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Sample records for preoperative seton drainage

  1. The use of a staged drainage seton for the treatment of anal fistulae or fistulous abscesses.

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    Lim, Cheong Ho; Shin, Hyeon Keun; Kang, Wook Ho; Park, Chan Ho; Hong, Sa Min; Jeong, Seung Kyu; Kim, June Young; Yang, Hyung Kyu

    2012-12-01

    The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method. According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool. The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal. In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.

  2. Management of complex anorectal fistulas with seton drainage plus partial fistulotomy and subsequent ligation of intersphincteric fistula tract (LIFT).

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    Schulze, B; Ho, Y-H

    2015-02-01

    Ligation of intersphincteric fistula tract (LIFT) is a relatively new technique in the treatment of complex anorectal fistulas. As it spares the anal sphincter, rates of post-operative incontinence may be lower when compared to conventional treatment. To date, there have not been enough reports of long-term fistula recurrence rates. We performed a long-term follow-up study of 75 patients who underwent LIFT following seton drainage and partial fistulotomy. Only patients with complex cryptogenic anorectal fistulas were included. After seton insertion and partial fistulotomy, the tract was reviewed at 4 months for the absence of anorectal sepsis. Patients then underwent LIFT in a day surgery setting. Operative time, complications, recurrences and incontinence were evaluated. Between May 2008 and June 2013, 75 patients [51 men, mean age 49.5 years, standard error of the mean (SEM) 1.4 years] were treated with a LIFT protocol. The mean operating time for LIFT was 13.2 min (SEM 1.5 min). Complications included minor bleeding, superficial wound dehiscence and perianal pain. At a mean follow-up of 14.6 months (SEM 1.7 months), there were nine (12 %) recurrences, diagnosed at a mean 9.2 months (SEM 2.7 months). They were treated with seton insertion followed by LIFT with biomesh or anorectal advancement flap, and there were no subsequent recurrences. Review of preoperative and post-operative continence scores revealed only one (1.3 %) patient with minor incontinence following LIFT. Recurrences were significantly related to fistulas with multiple tracts (p fistulotomy followed by LIFT is associated with a low recurrence rate comparing well with published results from studies involving other techniques and protocols for treating anal fistula.

  3. Similar outcomes for anti-tumor necrosis factor-α antibody and immunosuppressant following seton drainage in patients with Crohn's disease-related anal fistula.

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    Lin, Xutao; Fan, Dejun; Cai, Zerong; Lian, Lei; He, Xiaowen; Zhi, Min; Wu, Xiaojian; He, Xiaosheng; Lan, Ping

    2016-09-01

    Anal fistula is common in patients with Crohn's disease (CD) and leads to significant morbidity. The efficacy of seton drainage combined with anti-tumor necrosis factor-α monoclonal antibody (anti-TNF-α) or immunosuppressant in the treatment of CD-related anal fistula remains unclear. The aim of the present study was to compare the efficacy between seton drainage combined with anti-TNF-α and seton drainage combined with immunosuppressant postoperatively on the treatment of CD-related anal fistula. A total of 65 patients with CD-related anal fistula who had received seton drainage combined with postoperative medication were divided into an antibiotics only group, anti-TNF-α group and immunosuppressant group; all patients were treated with antibiotics. Fistula closure, external orifice exudation rate and recurrence rate were assessed among these patients. The duration of follow-up ranged from 3 to 84 months with an average of 25.3 months. There were 11 (16.9%) cases of recurrence after seton drainage, 9 of which underwent a second seton drainage. In the total study group, 34 (52.3%) cases achieved complete fistula closure, and 10 (15.4%) cases showed external orifice exudation. No significant difference was found among these three groups, regarding fistula closure rate, closure time of fistula and recurrence rate. The external orifice exudation rate was significantly higher in the anti-TNF-α group compared with the antibiotics only group and immunosuppressant group (P=0.004 and P=0.026, respectively). Seton drainage is an effective treatment for CD-related anal fistula. The efficacy is similar whether combined with anti-TNF-α or immunosuppressant.

  4. The results of seton drainage combined with anti-TNFα therapy for anal fistula in Crohn's disease.

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    Haennig, A; Staumont, G; Lepage, B; Faure, P; Alric, L; Buscail, L; Bournet, B; Moreau, J

    2015-04-01

    Combined infliximab and sphincter-sparing surgery can be effective in perianal fistula associated with Crohn's disease (CD). This study aimed to assess the efficacy of local surgery combined with infliximab on sustained fistula closure and to identify predictive factors for response after this combined treatment. Between 2000 and 2010, 81 patients with fistulising perianal CD were included in this observational study. Drainage with a loose seton was followed by infliximab therapy. The primary end-points were the rate of complete fistula closure and time required for this to occur. The fistula was complex in 71 (88%) of the 81 patients. Local proctological surgery was carried out in 77 (95%), including seton drainage in 62 (80.5%) of these. This was continued for a median duration of 3.8 months and the patient then received infliximab therapy. The median follow-up after treatment was 64 months (2-263). Initial complete closure of the fistula occurred in 71 (88%) cases at a median interval of 12.4 months (1-147) from the start of treatment. Recurrence was observed in 29 (41%) patients at a median interval of 38.5 months (2-48) from the start of treatment. They were treated again with combined treatment with successful closure in 19 (65.5%) patients. The total rate of closure of the fistula was 75.3%. Female gender, anal stenosis, rectovaginal and complex fistula formation were factors independently associated with failure of combined treatment. Seton drainage for several months combined with infliximab therapy is effective in closing the fistula in 75% of patients with complex perianal fistula formation associated with CD. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  5. Treatment of perianal fistula in Crohn's disease: a systematic review and meta-analysis comparing seton drainage and anti-tumour necrosis factor treatment.

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    de Groof, E J; Sahami, S; Lucas, C; Ponsioen, C Y; Bemelman, W A; Buskens, C J

    2016-07-01

    The introduction of anti-tumour necrosis factor (anti-TNF; infliximab and adalimumab) has changed the management of Crohn's perianal fistula from almost exclusively surgical treatment to one with a much larger emphasis on medical therapy. The aim of this systematic review was to provide an overview of the success rates of setons and anti-TNF for Crohn's perianal fistula. Studies evaluating the effect of setons and anti-TNF on Crohn's perianal fistula were included. Studies assessing perianal fistula in children, rectovaginal and rectourinary fistulae were excluded. The primary end-point was the fistula closure rate. Partial closure and recurrence rates were secondary end-points. Ten studies on seton drainage were included (n = 305). Complete closure varied from 13.6% to 100% and recurrence from 0% to 83.3%. In 34 anti-TNF studies (n = 1449), complete closure varied from 16.7% and 93% (partial closure 8.0-91.2%) and recurrence from 8.0% to 40.9%. Four randomized controlled trials (n = 1028) comparing anti-TNF with placebo showed no significant difference in complete or partial closure in meta-analysis (risk difference 0.12, 95% CI -0.06 to 0.30 and 0.09, 95% CI -0.23 to 0.41, respectively). Subgroup analysis (n = 241) showed a significant advantage for complete fistula closure with anti-TNF in two trials with follow-up > 4 weeks (46% vs 13%, P = 0.003 and 30% vs 13%, P = 0.03). Of four included cohort studies, two revealed a significant difference in response in favour of combined treatment (P = 0.001 and P = 0.014). Closure and recurrence rates after seton drainage as well as anti-TNF vary widely. Despite a large number of studies, no conclusions can be drawn regarding the preferred strategy. However, combination therapy with (temporary) seton drainage, immunomodulators and anti-TNF may be beneficial in achieving perianal fistula closure. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  6. Puborectal sling interposition combined with seton drainage for pouch-vaginal fistula after rectal cancer surgery with colonic J pouch-anal reconstruction: report of a case.

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    Kawamoto, Aya; Inoue, Yasuhiro; Okigami, Masato; Okugawa, Yoshinaga; Hiro, Junichiro; Toiyama, Yuji; Tanaka, Koji; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato

    2014-01-01

    The management of postoperative rectovaginal fistula (RVF) after rectal cancer surgery is difficult and requires reconstruction of the anastomotic site and fistula. Though various surgical procedures have been reported for the repair of RVFs, the results of surgical repair are often unsatisfactory, and failure of the initial repair leads to difficulty in the later operations. Furthermore, it has been reported that cases associated with local infection result in low success rates. We report a case of an 80-year-old woman with a recurrent colonic J pouch-vaginal fistula after anoabdominal rectal resection with partial internal sphincteric resection, who achieved a good outcome following a repair using a puborectal sling interposition combined with seton drainage. It may be a useful option for RVF management in repair of such pouch-vaginal fistula after coloanal anastomosis with intersphincteric resection.

  7. Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy

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    Chandra Shekhar Bhati; Chandrashekhar Kubal; Pankaj Kumar Sihag; Ankur Atal Gupta; Raj Kamal Jenav; Nicholas G Inston; Jagdish M Mehta

    2007-01-01

    AIM: To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticodu odenectomy.METHODS: A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted.RESULTS: Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable.CONCLUSION: Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.

  8. Current status of preoperative drainage for distal biliary obstruction

    Institute of Scientific and Technical Information of China (English)

    Harutoshi; Sugiyama; Toshio; Tsuyuguchi; Yuji; Sakai; Rintaro; Mikata; Shin; Yasui; Yuto; Watanabe; Dai; Sakamoto; Masato; Nakamura; Reina; Sasaki; Jun-ichi; Senoo; Yuko; Kusakabe; Masahiro; Hayashi; Osamu; Yokosuka

    2015-01-01

    Preoperative biliary drainage(PBD) was developed to improve obstructive jaundice, which affects a number of organs and physiological mechanisms in patients waiting for surgery. However, its role in patients who will undergo pancreaticoduodenectomy for biliary obstruction remains controversial. This article aims to review the current status of the use of preoperative drainage for distal biliary obstruction. Relevant articles published from 1980 to 2015 were identified by searching MEDLINE and Pub Med using the keywords "PBD", "pancreaticoduodenectomy", and "obstructive jaundice". Additional papers were identified by a manual search of the references from key articles. Current studies have demonstrated that PBD should not be routinely performed because of the postoperative complications. PBD should only be considered in carefully selected patients, particularly in cases where surgery had to be delayed. PBD may be needed in patients with severe jaundice, concomitant cholangitis, or severe malnutrition. The optimal method of biliary drainage has yet to be confirmed. PBD should be performed by endoscopic routes rather than by percutaneous routes to avoid metastatic tumor seeding. Endoscopic stenting or nasobiliary drainage can be selected. Although more expensive, the use of metallic stents remains a viable option to achieve effective drainage without cholangitis and reintervention.

  9. Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; DRainage vs. (direct OPeration (DROP-trial

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    Sosef Meindert N

    2007-03-01

    Full Text Available Abstract Background Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the general condition and thus reduce postoperative morbidity and mortality. Early studies showed a reduction in morbidity. However, more recently the focus has shifted towards the negative effects of drainage, such as an increase of infectious complications. Whether biliary drainage should always be performed in jaundiced patients remains controversial. The randomized controlled multicenter DROP-trial (DRainage vs. Operation was conceived to compare the outcome of a 'preoperative biliary drainage strategy' (standard strategy with that of an 'early-surgery' strategy, with respect to the incidence of severe complications (primary-outcome measure, hospital stay, number of invasive diagnostic tests, costs, and quality of life. Methods/design Patients with obstructive jaundice due to a periampullary tumor, eligible for exploration after staging with CT scan, and scheduled to undergo a "curative" resection, will be randomized to either "early surgical treatment" (within one week or "preoperative biliary drainage" (for 4 weeks and subsequent surgical treatment (standard treatment. Primary outcome measure is the percentage of severe complications up to 90 days after surgery. The sample size calculation is based on the equivalence design for the primary outcome measure. If equivalence is found, the comparison of the secondary outcomes will be essential in selecting the preferred strategy. Based on a 40% complication rate for early surgical treatment and 48% for preoperative drainage, equivalence is taken to be demonstrated if the percentage of severe complications with early surgical treatment is not more than 10% higher compared to standard treatment

  10. Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; DRainage vs. (direct) OPeration (DROP-trial)

    NARCIS (Netherlands)

    N.A. van der Gaag (Niels); S.M.M. de Castro (Steve); E.A.J. Rauws (Erik); M.J. Bruno (Marco); C.H.J. van Eijck (Casper); E.J. Kuipers (Ernst); J.J.G.M. Gerritsen (Josephus); J.P. Rutten (Joost Paul); J.W. Greve; E.J. Hesselink (Eric); J.H. Klinkenbijl (Jean); I.H.M.B. Rinkes; D. Boerma (Djamila); B.A. Bonsing (Bert); C.J. van Laarhoven (Cees); F.J. Kubben; E. van der Harst (Erwin); M.N. Sosef (Meindert); K. Bosscha (Koop); I.H.J.T. de Hingh (Ignace); L. Th de Wit (Laurens); O.M. van Delden (Otto); O.R.C. Busch (Olivier); T.M. van Gulik (Thomas); P.M.M. Bossuyt (Patrick); D.J. Gouma (Dirk)

    2007-01-01

    textabstractBackground. Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to im

  11. Ampullary carcinoma: Effect of preoperative biliary drainage on surgical outcome

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    Sheikh Anwar Abdullah; Tarun Gupta; Khairul Azhar Jaafar; Yaw Fui Alexander Chung; London Lucien Peng Jin Ooi; Steven Joseph Mesenas

    2009-01-01

    AIM: To evaluate the influence of preoperative biliary drainage on morbidity and mortality after surgical resection for ampullary carcinoma. METHODS: We analyzed retrospectively data for 82 patients who underwent potentially curative surgery for ampullary carcinoma between September 1993 and July 2007 at the Singapore General Hospital, a tertiary referral hospital. Diagnosis of ampullary carcinoma was confirmed histologically. Thirty-five patients underwent preoperative biliary drainage (PBD group), and 47 were not drained (non-PBD group). The mode of biliary drainage was endoscopic retrograde cholangiopancreatography ( n = 33) or percutaneous biliary drainage ( n = 2). The following parameters were analyzed: wound infection, intra-abdominal abscess, intra-abdominal or gastrointestinal bleeding, septicemia, biliary or pancreatic leakage, pancreatitis, gastroparesis, and re-operation rate. Mortality was assessed at 30 d (hospital mortality) and also longterm. The statistical endpoint of this study was patient survival after surgery. RESULTS: The groups were wel l matched for demographic criteria, clinical presentation and operative characteristics, except for lower hemoglobin in the non- PBD group (10.9 ± 1.6 vs 11.8 ± 1.6 in the PBD group). group (10.9 ± 1.6 vs 11.8 ± 1.6 in the PBD group). Of the parameters assessing postoperative morbidity, incidence of wound infection was significantly less in the PBD than the non-PBD group [1 (2.9%) vs 12 (25.5%)]. However, the rest of the parameters did not differ significantly between the groups, i.e. sepsis [10 (28.6%) vs 14 (29.8%)], intra-abdominal bleeding [1 (2.9%) vs 5 (10.6%)], intra-abdominal abscess [1 (2.9%) vs 8 (17%)], gastrointestinal bleeding [3 (8.6%) vs 5 (10.6%)], pancreatic leakage [2 (5.7%) vs 3 (6.4%)], biliary leakage [2 (5.7%) vs 3 (6.4%)], pancreatitis [2 (5.7%) vs 2 (4.3%)], gastroparesis [6 (17.1%) vs 10 (21.3%)], need for blood transfusion [10 (28.6%) vs 17 (36.2%)] and re-operation rate [1 (2

  12. Best options for preoperative biliary drainage in patients with Klatskin tumors.

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    Jo, Jung Hyun; Chung, Moon Jae; Han, Dai Hoon; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2017-01-01

    Operative treatment combined with PBD has been established as a safe management strategy for Klatskin tumors. However, controversy exists regarding the preferred technique for PBD among percutaneous transhepatic biliary drainage (PTBD), endoscopic biliary stenting (EBS), and endoscopic nasobiliary drainage (ENBD). This study aimed to identify the best technique for preoperative biliary drainage (PBD) in Klatskin tumor patients.

  13. Preoperative Biliary Drainage in Cases of Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgery

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    Tomofumi Tsuboi

    2016-01-01

    Full Text Available Objective. To elucidate the optimum preoperative biliary drainage method for patients with pancreatic cancer treated with neoadjuvant chemotherapy (NAC. Material and Methods. From January 2010 through December 2014, 20 patients with borderline resectable pancreatic cancer underwent preoperative biliary drainage and NAC with a plastic or metallic stent and received NAC at Hiroshima University Hospital. We retrospectively analyzed delayed NAC and complication rates due to biliary drainage, effect of stent type on perioperative factors, and hospitalization costs from diagnosis to surgery. Results. There were 11 cases of preoperative biliary drainage with plastic stents and nine metallic stents. The median age was 64.5 years; delayed NAC occurred in 9 cases with plastic stent and 1 case with metallic stent (p=0.01. The complication rates due to biliary drainage were 0% (0/9 with metallic stents and 72.7% (8/11 with plastic stents (p=0.01. Cumulative rates of complications determined with the Kaplan-Meier method on day 90 were 60% with plastic stents and 0% with metallic stents (log-rank test, p=0.012. There were no significant differences between group in perioperative factors or hospitalization costs from diagnosis to surgery. Conclusions. Metallic stent implantation may be effective for preoperative biliary drainage for pancreatic cancer treated with NAC.

  14. Partial fistulotomy and multiple setons in high anal fistulae.

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    Chatterjee, Gautam; Ray, Dipankar; Chakravartty, Saurav

    2009-08-01

    Setons are employed in high perianal fistulae. Our study aimed to use multiple setons in addition to a partial fistulotomy in high perianal fistulae involving the sphincter complex to combine the effects of cutting and drainage of the fistulous tract. This prospective study included 16 patients over a period of 4 years who presented with high perianal fistulae. The internal opening was identified and tract laid open till the dentate line. Four prolene threads were passed along the remainder of the tract and taken out through the external opening. One was tied tightly while the others were tightened every 7 days. No patients developed major faecal incontinence. Fistula recurred in one patient within a year and one patient had occasional incontinence to flatus. Multiple setons after partial fistulotomy is an effective treatment for high anal fistulae with low incidence of incontinence and recurrence and adequate patient satisfaction.

  15. Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis;preoperative catheter drainage : a case report

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    Kim, Tae Hoon [Dankook Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    Sclerosing encapsulating peritonitis is a well recognized, but uncommon, complication of chronic ambulatory peritoneal dialysis. I report a case of sclerosing encapsulating peritonitis in which percutaneous catheter drainage was performed preoperatively. Ultrasonography(US) and computed tomography(CT) showed a large multi-septated cystic mass which occupied nearly all the peritoneal cavity. Percutaneous drainage with two 8.5 French catheters was preoperatively performed under fluoroscopy and about 2100 ml of bloody fluid was drained for 20 days. On follow-up CT, the size of the cyst had significantly decreased and anoperation was performed. It is considered that percutaneous catheter drainage is useful in the preoperative decompression of sclerosing encapsulating peritonitis.

  16. Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction

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    Sasahira, Naoki; Hamada, Tsuyoshi; Togawa, Osamu; Yamamoto, Ryuichi; Iwai, Tomohisa; Tamada, Kiichi; Kawaguchi, Yoshiaki; Shimura, Kenji; Koike, Takero; Yoshida, Yu; Sugimori, Kazuya; Ryozawa, Shomei; Kakimoto, Toshiharu; Nishikawa, Ko; Kitamura, Katsuya; Imamura, Tsunao; Mizuide, Masafumi; Toda, Nobuo; Maetani, Iruru; Sakai, Yuji; Itoi, Takao; Nagahama, Masatsugu; Nakai, Yousuke; Isayama, Hiroyuki

    2016-01-01

    AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction. METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent (PS) or nasobiliary catheter (NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedure-related adverse events, stent/catheter dysfunction (occlusion or migration of PS/NBC, development of cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution (bilirubin level < 3.0 mg/dL) were evaluated. Cumulative incidence of jaundice resolution and dysfunction of PS/NBC were estimated using competing risk analysis. Patient characteristics and preoperative biliary drainage were also evaluated for association with the time to jaundice resolution and PS/NBC dysfunction using competing risk regression analysis. RESULTS: In total, 419 patients were included in the study (PS, 253 and NBC, 166). Primary cancers included pancreatic cancer in 194 patients (46%), bile duct cancer in 172 (41%), gallbladder cancer in three (1%), and ampullary cancer in 50 (12%). The median serum total bilirubin was 7.8 mg/dL and 324 patients (77%) had ≥ 3.0 mg/dL. During the median time to surgery of 29 d [interquartile range (IQR), 30-39 d]. PS/NBC dysfunction rate was 35% for PS and 18% for NBC [Subdistribution hazard ratio (SHR) = 4.76; 95%CI: 2.44-10.0, P < 0.001]; the pig-tailed tip was a risk factor for PS dysfunction. Jaundice resolution was achieved in 85% of patients and did not depend on the drainage method (PS or NBC). CONCLUSION: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored. PMID:27076764

  17. Effect of preoperative biliary drainage on malignantobstructive jaundice: A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yu-Dong Qiu; Jian-Ling Bai; Fang-Gui Xu; Yi-Tao Ding

    2011-01-01

    AIM: To evaluate the effect of preoperative biliary drainage(PBD) on obstructive jaundice resulting from malignant tumors.METHODS: According to the requirements of Cochrane systematic review, studies in the English language were retrieved from MEDLINE and Embase databases from 1995 to 2009 with the key word "preoperative biliary drainage". Two reviewers independently screened the eligible studies, evaluated their academic level and extracted the data from the eligible studies confirmed by cross-checking. Data about patients with and without PBD after resection of malignant tumors were processed for meta-analysis using the Stata 9.2 software, including postoperative mortality, incidence of postoperative pancreatic and bile leakage, abdominal abscess, delayed gastric emptying and incision infection.RESULTS: Fourteen retrospective cohort studies involving 1826 patients with malignant obstructive jaundice accorded with our inclusion criteria, and were included in meta-analysis. Their baseline characteristics were comparable in all the studies. No significant difference was found in combined risk ratio (RR) of postoperative mortality and incidence of pancreatic and bile leakage, abdominal abscess, delayed gastric emptying between patients with and without PBD. However, the combined RR for the incidence of postoperative incision infectionwas improved better in patients with PBD than in those without PBD (P<0.05).CONCLUSION: PBD cannot significantly reduce the postoperative mortality and complications of malignant obstructive jaundice, and therefore should not be used as a preoperative routine procedure for malignant obstructive jaundice.

  18. Fistulotomy or seton in anal fistula: a decisional algorithm.

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    Cariati, Andrea

    2013-09-01

    Fistula in ano is a common proctological disease. Several authors stated that internal and external anal sphincters preservation is in the interest of continence maintenance. The aim of the present study is to report our experience using a decisional algorithm on sphincter saving procedures that achieved us to obtain good results with low rate of complications. From 2008 to 2011, 206 patients underwent surgical treatment for anal fistula; 28 patients underwent perianal abscess drainage plus seton placement of trans-sphincteric or supra-sphincteric fistula (13.6 %), 41 patients underwent fistulotomy for submucosal or low inter-sphincteric or low trans-sphincteric anal fistula (19.9 %) and 137 patients underwent partial fistulectomy or partial fistulotomy (from cutaneous plan to external sphincter muscle plan) and cutting seton placement without internal sphincterotomy for trans-sphincteric anal fistula (66.50 %). Healing rates have been of 100 % and healing times ranged from 1 to 6 months in 97 % of patients treated by setons. Transient fecal soiling was reported by 19 patients affected by trans-sphincteric fistula (11.5 %) for 4-6 months and then disappeared or evolved in a milder form of flatus occasional incontinence. No major incontinence has been reported also after fistulotomy. Fistula recurred in five cases of trans-sphincteric fistula treated by seton placement (one with abscess) (1/28) (3.5 %) and four with trans-sphincteric fistula (4/137) (3 %). Our algorithm permitted us to reduce to 20 % sphincter cutting procedures without reporting postoperative major anal incontinence; it seems to open an interesting way in the treatment of anal fistula.

  19. Therapeutic Delay and Survival After Surgery for Cancer of the Pancreatic Head With or Without Preoperative Biliary Drainage

    NARCIS (Netherlands)

    W.J. Eshuis; N.A. van der Gaag; E.A.J. Rauws; C.H.J. van Eijck; M.J. Bruno; E.J. Kuipers; P.P. Coene; F.J.G.M. Kubben; J.J.G.M. Gerritsen; J.W. Greve; M.F. Gerhards; I.H.J.T. de Hingh; J.H. Klinkenbijl; C.Y. Nio; S.M.M. de Castro; O.R.C. Busch; T.M. van Gulik; P.M.M. Bossuyt; D.J. Gouma

    2010-01-01

    Objective: To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. Background: Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of

  20. Metal or plastic stents for preoperative biliary drainage in resectable pancreatic cancer.

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    Tol, J A M G; van Hooft, J E; Timmer, R; Kubben, F J G M; van der Harst, E; de Hingh, I H J T; Vleggaar, F P; Molenaar, I Q; Keulemans, Y C A; Boerma, D; Bruno, M J; Schoon, E J; van der Gaag, N A; Besselink, M G H; Fockens, P; van Gulik, T M; Rauws, E A J; Busch, O R C; Gouma, D J

    2016-12-01

    In pancreatic cancer, preoperative biliary drainage (PBD) increases complications compared with surgery without PBD, demonstrated by a recent randomised controlled trial (RCT). This outcome might be related to the plastic endoprosthesis used. Metal stents may reduce the PBD-related complications risk. A prospective multicentre cohort study was performed including patients with obstructive jaundice due to pancreatic cancer, scheduled to undergo PBD before surgery. This cohort was added to the earlier RCT (ISRCTN31939699). The RCT protocol was adhered to, except PBD was performed with a fully covered self-expandable metal stent (FCSEMS). This FCSEMS cohort was compared with the RCT's plastic stent cohort. PBD-related complications were the primary outcome. Three-group comparison of overall complications including early surgery patients was performed. 53 patients underwent PBD with FCSEMS compared with 102 patients treated with plastic stents. Patients' characteristics did not differ. PBD-related complication rates were 24% in the FCSEMS group vs 46% in the plastic stent group (relative risk of plastic stent use 1.9, 95% CI 1.1 to 3.2, p=0.011). Stent-related complications (occlusion and exchange) were 6% vs 31%. Surgical complications did not differ, 40% vs 47%. Overall complication rates for the FCSEMS, plastic stent and early surgery groups were 51% vs 74% vs 39%. For PBD in pancreatic cancer, FCSEMS yield a better outcome compared with plastic stents. Although early surgery without PBD remains the treatment of choice, FCSEMS should be preferred over plastic stents whenever PBD is indicated. Dutch Trial Registry (NTR3142). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. ARCPEP 2 Continuation Project (Seton Hill University)

    Science.gov (United States)

    2014-10-01

    Coaches uncover areas for possible goal development for Phase 2 participants • Supervised research hours of junior and senior dietetics students who...as website content and/or for training purposes for dietetics students The following tasks were completed at Seton Hill from 27 December 2013...assistants • Supervised student research hours for junior and senior dietetics majors • Scheduled and met with COSMED representative for annual BodPod

  2. Høje analfistler behandlet med langsomt skaerende seton

    DEFF Research Database (Denmark)

    Lykke, Anna; Steendahl, Joen Gregers Tryde; Wille-Jørgensen, Peer A

    2010-01-01

    The aim was to determine the incidence of anal incontinence, recurrence rate and patient satisfaction after using slow-cutting setons for transsphincteric anal fistula repair.......The aim was to determine the incidence of anal incontinence, recurrence rate and patient satisfaction after using slow-cutting setons for transsphincteric anal fistula repair....

  3. Effect of preoperative biliary drainage on surgical results after pancreaticoduodenectomy in patients with distal common bile duct cancer:Focused on the rate of decrease in serum bilirubin

    Institute of Scientific and Technical Information of China (English)

    Yun Mee Choi; Seok-Hwan Shin; Kyung Rae Kim; Ze-Hong Woo; Eung-Ho Cho; Keon-Young Lee; Seung-Ik Ahn; Sun Keun Choi; Sei Joong Kim; Yoon Seok Hut; Young Up Cho; Kee-Chun Hang

    2008-01-01

    AIM:To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct cancer.METHODS:A retrospective study was performed in 49 consecutive patients who underwent pancreaticoduodenectomy for distal common bile duct cancer.Potential risk factors were compared between the complicated and uncomplicated groups.Also,the rates of decrease in serum bilirubin were compared pre-and postoperatively.RESULTS:Preoperative biliary drainage (PBD) was performed in 40 patients (81.6%).Postoperative morbidity and mortality rates were 46.9% (23/49) and 6.1% (3/49),respectively.The presence or absence of PBD was not different between the complicated and uncomplicated groups.In patients with PBD,neither the absolute level nor the rate of decrease in serum bilirubin was significantly different.Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week (5.5±4.4 μmol/L vs-1.7±9.9μmol/L,P=0.004).CONCLUSION:PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer.There is a certain group of patients with a compromised hepatic excretory function,which is represented by the slow rate of decrease in serum bilirubin after PBD.

  4. Novel Technique for Management of Axillary Hidradenitis Suppurativa Using Setons

    Directory of Open Access Journals (Sweden)

    Sepehr Seyed Lajevardi

    2015-01-01

    Full Text Available Management of hidradenitis suppurativa (HS of the axilla which is nonresponding to conservative management presents a significant therapeutic challenge. Most surgical treatment options are associated with significant morbidities and prolonged hospital stay. We present a technique of management of HS using setons which is simple and allows the ongoing treatment to be done on an outpatient basis. Given the fact that HS is a chronic relapsing condition each recurrence may again be managed using this technique. This will allow the patients to manage their recurrences with minimal impact on their activities of daily living.

  5. SETON - AS A GOLD STANDARD TREATMENT FOR HIGH FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Kishore Babu

    2015-03-01

    Full Text Available Objective to determine the effectiveness of seton tie as treatment modality in a high anal fistula in contrary to diversion colostomy which also can be used for treating a high anal fistula.

  6. Management of low transsphincteric anal fistula with serial setons and interval muscle-cutting fistulotomy

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; Lester Rosen

    2016-01-01

    This study evaluates low transsphincteric anal ifstula managed by serial setons and interval ifstulotomy, with attention to healing without recurrence and preservation of continence.Folowing Institutional Review Board approval, consecutive anal ifstula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to folow up. Of the 71 patients, 26 (37%) had low transsphincteric ifstula (23 males and 3 females; mean age: 46 years), treated at our institution by seton placement folowed by interval surgical muscle cutting and subsequent seton replacement or ifnal ifstulotomy. Of the 26 patients, 22 (85%) were initialy referred due to previous failed treatment, with a 30.6 month mean duration of ifstula prior to referral and a mean of 2.2 (range: 0–6) prior anorectal surgeries. At a mean folow-up of 11.9 months, none of the 21 patients experienced recurrence or fecal incontinence. Serial seton with interval muscle-cutting sphincterotomy folowed by complete ifstulotomy is an effective treatment for the management of patients who are either initialy seen for low transsphincteric ifstula, or referred after failed anorectal surgery for that condition.

  7. Management of low transsphincteric anal fistula with serial setons and interval muscle-cutting fistulotomy.

    Science.gov (United States)

    Wang, Chen; Rosen, Lester

    2016-03-01

    This study evaluates low transsphincteric anal fistula managed by serial setons and interval fistulotomy, with attention to healing without recurrence and preservation of continence. Following Institutional Review Board approval, consecutive anal fistula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to follow up. Of the 71 patients, 26 (37%) had low transsphincteric fistula (23 males and 3 females; mean age: 46 years), treated at our institution by seton placement followed by interval surgical muscle cutting and subsequent seton replacement or final fistulotomy. Of the 26 patients, 22 (85%) were initially referred due to previous failed treatment, with a 30.6 month mean duration of fistula prior to referral and a mean of 2.2 (range: 0 -6) prior anorectal surgeries. At a mean follow-up of 11.9 months, none of the 21 patients experienced recurrence or fecal incontinence. Serial seton with interval muscle-cutting sphincterotomy followed by complete fistulotomy is an effective treatment for the management of patients who are either initially seen for low transsphincteric fistula, or referred after failed anorectal surgery for that condition.

  8. A New Method to Treat High Anal Fistula - Bidirectional Isobaric Drainage

    DEFF Research Database (Denmark)

    Zheng, Linghua; Wang, Yanmei; Zhao, Jingbo

    2016-01-01

    cavity, then put the drainage seton to form a two-way isobaric drainage with the low incision. The patients in Control group were treated using a high cutting seton therapy with the low incision. The changes of average wound healing time, the cure rate, the recurrence rate, the postoperative pain (four......-category verbal rating scale, VRS), and the score of anal function (Wexner Incontinence Score) were quantitatively evaluated. Results: Comparison of the efficacy between two groups indicated that the complete cure rate differed significantly between two groups (Phealing time was significantly shorter......: In this study we first time report to use the bidirectional isobaric drainage method to treat the simple high anal fistula. This method has high cure rate, less recurrence rate, low expenses, less wound, less pain and short course. In the future, we will use this method to treat complicated high anal fistula...

  9. Predictive factors for recurrence of high transsphincteric anal fistula after placement of seton.

    Science.gov (United States)

    Emile, Sameh Hany; Elfeki, Hossam; Thabet, Waleed; Sakr, Ahmed; Magdy, Alaa; El-Hamed, Tito M Abd; Omar, Waleed; Khafagy, Wael

    2017-06-01

    The optimal surgical treatment for high transsphincteric fistula-in-ano (FIA) should attain complete eradication of the fistulous track and, in the same time, not compromising the anal sphincters. The present study aimed to investigate the predictive factors for recurrence of high transsphincteric FIA after placement of draining seton and to evaluate the efficacy and complications of seton treatment for high cryptoglandular anal fistula. This is a retrospective case-control study of patients with high transsphincteric FIA who were treated with seton placement. Variables analyzed were the characteristics of FIA, incidence of recurrence, postoperative complications including fecal incontinence (FI), and the predictive factors for recurrence. A total of 251 patients (232 males) with high transsphincteric FIA were treated with loose seton placement. Patients were followed for a median period of 16 mo. Recurrence of FIA was recorded in 26 of patients (10.3%) after a mean duration of 12.2 ± 3.9 mo of seton removal. Previously recurrent fistula (odds ratio [OR] = 2.81, P = 0.02), supralevator extension (OR = 3.19, P = 0.01) and anterior fistula (OR = 3.36, P = 0.004), and horseshoe fistula (OR = 5.66, P = 0.009) were the most significant predictors of recurrence. FI was detected in eight patients (3.2%). Female gender (OR = 15.2, P = 0.0003) and horseshoe fistula (OR = 8.66, P = 0.01) were the significant risk factors for FI after the procedure. Significant risk factors for recurrence of FIA were previous fistula surgery, anterior anal fistula, and presence of secondary tracks or branches as supralevator extension, and horseshoe fistula. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. A case of ruptured descending thoracic aortic aneurysm into the right pleural cavity: importance of preoperative drainage of the right pleural cavity.

    Science.gov (United States)

    Akiyama, K; Takazawa, A; Hirota, J; Yamagishi, H; Akazawa, T

    1998-12-01

    We present an unusual case of a ruptured descending thoracic aortic aneurysm into the right pleural cavity of a patient with pectus carinatum. The presence of pectus carinatum played an important role in the development of the aneurysm at the atypical site and the rupture into the right pleural cavity. A small amount of right pleural bleeding on admission can increase and develop to massive hemothorax until emergency operation. Massive bleeding in the right pleural cavity where the dependent lung is located causes atelectasis and increased shunt fraction under one lung ventilation. Therefore, continuous drainage of the right pleural cavity is essential to prevent serious hypoxia during graft replacement in a case of ruptured descending thoracic aneurysm into the right hemithorax.

  11. Comparing Ksharasutra (Ayurvedic Seton) and open fistulotomy in the management of fistula-in-ano

    OpenAIRE

    2015-01-01

    Background: Most commonly practiced surgical “lay open” technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications. In our study, we have tried to compare these two techniques. Materials and Methods: A prospective randomized control study was designed involving patients referred to the Departmen...

  12. Long-term results of the cutting seton for high anal fistula.

    Science.gov (United States)

    Patton, Vicki; Chen, Chung Ming; Lubowski, David

    2015-10-01

    No single procedure for high anal fistula delivers a high cure rate while also completely protecting sphincter function. This paper reports our long-term results with the cutting seton for high fistulae and draws comparisons with advancement flap and ligation of intersphincteric fistula track (LIFT) procedures. A retrospective study of prospectively collected data in consecutive patients undergoing treatment with cutting seton for high cryptoglandular fistulae was carried out. A strict protocol dictated tightening intervals of at least 4 weeks and no muscle division. In 59 patients (male : female = 39:20) followed-up at mean 9.4 years (range 1.7-15.6 years) healing rates, continence (St Mark's score 0-24), patient-perceived overall change in bowel control (-5 to +5), faecal incontinence quality of life (FIQL) and overall patient satisfaction (visual analogue score 0-10) were assessed. Primary and secondary healing rates were 93% and 98%. Mean continence score was 4.1, significantly worse in women than men (median 6, range 0-22 versus median 1, range 0-17; P = 0.006). Seventy-eight per cent of patients had normal continence or minor incontinence (score 0-6), 13.5% moderate incontinence (score 7-12) and 8.5% severe incontinence (score >12). Sixty-three per cent of patients had no change or improved patient-perceived overall bowel control. Mean FIQL scores were high and significantly correlated with continence. Median satisfaction score was 9. Cutting seton for high anal fistula achieved healing in 98% with good continence in the majority, particularly in males, and a high level of patient satisfaction. Multicentre prospective studies are needed to adequately compare cutting seton, flap and LIFT procedures. © 2015 Royal Australasian College of Surgeons.

