medium range atomic structure can be unravelled. Here we give an overview of recent experimental advances, using X-rays as well as neutron scattering as well as current trends in modelling of total scattering data.

  4. Total lymphoid irradiation and discordant cardiac xenografts

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, E.; Dresdale, A.R.; Diehl, J.T.; Katzen, N.A.; Aronovitz, M.J.; Konstam, M.A.; Payne, D.D.; Cleveland, R.J. (Tufts Univ. School of Medicine, Boston, MA (USA))

    1990-01-01

    Total lymphoid irradiation can prolong concordant cardiac xenografts. The effects of total lymphoid irradiation in a discordant xenograft model (guinea pig to rat) were studied with and without adjuvant pharmacologic immunosuppression. Inbred Lewis rats were randomly allocated to one of four groups. Group 1 (n = 6) served as a control group and rats received no immunosuppression. Group 2 (n = 5) received triple-drug therapy that consisted of intraperitoneal azathioprine (2 mg/kg), cyclosporine (20 mg/kg), and methylprednisolone (1 mg/kg) for 1 week before transplantation. Group 3 animals (n = 5) received 15 Gy of total lymphoid irradiation in 12 divided doses over a 3-week period. Group 4 (n = 6) received both triple-drug therapy and total lymphoid irradiation as described for groups 2 and 3. Complement-dependent cytotoxicity assay was performed to determine if a correlation between complement-dependent cytotoxicity and rejection-free interval existed. Rejection was defined as cessation of graft pulsation and was confirmed by histologic test results. Only groups 1 and 2 showed a difference in survival (group 1, 6.9 +/- 1.0 minutes; group 2, 14.2 +/- 2.7 minutes, p = 0.02). Although total lymphoid irradiation did decrease complement-dependent cytotoxicity, linear regression revealed no correlation between complement-dependent cytotoxicity and graft survival (coefficient of correlation, 0.30). Unlike concordant cardiac xenografts, total lymphoid irradiation with or without triple-drug therapy does not prolong graft survival.

  5. What is Total Quality Management?

    Science.gov (United States)

    Bryan, William A.

    1996-01-01

    Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

  6. The Total Cost of Technology.

    Science.gov (United States)

    Freeman, Jim

    2002-01-01

    Presents overview of areas to consider when planning for the total cost of technology, including a brief look at the planning needed, equipment that should be considered, infrastructure needs, software considerations, maintenance issues, training, upgrades, and planning for system failures. (Author/PKP)

  7. Leadership and Total Quality Management

    Science.gov (United States)

    1992-04-15

    Quality Management when combine with good leadership and management skills yields increased productivity. This paper will focus on the skills required of...The leadership of large and complex organizations in today’s environment of shrinking resources requires a strong commitment by the leader. Total

  8. Spraakrevalidatie na een totale laryngectomie

    NARCIS (Netherlands)

    Timmermans, A.J.; Krap, M.; Hilgers, F.J.M.; van den Brekel, M.W.M.

    2012-01-01

    In patients with advanced laryngeal or hypopharyngeal cancer, or in cases when the disease recurs after treatment with (chemo)radiation, a total laryngectomy (TLE) is performed. For them to be able to function properly, speech rehabilitation is of the utmost importance for these patients. For voice

  9. The Total Cost of Ownership.

    Science.gov (United States)

    Day, C. William

    2000-01-01

    Examines what Total Cost of Ownership is regarding the purchase of technological resources for schools and the major expenses that are likely to occur after technological hardware and software have been installed. A list of best practices that can reduce costs approximately 15 percent and a checklist for technology budgeting are provided. (GR)

  10. Total enantioselective synthesis of (-)-cytisine.

    Science.gov (United States)

    Danieli, Bruno; Lesma, Giordano; Passarella, Daniele; Sacchetti, Alessandro; Silvani, Alessandra; Virdis, Andrea

    2004-02-19

    [reaction: see text] The first total enantiosynthesis of the biologically active alkaloid (-)-cytisine is reported, featuring a ruthenium-catalyzed RCM reaction as the key step. The approach relies on readily available cis-piperidine-3,5-dimethanol monoacetate as the chiral building block, and it is suited for achieving the target compound in both enantiomeric forms.

  11. [Hypoparathyroid risk after total thyroidectomy].

    Science.gov (United States)

    Milone, Antonino; Carditello, Antonio; Stilo, Francesco; Paparo, Domenica; Paparo, Teresa

    2004-01-01

    From January 1970 to December 1999, 881 patients with thyroid pathology underwent surgery consisting in 551 subtotal thyroidectomies and 330 total thyroidectomies. Permanent hypocalcaemia was present in 32 patients (3.6%). The importance of accurate isolation and ultraligature of the branches of the inferior thyroid artery in the prevention of parathyroid damage is stressed.

  12. Recurrent hemarthrosis after total knee arthroplasty.

    Science.gov (United States)

    Rukavina, Alexander; Kerkhoffs, Gino M M J; Schneider, Philipp; Kuster, Markus S

    2010-07-01

    This report describes a case of spontaneous recurrent hemarthrosis of the knee that presented 4 weeks after total knee arthroplasty. Femoral arteriography showed a false aneurysm of a branch of the inferior lateral geniculate artery. Therapeutic embolization of the arterial branch was performed using three platinum coils with good clinical result and good knee joint function. Hemarthrosis has not recurred since embolization.

  13. Recurrent hemarthrosis after total knee arthroplasty

    OpenAIRE

    Rukavina, A.; Kerkhoffs, G. M. M. J.; Schneider, P.; Kuster, M S

    2010-01-01

    This report describes a case of spontaneous recurrent hemarthrosis of the knee that presented 4 weeks after total knee arthroplasty. Femoral arteriography showed a false aneurysm of a branch of the inferior lateral geniculate artery. Therapeutic embolization of the arterial branch was performed using three platinum coils with good clinical result and good knee joint function. Hemarthrosis has not recurred since embolization.

  14. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    of the dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...

  15. Total pancreatic lipomatosis with malabsorption syndrome

    Directory of Open Access Journals (Sweden)

    Rama Anand

    2011-01-01

    Full Text Available Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.

  16. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  17. Modelling total energy costs of sports centres

    Energy Technology Data Exchange (ETDEWEB)

    Boussabaine, A.H.; Kirkham, R.J.; Grew, R.J. [Liverpool Univ., School of Architecture and Building Engineering, Liverpool (United Kingdom)

    1999-12-07

    Providing and maintaining safe and comfortable conditions in sport centres raises many issues, particularly cost. The paper gives an overview of the factors associated with sport centre servicing and attempts to highlight the governing factors associated with this, particularly energy costs. A total of 19 sport centres in the City of Liverpool in the UK are investigated, using data elicited from the Liverpool Leisure Services Directorate. The energy operating costs were analysed using statistical methods. Six models were developed to predict total energy costs. Testing and validation results showed a high level of model accuracy. The models would be of use to professionals involved in feasibility studies at the design stage. (Author)

  18. ANALYSIS AND ACCOUNTING OF TOTAL CASH FLOW

    Directory of Open Access Journals (Sweden)

    MELANIA ELENA MICULEAC

    2012-01-01

    Full Text Available In order to reach the objective of supplying some relevant information regarding the liquidity inflows and outflows during a financial exercise, the total cash flow analysis must include the analysis of result cashable from operation, of payments and receipts related to the investment and of financing decisions of the last exercise, as well as the analysis of treasury variation (of cash items. The management of total cash flows ensures the correlation of current liquidness flows as consequence of receipts with the payments ’flows, in order to provide payment continuity of mature obligations.

  19. ARTHROFIBROSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Ravi B. Solanki

    2014-11-01

    Full Text Available Arthrofibrosis following total knee arthroplasty is an uncommon complication defined as less than 80 degrees of knee flexion 6-8 weeks post operatively. It is characterized by abnormal scarring of the joint in which the formation of dense fibrous tissue and tissue metaplasia prevent normal range of motion. Clinical features include limited knee Range of motion with extension deficit, pain with activities of daily living and unusual amount of pain and swelling post operatively in the absence of infection, bleeding or mechanical complications. We present case of 55 years old female who undergone for total knee replacement before 3 months and presented to our department with complain of knee pain and swelling with activities of daily living. She was diagnosed on the basis of clinical examination. Her detailed evaluation was carried out and Physiotherapy treatment was started.

  20. The usefulness of total cholesterol and high density lipoprotein ...

    African Journals Online (AJOL)

    The usefulness of total cholesterol and high density lipoprotein - cholesterol ratio in ... cholesterol and/or highdensity lipoprotein cholesterol/total cholesterol ratios in the interpretation of lipid profile result in clinical practice. ... Article Metrics.

  1. Edge adaptive directional total variation

    Directory of Open Access Journals (Sweden)

    Hua Zhang

    2013-11-01

    Full Text Available The directional total variation (DTV model has been proposed very recently for image denoising. However, the DTV model works well when there is just one dominant direction in the image. In this Letter, the authors propose to make the DTV model adaptive to image edge direction so that the proposed model can handle images with several dominant directions. Experiment and comparison show the effectiveness of the proposed method.

  2. Rehabilitation for total joint arthroplasty.

    Science.gov (United States)

    Ritterman, Scott; Rubin, Lee E

    2013-05-01

    Total hip and knee replacement are two of the most common and successful elective surgeries preformed in the United States each year. Preoperative medical preparation and postoperative rehabilitation are equally important to a successful outcome. Physical deconditioning, tobacco use, obesity and medical co-morbidities can adversely affect outcomes and should be addressed before any elective procedure. Formal postoperative therapy is geared towards the specific surgery and is aimed at returning the patient to independent activity.

  3. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  4. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...... ). Results - 3,416 patients were included (2,064 females (60%)). AKI (according to KDIGO criteria) was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD of class 3-5, indicating moderately to severely...

  5. Total Monomeric Anthocyanin and Total Flavonoid Content of Processed Purple

    Directory of Open Access Journals (Sweden)

    Potato Florentina Damşa

    2016-01-01

    Full Text Available It is well known that processing change physical and chemical composition of foods, thus affecting the content in bioactive substances. Potatoes are almost always consumed after processing (baked, fried or boiled making it critical to understand the effect of such processing techniques on the containing in bioactive compounds. In order to determine the influence of processing on the content of anthocyanin pigments and flavonoids was achieved the extraction of these compounds from boiled and baked purple potato tuber (Albastru-Violet de Galanesti variety. Also, in order to obtain the maximum amount of anthocyanin pigments and flavonoids from processed potatoes was applied ultrasonic extraction (20 kHz and was performed the mathematical modeling (central composite design using SigmaXL software. The total anthocyanins content were determined spectrophotometrically by the pH differential method and the total flavonoids content were determine colorimetric by AlCl3 method. This study proves that the potato processing decreases the content of anthocyanin pigments and flavonoids.

  6. Total lymphoid irradiation of intractable rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Herbst, M.; Fritz, H.; Sauer, R.

    1986-12-01

    Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation, (total dose 20 Gy). Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four patients have since died, one of renal failure, another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and reduction in T-helper cells, the number of T-suppressor cells remaining unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored.

  7. Totally implantable catheter embolism: two related cases

    Directory of Open Access Journals (Sweden)

    Rodrigo Chaves Ribeiro

    Full Text Available CONTEXT AND OBJECTIVE: Long-term totally implantable catheters (e.g. Port-a-Cath® are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred. DESIGN AND SETTING: Case series study at Hospital do Servidor Público Estadual, São Paulo. METHODS: Retrospective review of catheter embolism in oncological pediatric patients with long-term totally implantable catheters. RESULTS: The first patient was a 3-year-old girl diagnosed with stage IV Wilms' tumor. Treatment was started with the introduction of a totally implantable catheter through the subclavian vein. At the time of removal, it was realized that the catheter had fractured inside the heart. An endovascular procedure was necessary to remove the fragment. The second case was a boy diagnosed with stage II Wilms' tumor at the age of two years. At the time of removal, it was noticed that the catheter had disconnected from the reservoir and an endovascular procedure was also necessary to remove the embolized catheter. CONCLUSION: Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.

  8. Observation of long-term results of total knee arthroplasty after failed high tibial osteotomy%胫骨高位截骨术失败后行全膝关节假体置换术的长期疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭林; 杨柳; Jean Louis Briard; 段小军; 陈光兴; 张颖

    2009-01-01

    Objective To evaluate the long-term clinical result and operating techniques of total knee arthroplasty(TKA) after failed high tibial osteetomy (HTO). Methods There were 18 patients (19 knees) undergone TKA from March 1990 to June 1992 after failed HTO in Center Medico-Chirurgical du Cedre. All patients had severe medial and lateral compartmental degeneration, and four patients had moderate degree of bone loss of lateral plateau. All patients were evaluated with postoperative roentgeno-gram and Knee Society Scoring System (KSS). X-ray was used to measure hip knee ankle angle (HKA), α angle, β angle, index of patella AP/AT and pente de tibial (PDT). Results Tibal tubercle osteoto-my and medial translation were done in 11 knees because of severe valgus and lateral subluxation of patel-la during TKA. Partial restrained knee prosthesises were put into five knees because of poor soft tissue condition or unbalance of collateral ligaments. Of all, two patients died and the other 16 patients were successfully followed up, which showed severe polyethylene wear in seven knees at follow-up, with no re-vision for mild symptom. The average KSS score was 147.2 points, with excellence rate of 82%. Con-dusions TKA after HTO has good therapeutic results. Patellofemoral malalignment and severe valgus deformity are commonly seen, when tibial tubercle osteotomy combined with medial translation may be needed. Severe valgus deformity of knee causes difficulties to ligament balance and tibial osteotomy, so,implantation of knee prosthesises with higher restriction is needed.%目的 针对胫骨高位截骨术(high tibial osteotomy,HTO)失败后行全膝人工关节置换术(total knee arthmplasty,TKA)进行长期疗效观察,分析其远期临床疗效及术中注意事项.方法 选择法国Medico-Chirurgical du Cedre中心1990年3月-1992年6月18例(19膝)HTO术后失败的患者并行TKA治疗.所有关节均有内外侧间室退变,4例伴有外侧胫骨平台中度骨缺损.采

  9. Heliophysics at total solar eclipses

    Science.gov (United States)

    Pasachoff, Jay M.

    2017-08-01

    Observations during total solar eclipses have revealed many secrets about the solar corona, from its discovery in the 17th century to the measurement of its million-kelvin temperature in the 19th and 20th centuries, to details about its dynamics and its role in the solar-activity cycle in the 21st century. Today's heliophysicists benefit from continued instrumental and theoretical advances, but a solar eclipse still provides a unique occasion to study coronal science. In fact, the region of the corona best observed from the ground at total solar eclipses is not available for view from any space coronagraphs. In addition, eclipse views boast of much higher quality than those obtained with ground-based coronagraphs. On 21 August 2017, the first total solar eclipse visible solely from what is now United States territory since long before George Washington's presidency will occur. This event, which will cross coast-to-coast for the first time in 99 years, will provide an opportunity not only for massive expeditions with state-of-the-art ground-based equipment, but also for observations from aloft in aeroplanes and balloons. This set of eclipse observations will again complement space observations, this time near the minimum of the solar activity cycle. This review explores the past decade of solar eclipse studies, including advances in our understanding of the corona and its coronal mass ejections as well as terrestrial effects. We also discuss some additional bonus effects of eclipse observations, such as recreating the original verification of the general theory of relativity.