  13. Anal fistula with foot extension—Treated by kshara sutra (medicated seton) therapy: A rare case report

    Science.gov (United States)

    Ramesh, P. Bhat

    2013-01-01

    INTRODUCTION An ‘anal’ fistula is a track which communicates anal canal or rectum and usually is in continuity with one or more external openings. Distant communication from rectum is rare. It is a challenging disease because of its recurrence especially, with high level and distant communications. Ksharasutra (medicated seton) therapy is being practiced in India with high success rate (recurrence of 3.33%) in the management of complicated anal fistula. PRESENTATION OF CASE A 56 year old man presented with recurrent boils in the left lower limb at different places from thigh to foot. He underwent repeated incision and drainage at different hospitals. Examination revealed sinus with discharge and multiple scars on left lower limb from thigh up to foot. Suspecting anal fistula, MRI was advised which revealed a long cutaneous fistula from rectum to left lower limb. Patient was treated with Ksharasutra therapy. Within 6 months of treatment whole tract was healed completely. DISCUSSION Sushrutha (500BC) was the first to explain the role of surgical excision and use of kshara sutra for the management of anal fistula. Ksharasutra therapy showed least recurrence. Fistula from rectum to foot is of extremely rare variety. Surgical treatment of anal fistula requires hospitalization, regular post-operative care, is associated with a significant risk of recurrence (0.7–26.5%) and a high risk of impaired continence (5–40%). CONCLUSION Rectal fistula communicating till foot may be a very rare presentation in proctology practice. Kshara sutra treatment was useful in treating this condition, with minimal surgical intervention with no recurrence. PMID:23702360

  14. Definitive seton management for transsphincteric fistula-in-ano: harm or charm?

    Science.gov (United States)

    Rosen, D R; Kaiser, A M

    2016-05-01

    The treatment of transsphincteric anal fistula requires a balance between eradication of the disease and preservation of faecal control. A cutting seton is an old tool that is now out of vogue for many surgeons. We hypothesized that the concept remains reliable and safe with results that exceed those reported for many of the more recently described methods. A retrospective review was conducted of real-time electronic health records (single institution, single surgeon) of patients presenting during the 14 years between 2001 and 2014 with a transsphincteric anal fistula who were treated with a cutting seton. Excluded were patients with Crohn's disease, fistulae related to malignancy or a previous anastomosis and patients whose fistula was treated by another method including a loose draining seton. Data collection included demographics, duration of the disease, duration of the treatment, outcome and continence. In all, 121 patients (80 men) of mean age 40.2 ± 12.2 years (range 18-76) with a mean follow-up of 5.1 ± 3.3 (1-24) months were included in the analysis. The median duration of symptoms was 6 (1-84) months; 36% had failed other fistula surgery, 12% had a complex fistula with more than one track and 35% had some form of comorbidity. The median time to healing was 3 (1-18) months; 7.4% required further surgery, but eventually 98% had complete fistula healing. The incontinence rate decreased postoperatively to 11.6% from 19% before treatment with 17/121 with pre-existing incontinence resolved and 8/107 new cases developing. Despite its retrospective non-comparative design, the study has demonstrated that a cutting seton is a safe, well tolerated and highly successful treatment for transsphincteric anal fistula and is followed overall by improved continence. The results compare very favourably with other techniques. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  15. Hunt-Hess Ⅰ~Ⅲ级动脉瘤性蛛网膜下腔出血早期手术术前腰大池外引流的临床观察%The clinical study of preoperative external lumbar drainage in patients with aneurysmal subarachnoid hemorrhage in Hunt and Hess grades Ⅰ~Ⅲ undergoing early surgery

    Institute of Scientific and Technical Information of China (English)

    王珏基; 袁坚列; 陈杰; 单国进; 章威; 吴晓华

    2011-01-01

    Objective To explore the therapeutic effect of preoperative external hunbar drainage in Hunt and Hess grade Ⅰ~Ⅲ patients with subarachnoid hemorrhage ( SAH ) undergoing early surgery for intracranial aneurysms. Method The 101 cases of grade Ⅰ~Ⅲ patients according to the classification of Hunt and Hess with early surgical treatment were devided into preoperative external lumbar drainage group(47 cases) and postoperative external lumbar drainage group(54 cases).Outcome of patients with different external drainage of cerebrospinal fluid was analyzed. Results There was no case of aneurysm rebleeding could be associated with preoperative spinal drain placement. Tne incidences of intraoperative aneurysm rapture in preoperative external lumbar drainage group was 8. 5%,which was lower than 11. 1% in postoperative external lumbar drainage group. The incidences of symptomatic cerebral vasospasm and chronic hydrocephalus in preoperative external lumbar drainage group were 12. 8% and 12.8% ,which were lower than 20. 4% and 14. 8% in postoperative external lumbar drainage group. There all were not significant differences between the two groups. Conclusions Preoperative external lumbar drainage wont increase a risk of rebleeding for grade Ⅰ~Ⅲ patients with aneurysmal SAH undergoing early surg ery. Furthermore, it can decrease the incidences of symptomatic cerebral vasospasm and chronic hydrocephalus,which is a safe and useful method of removing bloody cerebrospinal fluid.%目的 探讨Hunt-Hess Ⅰ~Ⅲ级动脉瘤性蛛网膜下腔出血(SAH)早期手术术前腰大池外引流的临床疗效.方法 将早期手术的Hunt-Hess Ⅰ~Ⅲ级动脉瘤性SAH患者分为术前腰大池外引流组(47例)和术后腰大池外引流组(54例),分析两组病例的疗效差异.结果 术前腰大池外引流组无置管导致的动脉瘤再破裂出血病例,其术中动脉瘤破裂、症状性脑血管痉挛、慢性脑积水的发生率分别为8.5%、12.8%、12

  16. The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life.

    Science.gov (United States)

    Kristo, I; Stift, A; Staud, C; Kainz, A; Bachleitner-Hofmann, T; Chitsabesan, P; Riss, S

    2016-06-01

    The use of a loose seton for complex anal fistulae can cause perianal discomfort and reduced quality of life. The aim of this study was to assess the impact of the novel knot-free Comfort Drain on quality of life, perianal comfort and faecal continence compared to conventional loose setons. Forty-four patients treated for complex anal fistula at a single institution between July 2013 and September 2014 were included in the study. A matched-pair analysis was performed to compare patients with a knot-free Comfort Drain and controls who were managed by conventional knotted setons. The 12-item Short Form survey (SF-12) questionnaire was used to assess quality of life. Additionally, patients reported perianal comfort and faecal incontinence using a Visual Analog Scale (VAS) and the St Mark's Incontinence Score. The Comfort Drain was associated with improved quality of life with significant higher median physical (P = 0.001) and mental (P = 0.04) health scores compared with a conventional loose seton. According to the VAS, patients with a Comfort Drain in situ reported greater perianal comfort with significantly less burning sensation (P fistula-in-ano. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  17. Surgical Management of Fistula-in-ano Among Patients With Crohn's Disease: Analysis of Outcomes After Fistulotomy or Seton Placement-Single-Center Experience.

    Science.gov (United States)

    Papaconstantinou, I; Kontis, E; Koutoulidis, V; Mantzaris, G; Vassiliou, I

    2017-09-01

    Fistula-in-ano is a common problem among patients with Crohn's disease and carries significant morbidity. We aimed to study the outcomes of surgical treatment of fistula-in-ano after fistulotomy or seton placement in patients with perianal fistulizing Crohn's disease. A retrospective observational study of 59 patients diagnosed with Crohn's disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department. The assessment of disease complexity included a detailed physical examination, magnetic resonance imaging of the rectum, and examination under anesthesia. Outcomes for analysis included wound healing rate and postoperative incontinence. High transsphincteric fistula was found in 44% of the patients, while mid or low transsphincteric fistulas were found in 51%. Three women (5%) had a rectovaginal fistula. All patients with high transsphincteric fistulas were treated with loose seton placement. Patients with mid- or low-level transsphincteric fistula were offered either fistulotomy or seton placement based on the clinical evaluation. The mean follow-up duration was 1.6 ± 1.1 years. In terms of recurrence, one patient treated with seton placement presented with recurrence 6 months after seton removal and one patient with fistulotomy failed to achieve wound healing. Minor incontinence was found in six patients treated with fistulotomy and in three patients treated with seton placement; however, this difference was not significant (chi-square = 1.723, df = 1, Monte-Carlo: p = 0.273). Fistulotomy could achieve good results in terms of wound healing and incontinence in strictly selected patients with Crohn's disease suffering from low-lying transsphincteric fistulae. For more high-lying or complicated fistulae, seton placement is more appropriate. For high transsphincteric fistulae, the only option is placement of loose seton.

  18. Comparing Ksharasutra (Ayurvedic Seton) and open fistulotomy in the management of fistula-in-ano.

    Science.gov (United States)

    Dutta, Gouranga; Bain, Jayanta; Ray, Ajay Kumar; Dey, Soumedhik; Das, Nandini; Das, Biswanath

    2015-01-01

    Most commonly practiced surgical "lay open" technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications. In our study, we have tried to compare these two techniques. A prospective randomized control study was designed involving patients referred to the Department of General Surgery in RG Kar Medical College, Kolkata, India, from January 2010 to September 2011. Among 50 patients, 26 were in Ksharasutra and 24 were in fistulotomy group. 86% patients were male and 54% of the patients were in the fourth decade. About 74% fistulas are inter-sphincteric and 26% were of trans-sphincteric variety. Severe postoperative pain was more (7.7% vs. 25%) in fistulotomy group, while wound discharge was more associated with Ksharasutra group (15.3% vs. 8.3%). Wound scarring, bleeding, and infection rate were similar in both groups. Ksharasutra group took more time to heal (mean: 53 vs. 35.7 days, P = 0.002) despite reduced disruption to their routine work (2.7 vs. 15.5 days work off, P fistulotomy and it was significantly cost effective (Rupees 166 vs. 464). Treatment of fistula-in-ano with Ksharasutra is a simple with low complications and minimal cost.

  19. [Little Dry Creek Drainage

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Map of the drainage boundary, direction of flow, canals and ditches, and streets for the drainage study plan and profile for Little Dry Creek sub area in the North...

  20. Percutaneous Abscess Drainage

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Percutaneous Abscess Drainage An abscess is an infected fluid collection ... are the benefits vs. risks? What is Percutaneous Abscess Drainage? An abscess is an infected fluid collection ...

  1. Transient drainage summary report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    This report summarizes the history of transient drainage issues on the Uranium Mill Tailings Remedial Action (UMTRA) Project. It defines and describes the UMTRA Project disposal cell transient drainage process and chronicles UMTRA Project treatment of the transient drainage phenomenon. Section 4.0 includes a conceptual cross section of each UMTRA Project disposal site and summarizes design and construction information, the ground water protection strategy, and the potential for transient drainage.

  2. Preoperative assessment and optimization in periampullary and pancreatic cancer

    Directory of Open Access Journals (Sweden)

    S Myatra

    2011-01-01

    Full Text Available Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign, stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.

  3. Foam consolidation and drainage.

    Science.gov (United States)

    Jun, S; Pelot, D D; Yarin, A L

    2012-03-27

    A theoretical model of foam as a consolidating continuum is proposed. The general model is applied to foam in a gravity settler. It is predicted that liquid drainage from foam in a gravity settler begins with a slow drainage stage. Next, a stage with faster drainage occurs where the drainage rate doubles compared to the initial stage. The experiments conducted within the framework of this work confirmed the theoretical predictions and allowed measurements of foam characteristics. Foams of three different concentrations of Pantene Pro-V Classic Care Solutions shampoo were studied, as well as the addition of polyethylene oxide (PEO) in one case. The shampoo's main foaming components are sodium lauryl sulfate and sodium laureth sulfate. It is shown to what extent foam drainage is slowed down by using higher shampoo concentrations and how it is further decreased by adding polymer (PEO).

  4. Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

    DEFF Research Database (Denmark)

    Nilsson, Jan; Eriksson, Sam; Nørgaard Larsen, Peter

    2015-01-01

    BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have...

  5. Preoperative preparation of children

    Directory of Open Access Journals (Sweden)

    Priya Reshma Aranha

    2017-01-01

    Full Text Available Surgery is a stressful and anxiety provoking experience for children. Millions of children undergo surgery every year. The majority of children experience significant preoperative anxiety which intern can affect their recovery. Preoperative anxiety may bring about physical and physiological changes in children, which can be particularly evident in terms of increased heart rate and blood pressure. To identify various strategies used to minimize the preoperative anxiety of children and update their clinical effectiveness among children undergoing surgery, the authors searched PubMed, MEDLINE, CINAHL, ScienceDirect, Google Scholar, Scopus, and Cochrane Library for identifying the relevant studies and retrieved available literature. It is concluded that utilization of the strategies available to reduce the preoperative anxiety of children will be a promising intervention to reduce anxiety, to promote relaxation, satisfaction, and speedy recovery. Many of these techniques are simple, cost-effective and can be easily carried out by nurses. It is essential to use the age appropriate and individualized methods in preparing children for surgery. Further research is required to strengthen the evidence.

  6. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

  7. Agricultural Drainage Well Intakes

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Locations of surface intakes for registered agriculture drainage wells according to the database maintained by IDALS. Surface intakes were located from their...

  8. Surface Water & Surface Drainage

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This data set contains boundaries for all surface water and surface drainage for the state of New Mexico. It is in a vector digital data structure digitized from a...

  9. Airport Pavement Drainage

    Science.gov (United States)

    1990-06-01

    drainage layer and trench drains can be found in Cedergren (10). 4.2 COMPONENTS OF SUBSURFACE DRAINAGE SYSTEM 4.2.1 Outflow Once the water has found...According to Cedergren (10) the open graded aggregate can replace the normally used dense graded materials on an inch-for-inch basis. A main problem in...the perforated pipe to prevent fines from entering, Figure 4.24 (11). Cedergren (10) suggests that collector pipes should be 42 laid with the

  10. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  11. 采用间断暴露瘘道切开挂线治疗高位单纯性肛瘘报告%Interrupted Exposing Fistula Tract and Seton Division for Simple High Anal Fistula: 30 Cases Report

    Institute of Scientific and Technical Information of China (English)

    王俊江; 刘希家; 王荣

    2012-01-01

    目的:观察间断暴露瘘道切开挂线术治疗高位单纯性肛瘘的临床疗效.方法:选择30例高位单纯性肛瘘患者,采用间断暴露瘘道,切开挂线治疗.结果:30例患者全部一次性治愈,平均住院时间25~30天.结论:间断暴露瘘道,切开挂线治疗高位单纯性肛瘘疗效确切,疗程短、安全,无后遗症.%Objective: To assess the clinical effects of interrupted exposing fistula tract and seton division for simple high anal fistula. Methods: 30 cases of simple high anal fistula were selected and treated with interrupted exposing fistula tract and seton division. Results: All patients achieved primary cure, the mean hospital stays was 25~30 days. Conclusion: The interrupted exposing fistula tract and seton division had definitely curative effect and short course, which was a safe and few complicating method.

  12. Wound Drainage Culture (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Wound Drainage Culture KidsHealth > For Parents > Wound Drainage Culture Print A A A What's in this article? ... Have Questions What It Is A wound drainage culture is a test to detect germs such as ...

  13. Preoperative anxiety in neurosurgical patients.

    Science.gov (United States)

    Perks, Anna; Chakravarti, Sucharita; Manninen, Pirjo

    2009-04-01

    Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (+/-SD) was 50+/-13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2+/-2.7; the score was higher for female (5.8+/-2.8) than male patients (4.6+/-2.5) (PAmsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.

  14. Predicting tile drainage discharge

    DEFF Research Database (Denmark)

    Iversen, Bo Vangsø; Kjærgaard, Charlotte; Petersen, Rasmus Jes;

    of the water load coming from the tile drainage system is therefore essential. This work aims at predicting tile drainage discharge using dynamic as well as a statistical predictive models. A large dataset of historical tile drain discharge data, daily discharge values as well as yearly average values were......More than 50 % of Danish agricultural areas are expected to be artificial tile drained. Transport of water and nutrients through the tile drain system to the aquatic environment is expected to be significant. For different mitigation strategies such as constructed wetlands an exact knowledge...... used in the analysis. For the dynamic modelling, a simple linear reservoir model was used where different outlets in the model represented tile drain as well as groundwater discharge outputs. This modelling was based on daily measured tile drain discharge values. The statistical predictive model...

  15. Acid mine drainage

    Science.gov (United States)

    Bigham, Jerry M.; Cravotta, Charles A.

    2016-01-01

    Acid mine drainage (AMD) consists of metal-laden solutions produced by the oxidative dissolution of iron sulfide minerals exposed to air, moisture, and acidophilic microbes during the mining of coal and metal deposits. The pH of AMD is usually in the range of 2–6, but mine-impacted waters at circumneutral pH (5–8) are also common. Mine drainage usually contains elevated concentrations of sulfate, iron, aluminum, and other potentially toxic metals leached from rock that hydrolyze and coprecipitate to form rust-colored encrustations or sediments. When AMD is discharged into surface waters or groundwaters, degradation of water quality, injury to aquatic life, and corrosion or encrustation of engineered structures can occur for substantial distances. Prevention and remediation strategies should consider the biogeochemical complexity of the system, the longevity of AMD pollution, the predictive power of geochemical modeling, and the full range of available field technologies for problem mitigation.

  16. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  17. Sustainable Drainage Systems

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2015-05-01

    Full Text Available Urban water management has somewhat changed since the publication of The Sustainable Drainage System (SuDS Manual in 2007 [1], transforming from building traditional sewers to implementing SuDS, which are part of the best management practice techniques used in the USA and seen as contributing to water-sensitive urban design in Australia. Most SuDS, such as infiltration trenches, swales, green roofs, ponds, and wetlands, address water quality and quantity challenges, and enhance the local biodiversity while also being acceptable aesthetically to the public. Barriers to the implementation of SuDS include adoption problems, flood and diffuse pollution control challenges, negative public perception, and a lack of decision support tools addressing, particularly, the retrofitting of these systems while enhancing ecosystem services. [...

  18. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2014-01-01

    : Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors......BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA...

  19. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  20. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  1. Filter Fabrics for Airport Drainage.

    Science.gov (United States)

    1979-09-01

    Systems for *r- field Pavements," Harry R. Cedergren . d. "Development of Guidelines for the Design of Subsurfac( Drainage Systems for Highway Pavement...Structural 4Sectic s," H. R. Cedergren , J. A. Arman, and K. H. O’Brien. e. Drainage of Highway and Airfield Pavements, Harry R. Cedergren .> Five...by Cedergren (974).5 Additionally, several references were used, particularly those describing experimental anu construction prolects using filter

  2. [Preoperative fasting guidelines: an update].

    Science.gov (United States)

    López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

    2015-03-01

    Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2010-01-01

    and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered......Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...

  4. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete;

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  5. Giant retroperitoneal abscess following necrotizing pancreatitis treated with internal drainage

    Institute of Scientific and Technical Information of China (English)

    Ludmil Marinov Veltchev; Manol Anastasov Kalniev

    2009-01-01

    BACKGROUND: Retroperitoneal abscess is a dangerous complication of the inflammatory process in organs. The pancreas reacts by enzymatic autodigestion and inflammation to external and internal factors: alcohol abuse, trauma, biliary stones, and viral infections. Chronic pancreatitis and formation of pseudocysts are late complications. The diffuse spread of pancreatic inflammation may form a retroperitoneal phlegmon. A better outcome is the limitation of the process by capsule formation-retroperitoneal abscess. METHODS: A 62-year-old man, with a history of alcohol abuse, was admitted for intermittent abdominal pain, fever, and significant weight loss. Previous medical consultations (laboratory tests, US, CT) confirmed chronic pancreatitis with pseudocyst formation. A new CT depicted a giant retroperitoneal abscess. RESULTS: After preoperative preparation with antibiotics, laparotomy and internal drainage-longitudinal cystoje-junostomy with Roux-en-Y loop were performed. At the 8th postoperative day the patient was in good condition. CONCLUSIONS: Giant retroperitoneal abscess is a dangerous pathology with significant mortality and morbidity. Diagnosis strongly necessitates operative intervention in order to evacuate and drain the space. These conditions include one internal drainage (in the GI tract) with the stomach, duodenum, or jejunum, which does not cause early and late GI discomfort and will gradually liquidate the cavity. We propose internal drainage with Roux-en-Y jejunal loop as the only method for accomplishing these conditions in cases of giant retroperitoneal abscesses.

  6. DRAINAGE AND FLEXIBLE PAVEMENT PERFORMANCE

    Directory of Open Access Journals (Sweden)

    SIDDHARTHA ROKADE

    2012-04-01

    Full Text Available Providing adequate drainage to a pavement system has been considered as an important design consideration to prevent premature failures due to water related problems such as pumping action, loss of support, and rutting, among others. Most water in pavements is due to rainfall infiltration into unsaturated pavement layers, throughjoints, cracks, shoulder edges, and various other defects, especially in older deteriorated pavements. Water also seep upward from a high groundwater table due to capillary suction or vapour movements, or it may flow laterally from the pavement edges and side ditches. Providing adequate drainage to a pavement system has been considered as an important design consideration to ensure satisfactory performance of the pavement, particularly from the perspective of life cycle cost and serviceability. To minimize premature pavement distresses and to enhance the pavement performance, it is imperative to provide adequate drainage to allow infiltrated water to drain out from the base and sub-base, thus avoiding saturation of base and subgrade soils. This paper deals with the analysis of the impact of subsurface drainage on pavement system performance. The requirement ofeffective subsurface drainage for pavement performance is also discussed.

  7. Klatskin tumor: Diagnosis, preoperative evaluation and surgical considerations.

    Science.gov (United States)

    Molina, Víctor; Sampson, Jaime; Ferrer, Joana; Sanchez-Cabus, Santiago; Calatayud, David; Pavel, Mihai Calin; Fondevila, Constantino; Fuster, Jose; García-Valdecasas, Juan Carlos

    2015-11-01

    Hiliar cholangiocarcinoma is the most common type of cholangiocarcinoma, an represent around 10% of all hepatobiliary tumors. It is an aggressive malignancy, resectable in around 47% of the patients at diagnosis. Complete resection is the most effective and only potentially curative therapy, with a survival rate of less than 12 months in unresectable cases. Axial computerized tomography and magnetic resonance are the most useful image techniques to determine the surgical resectability. Clinically, jaundice and pruritus are the most common symptoms at diagnosis;preoperative biliary drainage is recommended using endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography. Surgery using extended liver resections with an en bloc resection of the liver with vascular reconstruction is the technique with the highest survival. Complete resection with histologically negative resection margins (R0), nodal involvement and metastases are the most important prognostic factors.

  8. Role of percutaneous abscess drainage in the management of young patients with Crohn disease

    Energy Technology Data Exchange (ETDEWEB)

    Pugmire, Brian S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Gee, Michael S. [Massachusetts General Hospital for Children, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Kaplan, Jess L.; Winter, Harland S. [Massachusetts General Hospital for Children, Department of Pediatrics, Boston, MA (United States); Hahn, Peter F.; Gervais, Debra A. [Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Doody, Daniel P. [Massachusetts General Hospital for Children, Department of Surgery, Boston, MA (United States)

    2016-05-15

    Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection. (orig.)

  9. Do psychological interventions reduce preoperative anxiety?

    Science.gov (United States)

    Renouf, Tessa; Leary, Alison; Wiseman, Theresa

    The systematic review investigates whether, during preoperative assessments, nurse-delivered psychological interventions reduce anxiety levels preoperatively for patients undergoing elective surgery. Seventeen studies met the inclusion criteria for data extraction and in-depth critiquing. Of these, two were discarded due to lack of validity, while the remaining studies were organised thematically in a narrative synthesis, generating two principal results: patients' preoperative anxieties were lowered by nurse-delivered general preoperative psychological interventions; and patients valued individualised preoperative interventions delivered by nurses. However, the single oncology study in the review showed an elevation in preoperative anxiety, regardless of intervention, and highlights the need for more research in this under-reviewed area. In the meantime, the authors believe that service improvements should be implemented to ensure that, where possible, psychological preoperative interventions are individualised.

  10. Technical note on drainage systems

    DEFF Research Database (Denmark)

    Bentzen, Thomas Ruby

    This technical note will present simple but widely used methods for the design of drainage systems. The note will primarily deal with surface water (rainwater) which on a satisfactorily way should be transport into the drainage system. Traditional two types of sewer systems exist: A combined system......’s not major different than described below - just remember to include this contribution for combined systems where the surface water (rain) and sewage are carried in the same pipes in the system and change some of the parameters for failure allowance (this will be elaborated further later on). The technical...

  11. Preoperative localization in primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sanson; Kitamura, Hiroyuki; Takagita, Shin-ichi; Maetani, Toshiki; Iwahashi, Yuka; Miyazaki, Masakazu; Yamamoto, Norio [Tenri Hospital, Nara (Japan)

    1998-04-01

    Between 1992 and 1996, 31 cases (8 men and 23 women) with primary hyperparathyroidism (PHPT) were treated in our department. In this study, we compared which of the preoperative localization methods was most useful in the detection of PHPT. The sensitivity for detection of abnormal parathyroid glands was 88.6% on ultrasonography (US), 76.9% on magnetic resonance imaging (MRI), 74.3% on Tl-Tc subtraction scintigraphy and 68.8% on computed tomography. We concluded that US should be performed first, with MRI as a supplementary method, for the detection of abnormal parathyroid glands and the evaluation of invasion within the body. (author)

  12. Preoperative Evaluation for Noncardiac Surgery.

    Science.gov (United States)

    Cohn, Steven L

    2016-12-06

    This issue provides a clinical overview of preoperative evaluation for noncardiac surgery, focusing on risk factors, elements of evaluation, medication management, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  13. Preoperative fasting time in children.

    LENUS (Irish Health Repository)

    Adeel, S

    2012-02-01

    The aim of preoperative fasting is to prevent regurgitation and pulmonary aspiration while limiting potential problems of thirst, dehydration and hypoglycaemia. The American Society of Anaesthesiologists (ASA) has suggested guidelines for preoperative fasting for children undergoing elective surgery. We did a postal survey to determine the current practice regarding these guidelines amongst all specialist registrars in anaesthesia in Ireland. A questionnaire was sent to all specialist registrars in anaesthesia (90 in total), 60 (67%) were returned and analysed. The question asked was how long children should be kept fasting before elective surgery. The results of our survey suggest that most of the respondents are following the ASA guidelines for clear fluids and solids however there were differing opinion regarding the duration of fasting for formula milk and breast milk. In conclusion, we would recommend greater awareness and collaboration between anaesthetists, nurses and surgeons to ensure that fasting instructions are consistent with the ASA guidelines and that patient and their parents understand these directives as well.

  14. Percutaneous drainage of abdominal abcess

    Energy Technology Data Exchange (ETDEWEB)

    Men, Sueleyman E-mail: suleyman.men@deu.edu.tr; Akhan, Okan; Koeroglu, Mert

    2002-09-01

    The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that have been described to drain pelvic abscesses include transrectal or transvaginal approach with sonographic guidance, a transgluteal, paracoccygeal-infragluteal, or perineal approach through the greater sciatic foramen with CT guidance. Both the renal and the perirenal abscesses are amenable to percutaneous drainage. Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses as well.

  15. Definition of the drainage filter problem

    NARCIS (Netherlands)

    Zaslavsky, D.

    1977-01-01

    It is common to consider the following: I. Retention of soil particles that may enter the drainage pipe and cause its clogging. For some sensitive structures it is important to prevent settlements due to soil transportation by drainage water.

  16. Preoperative information management system using wireless PDAs.

    Science.gov (United States)

    Sawa, Tomohiro; Okahara, Masaharu; Santo, Masayuki; Schmidt, Ulrich; Nakata, Yoshinori; Morita, Shigeho; Ohno-Machado, Lucila

    2003-01-01

    Personal Digital Assistant (PDA) and wireless communication are currently available in clinical settings. We developed wireless PDA software that assists anesthesiologists in pre-operative patient assessment. The device communicates with the hospital information system through a wireless LAN and is equipped with pre-programmed data entry templates for pre-operative assessment. As a preliminary test of the device, we randomly assigned residents in preoperative assessment to an intervention and a control arm and compared the results.

  17. Percutaneous catheter drainage of intrapulmonary fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H. [Gyeongsang National University Hospital, Chinju (Korea, Republic of)

    1994-01-15

    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment.

  18. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  19. 保留括约肌虚挂线法治疗高位肛周脓肿%Clinical Efficacy of Sphincter-retaining and Loose-seton Therapy in Treating Patients with High Perianal Abscess

    Institute of Scientific and Technical Information of China (English)

    伍静; 刘洪; 杨春梅; 何洪波

    2012-01-01

    Objective To investigate the clinical efficacy of sphincter-retaining and loose-seton therapy in treating high perianal abscess. Methods Using randomized controlled trial, 52 patients with high perianal abscess were randomly assigned to treatment group (n=26) treated with sphincter-retaining and loose-seton therapy and the control group (n=26) treated with perianal abscess radical surgery. The incidence of anal fistula 6 months after the treatment, healing time of incision, V AS scores of night pain 1 to 15 day s after treatment, and sequelae of anal function 6 months later were observed and compared. Results Six months after treatment, the incidences of anal fistula of the treatment group and the control group were respectively 4.0% and 3.8% (P > 0.05). The healing time of incision and night pain score of the surgery day and the 14 days after operation in the treatment group were shorter or slighter compared with those in the control group (P < 0.05). After six-month follow-up, the anal function of treatment group was normal, and the control group had a 12.0% incidence of complications, the difference of which was of statistical significance (P < 0.05). Conclusion The sphincter-retaining and loose-seton therapy on high perianal abscess is better than radical surgery in terms of postoperative pain, healing time of incision and protection of anal function.%目的 探讨保留括约肌虚挂线法治疗高位肛周脓肿的临床疗效.方法 2009年10月-2010年10月采用随机对照试验,对52例高位肛周脓肿患者施行手术治疗,其中保留括约肌虚挂线法(治疗组)26例,切开挂线引流法(对照组)26例.对两组患者术后6个月肛瘘发生率、切口愈合时间、术后1~15d每晚疼痛视觉模拟评分(VAS)和术后6个月痊愈患者肛门功能后遗症发生率进行比较.结果 术后6个月,治疗组和对照组肛瘘发生率分别为4.0%和3.8%,差异无统计学意义(P>0.05).术后7~15d治疗组VAS评分均低于

  20. EUS-Guided Biliary Drainage

    Directory of Open Access Journals (Sweden)

    Marc Giovannini

    2012-01-01

    Full Text Available The echoendoscopic biliary drainage is an option to treat obstructive jaundices when ERCP drainage fails. These procedures compose alternative methods to the side of surgery and percutaneous transhepatic biliary drainage, and it was only possible by the continuous development and improvement of echoendoscopes and accessories. The development of linear setorial array echoendoscopes in early 1990 brought a new approach to diagnostic and therapeutic dimenion on echoendoscopy capabilities, opening the possibility to perform punction over direct ultrasonographic view. Despite of the high success rate and low morbidity of biliary drainage obtained by ERCP, difficulty could be found at the presence of stent tumor ingrown, tumor gut compression, periampulary diverticula, and anatomic variation. The echoendoscopic technique starts performing punction and contrast of the left biliary tree. When performed from gastric wall, the access is made through hepatic segment III. From duodenum, direct common bile duct punction. Dilatation is required before stent introduction, and a plastic or metallic stent is introduced. This phrase should be replaced by: diathermic dilatation of the puncturing tract is required using a 6F cystostome. The technical success of hepaticogastrostomy is near 98%, and complications are present in 36%: pneumoperitoneum, choleperitoneum, infection, and stent disfunction. To prevent bile leakage, we have used the 2 stent techniques, the first stent introduced was a long uncovered metallic stent (8 or 10 cm, and inside this first stent a second fully covered stent of 6 cm was delivered to bridge the bile duct and the stomach. Choledochoduodenostomy overall success rate is 92% and described complications include, in frequency order, pneumoperitoneum and focal bile peritonitis, present in 19%. By the last 10 years, the technique was especially performed in reference centers, by ERCP experienced groups, and this seems to be a general

  1. Exploring Agricultural Drainage's Influence on Wetland and ...

    Science.gov (United States)

    Artificial agricultural drainage (i.e. surface ditches or subsurface tile) is an important agricultural management tool. Artificial drainage allows for timely fieldwork and adequate root aeration, resulting in greater crop yields for farmers. This practice is widespread throughout many regions of the United States and the network of artificial drainage is especially extensive in flat, poorly-drained regions like the glaciated Midwest. While beneficial for crop yields, agricultural drains often empty into streams within the natural drainage system. The increased network connectivity may lead to greater contributing area for watersheds, altered hydrology and increased conveyance of pollutants into natural water bodies. While studies and models at broader scales have implicated artificial drainage as an important driver of hydrological shifts and eutrophication, the actual spatial extent of artificial drainage is poorly known. Consequently, metrics of wetland and watershed connectivity within agricultural regions often fail to explicitly include artificial drainage. We use recent agricultural census data, soil drainage data, and land cover data to create estimates of potential agricultural drainage across the United States. We estimate that agricultural drainage in the US is greater than 31 million hectares and is concentrated in the upper Midwest Corn Belt, covering greater than 50% of available land for 114 counties. Estimated drainage values for numerous countie

  2. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Grønkjær, Marie; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang;

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  3. Correlation between theoretical anatomical patterns of lymphatic drainage and lymphoscintigraphy findings during sentinel node detection in head and neck melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Vidal, Monica; Ruiz, Diana Milena [Hospital Clinic de Barcelona, Nuclear Medicine Department, Barcelona (Spain); Vidal-Sicart, Sergi; Paredes, Pilar; Pons, Francesca [Hospital Clinic de Barcelona, Nuclear Medicine Department, Barcelona (Spain); Institut d' Investigacions Biomediques Agusti Pi i Sunyer (IDIBAPS), Barcelona (Spain); Torres, Ferran [Hospital Clinic Barcelona, Statistical of Biostatistics and Data Management Core Facility, IDIBAPS, Barcelona (Spain); Universitat Autonoma de Barcelona, Biostatistics Unit, Faculty of Medicine, Barcelona (Spain)

    2016-04-15

    In the diagnosis of head and neck melanoma, lymphatic drainage is complex and highly variable. As regional lymph node metastasis is one of the most important prognostic factors, lymphoscintigraphy can help map individual drainage patterns. The aim of this study was to compare the results of lymphoscintigraphy and sentinel lymph node (SLN) detection with theoretical anatomical patterns of lymphatic drainage based on the location of the primary tumour lesion in patients with head and neck melanoma. We also determined the percentage of discrepancies between our lymphoscintigraphy and the theoretical location of nodal drainage predicted by a large lymphoscintigraphic database, in order to explain recurrence and false-negative SLN biopsies. In this retrospective study of 152 patients with head and neck melanoma, the locations of the SLNs on lymphoscintigraphy and detected intraoperatively were compared with the lymphatic drainage predicted by on-line software based on a large melanoma database. All patients showed lymphatic drainage and in all patients at least one SLN was identified by lymphoscintigraphy. Of the 152 patients, 4 had a primary lesion in areas that were not described in the Sydney Melanoma Unit database, so agreement could only be evaluated in 148 patients. Agreement between lymphoscintigraphic findings and the theoretical lymphatic drainage predicted by the software was completely concordant in 119 of the 148 patients (80.4 %, 95 % CI 73.3 - 86 %). However, this concordance was partial (some concordant nodes and others not) in 18 patients (12.2 %, 95 % CI 7.8 - 18.4 %). Discordance was complete in 11 patients (7.4 %, 95 % CI 4.2 - 12.8 %). In melanoma of the head and neck there is a high correlation between lymphatic drainage found by lymphoscintigraphy and the predicted drainage pattern and basins provided by a large reference database. Due to unpredictable drainage, preoperative lymphoscintigraphy is essential to accurately detect the SLNs in head and

  4. Vertical drainage capacity of new electrical drainage board on improvement of super soft clayey ground

    Institute of Scientific and Technical Information of China (English)

    沈扬; 励彦德; 黄文君; 徐海东; 胡品飞

    2015-01-01

    As an advanced polymer composites electro-kinetic geosynthetics, the electro-osmotic vertical drainage (EVD) board could drain water quickly and accelerate consolidation process. However, the drainage rate was mainly impacted by the vertical drainage capability. Therefore, vertical drainage capability at the top of EVD board was theoretically analyzed. Basic requirements for drainage at the top of the board were summed up, as well as the formula of anode pore pressure when losing the vertical drainage capability. Meanwhile, a contrast test on the top and bottom drainage capacities was conducted. In use of the advanced EVD board, the voltage potential and pore pressure of anode were measured. Moreover, the derived formulas were verified. The result shows that the decrease of electric force gradient had an observable impact on the drainage capability. There was nearly no difference between the energy consumption for the two drainage methods. Although a little less water was discharged, the top drainage method had more advantages, such as high initial drainage velocity, few soil cracks, low anode water content and high soil strength. All of these show that the super soft soil ground could be consolidated quickly in use of the advanced EVD board through the top drainage. The top drainage method could efficiently improve the drainage effect, decrease the energy consumption and speed up the project proceeding.

  5. Pericardial drainage for pericardial tamponade: surgical management criteria.

    Science.gov (United States)

    Ballore, L; Nicolini, F; Borrello, B; Beghi, C; De Cicco, G; Contini, G A; Gherli, T

    2001-01-01

    Aim of this study is the review of our experience in 82 patients treated by pericardial drainage for cardiac tamponade, to assess the efficacy and safety of different techniques and the related indications. The causes of pericardial effusion were: malignancy in 8 patients (9.7%), post-cardiac surgery in 12 (14.6%), while the others patients were admitted at our Institution with no identified preoperative diagnosis. Thirty-eight patients (46%) underwent subxiphoid pericardial drainage and 44 (54%) were operated on by catheter pericardiocentesis. There were no perioperative deaths. Two patients, who initially underwent pericardiocentesis, needed urgent sternotomy: the first patient developed a severe hypotension and bradicardia related to a vagal reaction and the other one because of accidental right ventricle puncture. Our experience indicates that subxiphoid pericardiocentesis provides expeditious, effective and durable treatment, with low morbidity, in case of pericardial effusions related to all causes. We believe that echocardiography is a powerful tool in the diagnosis and management of pericardial effusion. We conclude that pericardiocentesis seems to be the procedure of choice for patients with pericardial tamponade requiring an emergency treatment.

  6. Drainage area data for Alabama streams

    Science.gov (United States)

    Stallings, J.S.; Peirce, L.B.

    1957-01-01

    The drainage area of a river basin is an important parameter in many engineering equations used for hydrologic design. It is not a parameter, however, that always requires precise measurement. Factors in the hydrologic cycle such as rainfall, runoff, transpiration, and infiltration cannot be measured nearly as closely as drainage area. Largely for this reason, drainage areas are often measured to varying degrees of precision depending upon the immediate need, with little thought to some other use or some other user of the figure obtained. It can readily be appreciated that this practice, continued for long by many different agencies, will result in a heterogeneous collection of drainage area figures, often discordant and of an accuracy unknown to any but those who computed them. Figures of drainage area published by various Federal agencies are frequently discrepant or contradictory, giving rise to confusion in the use of drainage area data. Seeking to better this situation, the Federal Inter-Agency River Basin Committee (FIARBC) in November 1951 published its Bulletin No. 4, Inter-Agency Coordination of Drainage Area Data. That Bulletin recommended procedures to be followed by the interested Federal agencies “for coordinating drainage area data in the interest of promoting uniformity, reducing confusion and contradiction of published figures, and improving the ready availability of drainage area data pertaining to drainage basins of the United States and its possessions.”

  7. Mine Drainage Generation and Control Options.

    Science.gov (United States)

    Wei, Xinchao; Rodak, Carolyn M; Zhang, Shicheng; Han, Yuexin; Wolfe, F Andrew

    2016-10-01

    This review provides a snapshot of papers published in 2015 relevant to the topic of mine drainage generation and control options. The review is broken into 3 sections: Generation, Prediction and Prevention, and Treatment Options. The first section, mine drainage generation, focuses on the characterization of mine drainage and the environmental impacts. As such, it is broken into three subsections focused on microbiological characterization, physiochemical characterization, and environmental impacts. The second section of the review is divided into two subsections focused on either the prediction or prevention of acid mine drainage. The final section focuses on treatment options for mine drainage and waste sludge. The third section contains subsections on passive treatment, biological treatment, physiochemical treatment, and a new subsection on beneficial uses for mine drainage and treatment wastes.

  8. Preoperative surgical planning for intracranial meningioma resection by virtual reality

    Institute of Scientific and Technical Information of China (English)

    TANG Hai-liang; WANG Dai-jun; ZHU Hong-da; TANG Wei-jun; FENG Xiao-yuan; CHEN Xian-cheng; ZHOU Liang-fu; SUN Hua-ping; GONG Ye; MAO Ying; WU Jing-song; ZHANG Xiao-luo; XIE Qing; XIE Li-qian; ZHENG Ming-zhe

    2012-01-01

    Background The Dextroscope system by Volume Interactions (Singapore) had been applied to minimally invasive neurosurgery in many units.This system enables the neurosurgeon to interact intuitively with the three-dimensional graphics in a direct manner resembling the way one communicates with the real objects.In the paper,we explored its values in pre-operation surgical planning for intracranial meningiomas resection.Methods Brain compuled tomography (CT),magnetic resonance imaging (MRI),and magnetic resonance venography (MRV) were performed on 10 patients with parasagittal and falcine meningiomas located on central groove area; brain CT,MRI and magnetic resonance angiography (MRA) were performed on 10 patients with anterior skull base meningiomas and 10 patients with sphenoid ridge meningiomas.All these data were transferred to Dextroscope virtual reality system,and reconstructed.Then meningiomas,skull base,brain tissue,drainage vein and cerebral arteries were displayed within the system,and their anatomic relationships were evaluated.Also,the simulation operations were performed.Results For parasagittal and falcine meningiomas,the relationships of tumor with drainage vein and superior sagittal sinus were clearly displayed in the Dextroscope system.For anterior skull base and sphenoid ridge meningiomas,the relationships of tumor with bilateral internal carotid arteries,anterior cerebral arteries,middle cerebral arteries and skull base were vividly displayed within the virtual reality system.Surgical planning and simulation operation of all cases were performed as well.The real operations of all patients were conducted according to the simulation with well outcomes.Conclusions According to the virtual reality planning,neurosurgeons could get more anatomic information about meningioma and its surrounding structures,especially important vessels,and choose the best approach for tumor resection,which would lead to better prognosis for patients.

  9. [Simple cholecystectomy without drainage. A dilemma?].

    Science.gov (United States)

    Macellari, G; Baraldi, U; Giustina, A; David, P; Parigi, M; De Angelis, E

    1980-04-30

    A retrospective study was carried out to show the uselessness of the routine employment of the drainage after simple cholecystectomy. 1425 patients underwent cholecystectomy because for cholelithiasis; of these 164 (13%) were drained because of adhesions, concomitant pancreatitis, inadvertent damage, empiema, gangrena and perforation of the gallbladder. In no case of the 1261 patients without drainage it has been possible to demonstrate the presence of one of those complications for which the use of a drainage after simple cholecystectomy is commonly advised.

  10. Drainage basin delineations for selected USGS streamflow-gaging stations in Virginia (Drainage_Basin)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Drainage_Basin polygon feature class was created as a digital representation of drainage basins for more than 1,650 continuous-record streamflow-gaging stations,...

  11. A fresh look at preoperative body washing

    Science.gov (United States)

    Tanner, Judith; Gould, Dinah; Jenkins, Philip; Hilliam, Rachel; Mistry, Neetesh; Walsh, Susannah

    2012-01-01

    National guidelines do not support preoperative body washing to reduce surgical site infections, instead recommending bathing or showering with soap. Yet preoperative body washing continues to be widely used in many hospitals across Europe. This paper suggests that existing trials of preoperative body washing, upon which guidelines are based, are dated and proposes a new investigation of preoperative body washing using modern definitions of surgical site infection with standardised patient follow up, modern surgical techniques and well designed trials. This paper provides a critique of existing guidelines and describes a randomised trial with 60 participants to compare the effect of soap and two antiseptic washing products on colony forming units (CFUs) for up to six hours. Chlorhexidine gluconate and octenidine were significantly more effective than soap in reducing CFUs in the underarm, and chlorhexidine was significantly more effective than soap in reducing CFUs in the groin. PMID:22448182

  12. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  13. Preoperative alcohol cessation prior to elective surgery

    DEFF Research Database (Denmark)

    Oppedal, Kristian; Møller, Ann Merete; Pedersen, Bolette

    2012-01-01

    Hazardous drinking has been associated with an increased postoperative complication rate after surgery. Common complications include postoperative infections, cardiopulmonary complications, and bleeding episodes. Preoperative abstinence may to some degree reverse alcohol-induced pathophysiological...