  10. Comparação entre o laser endovenoso e a fleboextração total da veia safena interna: resultados em médio prazo Comparison of endovenous laser therapy vs. conventional stripping of the great saphenous vein: midterm results

    Directory of Open Access Journals (Sweden)

    Charles Angotti Furtado de Medeiros

    2006-12-01

    Full Text Available OBJETIVO: Comparar a fotocoagulação endovenosa com laser diodo e a fleboextração total da veia safena interna. MÉTODOS: Trata-se de um estudo prospectivo, controlado e cego de 20 pacientes com varizes sintomáticas e insuficiência bilateral da veia safena interna que foram operados entre março de 2002 e fevereiro de 2004. Para cada caso, foram realizadas aleatoriamente (sorteio as duas técnicas, sendo uma em cada lado. A avaliação pós-operatória consistiu na aplicação de questionários, exame físico e fotografia digital em todos os pacientes desde o 7º dia de pós-operatório. Também foi realizado controle ultra-sonográfico no 30º dia de pós-operatório e pletismografia a ar no 60º dia após a cirurgia. Este projeto foi aprovado pela comissão de ética, e os pacientes foram incluídos ao assinarem o consentimento pós-informação. Os dados foram submetidos a análise estatística com os programas SPSS e SAS. RESULTADOS: A técnica que utilizou o laser endovenoso apresentou dor semelhante, mas menos edema e menos hematoma durante o pós-operatório. O índice de melhora estética e de satisfação com a cirurgia foi de 100% para as duas técnicas, mas a maioria dos pacientes respondeu que o membro operado com o laser foi o mais beneficiado. Houve melhora do tempo de enchimento venoso nos dois grupos, mas sem diferença significativa entre eles. Durante o seguimento (média de 26 meses, houve um caso de parestesia leve e transitória do lado convencional e somente uma recanalização do lado laser. CONCLUSÃO: A fotocoagulação endovenosa para o tratamento da veia safena interna em pacientes com varizes de membros inferiores é segura e apresenta resultados comparáveis aos da fleboextração convencional.OBJECTIVE: To compare endovenous diode laser photocoagulation and conventional stripping of the great saphenous vein. METHODS: A controlled and blind prospective study of 20 patients with symptomatic varicose veins and

  11. Diverticulosis in total colonic aganglionosis

    Energy Technology Data Exchange (ETDEWEB)

    Ivancev, K.; Fork, T.; Haegerstrand, I.; Ivarsson, S.; Kullendorff, C.M.

    Two infants with total colonic aganglionosis (TCA) extending into the distal part of the ileum are described. Considerable diagnostic delay occurred with the correct diagnosis established first at 3 and 8 months, respectively. Radiologic findings compatible with TCA such as prolonged barium retention, reflux into ileum following barium enema, and foreshortening of colon were not clearly evident initially. Both patients demonstrated multiple acquired colon diverticula which increased both in number and size during the period of observation. These diverticula are probably a late manifestation of the spastic state of the anganglionic colon. Thus demonstration of diverticula supplies a strong evidence of TCA in infants with intestinal obstruction. (orig.).

  12. The total synthesis of (-)-nitidasin.

    Science.gov (United States)

    Hog, Daniel T; Huber, Florian M E; Mayer, Peter; Trauner, Dirk

    2014-08-01

    Nitidasin is a pentacyclic sesterterpenoid with a rare 5-8-6-5 carbon skeleton that was isolated from the Peruvian folk medicine "Hercampuri". It belongs to a small class of sesterterpenoids that feature an isopropyl trans-hydrindane moiety fused to a variety of other ring systems. As a first installment of our general approach toward these natural products, we report the total synthesis of the title compound. Our stereoselective, convergent route involves the addition of a complex alkenyl lithium compound to a trans-hydrindanone, followed by chemoselective epoxidation, ring-closing olefin metathesis, and redox adjustment.

  13. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  14. Total eclipses of the sun

    CERN Document Server

    Zirker, Jack B

    2014-01-01

    Eclipses have captured attention and sparked curiosity about the cosmos since the first appearance of humankind. Having been blamed for everything from natural disasters to the fall of kings, they are now invaluable tools for understanding many celestial as well as terrestrial phenomena. This clear, easy-to-understand guide explains what causes total eclipses and how they can be used in experiments to examine everything from the dust between the planets to general relativity. A new chapter has been added on the eclipse of July 11, 1991 (the great Hawaiian eclipse). Originally published in 19

  15. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    Yamu Xia; Xiaoli Dai; Haixin Liu; Chen Chai

    2014-05-01

    The first total synthesis of dilignan Boehmenan has been achieved. A biomimetic oxidative coupling of the ferulic acid methyl ester in the presence of silver oxide is the crucial step in the synthesis sequence, generating the dihydrobenzofuran skeleton. Hydroxyl group was protected with DHP and reducted with LiAlH4 to afford the intermediate diol. The diol was condensated with the derivative of ferulic acid, then removed the protecting groups, to get Boehmenan. Meanwhile, a study on the ring-opening reaction of the intermediate dihydrobenzofuran neolignan under base conditions was described.

  16. Employees in Total Quality Management

    Directory of Open Access Journals (Sweden)

    M. G. Matlhape

    2002-12-01

    Full Text Available Companies have become very disillusioned with Total Quality Management (TQM as a solution to their quality related problems. Part of the problem has been that companies' expectations from TQM is as a solution to their existing problems rather than as a new philosophy towards creating value for shareholders, employees, and customers. Employee involvement is usually the element in the TQM philosophy that is most difficult to manage. Central to employee participation within the TQM philosophy is teamwork. In the attempt to facilitate total quality management, this article explores specific South African challenges to achieving this. These areaffirmative action and divers ity management skills shortages, training and development low levels of employee well-being. Working with people requires fundamental understanding of the uniqueness of each individual with their own identity and set of preferences. It also requires an understanding of teams and the mechanisms of making a group of individuals work well or poorly together. This will assist managers to realise active participation, quality output from their workers through individualised, and team based motivational processes.

  17. 'Total IBA' - Where are we?

    Energy Technology Data Exchange (ETDEWEB)

    Jeynes, C., E-mail: c.jeynes@surrey.ac.uk [University of Surrey Ion Beam Centre, Guildford (United Kingdom); Bailey, M.J.; Bright, N.J.; Christopher, M.E.; Grime, G.W.; Jones, B.N.; Palitsin, V.V.; Webb, R.P. [University of Surrey Ion Beam Centre, Guildford (United Kingdom)

    2012-01-15

    The suite of techniques which are available with the small accelerators used for MeV ion beam analysis (IBA) range from broad beams, microbeams or external beams using the various particle and photon spectrometries (including RBS, EBS, ERD, STIM, PIXE, PIGE, NRA and their variants), to tomography and secondary particle spectrometries like MeV-SIMS. These can potentially yield almost everything there is to know about the 3-D elemental composition of types of samples that have always been hard to analyse, given the sensitivity and the spacial resolution of the techniques used. Molecular and chemical information is available in principle with, respectively, MeV-SIMS and high resolution PIXE. However, these techniques separately give only partial information - the secret of 'Total IBA' is to find synergies between techniques used simultaneously which efficiently give extra information. We here review how far 'Total IBA' can be considered already a reality, and what further needs to be done to realise its full potential.

  18. "Total IBA" - Where are we?

    Science.gov (United States)

    Jeynes, C.; Bailey, M. J.; Bright, N. J.; Christopher, M. E.; Grime, G. W.; Jones, B. N.; Palitsin, V. V.; Webb, R. P.

    2012-01-01

    The suite of techniques which are available with the small accelerators used for MeV ion beam analysis (IBA) range from broad beams, microbeams or external beams using the various particle and photon spectrometries (including RBS, EBS, ERD, STIM, PIXE, PIGE, NRA and their variants), to tomography and secondary particle spectrometries like MeV-SIMS. These can potentially yield almost everything there is to know about the 3-D elemental composition of types of samples that have always been hard to analyse, given the sensitivity and the spacial resolution of the techniques used. Molecular and chemical information is available in principle with, respectively, MeV-SIMS and high resolution PIXE. However, these techniques separately give only partial information - the secret of "Total IBA" is to find synergies between techniques used simultaneously which efficiently give extra information. We here review how far "Total IBA" can be considered already a reality, and what further needs to be done to realise its full potential.

  19. Qualidade total: Um novo paradigma?

    Directory of Open Access Journals (Sweden)

    Suzana da Rosa Tolfo

    1999-01-01

    Full Text Available Nos últimos anos, o movimento para a implantação da Gestão da Qualidade Total vem crescendo ao redor do mundo. Em razão disso, há uma diversidade de ações realizadas com o nome de "Qualidade Total'. Uma revisão da teoria é complexa, porque existem muitos autores que tratam da questão. Eles escolhem diferentes perspectivas de análises (teóricas e empíricas e há dificuldades em se identificar um corpo conceitual. Há uma ampla difusão de modelos, ferramentas, técnicas, mercado e consultores. Essa popularidade, muitas vezes, faz com que determinadas organizações adotem essa forma de gestão do trabalho sem o conhecimento necessário das implicações que um modelo dessa ordem representa; especialmente no caso brasileiro, suscetível a proposições importadas. O presente artigo propõe um exame daquilo que os fundadores têm articulado sobre TQM, as principais críticas nesta direção e a avaliação de como vem sendo aplicadono nosso país.

  20. Enceladus Results

    Data.gov (United States)

    National Aeronautics and Space Administration — Here are some results from the Spectra Decomposition Algorithm on infrared spectral images of Saturn's moon Enceladus. Figure 1 is the spatial contribution of the...

  1. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    of the dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...... the potential advantages seem to be related to a bulky mesorectum in the male pelvis. The preliminary results are encouraging and the most serious complication is urethral injury. The oncological results are acceptable, although the follow-up is short. CONCLUSION: TaTME is a feasible approach for mid and low...

  2. Totally laparoscopic total gastrectomy for gastric cancer: Literature review and comparison of the procedure of esophagojejunostomy

    Directory of Open Access Journals (Sweden)

    Akira Umemura

    2015-04-01

    Full Text Available There has been a recent increase in the use of totally laparoscopic total gastrectomy (TLTG for gastric cancer. However, there is no scientific evidence to determine which esophagojejunostomy (EJS technique is the best. In addition, both short- and long-term oncological results of TLTG are inconsistent. We reviewed 25 articles about TLTG for gastric cancer in which at least 10 cases were included. We analyzed the short-term results, relationships between EJS techniques and complications, long-term oncological results, and comparative study results of TLTG. TLTG was performed in a total of 1170 patients. The mortality rate was 0.7%, and the short-term results were satisfactory. Regarding EJS techniques and complications, circular staplers (CSs methods were significantly associated with leakage (4.7% vs. 1.1%, p < 0.001 and stenosis (8.3% vs. 1.8%, p < 0.001 of the EJS as compared with the linear stapler method. The long-term oncological prognosis was acceptable in patients with early gastric cancers and without metastases to lymph nodes. Although TLTG tended to increase surgical time compared with open total gastrectomy and laparoscopy-assisted total gastrectomy, it reduced intraoperative blood loss and was expected to shorten postoperative hospital stay. TLTG is found to be safer and more feasible than open total gastrectomy and laparoscopy-assisted total gastrectomy. At present, there is no evidence to encourage performing TLTG for patients with advanced gastric cancer from the viewpoint of long-term oncological prognosis. Although the current major EJS techniques are CS and linear stapler methods, in this review, CS methods are significantly associated with leakage and stenosis of the EJS.

  3. Evaluation of salivary sialic acid, total protein, and total sugar in oral cancer: A preliminary report

    Directory of Open Access Journals (Sweden)

    Sanjay P

    2008-01-01

    Full Text Available Aim: Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, noninvasive methods like analysis of saliva may provide a cost-effective approach for screening a large population. Thus, this study aimed to estimate salivary levels of sialic acid, total protein, and total sugar in the oral cancer patients and in healthy control group to evaluate their role in diagnosis and prognosis of oral cancer. Study Design: Unstimulated whole saliva samples were collected from 30 healthy controls (Group I and 30 squamous cell carcinoma patients (group II. Estimations of salivary levels of sialic acid, total protein, and total sugar were performed. This was correlated histopathologically with the grades of carcinoma. Statistical Analysis and Results: The Student′s ′ t ′ test and multivariate regression analysis were performed. The results showed that salivary levels of total protein, total sugar, protein-bound sialic acid, and free sialic acid were significantly higher in oral cancer patients compared to those of normal healthy controls ( P values in all the results were less than 0.001. The salivary free sialic acid levels were found to be significantly higher in well-differentiated squamous cell carcinoma than in moderately differentiated carcinoma ( P < 0.001. However, protein-bound sialic acid, total proteins, and total sugars did not show any statistical significance between well and moderately differentiated carcinomas. Conclusion: Biochemical analysis of saliva can be used in early detection of cancer and is best correlated with histopathological degree of squamous cell carcinoma.

  4. 人工全膝关节置换术治疗终末期膝关节病变合并膝外翻畸形的手术技巧及临床疗效评价%SURGICAL TECHNIQUE AND CLINICAL RESULTS OF TOTAL KNEE ARTHROPLASTY IN TREATING ENDSTAGE GONARTHROSIS COMBINED WITH VALGUS KNEE DEFORMITY

    Institute of Scientific and Technical Information of China (English)

    王兴山; 翁习生; 林进; 金今; 钱文伟

    2012-01-01

    目的 探讨对终末期膝关节病变合并膝外翻畸形患者行经髌旁内侧入路人工全膝关节置换( total knee arthroplasty,TKA)时膝外翻畸形矫正方法及临床疗效.方法 1998年11月-2010年10月,收治64例72膝合并膝外翻畸形的终末期膝关节病变患者.男18例,女46例;年龄23~82岁,平均62.5岁.骨关节炎44例49膝,类风湿性关节炎17例20膝,血友病性关节炎2例2膝,创伤性关节炎1例1膝.双膝8例,单膝56例.膝关节屈伸活动度为(82.2±28.7)°,X线片测量股胫角为(18.0±5.8)°.膝关节学会评分系统(KSS)临床评分为(31.2±10.1)分,功能评分(37.3±9.0)分.根据Krackow膝外翻分型标准:Ⅰ型65膝,Ⅱ型7膝.手术经髌旁内侧入路,采用常规方法行股骨及胫骨截骨,Ranawat技术进行软组织松解.6例7膝采用保留后交叉韧带型假体,54例60膝采用后稳定型假体,4例5膝采用髁限制型假体.结果 术后患者切口均Ⅰ期愈合.1例血友病性关节炎合并严重膝外翻畸形(股胫角41°)、屈曲挛缩20°的患者术后出现腓总神经麻痹,经保守治疗1年后神经功能恢复.1例术后2年发生深部感染,行二期翻修术后治愈.患者术后均获随访,随访时间1~13年,平均4.9年.末次随访时X线片示股胫角为(7.0±2.5)°,与术前比较差异有统计学意义(t=15.502,P=0.000).KSS临床评分为(83.0±6.6)分,功能评分(85.1±10.5)分,膝关节屈伸活动度为(106.1±17.0)°,与术前比较差异均有统计学意义(P<0.05).5例遗留12~15°膝外翻畸形,但患膝关节功能良好.结论 通过恰当的术中截骨和软组织平衡,采用经髌旁内侧入路TKA治疗合并膝外翻畸形的终末期膝关节病变可有效改善膝外翻畸形和恢复关节功能,临床疗效满意.%Objective To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. Methods Between November

  5. 20 CFR 10.400 - What is total disability?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What is total disability? 10.400 Section 10... AMENDED Compensation and Related Benefits Compensation for Disability and Impairment § 10.400 What is total disability? (a) Permanent total disability is presumed to result from the loss of use of both...