  14. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  15. Preoperative education for lumbar surgery for radiculopathy

    OpenAIRE

    Louw, A; Louw, Q; L. Crous

    2009-01-01

    To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptive...

  16. Preoperative prediction of severe postoperative pain.

    Science.gov (United States)

    Kalkman, C J; Visser, K; Moen, J; Bonsel, G J; Grobbee, D E; Moons, K G M

    2003-10-01

    We developed and validated a prediction rule for the occurrence of early postoperative severe pain in surgical inpatients, using predictors that can be easily documented in a preoperative setting. A cohort of surgical inpatients (n=1416) undergoing various procedures except cardiac surgery and intracranial neurosurgery in a University Hospital were studied. Preoperatively the following predictors were collected: age, gender, type of scheduled surgery, expected incision size, blood pressure, heart rate, Quetelet index, the presence and severity of preoperative pain, health-related quality of life the (SF-36), Spielberger's State-Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The outcome was the presence of severe postoperative pain (defined as Numeric Rating Scale > or =8) within the first hour postoperatively. Multivariate logistic regression in combination with bootstrapping techniques (as a method for internal validation) was used to derive a stable prediction model. Independent predictors of severe postoperative pain were younger age, female gender, level of preoperative pain, incision size and type of surgery. The area under the receiver operator characteristic (ROC) curve was 0.71 (95% CI: 0.68-0.74). Adding APAIS scores (measures of preoperative anxiety and need for information), but not STAI, provided a slightly better model (ROC area 0.73). The reliability of this extended model was good (Hosmer and Lemeshow test p-value 0.78). We have demonstrated that severe postoperative pain early after awakening from general anesthesia can be predicted with a scoring rule, using a small set of variables that can be easily obtained from all patients at the preoperative visit. Before this internally validated preoperative prediction rule can be applied in clinical practice to support anticipatory pain management, external validation in other clinical settings is necessary.

  17. Subsurface drainage volume reduction with drainage water management: Case studies in Ohio, USA

    Science.gov (United States)

    One of the main contributors to poor water quality in the Mississippi River and aeral increase in the hypoxic zone in the Gulf of Mexico is intensive drainage of the cropland within the watershed. Controlled drainage has been demonstrated as an approach to curb totla drainage outflow and nutrient di...

  18. Clamping drainage is unnecessary after minimally invasive total knee arthroplasty in patients with tranexamic acid

    Science.gov (United States)

    Wu, Yuangang; Yang, Timin; Zeng, Yi; Li, Canfeng; Shen, Bin; Pei, Fuxing

    2017-01-01

    Abstract Background: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. Methods: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups. In the clamping group (N = 60), drainage was clamped for the 1st 4 postoperative hours. In the nonclamping group (N = 61), drainage was not clamped. All patients underwent a minimidvastus approach and received 10 mg/kg TXA intravenously before tourniquet deflation. We recorded the total blood loss, drainage volume, and transfusion requirements in the postoperative period. We also measured the hemoglobin (Hb) and hematocrit (Hct) levels on postoperative days 1, 3, and 5. Other factors, including range of motion (ROM), visual analog scale (VAS), and occurrence of wound-related complications, deep vein thrombosis (DVT), and pulmonary embolism (PE) were recorded at the time of discharge and 1 and 6 months postoperatively. No statistically significant differences were found between the 2 groups with regard to age, gender, weight, BMI, preoperative Hb and Hct levels, preoperative ROM, VAS, duration of surgery, anesthesia method, and the American Society of Anesthesiologists classification. Results: The clamping group experienced better drainage volume results than the nonclamping group (P < 0.001). There were no statistically significant differences in TBL and transfusion requirements (P = 0.105 and 0.276, respectively); Hb and Hct levels on postoperative days 1, 3, and 5 were similar between the 2 groups. No significant differences were found for ROM, VAS, DVT, PE, wound-related complications, and hospital

  19. 24 CFR 3285.604 - Drainage system.

    Science.gov (United States)

    2010-04-01

    ... § 3285.604 Drainage system. (a) Crossovers. Multi-section homes with plumbing in more than one section require drainage system crossover connections to join all sections of the home. The crossover design requirements are located in, and must be designed in accordance with, § 3280.610 of this chapter. (b)...

  20. Agricultural drainage: Towards an integrated approach

    NARCIS (Netherlands)

    Abdeldayem, S.; Hoevenaars, J.; Mollinga, P.P.; Scheuman, W.; Slootweg, R.; Steenbergen, van F.

    2005-01-01

    Drainage needs to reclaim its rightful position as an indispensable element in the integrated management of land and water. An integrated approach to drainage can be developed by means of systematic mapping of the functions of natural resources systems (goods and services) and the values attributed

  1. Simultaneous pancreas-kidney transplantation with enteric drainage of exocrine secretions

    Institute of Scientific and Technical Information of China (English)

    明长生; 曾凡军; 陈知水; 张伟杰; 林正斌; 刘斌; 蒋继贫; 魏来; 陈实; 陈忠华

    2003-01-01

    Objectives To simplify the enteric drainage (ED) procedure and to decrease surgical and metabolic complications in simultaneous pancreas-kidney transplantation (SPK) patients.Results This procedure was successfully applied in all 9 patients without complication referable to the technique. All patients had achieved euglycemia and excellent renal function, and stopped being dependent on an external insulin source. Fasting serum glucose fell from 9.5 preoperatively to 4.8 mmol/L and remained stable thereafter. At the time this paper was written, the grafts from eight patients were functioning well. Conclusions Our primary experience suggests that SPK with ED without Roux-en-Y anastomosis represents a more physiologic milieu, and a viable alternation to replace the bladder (BD) as the primary route of drainage for exocrine secretions of the pancreas. It is a feasible and safer procedure.

  2. Nursing Research of High Complex Anal Fistula Seton Surgery in 60 Patients%高位复杂性肛瘘切开挂线术60例患者护理研究

    Institute of Scientific and Technical Information of China (English)

    姜玉芹

    2015-01-01

    目的:研究高位复杂性肛瘘切开挂线术60例患者护理方式。方法本次临床护理研究主要选取在本院接受治疗的高位复杂性肛瘘切开挂线术60例患者作为临床护理研究的对象,进行临床护理的回顾性分析。结果在经过细致的护理之后,60例患者住院时间均没有发生其他并发症状,术后平均住院时间为(25.12±2.33)天,均已康复出院。结论有效的护理在高位复杂性肛瘘切开挂线术患者护理中的应用,能够有效降低患者的术后并发症状发生几率,减少患者的住院时间。%Objective To study the high complex anal fistula Seton surgery 60 patients nursing.Methods The clinical study selected the incision and thread drawing therapy in 60 patients as the object of clinical nursing research in high complex anal fistula in our hospital for treatment, were retrospectively analyzed the clinical nursing. Results After careful nursing, 60 patients hospitalized time there are no other symptoms, the mean postoperative hospital stay was (25.12±2.33) days, have been discharged.ConclusionThe effective nursing care of patients with postoperative incision and application of line in high complex anal fistula, and can effectively reduce the incidence of complications of patients after operation, reducing hospitalization time.

  3. Endoscopic ultrasound-guided drainage of pancreatic pseudocysts

    DEFF Research Database (Denmark)

    Saftoiu, Adrian; Vilmann, Andreas; Vilmann, Peter

    2015-01-01

    Pancreatic pseudocysts are fluid collections in the peripancreatic tissues associated with acute or chronic pancreatitis. Endoscopic ultrasound (EUS)-guided drainage has become an established indication, having better results as compared to percutaneous drainage, nonguided endoscopic drainage...

  4. Preoperative education for lumbar surgery for radiculopathy

    Directory of Open Access Journals (Sweden)

    A. Louw

    2009-02-01

    Full Text Available To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptiveand inferential statistical tests. Results showed that 100% of the patients and 99% of therapists view preoperative education to be an important component for lumbar surgery for radiculopathy. The most important factors identifiedfor inclusion in preoperative educational programs were reason for surgery, risks associated with surgery, limitations following surgery and more education regarding pain. The preferred method of education delivery was verbal one-on-one education. This study demonstrates that there is a demand for preoperative education for patients who had lumbar surgery.

  5. [Preoperative assessment of lung disease patients.].

    Science.gov (United States)

    Ramos, Gilson; Ramos Filho, José; Pereira, Edísio; Junqueira, Marcos; Assis, Carlos Henrique C

    2003-02-01

    Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients. Major anesthetic-surgical repercussions in lung function have already been described. Similarly, we tried to select higher-risk patients, submitted or not to lung resection. To that end, clinical and laboratorial propedeutics were used. Finally, a proposal of a preoperative algorithm was presented for procedures with lung resection. Lung disease patients, especially those with chronic evolution, need to be preoperatively thoroughly evaluated. ASA physical status and Goldmans cardiac index are important risk forecasting factors for lung disease patients not candidates for lung resection. Adding to these criteria, estimated postoperative max VO2, FEV1 and diffusion capacity are mandatory for some patients submitted to lung resection. beta2-agonists and steroids should be considered in the preoperative period of these patients.

  6. Perianal Abscess by Deep Multi Gap Multi Incision of Drainage in the Treatment of Clinical Hanging Line Incision%肛周深部多间隙脓肿采用多切口切开引流挂线术治疗的临床体会

    Institute of Scientific and Technical Information of China (English)

    郭春海

    2015-01-01

    目的:对肛周深部多间隙脓肿患者采用多切口切开引流挂线术进行治疗的临床效果进行探讨。方法选取我院收治的32例肛周深部多间隙脓肿患者作为研究对象,所有患者均采用多切口切开引流挂线术治疗,治疗后,观察术后并发症、不良反应以及切口愈合等情况。结果患者手术均一次性治愈;肛门功能恢复正常;无一例患者发生肛门狭窄、肛门失禁以及肛门畸形等并发症。结论治疗肛周深部多间隙脓肿患者采取多切口切开引流挂线术,能够缩短愈合时间,降低复发率。%Objective To incision and drainage of the clinical effect of treatment for the discussion hangs the line operation on perianal abscess were treated by deep multi gap multi incision. Methods In our hospital 32 cases of perianal abscess in patients with deep gap as the object of study,al patients were treated by multiple incision and drainage seton treatment,and observed postoperative complications,adverse reaction and wound healing. Results The patients were healed in one operation,anal function returned to normal,no patients had stricture of anus,anal incontinence and anal deformity or other complications. Conclusion The treatment of perianal abscess patients to take deep multi gap multi incision and drainage Seton,can shorten the healing time,reduce the recurrence rate.

  7. The Geochemistry of Acid Mine Drainage

    Science.gov (United States)

    Blowes, D. W.; Ptacek, C. J.; Jambor, J. L.; Weisener, C. G.

    2003-12-01

    Mine wastes are the largest volume of materials handled in the world (ICOLD, 1996). The generation of acidic drainage and the release of water containing high concentrations of dissolved metals from these wastes is an environmental problem of international scale. Acidic drainage is caused by the oxidation of sulfide minerals exposed to atmospheric oxygen. Although acid drainage is commonly associated with the extraction and processing of sulfide-bearing metalliferous ore deposits and sulfide-rich coal, acidic drainage can occur wherever sulfide minerals are excavated and exposed to atmospheric oxygen. Engineering projects, including road construction, airport development, and foundation excavation are examples of civil projects that have resulted in the generation of acidic drainage. On United States Forest Service Lands there are (2-5)×104 mines releasing acidic drainage (USDA, 1993). Kleinmann et al. (1991) estimated that more than 6,400 km of rivers and streams in the eastern United States have been adversely affected by mine-drainage water. About (0.8-1.6)×104 km of streams have been affected by metal mining in the western United States. The annual worldwide production of mine wastes exceeded 4.5 Gt in 1982 (ICOLD, 1996). Estimated costs for remediating mine wastes internationally total in the tens of billions of dollars ( Feasby et al.,1991).

  8. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children......Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  9. Gravity Drainage Kinetics of Papermaking Fibrous Suspensions

    Directory of Open Access Journals (Sweden)

    Przybysz Piotr

    2014-12-01

    Full Text Available The study analyses application possibilities of filtration and thickening models in evaluation of papermaking suspension drainage rate. The authors proposed their own method to estimate the drainage rate on the basis of an existing Ergun capillary model of liquid flow through a granular material. The proposed model was less sensitive to porosity changes than the Ergun model. An empirical verification proved robustness of the proposed approach. Taking into account discrepancies in the published data concerning how the drainage velocity of papermaking suspension is defined, this study examines which of the commonly applied models matches experimental results the best.

  10. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice.

    Science.gov (United States)

    Gundry, S R; Strodel, W E; Knol, J A; Eckhauser, F E; Thompson, N W

    1984-06-01

    Fifty consecutive matched patients with benign or malignant biliary tract obstruction were compared to determine the efficacy of preoperative percutaneous biliary drainage (PBD). Twenty-five patients underwent PBD for an average of nine days before operation; 25 patients underwent percutaneous transhepatic cholangiography ( PTHC ) followed immediately by operation. Serum bilirubin levels before PTHC were 16.5 +/- 7.6 mg/dL and 14.9 +/- 7.6 mg/dL in PBD and non-PBD groups, respectively. Serum bilirubin levels decreased to 6.5 +/- 6.2 mg/dL preoperatively in patients having PBD. One week after operation, bilirubin levels were 4.2 +/- 4.3 mg/dL and 9.0 +/- 5.2 mg/dL in the PBD and non-PBD groups, respectively. Major morbidity (sepsis, abscess, renal failure, or bleeding) occurred in two patients (8%) having PBD and in 13 patients (52%) without PBD. One patient (4%) with PBD, and five patients (20%) without PBD, died. The mean hospital stay was shorter for the PBD group. Preoperative PBD reduces operative mortality and morbidity and results in a more rapid resolution of hyperbilirubinemia during the postoperative period.

  11. The role of preoperative angiography in the management of giant meningiomas associated to vascular malformation

    Directory of Open Access Journals (Sweden)

    Fabio Papacci

    2015-01-01

    Full Text Available Background: The role of preoperative digital subtraction angiography (DSA in meningiomas is currently under discussion because of the introduction of noninvasive magnetic resonance imaging (MRI angiography to study vascular anatomy associated to the tumor. Preoperative DSA is mainly performed to obtain embolization of the lesion, although a number of complications have been reported after this procedure. Nonetheless, the coexistence of meningiomas with vascular malformations has previously been reported and it has been evidenced that this event could be underestimated because of neglect of preoperative DSA. Here, we report on two challenging cases of giant meningiomas associated to vascular malformations and we discuss the pertinent literature. Case Descriptions: In the first case: A large right temporal meningioma with erosion of the sphenoid greater wing and extension toward infratemporal fossa and right orbit - a large pseudoaneurysm of right middle cerebral artery branch was found end embolized during DSA. In the second case: A giant parieto-temporal meningioma - DSA permitted the full visualization of an abnormal drainage of superior sagittal sinus like a "sinus pericranii" that was respected during the following surgery. Conclusion: We think that MRI angiography is the exam of choice to study vascular anatomy in meningiomas. Nonetheless, DSA remains a useful tool in giant meningiomas not only to embolizate the lesion but also to treat tumor associated vascular malformation and to achieve the full knowledge of vascular anatomy. We think that a wide communication between interventionalist and surgeon is essential for the optimal management of these patients.

  12. Drainage filter technologies to mitigate site-specific phosphorus losses in agricultural drainage discharge

    DEFF Research Database (Denmark)

    Kjærgaard, Charlotte; Heckrath, Goswin Johann; Canga, Eriona;

    Losses of phosphorus (P) in drainage waters contribute an estimated 33% to the total agricultural P load in Denmark. Mitigating agricultural P losses is challenging, as critical P losses comprise only a very small fraction of actual soil P contents and are not directly related to fertilizer P input...... in drainage. The Danish “SUPREME-TECH” project (2010-2016) (www.supreme-tech.dk) aims at providing the scientific basis for developing cost-effective filter technologies for P in agricultural drainage waters. The project studies different approaches of implementing filter technologies including drainage well...... the occurrence of surface-induced precipitation processes. The P-retention efficiency of granular drainage filters and constructed wetlands was compared for treating drainage water, and a subcatchment analysis illustrated the potential of implementing such measures....

  13. Fractal Analysis of Drainage Basins on Mars

    Science.gov (United States)

    Stepinski, T. F.; Marinova, M. M.; McGovern, P. J.; Clifford, S. M.

    2002-01-01

    We used statistical properties of drainage networks on Mars as a measure of martian landscape morphology and an indicator of landscape evolution processes. We utilize the Mars Orbiter Laser Altimeter (MOLA) data to construct digital elevation maps (DEMs) of several, mostly ancient, martian terrains. Drainage basins and channel networks are computationally extracted from DEMs and their structures are analyzed and compared to drainage networks extracted from terrestrial and lunar DEMs. We show that martian networks are self-affine statistical fractals with planar properties similar to terrestrial networks, but vertical properties similar to lunar networks. The uniformity of martian drainage density is between those for terrestrial and lunar landscapes. Our results are consistent with the roughening of ancient martian terrains by combination of rainfall-fed erosion and impacts, although roughening by other fluvial processes cannot be excluded. The notion of sustained rainfall in recent Mars history is inconsistent with our findings.

  14. Results of percutaneous transhepatic cholangiography drainages (PTCD)

    Energy Technology Data Exchange (ETDEWEB)

    Schoenemann, J.; Willems, M.; Wolf, G.; Fromme, M.

    1987-12-01

    From September 1980 to December 1986, 72 percutaneous transhepatic cholangiography drainages (PTCD) were performed in 64 patients (58 palliative in malignant obstructions, 14 temporary). The median duration of drainage was 26.8 days (2-183 days). The median survival time in 37 patients with palliative tumour drainage was 55.3 days (7-473 days). 9/37 patients survived longer than 3 months (max. 15.5 months). Complications occurred in 29.5% (10.3% severe). 3/64 patients (4.7%) died. Patients with palliative transpapillary drainages (23), especially with endoprostheses (14), survived longer, and the complication rate was lower. Therefore, we prefer the endoscopic transpapillary approach. PTCD patients must be selected carefully.

  15. Fractal Analysis of Drainage Basins on Mars

    Science.gov (United States)

    Stepinski, T. F.; Marinova, M. M.; McGovern, P. J.; Clifford, S. M.

    2002-01-01

    We used statistical properties of drainage networks on Mars as a measure of martian landscape morphology and an indicator of landscape evolution processes. We utilize the Mars Orbiter Laser Altimeter (MOLA) data to construct digital elevation maps (DEMs) of several, mostly ancient, martian terrains. Drainage basins and channel networks are computationally extracted from DEMs and their structures are analyzed and compared to drainage networks extracted from terrestrial and lunar DEMs. We show that martian networks are self-affine statistical fractals with planar properties similar to terrestrial networks, but vertical properties similar to lunar networks. The uniformity of martian drainage density is between those for terrestrial and lunar landscapes. Our results are consistent with the roughening of ancient martian terrains by combination of rainfall-fed erosion and impacts, although roughening by other fluvial processes cannot be excluded. The notion of sustained rainfall in recent Mars history is inconsistent with our findings.

  16. PREOPERATIVE ENDOSCOPIC MARKING OF UNPALPABLE COLONIC TUMORS

    Directory of Open Access Journals (Sweden)

    A. L. Goncharov

    2013-01-01

    Full Text Available The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm malignant tumors of the left colon is performed.Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001.Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.

  17. Preoperative exercise training to improve postoperative outcomes

    NARCIS (Netherlands)

    Valkenet, K.

    2017-01-01

    It is common knowledge that better preoperative physical fitness is associated with better postoperative outcomes. However, as a result of aging of the population and improved surgical and anaesthesia techniques, the proportion of frail patients with decreased physical fitness levels undergoing majo

  18. Preoperational test report, primary ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  19. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  20. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  1. Preoperational test report, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  2. Preoperative and intraoperative continuous use of ...

    African Journals Online (AJOL)

    2016-09-13

    Sep 13, 2016 ... in clinics to improve patient safety and effectiveness with. Introduction ... and control group according to different use of drugs. The two ... Key words: Anesthesia, dexmedetomidine, effect, intervention, preoperative, recovery, remifentanil .... will lead to postoperative pain in patients and severe agitation after ...

  3. Preoperational test, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T., Westinghouse Hanford

    1996-08-20

    Preoperational Test Procedure for Vent Building Ventilation System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The Vent Building ventilation system provides ventilation, heating, cooling, and zone confinement control for the W-030 Project Vent Building. The tests verify correct System operation and correct indications displayed by the central Monitor and Control system.

  4. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from preo

  5. The Value of Abdominal Drainage After Laparoscopic Cholecystectomy for Mild or Moderate Acute Calculous Cholecystitis: A Post Hoc Analysis of a Randomized Clinical Trial.

    Science.gov (United States)

    Prevot, Flavien; Fuks, David; Cosse, Cyril; Pautrat, Karine; Msika, Simon; Mathonnet, Muriel; Khalil, Haitham; Mauvais, François; Regimbeau, Jean-Marc

    2016-11-01

    Although the preoperative management of mild and moderate (Grade I-II) acute calculous cholecystitis (ACC) has been standardized, there is no consensus on the value of abdominal drainage after early cholecystectomy. In a post hoc analysis of a randomized controlled trial (NCT01015417) focused on the value of postoperative antibiotic therapy in patients with ACC, we determined the value of abdominal drainage in patients having undergone laparoscopic cholecystectomy for Grades I-II ACC. All postoperative complications were analyzed after using a propensity score. A post hoc test was used to assess the statistical robustness of our results. Of the 414 enrolled patients, 178 did not have abdominal drainage (forming the no-drainage group) and 236 had drainage (the drainage group). After matching on PS, the deep incisional site infection was 1.1 versus 0.8 %, p = 0.78. This result is similar for the superficial incisional site infections; the distant infections; the overall morbidity, and the readmission rate. Only the hospital length of stay was significantly longer in the drainage group (3.3 vs. 5.1 days, p = 0.003). Neither abdominal drainage nor the absence of postoperative antibiotic therapy was found to be a risk factor for deep incisional site infections. The use of abdominal drainage depends on the surgeon's personal preferences but is often used in high-risk populations. However, abdominal drainage does not appear to be of any benefit (in terms of postoperative outcomes) and may even compromise recovery in patients having undergone early laparoscopic cholecystectomy for mild or moderate ACC.

  6. THE ENVIRONMENTAL IMPACT OF ACID MINE DRAINAGE

    OpenAIRE

    GRAY, NICHOLAS FREDERICK; Sullivan, Monica

    2017-01-01

    This review examine the action of acid mine drainage (AMD), which is a multifactor pollutant, on surface waters. It affects aquatic ecosystems via a number of direct and indirect pathways. Major impact areas are coastal waters, rivers, lakes and estuaries, with AMD affecting ecosystems in different ways. Ground waters can also be severely impacted. Due to its complexity, the impact of AMD is particularly difficult to quantify and predict in lotic systems. Acid mine drainage pollut...

  7. Ultrasound-guided percutaneous transhepatic cholangiography and drainage in patients with hilar cholangiocarcinoma.

    Science.gov (United States)

    Laméris, J S; Hesselink, E J; Van Leeuwen, P A; Nijs, H G; Meerwaldt, J H; Terpstra, O T

    1990-05-01

    The use of ultrasound-guided PTCD in 49 patients with hilar cholangiocarcinoma was evaluated. In 11 patients PTCD was performed as a preoperative measure either to outline tumor extension or to treat cholangitis. Postoperatively, the catheters were used to stent bilioenteric anastomoses and served to guide iridium wires for radiotherapy in nine patients with nonresectable tumor or tumor residue after resection. In 20 inoperable patients with tumor diameter smaller than 3 cm and in whom at least one catheter could be manipulated through the tumor, PTCD was combined with internal and external radiotherapy. The remaining 18 patients were palliated with PTCD only. In 29 patients (59%) complete drainage of the biliary system was achieved. Twenty-seven of these had complete internal drainage using endoprostheses. Two had a combination of an endoprosthesis and external catheter drainage. Of the 20 patients (41%) with incomplete drainage, 12 had endoprostheses, four had a catheter and an endoprosthesis, and in the remaining four external catheter drainage was the optimum result. PTCD was successful in treating eight of ten patients with cholangitis and 12 of 16 patients with pruritus. Procedure-related complication occurred in 11 patients (22%). With the exception of one, all complications could be classified as minor, requiring only conservative measures. A major complication was seen in a patient with ascitic fluid and severe cholangitis. PTCD caused a bacterial peritonitis, of which the patient died. The median survival of patients treated with PTCD alone only was 4 months. A significant increase in survival was noted in patients treated with PTCD and radiotherapy (median survival 8 months).(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Percutaneous drainage of pelvic fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Young; Sohn, Cheol Ho [School of Medicine Keimyung University, Daegu (Korea, Republic of)

    1995-10-15

    To evaluate safe access route and success rate of percutaneous drainage of pelvic fluid collection. The 35 percutaneous drainages of pelvic fluid collection under the CT and fluorosocpic guidance were done in 32 patients. The anterior transabdominal approach was done in 20 patients, while the nine patients used the transgluteal approach through greater sciatic foramen. Three patients, who had septated or noncommunicating abscesses, underwent drainage using both approaches. The catheter was removed when the patient's symptom and laboratory data were improved or the amount of drainage and the size of fluid collection were markedly reduced. Success, partial success and failure were classified. The causes of fluid collection were complication of intraabdominal operation in 27 patient. The diagnosis after drainage included abscess (21), loculated ascites (6), and hematoma (4). The 27 cases (30 procedure) were treated successfully and the mean duration of catheter insertion was 10 days. The partial successes were two cases (2 procedures), which had palliative purpose. Three cases (3 procedures) were failed, which were multiple loculated ascites of pancreatic origin (2) and recurrent abscess (1). The significant complication during the procedure or drainage was not noted.

  9. 46 CFR 171.155 - Drainage of an open boat.

    Science.gov (United States)

    2010-10-01

    ... PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.155 Drainage of an open boat. The deck within the hull of an open boat must drain to the bilge. Overboard drainage of the deck is not... 46 Shipping 7 2010-10-01 2010-10-01 false Drainage of an open boat. 171.155 Section 171.155...

  10. [The value of wound drainage with or without suction].

    Science.gov (United States)

    Schmidt, J; Hasselbach, A; Schnorr, W; Baranek, T; Letsch, R

    2005-11-01

    Even though the discussion for desisting from wound drainage has arisen, this is not reflected in the reality of surgical treatment. In more than 90% of all procedures wound drainage is used. It remains to be proven whether suction drainage actually is superior to gravity drainage in everyday use. In a random study with 200 patients it was proven that suction drainage shows no significant advantage in liquid quantum, haematoma and the frequency of complications. We conclude that the economically favourable gravity drainage can replace the more expensive suction drainage in most cases.

  11. Failures and complications of thoracic drainage

    Directory of Open Access Journals (Sweden)

    Đorđević Ivana

    2006-01-01

    Full Text Available Background/Aim. Thoracic drainage is a surgical procedure for introducing a drain into the pleural space to drain its contents. Using this method, the pleura is discharged and set to the physiological state which enables the reexpansion of the lungs. The aim of the study was to prove that the use of modern principles and protocols of thoracic drainage significantly reduces the occurrence of failures and complications, rendering the treatment more efficient. Methods. The study included 967 patients treated by thoracic drainage within the period from January 1, 1989 to June 1, 2000. The studied patients were divided into 2 groups: group A of 463 patients treated in the period from January 1, 1989 to December 31, 1994 in whom 386 pleural drainage (83.36% were performed, and group B of 602 patients treated form January 1, 1995 to June 1, 2000 in whom 581 pleural drainage (96.51% were performed. The patients of the group A were drained using the classical standards of thoracic drainage by the general surgeons. The patients of the group B, however, were drained using the modern standards of thoracic drainage by the thoracic surgeons, and the general surgeons trained for this kind of the surgery. Results. The study showed that better results were achieved in the treatment of the patients from the group B. The total incidence of the failures and complications of thoracic drainage decreased from 36.52% (group A to 12.73% (group B. The mean length of hospitalization of the patients without complications in the group A was 19.5 days versus 10 days in the group B. The mean length of the treatment of the patients with failures and complications of the drainage in the group A was 33.5 days versus 17.5 days in the group B. Conclusion. The shorter length of hospitalization and the lower morbidity of the studied patients were considered to be the result of the correct treatment using modern principles of thoracic drainage, a suitable surgical technique, and a

  12. Preoperative staging of perforated diverticulitis by computed tomography scanning

    NARCIS (Netherlands)

    M.P.M. Gielens; I.M. Mulder (Irene); E. van der Harst (Erwin); M.P. Gosselink (Martijn Pieter); K.J. Kraal; H.T. Teng; J.F. Lange (Johan); J. Vermeulen (Jefrey)

    2012-01-01

    textabstractBackground: Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. Methods: All patie

  13. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    National Research Council Canada - National Science Library

    Moerman, N; Dam, van, F.S.A.M; Muller, M.J; Oosting, H

    1996-01-01

    ... phase.During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS...

  14. Location of Agricultural Drainage Pipes and Assessment of Agricultural Drainage Pipe Conditions Using Ground Penetrating Radar

    Science.gov (United States)

    Methods are needed to not only locate buried agricultural drainage pipe, but to also determine if the pipes are functioning properly with respect to water delivery. The primary focus of this research project was to confirm the ability of ground penetrating radar (GPR) to locate buried drainage pipe ...

  15. [Preoperative assessment of patients with diabetes mellitus].

    Science.gov (United States)

    Takeda, Kiyoshi

    2010-07-01

    The perioperative morbidity of diabetic patients is related to preoperative end-organ damage. Due to the microvascular pathology, autonomic neuropathy is common and cardiovascular abnormalities such as hypertension, painless myocardial ischemia, and orthostatic hypotension may predispose patients to perioperative cardiovascular instability. Autonomic dysfunction also contributes to delayed gastric emptying, and preoperative administration of a histamine antagonist and a gastric emptying agent is needed. Chronic hyperglycemia leads to glycosylation of tissue proteins and the accumulation of abnormal collagen can cause stiff joint syndrome resulting in difficult tracheal intubation. The primary goal of pre and intraoperative blood glucose control is to avoid hypoglycemia and ketosis. Moreover, the tight glycemic control has been reported to improve survival in critically ill patients who were treated in the intensive care unit.

  16. Preoperatively diagnosed mucocele of the appendix.

    Science.gov (United States)

    Rojnoveanu, Gh; Ghidirim, Gh; Mishin, I; Vozian, M; Mishina, A

    2014-01-01

    Mucocele of the appendix is an infrequent entity, characterized by distension of the lumen due to accumulation of mucoid substance and is rarely diagnosed preoperatively. If untreated, mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The type of surgical treatment is related to the dimensions and the histology of the mucocele. Appendectomy is used for simple mucocele or for cystadenoma. Right hemi-colectomy is recommended for cystadeno carcinoma. In this paper, we report a case of an asymptomatic 37-year-old woman in whom mucocele was found on a routine ultrasound examination and preoperative computed tomography scan. Surgery revealed a big appendix measuring 84 mm in length and 40 mm in diameter. The final pathologic diagnosis was simple mucocele. Celsius.

  17. Preoperative Alcohol Consumption and Postoperative Complications

    DEFF Research Database (Denmark)

    Eliasen, Marie; Grønkjær, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2013-01-01

    .30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to moderate preoperative alcohol...... complications, prolonged stay at the hospital, and admission to intensive care unit....

  18. The use of a portable gamma camera for preoperative lymphatic mapping: a comparison with a conventional gamma camera

    Energy Technology Data Exchange (ETDEWEB)

    Vidal-Sicart, Sergi; Paredes, Pilar [Hospital Clinic Barcelona, Nuclear Medicine Department (CDIC), Barcelona (Spain); Institut d' Investigacio Biomedica Agusti Pi Sunyer (IDIBAPS), Barcelona (Spain); Vermeeren, Lenka; Valdes-Olmos, Renato A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Nuclear Medicine Department, Amsterdam (Netherlands); Sola, Oriol [Hospital Clinic Barcelona, Nuclear Medicine Department (CDIC), Barcelona (Spain)

    2011-04-15

    Planar lymphoscintigraphy is routinely used for preoperative sentinel node visualization, but large gamma cameras are not always available. We evaluated the reproducibility of lymphatic mapping with a smaller and portable gamma camera. In two centres, 52 patients with breast cancer received preoperative lymphoscintigraphy with a conventional gamma camera with a field of view of 40 x 40 cm. Static anterior and lateral images were performed at 15 min, 2 h and 4 h after injection of the radiotracer ({sup 99m}Tc-nanocolloid). At 2 h after injection, anterior and oblique images were also performed with a portable gamma camera (Sentinella, Oncovision) positioned to obtain a field of view of 20 x 20 cm. Visualization of lymphatic drainage on conventional images and images with the portable device were compared for number of nodes depicted, their intensity and localization of sentinel nodes. The images performed with the conventional gamma camera depicted sentinel nodes in 94%, while the portable gamma camera showed drainage in 73%. There was however no significant difference in visualization between the two devices when a lead shield was used to mask the injection area in 43 patients (95 vs 88%, p = 0.25). Second-echelon nodes were visualized in 62% of the patients with the conventional gamma camera and in 29% of the cases with the portable gamma camera. Preoperative imaging with a portable gamma camera fitted with a pinhole collimator to obtain a field of view of 20 x 20 cm is able to depict sentinel nodes in 88% of the cases, if a lead shield is used to mask the injection site. This device may be useful in centres without the possibility to perform a preoperative image. (orig.)

  19. Drainage Pathway of the Superior Petrosal Vein Evaluated by CT Venography in Petroclival Meningioma Surgery.

    Science.gov (United States)

    Kaku, Shougo; Miyahara, Kosuke; Fujitsu, Kazuhiko; Hataoka, Shunsuke; Tanino, Shin; Okada, Tomu; Ichikawa, Teruo; Abe, Toshiaki

    2012-10-01

    Objectives This study aimed to clarify the drainage location of the superior petrosal vein (SPV) in relation to Meckel's cave and the internal acoustic meatus (IAM) and to discuss its significance in petroclival meningioma surgery. Design Prospective clinical study. Setting Hospital-based. Participants Five patients with petroclival meningioma and 50 patients (primarily unruptured supratentorial aneurysm patients, with a few hemifacial spasm patients) with no posterior fossa lesions. Main Outcome Measures On computed tomography venography (CTV), the drainage site was classified into three patterns based on its relationship to Meckel's cave and the IAM: Meckel's cave type, Intermediate type, and Meatal type. Results In all patients, the SPV was patent and emptied into the superior petrosal sinus (SPS). In patients without posterior fossa lesions, 35% had Meckel's cave type, 54% had Intermediate type, and 11% had Meatal type. Of the five patients with petroclival meningioma, three had Intermediate type, and two had Meckel's cave type. Conclusion The SPV is a significant vein that should be preserved to prevent venous complications. Preoperative knowledge of the SPV drainage site is helpful for planning the approach and preserving the SPV in petroclival meningioma surgery.

  20. Histological changes at an endosonography-guided biliary drainage site: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Endosonography-guided biliary drainage (ESBD) is a new method enabling internal drainage of an obstructed bile duct. However, the histological conditions associated with fistula development via the duodenum to the bile duct have not been reported. We performed ESBD 14 d preoperatively in a patient with an ampullary carcinoma and histologically confirmed changes in and around the fistula. The female patient developed no complications relevant to ESBD. Levels of serum bilirubin and hepatobiliary enzymes declined quickly, and pancreatoduodenectomy was carried out uneventfully. The resected specimen was sliced and stained with hematoxylin-eosin. Histological evaluation of the puncture site in the duodenum and bile-duct wall, and the sinus tract revealed no hematoma, bile leakage, or abscess in or around the sinus tract. Little sign of granulation, fibrosis, and inflammatory cell infiltration was observed. Although further large-scale confirmatory studies are needed, the findings here may encourage more active use of ESBD as a substitute for percutaneous transhepatic drainage in cases with failed/difficult endoscopic biliary stenting.

  1. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  2. Citrus aurantium blossom and preoperative anxiety.

    Science.gov (United States)

    Akhlaghi, Mahmood; Shabanian, Gholamreza; Rafieian-Kopaei, Mahmoud; Parvin, Neda; Saadat, Mitra; Akhlaghi, Mohsen

    2011-01-01

    Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossomon preoperative anxiety. We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1mL.kg(-1) (C-group); 2) Saline solution 1mL.kg(-1) as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. After premedication, both the STAI-state and the APAIS scales were decreased in C-group (ppreoperative anxiety before minor operation. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  3. Preoperative imaging diagnosis of carotid body tumors.

    Science.gov (United States)

    Pacheco-Ojeda, Luis A; Martínez-Viteri, Miguel A

    2010-01-01

    Carotid body tumors (CBTs) are relatively frequent lesions encountered at high altitudes, such in as the Andean Mountains. A correct preoperative diagnosis is essential for surgical planning and performance. For this reason, we have reviewed the evolution of our experience in the imaging diagnosis of these tumors. Between 1980 and June 2008, 160 CBTs were diagnosed. A total of 138 tumors were operated on, 4 are waiting for surgery, and 18 were not operated on because of age, medical conditions, or patient refusal. We have reviewed retrospectively the modalities of imaging diagnosis in our patients who underwent operation. Among the 138 tumors operated on, a correct preoperative diagnosis was done in 127 cases (92%). The preoperative diagnosis of the remaining 11 patients was unspecified benign tumor for 6 patients and neck lymph node for 5 patients. The imaging methods performed by different radiologists were conventional ultrasound, color Doppler ultrasound, carotid conventional angiography (CA), axial tomography, magnetic resonance and magnetic resonance angiography, and computed tomographic angiography (CTA). Most patients had more than one image study. Review of radiologist reports revealed a correct diagnosis in all carotid CA, magnetic resonance studies, and CTA. Additionally, CTA appeared to be a valuable method to predict the Shamblin group. Clinical suspicion and current image techniques permit a correct diagnosis in practically all cases of CBT.

  4. Implications of preoperative hypoalbuminemia in colorectal surgery

    Institute of Scientific and Technical Information of China (English)

    Adam Truong; Mark H Hanna; Zhobin Moghadamyeghaneh; Michael J Stamos

    2016-01-01

    Serum albumin has traditionally been used as a quantitative measure of a patient’s nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient’s chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.

  5. Urban Drainage Modeling and Flood Risk Management

    Science.gov (United States)

    Schmitt, Theo G.; Thomas, Martin

    The European research project in the EUREKA framework, RisUrSim (Σ!2255) has been worked out by a project consortium including industrial mathematics and water engineering research institutes, municipal drainage works as well as an insurance company. The overall objective has been the development of a simulation to allow flood risk analysis and cost-effective management for urban drainage systems. In view of the regulatory background of European Standard EN 752, the phenomenon of urban flooding caused by surcharged sewer systems in urban drainage systems is analyzed, leading to the necessity of dual drainage modeling. A detailed dual drainage simulation model is described based upon hydraulic flow routing procedures for surface flow and pipe flow. Special consideration is given to the interaction between surface and sewer flow in order to most accurately compute water levels above ground as a basis for further assessment of possible damage costs. The model application is presented for small case study in terms of data needs, model verification, and first simulation results.

  6. Autogenic Drainage in Children With Cystic Fibrosis.

    Science.gov (United States)

    Corten, Lieselotte; Morrow, Brenda M

    2017-04-01

    Airway clearance is an essential part of the management of cystic fibrosis (CF) as it facilitates clearance of viscous pulmonary secretions. This review aimed to determine the effect of autogenic drainage (AD) and assisted autogenic drainage (AAD) compared with no, sham, or other types of airway clearance in children with CF. Two pediatric randomized cross-over trials were identified on the use of AD in children with CF; no studies were available on the use of AAD. In one study AD had a positive influence on the Huang score, and is preferred over postural drainage in this population. We could not determine the efficacy of AD and AAD in children with CF. We recommend the implementation of pediatric-specific randomized controlled trials with adequate sample sizes, appropriate clinical outcome measures, and analysis of adverse effects.

  7. [Methods of internal drainage of pancreatic pseudocysts].

    Science.gov (United States)

    Starkov, Yu G; Solodinina, E N; Zamolodchikov, R D

    2016-01-01

    To present own experience of internal drainage and characteristics of its different variants which are applied in various countries. Endosonography-assisted internal drainage of pancreatic pseudocysts was performed in 25 patients. Plastic stents were implanted in one stage without change of instruments while metal stents - with change of instruments during manipulation. Intervention was successful in 24 patients. In 1 case bleeding developed during cystostomy that required open surgery. Plastic and metal stents were used in 11 and 12 patients respectively. 1 patient had two pancreatic pseudocysts. Therefore 2 stents of both types were used in this case. Clinical success was achieved in 91% of cases. Different variants of method resolve problem of surgical approach, stomy and choice of stent. However every technique is targeted to resolve separate problem while single method is not accepted. Further large comparative studies are necessary to define optimal technique of internal drainage.

  8. Percutaneous epidural drainage through a burr hole

    Directory of Open Access Journals (Sweden)

    Priscila M Falsarella

    2016-01-01

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

  9. Iron therapy for pre-operative anaemia.

    Science.gov (United States)

    Ng, Oliver; Keeler, Barrie D; Mishra, Amitabh; Simpson, Alastair; Neal, Keith; Brookes, Matthew J; Acheson, Austin G

    2015-12-22

    Pre-operative anaemia is common and occurs in up to 76% of patients. It is associated with increased peri-operative allogeneic blood transfusions, longer hospital lengths of stay and increased morbidity and mortality. Iron deficiency is one of the most common causes of this anaemia. Oral iron therapy has traditionally been used to treat anaemia but newer, safer parenteral iron preparations have been shown to be more effective in other conditions such as inflammatory bowel disease, chronic heart failure and post-partum haemorrhage. A limited number of studies look at iron therapy for the treatment of pre-operative anaemia. The aim of this Cochrane review is to summarise the evidence for use of iron supplementation, both enteral and parenteral, for the management of pre-operative anaemia. The objective of this review is to evaluate the effects of pre-operative iron therapy (enteral or parenteral) in reducing the need for allogeneic blood transfusions in anaemic patients undergoing surgery. We ran the search on 25 March 2015. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic and EMBASE (Ovid), CINAHL Plus (EBSCO), PubMed, clinical trials registries, conference abstracts, and we screened reference lists. We included all randomised controlled trials (RCTs) which compared pre-operative iron monotherapy to placebo, no treatment, standard of care or another form of iron therapy for anaemic adults undergoing surgery. Anaemia was defined by haemoglobin values less than 13 g/dL for males and 12 g/dL for non-pregnant females. Data were collected by two authors on the proportion of patients who receive a blood transfusion, amount of blood transfused per patient (units) and haemoglobin measured as continuous variables at pre-determined time-points: pre

  10. Gas drainage technology of high gas and thick coal seam

    Institute of Scientific and Technical Information of China (English)

    HE Tian-cai; LI Hai-gui; ZHANG Hai-jun

    2009-01-01

    Gas drainage in Jincheng Mining Group Co., Ltd. was introduced briefly and the importance of gas drainage in gas control was analyzed. Combined with coal-bed gas oc-currence and gas emission, the double system of gas drainage was optimized and a pro-gressive gas drainage model was experimented on. For guaranteed drainage, excavation and mining and realization of safety production and reasonable exploitation of gas in coal seams, many drainage methods were adopted to solve the gas problem of the working face.

  11. Continuous irrigation and drainage for early postoperative deep wound infection after posterior instrumented spinal fusion.

    Science.gov (United States)

    Lian, Xiao-Feng; Xu, Jian-Guang; Zeng, Bing-Fang; Liu, Xiao-Kang; Li, Hao; Qiu, Man-le; Yang, Er-Zhu

    2014-12-01

    A retrospective study of clinical cases. To evaluate the efficacy of continuous irrigation and drainage for early postoperative deep wound infection after posterior instrumented spinal fusion. Aggressive debridement and irrigation has been recommended to treat postoperative wound infections after instrumented spinal fusion. However, this method of management, indicating repeating visits to the operating room until the wound is clean enough for closure, often results in prolonged hospitalization, increased cost, and sometimes compromise of the desired outcome. We hypothesize that repeat visits to the operating room for debridements can be avoided by aggressive debridements and primary closure with continuous irrigation and drainage for postoperative wound infections. From 2004 to 2009, 23 patients with early postoperative deep wound infections after spinal fusion with instrumentation were surgically treated with thorough debridement and primary closure with continuous irrigation and drainage. All patients were followed up for 30.6 months (range, 24-54 mo). The mean duration of irrigation was 12.0 days (range, 7-16 d). In 21 patients (91.3%), the wound healed after continuous irrigation. The removal of the instrumentation or cages was not required in any case. Spinal fusion was achieved in all cases, except 1, where the patient developed a pseudoarthrosis at the L4-L5 level after L4-S1 fusion. The mean ODI for these 23 patients improved significantly from 53.4±18.7 preoperatively to 18.3±11.2 at the final follow-up visit (Pirrigation and drainage is an effective and safe method for the treatment of early postoperative deep wound infection after posterior instrumented spinal fusion.

  12. Preoperative urinary tract obstruction in scoliosis patients.

    Science.gov (United States)

    Suzuki, Shigeru; Kotani, Toshiaki; Mori, Kazuetsu; Kawamura, Ken; Ohtake, Akira

    2017-01-01

    While the association between scoliosis and cardiac and respiratory function impairments has been well characterized in clinical practice and research, the potential effect of scoliosis on urinary tract structure and renal function has received little attention. Therefore, the purpose of this study was to evaluate the preoperative clinical characteristics of urinary tract structure and renal function in pediatric patients with idiopathic scoliosis, using a combination of blood tests, urinalysis, and imaging. Preoperative measures of urinary tract structure and renal function were obtained for 16 patients, 13-17 years old, scheduled for corrective surgery for idiopathic scoliosis. Preoperative assessment included blood test and urinalysis, combined with structural imaging on ultrasound (US), magnetic resonance imaging (MRI), magnetic resonance urography (MRU), and radioisotope tracing (RI), using technetium-99 m mercaptoacetyltriglycine ((99m) Tc-MAG3). Differences in blood and urine tests between patients with and without urinary tract obstruction (UTO) were evaluated for significance using Mann-Whitney U test. For all 16 patients, blood tests and MRU were within normal limits. Dilatation of the renal pelvis was identified on US in eight patients (50.0%). UTO was identified on RI in six patients (37.5%). UTO was associated with elevated β2-microglobulin concentration. Urinary β2-microglobulin concentration >0.7 μg/mg Cr differentiated patients with UTO from those without UTO, with a sensitivity of 100% and specificity of 70%. β2-Microglobulin concentration may be a useful marker to screen for asymptomatic UTO in patients with idiopathic scoliosis. © 2016 Japan Pediatric Society.

  13. Preoperative Evaluation: Estimation of Pulmonary Risk.

    Science.gov (United States)

    Lakshminarasimhachar, Anand; Smetana, Gerald W

    2016-03-01

    Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. A preoperative checklist in esthetic plastic surgery

    OpenAIRE

    Anger,Jaime; Letizio,Nelson; Orel,Maurício; Souza Junior,José Leão de; Santos,Márcio Martines dos

    2011-01-01

    The authors present a checklist to be used at the last stage of a preoperative visit for esthetic plastic surgery composed of 29 yes/no questions, four blank spaces for entering data, and one question for ranking the level of risk of deep vein thrombosis. The criteria are divided into three tables relating to three areas: anesthesia, psychological aspects, and clinical risk factors. The answers are framed in four colors that identify the level of risk and suggest the degree of attention warra...

  15. Preoperational test report, recirculation ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-11

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  16. Preoperational test report, raw water system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  17. Preoperative irradiation and cystectomy for bladder cancer.

    Science.gov (United States)

    Smith, J A; Batata, M; Grabstald, H; Sogani, P C; Herr, H; Whitmore, W F

    1982-03-01

    Between 1971 and 1974, 101 patients at Memorial Sloan-Kettering Cancer Center underwent planned integrated treatment for bladder cancer with 2000 rads by megavoltage delivered to the whole pelvis over five consecutive days followed by radical cystectomy within a week. The overall five-year survival rate was 39%; the hospital mortality rate was 2%. In the pelvis alone tumor recurred in 9% of the patients. These results support other studies demonstrating the efficacy of this and other regimens of preoperative irradiation and cystectomy.

  18. Urban drainage models - making uncertainty analysis simple

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Mikkelsen, Peter Steen; Deletic, Ana

    2012-01-01

    There is increasing awareness about uncertainties in modelling of urban drainage systems and, as such, many new methods for uncertainty analyses have been developed. Despite this, all available methods have limitations which restrict their widespread application among practitioners. Here, a modif...

  19. 24 CFR 3280.610 - Drainage systems.

    Science.gov (United States)

    2010-04-01

    ... designs the system for site assembly and also provides all materials and components, including piping... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Drainage systems. 3280.610 Section 3280.610 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued...

  20. Reality named endoscopic ultrasound biliary drainage

    Institute of Scientific and Technical Information of China (English)

    Hugo; Gon?alo; Guedes; Roberto; Iglesias; Lopes; Joel; Fernandez; de; Oliveira; Everson; Luiz; de; Almeida; Artifon

    2015-01-01

    Endoscopic ultrasound(EUS) is used for diagnosis and evaluation of many diseases of the gastrointestinal (GI) tract. In the past, it was used to guide a cholangio-graphy, but nowadays it emerges as a powerful thera-peutic tool in biliary drainage. The aims of this review are: outline the rationale for endoscopic ultrasound-guided biliary drainage(EGBD); detail the procedural technique; evaluate the clinical outcomes and limitations of the method; and provide recommendations for the practicing clinician. In cases of failed endoscopic retro-grade cholangiopancreatography(ERCP), patients are usually referred for either percutaneous transhepatic biliary drainage(PTBD) or surgical bypass. Both these procedures have high rates of undesirable complications. EGBD is an attractive alternative to PTBD or surgery when ERCP fails. EGBD can be performed at two locations: transhepatic or extrahepatic, and the stent can be inserted in an antegrade or retrograde fashion. The drainage route can be transluminal, duodenal or trans-papillary, which, again, can be antegrade or retrograde [rendezvous(EUS-RV)]. Complications of all techniques combined include pneumoperitoneum, bleeding, bile leak/peritonitis and cholangitis. We recommend EGBD when bile duct access is not possible because of failed cannulation, altered upper GI tract anatomy, gastric outlet obstruction, a distorted ampulla or a periampullary diverticulum, as a minimally invasive alternative to surgery or radiology.

  1. [Artificial drainage devices--history, indications].

    Science.gov (United States)

    Barac, Ileana Ramona; Pop, Monica

    2012-01-01

    Glaucoma is a degenerative optic neuropathy progressive, multifactorial, which can lead to blindness. Blindness in patients with glaucoma is defined as visual field reduction below 10 degrees. Artificial drainage systems are a solution for refractory to medication, laser treatment or conventional surgery. Used by over 100 years, improved with good surgical technique and careful patient follow-up surgery, postoperative results are satisfactory.

  2. Optimizing the closed suction surgical drainage system.

    Science.gov (United States)

    Carruthers, Katherine H; Eisemann, Bradley S; Lamp, Susan; Kocak, Ergun

    2013-01-01

    Closed suction drains are indicated in a wide array of postoperative settings, with many distinct drainage systems available to the surgeon. The purpose of this study was to compare the suction gradients achieved using 2 different sizes of suction reservoirs and 2 different techniques for generating negative pressure. Drainage reservoirs of 100 and 400 ml were chosen to evaluate their ability to achieve suction. Suction was established in both sizes of drains by pressing the sides of the reservoir together or by pushing the bottom of the reservoir toward the top. Negative pressures were recorded with the reservoir empty, and after every 10-ml addition of saline. Averages were graphed to illustrate the applied suction over a range of drain volumes. The 100-ml drainage system reached a peak suction of -117.6 mmHg, while the 400-ml drainage system reached only a peak suction of -71.4 mmHg. Both of the maximum suction readings were achieved using the full-squeeze technique. The bottom-pushed-in technique did not result in any sustained measurable levels of suction using either of the reservoir volumes. Smaller drain reservoirs are more successful in generating a high initial suction than larger reservoirs, especially when the volume of fluid in the drain is relatively low. In all sizes of drains, compressing the sides of the reservoir is a far better technique for establishing negative pressure than pressing the bottom of the drain up toward the top.

  3. Selecting the drainage method for agricultural land

    NARCIS (Netherlands)

    Bos, M.G.

    2001-01-01

    To facilitate crop growth excess water should be drained from the rooting zone to allow root development of the crop and from the soil surface to facilitate access to the field. Basically, there are three drainage methods from which the designer can select being; surface drains, pumped tube wells an

  4. Drainage hydraulics of permeable friction courses

    Science.gov (United States)

    Charbeneau, Randall J.; Barrett, Michael E.

    2008-04-01

    This paper describes solutions to the hydraulic equations that govern flow in permeable friction courses (PFC). PFC is a layer of porous asphalt approximately 50 mm thick that is placed as an overlay on top of an existing conventional concrete or asphalt road surface to help control splash and hydroplaning, reduce noise, and enhance quality of storm water runoff. The primary objective of this manuscript is to present an analytical system of equations that can be used in design and analysis of PFC systems. The primary assumptions used in this analysis are that the flow can be modeled as one-dimensional, steady state Darcy-type flow and that slopes are sufficiently small so that the Dupuit-Forchheimer assumptions apply. Solutions are derived for cases where storm water drainage is confined to the PFC bed and for conditions where the PFC drainage capacity is exceeded and ponded sheet flow occurs across the pavement surface. The mathematical solutions provide the drainage characteristics (depth and residence time) as a function of rainfall intensity, PFC hydraulic conductivity, pavement slope, and maximum drainage path length.

  5. Impact of land drainage on peatland hydrology.

    Science.gov (United States)

    Holden, J; Evans, M G; Burt, T P; Horton, M

    2006-01-01

    There is a long history of drainage of blanket peat but few studies of the long-term hydrological impact of drainage. This paper aims to test differences in runoff production processes between intact and drained blanket peat catchments and determine whether there have been any long-term changes in stream flow since drainage occurred. Hillslope runoff processes and stream discharge were measured in four blanket peat catchments. Two catchments were drained with open-cut ditches in the 1950s. Ditching originally resulted in shorter lag times and flashier storm hydrographs but no change in the annual catchment runoff efficiency. In the period between 2002 and 2004, the hydrographs in the drained catchments, while still flashy, were less sensitive to rainfall than in the 1950s and the runoff efficiency had significantly increased. Drains resulted in a distinctive spatial pattern of runoff production across the slopes. Overland flow was significantly lower in the drained catchments where throughflow was more dominant. In the intact peatlands, matrix throughflow produced by peat layers below 10 cm was rare and produced structure could explain the long-term changes in river flow, which are in addition to those occurring in the immediate aftermath of peatland drainage.

  6. Interventional radiology in the lacrimal drainage system

    Energy Technology Data Exchange (ETDEWEB)

    Ilgit, Erhan T. [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey)]. E-mail: erhanti@gazi.edu.tr; Oenal, Baran [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey); Coskun, Bilgen [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey)

    2005-09-01

    This article presents a review of the interventional radiological procedures in the lacrimal drainage system. Balloon dacryocystoplasty and nasolacrimal polyurethane stent placement are the main fluoroscopically guided interventions for the treatment of epiphora by recanalizing the obstructed LDS. These procedures can also be used for dacryolith removal and lacrimal sac abscess treatment.

  7. Role of ultrasound in the perioperative evaluation of percutaneous transhepatic biliary drainage

    Institute of Scientific and Technical Information of China (English)

    Chuan Fu; Si-Ze Wu; Guang-Qing Liu; Tian-Lun Fan; You-Ke Chen

    2015-01-01

    Objective:To explore the evaluation and application of the color doppler ultrasound imaging for percutaneous transhepatic biliary drainage (PTBD) in the treatment of obstructive jaundice of preoperative, intraoperative and postoperative.Methods: The related information of 133 patients prepared with PTBD in our hospital from January 2009 to January 2015 was analyzed retrospectively. Including the clinical manifestation of PTBD preoperative, intraoperative and postoperative, laboratory examination, color Doppler ultrasound imaging, CT and/or MR imaging, X-ray and ultrasound guided interventional therapy, surgical treatment, histopathologic analysis record, the evaluation analysis of the role of ultrasound in the perioperative PTBD.Result:In 133 patients prepare with PTBD, preoperative evaluation for ultrasound guided PTBD 105 cases (78.94%, 105/133), finally complete the ultrasound guided PTBD 56 cases, with smoothly and one-time 100% success rate. Postoperative patients with jaundice and skin itching rate significantly reduced, increase food intake and better mental state. At seventh day of postoperative, liver function index improved significantly, ultrasonic follow-up show bile duct with different degree of inside and outside diameters. Postoperative complications were mild with the rate of 7.14%. No biliary infection, liver abscess, bile leakage complications, biliary tumor or liver function damage.Conclusion:The ultrasound evaluation of preoperative PTBD can be helpful with certain patients. Also to formulate operation program, correct positioning and guided with ultrasound is the key to the successful PTBD. Beside to avoid or reduce the complications, ultrasound follow-up provide important information in the detection of postoperative complications.

  8. Physical modeling of transverse drainage mechanisms

    Science.gov (United States)

    Douglass, J. C.; Schmeeckle, M. W.

    2005-12-01

    Streams that incise across bedrock highlands such as anticlines, upwarps, cuestas, or horsts are termed transverse drainages. Their relevance today involves such diverse matters as highway and dam construction decisions, location of wildlife corridors, better-informed sediment budgets, and detailed studies into developmental histories of late Cenozoic landscapes. The transient conditions responsible for transverse drainage incision have been extensively studied on a case-by-case basis, and the dominate mechanisms proposed include: antecedence, superimposition, overflow, and piracy. Modeling efforts have been limited to antecedence, and such the specific erosional conditions required for transverse drainage incision, with respect to the individual mechanisms, remains poorly understood. In this study, fifteen experiments attempted to simulate the four mechanisms and constructed on a 9.15 m long, 2.1 m wide, and 0.45 m deep stream table. Experiments lasted between 50 and 220 minutes. The stream table was filled with seven tons of sediment consisting of a silt and clay (30%) and a fine to coarse sand (70%) mixture. The physical models highlighted the importance of downstream aggradation with regard to antecedent incision versus possible defeat and diversion. The overflow experiments indicate that retreating knickpoints across a basin outlet produce a high probability of downstream flooding when associated with a deep lake. Misters used in a couple of experiments illustrate a potential complication with regard to headward erosion driven piracy. Relatively level asymmetrically sloped ridges allow for the drainage divide across the ridge to retreat from headward erosion, but hindered when the ridge's apex undulates or when symmetrically sloped. Although these physical models cannot strictly simulate natural transverse drainages, the observed processes, their development over time, and resultant landforms roughly emulate their natural counterparts. Proposed originally from

  9. Comparative study of internal anal competent seton combined with external anal fistula resection and suture or exclusion for the treatment of high anal fistula%肛管内主管挂线联合肛门外瘘管切除缝合或旷置治疗高位肛瘘疗效的对比研究

    Institute of Scientific and Technical Information of China (English)

    任炜

    2016-01-01

    Objective To compare the effects of internal anal competent seton combined with external anal fistula resection and suture or exclusion on high anal fistula. Methods The curative effect of 65 cases underwent internal anal competent seton combined with external anal fistula resection and su-ture and 62 cases underwent internal anal competent seton combined with external anal fistula exclusion were comparative analyzed. Results The total efficiency of suture group was 90. 77% ,which was signif-icantly higher than that of the exclusion group(70. 97% ),the difference was significant(P ﹤ 0. 05). The suture wound healing time and Wexner score of suture group were significantly lower than those of exclu-sion group(P ﹤ 0. 05). The recurrence rate of suture group(1. 54% )was significantly lower than that of the exclusion group(9. 68% ),the difference was significant(P ﹤ 0. 05). Conclusions Internal anal competent seton combined with external anal fistula resection and suture in the treatment of high anal fis-tula significant can accelerate the healing of incision and improve the recovery of anal function.%目的:比较肛管内主管挂线联合肛门外瘘管切除缝合或旷置治疗高位肛瘘的疗效。方法对65例行肛管内主管挂线联合肛门外瘘管切除缝合术与62例行肛管内主管挂线联合肛门外瘘管旷置术的疗效进行对比分析。结果缝合组的总有效率为90.77%,显著高于旷置组(70.97%),差异有统计学意义(P ﹤0.05);缝合组缝合处愈合时间和 Wexner 评分显著低于旷置组,差异有统计学意义(P ﹤0.05);缝合组复发率(1.54%)显著低于旷置组(9.68%),差异有统计学意义(P ﹤0.05)。结论肛管内主管挂线联合肛门外瘘管切除缝合术治疗高位肛瘘疗效显著,可加快切开愈合,提高肛门功能恢复。

  10. Topological Analysis of Urban Drainage Networks

    Science.gov (United States)

    Yang, Soohyun; Paik, Kyungrock; McGrath, Gavan; Rao, Suresh

    2016-04-01

    Urban drainage networks are an essential component of infrastructure, and comprise the aggregation of underground pipe networks carrying storm water and domestic waste water for eventual discharge to natural stream networks. Growing urbanization has contributed to rapid expansion of sewer networks, vastly increasing their complexity and scale. Importance of sewer networks has been well studied from an engineering perspective, including resilient management, optimal design, and malfunctioning impact. Yet, analysis of the urban drainage networks using complex networks approach are lacking. Urban drainage networks consist of manholes and conduits, which correspond to nodes and edges, analogous to junctions and streams in river networks. Converging water flows in these two networks are driven by elevation gradient. In this sense, engineered urban drainage networks share several attributes of flows in river networks. These similarities between the two directed, converging flow networks serve the basis for us to hypothesize that the functional topology of sewer networks, like river networks, is scale-invariant. We analyzed the exceedance probability distribution of upstream area for practical sewer networks in South Korea. We found that the exceedance probability distributions of upstream area follow power-law, implying that the sewer networks exhibit topological self-similarity. The power-law exponents for the sewer networks were similar, and within the range reported from analysis of natural river networks. Thus, in line with our hypothesis, these results suggest that engineered urban drainage networks share functional topological attributes regardless of their structural dissimilarity or different underlying network evolution processes (natural vs. engineered). Implications of these findings for optimal design of sewer networks and for modeling sewer flows will be discussed.

  11. Exit and Paradise Creek Drainage Area Boundaries, Alaska, 2012

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This dataset contains drainage area boundaries for Exit Creek and Paradise Creek in Kenai Fjords National Park, Alaska. A drainage area boundary identifies the land...

  12. Clinical outcome of routine drainage in simple laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    LIANG Zongchao

    2013-03-01

    Full Text Available ObjectiveTo retrospectively review outcomes of elective laparoscopic cholecystectomy (LC to evaluate the benefit of routine drainage in uncomplicated surgeries. MethodsTwo-hundred-and-ninety-five patients with cholecystolithiasis or gallbladder polyps who underwent LC with drainage (n=145 and or without drainage (n=150 between 2009 and 2011 were enrolled in the study. The decision for drainage was randomized. ResultsThe LC without drainage group had significantly shorter time to first flatus and shorter length of postoperative hospital stay than the LC with drainage group. One patient in the drainage group developed an intra-abdominal abscess, but there was no significant difference between the two LC groups with respect to overall postoperative complication rate. ConclusionApplication of a peritoneal drainage tube after simple elective, uncomplicated LC did not provide any clinical benefit to the patients, and should be considered according to the operating physician′s judgment on a case-by-case basis.

  13. A Theoretical Study of Subsurface Drainage Model Simulation of ...

    African Journals Online (AJOL)

    A Theoretical Study of Subsurface Drainage Model Simulation of Drainage Flow and ... of subsurface drain spacing, evapotranspiration and irrigation water quality on ... The study was carried out on a conceptual uniform homogenous irrigated ...

  14. Religiousness and preoperative anxiety: a correlational study

    Directory of Open Access Journals (Sweden)

    Karimollahi Mansoureh

    2007-06-01

    Full Text Available Abstract Background Major life changes are among factors that cause anxiety, and one of these changes is surgery. Emotional reactions to surgery have specific effects on the intensity and velocity as well as the process of physical disease. In addition, they can cause delay in patients recovery. This study is aimed at determining the relationship between religious beliefs and preoperative anxiety. Methods This survey is a correlational study to assess the relationship between religious beliefs and preoperative anxiety of patients undergoing abdominal, orthopaedic, and gynaecologic surgery in educational hospitals. We used the convenience sampling method. The data collection instruments included a questionnaire containing the Spielberger State-Trait Anxiety Inventory (STAI, and another questionnaire formulated by the researcher with queries on religious beliefs and demographic characteristics as well as disease-related information. Analysis of the data was carried out with SPSS software using descriptive and inferential statistics. Results were arranged in three tables. Results The findings showed that almost all the subjects had high level of religiosity and moderate level of anxiety. In addition, there was an inverse relationship between religiosity and intensity of anxiety, though this was not statistically significant. Conclusion The results of this study can be used as evidence for presenting religious counselling and spiritual interventions for individuals undergoing stress. Finally, based on the results of this study, the researcher suggested some recommendations for applying results and conducting further research.

  15. Preoperative chemoradiotherapy for locally advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Pepek Joseph M

    2013-01-01

    Full Text Available Abstract Background To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT for gastric cancer. Methods Patients with gastroesophageal (GE junction (Siewert type II and III or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS, local control (LC and disease-free survival (DFS were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Results Forty-eight patients were included. Most (73% had proximal (GE junction, cardia and fundus tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75% underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Conclusions Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated.

  16. Preoperative evaluation for lung cancer resection

    Science.gov (United States)

    Spyratos, Dionysios; Porpodis, Konstantinos; Angelis, Nikolaos; Papaiwannou, Antonios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Machairiotis, Nikolaos; Siminelakis, Stavros; Argyriou, Michael; Kotsakou, Maria; Kessis, George; Kolettas, Alexander; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have been associated with its development. Recently screening programs proved to reduce mortality among heavy-smokers although establishment of such strategies in everyday clinical practice is much more difficult and unknown if it is cost effective compared to other neoplasms (e.g., breast or prostate cancer). Adding severe comorbidities (coronary heart disease, COPD) to the above reasons as cigarette smoking is a common causative factor, we could explain the low surgical resection rates (approximately 20-30%) for lung cancer patients. Three clinical guidelines reports of different associations have been published (American College of Chest Physisians, British Thoracic Society and European Respiratory Society/European Society of Thoracic Surgery) providing detailed algorithms for preoperative assessment. In the current mini review, we will comment on the preoperative evaluation of lung cancer patients. PMID:24672690

  17. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety.

    Science.gov (United States)

    Boker, Abdulaziz; Brownell, Laurence; Donen, Neil

    2002-10-01

    To compare three anxiety scales; the anxiety visual analogue scale (VAS), the anxiety component of the Amsterdam preoperative anxiety and information scale (APAIS), and the state portion of the Spielburger state-trait anxiety inventory (STAI), for assessment of preoperative anxiety levels in same day admission patients. Patients completed the three anxiety assessment scales both before and after seeing the anesthesiologist preoperatively. The scales used were the STAI, the six-question APAIS, and the VAS. APAIS was further subdivided to assess anxiety about anesthesia (sum A), anxiety about surgery (sum S) and a combined anxiety total (i.e., sum C = sum A + sum S). These scales were compared to one another. Pearson's correlation (pair-wise deletion) was used for validity testing. Cronbach's alpha analysis was used to test internal validity of the various components of the APAIS scale. A correlation co-efficient (r) > or = 0.6 and P scale sets were completed by 197 patients. There was significant and positive correlation between VAS and STAI r = 0.64, P anxiety components of the APAIS (sum C) and desire for information were 0.84 and 0.77 respectively. In addition to VAS, the anxiety component of APAIS (sum C) is a promising new practical tool to assess preoperative patient anxiety levels.

  18. Measuring preoperative anxiety in patients with intracranial tumors: the Amsterdam preoperative anxiety and information scale.

    Science.gov (United States)

    Goebel, Simone; Kaup, Lea; Mehdorn, Hubertus Maximilian

    2011-10-01

    Preoperative anxiety is a major problem in patients with brain tumors and is of high clinical relevance. However, to date no instruments have been validated for the assessment of preoperative anxiety for this patient group. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has shown promising results for the assessment of preoperative anxiety. The aim of this study was to determine its psychometric properties and the optimal cutoff score for patients with intracranial tumors to make it applicable in the neurosurgical setting. The sample totaled 180 neurosurgical patients with intracranial tumors. Patients were administered the APAIS along with the Hospital Anxiety and Depression Scale as the gold standard against which the APAIS was compared. Patients scoring 11 or above in the anxiety subscale of the Hospital Anxiety and Depression Scale were defined as clinical cases having anxiety. The psychometric properties of the APAIS were evaluated for a postulated 2-factor structure, Cronbach α, and correlations. The postulated 2-factor structure could not be replicated. Instead, we found a 3-factor solution (anxiety about the operation, anxiety about the anesthesia, information requirement). The area under the receiver operating characteristics curve ranged from ≥0.65 to ≥0.77. Optimal cutoff scores were calculated. The cutoff score for the anxiety scale was ≥10 for the whole sample and men only, and was ≥11 for women only. Analysis of the psychometric properties yielded satisfactory results (eg. Cronbach α for the anxiety scale >0.84). Despite its brevity, the APAIS is valid and recommendable for the assessment of preoperative anxiety in patients with intracranial tumors. As this is the first validation study focusing on patients with severe diseases and major surgeries, we recommend the application of our cutoff scores also for patients similar to our study population with regard to disease and surgery severity.

  19. 46 CFR 178.420 - Drainage of cockpit vessels.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Drainage of cockpit vessels. 178.420 Section 178.420... TONS) INTACT STABILITY AND SEAWORTHINESS Drainage of Weather Decks § 178.420 Drainage of cockpit vessels. (a) Except as follows, the cockpit on a cockpit vessel may be watertight: (1) A cockpit may...

  20. Outcomes of surgery for total anomalous pulmonary venous drainage

    Directory of Open Access Journals (Sweden)

    Milovanović Vladimir

    2014-01-01

    Full Text Available Introduction. Total anomalous pulmonary venous connection (TAPVC is a rare congenital heart disease and in some variants represents the only true surgical emergency in congenital heart surgery. Basic anatomical characteristic of this anomaly is an abnormal connection of pulmonary veins with systemic venous circulation. Although the results of TAPVC repair in infancy have been markedly improved in recent years, the recurrent pulmonary venous obstruction (RPVO remains relatively frequent complication of surgical treatment. Objective. The aim of this study was a retrospective evaluation of TAPVC repair at a single institution, identifying the risk factors associated with the increased mortality and morbidity. Methods. Between January 2001 and January 2010, 43 consecutive patients underwent repair of TAPVC at the University Children’s Hospital, with median weight of 3.8 kg (1.8-13 kg. Median age at surgery varied from 5 days to 5 years. Distribution of TAPVC types was as follows: supracardiac 19 (44%, cardiac 12 (28%, infracardiac 9 (21%, and mixed 3 (7%. Eleven patients (26% were emergencies due to obstructed drainage. Results. Early mortality was 9.30% (4/43. An average time of followup/survival for 95% interval of confidence was 101.6±6.7 months. Kaplan-Meier cumulative survival was 83.7±5.7%. Freedom from reintervention after 10 years was 87.2±0.5%. The principal reason for reintervention was RPVO. Conclusion. Preoperative obstruction is not a risk factor of early mortality and RPVO. Low body mass (below 2.5 kg is the only identified risk factor of early mortality. Complex morphology of the confluens, particularly in a mixed type of TAPVR, is the main risk factor of RPVO development.

  1. The effect of preoperative smoking cessation or preoperative pulmonary rehabilitation on outcomes after lung cancer surgery: a systematic review.

    Science.gov (United States)

    Schmidt-Hansen, Mia; Page, Richard; Hasler, Elise

    2013-03-01

    The preferred treatment for lung cancer is surgery if the disease is considered resectable and the patient is considered surgically fit. Preoperative smoking cessation and/or preoperative pulmonary rehabilitation might improve postoperative outcomes after lung cancer surgery. The objectives of this systematic review were to determine the effectiveness of (1) preoperative smoking cessation and (2) preoperative pulmonary rehabilitation on peri- and postoperative outcomes in patients who undergo resection for lung cancer. We searched MEDLINE, PreMedline, Embase, Cochrane Library, Cinahl, BNI, Psychinfo, Amed, Web of Science (SCI and SSCI), and Biomed Central. Original studies published in English investigating the effect of preoperative smoking cessation or preoperative pulmonary rehabilitation on operative and longer-term outcomes in ≥ 50 patients who received surgery with curative intent for lung cancer were included. Of the 7 included studies that examined the effect of preoperative smoking cessation (n = 6) and preoperative pulmonary rehabilitation (n = 1) on outcomes after lung cancer surgery, none were randomized controlled trials and only 1 was prospective. The studies used different smoking classifications, the baseline characteristics differed between the study groups in some of the studies, and most had small sample sizes. No formal data synthesis was therefore possible. The included studies were marked by methodological limitations. On the basis of the reported bodies of evidence, it is not possible to make any firm conclusions about the effect of preoperative smoking cessation or of preoperative pulmonary rehabilitation on operative outcomes in patients undergoing surgery for lung cancer.

  2. EFFECTIVENESS OF AUTOGENIC DRAINAGE VERSUS POSTURAL DRAINAGE ON OXYGEN SATURATION IN PATIENTS WITH CHRONIC BRONCHITIS WITH 15 MINUTES POST THERAPY

    OpenAIRE

    Kiran, V.; Dr. Bhimasen .S; E. Mastanaiah; A. Thiruppathi

    2014-01-01

    Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD) and autogenic drainage (AD) on level of oxygen saturation in blood, and amount of sputum recovery. Methodology: The study was done ...

  3. Preoperative autologous plateletpheresis in patients undergoing open heart surgery.

    Directory of Open Access Journals (Sweden)

    Tomar Akhlesh

    2003-01-01

    Full Text Available Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB. It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I in which one unit of whole blood was withdrawn, and PRP group (Group II where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p<0.001 and required 38.5% less homologous blood and blood products (p<0.05, in the postoperative period. Haemoglobin levels on day zero (day of operation and day three were statistically not different between the two groups. We

  4. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... pain is not related to findings of hyperalgesia or other changes in sensory function that may support pain-induced pre-operative neuroplasticity as a pathogenic mechanism for the development of persistent postherniotomy pain....

  5. Numerical simulation of transient flow in horizontal drainage systems

    Institute of Scientific and Technical Information of China (English)

    Ze-yu MAO; Han XIAO; Ying LIU; Ying-jun HU

    2009-01-01

    A numerical simulation model based on the characteristic-based finite-difference method with a time-line interpolation scheme was developed for predicting transient free surface flow in horizontal drainage systems. The fundamental accuracy of the numerical model was first clarified by comparison with the experimental results for a single drainage pipe. Boundary conditions for junctions and bends, which are often encountered in drainage systems, were studied both experimentally and numerically. The numerical model was applied to an actual drainage system. Comparison with a full-scale model experiment indicates that the model can be used to accurately predict flow characteristics in actual drainage networks.

  6. Thermokarst lakes, drainage, and drained basins

    Science.gov (United States)

    Grosse, G.; Jones, B.; Arp, C.; Shroder, John F.

    2013-01-01

    Thermokarst lakes and drained lake basins are widespread in Arctic and sub-Arctic permafrost lowlands with ice-rich sediments. Thermokarst lake formation is a dominant mode of permafrost degradation and is linked to surface disturbance, subsequent melting of ground ice, surface subsidence, water impoundment, and positive feedbacks between lake growth and permafrost thaw, whereas lake drainage generally results in local permafrost aggradation. Thermokarst lakes characteristically have unique limnological, morphological, and biogeochemical characteristics that are closely tied to cold-climate conditions and permafrost properties. Thermokarst lakes also have a tendency toward complete or partial drainage through permafrost degradation and erosion. Thermokarst lake dynamics strongly affect the development of landscape geomorphology, hydrology, and the habitat characteristic of permafrost lowlands.

  7. Autogenic drainage: efficacy of a simplified method.

    Science.gov (United States)

    Lindemann, H; Boldt, A; Kieselmann, R

    1990-01-01

    A simplified and modified technique of the original autogenic drainage (AD) is described which is supplemented by breathing against an external flow resistance. The new method allows a better teaching and learning. It's efficacy is proven by means of a comparative trial of AD and PEP physiotherapy (i.e. expiration against a defined stenosis). The autogenic drainage (AD) was introduced by a Belgian working group (2). The basic idea was to support the elimination of mucus by deep breathing and by repressing the cough as long as possible. However, a rather sophisticated method impeded teaching and learning of AD (1). Thus, till now, there are only preliminary results which suggest the efficacy of AD (e.g. 3). Therefore, a simplified technique was developed and examined with regard to its sputum eliminating effect.

  8. Range of drainage effect of surface mines

    Energy Technology Data Exchange (ETDEWEB)

    Sozanski, J.

    1978-03-01

    This paper discusses methods of calculating the range of effects of water drainage from surface coal mines and other surface mines. It is suggested that methods based on test pumping (water drainage) are time consuming, and the results can be distorted by atmospheric factors such as rain fall or dry period. So-called empirical formulae produce results which are often incorrect. The size of a cone shaped depression calculated on the basis of empirical formulae can be ten times smaller than the size of the real depression. It is suggested that using a formula based on the Dupuit formula is superior to other methods of depression calculation. According to the derived formulae the radius of the depresion cone is a function of parameters of the water bearing horizons, size of surface mine working and of water depression. The proposed formula also takes into account the influence of atmospheric factors (water influx caused by precipitation, etc.). (1 ref.) (In Polish)

  9. Preoperational test report, recirculation condenser cooling systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Recirculation Condenser Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The four system provide condenser cooling water for vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102. Each system consists of a valved piping loop, a pair of redundant recirculation pumps, a closed-loop evaporative cooling tower, and supporting instrumentation; equipment is located outside the farm on concrete slabs. Piping is routed to the each ventilation condenser inside the farm via below-grade concrete trenches. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  10. Pre-operative antiseptic skin preparation.

    Science.gov (United States)

    Murkin, Claire Elizabeth

    Theatre nurses use antiseptic skin preparation products every day, but little thought seems to be given as to why a surgeon has a particular preference for one antiseptic skin preparation over another - whether it is for its efficacy, safety or application properties. Woodhead et al (2004) states that nurses still work in a ritualistic environment. Rituals are 'any action performed according to custom, without understanding the reasons why it is being practised'. Nursing practice should be evidence-based; nurses should understand the rationale behind the choice of a particular antiseptic, and be knowledgable about the clinical effectiveness of antiseptic's use pre-operatively, to achieve optimum results. This article focuses on the main types of antiseptic skin preparation while highlighting each product's activity and the relevant considerations for choosing the appropriate product for each patient. Theatre staff need to emphasize the importance of skin preparation and the correct application techniques, while educating the scrub team and surgeons with respect to skin preparation.

  11. Preoperational test report, recirculation condenser cooling systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Recirculation Condenser Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The four system provide condenser cooling water for vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102. Each system consists of a valved piping loop, a pair of redundant recirculation pumps, a closed-loop evaporative cooling tower, and supporting instrumentation; equipment is located outside the farm on concrete slabs. Piping is routed to the each ventilation condenser inside the farm via below-grade concrete trenches. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  12. Predictors of preoperative anxiety in children.

    Science.gov (United States)

    Wollin, S R; Plummer, J L; Owen, H; Hawkins, R M F; Materazzo, F

    2003-02-01

    This study aimed to identify factors contributing to anxiety at induction of anaesthesia in children. One hundred and twenty children aged five to twelve years and scheduled for surgery requiring general anaesthesia were included. Children were interviewed and assessed prior to surgery. Parents completed anxiety measures prior to surgery and were interviewed after the induction of anaesthesia. The level of children's anxiety was determined at the time of induction of anaesthesia by the modified Yale Preoperative Anxiety Scale. Factors associated with increased levels of anxiety in the children included increased number of people in the room at induction of anaesthesia; longer waiting time between admission at the hospital and induction of anaesthesia; negative memories of previous hospital experiences; and having a mother who does not practise a religion. Suggestions for implementation of the findings and for future research are provided.

  13. Preoperative information needs of children undergoing tonsillectomy.

    LENUS (Irish Health Repository)

    Buckley, Aoife

    2012-02-01

    AIMS AND OBJECTIVES: To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. BACKGROUND: Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. DESIGN: A qualitative descriptive study. METHOD: Data were collected from nine children (aged 6-9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. RESULTS: Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing \\'soreness\\' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. CONCLUSION: Preoperative educational interventions need to take account of children\\'s information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. RELEVANCE TO CLINICAL PRACTICE: Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children.

  14. Urban drainage models - making uncertainty analysis simple

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Mikkelsen, Peter Steen; Deletic, Ana;

    2012-01-01

    There is increasing awareness about uncertainties in modelling of urban drainage systems and, as such, many new methods for uncertainty analyses have been developed. Despite this, all available methods have limitations which restrict their widespread application among practitioners. Here, a modif...... probability distributions (often used for sensitivity analyses) and prediction intervals. To demonstrate the new method, it is applied to a conceptual rainfall-runoff model using a dataset collected from Melbourne, Australia....