  6. 国产人工膝关节假体治疗膝骨关节炎的中长期随访%Over ten-year clinical result of domestic TC-Dynamic posterior stabilized knee prosthesis in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    孙振杰; 刘瑞波; 袁一

    2015-01-01

    Background:Total knee prosthesis made by Europe and America is popular in China now, but it is very expensive and not fit for the anatomic structure of Chinese. Objective:To evaluate long-term clinical outcome and survival of TC-Dynamic domestic prosthesis in total knee arthroplas-ty (TKA) for OA, and to assess influencing factors of prosthesis survival rate and knee function. Methods: From March 2002 to February 2005, 84 patients (91 knees) underwent TKA. Eventially, 71 patients (75 knees) were followed up. TC-Dynamic domestic prosthesis was used in 35 patients (37 knees) and Scorpio single Axis prosthesis (Stryker, USA) was used in 36 patients (38 knees). In TC-Dynamic group, there were 6 males (6 knees) and 29 females (31 knees) with an average age of (77.1 ± 6.6) years. In Scorpio group, there were 6 males (7 knees) and 30 females (31 knees) with an average age of (76.2 ± 6.1) years. The KSS scores, joint function and range of motion (ROM) were evaluated be-tween the two groups at 6 months after operation ,as well was at the last follow-up. Results:The average duration of follow-up was (10.8±1.5) years (range, 10.1-13.0 years) in the 71 patients. There were no significant differences in the KSS scores, joint function or ROM between two groups at the last follow-up (P>0.05). The rate of lateral retinacular release in TC-Dynamic group was 5.4%(2/37) and 18.4%(7/38) in Scorpio group (P<0.05). No more than 2 mm X-ray radiolucent line was found in both groups. The line of force of lower limbs and the position of the prosthesis were satisfactory. No infection or dislocation occurred during follow up. Conclusions:Long-term clinical outcome of TKA is good when domestic posterior stabilized prosthesis is implanted. It is more suitable for Chinese patients because of low price and appropriating anatomy.%背景:目前国内使用的人工膝关节假体主要为欧美生产,费用昂贵且不符合国人的膝关节解剖数据。国产TC.Dynamic后稳定型人工

  7. Stereocontrolled Total Synthesis of (-)-Stemaphylline.

    Science.gov (United States)

    Varela, Ana; Garve, Lennart K B; Leonori, Daniele; Aggarwal, Varinder K

    2017-02-13

    Homologation of readily available α-boryl pyrrolidines with metal carbenoids is especially challenging even when good leaving groups (Cl(-) ) are employed. By performing a solvent switch from Et2 O to CHCl3 , efficient 1,2-metalate rearrangement of the intermediate boronate occurs with both halide and ester leaving groups. The methodology was used in the total synthesis of the Stemona alkaloid (-)-stemaphylline in just 11 steps (longest linear sequence), with high stereocontrol (>20:1 d.r.) and 11 % overall yield. The synthesis also features a late-stage lithiation-borylation reaction with a tertiary amine containing carbenoid. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Sociologist in the total institution

    Directory of Open Access Journals (Sweden)

    Krstić Željko

    2010-01-01

    Full Text Available On the basis of empirical experience from practical work this paper discusses the real place and role of the sociologist in the prison, as a total institution, where sociologists are employed as educators, along with other professions (psychologists, educationalists, social workers, etc., and usually closely cooperating with lawyers. According to the current work regulations, and on the basis of practice so far, the sociologist can work as classical educator, to be in charge of educational groups of inmates, work in the reception department on assessing incoming inmates, and to organize inmates' leisure time by directing them towards pro-social and creative activities (music, painting, reading, etc.. New reform trends in working with inmates suggest new work methods, such as creative workshops, counselling in the sphere of substance abuse and dependency, or expert teams in working with minors. In the prison, the sociologist is indispensable as a researcher of criminal activities.

  9. Total quality management program planning

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  10. NASA total quality management 1989 accomplishments report

    Science.gov (United States)

    1990-01-01

    Described here are the accomplishments of NASA as a result of the use of Total Quality Management (TQM). The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories of TQM discussed here are top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.

  11. The total parenteral nutrition service: an update.

    OpenAIRE

    1988-01-01

    A total parenteral nutrition (TPN) service was established in Oxford in 1978 and the results of the first 3 years were published in 1983. Since then the service has provided intravenous nutritional support to an increasing number of patients, representing a considerable and increasing financial burden on the constrained hospital budget. To assess whether this expansion is justified, and whether regular review has improved the care given to patients, a further audit has been performed for the ...

  12. Long-term clinical result of posterior cruciate ligament retaining total knee arthropinsty:15 years follow-up study%膝关节后交叉韧带保留型假体置换术15年远期疗效研究

    Institute of Scientific and Technical Information of China (English)

    郭林; 杨柳; Jean Louis Briard; 段小军; 陈光兴; 戴刚

    2008-01-01

    Objective To evaluate the long-term clinical result and reason of failure of posterior cruciate ligament(PCL)preserved prosthesis in a 15 years of follow-up study.nethods A case series of 153 patients(178 knees)undergoing total knee arthroplasty(TKA)with PCL preserved prosthesis between September 1990 and March 1992 in Center Medico-Chirurgical du Cedre wag reported.All cases were evaluated with postoperative roentgenogram and Keen Society Clinical Scale.Measurement of X-ray included average hip knee ankle angle(HKA),deviation of HKA,α angle,B angle,index of patella(AP/AT),proximal tibia angle(PTA).et al.Results Thirty-one patients died and 4 patients were lost at the time follow-up.And 118 patients(125 knees)out of 153 patients were successfully followed-up.Fifteen years survival rate was 93.7%.And 11 knees were revised and the reasons were as foUow:9 aseptic loosening(7knees with severe osteolysis,2 knees with radiolucent line around tibial prosthesis);1 recurvatum,1 medial tibial plateau collapse.Postoperative score was 173 points.And 95.9%patients got good or excellent result.Comparing the clinical data of revised patients and unrevised patients.there were obvious difference between the following clinical data:varus and valgus angel of contralateral knee,B angle of preoperative AP roentgenogram,preoperative and postoperative Knee Society Clinical Scale(P<0.05).Conclusions PCL preserved prosthesis could recover the knee function to good or excellent result.Sunrival rate over 15 years is good.The way to sterilize the prosthesis could be the main reason for surgery failure.Few failures are related to PCL rupture.High wear rate and patellofemoral syndrome could be avoided by correct PCL and soft tissue balancing.Varus and valgus deformity of unaurgeried knee and tibial varus deformity of surgeried knee could be important factors for prosthesis failure.%目的 针对后交叉韧带(posterior cruciate ligament,PCL)保留型膝关节假体置换术进行15年以

  13. The technology behind Colgate Total Advanced Fresh.

    Science.gov (United States)

    Williams, Malcolm I; Cummins, Diane

    2003-09-01

    In the early 1990s, a breakthrough toothpaste, Colgate Total, was launched with documented long-lasting activity against plaque, gingivitis, calculus, tooth decay, and bad breath. The technology behind this toothpaste is the combination of triclosan, a polyvinylmethylether/maleic acid copolymer, and sodium fluoride. The copolymer ensures maximal oral retention and subsequent release of the antibacterial triclosan. Effective levels of triclosan have been observed in the oral cavity 12 hours after brushing the teeth, allowing prolonged control of oral bacteria that may cause the most common dental problems, including bad breath. Similarly, the enhanced retention of triclosan to oral surfaces after using this revolutionary toothpaste for up to 2 years has led to significantly reduced incremental coronal caries compared to an American Dental Association-Approved anticavity fluoride toothpaste. Furthermore, significantly less calcium remained in dental plaque after brushing the teeth with the triclosan/copolymer toothpaste, resulting in the formation of less tartar. In keeping with the multiple oral health benefits provided by Colgate Total, consumers are now offered a new dentifrice, Colgate Total Advanced Fresh, which provides the numerous therapeutic and esthetic benefits that are the hallmark of Colgate Total. The new dentifrice, which contains an impactful breath-freshening flavor, has been documented to provide sustained control of bad breath over 12 hours.

  14. Improved selection in totally monotone arrays

    Energy Technology Data Exchange (ETDEWEB)

    Mansour, Y. (Harvard Univ., Cambridge, MA (United States). Aiken Computation Lab.); Park, J.K. (Sandia National Labs., Albuquerque, NM (United States)); Schieber, B. (International Business Machines Corp., Yorktown Heights, NY (United States). Thomas J. Watson Research Center); Sen, S. (AT and T Bell Labs., Murray Hill, NJ (United States))

    1991-01-01

    This paper's main result is an O(({radical}{bar m}lgm)(n lg n) + mlg n)-time algorithm for computing the kth smallest entry in each row of an m {times} n totally monotone array. (A two-dimensional A = a(i,j) is totally monotone if for all i{sub 1} < i{sub 2} and j{sub 1} < j{sup 2}, < a(i{sub 1},j{sub 2}) implies a(i{sub 2},j{sub 1})). For large values of k (in particular, for k=(n/2)), this algorithm is significantly faster than the O(k(m+n))-time algorithm for the same problem due to Kravets and Park. An immediate consequence of this result is an O(n{sup 3/2} lg{sup 2}n)-time algorithm for computing the kth nearest neighbor of each vertex of a convex n-gon. In addition to the main result, we also give an O(n lg m)-time algorithm for computing an approximate median in each row of an m {times} n totally monotone array; this approximate median is an entry whose rank in its row lies between (n/4) and (3n/4) {minus} 1. 20 refs., 3 figs.

  15. 旋转平台后交叉韧带保留型与替代型人工膝关节置换术短期疗效比较%Comparison of the cruciate-retaining rotating-platform and cruciate-substituting rotating-platform prostheses in total knee arthroplasty:a short-term result

    Institute of Scientific and Technical Information of China (English)

    柴伟; 任鹏; 陈继营; 周勇刚; 张国强; 倪明; 李想; 王岩

    2015-01-01

    背景:目前,国内外文献对后交叉韧带替代型旋转平台应用的报道较多,且其疗效良好.而后交叉韧带保留型旋转平台的临床、运动学研究均较少.目的:比较人工膝关节置换术中使用旋转平台后交叉韧带保留型假体和旋转平台后交叉韧带替代型假体的短期疗效.方法:回顾分析2011年6月至2013年1月我科两位高年资医师进行的人工膝关节置换术的病例资料.其中使用旋转平台后交叉韧带保留型假体,并最终纳入研究的患者80例(106膝);使用旋转平台后交叉韧带替代型假体并纳入研究的78例(108膝).两组患者均于术后3个月、6个月、1年、1年半、2年、3年进行随访.记录患者膝关节HSS评分、膝关节活动度,以及衬垫脱位等并发症.影像学检查假体移位、松动征象及骨溶解、假体周围放射性透亮线.结果:平均随访时间2.2年.两组患者末次随访时膝关节HSS评分和膝关节活动度均较术前明显改善,但组间无显著统计学差异(P>0.05).所有患者均未发生衬垫脱位.X线检查未发现假体移位、松动及骨溶解,两组患者各有3例膝关节出现局限于1区的不超过1 mm的放射性透亮线.结论:人工膝关节置换术使用旋转平台时,无论对后交叉韧带进行保留还是替代,均能获得良好的术后效果,两者短期临床及影像学结果无差异.保留后交叉韧带时,常需要对后交叉韧带进行平衡.%Background:There have been many reports on posterior cruciate-substituting rotating-platform prosthesis used in total knee arthroplasty (TKA) and clinical outcomes are good. But there are few of clinical and on kinematic studies on posterior cruci-ate-retaining rotating-platform prosthesis. Objective:To compare clinical and radiographic results between posterior cruciate-retaining rotating-platform and posterior cruciate-substituting rotating-platform used in TKAs. Methods:Clinical data of patients who underwent

  16. Asymmetric total synthesis of vindoline.

    Science.gov (United States)

    Kato, Daisuke; Sasaki, Yoshikazu; Boger, Dale L

    2010-03-24

    A concise asymmetric total synthesis of (-)-vindoline (1) is detailed based on a tandem intramolecular [4+2]/[3+2] cycloaddition cascade of a 1,3,4-oxadiazole inspired by the natural product structure, in which the tether linking the initiating dienophile and oxadiazole bears a chiral substituent that controls the facial selectivity of the initiating Diels-Alder reaction and sets absolute stereochemistry of the remaining six stereocenters in the cascade cycloadduct. This key reaction introduces three rings and four C-C bonds central to the pentacyclic ring system setting all six stereocenters and introducing essentially all the functionality found in the natural product in a single step. Implementation of the approach also required the development of a unique ring expansion reaction to provide a six-membered ring suitably functionalized for introduction of the Delta (6, 7)-double bond found in the core structure of vindoline and defined our use of a protected hydroxymethyl group as the substituent used to control the stereochemical course of the cycloaddition cascade.

  17. Influence of the insert design on clinical results and kinematics of the knee after total knee arthroplasty%垫片改良设计对膝关节置换术后临床功能和膝关节运动的影响

    Institute of Scientific and Technical Information of China (English)

    及松洁; 周一新; 李玉军; 刘庆华; 黄野

    2010-01-01

    Objective To investigate the influence of the insert design of knee prosthesis on clinical results and kinematics of the knee after total knee arthroplasty (TKA). Methods Forty-two knees in 28 patients with knee osteoarthritis undergoing TKA using the GENESIS Ⅱ from July 2007 to June 2009 were included in this study, mean follow-up of 27.7 months. The cases were divided into 2 groups according to the type of insert, one was high flexion insert group (23 knees) and the other was standard insert group (19 knees). Two groups were compared by clinical ratings of knee function. The motion of flexion and extension of the two groups was observed by cyclic fluoroscopy and the data was analyzed by mapping software. The influence of the insert design of knee prosthesis on kinematics of the knee after TKA was investigated by comparing the parameters of the two groups during the movement of knee joint, including femoral roll back and extensor mechanism arm. Results The range of motion of standard insert group and high flexion insert group was 120° and 123° respectively with no difference between them. There was no difference of knee society clinical rating system in both groups. Feller score of high flexion insert group was higher than the standard insert group, the difference was significant statistically (P =0.012). In the imaging measurement, the two groups had no differences in femoral rollback and extensor mechanism arm during the 0 to 120° range of movement. The two groups appeared significant statistically (P = 0.034) in the extensor mechanism arm when flexion extended to 130°. Conclusions The high flexion improved design may play a certain role on reducing anterior knee pain and improving knee function after TKA. However, the improved design may be reduced the extensor mechanism arm when high flexion, so that affecting the work ablility of quadriceps.%目的 探讨膝关节假体垫片设计对膝关节置换术后临床功能和膝

  18. Sign variation, the Grassmannian, and total positivity

    CERN Document Server

    Karp, Steven N

    2016-01-01

    The totally nonnegative Grassmannian is the set of k-dimensional subspaces V of R^n whose nonzero Pluecker coordinates all have the same sign. Gantmakher and Krein (1950) and Schoenberg and Whitney (1951) independently showed that V is totally nonnegative iff every vector in V, when viewed as a sequence of n numbers and ignoring any zeros, changes sign at most k-1 times. We generalize this result from the totally nonnegative Grassmannian to the entire Grassmannian, showing that if V is generic (i.e. has no zero Pluecker coordinates), then the vectors in V change sign at most m times iff certain sequences of Pluecker coordinates of V change sign at most m-k+1 times. We also give an algorithm which, given a non-generic V whose vectors change sign at most m times, perturbs V into a generic subspace whose vectors also change sign at most m times. We deduce that among all V whose vectors change sign at most m times, the generic subspaces are dense. These results generalize to oriented matroids. As an application o...

  19. Total Phosphorus in Surface Water

    Data.gov (United States)

    U.S. Environmental Protection Agency — Excess phosphorus in surface water can result in eutrophication. TOTALP is reported in kilograms/hectare/year. More information about these resources, including the...

  20. Total Nitrogen in Surface Water

    Data.gov (United States)

    U.S. Environmental Protection Agency — Excess nitrogen in surface water can result in eutrophication. TOTALN is reported in kilograms/hectare/year. More information about these resources, including the...

  1. Total positive curvature of circular DNA

    DEFF Research Database (Denmark)

    Bohr, Jakob; Olsen, Kasper Wibeck

    2013-01-01

    molecules, e.g., plasmids, it is shown to have implications for the total positive curvature integral. For small circular micro-DNAs it follows as a consequence of Fenchel's inequality that there must exist a minimum length for the circular plasmids to be double stranded. It also follows that all circular...... micro-DNAs longer than the minimum length must be concave, a result that is consistent with typical atomic force microscopy images of plasmids. Predictions for the total positive curvature of circular micro-DNAs are given as a function of length, and comparisons with circular DNAs from the literature......The properties of double-stranded DNA and other chiral molecules depend on the local geometry, i.e., on curvature and torsion, yet the paths of closed chain molecules are globally restricted by topology. When both of these characteristics are to be incorporated in the description of circular chain...

  2. Total quality management: achieving service excellence.

    Science.gov (United States)

    Adelson, R

    1997-01-01

    Total Quality Management (TQM) provides a philosophy and a method for organizational renewal and redesign. It is based on the principle that productive work is accomplished through processes. Improving these processes requires the office team to objectively measure performance, discover root causes of problems, take corrective action, determine the effect of these actions, and secure achievements. TQM is a technique that provides a series of steps and set of tools. Through staff involvement and a desire for quality improvement, organizations involved in total quality note the accompanying satisfaction in taking constructive action, improving patient relations, and achieving service excellence. In today's competitive delivery environment, implementation of TQM can result in more satisfied patients, higher staff morale, and a more effective office team.

  3. Total variation projection with first order schemes.

    Science.gov (United States)

    Fadili, Jalal M; Peyre, Gabriel

    2011-03-01

    This article proposes a new algorithm to compute the projection on the set of images whose total variation is bounded by a constant. The projection is computed through a dual formulation that is solved by first order non-smooth optimization methods. This yields an iterative algorithm that applies iterative soft thresholding to the dual vector field, and for which we establish convergence rate on the primal iterates. This projection algorithm can then be used as a building block in a variety of applications such as solving inverse problems under a total variation constraint, or for texture synthesis. Numerical results are reported to illustrate the usefulness and potential applicability of our TV projection algorithm on various examples including denoising, texture synthesis, inpainting, deconvolution and tomography problems. We also show that our projection algorithm competes favorably with state-of-the-art TV projection methods in terms of convergence speed.

  4. Total gastrectomy for non-neoplastic diseases

    DEFF Research Database (Denmark)

    Bjorn, Niels; Ainsworth, Alan Patrick; Mortensen, Michael Bau

    2017-01-01

    Background: The aim of this study was to describe patients who had total gastrectomy for non-neoplastic diseases within a well-defined geographical area. Material and Methods: Retrospective study of patients who had gastrectomy for a non-neoplastic disease at the Department of Surgery, Odense...... University Hospital from 1 January 2005 to 31 December 2014. Results: A total of 268 gastrectomies were performed with the 10-year period. Of these, ten (4%) were done for non-neoplastic diseases. Two were men and eight women with a median age of 51 years (range 31 to 96 years). Six had emergency surgery...... and four were planned procedures. Four patients had no complications following surgery, whereas severe complications where seen in 6 patients, where anastomotic leakage occurred in 3 patients. Median length of postoperative stay was 21 days (range 6 to 98 days), and the 30-days and 90-days mortality was 1...

  5. Total joint replacement preadmission programs.

    Science.gov (United States)

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems.

  6. Total irregular labeling of butterfly network on level two

    Science.gov (United States)

    Nurdin

    2017-08-01

    Previous results related to the concepts of the total irregular labeling of a graph indicate that the butterfly network was one of some graphs which have not been specified in term of the total irregularity strengths. This paper aimed to determine the total vertex irregularity strength, the total edge irregularity strength, and the total irregularity strength of butterfly network on level 2. The assessment of three parameters of butterfly network was conducted by determining the lower bound and the upper bound. The lower bound was analyzed based on the characteristics of the graph and other proponent theorems, while upper bound was analyzed by constructing a function. In this paper we determine that the total vertex irregularity strength, the total edge irregularity strength, and the total irregularity strength of butterfly network are 4, 6, and 6, respectively.

  7. Total and ionization cross sections of electron scattering by fluorocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Antony, B K [Department of Physics, Sardar Patel University, Vallabh Vidyanagar-388 120, Gujarat (India); Joshipura, K N [Department of Physics, Sardar Patel University, Vallabh Vidyanagar-388 120, Gujarat (India); Mason, N J [Department of Physics and Astronomy, Open University, Milton Keynes-MK7 6AA (United Kingdom)

    2005-02-14

    Electron impact total cross sections (50-2000 eV) and total ionization cross sections (threshold to 2000 eV) are calculated for typical plasma etching molecules CF{sub 4}, C{sub 2}F{sub 4}, C{sub 2}F{sub 6}, C{sub 3}F{sub 8} and CF{sub 3}I and the CF{sub x} (x 1-3) radicals. The total elastic and inelastic cross sections are determined in the spherical complex potential formalism. The sum of the two gives the total cross section and the total inelastic cross section is used to calculate the total ionization cross sections. The present total and ionization cross sections are found to be consistent with other theories and experimental measurements, where they exist. Our total cross section results for CF{sub x} (x = 1-3) radicals presented here are first estimates on these species.

  8. Educational Needs of Patients Undergoing Total Joint Arthroplasty

    Science.gov (United States)

    MacKay, Crystal; Saryeddine, Tina; Davis, Aileen M.; Flannery, John F.; Jaglal, Susan B.; Levy, Charissa; Mahomed, Nizar

    2010-01-01

    ABSTRACT Purpose: To identify the educational needs of adults who undergo total hip and total knee replacement surgery. Methods: A qualitative research design using a semi-standardized interviewing method was employed. A purposive sampling technique was used to recruit participants, who were eligible if they were scheduled to undergo total hip or total knee replacement or had undergone total hip or total knee replacement in the previous 3 to 6 months. A comparative contrast method of analysis was used. Results: Of 22 potential participants who were approached, 15 participated. Five were booked for upcoming total hip or total knee replacement and 10 had undergone at least one total hip or total knee replacement in the previous 3 to 6 months. Several themes related to specific educational needs and factors affecting educational needs, including access, preoperative phase, surgery and medical recovery, rehabilitation process and functional recovery, fears, and expectations counterbalanced with responsibility, emerged from the interviews. Conclusions: Educational needs of adults who undergo total hip and knee replacement surgery encompass a broad range of topics, confirming the importance of offering an all-inclusive information package regarding total hip and total knee replacement. PMID:21629598

  9. What Is a Total Artificial Heart?

    Science.gov (United States)

    ... the NHLBI on Twitter. What Is a Total Artificial Heart? A total artificial heart (TAH) is a device ... outside power source. Normal Heart and CardioWest Total Artificial Heart Figure A shows the normal structure and location ...

  10. Total Petroleum Hydrocarbons (TPH): ToxFAQs

    Science.gov (United States)

    ... a state: This map displays locations where Total Petroleum Hydrocarbons (TPH) is known to be present. On ... I get more information? ToxFAQs TM for Total Petroleum Hydrocarbons (TPH) ( Hidrocarburos Totales de Petróleo (TPH) ) August ...

  11. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  12. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  13. Outcome after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig

    2015-01-01

    (126 primary and 41 revision TEAs) in 141 patients were evaluated with patient-reported outcome measure by the Oxford Elbow Score (OES) and clinically assessed with the Mayo Elbow Performance Score (MEPS), range of motion (ROM), and standard radiographs. RESULTS: The mean follow-up was 10.5 years...... to the evaluations of the outcome after TEA surgery with a nuanced picture of the patient's perception....

  14. Total synthesis of the indolizidine alkaloid tashiromine

    Directory of Open Access Journals (Sweden)

    McElhinney Alison D

    2008-01-01

    Full Text Available Abstract Background Tashiromine 1 is a naturally occurring indolizidine alkaloid. It has been the subject of thirteen successful total syntheses to date. Our own approach centres on the stereoselective construction of the indolizidine core by capture of an electrophilic acyliminium species by a pendant allylsilane. The key cyclisation precursor is constructed using olefin cross-metathesis chemistry, which has the potential to facilitate both racemic and asymmetric approaches, depending upon the choice of the allylsilane metathesis partner. Results The use of the allyltrimethylsilane cross-metathesis approach enables the rapid construction of the key cyclisation precursor 3 (3 steps from commercial materials, which undergoes acid-induced cyclisation to give the desired bicyclic indolizidine skeleton as a 96:4 mixture of diastereomers. Simple functional group interconversions allowed the completion of the total synthesis of racemic tashiromine in six steps (19% overall yield. Three chiral α-alkoxyallylsilanes (12,14 and 15 were prepared in enantioenriched form and their cross-metathesis reactions studied as part of a putative asymmetric approach to tashiromine. In the event, α-hydroxysilane 12 underwent isomerisation under the reaction conditions to acylsilane 17, while silanes 14 and 15 were unreactive towards metathesis. Conclusion A concise, stereoselective total synthesis of racemic tashiromine has been developed. Attempts to translate this into an asymmetric synthesis have thus far been unsuccessful.

  15. MAJOR HEPATIC RESECTION UNDER TOTAL VASCULAR EXCLUSION

    Institute of Scientific and Technical Information of China (English)

    季加孚; 顾晋; 苏向前; 焦春雨; 王怡; 欧阳晓辉; 董培德; 杨成旺

    2001-01-01

    Objective: To eveluate major liver resections with vascular exclusion (TVE) in patients with hepatocellular carcinoma (HCC). Methods: Sixteen consecutive, major liver resections performed with TVE in HCC patients were analyzed retrospectively. The patients' mean ages were 54 years. Ten patients had cirrhosis and eleven patients had chronic hepatitis B. Results: There was no perioperative death and the mean hospital stay was 20 days and the average amount of intraoperative blood transfusion was 400 mL (range 0-2000 mL). Forty-four percent of the patients did not receive intraoperative blood transfusion. The mean total bilirubin(T-BIL) and aspartate aminotransferase (AST) were 24μmol/L (range 8-56μmol/L) and 56 IU/L (range 10-204 IU/L) measured prior to discharge. Conclusion: In our experience, total vascular exclusion is invaluable in major or difficult liver resections, especially when lesions adjacent to the hepatic veins and vena cava. It is associated with a low blood transfusion requirement and a low incidence of complications. It further obviates the need for dissection of the porta hepatis thus reduces the associated risks. Total vascular exclusion time of 30min appears to be well tolerated, even in patients with cirrhosis..

  16. Asthma and atopy - a total genome scan for susceptibility genes

    DEFF Research Database (Denmark)

    Haagerup, A; Bjerke, T; Schiøtz, P O;

    2002-01-01

    atopy, allergic asthma and increased total IgE. We performed a total genome scan using 446 microsatellite markers and obtained nonparametric linkage results from the MAPMAKER/SIBS computer program. RESULTS: Our study revealed four candidate regions (MLS > 2) on chromosome 1p36, 3q21-q22, 5q31 and 6p24-p...

  17. MINIMALLY INVASIVE TOTAL KNEE ARTHROPLASTY.

    Directory of Open Access Journals (Sweden)

    Pencho Kosev

    2015-03-01

    Full Text Available We present our experience with the MIS TKA through a mid-vastus approach. The indications and contraindications of the technique are discussed. Our series include 104 patients. The Knee Society Score is used to rate the results. The average KSS score on 6-th month is 89 points. Eleven patients had skin necrosis. Eight had transient stiffness. One developed late infection. The MIS-TKA is recommended for selected patients and must be performed by an experienced surgeon and prepared team.

  18. On the total variation dictionary model.

    Science.gov (United States)

    Zeng, Tieyong; Ng, Michael K

    2010-03-01

    The goal of this paper is to provide a theoretical study of a total variation (TV) dictionary model. Based on the properties of convex analysis and bounded variation functions, the existence of solutions of the TV dictionary model is proved. We then show that the dual form of the model can be given by the minimization of the sum of the l(1) -norm of the dual solution and the Bregman distance between the curvature of the primal solution and the subdifferential of TV norm of the dual solution. This theoretical result suggests that the dictionary must represent sparsely the curvatures of solution image in order to obtain a better denoising performance.

  19. Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

    Directory of Open Access Journals (Sweden)

    S. O'hEireamhoin

    2011-01-01

    Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

  20. Extensor mechanism allograft in total knee arthroplasty

    Science.gov (United States)

    Helito, Camilo Partezani; Gobbi, Riccardo Gomes; Tozi, Mateus Ramos; Félix, Alessandro Monterroso; Angelini, Fábio Janson; Pécora, José Ricardo

    2013-01-01

    Objective To analyze the experience with allograft transplantation of the extensor mechanism in total knee arthroplasty and compare results with the international experience. Methods We retrospectively evaluated three cases of extensor mechanism allograft after total knee arthroplasty performed in our hospital with the aid of one of the few tissue banks in Brazil and attempt to establish whether our experiences were similar to others reported in the world literature regarding patient indication, techniques, and outcomes. Results Two cases went well with the adopted procedure, and one case showed bad results and progressed to amputation. As shown in the literature, the adequate tension of the graft, appropriate tibial fixation and especially the adequate patient selection are the better predictors of good outcomes. Previous chronic infection can be an unfavorable predictor. Conclusion This surgical procedure has precise indication, albeit uncommon, either because of the rarity of the problem or because of the low availability of allografts, due to the scarcity of tissue banks in Brazil. Level of Evidence IV, Case Series. PMID:24453688

  1. Cortical bone total ossicular replacement prosthesis

    Directory of Open Access Journals (Sweden)

    Manu Malhotra

    2014-01-01

    Full Text Available Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P 0.5. Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

  2. Transanal total mesorectal excision - a systematic review

    DEFF Research Database (Denmark)

    Bjørn, Maya Xania; Perdawood, Sharaf Karim

    2015-01-01

    of the dissection. We aimed to evaluate the literature on TaTME. METHODS: We performed a systematic search of the literature in the PubMed and Embase databases. Both authors assessed the studies. All publications on TaTME were included with the exception of review articles. RESULTS: A total of 29 studies (336...... patients) were included. Only low-quality evidence is available, and the literature consists of case reports and case series. Studies represent the initial experience of surgeons/centres. No precise indication for TaTME is yet specified other than the presence of mid and low rectal tumours, although...... the potential advantages seem to be related to a bulky mesorectum in the male pelvis. The preliminary results are encouraging and the most serious complication is urethral injury. The oncological results are acceptable, although the follow-up is short. CONCLUSION: TaTME is a feasible approach for mid and low...

  3. Drain tip culture following total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Bahubali Aski

    2015-02-01

    Full Text Available Background: Placing a suction drain following total knee replacement is usual practice which is been followed by many surgeons. Closed suction drainage following arthroplasty is a routine with the aim of preventing wound hematoma and thereby reducing the risk of infection. Surgical site infections in orthopaedic surgeries are disastrous and often lead to significant morbidity and mortality. Usefulness of drain tip culture in predicting the wound infection is been tested but results are controversial. Methods: It is a prospective study of 546 drains (352 patients who underwent unilateral or bilateral Total Knee Arthroplasty (TKA. The drain tip was sent for culture at the time of removing. Cultures from the SSI (surgical site infection were also collected. Cases that had at least six months of follow up were included in the study. However in one patient with superficial infection, the drain tip culture was negative. Results: Drain tip culture was positive in total of 18 patients. Three patients had developed deep infection and 10 patients had superficial infection. All three patients with deep infection and 9 out of 10 patients of superficial infection were culture positive. Out of 8 culture positive superficial infections, one had different bacteria identified from the site. Drain tip culture was positive in 3.39% of drains and infection rate was positive in 1.88% of wounds. On statistical analysis we found drain tip culture sensitivity of 90%, specificity of 98.46%, positive predictive value of 52.9% and negative predictive value of 99.8%. Conclusion: Drain tip culture positivity helps in predicting the future chance of developing the infection. If drain tip culture is negative, then there is almost near nil chances of infection. [Int J Res Med Sci 2015; 3(2.000: 409-411

  4. Assessment of total efficiency in adiabatic engines

    Science.gov (United States)

    Mitianiec, W.