  15. Streaming potential during drainage and imbibition

    Science.gov (United States)

    Zhang, Jiazuo; Vinogradov, Jan; Leinov, Eli; Jackson, M. D.

    2017-06-01

    The rock pore space in many subsurface settings is saturated with water and one or more immiscible fluid phases. Examples include nonaqueous phase liquids (NAPLs) in contaminated aquifers, supercritical CO2 during sequestration in deep saline aquifers, the vadose zone, and hydrocarbon reservoirs. Self-potential (SP) and seismoelectric (SE) methods have been proposed to monitor multiphase flow in such settings. However, to properly interpret and model these data requires an understanding of the saturation dependence of the streaming potential. This paper presents a methodology to determine the saturation dependence of the streaming potential coupling coefficient (C) and streaming current charge density (Qs) in unsteady state drainage and imbibition experiments and applies the method to published experimental data. Unsteady state experiments do not yield representative values of C and Qs (or other transport properties such as relative permeability and electrical conductivity) at partial saturation (Sw) because Sw within the sample is not uniform. An interpretation method is required to determine the saturation dependence of C and Qs within a representative elementary volume with uniform saturation. The proposed method makes no assumptions about the pore space geometry. Application of the method to published experimental data from two natural sandstone samples shows that C exhibits hysteresis between drainage and imbibition, can exhibit significant nonmonotonic variations with saturation, is nonzero at the irreducible water saturation, and can exceed the value observed at Sw = 1. Moreover, Qs increases with decreasing Sw but is not given by 1/Sw as is often assumed. The variation in Qs with Sw is very similar for a given sample and a given drainage or imbibition process, and the difference between samples is less than the difference between drainage and imbibition. The results presented here can be used to help interpret SP and SE measurements obtained in partially

  16. Factors influencing pleural drainage in parapneumonic effusions.

    Science.gov (United States)

    Porcel, J M; Valencia, H; Bielsa, S

    2016-10-01

    The identification of parapneumonic effusions (PPE) requiring pleural drainage is challenging. We aimed to determine the diagnostic accuracy of radiological and pleural fluid findings in discriminating between PPE that need drainage (complicated PPE (CPPE)) and those that could be resolved with antibiotics only (uncomplicated PPE (UPPE)). A retrospective review of 641 consecutive PPE, of which 393 were categorized as CPPE and 248 as UPPE. Demographics, radiological (size and laterality on a chest radiograph) and pleural fluid parameters (pus, bacterial cultures, biochemistries) were compared among groups. Logistic regression was performed to determine variables useful for predicting chest drainage, and receiver-operating characteristic curves assisted in the selection of the best cutoff values. According to the likelihood ratios (LR), findings increasing the probability of chest tube usage the most were: effusions occupying ≥1/2 of the hemithorax (LR 13.5), pleural fluid pH ≤7.15 (LR 6.2), pleural fluid glucose ≤40mg/dL (LR 5.6), pus (LR 4.8), positive pleural fluid cultures (LR 3.6), and pleural fluid lactate dehydrogenase >2000U/L (LR 3.4). In the logistic regression analysis only the first two were selected as significant predictors of CPPE. In non-purulent effusions, the effusion's size and pleural fluid pH retained their discriminatory properties, in addition to a pleural fluid C-reactive protein (CRP) level >100mg/L. Large radiological effusions and a pleural fluid pH ≤7.15 were the best predictors for chest drainage in patients with PPE. In the subgroup of patients with non-purulent effusions, pleural fluid CRP also contributed to CPPE identification. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. Drainage and Stratification Kinetics of Foam Films

    Science.gov (United States)

    Zhang, Yiran; Sharma, Vivek

    2014-03-01

    Baking bread, brewing cappuccino, pouring beer, washing dishes, shaving, shampooing, whipping eggs and blowing bubbles all involve creation of aqueous foam films. Foam lifetime, drainage kinetics and stability are strongly influenced by surfactant type (ionic vs non-ionic), and added proteins, particles or polymers modify typical responses. The rate at which fluid drains out from a foam film, i.e. drainage kinetics, is determined in the last stages primarily by molecular interactions and capillarity. Interestingly, for certain low molecular weight surfactants, colloids and polyelectrolyte-surfactant mixtures, a layered ordering of molecules, micelles or particles inside the foam films leads to a stepwise thinning phenomena called stratification. Though stratification is observed in many confined systems including foam films containing particles or polyelectrolytes, films containing globular proteins seem not to show this behavior. Using a Scheludko-type cell, we experimentally study the drainage and stratification kinetics of horizontal foam films formed by protein-surfactant mixtures, and carefully determine how the presence of proteins influences the hydrodynamics and thermodynamics of foam films.

  18. Drawdown behavior of gravity drainage wells

    Energy Technology Data Exchange (ETDEWEB)

    Aasen, J.A.; Ramey, H.J. Jr.

    1993-10-01

    An analytical solution for drawdown in gravity drainage wells is developed. The free-surface flow is viewed as incompressible, and anisotropy effects are included. The well is a line source well, and the reservoir is infinitely large. The model is valid for small drawdowns. The uniform wellbore potential inner boundary condition is modelled using the proper Green`s function. The discontinuity at the wellbore is solved by introducing a finite skin radius, and the formulation produces a seepage face. The calculated wellbore flux distribution and wellbore pressures are in fair agreement with results obtained using a numerical gravity drainage simulator. Three distinct flow periods are observed. The wellbore storage period is caused by the moving liquid level, and the duration is short. During the long intermediate flow period, the wellbore pressure is nearly constant. In this period the free surface moves downwards, and the liquid is produced mainly by vertical drainage. At long times the semilog straight line appears. The confined liquid solutions by Theis (1935) and van Everdingen and Hurst (1949) may be used during the pseudoradial flow period if the flowrate is low. New type curves are presented that yield both vertical and horizontal permeabilities.

  19. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

    Heyckendorff-Diebold, Tina; Maeda, Yasuko; Buntzen, Steen;

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional...... outcomes, but the success rate varies. The endorectal advancement flap is considered to be the gold standard. Ligation of the intersphincteric fistula tract is promising. Proctectomy or proctocolectomy in combination with transposition flaps may be necessary. A success rate of 66-70% has been reported....

  20. Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

    Institute of Scientific and Technical Information of China (English)

    Chun Tang; Baolin Wang; Bing Xie; Hongming Liu; Ping Chen

    2011-01-01

    A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method.Ten patients received only drainage via retroperitoneai laparoscopy,four patients received drainage via both retroperitoneal and preperitoneal laparoscopy,and one patient received drainage via conversion to laparotomy.Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment.Two patients had encapsulated effusions or pancreatic pseudocysts after surgery,but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage.SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method,resulting in minor injury.

  1. Closed suction drainage versus closed simple drainage in the management of modified radical mastectomy wounds.

    Science.gov (United States)

    Ezeome, E R; Adebamowo, C A

    2008-09-01

    To compare the outcomes of modified radical mastectomy wounds managed by closed wound drainage with suction and without suction. A prospective randomised trial was conducted at the University College Hospital in Ibadan, and the University of Nigeria Teaching Hospital in Enugu. Fifty women who required modified radical mastectomy for breast cancer were randomised to have closed wound drainage with suction (26 patients) and closed wound drainage without suction (24 patients). There was no significant difference in the intraoperative and postoperative variables. Suction drainage drained less volume of fluid and stayed for a shorter time in the wound, but the differences were not significant. There was no difference in the length of hospital stay, time to stitch removal, and number of dressing changes. More haematomas and wound infections occurred in the simple drain group while more seromas occurred in the suction drain group, but these were not significant. The suction drain was more difficult to manage and the cost was 15 times higher than the simple drainage system. Closed simple drains are not inferior to suction drains in mastectomy wounds and, considering the cost saving and simplicity of postoperative care, they are preferable to suction drains.

  2. 胸腔引流术置入中心静脉导管的护理%Nursing of Central Venous Catheter Placed in the Thoracic Drainage

    Institute of Scientific and Technical Information of China (English)

    谢芳芳

    2015-01-01

    Objective To explore the nursing care of improved central venous catheter in thoracic drainage. Methods 40 cases of patients with pleural ef usion through improved central venous catheter drainage, preoperative personalized psychological care, strengthen the drainage, drainage, puncture point of protection and prevention of infection. Results 40 cases of patients with pleural ef usion were successful y cured, no complications, al cases were treated with pleural ef usion, relieve the symptoms of oppression. Conclusion The improved central venous catheter is convenient, safe and ef ective, and is an important measure to ensure the success of drainage.%目的探讨改良中心静脉导管在胸腔引流术中的护理。方法对40例经改良中心静脉置管引流术的胸腔积液患者,术前进行个性化心理护理,加强引流管引流术后引流、穿刺点的保护及预防感染。结果40例胸腔积液患者均成功治愈,无并发症,全部病例均经胸水取出,缓解压迫症状。结论改良中心静脉置管方便、安全、有效,是保证引流成功的重要措施。

  3. [Preoperative information for paediatric patients. The anaesthesiologist's point of view].

    Science.gov (United States)

    Orliaguet, G

    2006-04-01

    Medical information is mandatory before any medical procedure, including pediatric anesthesia. Preoperative information covers many aspects, including medico-psychologic and judicial aspects. When the patient is a child, information must be delivered to the parents in priority. However, the French law has given a particular attention to the opinion of the child. In 70% of the cases, preoperative anxiety of the parents is more related to anesthesia than to the surgical procedure itself. We have to explain the most frequent adverse effects, as well as the more severe and well known complications to the parents, even though they are very infrequent. The only cases where preoperative information is not required are: emergency cases and refusal of the patient or the parents to be informed. While information is necessarily oral, it may be completed using a written document. The quality of the preoperative information directly influences the quality of the psychological preoperative preparation of the parents, and thereafter of the child. Preoperative preparation programs have been developed, but controversial results have been observed. The great majority of the studies on preoperative programs were performed in the USA, where the demand for preoperative information is very important. It is far from sure that the results of all these studies may be extrapolated to French parents, and French studies are needed.

  4. The role of anxiolytic premedication in reducing preoperative anxiety.

    LENUS (Irish Health Repository)

    Carroll, Jennifer K

    2012-01-01

    Prevention of preoperative anxiety with anxiolytic premedication is associated with improved preoperative outcomes in surgical patients. The objective of the authors\\' study was to evaluate the percentage of surgical patients that are prescribed premedication for preoperative anxiety before their anticipated surgical procedure. A prospective study was carried out by theatre nursing staff in the theatre reception bay of a university teaching hospital. A questionnaire was designed to record the number of patients that described symptoms consistent with preoperative anxiety. The number of patients that had been offered anxiolytic premedication for preoperative anxiety was also recorded. Consent was obtained from 115 consecutive surgical patients (male, n=52; female, n=63). Of these, 66% (n=76) reported anxiety before their surgical procedure (male: n=27, female: n=49). Premedication with a low-dose benzodiazepine was prescribed by an anaesthetist in 4% of cases (n=5). Patients that received premedication preoperatively reported effective relief of their anxiety symptoms This study demonstrates that preoperative patient anxiety is highly prevalent. The authors\\' findings suggest that premedication with anxiolytic pharmacological therapy may be an underused therapeutic resource for managing preoperative patient anxiety.

  5. Preoperative distress predicts persistent pain after breast cancer treatment

    DEFF Research Database (Denmark)

    Mejdahl, Mathias Kvist; Mertz, Birgitte Goldschmidt; Bidstrup, Pernille Envold Hansen;

    2015-01-01

    at the Department of Breast Surgery, Rigshospitalet, Denmark, were invited to participate in the study. Patients filled out a questionnaire preoperatively, and 4 and 8 months after surgery. Preoperative distress was measured with the Distress Thermometer (DT; 11-point scale, 0-10). We examined the association...

  6. Long-term effects of a preoperative smoking cessation programme

    DEFF Research Database (Denmark)

    Villebro, Nete Munk; Pedersen, Tom; Møller, Ann M;

    2008-01-01

    Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation.......Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation....

  7. Fluoroscopy guided percutaneous catheter drainage of pneumothorax in good mid-term patency with tube drainage

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Young; Oh, Joo Hyung; Yoon, Yup; Sung, Dong Wook [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. We retrospectively reviewed effectiveness of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n =4), reptured bullae (n = 2), and histiocytosis-X (n = 1). Three patients had iatrogenic pneumothorax caused by trauma (n = 1) and surgery (n = 2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. All catheter were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.

  8. Effect of acupressure on preoperative anxiety: a clinical trial.

    Science.gov (United States)

    Valiee, Sina; Bassampour, Shiva Sadat; Nasrabadi, Alireza Nikbakht; Pouresmaeil, Zahra; Mehran, Abbas

    2012-08-01

    Preoperative anxiety, as an emotional reaction, is common among patients undergoing surgery. The purpose of this study was to examine the effect of acupressure on preoperative anxiety before abdominal surgery. The 70 subjects of this clinical trial were randomly assigned into the acupressure group (n=35), which received acupressure at the true points, or the placebo group (n=35), which received acupressure at sham (false) points. Preoperative anxiety and vital signs before and after the intervention were measured in both groups. The findings demonstrated a reduction in the level of preoperative anxiety for both groups (Pacupressure group (Pacupressure at true points (third eye and Shen men) can reduce higher preoperative anxiety of patients before abdominal surgery and that it has had a more clinically beneficial effect than sham points.

  9. Individual idea about the micro-invasive aspiration and drainage of intracranial hematoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM:This study aimed to expound the individual idea of micro-invasive surgery from pre-operative preparation,intra-operative processing and post-operative management.METHODS:Pre-operative preparation was improved by analyzing pathological factors and hematoma property,and considering patients' age,basic disease,blood pressure control,with persistent haemorrhagia/rehaemorrhagia or not,operative occasion choice,positioning and other procedures.In the surgery,positioner was used.Initial aspiration volume was cautiously controlled.After operation,vital signs of patients were kept stable by cautiously using hematoma liquefacient and combining with free radical scavenger.RESULTS:The core content of individual micro-invasive surgery was mainly to relieve intracranial pressure.Under the condition of sufficient pre-operative preparation known by patients' family members,precise positioning was determined and individual therapeutic regimen was made.Meanwhile,caution should be taken in hematoma aspiration.Liquefaction and drainage should be paid more attention,and complications were processed actively.CONCLUSION:During the process of micro-invasive evacuation of intracranial hematoma for treating cerebral hemorrhage,attention should be paid to analyzing cerebral hematoma etiology and pathophysiological mechanism,and individual idea should be considered in surgical treatment aiming at patients' concrete disease condition.

  10. New strategies for preoperative skin antisepsis.

    Science.gov (United States)

    Ulmer, Miriam; Lademann, Juergen; Patzelt, Alexa; Knorr, Fanny; Kramer, Axel; Koburger, Torsten; Assadian, Ojan; Daeschlein, Georg; Lange-Asschenfeldt, Bernhard

    2014-01-01

    During the past decades, encouraging progress has been made in the prevention of surgical site infections (SSI). However, as SSI still occur today, strategic prevention measures such as standardized skin antisepsis must be implemented and rigorously promoted. Recent discoveries in skin physiology necessitate the development of novel antiseptic agents and procedures in order to ameliorate their efficacy. In particular, alternate target structures in the skin need to be taken into consideration for the development of the next generation of antiseptics. Recent investigations have shown that a high number of microorganisms are located within and in the close vicinity of the hair follicles. This suggests that these structures are an important reservoir of bacterial growth and activity in human skin. To date, it has not been fully elucidated to what extent conventional liquid antiseptics sufficiently target the hair follicle-related microbial population. Modern technologies such as tissue-tolerable plasma (TTP) have been tested for their potential antiseptic efficiency by reducing the bacterial load in the skin and in the hair follicles. First experiments using liposomes to deliver antiseptics into the hair follicles have been evaluated for their potential clinical application. The present review evaluates these two innovative methods for their efficacy and applicability in preoperative skin antiseptics.

  11. Preoperative optimization of the vascular surgery patient

    Directory of Open Access Journals (Sweden)

    Zhan HT

    2015-07-01

    Full Text Available Henry T Zhan,1 Seth T Purcell,1,2 Ruth L Bush1 1Texas A&M Health Science Center College of Medicine, Bryan, 2Baylor Scott and White, Temple, TX, USA Abstract: It is well known that patients who suffer from peripheral (noncardiac vascular disease often have coexisting atherosclerotic diseases of the heart. This may leave the patients susceptible to major adverse cardiac events, including death, myocardial infarction, unstable angina, and pulmonary edema, during the perioperative time period, in addition to the many other complications they may sustain as they undergo vascular surgery procedures, regardless of whether the procedure is performed as an open or endovascular modality. As these patients are at particularly high risk, up to 16% in published studies, for postoperative cardiac complications, many proposals and algorithms for perioperative optimization have been suggested and studied in the literature. Moreover, in patients with recent coronary stents, the risk of noncardiac surgery on adverse cardiac events is incremental in the first 6 months following stent implantation. Just as postoperative management of patients is vital to the outcome of a patient, preoperative assessment and optimization may reduce, and possibly completely alleviate, the risks of major postoperative complications, as well as assist in the decision-making process regarding the appropriate surgical and anesthetic management. This review article addresses several tools and therapies that treating physicians may employ to medically optimize a patient before they undergo noncardiac vascular surgery. Keywords: perioperative care, intraoperative care, medical management, risk evaluation/stratification, medical treatment

  12. Recovery of water from acid mine drainage

    CSIR Research Space (South Africa)

    Mulopo, J

    2010-10-01

    Full Text Available acid mine drainage J Mulopo, SR Motaung , M Mashego and M Moalusi Natural Resources and the Environment, CSIR, P O Box 395, Pretoria, 0001, South Africa ConClusion The optimal region for the operation and design of a sulphate removal reactor... operating conditions results in a process with somehow large excess feed. Hence, one should not optimize the reactor configuration independently of the process in which the reactor is going to be used. Figure 1: Rate of Sulphate Removal at 25o...

  13. Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula

    Directory of Open Access Journals (Sweden)

    Gencosmanoglu Rasim

    2003-11-01

    Full Text Available Abstract Background Posterior horseshoe fistula with deep postanal space abscess is a complex disease. Most patients have a history of anorectal abscess drainage or surgery for fistula-in-ano. Methods Twenty-five patients who underwent surgery for posterior horseshoe fistula with deep postanal space abscess were analyzed retrospectively with respect to age, gender, previous surgery for fistula-in-ano, number of external openings, diagnostic studies, concordance between preoperative studies and operative findings for the extent of disease, operating time, healing time, complications, and recurrence. Results There were 22 (88% men and 3 (12% women with a median age of 37 (range, 25–58 years. The median duration of disease was 13 (range, 3–96 months. There was one external opening in 12 (48% patients, 2 in 8 (32%, 3 in 4 (16%, and 4 in 1 (4%. Preoperative diagnosis of horseshoe fistula was made by contrast fistulography in 4 (16% patients, by ultrasound in 3 (12%, by magnetic resonance imaging in 6 (24%, and by physical examination only in the remainder (48%. The mean ± SD operating time was 47 ± 10 min. The mean ± SD healing time was 12 ± 3 weeks. Three of the 25 patients (12% had diabetes mellitus type II. Nineteen (76% patients had undergone previous surgery for fistula-in-ano, while five (20% had only perianal abscess drainage. Neither morbidity nor mortality developed. All patients were followed up for a median of 35 (range, 6–78 months and no recurrence was observed. Conclusions Fistulotomy of the tracts along the arms of horseshoe fistula and drainage of the deep postanal space abscess with posterior midline incision that severs both the lower edge of the internal sphincter and the subcutaneous external sphincter and divides the superficial external sphincter into halves gives excellent results with no recurrence. When it is necessary, severing the halves of the superficial external sphincter unilaterally or even bilaterally in the

  14. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

    The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses...... (median diameter 7 cm), 19 were treated with catheter drainage and 18 of these cases resulted in favorable clinical outcomes. Of the smaller abscesses (median diameter 4 cm), 14 were treated with needle drainage. In two of these cases, follow-up US showed that a repeat puncture and drainage was necessary...... and the subsequent in-dwelling catheter period, there were no serious complications related to the drainage procedures. We conclude that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches. Based on our findings...

  15. Comparing twist-drill drainage with burr hole drainage for chronic subdural hematoma

    Directory of Open Access Journals (Sweden)

    LIN Xin

    2011-06-01

    Full Text Available 【Abstract】Objective: The surgical management of chronic subdural hematoma (CSDH is still a controver- sial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The intention of this paper is to find a simple and efficient surgical procedure for CSDH. Methods: A retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was con- ducted in order to compare the efficiency between two dif- ferent primary surgical methods, i.e. twist-drill drainage with- out irrigation in Group A (n=178 and one burr-hole with irrigation in Group B (n=270. The results were statistically analyzed. Results: The reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 75.5%, the complication was 7.9% and 20.7% in Group A and Group B, respectively. Conclusions: The burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treat- ment for CSDH. Thus in initial treatment, twist-drill drainage without irrigation of the hematoma cavity is recommended because it is relatively safe, time-saving and cost-effective. Key words: Hematoma, subdural; Brain injury, chronic; Drainage

  16. Reuse of drainage water model : calculation method of drainage water and watertable depth

    NARCIS (Netherlands)

    Roest, C.W.J.; Rijtema, P.E.; Abdel Khalik, M.A.

    1986-01-01

    The main objective of the project is to assist the Ministry of Irrigation in Egypt in the planning of future watermanagement strategies incorporating reuse of drainage water practices. In order to achieve this main objective a comprehensive measurement programme has been initiated and a mathematical

  17. Pancreatic tissue fluid pressure during drainage operations for chronic pancreatitis

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Madsen, P

    1990-01-01

    Pancreatic tissue fluid pressure was measured in 10 patients undergoing drainage operations for painful chronic pancreatitis. The pressure was measured by the needle technique in the three anatomic regions of the pancreas before and at different stages of the drainage procedure, and the results...... a decrease in pancreatic tissue fluid pressure during drainage operations for pain in chronic pancreatitis. Regional pressure decrease were apparently unrelated to ERCP findings....

  18. Pancreatic tissue fluid pressure during drainage operations for chronic pancreatitis

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Madsen, P

    1990-01-01

    Pancreatic tissue fluid pressure was measured in 10 patients undergoing drainage operations for painful chronic pancreatitis. The pressure was measured by the needle technique in the three anatomic regions of the pancreas before and at different stages of the drainage procedure, and the results...... a decrease in pancreatic tissue fluid pressure during drainage operations for pain in chronic pancreatitis. Regional pressure decrease were apparently unrelated to ERCP findings....

  19. Coupling between drainage and coarsening in wet foam

    Indian Academy of Sciences (India)

    S Saha; S Bhaumik; A Roy

    2009-06-01

    Drainage and coarsening are two coupled phenomena during the evolution of wet foam. We show the variation in the growth rate of bubble size, along the height in a column of Gillette shaving foam, by microscope imaging. Simultaneously, the drainage of liquid at the same heights has been investigated by Raman spectroscopic measurements. The observations made in these two sets of experiments indicate the coupling between drainage and coarsening in wet foam. We could explain the correlation between our observed data on drainage and coarsening by the empirical relation, proposed by others, in the literature.

  20. Bioreactor for acid mine drainage control

    Science.gov (United States)

    Zaluski, Marek H.; Manchester, Kenneth R.

    2001-01-01

    A bioreactor for reacting an aqueous heavy metal and sulfate containing mine drainage solution with sulfate reducing bacteria to produce heavy metal sulfides and reduce the sulfuric acid content of the solution. The reactor is an elongated, horizontal trough defining an inlet section and a reaction section. An inlet manifold adjacent the inlet section distributes aqueous mine drainage solution into the inlet section for flow through the inlet section and reaction section. A sulfate reducing bacteria and bacteria nutrient composition in the inlet section provides sulfate reducing bacteria that with the sulfuric acid and heavy metals in the solution to form solid metal sulfides. The sulfate reducing bacteria and bacteria nutrient composition is retained in the cells of a honeycomb structure formed of cellular honeycomb panels mounted in the reactor inlet section. The honeycomb panels extend upwardly in the inlet section at an acute angle with respect to the horizontal. The cells defined in each panel are thereby offset with respect to the honeycomb cells in each adjacent panel in order to define a tortuous path for the flow of the aqueous solution.

  1. Recognition and management of preoperative risk.

    Science.gov (United States)

    Nierman, E; Zakrzewski, K

    1999-08-01

    Internists are frequently asked to do preoperative consultations and to manage perioperative complications. Realistic goals are to identify patient factors that increase the risk of surgery, to quantify this risk in order to make decisions about the appropriateness of and timing of the surgery, to provide recommendations on how to minimize the risk, to identify and manage coexisting medical conditions and their associated medication requirements, to monitor the patient for perioperative problems, and to make recommendations to deal with these problems when they occur. With few exceptions, nonselective imaging and laboratory screening tests have repeatedly been shown to be of little value when the history and physical do not suggest a problem. The risk associated with the planned surgery can be estimated, with the most common serious complications being cardiac events. Updated versions of Goldman's risk indices are particularly helpful for this. Clinical variables are optimally combined with selective stress testing to discern which patients will benefit from preoperative revascularization. This has been studied best in the setting of vascular surgery. A critical guiding principle is that the value of revascularization must be judged in terms of long term gains rather than just immediate perioperative benefit. Other interventions include the selective use of beta blockers, adequate analgesia for all, control of hypertension, and appropriate volume management, especially in the settings of preexisting CHF or valvular disease. It must also be recognized that perioperative ischemia and CHF often present atypically. An approach that combines aspects of both the ACC/AHA and the ACP guidelines seems optimal. A variety of noncardiac issues must also be addressed. Postoperative pulmonary complications are common, especially with preexisting pulmonary disease, thoracic and upper abdominal surgery, and obesity. PFTs and ABGs are indicated in selected patients. Stopping

  2. Anterior mediastinal paraganglioma: A case for preoperative embolization

    Directory of Open Access Journals (Sweden)

    Shakir Murtaza

    2012-07-01

    Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

  3. Pre-operative investigations: yield and conformity to national guidelines.

    Science.gov (United States)

    Juliana, H; Lim, T A; Inbasegaran, K

    2003-03-01

    Routine ordering of pre-operative investigations yields a low true positive rate and is not cost effective. In this study, case notes of 251 adults who underwent elective surgery were reviewed. Pre-operative investigations were classified as 'indicated' or 'not indicated', based on the national guidelines. Only 56% of all tests done were indicated. The overall rates of expected and unexpected abnormal values from pre-operative blood investigations were 51.1% and 34.4% respectively. This study found that selective testing based on guidelines was beneficial. However, the results also suggest that the local guidelines need to be reviewed.

  4. Preoperative factors influencing success in pterygium surgery

    Directory of Open Access Journals (Sweden)

    Torres-Gimeno Ana

    2012-08-01

    Full Text Available Abstract Background To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. Methods This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue, graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis, and postoperative symptoms (foreign-body sensation, pain. The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. Results A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Conclusions Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

  5. [Spectrum and susceptibility of preoperative conjunctival bacteria].

    Science.gov (United States)

    Fernández-Rubio, M E; Cuesta-Rodríguez, T; Urcelay-Segura, J L; Cortés-Valdés, C

    2013-12-01

    To describe the conjunctival bacterial spectrum of our patients undergoing intraocular surgery and their antibiotic sensitivity during the study period. A retrospective study of preoperative conjunctival culture of patients consecutively scheduled for intraocular surgery from 21 February 2011 to 1 April 2013. Specimens were directly seeded onto blood-agar and MacConkey-agar (aerobiosis incubation, 2 days), and on chocolate-agar (6% CO2 incubation, 7 days). The identified bacteria were divided into 3 groups according to their origin; the bacteria susceptibility tests were performed on those more pathogenic and on some of the less pathogenic when more than 5 colonies were isolated. The sensitivity of the exigent growing bacteria was obtained with disk diffusion technique, and for of the non-exigent bacteria by determining their minimum inhibitory concentration. The Epidat 3.1 program was used for statistical calculations. A total of 13,203 bacteria were identified in 6,051 cultures, with 88.7% being typical colonizers of conjunctiva (group 1), 8.8% typical of airways (group 2), and the remaining 2.5% of undetermined origin (group 3). 530 cultures (8.8%) were sterile. The sensitivity of group 1 was: 99% vancomycin, 95% rifampicin, 87% chloramphenicol, 76% tetracycline. Levels of co-trimoxazole, aminoglycosides, quinolones, β-lactams and macrolides decreased since 2007. The group 2 was very sensitive to chloramphenicol, cefuroxime, rifampicin, ciprofloxacin and amoxicillin/clavulanate. In group 3, to levofloxacin 93%, ciprofloxacin 89%, tobramycin 76%, but ceftazidime 53% and cefuroxime 29% decreased. None of the tested antibiotics could eradicate all possible conjunctival bacteria. Bacteria living permanently on the conjunctiva (group 1) have achieved higher resistance than the eventual colonizers. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  6. Inventory of drainage wells and potential sources of contaminants to drainage-well inflow in Southwest Orlando, Orange County, Florida

    Science.gov (United States)

    Taylor, George Fred

    1993-01-01

    Potential sources of contaminants that could pose a threat to drainage-well inflow and to water in the Floridan aquifer system in southwest Orlando, Florida, were studied between October and December 1990. Drainage wells and public-supply wells were inventoried in a 14-square-mile area, and available data on land use and activities within each drainage well basin were tabulated. Three public-supply wells (tapping the Lower Floridan aquifer) and 38 drainage wells (open to the Upper Floridan aquifer) were located in 17 drainage basins within the study area. The primary sources of drainage-well inflow are lake overflow, street runoff, seepage from the surficial aquifer system, and process-wastewater disposal. Drainage-well inflow from a variety of ares, including resi- dential, commercial, undeveloped, paved, and industrial areas, are potential sources of con- taminants. The four general types of possible contaminants to drainage-well inflow are inorganic chemicals, organic compounds, turbidity, and microbiological contaminants. Potential contami- nant sources include plant nurseries, citrus groves, parking lots, plating companies, auto- motive repair shops, and most commonly, lake- overflow water. Drainage wells provide a pathway for contaminants to enter the Upper Floridan aquifer and there is a potential for contaminants to move downward from the Upper Floridan to the Lower Floridan aquifer.

  7. Is ultrasonography-guided drainage a safe and effective alternative to incision and drainage for deep neck space abscesses?

    Science.gov (United States)

    Dabirmoghaddam, P; Mohseni, A; Navvabi, Z; Sharifi, A; Bastaninezhad, S; Safaei, A

    2017-03-01

    Deep neck space abscesses are common head and neck surgery emergencies. Traditionally, surgical incision and drainage has been the main treatment for deep neck abscesses. Recently, it has been suggested that ultrasound-guided drainage of neck abscesses can be an effective and less invasive alternative to incision and drainage. Patients with deep neck space abscesses referred to the emergency department of Amiralam Hospital were assessed and enrolled to the study if they met the inclusion criteria. Patients were randomly assigned to incision and drainage or ultrasound-guided drainage groups using sealed envelopes. Sixty patients were evaluated, with 30 patients in each group. There was a significant difference (p < 0.001) in mean length of hospital stay between patients who underwent ultrasound-guided drainage (5.47 days) and those who underwent incision and drainage (9.70 days). Ultrasound-guided drainage is an effective and safe procedure, leading to shorter hospital stay, and thus may be a suitable alternative to incision and drainage of deep neck abscesses.

  8. Preoperative physical therapy for elective cardiac surgery patients

    NARCIS (Netherlands)

    Hulzebos, E.H.J.; Smit, Y.; Helders, P.P.J.M.; Meeteren, N.L.U. van

    2012-01-01

    BACKGROUND: After cardiac surgery, physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications. OBJECTIVES: To determine if preoperative physical therapy with an exercise component can prevent postoperative pulmonary complications in cardiac sur

  9. An audit of documented preoperative evaluation of surgery patients ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia 2015; 21(4):23-28 ... The information obtained from the standardised PAR form in each patient's file was audited using a ... inadequate preoperative assessment and management were.

  10. Preoperative preparation of patients with pituitary gland disorders

    National Research Council Canada - National Science Library

    Malenković, Vesna; Gvozdenović, Ljiljana; Milaković, Branko; Sabljak, Vera; Ladjević, Nebojsa; Zivaljević, Vladan

    2011-01-01

    This paper presents the most common disorders of pituitary function: acromegaly, hypopituitarism, diabetes insipidus and syndrome similar to diabetes insipidus, in terms of their importance in preoperative preparation of patients...

  11. Association of Preoperative Anemia With Postoperative Mortality in Neonates.

    Science.gov (United States)

    Goobie, Susan M; Faraoni, David; Zurakowski, David; DiNardo, James A

    2016-09-01

    Neonates undergoing noncardiac surgery are at risk for adverse outcomes. Preoperative anemia is a strong independent risk factor for postoperative mortality in adults. To our knowledge, this association has not been investigated in the neonatal population. To assess the association between preoperative anemia and postoperative mortality in neonates undergoing noncardiac surgery in a large sample of US hospitals. Using data from the 2012 and 2013 pediatric databases of the American College of Surgeons National Surgical Quality Improvement Program, we conducted a retrospective study of neonates undergoing noncardiac surgery. Analysis of the data took place between June 2015 and December 2015. All neonates (0-30 days old) with a recorded preoperative hematocrit value were included. Anemia defined as hematocrit level of less than 40%. Receiver operating characteristics analysis was used to assess the association between preoperative hematocrit and mortality, and the Youden J Index was used to determine the specific hematocrit cutoff point to define anemia in the neonatal population. Demographic and postoperative outcomes variables were compared between anemic and nonanemic neonates. Univariate and multivariable logistic regression analyses were used to determine factors associated with postoperative neonatal mortality. An external validation was performed using the 2014 American College of Surgeons National Surgical Quality Improvement Program database. Neonates accounted for 2764 children (6%) in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program databases. Neonates inlcuded in the study were predominately male (64.5%), white (66.3%), and term (69.9% greater than 36 weeks' gestation) and weighed more than 2 kg (85.0%). Postoperative in-hospital mortality was 3.4% in neonates and 0.6% in all age groups (0-18 years). A preoperative hematocrit level of less than 40% was the optimal cutoff (Youden) to predict in-hospital mortality

  12. A randomized trial of preoperative oral carbohydrates in abdominal surgery

    OpenAIRE

    Sada, Fatos; Krasniqi, Avdyl; Hamza, Astrit; Gecaj-Gashi, Agreta; Bicaj, Besnik; Kavaja, Floren

    2014-01-01

    Background Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. Methods A randomized, double blind, prospective study of patients undergoing open colorectal operations (CR) and open cholecyctectomy (CH) was conducted. Patients were divided into three groups: study, placebo, and ...

  13. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, Linda

    1999-01-01

    BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients continue to have abdominal pain. The aim of this study was to investigate whether preoperative variables could predict the symptomatic outcome after cholecystectomy. METHODS: One hundred and two patients...... and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome. RESULTS: Eighty...

  14. Preoperative Nutritional Status of the Surgical Patients in Jeju

    OpenAIRE

    Moon, Myung-Sang; Kim, Sung-Soo; Lee, Sang-Yup; Jeon, Dal-Jae; Yoon, Min-Geun; Kim, Sung-Sim; Moon, Hanlim

    2014-01-01

    Background To assess the preoperative nutritional status of patients with various disorders and to provide data for pre- and postoperative patient management plans, particularly in the elderly. There is no published information on age-matched and disease-matched preoperative nutritional/immunologic status for orthopedic patients, especially in the elderly, in Jeju. Methods In total, 331 patients with four categories of orthopedic conditions were assessed: 92 elective surgery patients, 59 arth...

  15. [Value of preoperative planning in total hip arthroplasty].

    Science.gov (United States)

    De Thomasson, E; Mazel, C; Guingand, O; Terracher, R

    2002-05-01

    Preoperative planning enables an assessment of the size of the implants needed before total hip replacement. Eggli and Müller demonstrated the reproduciblity of preoperative planning but did not evaluate its contribution to reducing limb length discrepancy. As femur lateralization and the position of the prosthetic center of rotation affect joint mechanics, it would be useful to assess their contribution to the efficacy of preoperative planning. We reviewed the files of 57 patients who underwent total hip arthroplasty for primary joint degeneration or necrosis limited to one hip. The healthy hip served as a control. The surgical plan was elaborated from the preoperative pelvis x-rays (AP and lateral views) and anatomic measurements on films obtained three months postoperatively. In 49 cases, preoperative planning predicted a restoration of the normal anatomy of the operated hip (center of rotation, femur lateralization, length of the operated limb). This objective was achieved in only 22.5% of the cases. Femur lateralization was the most difficult objective to achieve (59.2%). Equal limb length and good position of the center of rotation was achieved in 70% of the cases. For eight patients (14%) preoperative planning was not satisfactory, the implant offset not being adapted to the patient's anatomy. There are limits to preoperative planning, particularly for restitution of adequate femur lateralization. This difficulty appears to be related to three factors: inadequate adaptation of the implant to hip anatomy (14% of the cases in our experience), stiff rotation in degenerative hips inhibiting proper assessment of the length of the femoral neck, and relative imprecision of operative evaluation of femoral anteversion affecting femur lateralization and the level of the femoral cut. Although imperfect, preoperative planning is, in our opinion, essential before total hip arthroplasty in order to avoid major positioning errors and operative difficulties.

  16. Essential elements of the preoperative breast reconstruction evaluation

    OpenAIRE

    Cheng, Angela; Losken, Albert

    2015-01-01

    A plethora of options exist for breast reconstruction and preoperative evaluation must be thorough to lead to a successful outcome. We review multiple components of the preoperative assessment including the patient’s history, goals, imaging, and key elements of the physical exam. Consideration for tumor biology, staging, need or response to chemotherapy or radiation therapy is important in deciding on immediate versus delayed reconstruction. It is also important to consider the patient’s anat...

  17. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  18. Preoperative Chemoradiotheraph for Inflammatory Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Hongbo Ren; Qi Wang; Yaoxiong Yan; Shaolin Li; Biyou Huang

    2006-01-01

    OBJECTIVE To observe the effect of preoperative chemoradiotherapy for inflammatory breast cancer.METHODS From December 1996 to December 2000, we received and treated 21 patients with inflammatory breast carcinoma with a combinedmodality treatment. The chemotherapy protocol consisted of cyclophosphamide (CTX), pirarubicin (THP-ADM) and 5-fluorouracil (5-FU) or CTX, 5-Fu and methotrexate (MTX). The same infusion scheme was repeated on day 21. After 3~4 cycles the patients were treated with radiotherapy. When the radiation dose reached 40 Gy, the patients who were unable or unwilling to under go an operation received continued radiotherapy. When the radiation dose to the supra clavicular fossa and internal mammary lymph nodes reached 60 Gy and 50 Gy respectively, the radiotherapy was stopped. Chemotherapy was then continued with the original scheme. Patients who had indications for surgery and were willing to under go an operation received no treatment for 2 weeks, after which a total mastectomy was performed. Chemotherapy and radiotherapy was resumed with the original scheme after the operations. When the radiation dose reached 50 Gy, radiotherapy was stopped.RESULTS All patients were followed-up for more than 5 years with a follow-up rate of 100%. The overall 3 and 5-year survival rates of these patients were 42.9%, and 23.8% respectively. For patients in Stage ⅢB the 3 and 5-year survival rates were 50.0% and 27.8% respectively, and for patients in Stage Ⅳ, the 3 and 5-year survival rates were both 0.0%.There was a significant difference between the 2 stage groups (P<0.05,X2=11.60). For patients who received an operation, the 3 and 5-year survival rates were 80.0% and 33.3% respectively, For patients who were not treated with an operation, the 3 and 5-year survival rates were both0.0%, There was a significant difference between the operated and nonoperated groups (P<0.05, X2=11.64).CONCLUSION The prognosis of inflammatory breast carcinoma is poor

  19. Preoperative Planning of Orthopedic Procedures using Digitalized Software Systems.

    Science.gov (United States)

    Steinberg, Ely L; Segev, Eitan; Drexler, Michael; Ben-Tov, Tomer; Nimrod, Snir

    2016-06-01

    The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English. Digitalized software programs are enabled to import and export all picture archiving communication system (PACS) files (i.e., X-rays, computerized tomograms, magnetic resonance images) from either the local working station or from any remote PACS. Two-dimension (2D) and 3D CT scans were found to be reliable tools with a high preoperative predicting accuracy for implants. The short learning curve, user-friendly features, accurate prediction of implant size, decreased implant stocks and low-cost maintenance makes digitalized software programs an attractive tool in preoperative planning of total joint replacement, fracture fixation, limb deformity repair and pediatric skeletal disorders.

  20. The importance of preoperative diagnosis of blister aneurysms.

    Science.gov (United States)

    Russin, Jonathan J; Kramer, Daniel R; Thomas, Debi; Hasson, Denise; Liu, Charles Y; Amar, Arun P; Mack, William J; Giannotta, Steven L

    2015-09-01

    We describe a series of 14 surgical blister aneurysm (BA) patients and compare outcomes in those with known cerebral BA to those lacking preoperative BA diagnosis/recognition. BA are broad, fragile, pathologic dilatations of the intracranial arteries. They have a low prevalence but are associated with substantially higher surgical morbidity and mortality rates than saccular aneurysms. A confirmed, preoperative BA diagnosis can alter operative management and technique. We performed a retrospective review of prospectively collected data on aneurysm patients undergoing surgery at a major academic institution. All patients from 1990 to 2011 with a postoperative BA diagnosis were included. Chart reviews were performed to identify patients with preoperative BA diagnoses and collect descriptive data. We identified 14 patients, 12 of whom presented with subarachnoid hemorrhage. The age of the cohort (mean ± standard deviation: 41.8 ± 13.9 years) was lower than that generally reported for saccular aneurysm populations. Preoperatively diagnosed BA had an intraoperative rupture (IOR) rate of 28.6% (2/7) compared to a 57.1% (4/7) rate in the undiagnosed patients. The mortality rate in the preoperatively diagnosed cohort was 14.3% (1/7) while that of the undiagnosed group was 42.8% (3/7). BA remain a diagnostic and treatment challenge with morbidity and mortality rates exceeding those of saccular aneurysms. Preoperative BA diagnosis may decrease IOR and mortality rates and improve patient outcomes.

  1. Evaluating the effects of preoperative fasting and fluid limitation.

    Science.gov (United States)

    Tosun, Betül; Yava, Ayla; Açıkel, Cengizhan

    2015-04-01

    The aim of the study was to evaluate the effects of preoperative fasting and fluid limitation in patients undergoing laparoscopic cholecystectomy. Although traditional long-term fasting is not recommended in current preoperative guidelines, this is still a common intervention. Visual analogue scale was used to assess hunger, thirst, sleepiness, exhaustion, nausea and pain; State and Trait Anxiety Inventory was used to assess the preoperative anxiety of 99 patients undergoing elective laparoscopic cholecystectomy. Mean time of preoperative fasting and fluid limitation were, respectively, 14.70 ± 3.14 and 11.25 ± 3.74 h. Preoperatively, 58.60% of the patients experienced moderate anxiety. Patients fasting 12 h or longer had higher hunger, thirst, nausea and pain scores. The mean trait anxiety score of patients fasting 12 h or longer was statistically significantly higher. Receiving nothing by mouth after midnight preoperatively is a persisted intervention and results in discomfort of patients. Clinical protocols should be revised and nurses should be trained in current fasting protocols. © 2014 Wiley Publishing Asia Pty Ltd.

  2. Exact solutions for nonlinear foam drainage equation

    Science.gov (United States)

    Zayed, E. M. E.; Al-Nowehy, Abdul-Ghani

    2016-09-01

    In this paper, the modified simple equation method, the exp-function method, the soliton ansatz method, the Riccati equation expansion method and the ( G^' }/G) -expansion method are used to construct exact solutions with parameters of the nonlinear foam drainage equation. When these parameters are taken to be special values, the solitary wave solutions and the trigonometric function solutions are derived from the exact solutions. The obtained results confirm that the proposed methods are efficient techniques for analytic treatments of a wide variety of nonlinear partial differential equations in mathematical physics. We compare our results together with each other yielding from these integration tools. Also, our results have been compared with the well-known results of others.

  3. Exact solutions for nonlinear foam drainage equation

    Science.gov (United States)

    Zayed, E. M. E.; Al-Nowehy, Abdul-Ghani

    2017-02-01

    In this paper, the modified simple equation method, the exp-function method, the soliton ansatz method, the Riccati equation expansion method and the ( G^' }/G)-expansion method are used to construct exact solutions with parameters of the nonlinear foam drainage equation. When these parameters are taken to be special values, the solitary wave solutions and the trigonometric function solutions are derived from the exact solutions. The obtained results confirm that the proposed methods are efficient techniques for analytic treatments of a wide variety of nonlinear partial differential equations in mathematical physics. We compare our results together with each other yielding from these integration tools. Also, our results have been compared with the well-known results of others.

  4. Integrated urban drainage, status and perspectives

    DEFF Research Database (Denmark)

    Harremoës, Poul

    2002-01-01

    This paper summarises the status of urban storm drainage as an integrated professional discipline, including the management-policy interface, by which the goals of society are implemented. The paper assesses the development of the discipline since the INTERURBA conference in 1992 and includes...... with a significant conservatism in the business. However, significant integrated analyses have been reported. Most of them deal with the sewer system and the treatment plant, while few incorporate the receiving water as anything but the object of the loads to be minimised by engineering measures up-stream. Important...... measures are local infiltration, source control, storage basins, local treatment and real time control. New paradigms have been introduced: risk of pollution due to system failure, technology for water reuse, sustainability, new architecture and greener up-stream solutions as opposed to down...

  5. Integrated urban drainage, status and perspectives

    DEFF Research Database (Denmark)

    Harremoës, Poul

    2002-01-01

    with a significant conservatism in the business. However, significant integrated analyses have been reported. Most of them deal with the sewer system and the treatment plant, while few incorporate the receiving water as anything but the object of the loads to be minimised by engineering measures up-stream. Important...... aspects of the papers presented at the INTERURBA-II conference in 2001 and the discussions during the conference. Tools for integrated analysis have been developed, but there is less implementation than could be expected. That is due to lack of adequate knowledge about important mechanisms, coupled......This paper summarises the status of urban storm drainage as an integrated professional discipline, including the management-policy interface, by which the goals of society are implemented. The paper assesses the development of the discipline since the INTERURBA conference in 1992 and includes...

  6. Vertical Analysis of Martian Drainage Basins

    Science.gov (United States)

    Stepinski, T. F.; OHara, W. J.

    2003-01-01

    We have performed a vertical analysis of drainage basins on Mars that were computationally extracted from DEMs based on the MOLA data. Longitudinal profiles of main streams are calculated and the slope-area relation is established for 20 basins coming from assorted martian locations. An identical analysis is done for 19 terrestrial river basins. Our results show that, in comparison to terrestrial basins, martian basins have more linear longitudinal profiles, more frequent existence of knickpoints, predominance of asymmetric location of the main stream in the basin, and smaller values of concavity exponent. This suggests a limited role for surface runoff on the global scale. However, two basins extracted from the slopes of martian volcanoes show a strong similarity to terrestrial basins, indicating a possible local role for the process of surface runoff.

  7. Ecology and management of agricultural drainage ditches: a literature review

    Science.gov (United States)

    Agricultural drainage ditches are headwater streams that have been modified or constructed for agricultural drainage, and are often used in conjunction with tile drains. These modified streams are a common landscape feature in Ohio, and constitute 25% of stream habitat within the state. Management o...

  8. Remediation of Acid Mine Drainage with Sulfate Reducing Bacteria

    Science.gov (United States)

    Hauri, James F.; Schaider, Laurel A.

    2009-01-01

    Sulfate reducing bacteria have been shown to be effective at treating acid mine drainage through sulfide production and subsequent precipitation of metal sulfides. In this laboratory experiment for undergraduate environmental chemistry courses, students design and implement a set of bioreactors to remediate acid mine drainage and explain observed…

  9. A synthesis and comparative evaluation of drainage water management

    Science.gov (United States)

    Viable large-scale crop production in the United States requires artificial drainage in humid and poorly drained agricultural regions. Excess water removal is generally achieved by installing tile drains that export water to open ditches that eventually flow into streams. Drainage water management...

  10. Remediation of Acid Mine Drainage with Sulfate Reducing Bacteria

    Science.gov (United States)

    Hauri, James F.; Schaider, Laurel A.

    2009-01-01

    Sulfate reducing bacteria have been shown to be effective at treating acid mine drainage through sulfide production and subsequent precipitation of metal sulfides. In this laboratory experiment for undergraduate environmental chemistry courses, students design and implement a set of bioreactors to remediate acid mine drainage and explain observed…

  11. 49 CFR 192.189 - Vaults: Drainage and waterproofing.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Vaults: Drainage and waterproofing. 192.189 Section 192.189 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND... Components § 192.189 Vaults: Drainage and waterproofing. (a) Each vault must be designed so as to...

  12. 7 CFR 1924.108 - Grading and drainage.

    Science.gov (United States)

    2010-01-01

    .... In questionable or unsurveyed areas, the applicant or developer will provide an engineering report... affect the structure and show proposed solutions. Grading will promote drainage of surface water away from buildings and foundations, minimize earth settlement and erosion, and assure that drainage...

  13. Conceptual design report for site drainage control

    Energy Technology Data Exchange (ETDEWEB)

    Hunter, M.R.

    1996-07-01

    The Mound Plant (Mound), located in Miamisburg, Ohio, is a Department of Energy (DOE) development and production facility performing support work for DOE`s weapons and energy-related programs. EG&G Mound Applied Technologies, Inc. (EG&G) is the Operating Contractor (OC) for this Government-Owned, Contractor-Operated (GOCO) facility. The work performed at Mound emphasizes nuclear energy and explosives technology. Mound is currently implementing an Environmental, Safety & Health (ES&H) Upgrades Program designed to protect its employees, the public, and the environment from adverse effects caused by facility activities. The first project of this multiphase program is now in the final stages of construction, and the second project is currently under design. Four additional projects, one of which is presented in this report, are in the conceptual design stage. At Mound, 22 soil zones have become contaminated with radioactive material. These zones cover approximately 20 percent of the total area of developed property at the site. During a storm event, the rainwater washes contaminated soil from these zones into the storm sewer system. These radioactive contaminants may then be discharged along with the stormwater into the Great Miami River via the Miami Erie Canal. This conceptual design report (CDR), Site Drainage Control, the fourth project in the ES&H program, describes a project that will provide improvements and much needed repairs to inadequate and deteriorating portions of the storm drainage system on the developed property. The project also will provide a stormwater retention facility capable of storing the stormwater runoff, from the developed property, resulting from a 100-year storm event. These improvements will permit the effective control and monitoring of stormwater to prevent the spread of radioactive contaminants from contaminated soil zones and will provide a means to collect and contain accidental spills of hazardous substances.

  14. Sulphates Removal from Acid Mine Drainage

    Science.gov (United States)

    Luptáková, Alena; Mačingová, Eva; Kotuličová, Ingrida; Rudzanová, Dominika

    2016-10-01

    Acid mine drainage (AMD) are a worldwide problem leading to ecological destruction in river basins and the contamination of water sources. AMD are characterized by low pH and high content of heavy metals and sulphates. In order to minimize negative impacts of AMD appropriate treatment techniques has to be chosen. Treatment processes are focused on neutralizing, stabilizing and removing pollutants. From this reason efficient and environmental friendly methods are needed to be developed in order to reduce heavy metals as well as sulphates. Various methods are used for remediation of acid mine drainage, but any of them have been applied under commercial-scale conditions. Their application depends on geochemical, technical, natural, financial, and other factors. The aim of the present work was to interpret the study of biological methods for sulphates removal from AMD out-flowing from the shaft Pech of the deposit Smolmk in Slovak Republic. In the experimental works AMD were used after removal of heavy metals by precipitation and sorption using the synthetic sorbent Slovakite. The base of the studied method for the sulphates elimination was the anaerobic bacterial sulphate reduction using sulphate-reducing bacteria (SRB) genera Desulfovibrio. SRB represent a group of bacteria that uses sulphates as a terminal electron acceptor for their metabolism. These bacteria realize the conversion of sulphate to hydrogen sulphide under anaerobic conditions. For the purposes of experiments a few variants of the selective medium DSM-63 culture media were used in term of the sulphates and sodium lactate contents in the selective medium as well as sulphates in the studied AMD.

  15. Microbial decontamination of uranium mine drainage

    Energy Technology Data Exchange (ETDEWEB)

    Hard, B.C.; Babel, W. [UFZ - Umweltforschungszentrum Leipzig-Halle GmbH, Leipzig (Germany)

    2001-07-01

    One of the problems one is faced with when uranium mines are closed is the decontamination of acid mine drainage (AMD) from tailings and flooding of the underground mines. The high concentrations of sulfates and metals in mining water make it impossible to dispose of the water into rivers without having to decontaminate it first. A bioremediation process is proposed in which sulfate-reducing bacteria are used to remove metals, neutralize the water and reduce the sulfate concentrations. Methylotrophic sulfate-reducing strains have been isolated which can be used in such a process. Lab scale experiments with different reactor types were carried out in order to find the optimum design for this bioremediation process. Comparisons were made between methanol and other electron donors with regards to their suitability as substrate for this process. Methanol was found to be most suited. Laboratory data suggest that immobilizing the bacteria on pumice particles increases the sulfate-reduction rate (SRR) up to three fold to 18 mg/l.h, compared to the rates of free flowing cells of between 3.7 and 6.8 mg/l.h. Preliminary experiments on a larger scale (15 l) using acid mine drainage pH 2.5 show SRR of 0.71 mg/l.h. In biosorption experiments up to 140 mg of aluminium per g biomass was removed from the water. One strain was found to reduce uranium VI, thus changing it from the soluble to the insoluble form. The application of the proposed process with regards to bioremediation of AMD are discussed. (orig.)

  16. On the effectiveness of dry drainage in soil salinity control

    Institute of Scientific and Technical Information of China (English)

    WU JingWei; ZHAO LiRong; HUANG JieSheng; YANG JinZhong; VINCENT Bernard; BOUARFA Sami; VIDAL Alain

    2009-01-01

    Dry drainage is thought to be a potential approach to control soil salinity.This study took the Hetao Irrigation District as an example and evaluated the effectiveness of dry drainage by using remote sensing, a conceptual model and a field experiment.Archived remote sensing images from 1973-2006 were used to delineate the temporal and spatial change of soil salinity.The conceptual water and salt balance model was used to evaluate the role of dry drainage in removing excess salt from the irrigated land.The field experiment was performed to get field validation and give more accurate estimation.The results show that dry drainage did contribute to remove excess salt from the irrigated land and succeed in controlling soil salinity in the Hetao Irrigation District.it can be taken as an alternative approach in (semi-)arid area where artificial drainage is not applicable.

  17. On the effectiveness of dry drainage in soil salinity control

    Institute of Scientific and Technical Information of China (English)

    VINCENT; Bernard; BOUARFA; Sami; VIDAL; Alain

    2009-01-01

    Dry drainage is thought to be a potential approach to control soil salinity. This study took the Hetao Irrigation District as an example and evaluated the effectiveness of dry drainage by using remote sensing, a conceptual model and a field experiment. Archived remote sensing images from 1973―2006 were used to delineate the temporal and spatial change of soil salinity. The conceptual water and salt balance model was used to evaluate the role of dry drainage in removing excess salt from the irrigated land. The field experiment was performed to get field validation and give more accurate estimation. The results show that dry drainage did contribute to remove excess salt from the irrigated land and succeed in controlling soil salinity in the Hetao Irrigation District. It can be taken as an alternative approach in (semi-)arid area where artificial drainage is not applicable.

  18. Treatment of drainage solution from hydroponic greenhouse production with microalgae.

    Science.gov (United States)

    Hultberg, Malin; Carlsson, Anders S; Gustafsson, Susanne

    2013-05-01

    This study investigated treatment of the drainage solution from greenhouse production with microalgae, through inoculation with Chlorella vulgaris or through growth of the indigenous microalgal community. A significant reduction in nitrogen, between 34.7 and 73.7 mg L(-1), and particularly in phosphorus concentration, between 15.4 and 15.9 mg L(-1), was observed in drainage solution collected from commercial greenhouse production. The large reduction in nutrients was achieved through growth of the indigenous microalgal community i.e., without pre-treatment of the drainage solution or inoculation with the fast growing green microalgae C. vulgaris. Analysis of the fatty acid composition of the algal biomass revealed that compared with a standard growth medium for green algae, the drainage solution was inferior for lipid production. Despite the biorefinery concept being less promising, microalgae-based treatment of drainage solution from greenhouse production is still of interest considering the urgent need for phosphorus recycling.

  19. An anaesthetic pre-operative assessment clinic reduces pre-operative inpatient stay in patients requiring major vascular surgery.

    LENUS (Irish Health Repository)

    O'Connor, D B

    2012-02-01

    BACKGROUND: Patients undergoing major vascular surgery (MVS) require extensive anaesthetic assessment. This can require extended pre-operative stays. AIMS: We investigated whether a newly established anaesthetic pre-operative assessment clinic (PAC) would reduce the pre-operative inpatient stay, avoid unnecessary investigations and facilitate day before surgery (DBS) admissions for patients undergoing MVS. PATIENT AND METHODS: One year following and preceding the establishment of the PAC the records of patients undergoing open or endovascular aortic aneurysm repair, carotid endarterectomy and infra-inguinal bypass were reviewed to measure pre-operative length of stay (LoS). RESULTS: Pre-operative LoS was significantly reduced in the study period (1.85 vs. 4.2 days, respectively, P < 0.0001). Only 12 out of 61 patients in 2007 were admitted on the DBS and this increased to 33 out of 63 patients (P = 0.0002). No procedure was cancelled for medical reasons. CONCLUSION: The PAC has facilitated accurate outpatient anaesthetic assessment for patients requiring MVS. The pre-operative in-patient stay has been significantly reduced.

  20. Unilobar versus bilobar biliary drainage: effect on quality of life and bilirubin level reduction

    Directory of Open Access Journals (Sweden)

    Shivanand Gamanagatti

    2016-01-01

    Conclusion: Percutaneous biliary drainage provides good palliation of malignant obstructive jaundice. Partial-liver drainage achieved results as good as those after complete liver drainage with significant improvements in QOL and reduction of the bilirubin level.

  1. Preliminary results from agricultural drainage water management CIG projects on Ohio

    Science.gov (United States)

    Field demonstrations were monitored to compare the crop yields, drainage discharge, and nutrient loadings to streams from managed and unmanaged subsurface drainage systems. Paired drainage systems within the same field, under similar soil, area, cropping, and management conditions, were identified. ...

  2. Prognostic significance of preoperative fibrinogen in patients with colon cancer.

    Science.gov (United States)

    Sun, Zhen-Qiang; Han, Xiao-Na; Wang, Hai-Jiang; Tang, Yong; Zhao, Ze-Liang; Qu, Yan-Li; Xu, Rui-Wei; Liu, Yan-Yan; Yu, Xian-Bo

    2014-07-14

    To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients. A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1(st) 2005 to June 1(st) 2008 were enrolled in the study. All patients received radical surgery as their primary treatment method. Preoperative fibrinogen was detected by the Clauss method, and all patients were followed up after surgery. Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance. Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival (DFS) and overall survival (OS). The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17 ± 0.88 g/L. Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age, smoking status, tumor size, tumor location, tumor-node-metastasis (TNM) stage, modified Glasgow prognostic scores (mGPS), white blood cell (WBC) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) levels. Univariate survival analysis showed that TNM stage, tumor cell differentiation grade, vascular invasion, mGPS score, preoperative fibrinogen, WBC, NLR, PLR and CEA all correlated with both OS and DFS. Alpha-fetoprotein (AFP) and body mass index correlated only with OS. Kaplan-Meier analysis revealed that both OS and DFS of the total cohort, as well as of the stage II and III patients, were higher in the hypofibrinogen group compared to the hyperfibrinogen group (all P TNM stage, mGPS score, CEA, and AFP levels correlated with both OS and DFS. Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.

  3. Preoperative psychological testing--another form of prejudice.

    Science.gov (United States)

    Ashton, David; Favretti, Franco; Segato, Gianni

    2008-10-01

    Preoperative psychological screening of bariatric surgery candidates has become routine, and a significant proportion of patients have their surgery deferred as a consequence. If psychological testing is being used as a form of preoperative triage, both patients and surgeons are entitled to know whether there is sufficient evidence to justify its use in this way. We define the argument for psychological screening as consisting of four premises (p1-p4) and a conclusion (C) as follows: (p1) A significant minority of obese patients will not be successful in losing weight following bariatric surgery-the "failure" group; (p2) A significant minority of patients will exhibit abnormal psychological profiles during preoperative testing; (p3) The majority of individuals referred to in (p2) will be found in group (p1) i.e., abnormal psychological profiles identified preoperatively predict less favorable weight loss outcomes postoperatively; (p4) Identifying patients with adverse psychological profiles preoperatively would allow either exclusion of those at high risk of failure or provide a more secure rationale for targeted pre- and postoperative support; (C) Psychological screening should be part of the routine preoperative assessment for patients undergoing obesity surgery. We reviewed the literature to find evidence to support the premises and show that (p1) can be justified but that (p2) is problematic and can only be accepted in a heavily qualified version. We find no evidence for (p3) and since (p4) and (C) are predicated on (p3), the argument clearly fails. There is no evidence to suggest that preoperative psychological screening can predict postoperative outcomes and no justification for using such testing as a means of discriminating between candidates presenting themselves for bariatric surgery.

  4. Evaluation of long-term surgical site occurrences in ventral hernia repair: implications of preoperative site independent MRSA infection.

    Science.gov (United States)

    Baucom, R B; Ousley, J; Oyefule, O O; Stewart, M K; Phillips, S E; Browman, K K; Sharp, K W; Holzman, M D; Poulose, B K

    2016-10-01

    Previous work demonstrated that prior MRSA infection [MRSA(+)] is associated with 30-day surgical site infection (SSI) following ventral hernia repair (VHR). We aimed to determine the impact of MRSA(+) on long-term wound outcomes after VHR. A retrospective cohort study was performed at a tertiary center between July 11, 2005, and May 18, 2012, of patients undergoing elective VHR with class I wounds. Patients with documented preoperative MRSA infection at any site (urinary, bloodstream, SSI, etc.) were considered MRSA(+). Primary outcome was 2-year surgical site occurrence (SSO), defined as SSI, cellulitis, necrosis, nonhealing wound, seroma, hematoma, dehiscence, or fistula. SSOs were subdivided into those that required procedural intervention (SSOPI) and those that did not. Among 632 patients, 46 % were female with average age 53 ± 13 years. There were 368 SSOs in 193 patients (31 %); an SSOPI occurred in 9.8 % (n = 62). The most common SSOs were cellulitis (91/632), seroma (91/632), and serous drainage (58/632). The rate of 2-year SSO was higher with MRSA(+) compared to those without (46 vs. 29 %, p = 0.023), attributed to increased soft tissue necrosis, purulent drainage, serous drainage, cellulitis, and fistula. In multivariable analysis, MRSA(+) was not associated with 2-year SSO (HR 1.5, 95 % CI 0.91-2.55, p = 0.113); factors associated with SSO included obesity, immunosuppression, mesh repair, and operative times. This study is the first to evaluate long-term SSOs and SSOPIs after VHR, highlighting the importance of long-term follow-up. Though not independently associated with SSOs, MRSA(+) may be a marker of hernia complexity.

  5. Comparison of Methane Drainage Methods Used in Polish Coal Mines

    Science.gov (United States)

    Szlązak, Nikodem; Borowski, Marek; Obracaj, Dariusz; Swolkień, Justyna; Korzec, Marek

    2014-10-01

    Methane drainage is used in Polish coal mines in order to reduce mine methane emissions as well as to keep methane concentration in mine workings at safe levels. This article describes methods of methane drainage during mining used in Polish coal mines. The first method involves drilling boreholes from tailgate roadway to an unstressed zone in roof or floor layers of a mined seam. It is the main method used in Polish mining, where both the location of drilled boreholes as well as their parameters are dependent on mining and ventilation systems of longwalls. The second method is based on drilling overlying drainage galleries in seams situated under or over the mined seam. This article compares these methods with regard to their effectiveness under mining conditions in Polish mines. High effectiveness of methane drainage of longwalls with different ventilation and methane drainage systems has been proven. The highest effectiveness of methane drainage has been observed for the system with overlying drainage gallery and with the parallel tailgate roadways. In case of classic U ventilation system of longwall panel, boreholes drilled from the tailgate roadway behind the longwall front are lost.

  6. Systematic review comparing endoscopic, percutaneous and surgical pancreatic pseudocyst drainage

    Institute of Scientific and Technical Information of China (English)

    Anthony Yuen Bun Teoh; Vinay Dhir; Zhen-Dong Jin; Mitsuhiro Kida; Dong Wan Seo; Khek Yu Ho

    2016-01-01

    AIM: To perform a systematic review comparing the outcomes of endoscopic, percutaneous and surgical pancreatic pseudocyst drainage.METHODS: Comparative studies published between January 1980 and May 2014 were identified on Pub Med, Embase and the Cochrane controlled trials register and assessed for suitability of inclusion. The primary outcome was the treatment success rate. Secondary outcomes included were the recurrence rates, re-interventions, length of hospital stay, adverse events and mortalities.RESULTS: Ten comparative studies were identified and 3 were randomized controlled trials. Four studies reported on the outcomes of percutaneous and surgical drainage. Based on a large-scale national study, surgical drainage appeared to reduce mortality and adverse events rate as compared to the percutaneous approach. Three studies reported on the outcomes of endoscopic ultrasound(EUS) and surgical drainage. Clinical success and adverse events rates appeared to be comparable but the EUS approach reduced hospital stay, cost and improved quality of life. Three other studies comparedEUS and esophagogastroduodenoscopy-guided drainage. Both approaches were feasible for pseudocyst drainage but the success rate of the EUS approach was better for non-bulging cyst and the approach conferred additional safety benefits.CONCLUSION: In patients with unfavorable anatomy, surgical cystojejunostomy or percutaneous drainage could be considered. Large randomized studies with current definitions of pseudocysts and longer-term follow-up are needed to assess the efficacy of the various modalities.

  7. Technology of gas drainage and utilization in Huaibei mining area

    Institute of Scientific and Technical Information of China (English)

    LI Wei; XU Rui

    2009-01-01

    With the characteristics of coal seam geology and gas occurrence, a "ground-underground" integrated gas drainage method was formed, which can relieve gas pressure and increase permeability by mining the protection seams in conditional regions. After coal seam gas drainage, high gas outburst seam was converted to low gas safety seam. In the coal face mining process, safety and high efficient coal mining were realized by the measure of gas-suction over mining. In addition to the drainage gas for civil gas and gas power generation, the Huaibei Mining Group has actively carried out research on the utilization technology of methane drainage by ventilation. On the one hand, it can save precious energy; on the other hand, it can protect the environment for people's survival. In 2007, the amount of coal mine gas drainage was 120 hm3; the rate of coal mine gas drainage was 44%. Compared with the year 2002, the amount of coal mine gas drainage increased by two times. Meanwhile, the utilization rate of gas increased rapidly.

  8. Comparative experiments of gas drainage in different types of drillings

    Institute of Scientific and Technical Information of China (English)

    LI Cheng-wu; WEI Shan-yang; WANG Chuan; GAO Tian-bao; FU Yu-kai

    2012-01-01

    Gas drainage effect is the utmost important factor for mining speed and mining safety.It has great meaning to study the effect of gas drainage.Comparative experiment of gas drainage in different types of drillings shows that the initial rate of gas natural emission by hydraulic loosed cross drilling is 1.5 times more than that of parallel drilling,and the drilling gas attenuation coefficients reduces to 0.78 times,the effect of gas drainage is good.The ultimate quantity of gas drainage of parallel drilling,cross drilling,hydraulic loosed cross drilling are 859.1,1 323.5 and 1 833.6 m3/100 m.The results of the measurement through these three kinds of drillings of 100 meters drilling is considered as following:cross drilling is 1.54 times more than that of parallel drillings,hydraulic loosed cross drilling are 2.13 times more than parallel drilling.The drainage rate of parallel drilling,cross drilling and hydraulic loosed cross drilling reached 10% to 15% in 3 months with the pre-draining time.Among these,the drainage effect of hydraulic loosed cross drilling increased by 46% than that of parallel drilling in three months.

  9. The cold air drainage model KLAM_21

    Science.gov (United States)

    Kossmann, M.

    2010-09-01

    A brief description of the physics and numerical techniques of the cold air drainage model KLAM_21 is presented. The model has been developed by the Deutscher Wetterdienst (Sievers, 2005) for simulations of nocturnal airflow in hilly and mountainous terrain under dry fair weather conditions. The model has been widely used as an environmental consultancy tool. Typical model applications include frost protection (cold air ponding) and air quality (nocturnal ventilation). The single-layer model calculates the depth and the mean wind of a surface based stable layer that evolves from a neutrally stratified atmosphere during nighttime. The prediction of the velocity and direction of the cold air drainage is based on vertically averaged momentum tendency equations. Temporal changes in the total heat deficit in the cold air layer are calculated from a prescribed local heat loss rate (describing turbulent and radiative cooling) and advection (donor-cell algorithm). The depth of the cold air layer (depth of the surface based temperature inversion) is calculated diagnostically from the total heat loss deficit. The model is initialised with neutral stratification at sunset (onset time of nocturnal cooling). Optionally, effects of an ambient (regional) wind and/or the dispersion of a passive tracer can be simulated. Integration over time is carried out on a regular Arakawa C grid using dynamically calculated time steps. Spatial gradients are discretised using centred differential quotients. The standard size of the computational domains can reach up to 1500 x 1500 grid cells. Grid resolutions usually range between 10 m and 500 m. High resolution simulation can be limited to a nested inner grid domain, while the courser outer domain is covering the entire airshed of interest. A friendly user interface allows easy setup, control, and evaluation of model simulations. Some selected examples of KLAM_21 applications are shown to illustrate the features and capabilities of the model

  10. Preoperative cryotherapy use in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Koyonos, Loukas; Owsley, Kevin; Vollmer, Emily; Limpisvasti, Orr; Gambardella, Ralph

    2014-12-01

    Unrelieved postoperative pain may impair rehabilitation, compromise functional outcomes, and lead to patient dissatisfaction. Preemptive multimodal analgesic techniques may improve outcomes after surgery. We hypothesized that patients using preoperative cryotherapy plus a standardized postoperative treatment plan will have lower pain scores and require less pain medication compared with patients receiving a standardized postoperative treatment plan alone after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR). A total of 53 consecutive patients undergoing arthroscopically assisted ACLR performed by one of seven surgeons were randomly assigned to one of two groups. Group 1 received no preoperative cryotherapy and group 2 received 30 to 90 minutes of preoperative cryotherapy to the operative leg using a commercial noncompressive cryotherapy unit. Visual analog scale pain scores and narcotic use were recorded for the first 4 days postoperatively. Total hours of cold therapy and continuous passive motion (CPM) use and highest degree of flexion achieved were recorded as well. Group 1 consisted of 26 patients (15 allograft Achilles tendon and 11 autograft bone patellar tendon bone [BPTB]), and group 2 consisted of 27 patients (16 allograft Achilles tendon and 11 autograft BPTB). Group 2 patients reported less pain (average 1.3 units, p cryotherapy, hours of CPM use, or maximum knee flexion achieved. Complications did not occur in either group. This is the first report we are aware of showing the postoperative effects of preoperative cryotherapy. Our results support the safety and efficacy of preoperative cryotherapy in a multimodal pain regimen for patients undergoing ACL reconstruction.

  11. Preoperative thrombocytosis predicts poor survival in patients with glioblastoma

    Science.gov (United States)

    Brockmann, Marc A.; Giese, Alf; Mueller, Kathrin; Kaba, Finjap Janvier; Lohr, Frank; Weiss, Christel; Gottschalk, Stefan; Nolte, Ingo; Leppert, Jan; Tuettenberg, Jochen; Groden, Christoph

    2007-01-01

    Thrombocytosis, which is defined as a platelet count greater than 400 platelets/nl, has been found to be an independent predictor of shorter survival in various tumors. Release of growth factors from tumors has been proposed to increase platelet counts. Preoperative platelet counts and other clinical and hematological parameters were reviewed from the records of 153 patients diagnosed between 1999 and 2004 with histologically confirmed glioblastoma in order to evaluate the prognostic significance of preoperative thrombocytosis in these patients. The relationship between thrombocytosis and survival was initially analyzed in all patients regardless of further therapy. Univariate log-rank tests showed that the median survival time of 29 patients with preoperative thrombocytosis (19%) was significantly shorter (4 months; 95% confidence interval [95% CI], 3–6 months) compared to 124 patients with normal platelet counts (11 months; 95% CI, 8–13 months; p = 0.0006). Multivariate analysis (Cox proportional hazards model) confirmed preoperative platelet count, age, prothrombin time, and activated partial thromboplastin time to be prognostic factors of survival (all p thrombocytosis was diagnosed (6 months; 95% CI, 4–12 months) compared to patients with normal platelet count (13 months; 95% CI, 11–15 months; p = 0.0359). In multivariate analysis, age, platelet count, preoperative prothrombin time, and degree of tumor resection retained significance as prognostic factors of survival (all p thrombocytosis to be a prognostic factor associated with shorter survival time in patients with glioblastoma. PMID:17504931

  12. Significance of preoperative thrombocytosis in epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Crasta Julian

    2010-01-01

    Full Text Available Background: Reactive thrombocytosis is reported in a variety of solid tumors. A few studies have documented preoperative thrombocytosis in ovarian cancer and identified it as a marker of aggressive tumor biology. Aim: To study the incidence of preoperative thrombocytosis (platelets greater than 400x10 in epithelial ovarian cancer and its association with other clinicopathologic factors. Materials and Methods: Sixty-five patients with invasive ovarian epithelial cancer were retrospectively reviewed and analyzed for the association preoperative thrombocytosis with other clinical and histopathological prognostic factors. Means were analyzed by Student′s t test; proportions were determined by Chi-square analysis. Results: Twenty of 65 (37.5% patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have lower hemoglobin (P < 0.0002, more advanced stage disease (P < 0.05 and higher grade tumors (P < 0.02. Patients with thrombocytosis had greater likelihood of subpotimal cytoreduction. Conclusions: Preoperative thrombocytosis is a frequent finding in ovarian carcinomas and their association with advanced stage disease and higher grade denotes that platelets play a role in the tumor growth and progression.

  13. Environmental controls on drainage behavior of an ephemeral stream

    Science.gov (United States)

    Blasch, K.W.; Ferre, T. P. A.; Vrugt, J.A.

    2010-01-01

    Streambed drainage was measured at the cessation of 26 ephemeral streamflow events in Rillito Creek, Tucson, Arizona from August 2000 to June 2002 using buried time domain reflectometry (TDR) probes. An unusual drainage response was identified, which was characterized by sharp drainage from saturation to near field capacity at each depth with an increased delay between depths. We simulated the drainage response using a variably saturated numerical flow model representing a two-layer system with a high permeability layer overlying a lower permeability layer. Both the observed data and the numerical simulation show a strong correlation between the drainage velocity and the temperature of the stream water. A linear combination of temperature and the no-flow period preceding flow explained about 90% of the measured variations in drainage velocity. Evaluation of this correlative relationship with the one-dimensional numerical flow model showed that the observed temperature fluctuations could not reproduce the magnitude of variation in the observed drainage velocity. Instead, the model results indicated that flow duration exerts the most control on drainage velocity, with the drainage velocity decreasing nonlinearly with increasing flow duration. These findings suggest flow duration is a primary control of water availability for plant uptake in near surface sediments of an ephemeral stream, an important finding for estimating the ecological risk of natural or engineered changes to streamflow patterns. Correlative analyses of soil moisture data, although easy and widely used, can result in erroneous conclusions of hydrologic cause—effect relationships, and demonstrating the need for joint physically-based numerical modeling and data synthesis for hypothesis testing to support quantitative risk analysis.

  14. Separation of drainage runoff during rainfall-runoff episodes using the stable isotope method and drainage water temperature

    Science.gov (United States)

    Zajíček, Antonín; Kvítek, Tomáš; Pomije, Tomáš

    2014-05-01

    Stabile isotopes of 2H 18O and drainage water temperature were used as natural tracers for separation rainfall-runoff event hydrograph on several tile drained catchments located in Bohemian-Moravian Highland, Czech Republic. Small agricultural catchments with drainage systems built in slopes are typical for foothill areas in the Czech and Moravian highland. Often without permanent surface runoff, the drainage systems represent an important portion of runoff and nitrogen leaching out of the catchment. The knowledge of the drainage runoff formation and the origin of its components are prerequisites for formulation of measures leading to improvement of the drainage water quality and reduction of nutrient leaching from the drained catchments. The results have proved presence of event water in the drainage runoff during rainfall-runoff events. The proportion of event water observed in the drainage runoff varied between 15 - 60 % in the summer events and 0 - 50 % in winter events, while the sudden water temperature change was between 0,1 - 4,2 °C (2 - 35 %). The comparison of isotope separation of the drainage runoff and monitoring the drainage water temperature have demonstrated that in all cases of event water detected in the runoff, a rapid change in the drainage water temperature was observed as well. The portion of event water in the runoff grows with the growing change in water temperature. Using component mixing model, it was demonstrated that water temperature can be successfully used at least as a qualitative and with some degree of inaccuracy as a quantitative tracer as well. The drawback of the non-conservative character of this tracer is compensated by both its economic and technical accessibility. The separation results also resemble results of separations at small streams. Together with a similarly high speed of the discharge reaction to beginning of precipitation, it is obvious that the mechanism of surface runoff formation and drainage runoff formation

  15. Foam drainage wave coalescing and its energy evolution

    Institute of Scientific and Technical Information of China (English)

    SUN QiCheng; HUANG Jin; WANG GuangQian

    2008-01-01

    Liquid foam is a dense packing of gas bubbles in a small amount of surfactant solution. Liquid drains out of foams until equilibrium is reached due to the compromise between gravity and capillarity, which greatly affects the stability of foam. Based on a series of work on foam structure and drainage we conducted previously, this paper reports the results on coalescence of an original forced drainage wave at a low flow rate with subsequent drainage waves with higher flow rates. The evolutions of vis-cous energy and surface energy during the process of coalescence are theoretically analyzed.

  16. Application of digital elevation model in delineating drainage networks

    Institute of Scientific and Technical Information of China (English)

    SUN Yan-ling; XIE De-ti; LIU Hong-bin; WEI Chao-fu

    2005-01-01

    A practical method to extract drainage network from DEM (digital elevation model) is introduced. DEM pretreatment includes depression and flat areas treatment. The flow direction of each grid cell in DEM is calculated according to the 8-direction pour point model, and then the flow accumulation grid from the flow direction grid. With the flow accumulation grid, streams are defined according to the given threshold value of flow accumulation. Taking Gufo River watershed as an example, the extraction of drainage network was done from DEM. The results are basically consistent with the digitized drainage network from the relief maps.

  17. Long hole waterjet drilling for gas drainage

    Energy Technology Data Exchange (ETDEWEB)

    Matt Stockwell; M. Gledhill; S. Hildebrand; S. Adam; Tim Meyer [CMTE (Australia)

    2003-04-01

    In-seam drilling for gas drainage is now an essential part of operations at many Australian underground coalmines. The objective of this project is to develop and trial a new drilling method for the accurate and efficient installation of long inseam boreholes (>1000 metres). This involves the integration of pure water-jet drilling technology (i.e. not water-jet assisted rotary drilling) developed by CMTE with conventional directional drilling technology. The system was similar to conventional directional drilling methods, but instead of relying on a down-hole-motor (DHM) rotating a mechanical drill bit for cutting, high pressure water-jets were used. The testing of the system did not achieve the full objectives set down in the project plan. A borehole greater than 1000 metres was not achieved. The first trial site had coal that was weathered, oxidized and dry. These conditions significantly affected the ability of the drilling tool to stay 'in-seam'. Due to the poor conditions at the first trial, many experimental objectives were forwarded to the second field trial. In the second trial drilling difficulties were experienced, this was due to the interaction between the confinement of the borehole and the dimensions of the down hole drilling assembly. This ultimately reduced the productivity of the system and the distance that could be drilled within the specified trial periods. Testing in the first field trial did not show any indication that the system would have this difficulty.

  18. DROUGHT ANALYSIS IN OZANA DRAINAGE BASIN

    Directory of Open Access Journals (Sweden)

    Marina IOSUB

    2016-03-01

    Full Text Available Ozana drainage basin is located at the contact between large landscape units (the Carpathian mountains, the Subcarpathian area, and the plateau region. This placement determines the existence of a complex climate in the region. Despite being small in size, and its extension on an W-E direction, differences can be observed, especially of the way extreme phenomena take place. In the case of droughts, it had different intensities in the mountains, compared to the plateau region. In order to emphasize the different distribution on the territory, several climatic indexes have been calculated, regarding dryness (De Martonne Index, Hellman criterion. The analysis of these indexes at the same monitoring stations (Pluton, Leghin and Dumbrava emphasizes the growth of the drought periods in the plateau region and the fact that they shorten in the mountain area. In the mountainous area, where the land is very well forested, the values of the De Martonne index can reach 45.4, and in the plateau regions, where the forest associations are sparse, the values dropped to 30.6. According to the Hellman criterion, several differences can be emphasized, at basin level. In the mountainous region, there is only one month that, at a multi-annual level, has stood up among the rest, as being excessively droughty, while in the median /central region of the basin, three months have been identified, that have such potential, as well as five months, at Dumbrava.