    2016-09-01

    The paper presents influence of ceramic coating in all surfaces of the combustion chamber of SI four-stroke engine on working parameters mainly on heat balance and total efficiency. Three cases of engine were considered: standard without ceramic coating, fully adiabatic combustion chamber and engine with different thickness of ceramic coating. Consideration of adiabatic or semi-adiabatic engine was connected with mathematical modelling of heat transfer from the cylinder gas to the cooling medium. This model takes into account changeable convection coefficient based on the experimental formulas of Woschni, heat conductivity of multi-layer walls and also small effect of radiation in SI engines. The simulation model was elaborated with full heat transfer to the cooling medium and unsteady gas flow in the engine intake and exhaust systems. The computer program taking into account 0D model of engine processes in the cylinder and 1D model of gas flow was elaborated for determination of many basic engine thermodynamic parameters for Suzuki DR-Z400S 400 cc SI engine. The paper presents calculation results of influence of the ceramic coating thickness on indicated pressure, specific fuel consumption, cooling and exhaust heat losses. Next it were presented comparisons of effective power, heat losses in the cooling and exhaust systems, total efficiency in function of engine rotational speed and also comparison of temperature inside the cylinder for standard, semi-adiabatic and full adiabatic engine. On the basis of the achieved results it was found higher total efficiency of adiabatic engines at 2500 rpm from 27% for standard engine to 37% for full adiabatic engine.

  5. Total cross sections for neutron scattering

    Science.gov (United States)

    Chinn, C. R.; Elster, Ch.; Thaler, R. M.; Weppner, S. P.

    1995-02-01

    Measurements of neutron total cross sections are both extensive and extremely accurate. Although they place a strong constraint on theoretically constructed models, there are relatively few comparisons of predictions with experiment. The total cross sections for neutron scattering from 16O and 40Ca are calculated as a function of energy from 50 to 700 MeV laboratory energy with a microscopic first-order optical potential derived within the framework of the Watson expansion. Although these results are aleady in qualitative agreement with the data, the inclusion of medium corrections to the propagator is essential to correctly predict the energy dependence given by the experiment. In the region between 100 and 200 MeV, where off-shell tρ calculations for both 16O and 40Ca overpredict the experiment, the modification due to the nuclear medium reduces the calculated values. Above 300 MeV these corrections are very small and depending on the employed nuclear mean field tend to compensate for the underprediction of the off-shell tρ results.

  6. Total cross sections for neutron scattering

    Energy Technology Data Exchange (ETDEWEB)

    Chinn, C.R.; Elster, C.; Thaler, R.M.; Weppner, S.P. (Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee 37235 (United States) Center for Computationally Intensive Physics, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States) Institute of Nuclear Particle Physics and Department of Physics, Ohio University, Athens, Ohio 45701 (United States) Physics Department, Case Western Reserve University, Cleveland, Ohio 44106 (United States))

    1995-02-01

    Measurements of neutron total cross sections are both extensive and extremely accurate. Although they place a strong constraint on theoretically constructed models, there are relatively few comparisons of predictions with experiment. The total cross sections for neutron scattering from [sup 16]O and [sup 40]Ca are calculated as a function of energy from 50 to 700 MeV laboratory energy with a microscopic first-order optical potential derived within the framework of the Watson expansion. Although these results are aleady in qualitative agreement with the data, the inclusion of medium corrections to the propagator is essential to correctly predict the energy dependence given by the experiment. In the region between 100 and 200 MeV, where off-shell [ital t][rho] calculations for both [sup 16]O and [sup 40]Ca overpredict the experiment, the modification due to the nuclear medium reduces the calculated values. Above 300 MeV these corrections are very small and depending on the employed nuclear mean field tend to compensate for the underprediction of the off-shell [ital t][rho] results.

  7. Results obtained in the intercomparison of dosimetry systems Total body organized by In 2012, the European Group for radiation dosimetry (EURADOS) has organized an intercomparison of systems; Resultados obtenidos en la intercomparacion de sistemas dosimetricos de cuerpo entero organizada pro Eurados (IC2012)

    Energy Technology Data Exchange (ETDEWEB)

    Casal Zamorano, E.; Soriano Cruz, A.; Alabau Albors, J.; Palma Copete, J. D.

    2013-07-01

    dosimetric full-length for photons, within the action on {sup h}armonization of the monitoring Individual of the radiation External{sup e}stablished by the group. 88 dosimetric systems, 75 30 institutions have participated in the intercomparison countries. Each participant has sent a group of 26 dosimeters which have been irradiated with various doses and radiation qualities. The overall results of the intercomparison were presented recently (1). This communication presents the results obtained by our Center. EURADOS (IC2012). (Author)

  8. Intermediate follow-up results after treatment of secondary ankle arthritis with the agility total ankle system%全踝关节置换术治疗继发性踝关节炎的中期随访及疗效分析

    Institute of Scientific and Technical Information of China (English)

    杨述华; 许伟华; 杨操; 李进; 叶树楠; 叶哲伟; 吴星火; 张宇坤; 刘先哲

    2009-01-01

    目的 评估全踝关节置换术(total ankle replacement,TAR)治疗继发性踝关节炎的治疗效果.方法 回顾性分析1999年5月至2006年5月行TAR的18例患者,男2例,女16例;年龄52~66岁,平均61岁;病程9个月~18年.其中骨关节炎5例,创伤性关节炎9例,类风湿关节炎4例.患者均经保守治疗无效,且踝关节疼痛,活动障碍.术后患者定期随访,进行临床和影像学评估.结果 患者均获随访,随访时间2~9年,平均5.4年;其中16例获得满意疗效.依据美国矫形足踝协会(American orthopaedic foot and ankle society,AOFAS)评分标准评分,由术前的27~53分,平均(41.5±6.8)分,提高至术后的60~91分,平均(74.6±9.7)分,视觉模拟评分(vis-ual analogue scale,VAS)由术前的5~10分,平均(8.4±2.1)分改善至术后的1~4分,平均(2.3±0.9)分.无一例患者需行踝关节融合术或踝关节翻修术.影像学评估,16例假体位置稳定、无下沉迹象,2例在胫骨假体和骨质接触发生气球样骨溶解,但无任何症状.结论 TAR可用于治疗踝关节炎.尽管TAR的中期随访效果比较满意,但TAR仍属较新技术,其远期临床效果有待进一步随访评估.

  9. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

  10. Results of high intensity afterloading irradiation with 192 iridium in the therapy of genital tumors in women under different dose rates, fractionations and total doses in comparison with conventional radium contact irradiation. Ergebnisse der High-Intensity-Afterloadingbestrahlung mit 192 Iridium in der Therapie von Genitaltumoren der Frau unter verschiedenen Dosisleistungen, Fraktionierungen und Gesamtdosen im Vergleich mit konventioneller Radiumkontaktbestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Giers, G.

    1986-05-07

    In comparison to conventional radium therapy are to be evaluated the results of the high intensity afterloading technique with the help of the parameters survial rate and complication rate. Thereby were included in the examination 4 documentations of results (collum, cervix stump, corpus and vaginal carcinoma) with altogether 742 patients with 2806 single irradiations and an evaluation of the therapy after several modifications of the therapy schemes. The 5-year survival rate was in the case of collum carcinoma: 68.4%, cervix stump: 50%, corpus carcinoma: 76%, and vaginal carcinoma: 66.6%. The corresponding 3-year survival rates were: 74.2%, 80%, 84% and 70% with primary irradiation. Only with cervix stump carcinoma were the values for post-operative irradiation. The description of the irradiation results showed, that with the changing of the fractionation mode and the dose level in collum and corpus carcinoma the irreversible complications as an expression of the success of a new therapy were reduced. The for now best suited therapy schema (fractionation and dosing) are described. (TRV).

  11. Midterm Results of Total Hip Resurfacing Arthroplasty for Treatment of Developmental Dysplasia of the Hip%全髋关节表面置换术治疗成人髋关节发育不良25例中期随访

    Institute of Scientific and Technical Information of China (English)

    沈彬; 黄强; 杨静; 周宗科; 康鹏德; 裴福兴

    2009-01-01

    目的 探讨全髋关节表面置换术(total hip resurfacing arthroplasty,TUNA)治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)继发骨关节炎的中期疗效.方法 2005年3月至2006年6月,采用THRA治疗DDH患者25例,女18例,男7例;30~59岁,平均48岁;双髋1例,共26髋.根据Hartofilakidis分型,半脱位22髋,低位脱位4髋.采用Conservc-plus金属对金属全髋关节表面置换假体,髋臼假体为非骨水泥固定,股骨头假体采用低黏骨水泥固定.临床随访采用Harris评分,测量髋臼外展角、垂直距离、水平距离、股骨柄干角、髋臼假体覆盖率;记录髋臼和股骨假体周围透亮线及骨溶解;以各种原因所致翻修或影像学松动为随访终点.结果 所有患者均随访3年以上,平均随访3.5年.截至随访终点无翻修或影像学松动.患者的Harris评分由术前平均46分提高至术后平均92.1分,26髋均为优.术后轻度跛行2例,所有患者均无迟发感染、术后股骨颈骨折、术后残余股骨头坏死、术后假体松动、脱位、术后异位骨化.髋关节活动度:屈曲由97.5°增加至127.5°,外展由19.3°增加至40°,外旋由23.2°增加至42.5°,内旋由4.2°增加至28.5°.X线片显示:关节假体位置正常,髋臼假体平均外展角为41.6°,髋关节旋转中心位置平均下移6.2 mm、内移15 mm,股骨柄干角平均146.4°.宿主骨对臼杯的平均覆盖率为94.4%,1例宿主骨与臼杯界面在2区出现透亮线,宿主骨与股骨假体柄界面无一例出现透亮线.结论 THRA治疗成人半脱位型及低位脱位型DDH继发骨关节炎具有良好的中期疗效,熟练的手术技术和正确的适应证选择是降低中远期并发症的关键.

  12. A method comparison of total and HMW adiponectin: HMW/total adiponectin ratio varies versus total adiponectin, independent of clinical condition.

    Science.gov (United States)

    van Andel, Merel; Drent, Madeleine L; van Herwaarden, Antonius E; Ackermans, Mariëtte T; Heijboer, Annemieke C

    2017-02-01

    Total and high-molecular-weight (HMW) adiponectin have been associated with endocrine and cardiovascular pathology. As no gold standard is available, the discussion about biological relevance of isoforms is complicated. In our study we perform a method comparison between two commercially available assays measuring HMW and total adiponectin, in various patient groups, thus contributing further to this discussion. We determined levels of HMW and total adiponectin using assays by Lumipulse® and Millipore® respectively, in 126 patients with different clinical characteristics (n=29 healthy volunteers, n=22 dialysis patients, n=25 elderly with body mass index (BMI) adiponectin ratio varies with total adiponectin concentration independent of clinical conditions studied. Our results imply that total and HMW adiponectin have similar utility when assessing adiponectin levels in blood, as the ratio is independent of clinical condition. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Total: overview of the 2002 financial year; Total: panorama de l'exercice 2002

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2003-06-01

    In a globally less favourable environment than 2001, Total company (the former 'TotalFinaElf') succeeded in limiting the decay of its results thanks to the increase of its hydrocarbons production which reached the record level of 10% and to the implementation of its synergy and productivity programs. The three activity sectors of the group are: the upstream (exploration, production of hydrocarbons, gas electric power and other energies), the downstream (refining, distribution of petroleum products, special products, trading and shipping of crudes and products), and the chemistry (basic chemistry and big polymers, intermediate and performance polymers, special products). This article details the 2002 results of the group for the three sectors: upstream (exploration and development, reserves, production, natural gas sales), gas and electric power integration (Europe, Americas, Asia), electric power and cogeneration. (J.S.)

  14. Evaluation of total phosphorus and total nitrogen methods in pulp mill effluents.

    Science.gov (United States)

    Cook, D L; Frum, N L

    2004-01-01

    Under the Clean Water Action Plan, the US Environmental Protection Agency is requiring states to establish numeric criteria for phosphorus and nitrogen. In preparation for the development of nutrient criteria NCASI undertook a research project to conduct a comparative study of methods for the determination of total phosphorus and total nitrogen in pulp and paper mill matrices. This paper presents results of a single laboratory method evaluation and comparative study of digestion techniques and analytical methods for the determination of total phosphorus (TP) and total nitrogen (TN) in pulp and paper mill secondary treated effluents. Analytical methods included EPA Methods 365.2 and 365.4 for TP. TN and total kjeldahl nitrogen (TKN) methods included EPA Methods 351.2, 351.4, and 353.2. Examinations of sample preservation and storage stability were conducted. Substitution of mercuric sulfate with copper sulfate during block digestion resulted in higher blank levels and method detection limits. TP measurements using EPA Method 365.4 (autoanalyzer) were found to be accurate with a positive bias as determined using matrix spike experiments. Sample digestion by acidic persulfate oxidation or mercuric sulfate block digestion in conjunction with EPA Method 365.4 yielded low blank levels (averages of 0.01 and 0.02 mg/L, respectively), precision of 2.1 and 2.4% relative standard deviations, respectively, and accuracy expressed as an average recovery (%R) of 117% for both. EPA Method 351.2 (autoanalyzer) was more precise than EPA Method 351.4 (ammonia probe). Accuracy (%R) for EPA Method 351.2 ranged from 81 to 95%, depending on the digestion technique applied, and was 55% when EPA Method 351.4 was utilized. Investigation of a method utilizing basic to acidic persulfate oxidation for the simultaneous determination of TN and TP using only two analytical techniques was found to be effective at concentrations above 1 mg/L in pulp mill effluents.

  15. Deformation analysis with Total Least Squares

    Directory of Open Access Journals (Sweden)

    M. Acar

    2006-01-01

    Full Text Available Deformation analysis is one of the main research fields in geodesy. Deformation analysis process comprises measurement and analysis phases. Measurements can be collected using several techniques. The output of the evaluation of the measurements is mainly point positions. In the deformation analysis phase, the coordinate changes in the point positions are investigated. Several models or approaches can be employed for the analysis. One approach is based on a Helmert or similarity coordinate transformation where the displacements and the respective covariance matrix are transformed into a unique datum. Traditionally a Least Squares (LS technique is used for the transformation procedure. Another approach that could be introduced as an alternative methodology is the Total Least Squares (TLS that is considerably a new approach in geodetic applications. In this study, in order to determine point displacements, 3-D coordinate transformations based on the Helmert transformation model were carried out individually by the Least Squares (LS and the Total Least Squares (TLS, respectively. The data used in this study was collected by GPS technique in a landslide area located nearby Istanbul. The results obtained from these two approaches have been compared.

  16. Total body irradiation for children with malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Sanuki, Eiichi; Maeno, Toshio; Kamata, Rikisaburo; Tanaka, Yoshiaki; Mugishima, Hideo [Nihon Univ., Tokyo (Japan). School of Medicine

    1995-12-01

    Total body irradiation combined with high dose chemotherapy has been performed just before bone marrow transplantation in 35 children with advanced malignancies, with the object of achieving successful transplantation and improving the prognosis. Simulation was performed as follows: back scatter, flatness, dose accumulation using randophantom and dose distribution using a thermo-luminescence dosimeter and linac-graphy. The standard error of dose distribution was within 10%. In neuroblastoma, of which there were 14 cases in stage IV and one case in stage III, the 5-year survival rate was 55%. In leukemia, of which all cases were in the high-risk group (7 cases of acute lymphoblastic leukemia and 2 of acute myeloblastic leukemia) the 5-year survival rate was 55%. The 5 cases having first remission survived disease-free while the 4 cases having non-first remission died. In malignant lymphoma (6 cases in stage IV and one case in stage III, with bulky mass) the 5-year survival rate was 67%. Four cases with other diagnoses (severe aplastic anemia, and others) all survived. As yet no side effects resulting from total body irradiation have been recognized in our cases, but a longer follow-up period is necessary to observe possible late side effects. (author).