  19. Upper airway imaging and its role in preoperative airway evaluation

    Directory of Open Access Journals (Sweden)

    Jagadish G Sutagatti

    2016-01-01

    Full Text Available Ultrasonography (USG is well-known as a fast, safe, and noninvasive technique. Its application for imaging of the airway is now gaining momentum. The upper airway has a complex anatomy, and its assessment forms a vital part of every preanesthetic evaluation. Ultrasound (US imaging can help in upper airway assessment in the preoperative period. There are various approaches to upper airway USG. The technique has its own advantages, disadvantages, and limitations. This simple yet challenging imaging technique is all set to become an important part of routine preoperative airway evaluation. This article reviews the various approaches to upper airway US imaging, interpretation of the images, limitations, and disadvantages of the technique and its varied clinical applications in the preoperative period. The scientific material presented here was hand searched from textbooks and journals, electronically from PubMed, and Google scholar using text words.

  20. Pancreatic Somatostatinoma Diagnosed Preoperatively: Report of a Case

    Directory of Open Access Journals (Sweden)

    Yasuhisa Mori

    2014-01-01

    Full Text Available Context Somatostatinoma is a rare neoplasm of the pancreas. Preoperative diagnosis is often difficult. Case report We report a 72-year-old woman with a pancreatic head tumor measuring 37 mm in diameter, and enlargement of the lymphnodes on the anterior surface of the pancreatic head and the posterior surface of the horizontal part of the duodenum.Laboratory data showed an elevated plasma somatostatin concentration. Examination of a biopsy specimen of thepancreatic head mass obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA showedhistopathological features of a neuroendocrine tumor. Immunohistochemical staining showed that the tumor cells werepositive for somatostatin, leading to a preoperative diagnosis of pancreatic somatostatinoma. The patient underwentpylorus-preserving pancreaticoduodenectomy. The plasma somatostatin concentration decreased progressively aftersurgery. Conclusions A rare case of pancreatic somatostatinoma with lymph node metastases was presented.Immunohistochemical analysis of a biopsy specimen obtained by EUS-FNA was useful for preoperative diagnosis.

  1. CLINICAL AND BIOLOGICAL BEHAVIOR OF NEUROGENIC TUMOR AFTER PREOPERATIVE CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    Gao Jiechun; Dong Kuiran; Jing Baixiang

    1998-01-01

    Objective: To study the significance of preoperative chemotherapy for the treatment of neurogenic tumor in children. Methods: VMA, MYCN gene and DNA content of 21 cases of neuroblastoma treated with preoperative chemotherapy were studied with a control group. Results: Resection rate was 95.5%. Mean survival time was 28.1±10.2 months, which was significantly higher than the control group (8.8±6.8 months, P<0.01).Post chemotherapeutic VMA was lower. DNA index was also reduced and the percentage of cells in G0+G1 phases was elevated. The MYCN expression was suppressed.Conclusion: Preoperative chemotherapy can induce the apoptosis of neurogenic tumor cells and inhibit its proliferative activity.

  2. Indications of laparoscopic cholecystectomy based on preoperative imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Wakizaka, Yoshitaka; Sano, Syuichi; Nakanishi, Yoshimi; Koike, Yoshinobu; Ozaki, Susumu; Iwanaga, Rikizo (Sapporo City General Hospital (Japan)); Uchino, Junichi

    1994-03-01

    We studied the indications for laparoscopic cholecystectomy (LC) and values of preoperative imaging findings in 82 patients who underwent preoperative imaging diagnostic tests (abdominal echogram, abdominal CAT scan, ERCP). We analyzed mainly patients who were considered to be indicated for LC but whose gallbladders could be removed by open laparotomy, or whose gallbladders were removed by open laparotomy but were considered indicated for LC from retrospective study. We found the following results. LC could be easily performed in patients with a history of severe acute cholecystitis if they had no findings of a thickened wall or negative gallbladder signs. Abdominal echogram and CAT scan were the best preoperative imaging tests for determining the gallbladder's state, especially for obstruction of the cystic duct. These results are important today when the operative indications of LC are extremely indefinite because of the accumulation of operative experience and technological improvements. (author).

  3. Effect of phacoemulsification on drainage angle status in angle closure eyes with or without extensive peripheral anterior synechiae.

    Science.gov (United States)

    Latifi, Golshan; Moghimi, Sasan; Eslami, Yadollah; Fakhraie, Ghasem; Zarei, Reza; Lin, Shan

    2013-01-21

    Purpose. To evaluate the anatomic effects of phacoemulsification on drainage angle status in primary angle closure glaucoma (PACG) using anterior segment optical coherence tomography (AS-OCT). Methods. A total of 62 eyes of 58 patients underwent cataract surgery in Farabi Rye Hospital, Tehran, Iran. Patients were examined postoperatively on day 1, week 1, and week 6. Indentation gonioscopy and AS-OCT were performed preoperatively and at 6 weeks after surgery. Main outcome measures were angle and anterior segment parameters by AS-OCT and amount of peripheral anterior synechiae (PAS) by gonioscopy. Thirty-five eyes had PAS =180 degrees (group 1) and 27 eyes had >180-degree synechial closure (group 2). Results. Mean age of the patients was 64.3±9.0 years. The mean extent of PAS was significantly reduced from 45.9 to 32.2 degrees (p180 degrees.

  4. Bibliography for acid-rock drainage and selected acid-mine drainage issues related to acid-rock drainage from transportation activities

    Science.gov (United States)

    Bradley, Michael W.; Worland, Scott C.

    2015-01-01

    Acid-rock drainage occurs through the interaction of rainfall on pyrite-bearing formations. When pyrite (FeS2) is exposed to oxygen and water in mine workings or roadcuts, the mineral decomposes and sulfur may react to form sulfuric acid, which often results in environmental problems and potential damage to the transportation infrastructure. The accelerated oxidation of pyrite and other sulfidic minerals generates low pH water with potentially high concentrations of trace metals. Much attention has been given to contamination arising from acid mine drainage, but studies related to acid-rock drainage from road construction are relatively limited. The U.S. Geological Survey, in cooperation with the Tennessee Department of Transportation, is conducting an investigation to evaluate the occurrence and processes controlling acid-rock drainage and contaminant transport from roadcuts in Tennessee. The basic components of acid-rock drainage resulting from transportation activities are described and a bibliography, organized by relevant categories (remediation, geochemical, microbial, biological impact, and secondary mineralization) is presented.

  5. Preoperative predictors of weight loss following bariatric surgery: systematic review.

    Science.gov (United States)

    Livhits, Masha; Mercado, Cheryl; Yermilov, Irina; Parikh, Janak A; Dutson, Erik; Mehran, Amir; Ko, Clifford Y; Gibbons, Melinda Maggard

    2012-01-01

    Obesity affects 32% of adults in the USA. Surgery generates substantial weight loss, but 20-30% fails to achieve successful weight loss. Our objective was to identify preoperative psychosocial factors associated with weight loss following bariatric surgery. We performed a literature search of PubMed® and the Cochrane Database of Reviews of Effectiveness between 1988 and April 2010. Articles were screened for bariatric surgery and weight loss if they included a preoperative predictor of weight loss: body mass index (BMI), preoperative weight loss, eating disorders, or psychiatric disorder/substance abuse. One thousand seven titles were reviewed, 534 articles screened, and 115 included in the review. Factors that may be positively associated with weight loss after surgery include mandatory preoperative weight loss (7 of 14 studies with positive association). Factors that may be negatively associated with weight loss include preoperative BMI (37 out of 62 studies with negative association), super-obesity (24 out of 33 studies), and personality disorders (7 out of 14 studies). Meta-analysis revealed a decrease of 10.1% excess weight loss (EWL) for super-obese patients (95% confidence interval (CI) [3.7-16.5%]), though there was significant heterogeneity in the meta-analysis, and an increase of 5.9% EWL for patients with binge eating at 12 months after surgery (95% CI [1.9-9.8%]). Further studies are necessary to investigate whether preoperative factors can predict a clinically meaningful difference in weight loss after bariatric surgery. The identification of predictive factors may improve patient selection and help develop interventions targeting specific needs of patients.

  6. Preoperative antibiotics for septic arthritis in children: delay in diagnosis.

    Science.gov (United States)

    MacLean, Simon B M; Timmis, Christopher; Evans, Scott; Lawniczak, Dominik; Nijran, Amit; Bache, Edward

    2015-04-01

    To review the records of 50 children who underwent open joint washout for septic arthritis with (n=25) or without (n=25) preoperative antibiotics. Records of 50 children who underwent open joint washout for presumed septic arthritis with (n=25) or without (n=25) preoperative antibiotics were reviewed. 17 boys and 8 girls aged 3 weeks to 16 years (median, 1.5 years) who were prescribed preoperative antibiotics before joint washout were compared with 12 boys and 13 girls aged one month to 14 years (median, 2 years) who were not. Following arthrotomy and washout, all patients were commenced on high-dose intravenous antibiotics. Patients were followed up for 6 to 18 months until asymptomatic. Patients who were referred from places other than our emergency department were twice as likely to have been prescribed preoperative antibiotics (p=0.0032). Patients prescribed preoperative antibiotics had a longer median (range) time from symptom onset to joint washout (8 [2-23] vs. 4 [1-29] days, p=0.05) and a higher mean erythrocyte sedimentation rate (93.1 vs. 54.3 mm/h, p=0.023) at presentation. Nonetheless, the 2 groups were comparable for weight bearing status, fever, and positive culture, as well as the mean (range) duration of antibiotic treatment (4.9 [4-7] vs. 4.7 [1-8] weeks, p=0.586). Preoperative antibiotics should be avoided in the management of septic arthritis in children. Their prescription delays diagnosis and definitive surgery, and leads to additional washouts and complications. A high index of suspicion and expedite referral to a specialist paediatric orthopaedic unit is needed if septic arthritis is suspected.

  7. Assessment of patient satisfaction with the preoperative anesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gebremedhn EG

    2014-09-01

    Full Text Available Endale Gebreegziabher Gebremedhn, Vidhya Nagaratnam Department of Anesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: The evaluation of patient satisfaction is a core aspect of the continuous quality improvement in anesthesia service that can be affected by the preoperative anesthetist visit. This visit enables the anesthetist to know about the patient's general health status and the nature of surgery, to choose the type of anesthesia, and to discuss perioperative complications and their management with the patient. Patients have sometimes complained about the information given during the preoperative anesthetic evaluation in the University of Gondar teaching and referral hospital. The aim of this study was to determine the level of patient satisfaction with the preoperative anesthetist visit. Methods: A cross-sectional study was conducted from February 15 to April 15, 2013. All consecutive elective patients who were operated upon under anesthesia during the study period were interviewed 24 hours after operation. A pretested questionnaire and checklists, which were developed based on the hospital's anesthetic evaluation sheet, were used for data collection. Results: A total of 116 elective patients were operated upon under anesthesia during the study period. Of these, 102 patients were included in our study, with a response rate of 87.9%. Anesthetists introduced themselves to ~24% patients; provided information about anesthesia to ~32%, postoperative complications to ~21%, postoperative analgesia to ~18, and postoperative nausea and vomiting to ~21%; and spent adequate time with ~74%. Patients' questions were answered by the anesthetist in ~65% of cases, and ~65% of patients had reduced anxiety after the anesthetist visit. The patients' overall satisfaction with the preoperative anesthetist visit was ~65%. Conclusion and recommendation: Patient satisfaction with the

  8. Preoperative evaluation of synchronous colorectal cancer using MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael P; Andersen, Lars Peter Holst; Klein, Mads

    2009-01-01

    it is noninvasive, and most of the colon can be evaluated. Furthermore, it has higher patient acceptance, and no sedation or radiation is used. The purpose of this study was to determine the feasibility of performing MRC preoperatively in an everyday clinical situation in a group of patients who were not offered......RATIONALE AND OBJECTIVES: It is well known that synchronous cancers (incidence, 2%-11%) and polyps (incidence, 12%-58%) occur in patients with colorectal cancer. Magnetic resonance colonography (MRC) seems like the obvious choice as a diagnostic tool in preoperative evaluation, because...

  9. [Importance of preoperative and intraoperative imaging for operative strategies].

    Science.gov (United States)

    Nitschke, P; Bork, U; Plodeck, V; Podlesek, D; Sobottka, S B; Schackert, G; Weitz, J; Kirsch, M

    2016-03-01

    Recent advances in preoperative and postoperative imaging have an increasing influence on surgical decision-making and make more complex surgical interventions possible. This improves the possibilities for frequently occurring challenges and promoting improved functional and oncological outcome. This manuscript reviews the role of preoperative and intraoperative imaging in surgery. Various techniques are explained based on examples from hepatobiliary surgery and neurosurgery, in particular real-time procedures, such as the online use of augmented reality and in vivo fluorescence, as well as new and promising optical techniques including imaging of intrinsic signals and vibrational spectroscopy.

  10. 1986 moose census, lower Nowitna River drainage: Final report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A moose survey of the lower Nowitna drainage on the Nowitna National Wildlife Refuge was conducted from 17-21 November 1986. The 1986 population estimate for the...

  11. Adaptive Drainage Slots for Acoustic Noise Attenuation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group, Inc. (CRG) demonstrated feasibility in the reduction of noise attributed to drainage slots in jet engine acoustic liners. This was...

  12. Drainage report for Delair Division of Great River NWR

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Obstacles such as ground seepage, inefficient water control structures, and backwater in the Sny Ditch are all contributing to drainage problems at the Delair...

  13. Monitoring and remediation technologies of organochlorine pesticides in drainage water

    Directory of Open Access Journals (Sweden)

    Ismail Ahmed

    2015-03-01

    Full Text Available This study was carried out to monitor the presence of organochlorine in drainage water in Kafr-El-Sheikh Governorate, Egypt. Furthermore, to evaluate the efficiencies of different remediation techniques (advanced oxidation processes [AOPs] and bioremediation for removing the most frequently detected compound (lindane in drainage water. The results showed the presence of several organochlorine pesticides in all sampling sites. Lindane was detected with high frequency relative to other detected organochlorine in drainage water. Nano photo-Fenton like reagent was the most effective treatment for lindane removal in drainage water. Bioremediation of lindane by effective microorganisms (EMs removed 100% of the lindane initial concentration. There is no remaining toxicity in lindane contaminated-water after remediation on treated rats relative to control with respect to histopathological changes in liver and kidney. Advanced oxidation processes especially with nanomaterials and bioremediation using effective microorganisms can be regarded as safe and effective remediation technologies of lindane in water.

  14. Recycling Facilities - Mine Drainage Treatment/Land Recycling Project Locations

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Mine Drainage Treatment/Land Reclamation Locations are clean-up projects that are working to eliminate some form of abandoned mine. The following sub-facility types...

  15. Gravity Drainage of Activated Sludge on Reed Beds

    DEFF Research Database (Denmark)

    Christensen, Morten Lykkegaard; Dominiak, Dominik Marek; Keiding, Kristian;

    Activated sludge is a by-product from waste water treatment plants, and the water content in the sludge is high (> 90%). Among several methods to remove the water, sludge drying reed beds are often used to dewater the sludge by drainage. There is, however, no well-defined criterion for design...... has therefore been developed to measure relevant quality parameters: specific cake resistance, settling velocity and cake compressibility. It has been found that activated sludge form highly compressible cake even at the low compressive pressures obtained during drainage. Numerical simulation shows...... that the compressibility has a high influence on the drainage process especially during the start-up phases where the volumetric load on the sludge bed is critical. The load has to be low in order to ensure that the drainage properties of the bed are not destroyed. The data also shows that transport of activated sludge...

  16. Fall 1979 moose surveys, Sheenjek, Old Woman, Coleen drainages

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Summary of fall moose population statistics for the upper Sheenjek River drainage (including all tributaries upstream of Lobo Lake) and of Old Woman Creek. William...

  17. Vegetation damage and recovery after Chiginagak Volcano Crater drainage event

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — From August 20 — 23, 2006, I revisited Chiginigak volcano to document vegetation recovery after the crater drainage event that severely damaged vegetation in May of...

  18. Adaptive Drainage Slots for Acoustic Noise Attenuation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group, Inc. (CRG), proposes to demonstrate feasibility in the reduction of noise attributed to drainage slots in jet engine acoustic liners....

  19. Shallow Melting and Underground Drainage in Utopia Planitia, Mars

    Science.gov (United States)

    Costard, F.; Sejourne, A.; Kargel, J.; Soare, R.

    2012-03-01

    Based on the identification of sinuous and elongated pits in Utopia Planitia, we suggest that shallow melting and underground drainage are possible. We test that hypothesis using a thermal model that comprises a thick insulating dusty layer.

  20. 13 Morphometric Analysis of Ogunpa and Ogbere Drainage Basins ...

    African Journals Online (AJOL)

    `123456789jkl''''#

    Morphometric Analysis of Ogunpa and Ogbere Drainage Basins, Ibadan, Nigeria. *Ajibade ... complex rock in Southwestern Nigeria. .... This work was based on map analysis ..... Bs = VI/HE where Bs = Basin slope, VI = Vertical Interval and.

  1. Mercury mine drainage and processes that control its environmental impact

    Science.gov (United States)

    Rytuba, J.J.

    2000-01-01

    Mine drainage from mercury mines in the California Coast Range mercury mineral belt is an environmental concern because of its acidity and high sulfate, mercury, and methylmercury concentrations. Two types of mercury deposits are present in the mineral belt, silica-carbonate and hot-spring type. Mine drainage is associated with both deposit types but more commonly with the silica-carbonate type because of the extensive underground workings present at these mines. Mercury ores consisting primarily of cinnabar were processed in rotary furnaces and retorts and elemental mercury recovered from condensing systems. During the roasting process mercury phases more soluble than cinnabar are formed and concentrated in the mine tailings, commonly termed calcines. Differences in mineralogy and trace metal geochemistry between the two deposit types are reflected in mine drainage composition. Silica-carbonate type deposits have higher iron sulfide content than hot- spring type deposits and mine drainage from these deposits may have extreme acidity and very high concentrations of iron and sulfate. Mercury and methylmercury concentrations in mine drainage are relatively low at the point of discharge from mine workings. The concentration of both mercury species increases significantly in mine drainage that flows through and reacts with calcines. The soluble mercury phases in the calcines are dissolved and sulfate is added such that methylation of mercury by sulfate reducing bacteria is enhanced in calcines that are saturated with mine drainage. Where mercury mine drainage enters and first mixes with stream water, the addition of high concentrations of mercury and sulfate generates a favorable environment for methylation of mercury. Mixing of oxygenated stream water with mine drainage causes oxidation of dissolved iron(II) and precipitation of iron oxyhydroxide that accumulates in the streambed. Both mercury and methylmercury are strongly adsorbed onto iron oxyhydroxide over the p

  2. Airway physiology, autogenic drainage, and active cycle of breathing.

    Science.gov (United States)

    Lapin, Craig D

    2002-07-01

    Airway clearance techniques are used to aid in mucus clearance in a variety of disease states. Autogenic drainage and active-cycle-of-breathing technique are 2 such modalities that rely heavily on basic airway physiology to enhance clearance. In this review I discuss the equal pressure point, huffing, and asynchronous and collateral ventilation, and review the literature and theory regarding autogenic drainage and active cycle of breathing. Selection of airway clearance techniques is discussed in the light of evidence-based medicine.

  3. Abdominal drainage following cholecystectomy: high, low, or no suction?

    OpenAIRE

    McCormack, T T; Abel, P D; Collins, C. D.

    1983-01-01

    A prospective trial to assess the effect of suction in an abdominal drain following cholecystectomy was carried out. Three types of closed drainage system were compared: a simple tube drain, a low negative pressure drain, and a high negative pressure drain: 120 consecutive patients undergoing cholecystectomy were randomly allocated to one of the three drainage groups. There was no significant difference in postoperative pyrexia, wound infection, chest infection, or hospital stay. This study f...

  4. Infected Baerveldt Glaucoma Drainage Device by Aspergillus niger

    Directory of Open Access Journals (Sweden)

    Nurul-Laila Salim

    2015-01-01

    Full Text Available Fungal endophthalmitis is rare but may complicate glaucoma drainage device surgery. Management is challenging as the symptoms and signs may be subtle at initial presentation and the visual prognosis is usually poor due to its resistant nature to treatment. At present there is lesser experience with intravitreal injection of voriconazole as compared to Amphotericin B. We present a case of successfully treated Aspergillus endophthalmitis following Baerveldt glaucoma drainage device implantation with intravitreal and topical voriconazole.

  5. Percutaneous transhepatic biliary drainage: analysis of 175 cases

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Jin; Lee, Sang Kwon; Kim, Tae Hun; Kim, Yong Joo; Kang, Duk Sik [College of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    1990-10-15

    Percutaneous transhepatic biliary drainage is a safe, effective and palliative means of treatment in biliary obstruction, especially in cases with malignant obstruction which are inoperable. 175 cases of transhepatic biliary drainage were performed on 119 patients with biliary obstruction from January 1985 to June 1989 at Kyung-pook National University Hospital. The causes of obstructive jaundice were 110 malignant diseases and 9 benign diseases. The most common indication for drainage was palliative intervention of obstruction secondary to malignant tumor in 89 cases. 86 cases of external drainage were performed including 3 cases of left duct approach, 29 cases of external-internal drainage and 60 cases of endoprosthesis. In external and external-internal drainages, immediate major complications (11.9%) occurred, including not restricted to, but sepsis, bile peritonitis and hemobilia. Delayed major complications (42.9%) were mainly catheter related. The delayed major complication of endoprosthesis resulted from obstruction of the internal stent. The mean time period to reobstruction of the internal stent was about 12 weeks. To improve management status, regular follow-up is required, as is education of both patients and their families as to when immediate clinical attention is mandated. Close communication amongst the varying medical specialities involved will be necessary to provide optional treatment for each patient.

  6. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  7. Effects of drainage salinity evolution on irrigation management

    Science.gov (United States)

    Kan, Iddo

    2003-12-01

    A soil physics theory of solute movement through a drained saturated zone underlying agricultural land is introduced into a long-term economic analysis of farm-level irrigation management; this is an alternative to the immediate, homogeneous blending assumption employed in previous studies as a base for calculating changes in drainage salinity over time. Using data from California, the effect of drainage salinity evolution is analyzed through a year-by-year profit optimization under the requirement of on-farm drainage disposal. Paths of optimal land allocation among crop production with fresh surface water, saline drainage reuse and evaporation ponds appear to depend on the relative profitability of the first two; that of reuse is affected by the trend of drainage salinity. Tile spacing and environmental regulations associated with evaporation ponds affect the timing of evaporation pond construction. The system converges into a solution involving both drainage-disposal activities; this solution includes an outlet for salts and is therefore sustainable. Following this strategy, the system is asymptotically approaching a steady state that possesses both hydrological and salt balances. Economic implications associated with land retirement programs in California are discussed.

  8. A cost comparison of traditional drainage and SUDS in Scotland.

    Science.gov (United States)

    Duffy, A; Jefferies, C; Waddell, G; Shanks, G; Blackwood, D; Watkins, A

    2008-01-01

    The Dunfermline Eastern Expansion (DEX) is a 350 ha mixed development which commenced in 1996. Downstream water quality and flooding issues necessitated a holistic approach to drainage planning and the site has become a European showcase for the application of Sustainable Urban Drainage Systems (SUDS). However, there is minimal data available regarding the real costs of operating and maintaining SUDS to ensure they continue to perform as per their design function. This remains one of the primary barriers to the uptake and adoption of SUDS. This paper reports on what is understood to be the only study in the UK where actual costs of constructing and maintaining SUDS have been compared to an equivalent traditional drainage solution. To compare SUDS costs with traditional drainage, capital and maintenance costs of underground storage chambers of analogous storage volumes were estimated. A whole life costing methodology was then applied to data gathered. The main objective was to produce a reliable and robust cost comparison between SUDS and traditional drainage. The cost analysis is supportive of SUDS and indicates that well designed and maintained SUDS are more cost effective to construct, and cost less to maintain than traditional drainage solutions which are unable to meet the environmental requirements of current legislation. (c) IWA Publishing 2008.

  9. 21 CFR 878.4200 - Introduction/drainage catheter and accessories.

    Science.gov (United States)

    2010-04-01

    ... catheters (including dialysis), and other general surgical catheters. An introduction/drainage catheter... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Introduction/drainage catheter and accessories... Introduction/drainage catheter and accessories. (a) Identification. An introduction/drainage catheter is a...

  10. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, L

    1999-01-01

    patients completed all questionnaires. Twenty-one patients continued to have abdominal pain after the operation. Patients with pain 1 year after cholecystectomy were characterized by the preoperative presence of a high dyspepsia score, 'irritating' abdominal pain, and an introverted personality...

  11. [The 'paper-based' preoperative evaluation: sometimes, a suitable alternative].

    NARCIS (Netherlands)

    Bucx, M.J.L.; Wolff, A.P.; Scheffer, G.J.

    2012-01-01

    In the Netherlands, the majority of elective-surgery patients are evaluated by the anaesthesiologist at the preoperative assessment clinic. We believe that this visit can be omitted in selected patients as it has only minimal benefit, whereas its disadvantages can be substantial. Alternatively, the

  12. Accuracy of diagnostic imaging in nephroblastoma before preoperative chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rieden, K. [Radiologische Klinik, Abt. Klinische Radiologie, Heidelberg (Germany); Weirich, A. [Kinderklinik, Univ. of Heidelberg (Germany); Troeger, J. [Radiologische Klinik, Abt. Paediatrische Radiologie, Univ. of Heidelberg (Germany); Gamroth, A.H. [Deutsches Krebsforschungszentrum, Heidelberg (Germany); Raschke, K. [Radiologische Klinik, Abt. Paediatrische Radiologie, Univ. of Heidelberg (Germany); Ludwig, R. [Kinderklinik, Univ. of Heidelberg (Germany)

    1993-04-01

    From July 1988 to February 1991, 130 children with the tentative diagnosis of nephroblastoma were treated preoperatively. The initial diagnostic images (excretory urography, ultrasound, CT, MRI) have been analysed both prospectively and retrospectively and the findings correlated with the intraoperative and histological results. Of the preoperatively treated patients 93.8% had a Wilms` tumour or one of its variants. Five patients had a different malignant tumour and 3 patients, i.e. 2.3% of those preoperatively treated or 1.6% of all registered patients, had benign tumours of the kidney. Wilms` tumour generally presented as a well-defined mass with an inhomogeneous morphology on CT. On ultrasound only 24% of the tumours were homogeneous. Intratumoral haemorrhage and cystic areas occurred frequently; calcifications were rare (8%). With regard to caval involvement only ultrasound and MRI enabled the correct diagnosis, while CT could not differentiate compressions from invasion. The pretherapeutic diagnostic imaging was of sufficient accuracy to start preoperative chemotherapy without diagnostic biopsy. (orig.)

  13. Ranitidine improves postoperative suppression of antibody response to preoperative vaccination

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F;

    1992-01-01

    The effect of the histamine-2 receptor antagonist ranitidine (100 mg intravenously every 12 hours for 72 hours) on postoperative serum antibody responses to preoperative immunization with six limit of flocculation tetanus toxoid and six limit of flocculation diphtheria toxoid was assessed...

  14. Preoperative subtyping of meningiomas by perfusion MR imaging

    NARCIS (Netherlands)

    Zhang, Hao; Roediger, Lars A.; Shen, Tianzhen; Miao, Jingtao; Oudkerk, Matthijs

    2008-01-01

    Introduction This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Materials and methods Thirty-seven menin

  15. Pheochromocytoma : a review on preoperative treatment with phenoxybenzamine or doxazosin

    NARCIS (Netherlands)

    van der Zee, P A; de Boer, A|info:eu-repo/dai/nl/075097346

    2014-01-01

    BACKGROUND: During surgical treatment of pheochromocytoma,`haemodynamic instability may occur. To prevent this, patients receive preoperative treatment with an alpha-blocker. Nowadays, some centres use phenoxybenzamine, while others use doxazosin. The purpose of this review is to analyse the current

  16. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, Linda

    1999-01-01

    BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients continue to have abdominal pain. The aim of this study was to investigate whether preoperative variables could predict the symptomatic outcome after cholecystectomy. METHODS: One hundred and two patients w...

  17. Preoperative statin therapy and infectious complications in cardiac surgery

    NARCIS (Netherlands)

    Hartholt, N L; Rettig, T C D; Schijffelen, M; Morshuis, W J; van de Garde, E M W; Noordzij, P G

    AIM: To assess whether preoperative statin therapy is associated with the risk of postoperative infection in patients undergoing cardiac surgery. METHODS: 520 patients undergoing cardiac surgery in 2010 were retrospectively examined. Data regarding statin and antibiotic use prior to and after

  18. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors.

    Science.gov (United States)

    Kain, Zeev N; Caldwell-Andrews, Alison A; Maranets, Inna; McClain, Brenda; Gaal, Dorothy; Mayes, Linda C; Feng, Rui; Zhang, Heping

    2004-12-01

    Based on previous studies, we hypothesized that the clinical phenomena of preoperative anxiety, emergence delirium, and postoperative maladaptive behavioral changes were closely related. We examined this issue using data obtained by our laboratory over the past 6 years. Only children who underwent surgery and general anesthesia using sevoflurane/O(2)/N(2)O and who did not receive midazolam were recruited. Children's anxiety was assessed preoperatively with the modified Yale Preoperative Anxiety Scale (mYPAS), emergence delirium was assessed in the postanesthesia care unit, and behavioral changes were assessed with the Post Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 2, 3, 7, and 14. Regression analysis showed that the odds of having marked symptoms of emergence delirium increased by 10% for each increment of 10 points in the child's state anxiety score (mYPAS). The odds ratio of having new-onset postoperative maladaptive behavior changes was 1.43 for children with marked emergence status as compared with children with no symptoms of emergence delirium. A 10-point increase in state anxiety scores led to a 12.5% increase in the odds that the child would have a new-onset maladaptive behavioral change after the surgery. This finding is highly significant to practicing clinicians, who can now predict the development of adverse postoperative phenomena, such as emergence delirium and postoperative behavioral changes, based on levels of preoperative anxiety.

  19. Comparison of preoperative anxiety in reconstructive and cosmetic surgery patients.

    Science.gov (United States)

    Sönmez, Ahmet; Bişkin, Nurdan; Bayramiçli, Mehmet; Numanoğlu, Ayhan

    2005-02-01

    Surgery is a serious stressor and a cause of anxiety for the patients. Reconstructive surgery patients are mostly operated on because of certain functional impairment or disability; on the contrary, cosmetic surgery patients do not have any physical impairment and they are operated on because of mostly psychologic reasons. The aim of this study was to compare the anxiety levels in the reconstructive surgery patients and cosmetic surgery patients preoperatively. Thirty-two patients in the reconstructive surgery group and 30 patients in the cosmetic surgery group were included in the study. State Trait Anxiety Inventory was used to measure the anxiety levels in these 2 groups preoperatively. The 2 groups were similar in characteristics such as age, gender distribution, number of previous operations, and trait anxiety scores. Mean state anxiety scores obtained for the reconstructive surgery group was 38.0 +/- 8.7, while it was 44.2 +/- 10.79 for the cosmetic surgery group (t test, degrees of freedom = 60, P = 0.015). This study reveals that preoperative anxiety levels in the cosmetic surgery patients are higher than those of the reconstructive surgery patients. Therefore, adequate preoperative preparation for cosmetic surgery should include attempts to cope with anxiety. Anxiolytics may be used more liberally and professional psychologic assistance may be required.

  20. Preoperative diagnosis of colonic angiolipoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Yang-Yuan Chen; Maw-Soan Soon

    2005-01-01

    Angiolipoma, a common benign tumor mostly seen in the subcutaneous tissue, is a rare pathological condition in the gastrointestinal tract that is usually diagnosed postoperatively. Tn this case report, an angiolipoma was diagnosed preoperatively by imaging (including CT scans,abdominal echo, barium enema, and colonoscopy). This pathology was confirmed postoperatively. Computed tomography scan, abdominal echo, and barium enema images were presented.

  1. Evaluating the effect of preoperative oral gabapentin on ...

    African Journals Online (AJOL)

    2010-05-02

    May 2, 2010 ... 0riginal Research: Preoperative oral gabapentin in patients ... having pain scores ≥ 5 received rescue analgesia in the form of intravenous tramadol 0.5 mg.kg-1. If the ... decreases postoperative pain scores at zero hour and the rescue ... decreased physical and social function, as well as ... 2% lignocaine.

  2. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    Science.gov (United States)

    Moerman, N; van Dam, F S; Muller, M J; Oosting, H

    1996-03-01

    The purpose of the present study was to assess patients' anxiety level and information requirement in the preoperative phase. During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Two hundred patients also completed Spielberger's State-Trait Anxiety Inventory (STAI-State). Patients were able to complete the questionnaire in less than 2 min. On factor analysis, two factors emerged clearly: anxiety and the need for information. The anxiety scale correlated highly (0.74) with the STAI-State. It emerged that 32% of the patients could be considered as "anxiety cases" and over 80% of patients have a positive attitude toward receiving information. Moreover, results demonstrated that 1) women were more anxious that men; 2) patients with a high information requirement also had a high level of anxiety; 3) patients who had never undergone an operation had a higher information requirement than those who had. The APAIS can provide anesthesiologists with a valid, reliable, and easily applicable instrument for assessing the level of patients' preoperative anxiety and the need for information.

  3. A psychological preoperative program: effects on anxiety and cooperative behaviors.

    Science.gov (United States)

    Cuzzocrea, Francesca; Gugliandolo, Maria C; Larcan, Rosalba; Romeo, Carmelo; Turiaco, Nunzio; Dominici, Tiziana

    2013-02-01

    To evaluate the effectiveness of a psychological preoperative program in reducing preoperative anxiety and in promoting compliance of pediatric participants with surgical procedures. Fifty children and their mothers were subjected to two conditions of treatment to investigate whether psychological preparation activities and psychologist's support during all phases of the operatory iter (group 1) were as efficient in reducing mothers' and child's anxiety and in increasing the child's compliance as distraction activities (group 2). The observed child anxiety was assessed using mYPAS; compliant behaviors with Induction Compliance Checklist; and mothers' anxiety with Amsterdam Pre-operative Anxiety and Information Scale. Children of the first group were less anxious and more cooperative in the preoperative period and during anesthesia induction than in the other condition. The psychological program was also more efficient in reducing mothers' anxiety. Finally, the mothers of group 1 showed a significantly higher satisfaction and judged as significantly more effective the program proposed to prepare their children than the mothers of group 2. Preparing children through playful dramatization of the operative procedure, manipulation of medical instruments and psychologist's support may be useful in pediatric surgery structures. © 2013 Blackwell Publishing Ltd.

  4. Effect of routine preoperative fasting on residual gastric volume and ...

    African Journals Online (AJOL)

    2016-02-10

    Feb 10, 2016 ... Nigerian Journal of Clinical Practice • Nov‑Dec 2016 • Vol 19 • Issue 6 induction of ... disorder, receiving antacids, or H2 receptor blockers, or those who ... The patients' preoperative anxiety states were graded using the ...

  5. Usefulness of preoperative MRI in recurrent anorectal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwa Jin; Cho, Jae Ho; Kim, Jae Woon; Park, Bok Hwan; Hwang, Mi Soo; Sim, Min Chul; Byun, Woo Mok [Yeungnam Univ. School of Medicine, Daegu (Korea, Republic of)

    1997-04-01

    To evaluate the usefulness of preoperative MRI in the patient with recurrent anorectal fistula. Fourteen patients with recurrent anorectal fistula underwent non-contrast MRI. In eight patients, T1-, T2- and proton-weighted images were taken in the axial, coronal and sagittal planes, and T1- and T2-weighted images taken in the axial and coronal planes were obtained from the other six. Fourteen cases of anorectal fistula and eight cases in which there was a combined abscess were detected. Preoperative MRI clearly showed the exact anatomical relationship with the anal sphincter, levator ani and surrounding soft tissue. In two cases in which there was fibrous scarring of the fistula tract, low signal intensities were seen on all MRI sequences. Preoperative information in the group in which only axial and coronal T1- and T2-weighted images were obtained was sufficient. Preoperative MRI in patients with recurrent anorectal fistula or suspected multiple fistulous tracts provide objective information concerning the anatomical location and extension of a fistula and combined abscess and could thus reduce the reoperation rate. An understanding of pathologic state through MRI signal intensity can help decide the most appropriate course of treatment.

  6. A comparative analysis of nasogastric and intravenous fluid resuscitation in patients with malignant obstructive jaundice prior to endoscopic biliary drainage

    Directory of Open Access Journals (Sweden)

    Kavita Baghel

    2013-01-01

    Full Text Available Background: An alternative to intravenous is nasogastric fluid administration through normal functioning gut. Though not common, this practice has significance in mass causalities and elective situations. Aim: The study was designed to compare nasogastric and intravenous fluid resuscitation in malignant obstructive jaundice (OJ and their effect on endotoxemia. Materials and Methods: Sixty patients with malignant OJ undergoing endoscopic biliary drainage were randomized into two groups. A total of 4 l of fluid (Ringer′s lactate was administered to Group A through nasogastric tube and to Group B through intravenous route for 48 h. Vital parameters, serum bilirubin, serum creatinine, creatinine clearance rate, electrolytes, and endotoxemia were monitored. Results: Significant improvement in blood pressure (Group A, P = 0.014; Group B, P = 0.020 and significant decrease in serum bilirubin level (Group A, P = 0.001; Group B, P < 0.0001 was observed in both groups after resuscitation. Significantly decreased (P = 0.036 post hydration endotoxin level was observed in Group A as compared to Group B. Febrile events were significantly higher (P = 0.023 in Group B as compared to Group A (6 vs 0. Electrolyte abnormalities were found more in Group B, however statistically insignificant. Conclusion: In OJ patient undergoing biliary drainage, preoperative fluid resuscitation through nasogastric tube may be helpful in reducing postoperative septic complications and endotoxemia.

  7. Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

    Science.gov (United States)

    Yu, Jea H.; Nguyen, Chuck; Gallemore, Esmeralda

    2016-01-01

    Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG). On average, intraocular pressure was reduced from 39 ± 14 mmHg to 15 ± 2 mmHg and the number of glaucoma medications was reduced from 4 ± 1 to 0. Preoperative and most recent visual acuities were hand-motion (HM) and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis. PMID:27747118

  8. Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

    Directory of Open Access Journals (Sweden)

    Jea H. Yu

    2016-01-01

    Full Text Available Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG. On average, intraocular pressure was reduced from 39±14 mmHg to 15±2 mmHg and the number of glaucoma medications was reduced from 4±1 to 0. Preoperative and most recent visual acuities were hand-motion (HM and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively. Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis.

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

    OpenAIRE

    2013-01-01

    Introduction Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases. Objectives To compare I&D vs USD of well-defined DNAs, using a randomized control...

  10. [Evaluation of preoperative anxiety in patients requiring glaucoma filtration surgery].

    Science.gov (United States)

    Lemaitre, S; Blumen-Ohana, E; Akesbi, J; Laplace, O; Nordmann, J-P

    2014-01-01

    Preoperative anxiety is often expressed by patients requiring filtration surgery for their glaucoma. So far, there has been no scale for screening this group of patients for preoperative anxiety. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-evaluation questionnaire which has been used in specialties other than ophthalmology and which makes it possible to identify the adult patients with a high level of preoperative anxiety over an upcoming surgical procedure. The purpose of this study is to estimate the preoperative anxiety in glaucoma patients requiring filtration surgery. We performed a prospective study of 36 adult patients with chronic glaucoma not responding to medical treatment and who were about to undergo filtration surgery (trabeculectomy or deep sclerectomy). The APAIS questionnaire was given to the patients after discussing the indication for surgery. A global anxiety score (ranging from 4 to 20) above 10 defined patients with a high level of preoperative anxiety. We attempted to identify among these patients the factors related to filtration surgery which caused them anxiety (lack of control of intraocular pressure, risk of blindness, presence of the filtering bleb). In our sample of patients, we found that glaucoma was a source of anxiety. That was also true for the surgical procedure, though most patients believe that once the decision had been made, their psychological status was not modified by the upcoming procedure. The patient-clinician relationship is important in any chronic disease, all the more so in glaucoma, since this disease remains asymptomatic for a long time. When filtration surgery is necessary, the patients are going to express less preoperative anxiety if they trust their physician and if individualized information has been given to them The French version of the APAIS is a quick scale, easily completed, that can be recommended for evaluating anxiety and patients' need for information prior to filtering

  11. Sensitivity of drainage efficiency of cranberry fields to edaphic conditions

    Science.gov (United States)

    Periard, Yann; José Gumiere, Silvio; Rousseau, Alain N.; Caron, Jean; Hallema, Dennis W.