  17. Postoperative Autologous Reinfusion in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    A. Crescibene

    2015-01-01

    Full Text Available Surgeries for total knee replacement (TKR are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p=0.08 and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p=0.03. Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p<0.01, and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR.

  18. RESULTS RESULTING FROM AUTOFRETTAGE OF CYLINDER

    Institute of Scientific and Technical Information of China (English)

    ZHU Ruilin

    2008-01-01

    Autofrettage is used to introduce advantageous residual stresses into wall of a cylinder and to even distributions of total stresses. Basic theory on autofrettage has been functioning for several decades. It is necessary to reveal profound relations between parameters in the theory. Therefore, based on the 3rd strength theory, δei/δy, δei/δy, δei′/δy, δei′/δy and their relations, as well as p/δy, are studied under ideal conditions, where δei/δy is equivalent stress of total stresses at elastoplastic juncture/yield strength, δei/δy is equivalent stress of total stresses at inside surface/yield strength, δei′/δy is equivalent stress of residual stresses at elastoplastic juncture/yield strength, δei′/δy is equivalent stress of residual stresses at inside surface/yield strength, p/δy is load-bearing capacity of an autofrettaged cylinder/yield strength. Theoretical study on the parameters results in noticeable results and laws. The main idea is: to satisfy |δei′|=δy, the relation between kj and k is , where k is outside/inside radius ratio of a cylinder, kj is ratio of elastoplastic juncture radius to inside radius of a cylinder; when the plastic region covers the whole wall of a cylinder, for compressive yield not to occur after removing autofrettage pressure, the ultimate k is k=2.218 46, with k=2.218 46, a cylinder's ultimate load-bearing capacity equals its entire yield pressure, or =lnk; when kj≤=1.648 72, no matter how great k is, compressive yield never occurs after removing pa; the maximum and optimum load-bearing capacity of an autofrettaged cylinder is just two times the loading which an unautofrettaged cylinder can bear elastically, or , thus the limit of the load-bearing capacity of an autofrettaged cylinder is also just 2 times that of an unautofrettaged cylinder.

  19. Expanding Applicability of Total Artificial Heart Therapy: The 50-cc SynCardia Total Artificial Heart.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Guersoy, Dilek; Koerfer, Reiner; Tenderich, Gero

    2015-09-01

    The 50-cc SynCardia total artificial heart is designed to facilitate orthotopic replacement of the native ventricles in patients with a body surface area below 1.7 m(2) in need of long-term circulatory support as a result of end-stage biventricular heart failure. We describe the implementation of this technology in a female patient with irreversible cardiogenic shock on the grounds of acute myocardial infarction and chronic ischemic cardiomyopathy.

  20. Dislocated ankle fracture complicated by near total distal ischaemia

    Science.gov (United States)

    Duygun, Fatih; Sertkaya, Omer; Aldemir, Cengiz; Dogan, Ali

    2013-01-01

    Total arterial ischaemia is rarely seen following a dislocated ankle fracture but if it does and intervention is not made, it can lead to serious morbidity. We present a 39-year-old woman with almost total occlusion in the arteria tibialis and arteria dorsalis pedis following a dislocated ankle fracture as a result of a bicycle fall. PMID:24248319

  1. Total Quality Management Case Study in a Navy Headquarters Organization

    Science.gov (United States)

    1990-02-01

    This report documents the efforts of Fleet Support and Field Activity Management (AIR-04), Naval Air Systems Command, to implement Total Quality Management (TQM...immediate results, and documentation of future actions. Keywords: Total quality management ; Project action team; Continuous improvement; Special cause; Common cause; Control charts; Flow chart.

  2. Synovial hypertrophy causing recurrent hemarthrosis after total knee replacement.

    Science.gov (United States)

    Gajjar, Shreyash M; Platts, Andrew; Dowd, George

    2010-03-01

    Recurrent hemarthrosis following total knee replacement is relatively uncommon and can result from causes that may not always be easy to diagnose. We report three patients with late-onset recurrent hemarthrosis following total knee replacement due to synovial hypertrophy and impingement, which were successfully treated by embolization.

  3. Concentration and flux of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids for monitored tributaries of Lake Champlain, 1990-2012

    Science.gov (United States)

    Medalie, Laura

    2014-01-01

    Annual and daily concentrations and fluxes of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids were estimated for 18 monitored tributaries to Lake Champlain by using the Weighted Regressions on Time, Discharge, and Seasons regression model. Estimates were made for 21 or 23 years, depending on data availability, for the purpose of providing timely and accessible summary reports as stipulated in the 2010 update to the Lake Champlain “Opportunities for Action” management plan. Estimates of concentration and flux were provided for each tributary based on (1) observed daily discharges and (2) a flow-normalizing procedure, which removed the random fluctuations of climate-related variability. The flux bias statistic, an indicator of the ability of the Weighted Regressions on Time, Discharge, and Season regression models to provide accurate representations of flux, showed acceptable bias (less than ±10 percent) for 68 out of 72 models for total and dissolved phosphorus, total nitrogen, and chloride. Six out of 18 models for total suspended solids had moderate bias (between 10 and 30 percent), an expected result given the frequently nonlinear relation between total suspended solids and discharge. One model for total suspended solids with a very high bias was influenced by a single extreme value; however, removal of that value, although reducing the bias substantially, had little effect on annual fluxes.

  4. Analisis Total Zat Padat Terlarut (Total Dissolved Solid) Dan Total Zat Padat Trsuspensi (Total Suspended Solid) Pada Air Badan Air Khususnya Air Sungai

    OpenAIRE

    Saraswaty, Asri

    2015-01-01

    Total dissolved solids ( Total Dissolved Solid ) is a measure of the solute( both organic and inorganic , for example : salt , etc.) contained in the river water. The total suspended solids (Total Suspended Solid) are solids that are in suspension , can be distinguished according to their size as suspended colloidal particles (colloidal particles) and particles suspended regular (suspended particles). The purpose of to determine whether the water meets the river that were analyzed in accordan...

  5. 总前列腺特异性抗原在化学发光免疫检测系统间的可比性研究%Comparability Research on Results of Total Prostate-specific Antigen Between Chemiluminescence Immunoassay Systems

    Institute of Scientific and Technical Information of China (English)

    周俊; 宋超

    2013-01-01

    目的 探讨化学发光免疫分析系统测定PSA结果的可比性,为该项目推广互认提供依据.方法 选择Roche与Abbott Architect作为研究对象,通过比较各台仪器的正常人参考值以及健康人群P50、P95和P975来考虑两者是否具有可比性.随后6个月内跟踪6台检测系统的室内质控、进行40份不同浓度新鲜患者血清的比对、结合4年内35个批次的室间质评数据,综合分析两款检测系统在整体上与个体间的可比性和差异情况,并对照澳大利亚室间质评的相关要求来讨论两款检测系统间结果是否可以推广互认.结果 两款检测系统具有接近的健康人群参考范围;同款检测系统之间具有较好的一致性;不同款检测系统间则表现出整体一致性优于个体之间的一致性,且随实验室不同而表现出不同的差异率,部分差异超出了相关要求.结论 基于稳定的实验室室内质控和规范的校准条件下,两款检测系统在低浓度的结果可以推广互认,不同实验室的同款检测系统也满足推广互认的要求,但不同款的检测系统之间的互认尚存在不确定性,需进一步验证.%Objective To investigate and analyze the comparability of serum prostate - specific antigen measurements between automated chemiluminescence immunoassay systems. It is valuable to provide the basis for the mutual approval between laboratories on results. Methods Six systems from Roche and Abbott Architect in six laboratories were involved in this research. Normal reference ranges of each laboratory were compared to confirm that both two brands of systems are comparable. We measured PSA concentrations in each of 40 serum samples during six months and compared the results using various statistical methods. EQA data from National Center for Clinical Laboratory were analyzed to show the comparability between analyzer groups. Evaluation standards of Australia were used to measure whether these

  6. Environmental investigations. Main road reconstruction Oslo East. Traffic pollution and noise and self reporting symptoms for health and well-being. Total results from the cross section investigations for 1987, 1994 and 1996; Miljoeundersoekelsene hovedveiomlegging Oslo Oest. Trafikkforurensning og stoey og selvrapporterende symptomer paa helse og trivsel. Samlede resultater fra tverrsnittundersoekelsene for 1987, 1994 og 1996

    Energy Technology Data Exchange (ETDEWEB)

    Clench-Aas, Jocelyne; Bartonova, Alena

    1999-07-01

    The report describes the effects of exposure to NO{sub 2}, PM{sub 2}.5 and PM{sub 1}0 -{sub 2}.5 on symptoms of reduced health and well-being in adults living in the Vaalerenga/Gamlebyen area in Oslo. Results for some chronic diseases are also reported. In connection with measures taken in order to reduce the environmental burden in the study area, we show that reduced exposure to air pollutants (NO{sub 2} and PM{sub 2}.5) decreased the reporting of symptoms in the upper and lower airways and symptoms of general bad health. For these symptoms, dose-response functions are quantified. The effect of exposure to coarse particles is small, compared to NO{sub 2} and PM{sub 2}.5. Noise perturbs sleep significantly and leads to fatigue.

  7. Total Quality Management (TQM): Group Dynamics Workshop

    Science.gov (United States)

    1990-05-15

    TOTAL QUALITY MANAGEMENT (TQM) Group Dynamics Workshop © Copyright 1990 Booz*Allen & Hamilton... QUALITY MANAGEMENT (TQM) GROUP DYNAMICS COURSE -’ Total Quality Management * This course has been designed under the direction and approval of OASD (P...participants’ use of group dynamics skills as leaders and members of OSD TQM groups. Total Quality Management " Examples of such groups include

  8. Evolution of the total logistics costs concept

    Directory of Open Access Journals (Sweden)

    2011-09-01

    Full Text Available The article considers the evolution stages of the total logistics cost concept; an interrelations of TLC and EOQ models has been analyzed. The author presented analytical approaches to determine a value of total cost, as well as an integral criterion for logistics systems' functioning, based upon package treatment of the total costs value and service level.

  9. Total Ankle Arthroplasty: A Brief Review

    Directory of Open Access Journals (Sweden)

    Roger A. Mann

    2012-12-01

    Full Text Available Ankle fusion has long been the standard of treatment for end-stage ankle arthritis, and a successful arthroplasty has been a long sought alternative. It is a motion sparing procedure and may greatly reduce the potential for adjacent level degeneration as seen with arthrodesis. The typical candidate for arthroplasty is a healthy low demand patient, although the indications are widening as the success of the procedure has increased. Nevertheless, it is not fail-safe, technical expertise and experience are necessary to achieve a successful result. We have been treating ankle arthritis with the Scandinavian Total Ankle Replacement (STAR ankle replacement prosthesis for over ten years. We believe that arthroplasty will surpass arthrodesis as the standard of care for severe ankle arthritis.

  10. Total quality management in clinical virology laboratories.

    Science.gov (United States)

    Tibbets, M W; Gomez, R; Kannangai, R; Sridharan, G

    2006-10-01

    The diagnostic laboratories in India are progressively promoting higher standards and are moving towards accreditation and international acceptance. Hence, the concept of "Quality" will need to be understood and implemented. Total quality management (TQM) in a laboratory is an integrated program involving all laboratory staff and management. TQM is a framework to operate and it is aiming for integration, consistency, increase in efficiency and a continuous drive for improvement. A well structured clinical virology service will include serology setup, cell culture facility and capacity for molecular diagnosis. The quality of results from the laboratory is significantly influenced by many pre-analytical and post-analytical factors which needed attention. The end goal of the TQM should be to provide the best care possible for the patient.

  11. Web applications for total quality management.

    Science.gov (United States)

    Golaz, O; Hochstrasser, D

    1999-05-01

    Total quality management involves the consideration of many quality subjects as part of the management, such as quality processes, quality education, quality assurance, quality planning, quality results and quality document management. But crucial quality elements are also communication, data management and information sharing. Web applications and other associated computer communication applications such as E-mail and newsgroups, for example, offer to the laboratory environment the best tools to achieve proper communication and data management/sharing. These applications, enabling the set-up of Internet and Intranet sites, are used to share the information in the form of simple text pages or of completely interactive pages, which could comprise audio and video files, web page formulae and web data management applications. These applications are being associated to several applications and also being integrated into the laboratory information system (LIS).

  12. Antioxidant activity, total phenolic and total flavonoid contents of whole plant extracts Torilis leptophylla L

    Directory of Open Access Journals (Sweden)

    Saeed Naima

    2012-11-01

    Full Text Available Abstract Background The aim of this study was to screen various solvent extracts of whole plant of Torilis leptophylla to display potent antioxidant activity in vitro and in vivo, total phenolic and flavonoid contents in order to find possible sources for future novel antioxidants in food and pharmaceutical formulations. Material and methods A detailed study was performed on the antioxidant activity of the methanol extract of whole plant of Torilis leptophylla (TLM and its derived fractions {n-hexane (TLH, chloroform (TLC ethyl acetate (TLE n-butanol (TLB and residual aqueous fraction (TLA} by in vitro chemical analyses and carbon tetrachloride (CCl4 induced hepatic injuries (lipid peroxidation and glutathione contents in male Sprague-Dawley rat. The total yield, total phenolic (TPC and total flavonoid contents (TFC of all the fractions were also determined. TLM was also subjected to preliminary phytochemical screening test for various constituents. Results The total phenolic contents (TPC (121.9±3.1 mg GAE/g extract of TLM while total flavonoid contents (TFC of TLE (60.9 ±2.2 mg RTE/g extract were found significantly higher as compared to other solvent fractions. Phytochemical screening of TLM revealed the presence of alkaloids, anthraquinones, cardiac glycosides, coumarins, flavonoids, saponins, phlobatannins, tannins and terpenoids. The EC50 values based on the DPPH (41.0±1 μg/ml, ABTS (10.0±0.9 μg/ml and phosphomolybdate (10.7±2 μg/ml for TLB, hydroxyl radicals (8.0±1 μg/ml for TLC, superoxide radicals (57.0±0.3 μg/ml for TLM and hydrogen peroxide radicals (68.0±2 μg/ml for TLE were generally lower showing potential antioxidant properties. A significant but marginal positive correlation was found between TPC and EC50 values for DPPH, hydroxyl, phosphomolybdate and ABTS, whereas another weak and positive correlation was determined between TFC and EC50 values for superoxide anion and hydroxyl radicals. Results of in vivo

  13. Current trends in total hip arthroplasty.

    Science.gov (United States)

    Eingartner, Christoph

    2007-01-01

    After 20 years of application, with excellent short-term and long-term results, uncemented total hip arthroplasty (THA) is now generally regarded as the standard procedure for younger patients undergoing THA. However, expectations regarding hip replacement are continuously rising, along with the increasing number of young and active patients undergoing hip arthroplasty: a complication rate, including postoperative dislocation, close to zero, faster postoperative rehabilitation, low wear even in active patients, high durability and long term survival, etc. Demographic changes in aging societies are also leading to an increased need for cost-effective THA for the low-demand trauma patient. For high-demand patients, modern THA bearings, such as ceramic-ceramic articulations and other improved PE and metal materials, provide high durability and low wear, if the components are properly aligned. Navigation technology has been introduced in THA to ensure perfect component positioning without outliers and concomitant risk of increased wear and implant failure. Minimally and less invasive approaches are becoming increasingly popular in order to facilitate rehabilitation and fast-track surgery in younger patients. Navigation provides assistance for implant positioning in procedures with limited surgical exposure and visibility. New bone-preserving implants, such as surface replacement or short-stemmed femoral shaft prostheses, have been introduced especially for younger patients. Some of these new procedures are still under development,and the long-term results of new implant concepts have to be evaluated over the next decades. Not every modern concept will likely stand the test of time, but some will be beneficial for patients undergoing total hip arthroplasty in the future.

  14. Digital versus analogue preoperative planning of total hip arthroplasties - A randomized clinical trial of 210 total hip arthroplasties

    NARCIS (Netherlands)

    The, Bertram; Verdonschot, Nico; van Horn, Jim R.; van Ooijen, Peter M. A.; Diercks, Ron L.

    2007-01-01

    The objective of this randomized clinical trial was to compare the clinical and technical results of digital preoperative planning for primary total hip arthroplasties with analogue planning. Two hundred and ten total hip arthroplasties were randomized. All plans were constructed on standardized rad

  15. Total hemispherical emissivity of Inconel 718

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Benjamin P.; Nelson, Shawn E.; Walton, Kyle L.; Ghosh, Tushar K.; Tompson, Robert V.; Loyalka, Sudarshan K., E-mail: LoyalkaS@missouri.edu

    2015-06-15

    Highlights: • We have measured the total hemispherical emissivity for Inconel 718 from about 600–1250 K. • Oxidation in air at 1073 K resulted in an increase in emissivity. • Sandblasting of Inconel 718 was also observed to increase the emissivity. • Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase in the emissivity. • Coating of graphite powder onto the 220 grit sandblasted Inconel 718 did show an increase in emissivity. - Abstract: Total hemispherical emissivity for Inconel 718 was measured in anticipation of its application in Very High Temperature Gas Reactors (VHTRs). A majority of current emissivity data for Inconel 718 is in the form of spectral measurements. The data presented here were obtained with an experimental apparatus based on the standard ASTM C835-06 for total hemispherical emittance. Measurements of Inconel 718 were made for four different surface types including: (i) ‘as-received’ from the manufacturer, (ii) oxidized in air and humidified helium, (iii) sandblasted with aluminum oxide powder, and (iv) with a thin coating of nuclear grade graphite powder (grade NGB-18). The emissivity for the ‘as-received’ sample ranged from 0.21 to 0.28 in the temperature interval from 760 K to 1275 K. Oxidation in air at 1073 K resulted in an increase in emissivity into the range from 0.2 at 650 K to 0.52 at 1200 K. There was no dependence on the oxidation times studied here. Oxidation with humidified helium at 1073 K produced less of an increase in emissivity than the oxidation in air but there was an increase up to the range from 0.2 at 600 K to 0.35 at 1200 K. Sandblasting of Inconel 718 was also observed to increase the emissivity up to the range from 0.43 at 780 K to 0.53 at 1270 K when 60 grit sized powder was used and up to the range from 0.45 at 683 K to 0.57 at 1267 K when 120 and 220 grit sized powders were used. Coating of graphite powder onto the ‘as-received’ Inconel 718 showed no increase

  16. Dual mobility total hip replacement in a high risk population

    Science.gov (United States)

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  17. Dual mobility total hip replacement in a high risk population

    Directory of Open Access Journals (Sweden)

    Luthra Jatinder Singh

    2016-01-01

    Full Text Available Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

  18. Speech rehabilitation during the first year after total laryngectomy.

    Science.gov (United States)

    Singer, Susanne; Wollbrück, Dorit; Dietz, Andreas; Schock, Juliane; Pabst, Friedemann; Vogel, Hans-Joachim; Oeken, Jens; Sandner, Annett; Koscielny, Sven; Hormes, Karl; Breitenstein, Kerstin; Richter, Heike; Deckelmann, Andreas; Cook, Sarah; Fuchs, Michael; Meuret, Sylvia

    2013-11-01

    Gaining a new voice is one of the major aims after total laryngectomy. The objective of this study was to describe the process and results of speech rehabilitation during the first year after surgery. Speech intelligibility was measured 6 months (n = 273) and 1 year (n = 225) after total laryngectomy. Objective (23.4 to 47.5 points, p speech intelligibility improved between 6 months and 1 year after total laryngectomy. Patients who used tracheoesophageal puncture (TEP) had the best results in speech intelligibility 6 months and 1 year after total laryngectomy. In all, 12% of the patients who used TEP initially no longer used it 1 year later. Patients who had received rehabilitation had better objective speech intelligibility than those who did not. Speech improves considerably between 6 months and 1 year after total laryngectomy. Nonattendance of rehabilitation is associated with a worse functional outcome in speech rehabilitation. Copyright © 2012 Wiley Periodicals, Inc.

  19. 直接前入路微创髋关节置换学习曲线早期病例的短期结果%Primary total hip arthroplasty via minimally direct anterior approach:short-term results in cases of early learning curve

    Institute of Scientific and Technical Information of China (English)

    彭慧明; 钱文伟; 翁习生; 冯宾; 蒋超; 叶灿华; 肖刻

    2016-01-01

    Background:The direct anterior approach (DAA) is gaining popularity in the hip arthroplasty (THA). We still concern about the learning curve and early complications of this approach. Objective:To investigate short-term results and feasibility of THA via minimally invasive DAA. Methods:From April 2014 to September 2015, 17 patients underwent THA via minimally invasive DAA. There were 5 males and 12 females with an average age of 62.4 years (55-84 years). Their av-erage BMI was (23.9±4.5) kg/m2. Diagnosis included 2 cases of osteoarthritis, 7 of osteonecrosis, 3 of developmental dyspla-sia hip and 1 of ankylosing hip. ASA score was 1-2 points in 11 cases and 3 points in 6 cases. Preoperative average VAS score was 6±1.3 and Harris scale was 43.4±5. Operation time, intraoperative blood loss, length of incisions, hospitalization time, operation related complication, radiological outcomes and postoperative pain relief and function rehabilitation were an-alyzed. Results:We performed simultaneous bilateral THA for 3 patients, unilateral THA for 12 patients (6 in the left and 6 in the right) and femoral head replacement for 2 patients. All the operations were performed under general anesthesia and no special traction table was used. The average operation time and intraoperative blood loss was 140.7 min (90-195 min) and 520 ml (200-1000 ml) in unilateral THA. The average operation time and intraoperative blood loss was 265.0 min (242-295 min) and 80-1500 ml in bilateral THA. Thirteen cases received intraoperative fluoroscopy and five cases received postopera-tive transfusion. The patients were followed up for a median of 6 months (5-12 months). The average postoperative leg-length discrepancy, femoral offset, angles of acetabular abduction and anteversion were (3 ± 2) mm, (3.1 ± 0.6) mm, 42.3° ± 5.7°, and 19.8°±5.7°. In this cohort, the complications were:4 calcar fractures (all healed), 3 lateral femoral cutaneous nerve dysfunction (all resolved). No infection

  20. Muscular strength after total hip arthroplasty

    Science.gov (United States)

    Winther, Siri B; Husby, Vigdis S; Foss, Olav A; Wik, Tina S; Svenningsen, Svein; Engdal, Monika; Haugan, Kristin; Husby, Otto S

    2016-01-01

    Background and purpose Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. Patients and methods In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up. Results Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups. Interpretation The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery. PMID:26141371

  1. Best Simultaneous Approximation to Totally Bounded Sequences in Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    Xian Fa LUO; Chong LI; Genaro LOPEZ

    2008-01-01

    This paper is concerned with the problem of best weighted simultaneous approximations to totally bounded sequences in Banach spaces. Characterization results from convex sets in Banach spaces are established under the assumption that the Banach space is uniformly smooth.

  2. A New Kinetic Spectrophotometric Method for Total Polyphenols ...

    African Journals Online (AJOL)

    NICO

    determination of total polyphenols in white wine samples and the results were in excellent agreement with the Folin- ... Kinetic-spectrophotometric method, phenolics oxidation, white wine. 1. ..... V.L Singleton and J.A. Rossi, Am. J. Enol. Vitic.

  3. Asthma and atopy - a total genome scan for susceptibility genes

    DEFF Research Database (Denmark)

    Haagerup, A; Bjerke, T; Schiøtz, P O

    2002-01-01

    . Investigation of different populations will further clarify the topic. We therefore evaluated allergic asthma and increased total and specific IgE in 39, 45 and 57 sib-pairs from 100 Danish allergy families. METHODS: Affected sib-pairs meeting a narrow phenotype definition were selected for the three phenotypes...... atopy, allergic asthma and increased total IgE. We performed a total genome scan using 446 microsatellite markers and obtained nonparametric linkage results from the MAPMAKER/SIBS computer program. RESULTS: Our study revealed four candidate regions (MLS > 2) on chromosome 1p36, 3q21-q22, 5q31 and 6p24-p...

  4. Refractometric total protein concentrations in icteric serum from dogs.

    Science.gov (United States)

    Gupta, Aradhana; Stockham, Steven L

    2014-01-01

    To determine whether high serum bilirubin concentrations interfere with the measurement of serum total protein concentration by refractometry and to assess potential biases among refractometer measurements. Evaluation study. Sera from 2 healthy Greyhounds. Bilirubin was dissolved in 0.1M NaOH, and the resulting solution was mixed with sera from 2 dogs from which food had been withheld to achieve various bilirubin concentrations up to 40 mg/dL. Refractometric total protein concentrations were estimated with 3 clinical refractometers. A biochemical analyzer was used to measure biuret assay-based total protein and bilirubin concentrations with spectrophotometric assays. No interference with refractometric measurement of total protein concentrations was detected with bilirubin concentrations up to 41.5 mg/dL. Biases in refractometric total protein concentrations were detected and were related to the conversion of refractive index values to total protein concentrations. Hyperbilirubinemia did not interfere with the refractometric estimation of serum total protein concentration. The agreement among total protein concentrations estimated by 3 refractometers was dependent on the method of conversion of refractive index to total protein concentration and was independent of hyperbilirubinemia.

  5. Total Mercury in Lake Neusiedl, Austria

    Directory of Open Access Journals (Sweden)

    Jirsa F.

    2013-04-01

    Full Text Available Between May and September 2011 a total of 361 samples from water, sediment, macrophytes and fish tissues from the shallow, slightly alkaline Lake Neusiedl were measured for their total mercury content with cold vapour atomic absorption spectroscopy (CV-AAS. Hg content of surface water was below the LOD of 0.1 μg/L and the sediments displayed contents between 0.025 and 0.113 μg/g dw, significantly correlated with the proportion of organic components (fig 1. Although these results do not point to an anthropogenic pollution of the lake, considerable amounts of mercury could be measured in fish samples and macrophytes. Both investigated submerged plant species, namely Potamogeton pectinatus and Myriophyllum spicatum show a high potential for bioaccumulation of Hg, presenting mean values of 0.245 ± 0.152 and 0.298 ± 0.115 μg/g dw respectively. Compared to freshwater fish from other unpolluted sites high amounts of Hg could be measured (fig. 2. Biomagnification and significant differences could be observed when comparing muscle samples of the planctivorous fish species rudd Scardinus erythrophthalmus (n = 10, mean = 0.084 μg/g ww with the piscivorous perch Perca fluviatilis (n = 21, mean = 0.184 μg/g ww or pike-perch Sander lucioperca (n=9, mean = 0.205 μg/g ww respectively. Significantly lower values were measured in the muscle of the piscivorous pike Esox lucius (n = 25, mean = 0.135 μg/g ww in which a strong correlation between fish age and Hg content did not occur. In addition the muscle/liver ratio of Hg in pike was significantly lower compared to the other fish species, which points to a different Hg metabolism in pike, maybe under the specific saline alkaline conditions of this lake.

  6. Total sleep time severely drops during adolescence.

    Directory of Open Access Journals (Sweden)

    Damien Leger

    Full Text Available UNLABELLED: Restricted sleep duration among young adults and adolescents has been shown to increase the risk of morbidities such as obesity, diabetes or accidents. However there are few epidemiological studies on normal total sleep time (TST in representative groups of teen-agers which allow to get normative data. PURPOSE: To explore perceived total sleep time on schooldays (TSTS and non schooldays (TSTN and the prevalence of sleep initiating insomnia among a nationally representative sample of teenagers. METHODS: Data from 9,251 children aged 11 to 15 years-old, 50.7% of which were boys, as part of the cross-national study 2011 HBSC were analyzed. Self-completion questionnaires were administered in classrooms. An estimate of TSTS and TSTN (week-ends and vacations was calculated based on specifically designed sleep habits report. Sleep deprivation was estimated by a TSTN - TSTS difference >2 hours. Sleep initiating nsomnia was assessed according to International classification of sleep disorders (ICSD 2. Children who reported sleeping 7 hours or less per night were considered as short sleepers. RESULTS: A serious drop of TST was observed between 11 yo and 15 yo, both during the schooldays (9 hours 26 minutes vs. 7 h 55 min.; p<0.001 and at a lesser extent during week-ends (10 h 17 min. vs. 9 h 44 min.; p<0.001. Sleep deprivation concerned 16.0% of chidren aged of 11 yo vs. 40.5% of those of 15 yo (p<0.001. Too short sleep was reported by 2.6% of the 11 yo vs. 24.6% of the 15 yo (p<0.001. CONCLUSION: Despite the obvious need for sleep in adolescence, TST drastically decreases with age among children from 11 to 15 yo which creates significant sleep debt increasing with age.

  7. Activation of Complement Following Total Hip Replacement.

    Science.gov (United States)

    Thordardottir, S; Vikingsdottir, T; Bjarnadottir, H; Jonsson, H; Gudbjornsson, B

    2016-03-01

    The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement (THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-9, as well as C-reactive protein (CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.

  8. Recent CDF results

    Energy Technology Data Exchange (ETDEWEB)

    Conway, J.S. [Rutgers--the State Univ., Piscataway, NJ (United States). Dept. of Physics and Astronomy; CDF Collaboration

    1996-07-01

    Preliminary results form the CDF detector, based on analysis of data collected in Run 1a and Run 1b at the Tevatron, totaling 110 pb{sup - 1} integrated luminosity, place new limits on the masses and couplings of new particles including charged Higgs bosons, supersymmetric gauge particles and quarks, and new vector bosons. One of the observed events, having an {ital e}{sup +}{ital e}{sup -} pair, two photons, and large missing energy would not occur with significant rate in the Standard Model, leading to speculation regarding its origin and the possible existence of related events.

  9. Preliminary results of an algorithm to determine the total absorption coefficient of water

    Digital Repository Service at National Institute of Oceanography (India)

    Suresh, T.; Talaulikar, M.; Desa, E.J.; Lotlikar, A.

    coefficient of net irradiance, KE were obtained from radiative transfer simulations using Hydrolight with large in-situ measured data from the coastal and estuarine waters of Goa. A refined algorithm of spectral micro as in Ref. [1] is used...

  10. Process evaluation results from the HEALTHY nutrition intervention to modify the total school food environment.

    Science.gov (United States)

    Volpe, S L; Hall, W J; Steckler, A; Schneider, M; Thompson, D; Mobley, C; Pham, T; El ghormli, L

    2013-12-01

    The process evaluation of HEALTHY, a large multi-center trial to decrease type 2 diabetes mellitus in middle school children, monitored the implementation of the intervention to ascertain the extent that components were delivered and received as intended. The purpose of this article is to report the process evaluation findings concerning the extent to which the HEALTHY nutrition intervention was implemented during the HEALTHY trial. Overall, the observed fidelity of implementing nutrition strategies improved from baseline to the end of the study. By the last semester, all but two nutrition process evaluation goals were met. The most challenging goal to implement was serving high fiber foods, including grain-based foods and legumes. The easiest goals to implement were lowering the fat content of foods offered and offering healthier beverages. The most challenging barriers experienced by research dietitians and food service staff were costs, availability of foods and student acceptance. Forming strong relationships between the research dietitians and food service staff was identified as a key strategy to meet HEALTHY nutrition goals.

  11. Results of fission products β decay properties measurement performed with a total absorption spectrometer

    Directory of Open Access Journals (Sweden)

    Zakari-Issoufou A.-A.

    2014-03-01

    Full Text Available β-decay properties of fission products are very important for applied reactor physics, for instance to estimate the decay heat released immediately after the reactor shutdown and to estimate the ν¯$\\bar \

  12. Functional outcome following a large head total hip arthroplasty A retrospective analysis of mid term results

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2014-01-01

    Conclusion: This study has shown that large head ceramic on ceramic THA is a good alternative to large head metal on metal THA with comparable dislocation rates and range of movements and without complications of metallosis in Asian patients.

  13. Late results of total shoulder replacement in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Søjbjerg, J.O.; Frich, Lars Henrik; Johannsen, H.V.

    1999-01-01

    with rheumatoid arthritis. Proximal migration of the humeral prosthesis attributable to rotator cuff failure, with secondary eccentric glenoid loading and progressive loosening, is latent in patients with chronic progressive rheumatoid disease and was by far the most common complication (42%) in the present...

  14. Process evaluation results from the HEALTHY nutrition intervention to modify the total school food environment

    Science.gov (United States)

    The process evaluation of HEALTHY, a large multi-center trial to decrease type 2 diabetes mellitus in middle school children, monitored the implementation of the intervention to ascertain the extent that components were delivered and received as intended. The purpose of this article is to report the...

  15. Mid term results of total hip arthroplasty using polyethylene-ceramic composite (Sandwich liner

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2016-01-01

    Conclusions: Our experience with the ceramic-polyethylene sandwich liner acetabular component has been disappointing because of the high rate of fracture and osteolyis. We have discontinued the use of this device and recommend the same.

  16. Wear debris in cemented total hip arthroplasty.

    Science.gov (United States)

    Huo, M H; Salvati, E A; Buly, R L

    1991-03-01

    One of the most prevalent clinical problems in long-term follow up of total hip arthroplasty patients is loosening of prosthetic fixation. Factors contributing to mechanical failure of total hip reconstruction are complex and multiple. It has become increasingly apparent that wear debris from the prosthetic components may contribute significantly to this process. The authors summarize some of the current concepts concerning the detrimental effects of metallic debris in total hip arthroplasty.

  17. Total solar eclipse of 3 November 1994

    Science.gov (United States)

    Espenak, Fred; Anderson, Jay

    1993-01-01

    A total eclipse of the Sun will be visible from the southern half of the Western Hemisphere on 3 November 1994. The path of the Moon's shadow passes through Peru, Chile, Bolivia, Paraguay, and Brazil. Detailed predictions for this event are presented and include tables of geographic coordinates of the path of totality, local circumstances for hundreds of cities, maps of the path of total and partial eclipse, weather prospects, and the lunar limb profile.

  18. Total Productive Maintenance at Paccar INC

    OpenAIRE

    2010-01-01

    This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  19. Total Productive Maintenance at Paccar INC

    Directory of Open Access Journals (Sweden)

    Ştefan Farkas

    2010-06-01

    Full Text Available This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.

  20. Defense Depot Tracy Total Quality Management Plan

    Science.gov (United States)

    1989-07-01

    PAGES TQM ( Total Quality Management ), Depot Operations, Continuous Process Improvement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...make up our pcrceptions of Total Quality Management . Our goal is to improve those proven management processes that have brought us success while being...MANIAGEMENT F. QUALITY AUDITS OF PRODUCTS AND OPERATIONS ASSETS MANAGEMENT 00 i .......... / ~899 29 03 1 EFENSE DEPOT TACY TOTAL QUALITY MANAGEMENT PLAN

  1. Total Quality Management (TQM). Implementers Workshop

    Science.gov (United States)

    1990-05-15

    SHEE’T :s t’ii ,rrl DEPARTMENT OF DEFENSE May 15, 1990 Lfl CN I TOTAL QUALITY MANAGEMENT (TQM) Implementers Workshop © Copyright 1990 Booz.Allen...must be continually performed in order to achieve successful TQM implementation. 1-5 = TOTAL QUALITY MANAGEMENT Implementers Workshop Course Content...information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar, that was provided for the Awareness Course. You may

  2. Total Quality Management, DLA Finance Center

    Science.gov (United States)

    1989-07-01

    ton. DC 20503. DATE 3. REPORT TYPE AND DATES COVERED SJuly 1989 4. TITLE AND SUBTIT’LE 5. FUNDING NUMBERS Total Quality Management , DLA Finance Center 6...1989 ~ D 14. SUBJECT TERMS 15. NUMBER OF PAGES TQM ( Total Quality Management ), Continuous Process Improvement. ., I Management 16. PRICE CODE 17...CONCEPTS TQM BASICS Total Quality Management (TQM) is a concept which is based on the work of a variety of people in a variety of fields. It includes

  3. Improving Operational Readiness through Total Quality Management

    Science.gov (United States)

    1991-06-21

    DTIC AD-A236 611 EL CT F NAVAL WAR COLL GE C Newport, R. I. IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT by Herb Westphal Defense...IMPROVING OPERATIONAL READINESS THROUGH TOTAL QUALITY MANAGEMENT (TQM) A Case Study: The Defense Mapping Agency Combat Support Center (DMACSC) initiated a...of the Defense Mapping Agency Combat Support Center’s (DMACSC) Total Quality Management (TQM) improvement methodology. This allows the reader to

  4. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    Science.gov (United States)

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  5. Total ankle replacement for posttraumatic arthritis

    Science.gov (United States)

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

  6. 10-year survival of total ankle arthroplasties

    Science.gov (United States)

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  7. Total Formulates Aggressive Plan in China

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ The world's fourth largest oil company Total is expanding its business in China's oil and gas exploration and production sector. Charles Mattenet, Total's senior vice president for Asia and the Far East, recently said in an interview with the news media that his company plans to start exploring in north China's Ordos Basin next year with its partner PetroChina. Total expects to invest60 million to 80 million U.S. dollars in its China project between 2007 and 2008, amounting for nearly 5 to 6percent of Total's worldwide budget for exploration and production.

  8. Development of meteorological parameters and total ozone during the total solar eclipse of August 11, 1999

    Directory of Open Access Journals (Sweden)

    Peter Winkler

    2001-05-01

    Full Text Available During the total eclipse of August 11, 1999 frequent showers occurred due to a unstable stratification of the air mass. At different observation sites, meteorological effects from the eclipse (99.4% coverage at Hohenpeißenberg and from showers were superimposed making it partly difficult to unambiguously interpret the observations. The weather radar at Hohenpeißenberg observatory provided a general overview of the distribution of clouds and precipitation in this area (200 km diameter. From the Garching site in the zone of totality (100% temperature and wind data taken on a 50 m mast were evaluated. By selecting periods with relatively low cloud cover it was possible to approximately follow the development of the vertical temperature and wind profiles during the eclipse. The minimum temperature at Hohenpeißenberg (about 450 m above the altitude of Garching during the eclipse was comparable to that during the previous night, the corresponding value measured at Garching remained about 2 K above the minimum observed during clear sky conditions in the previous night. Showers before, during or after the eclipse may have induced vertical exchange of air parcels. Temperatures during a shower change towards the same direction at all altitudes, thus no inversion forms. Additionally, air parcels with relatively lower concentrations of trace constituents were transported down from aloft for time periods of 10–15 minutes. These mixing processes significantly determined the temporal variations of various trace substances measured during the eclipse. Total ozone measurements at Hohenpeißenberg were performed with both DOBSON and BREWER spectrophotometers and at another site within the zone of totality by using a portable Microtops II filter instrument. Different results were obtained for both sites. These differences can be to a large extend, but not exclusively, attributed to eclipse induced shifts (limb darkening and straylight effects in the atmosphere

  9. Open Maximal Mucosa-Sparing Functional Total Laryngectomy

    Directory of Open Access Journals (Sweden)

    Pavel Dulguerov

    2017-10-01

    Full Text Available BackgroundTotal laryngectomy after (chemoradiotherapy is associated with a high incidence of fistula and therefore flaps are advocated. The description of a transoral robotic total laryngectomy prompted us to develop similar minimally invasive open approaches for functional total laryngectomy.MethodsA retrospective study of consecutive unselected patients with a dysfunctional larynx after (chemoradiation that underwent open maximal mucosal-sparing functional total laryngectomy (MMSTL between 2014 and 2016 is presented. The surgical technique is described, and the complications and functional outcome are reviewed.ResultsThe cohorts included 10 patients who underwent open MMSTL. No pedicled flap was used. Only one postoperative fistula was noted (10%. All patients resumed oral diet and experienced a functional tracheo-esophageal voice.ConclusionMMSTL could be used to perform functional total laryngectomy without a robot and with minimal incidence of complications.

  10. Airway Complications of Total Artificial Heart.

    Science.gov (United States)

    Pathak, Vikas; Donovan, Colin; Malhotra, Rajiv

    2017-02-01

    The total artificial heart is the mechanical device which is used as a bridge to the heart transplant in patients with biventricular failure. Due to the mechanical nature of the device, patients receiving total artificial heart (TAH) require to be on anticoagulation therapy. Hemorrhage and coagulopathy are few of the known complications of TAH.

  11. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  12. Sexuality after total vs. subtotal hysterectomy

    DEFF Research Database (Denmark)

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe;

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  13. Total Quality Management: A Guide to Implementation

    Science.gov (United States)

    1989-08-01

    Total Quality Management (TQM) is a means for improving personal effectiveness and performance and for aligning and focusing all individual efforts...your individual effort and extending its effect and its importance throughout an organization and beyond. Total Quality Management is not a destination

  14. Sexuality after total vs. subtotal hysterectomy

    DEFF Research Database (Denmark)

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  15. The total cost of EHR ownership.

    Science.gov (United States)

    Eastaugh, Steven R

    2013-02-01

    Consider total cost of ownership, not just initial cost of acquisition and annual maintenance, when reviewing electronic health record (EHR) system bids. Support costs--a key part of total cost of ownership--include FTEs dedicated to the system. The long-term costs of an EHR system can vary dramatically (up to 200 percent) depending on which system is selected.

  16. A phylogenetic approach to total evaporative water loss in mammals.

    Science.gov (United States)

    Van Sant, Matthew J; Oufiero, Christopher E; Muñoz-Garcia, Agustí; Hammond, Kimberly A; Williams, Joseph B

    2012-01-01

    Maintaining appropriate water balance is a constant challenge for terrestrial mammals, and this problem can be exacerbated in desiccating environments. It has been proposed that natural selection has provided desert-dwelling mammals physiological mechanisms to reduce rates of total evaporative water loss. In this study, we evaluated the relationship between total evaporative water loss and body mass in mammals by using a recent phylogenetic hypothesis. We compared total evaporative water loss in 80 species of arid-zone mammals to that in 56 species that inhabit mesic regions, ranging in size from 4 g to 3,500 kg, to test the hypothesis that mammals from arid environments have lower rates of total evaporative water loss than mammals from mesic environments once phylogeny is taken into account. We found that arid species had lower rates of total evaporative water loss than mesic species when using a dichotomous variable to describe habitat (arid or mesic). We also found that total evaporative water loss was negatively correlated with the average maximum and minimum environmental temperature as well as the maximum vapor pressure deficit of the environment. Annual precipitation and the variable Q (a measure of habitat aridity) were positively correlated with total evaporative water loss. These results support the hypothesis that desert-dwelling mammals have lower rates of total evaporative water loss than mesic species after controlling for body mass and evolutionary relatedness regardless of whether categorical or continuous variables are used to describe habitat.

  17. Total`s LNG activities from Algeria to Yemen; Total et le GNL de l`Algerie au Yemen

    Energy Technology Data Exchange (ETDEWEB)

    Vedrenne, J.P. [Compagnie de Raffinage et de Distribution TOTAL France, 75 - Paris (France)

    1997-05-01

    In March 1995, further to an international tender, Total was awarded the leadership of the first LNG project in Yemen. On January 1997 Total announced the extension of the share-holding of the Yemen LNG Co. to include the companies with interests in the Marib area (Hunt-Exxon-Yukong). The Marib area will supply the gas to the future liquefaction plant. The ratification of these agreements confirms the role of Total as lead shareholder with 36% in the share-holding structure and guarantees gas supply from the Marib licence, operated by Hunt-Exxon. (author).

  18. Total loss of AC power analysis for EPR reactor

    Energy Technology Data Exchange (ETDEWEB)

    Darnowski, Piotr, E-mail: piotr.darnowski@itc.pw.edu.pl [Warsaw University of Technology, Institute of Heat Engineering, Nowowiejska 21/25, 00-665 Warsaw (Poland); Skrzypek, Eleonora, E-mail: eleonora.skrzypek@ncbj.gov.pl [Warsaw University of Technology, Institute of Heat Engineering, Nowowiejska 21/25, 00-665 Warsaw (Poland); National Centre for Nuclear Research (NCBJ), A. Sołtana 7, 05-400 Otwock-Świerk (Poland); Mazgaj, Piotr, E-mail: piotr.mazgaj@itc.pw.edu.pl [Warsaw University of Technology, Institute of Heat Engineering, Nowowiejska 21/25, 00-665 Warsaw (Poland); Świrski, Konrad [Warsaw University of Technology, Institute of Heat Engineering, Nowowiejska 21/25, 00-665 Warsaw (Poland); Gandrille, Pascal [AREVA NP SAS, Tour AREVA, 1 place Jean Millier, 92084 Paris La Défense (France)

    2015-08-15

    Highlights: • Total loss of AC power (Station Blackout) was simulated for the EPR reactor model. • In-vessel phase of the accident is under consideration. • Comparison of MELCOR and MAAP results is presented. • MELCOR and MAAP results are comparable. - Abstract: In this paper the results of severe accident simulations for the EPR reactor in the case of loss of offsite power combined with total failure of all diesel generators (total loss of AC power) are presented. Calculations were performed with MELCOR 2.1 computer code for in-vessel phase of the accident. In this scenario, the unavailability of all offsite and onsite power sources and the lack of cooling leads directly to core degradation, material relocation to the lower plenum and rupture of the reactor pressure vessel. MELCOR results were compared qualitatively and quantitatively with MAAP4 code results and show a good agreement.

  19. 'Total disability' and the wrongness of killing.

    Science.gov (United States)

    Omelianchuk, Adam

    2015-08-01

    Walter Sinnott-Armstrong and Franklin G Miller recently argued that the wrongness of killing is best explained by the harm that comes to the victim, and that 'total disability' best explains the nature of this harm. Hence, killing patients who are already totally disabled is not wrong. I maintain that their notion of total disability is ambiguous and that they beg the question with respect to whether there are abilities left over that remain relevant for the goods of personhood and human worth. If these goods remain, then something more is lost in death than in 'total disability,' and their explanation of what makes killing wrong comes up short. But if total disability is equivalent with death, then their argument is an interesting one.

  20. Unfavorable results in replantation

    Directory of Open Access Journals (Sweden)

    Abraham G Thomas

    2013-01-01

    Full Text Available Reattachment of amputated parts of the body (Replantation has become a reality since the first arm replant was carried out six decades ago. Failures were not uncommon in the beginning, leading on to the analysis of the problem and refinements in technique. Improvements in sutures, instrumentation and better microscopes further helped the surgeons to do replantation with better finesse and functional results. Evaluation of results and particularly failure and long term results help the younger surgeons to learn from the difficulties faced earlier to do better in the future. An attempt is made to list various aspects of replantation experienced by the author during the past 30 years, particularly in reference to unfavorable results, which had been occasionally total failure, or a partial failure, with poor function and cosmesis due to infection. An insensate limb with poor function is the result of inadequate or improper nerve coaptation or infection destroying the whole repair. It is apt to mention that infection is mostly the result of poor vascularity due to devitalized tissue. Difficulties arise often in identifying the viable tissue, particularly while debriding in the distal amputated part since there is no bleeding. Experience counts in this, specifically to identify the viable muscle. The factors that may lead to complications are listed with remarks to avoid them.