    2014-05-01

    Water management on a cranberry farm requires intelligent irrigation and drainage strategies to sustain strong productivity and minimize environmental impact. For example, to avoid propagation of disease and meet evapotranspiration demand, it is imperative to maintain optimal moisture conditions in the root zone, which depends on an efficient drainage system. However, several drainage problems have been identified in cranberry fields. Most of these drainage problems are due to the presence of a restrictive layer in the soil profile (Gumiere et al., 2014). The objective of this work is to evaluate the effects of a restrictive layer on the drainage efficiency by the bias of a multi-local sensitivity analysis. We have tested the sensitivity of the drainage efficiency to different input parameters set of soil hydraulic properties, geometrical parameters and climatic conditions. Soil water flux dynamic for every input parameters set was simulated with finite element model Hydrus 1D (Simanek et al., 2008). Multi-local sensitivity was calculated with the Gâteaux directional derivatives with the procedure described by Cheviron et al. (2010). Results indicate that drainage efficiency is more sensitive to soil hydraulic properties than geometrical parameters and climatic conditions. Then, the geometrical parameters of the depth are more sensitive than the thickness. The drainage efficiency was very insensitive to the climatic conditions. Understanding the sensitivity of drainage efficiency according to soil hydraulic properties, geometrical and climatic conditions are essential for diagnosis drainage problems. However, it becomes important to identify the mechanisms involved in the genesis of anthropogenic soils cranberry to identify conditions that may lead to the formation of a restrictive layer. References: Cheviron, B., S.J. Gumiere, Y. Le Bissonnais, R. Moussa and D. Raclot. 2010. Sensitivity analysis of distributed erosion models: Framework. Water Resources Research

  12. Drainage pits in cohesionless materials: implications for surface of Phobos.

    Science.gov (United States)

    Horstman, K C; Melosh, H J

    1989-09-10

    Viking orbiter images show grooves and chains of pits crossing the surface of Phobos, many of which converge toward the large crater Stickney or its antipode. Although it has been proposed that the pits and grooves are chains of secondary craters, their morphology and geometric relations suggest that they are the surface traces of fractures in the underlying solid body of Phobos. Several models have been proposed to explain the pits, of which the most plausible are gas venting and drainage of regolith into open fractures. the latter mechanism is best supported by the image data and is the mechanism studied in this investigation. Drainage pits and fissures are modeled experimentally by using two rigid substrate plates placed edge to edge and covered by uniform thicknesses of dry fragmental debris (simulated regolith). Fracture extension is simulated by drawing the plates apart, allowing drainage of regolith into the newly created void. A typical drainage experiment begins with a shallow depression on the surface of the regolith, above the open fissure. Increased drainage causes local drainage pits to form; continued drainage causes the pits to coalesce, forming a cuspate groove. The resulting experimental patterns of pits and grooves have pronounced similarities to those observed on Phobos. Characteristics such as lack of raised rims, linearity of grooves and chains of pits, uniform spacing of pits, and progression from discrete pits to cuspate grooves are the same in the experiments and on Phobos. In contrast, gas-venting pits occur in irregular chains and have raised rims. These experiments thus indicate that the Phobos grooves and pits formed as drainage structures. The pit spacing in an experiment is measured at the time that the maximum number of pits forms, prior to groove development. The average pit spacing is compared to the regolith thickness for each material. Regression line fits indicate that the average spacing of drainage pits in unconsolidated

  13. Preoperative anemia in colon cancer: assessment of risk factors.

    Science.gov (United States)

    Dunne, James R; Gannon, Christopher J; Osborn, Tiffany M; Taylor, Michelle D; Malone, Debra L; Napolitano, Lena M

    2002-06-01

    Anemia is common in cancer patients and is associated with reduced survival. Recent studies document that treatment of anemia with blood transfusion in cancer patients is associated with increased infection risk, tumor recurrence, and mortality. We therefore investigated the incidence of preoperative anemia in colorectal cancer and assessed risk factors for anemia. Prospective data were collected on 311 patients diagnosed with colorectal cancer over a 6-year period from 1994 through 1999. Patients were stratified by age, gender, presenting complaint, preoperative hematocrit, American Joint Committee on Cancer (AJCC) stage, and TNM classification. Discrete variables were compared using Pearson's Chi-square analysis. Continuous variables were compared using Student's t test. Differences were considered significant when P colon cancer with an incidence of 57.6 per cent followed by left colon cancer (42.2%) and rectal cancer (29.8%). Patients with right colon cancer had significantly lower preoperative hematocrits compared with left colon cancer (33 +/- 8.5 vs 36 +/- 7.4; P rectal cancer (33 +/- 8.5 vs 38 +/- 6.0; P colon cancer also had significantly increased stage at presentation compared with left colon cancer (2.3 +/- 1.3 vs 2.1 +/- 1.2; P cancer. We conclude that there is a high incidence of anemia in patients with colon cancer. Patients with right colon cancer had significantly lower preoperative hematocrits and higher stage of cancer at diagnosis. Complete colon evaluation with colonoscopy is warranted in patients with anemia to improve earlier diagnosis of right colon cancer. A clinical trial of preoperative treatment of anemic colorectal cancer patients with recombinant human erythropoietin is warranted.

  14. Preoperative anxiety in surgical patients - experience of a single unit.

    Science.gov (United States)

    Matthias, Anne Thushara; Samarasekera, Dharmanbandhu Nandadeva

    2012-03-01

    Preoperative anxiety has a significant effect on the outcome of anesthesia and surgery. At present, there is no published data on the preoperative anxiety levels in Sri Lankan patients. In the West, several validated questionnaires such as The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and State Trait Anxiety Inventory (STAI) are used. To measure the preoperative anxiety levels in patients using APAIS and to analyze the factors affecting anxiety and the role played by the anesthetist in allaying anxiety. One hundred patients scheduled for elective surgery were prospectively studied using the APAIS. The internal consistency was checked using Cronbach's alpha. The ages varied 25 to 72 years (mean=48.7 years, SD=13.6). Reliability of the APAIS was high; Cronbach's alpha=0.864 in the overall component and 0.84, 0.73 and 0.97 in the anxiety related to surgery, anesthesia and in the information desire components, respectively. Females were more anxious than males (p=0.02) and those who had never sustained surgery were more anxious than those who previously had surgery (p=0.05). An anesthetist's visit and premedication reduced total anxiety scores (Z=-3.07, p=0.002) and anesthesia related anxiety scores (Z=-3.45, p=0.001). The prevalence of anxiety is high among Sri Lankan patients. Females are more anxious than males and those who have never had surgery are more anxious than those who have had surgery. The anesthetist's visit could reduce anxiety. Sinhala version of the APAIS is highly reliable in assessing the preoperative anxiety levels. Copyright © 2012. Published by Elsevier B.V.

  15. Drainage filters and constructed wetlands to mitigate site-specific nutrient losses

    DEFF Research Database (Denmark)

    Kjærgaard, Charlotte; Hoffmann, Carl Christian; Iversen, Bo Vangsø

    options targeting subsurface drainage are lacking. An end-of-pipe drainage filter solution offers the benefits of a targeted measure typically applied to point sources. This calls for a shift of paradigm towards the development of new, cost-efficient technologies to mitigate site-specific nutrient losses...... drainage. The project studies different approaches of implementing the filter technologies including drainage well or drainage pipe filters as well as surface-flow and sub-surface flow constructed wetlands....

  16. Nitrogen budget in the Changjiang River drainage area

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; YU Zhiming; SONG Xiuxian; CAO Xihua

    2012-01-01

    We established a budget model of nitrogen (N) inputs and outputs between watersheds and waterbodies to determine the sources of riverine N in the Changjiang (Yangtze) River drainage area.Nitrogen inputs in the budget included N from synthetic fertilizer,biological fixation by leguminous and other crops,wet/dry atmospheric deposition,excreta from humans and animals,and crop residues.The total N input was estimated to be 17.6 Tg,of which 20% or 3.5 Tg N was transported into waterbodies.Of the total N transported into waterbodies,the largest proportion was N from animal waste (26%),followed by N from atmospheric wet/dry deposition (25%),synthetic fertilizer N (17%),N in sewage wastes (17%),N in human waste from rural areas (6%) and industrial wastewater N (9%).We studied the spatial patterns of N inputs and outputs by dividing the Changjiang River drainage area into four sub-basins,from upstream to downstream:the Tongtian River drainage area (TTD,the headwater drainage area,138 000 km2,less disturbed by human activities); the Jinsha River drainage area (JSD,347 000 km2,less disturbed by human activities,approx.3 500 km upstream of the Changjiang estuary); the Pingshan-Yichang drainage area (PYD,520 500 km2,large-scale human disturbance,about 2 000 km upstream of the Changjiang estuary);and the Yichang-Datong drainage area (YDD,699 900 km2,large-scale human disturbance,approx.620 km upstream of the Changjiang estuary).The average N input into waterbodies was 2.3,7.3,24.1,and 28.2 kg N/ha in the TTD,JSD,PYD,and YDD sub-basins,respectively,suggesting an increase of N-components of more than 10 times from upstream to downstream areas.

  17. Geochemical characterisation of seepage and drainage water quality from two sulphide mine tailings impoundments: Acid mine drainage versus neutral mine drainage

    Science.gov (United States)

    Heikkinen, P.M.; Raisanen, M.L.; Johnson, R.H.

    2009-01-01

    Seepage water and drainage water geochemistry (pH, EC, O2, redox, alkalinity, dissolved cations and trace metals, major anions, total element concentrations) were studied at two active sulphide mine tailings impoundments in Finland (the Hitura Ni mine and Luikonlahti Cu mine/talc processing plant). The data were used to assess the factors influencing tailings seepage quality and to identify constraints for water treatment. Changes in seepage water quality after equilibration with atmospheric conditions were evaluated based on geochemical modelling. At Luikonlahti, annual and seasonal changes were also studied. Seepage quality was largely influenced by the tailings mineralogy, and the serpentine-rich, low sulphide Hitura tailings produced neutral mine drainage with high Ni. In contrast, drainage from the high sulphide, multi-metal tailings of Luikonlahti represented typical acid mine drainage with elevated contents of Zn, Ni, Cu, and Co. Other factors affecting the seepage quality included weathering of the tailings along the seepage flow path, process water input, local hydrological settings, and structural changes in the tailings impoundment. Geochemical modelling showed that pH increased and some heavy metals were adsorbed to Fe precipitates after net alkaline waters equilibrated with the atmosphere. In the net acidic waters, pH decreased and no adsorption occurred. A combination of aerobic and anaerobic treatments is proposed for Hitura seepages to decrease the sulphate and metal loading. For Luikonlahti, prolonged monitoring of the seepage quality is suggested instead of treatment, since the water quality is still adjusting to recent modifications to the tailings impoundment.

  18. Efficiency of lachrymal sac drainage in newborns with dacryocystocele

    Directory of Open Access Journals (Sweden)

    Sakovich V.N.

    2016-12-01

    Full Text Available The article represents results of treatment of 14 newborns with unilateral dacryocystocele. Patients age was 7.2±0.5 days. In 9 newborns (64.3% dacryocystocele was complicated with lachrymal sac phlegmon; in 5 children (35.7% any complications were absent. Drainage of lachrymal sac through the lower lachrymal canaliculus, instillation of antibiotics, systemic antibiotic therapy in case of phlegmon were performed in all the children. Lachrymal sac washing was performed with a solution of the antibiotic ofloxacin till clear fluid evacuation. If necessary the drainage was repeated in 10 days. The drainage of lachrymal sac was successful in all the patients. 2-3 weeks after the drainage probing of nasolachrymal duct was perfomed in 4 children (28.6% including those 3 with lacrymal sac phlegmon. In 71.4% regression of dacryocystocele occurred itself. Any complications and side effects were not observed. Positive effect of the drainage, according to the authors, can be explained so that dilatation of lachrymal canaliculus before the procedure allows to eliminate Rosenmьller valve stenosis and evacuation of fluid, mucus and pus, being breeding ground for microorganisms from lachrymal sac, promotes inflammation subsiding. Authors also recommend to pay attention on prenatal diagnosis of dacryocystocele, using ultrasound investigation in the 3rd trimester of pregnancy.

  19. Bubble motion measurements during foam drainage and coarsening.

    Science.gov (United States)

    Maurdev, G; Saint-Jalmes, A; Langevin, D

    2006-08-15

    We have studied bubble motion within a column of foam allowed to undergo free drainage. We have measured bubble motion upward with time and as a function of their initial positions. Depending on the gas used, which sets the coarsening and drainage rates, different bubble upward motion types have been identified (constant speed, acceleration or deceleration) and explained in relation with liquid downward flows. The proofs of the consistency between bubble upward motion and liquid downward flow are obtained both by comparing the bubble motion curves to the liquid drainage ones, and by comparing the time variations of the liquid fraction extracted from bubble motion to direct liquid fraction measurements by electrical conductimetry. The agreement between bubble position tracking and electrical conductivity shows in particular that it is possible to determine the drainage regime from such simple bubble motion measurements. This work also allowed us to demonstrate a special case of foam coarsening and expansion, occurring when the foam gas is less soluble than the outside one, caused by diffusion of this external gas into the foam. All these results allow us to build a picture of drainage and coarsening seen from the bubble point of view.

  20. Management of chest drainage tubes after lung surgery.

    Science.gov (United States)

    Satoh, Yukitoshi

    2016-06-01

    Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.

  1. Basinsoft, a computer program to quantify drainage basin characteristics

    Science.gov (United States)

    Harvey, Craig A.; Eash, David A.

    2001-01-01

    Surface water runoff is a function of many interrelated factors including climate, soils, landuse, and the physiography of the drainage basin. A practical and effective method to quantify drainage basin characteristics would allow analysis of the interrelations of these factors, leading to an improved understanding of the effects of drainage basin characteristics on surface-water runoff. Historically, the quantification of drainage basin characteristics has been a tedious and time-consuming process. Recent improvements in computer hardware and software technology have enabled the developers of a program called Basinsoft to automate this process. Basinsoft requires minimal preprocessing of data and provides an efficient, automated procedure for quantifying selected morphometric characteristics and the option to area-weight characteristics for a drainage basin. The user of Basinsoft is assumed to have a limited amount of experience in the use of ARC/INFO, a proprietary geographic information system (GIS). (The use of brand names in this chapter is for identification purposes only and does not constitute endorsement by the U.S. Geological Survey [USGS].)

  2. Right Gastric Venous Drainage: Angiographic Analysis in 100 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Nak Jong [Seoul National University Bundang Hospital, Sungnam (Korea, Republic of); Chung, Jin Wook; Kim, Hyo Cheol; Park, Jae Hyung; Jae, Hwan Jun [Seoul National University Hospital, Seoul (Korea, Republic of); An, Sang Bu [National Cancer Center, Ilsan (Korea, Republic of); Cho, Baik Hwan [Chonbuk National University Hospital, Chonju (Korea, Republic of)

    2012-01-15

    To evaluate the pattern of right gastric venous drainage by use of digital subtraction angiography. A series of 100 consecutive patients who underwent right gastric arteriography during transcatheter arterial chemoembolization for hepatocellular carcinoma were included in this study. Angiographic findings were retrospectively analyzed with respect to the presence or absence of the right and aberrant gastric veins, multiplicity of draining veins, aberrant right gastric venous drainage sites, and the termination pattern of aberrant right gastric veins (ARGVs). We also compared the relative size of the right and left gastric veins. A total of 49 patients collectively had 66 ARGVs. The common drainage sites for the ARGVs included the hepatic segment IV (n = 35) and segment I (n = 15). The termination pattern of ARGV could be classified into 4 different types. The most common type was termination as a superficial parenchymal blush formation in small areas without demonstrable portal branches. A statistically significant difference was found for the dominance of the right gastric vein in gastric venous drainage between the two groups with or without ARGV (p < 0.05, Fisher's exact test). In the group of patients without ARGV (n = 51), the right gastric vein was equal to (n = 9) or larger than (n = 17) the left gastric vein in 26 patients (26 of 51, 51%). The incidence of ARGV is higher than expected with four distinct types in its termination pattern. The right gastric vein may play a dominant role in gastric venous drainage.

  3. Connected subglacial lake drainage beneath Thwaites Glacier, West Antarctica

    Science.gov (United States)

    Smith, Benjamin E.; Gourmelen, Noel; Huth, Alexander; Joughin, Ian

    2017-02-01

    We present conventional and swath altimetry data from CryoSat-2, revealing a system of subglacial lakes that drained between June 2013 and January 2014 under the central part of Thwaites Glacier, West Antarctica (TWG). Much of the drainage happened in less than 6 months, with an apparent connection between three lakes spanning more than 130 km. Hydro-potential analysis of the glacier bed shows a large number of small closed basins that should trap water produced by subglacial melt, although the observed large-scale motion of water suggests that water can sometimes locally move against the apparent potential gradient, at least during lake-drainage events. This shows that there are important limitations in the ability of hydro-potential maps to predict subglacial water flow. An interpretation based on a map of the melt rate suggests that lake drainages of this type should take place every 20-80 years, depending on the connectivity of the water flow at the bed. Although we observed an acceleration in the downstream part of TWG immediately before the start of the lake drainage, there is no clear connection between the drainage and any speed change of the glacier.

  4. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Yeliz Yilmaz

    2016-08-01

    Conclusion: Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.

  5. Effect of preoperative neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement

    DEFF Research Database (Denmark)

    Huber, Erika O; Roos, Ewa M.; Meichtry, André

    2015-01-01

    BACKGROUND: Improving functional status preoperatively through exercise may improve postoperative outcome. Previous knowledge on preoperative exercise in knee osteoarthritis is insufficient. The aim of the study was to compare the difference in change between groups in lower extremity function fr...

  6. Effect of preoperative education on recovery time of laparoscopic cholecystectomy: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Leila Sadati

    2014-07-01

    Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery. Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes.

  7. 77 FR 70484 - Preoperational Testing of Onsite Electric Power Systems To Verify Proper Load Group Assignments...

    Science.gov (United States)

    2012-11-26

    ... COMMISSION Preoperational Testing of Onsite Electric Power Systems To Verify Proper Load Group Assignments... Power Systems to Verify Proper Load Group Assignments, Electrical Separation, and Redundancy.'' DG-1294... encompass preoperational testing of electrical power systems used to meet current Station...

  8. Validation of the French version of the Amsterdam preoperative anxiety and information scale (APAIS)

    National Research Council Canada - National Science Library

    Maurice-Szamburski, Axel; Loundou, Anderson; Capdevila, Xavier; Bruder, Nicolas; Auquier, Pascal

    2013-01-01

    .... The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-report questionnaire comprising six questions that have been developed and validated to evaluate the preoperative anxiety of patients...

  9. Ranitidine improves postoperative suppression of antibody response to preoperative vaccination

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F;

    1992-01-01

    The effect of the histamine-2 receptor antagonist ranitidine (100 mg intravenously every 12 hours for 72 hours) on postoperative serum antibody responses to preoperative immunization with six limit of flocculation tetanus toxoid and six limit of flocculation diphtheria toxoid was assessed...... in a double-blind, placebo-controlled randomized study in 26 patients undergoing major abdominal surgery. The preoperative antitetanus antibody level was less than 0.1 IU/ml in all patients, and they were inoculated with both antigens 48 hours before surgery. Serum samples for analysis of antitetanus toxoid...... and antidiphtheria toxoid were drawn before skin incision and on postoperative days 1, 3, 5, 7, 10, 14, 21, and 28. Ranitidine significantly increased the postoperative antibody response to tetanus toxoid, (p less than 0.01) and insignificantly increased that to diphtheria toxoid vaccination (p less than 0...

  10. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

    Directory of Open Access Journals (Sweden)

    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  11. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... (rho=-0.413, p=0.049), indicating a paradoxical association between level of mechanical pain threshold and magnitude of spontaneous pain. No other sensory modality was significantly correlated to pain intensity. New/increased pain during repetitive pinprick stimulation (wind-up) was seen in 3 patients......]) and assessments were correlated to patients' reports of intensity and frequency of spontaneous pain in the groin area. RESULTS: Forty-two patients were examined, whereof one was excluded since no hernia was found intraoperatively. Mechanical pain threshold was inversely correlated with spontaneous pain intensity...

  12. PREOPERATIVE SEGMENTAL LOCALIZATION OF FOCAL HEPATIC LESION ON MRI

    Institute of Scientific and Technical Information of China (English)

    陈正光; 苏学曾; 欧阳汉; 孟涛; 袁兴华; 邵永孚

    1995-01-01

    In order to evaluate the accuracy of preoperative segmental localization of hepatic mass lesinns,68 cases were prospectively studied and evaluated by the correlation of magnetic resonance imaging(MRI) and surgical findings. Right, middle and left hepatic veins were seen in 100%, 97% and 94% of the subjects respectively on MRI, The right and left portal veins were seen in 100% and 95. 6% respectively. The accuracy in determining the segmental location of hepatic lesions was 89. 7%. The accuracy could be increased to 91.3% if the lesion was located at single segment whereas it was only 86. 4% when the lesion extended across several segments. It is possible to say that MRI is an important modality in the preoperative segmental localization of masses.

  13. Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms.

    Science.gov (United States)

    Borecky, N; Rickard, M

    2008-02-01

    Three cases of fibroadenoma associated with carcinoma are reported. These cases were diagnosed within a screening programme as a result of suspicious mammographic findings, and the diagnosis of malignancy was confirmed preoperatively by core biopsy in all cases. The mammographic findings suggestive of carcinoma within fibroadenoma were irregularity of margins in one case and associated new suspicious pleomorphic and linear calcifications in the two other cases. The preoperative diagnosis of carcinoma within fibroadenoma was provided by ultrasound-guided core biopsy in two cases and core biopsy under stereotactic guidance in one case. Whereas asymptomatic fibroadenoma with benign imaging appearances usually does not require further investigation, fibroadenoma with atypical imaging features requires a triple test investigation.

  14. Asian Rhinoplasty: Preoperative Simulation and Planning Using Adobe Photoshop.

    Science.gov (United States)

    Kiranantawat, Kidakorn; Nguyen, Anh H

    2015-11-01

    A rhinoplasty in Asians differs from a rhinoplasty performed in patients of other ethnicities. Surgeons should understand the concept of Asian beauty, the nasal anatomy of Asians, and common problems encountered while operating on the Asian nose. With this understanding, surgeons can set appropriate goals, choose proper operative procedures, and provide an outcome that satisfies patients. In this article the authors define the concept of an Asian rhinoplasty-a paradigm shift from the traditional on-top augmentation rhinoplasty to a structurally integrated augmentation rhinoplasty-and provide a step-by-step procedure for the use of Adobe Photoshop as a preoperative program to simulate the expected surgical outcome for patients and to develop a preoperative plan for surgeons.

  15. Combined modality preoperative therapy for unresectable rectal cancer.

    Science.gov (United States)

    Percarpio, B; Bitterman, J; Sabbath, K; Alfano, F; Ruszkowski, R; Bowen, J

    1992-01-01

    Locally advanced rectal cancer has been a surgical challenge because of fixation of the primary tumor to the boney pelvis or to other pelvic soft tissues. During a 12-month period seven patients with locally advanced adenocarcinoma of the rectum were treated preoperatively with simultaneous pelvic irradiation (4500-5040 cGy) and infusion chemotherapy (5-fluorouracil 1000 mg per m2 per day over 96 hours and mitomycin 10 mg per m2. Tolerance was reasonable and all patients underwent successful resection of the primary lesion. Two patients had a complete response to preoperative combined modality therapy with no cancer found in the surgical specimen. With a short follow-up period, all patients have experienced satisfactory healing and none have suffered local or distant recurrence. The results of this limited series are encouraging for future clinical trials.

  16. Assessment of spiral CT pneumocolon in preoperative colorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Can-Hui Sun; Zi-Ping Li; Quan-Fei Meng; Shen-Ping Yu; Da-Sheng Xu

    2005-01-01

    AIM: To investigate the value of spiral CT pneumocolon in preoperative colorectal carcinoma.METHODS: Spiral CT pneumocolon was performed prior to surgery in 64 patients with colorectal carcinoma. Spiral CT images were compared to specimens from the resected tumor.RESULTS: Spiral CT depicted the tumor in all patients.Comparison of spiral CT and histologic results showed that the sensitivity and specificity were 95.2%, 40.9% in detection of local invasion, and 75.0%, 90.9% in detection of lymph node metastasis. Compared to the Dukes classification,the disease was correctly staged as A in 6 of 18 patients,as B in 18 of 23, as C in 10 of 15, and as D in 7 of 8. Overall,spiral CT correctly staged 64.1% of patients.CONCLUSION: Spiral CT pneumocolon may be useful in the preoperative assessment of patients with colorectal carcinoma as a means for assisting surgical planning.

  17. Identifying and assessing anxiety in pre-operative patients.

    Science.gov (United States)

    Pritchard, Michael John

    Increasing demands for hospitals to be more efficient mean that patients attending for an operation are generally admitted on the day of surgery. As a result, healthcare professionals have little time to talk to the patient to ascertain his or her wellbeing, to check for any signs of anxiety and ask whether the patient requires further information about the forthcoming procedure. Healthcare professionals should be encouraged to use appropriate interventions to identify and assess anxious patients. There are several instruments available to measure the patient's level of pre-operative anxiety. This article reviews the Amsterdam Preoperative Anxiety and Information Scale, which is easy for patients to complete and may help to identify which individuals need extra support.

  18. [Endosonography control of percutaneous paracoccygeal drainage of deep pelvic abscesses after rectum resection].

    Science.gov (United States)

    Truong, S; Willis, S; Jansen, M; Neuerburg, J; Schumpelick, V

    1997-06-01

    Pelvic abscesses are severe complications after rectal surgery. In recent years, surgical drainage has been edged out by percutaneous drainage techniques. We report our experience with the drainage of postoperative pelvic abscesses via the paracoccygeal route controlled by endosonography. In eight patients the diagnosis of a retrorectal pelvic abscess was established by endosonography and confirmed by endosonographically controlled exploratory puncture. Drainage of the abscesses was performed via the paracoccygeal access route by trocar or Seldinger technique under permanent visual control by endoluminal sonography. Irrigation of the abscess cavity was than performed daily. In all cases drainage was successful without complications. Duration of drainage was 9-14 days with a mean of 10.8 days. In one patient there was a recurrence of the abscess because of early removal of the drainage catheter. Because of its overall availability and its good results, paracoccygeal percutaneous endosonographically controlled drainage seems to be a suitable uncomplicated method for drainage of postoperative pelvic abscesses.

  19. Evaluation of the sustainability of road drainage systems

    Science.gov (United States)

    García-Diez, Iván; Palencia, Covadonga; Fernández Raga, María

    2017-04-01

    Water is the most erosive agent that exists on the linear structures, because they are constantly subjected to outdoor condition like irregular infiltration, frosts and different rain intensities. Another variables that highly influence in the entire lifetime of a natural drainage system are the spatial and temporal variability of the rainfall, the soil, the vegetation cover and the design. All this factors are affecting the vulnerability of the clearings and embankments, by wearing away the weakest materials which surround the roads or train rails, producing erosion and very bumpy surfaces. The result is that the original pattern, developped to disminished the lost of soil, is not properly working and it cannot eliminate water, with the consequence destruction of the linear structure after several rainfall periods, and the accumulation of material down slope. The propose of this research focuses on analysing the drainage systems used in spanish roads and railways lines. For this purpose, a revision of the literature has been done, and the main drainage solutions have been recovered, carrying out an evaluation of them from an environmental point of view. This procedure has been requested by several authors in the past (Nwa, E.U. & Twocock, J.G., 1969; Goulter, I.C., 1992), together with the need of designing a more sustainable drainage system. The final objective of this complete revision is to compare objetively the designs to valuate them in order to develop a new drainage patter which minimize the erosion, increasing the durability and effectiveness of the drainage system. For this purpose, it is neccesary to assure that all the systems will be compare under similar parameters of flow rate, vegetation, substrate, lenght, slope and total section. Only the channels pattern and water distribution will change. The analysis has been done following Liu, H. & Zhu, X.B., (2012), who pointed out that the main parameters to take into account to select a road drainage

  20. Measure Guideline: Guidance on Taped Insulating Sheathing Drainage Planes

    Energy Technology Data Exchange (ETDEWEB)

    Grin, A. [Building Science Corporation, Somerville, MA (United States); Lstiburek, J. [Building Science Corporation, Somerville, MA (United States)

    2014-09-01

    The goal of this research is to provide durable and long-term water management solutions using exterior insulating sheathing as part of the water management system. It is possible to tape or seal the joints in insulating sheathing to create a drainage plane and even an air control layer. There exists the material durability component of the tape as well as the system durability component being the taped insulating sheathing as the drainage plane. This measure guideline provides best practice and product recommendations from the interviewed contractors and homebuilders who collectively have a vast amount of experience. Three significant issues were discussed with the group, which are required to make taped insulating sheathing a simple, long-term, and durable drainage plane: horizontal joints should be limited or eliminated wherever possible; where a horizontal joint exists use superior materials; and frequent installation inspection and regular trade training are required to maintain proper installation.

  1. Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages

    Science.gov (United States)

    de Carvalho Filho, Élio Barreto; Marson, Fernando Augusto de Lima; da Costa, Loredana Nilkenes Gomes; Antunes, Nilson

    2014-01-01

    Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas. PMID:25140478

  2. Urban Drainage System Improvement for Climate Change Adaptation

    Directory of Open Access Journals (Sweden)

    Narae Kang

    2016-06-01

    Full Text Available Recently, urban areas have experienced frequent, large-scale flooding, a situation that has been aggravated by climate change. This study aims to improve the urban drainage system to facilitate climate change adaptation. A methodology and a series of mitigation strategies are presented to efficiently improve the urban drainage system in light of climate change. In addition, we assess the impact of climate change and predict the scale of potential future flood damage by applying the methodology and mitigation strategies to urban areas. Based on the methodology presented, urban flood prevention measures for Gyeyang-gu (Province, Incheon, Korea, was established. The validity of the proposed alternatives is verified by assessing the economic feasibility of the projects to reduce flood damage. We expect that the methodology presented will aid the decision-making process and assist in the development of reasonable strategies to improve the urban drainage system for adaptation to climate change.

  3. Electronic versus traditional chest tube drainage following lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Licht, Peter B; Neckelmann, Kirsten

    2015-01-01

    OBJECTIVES: Electronic drainage systems have shown superiority compared with traditional (water seal) drainage systems following lung resections, but the number of studies is limited. As part of a medico-technical evaluation, before change of practice to electronic drainage systems for routine...... thoracic surgery, we conducted a randomized controlled trial (RCT) investigating chest tube duration and length of hospitalization. METHODS: Patients undergoing lobectomy were included in a prospective open label RCT. A strict algorithm was designed for early chest tube removal, and this decision...... time for chest tube removal, as well as length of hospitalization. RESULTS: A total of 105 patients were randomized. We found no significant difference between the electronic group and traditional group in optimal chest tube duration (HR = 0.83; 95% CI: 0.55-1.25; P = 0.367), actual chest tube duration...

  4. A new thermogeomechanical theory for gravity drainage in SAGD

    Energy Technology Data Exchange (ETDEWEB)

    Cokar, M.; Kallos, M.S.; Gates, I.D. [Dept. of Chemical and Petroleum Engineering, University of Calgary (Canada)

    2011-07-01

    In the heavy oil and bitumen industry, the steam assisted gravity drainage (SAGD) process is often used to enhance oil recovery. In such deposits, oil usually has no mobility due to its high viscosity and the injection of steam leads to an increase in the mobility of bitumen. Since the thermogeomechanical evolution of the oil sand at the chamber edge is important to the SAGD's performance, this paper aimed at taking these effects into account in a new SAGD drainage formula. The SAGD theory was modified to incorporate the effects of geomechanics and the results were then compared with Butler's model and the Sharma and Gates model. Results showed that thermal expansion has an important impact on oil rates and that geomechanical effects need to be considered when analysing the flow at the edge of steam chambers. This study developed a SAGD drainage formula and demonstrated the importance of geomechanics in the SAGD's performance.

  5. Gas drainage management systems for modern coal mines

    Energy Technology Data Exchange (ETDEWEB)

    Creedy, D.; Lunarzewski, L. [Wardell Armstrong, Newcastle-under-Lyme (United Kingdom)

    2001-07-01

    Gas emission and outburst problems remain one of the major difficulties facing the world coal mining industry. Methane emission in coal mines adversely affects the efficiency of coal production and mine safety conditions. Risk can be reduced by gas drainage. The methane thus recovered is a potentially valuable energy source which if used can produce both financial and environmental benefits. The generic gas control methods of gas drainage and ventilation are common to most coal mining countries but the detailed technologies applied differ according to the geological, mining and economic conditions, and also with the magnitudes of coal production. However, the critical element of all gas drainage management systems is the management organisation which ensures allocation of responsibility and provides a systematic framework for effective application of the most appropriate technology. 8 refs., 6 figs., 1 tab.

  6. Necrotizing fasciitis: unreliable MRI findings in the preoperative diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Arslan, Arzu E-mail: arzuarslan@netscape.net; Pierre-Jerome, Claude; Borthne, Arne

    2000-12-01

    The authors present two cases of necrotizing fasciitis (NF), one case of dermatomyositis and one case of posttraumatic muscle injury, which have similar magnetic resonance imaging findings in terms of skin, subcutaneous fat, superficial and deep fasciae and muscle involvement. These cases highlight the need for cautious interpretation of magnetic resonance imaging (MRI) findings, for they are nonspecific and the preoperative decision should be based mostly on the evolution of the clinical status.

  7. Outpatient Preoperative Education Needs Identified by Nurses and Patients.

    Science.gov (United States)

    2007-11-02

    PREOPERATIVE EDUCATION NEEDS IDENTIFIED BY NURSES AND PATIENTS Cheryl Anne Reilly APPROVED: Supervising Prdessor Date APPROVED: / "Sanfor• Miller , P... anesthesiologist will visit them before 5 4 3 2 1 surgery to discuss what anesthesia would be used. 27. Their incision may pull, bum, or itch while it is 5 4...such as, giving me an injection & asking me to empty my bladder. 26. An anesthesiologist would visit me before Yes No 5 4 3 2 1 surgery to discuss

  8. Preoperative Patient Education for Hip and Knee Arthroplasty: Financial Benefit?

    Science.gov (United States)

    Tait, Mark A; Dredge, Carter; Barnes, C Lowry

    2015-01-01

    Of 904 patients who underwent primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) at the same hospital, 802 participated in a preoperative education day called "Joint Academy" (JA). The length of stay of JA participants was 2.12 days (49.5%) less than patients who did not attend a JA (p education program may significantly reduce overall costs for primary TKA and THA procedures.

  9. The pelvic support osteotomy: indications and preoperative planning

    OpenAIRE

    Pafilas, Dimitrios; Nayagam, Selvadurai

    2008-01-01

    The pelvic support osteotomy is a double level femoral osteotomy with the objective of eliminating a Trendelenburg and short limb gait in young patients with severe hip joint destruction as a consequence of neonatal septic arthritis. The osteotomy has seen several changes and a brief historical overview is provided to set the evolution of the modifications of the procedure in context. We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure....

  10. Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical–radiologic–pathologic correlations

    Science.gov (United States)

    Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei

    2013-01-01

    Abstract Purpose: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. Materials and methods: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9–32 years (mean age 15.9 years). Results: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. Conclusion: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of

  11. Preoperative administration of cephalosporins for elective caesarean delivery

    Directory of Open Access Journals (Sweden)

    Bogavac Mirjana

    2010-01-01

    Full Text Available Introduction. Antibiotic prophylaxis means administration of antibiotics in prevention of infections. Objective. To investigate the efficacy of a single dose preoperative administration of ceftriaxone and cefazolin in the prevention of intra- and postoperative infections in the parturients without high risk of inflammation. Methods. The first group of 45 pregnant and 4 non-pregnant women were preoperatively administered ceftriaxone in a dose of 2 g, i.v., 10 minutes before the planned surgery. The second group of 45 pregnant and 4 non-pregnant women were preoperatively administered cefazolin in a dose of 2 g i.v., 10 minutes before the planned surgery. The concentrations of antibiotics were estimated immediately and 6 hours following the operation, as well as in the amniotic fluid and umbilical cord in the group of pregnant women. The estimation of antibiotic concentration was done by the method of liquid chromatography. Results. The mean concentrations of antibiotics in the patients following the elective caesarean section were as follows: ceftriaxone - 22.7 μg/l. vs cefazolin - 44.8 μg/l. Six hours later, the concentration of antibiotic decreased, but the concentration of cefazolin was still over the MIC for sensitive bacteria. The mean concentrations of antibiotics following gynaecological surgery in the non-pregnant patients were as follows: ceftriaxone - 12.0 μg/l vs cefazolin - 30.1 μg/l. Six hours later, the concentration of antibiotic decreased. Conclusion. It is most optimal to administer a single-dose of the first generation cephalosporins-cefazolin-immediately following the clamping of the umbilical cord as well as in preoperative prophylaxis in gynaecological operations.

  12. Preoperative embolization of primary bone tumors: A case control study

    Science.gov (United States)

    Jha, Roushan; Sharma, Raju; Rastogi, Shishir; Khan, Shah Alam; Jayaswal, Arvind; Gamanagatti, Shivanand

    2016-01-01

    AIM: To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss, intraoperative blood transfusion volume and surgical time. METHODS: Thirty-three patients underwent preoperative embolization of primary tumors of extremities, hip or vertebrae before resection and stabilization. The primary osseous tumors included giant cell tumors, aneurysmal bone cyst, osteoblastoma, chondroblastoma and chondrosarcoma. Twenty-six patients were included for the statistical analysis (embolization group) as they were operated within 0-48 h within preoperative embolization. A control group (non-embolization group, n = 28) with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison. RESULTS: The mean intraoperative blood loss was 1300 mL (250-2900 mL), the mean intraoperative blood transfusion was 700 mL (0-1400 mL) and the mean surgical time was 221 ± 76.7 min for embolization group (group I, n = 26). Non-embolization group (group II, n = 28), the mean intraoperative blood loss was 1800 mL (800-6000 mL), the mean intraoperative blood transfusion was 1400 mL (700-8400 mL) and the mean surgical time was 250 ± 69.7 min. On comparison, statistically significant (P < 0.001) difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion. There was no statistical difference between the two groups for the surgical time. No patients developed any angiography or embolization related complications. CONCLUSION: Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume. PMID:27158424

  13. Preoperative thrombocytosis and poor prognostic factors in endometrial cancer.

    Science.gov (United States)

    Heng, Suttichai; Benjapibal, Mongkol

    2014-01-01

    This study aimed to evaluate the prevalence of preoperative thrombocytosis and its prognostic significance in Thai patients with endometrial cancer. We retrospectively reviewed the medical records of 238 cases who had undergone surgical staging procedures between January 2005 and December 2008. Associations between clinicopathological variables and preoperative platelet counts were analyzed using Pearson's chi square or two- tailed Fisher's exact tests. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox- regression models were used to evaluate the prognostic impact of various factors including platelet count in terms of disease-free survival and overall survival. The mean preoperative platelet count was 315,437/μL (SD 100,167/ μL). Patients who had advanced stage, adnexal involvement, lymph node metastasis, and positive peritoneal cytology had significantly higher mean preoperative platelet counts when compared with those who had not. We found thrombocytosis (platelet count greater than 400,000/μL) in 18.1% of our patients with endometrial cancer. These had significant higher rates of advanced stage, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with a normal pretreatment platelet count. The 5-year disease-free survival and overall survival were significantly lower in patients who had thrombocytosis compared with those who had not (67.4% vs. 85.1%, p=0.001 and 86.0% vs. 94.9%, p=0.034, respectively). Thrombocytosis was shown to be a prognostic factor in the univariate but not the multivariate analysis. In conclusion, presence of thrombocytosis is not uncommon in endometrial cancer and may reflect unfavorable prognostic factors but its prognostic impact on survival needs to be clarified in further studies.

  14. Effectiveness of binaural beats in reducing preoperative dental anxiety.

    Science.gov (United States)

    Isik, B K; Esen, A; Büyükerkmen, B; Kilinç, A; Menziletoglu, D

    2017-07-01

    Binaural beats are an auditory illusion perceived when two different pure-tone sine waves are presented one to each ear at a steady intensity and frequency. We evaluated their effectiveness in reducing preoperative anxiety in dentistry. Sixty patients (30 in each group) who were to have impacted third molars removed were studied (experimental group: 20 women and 10 men, mean (range) age 24 (18-35) years, and control group: 22 women and 8 men, mean (range) age 28 (15-47) years). All patients were fully informed about the operation preoperatively, and their anxiety recorded on a visual analogue scale (VAS). The local anaesthetic was given and the patients waited for 10minutes, during which those in the experimental group were asked to listen to binaural beats through stereo earphones (200Hz for the left ear and 209.3Hz for the right ear). No special treatment was given to the control group. In both groups anxiety was then recorded again, and the tooth removed in the usual way. The paired t test and t test were used to assess the significance of differences between groups. The degree of anxiety in the control group was unchanged after the second measurement (p=0.625), while that in the experimental group showed a significant reduction in anxiety (p=0.001). We conclude that binaural beats may be useful in reducing preoperative anxiety in dentistry. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Preoperative rectal cancer staging with phased-array MR

    Directory of Open Access Journals (Sweden)

    Giusti Sabina

    2012-03-01

    Full Text Available Abstract Background We retrospectively reviewed magnetic resonance (MR images of 96 patients with diagnosis of rectal cancer to evaluate tumour stage (T stage, involvement of mesorectal fascia (MRF, and nodal metastasis (N stage. Our gold standard was histopathology. Methods All studies were performed with 1.5-T MR system (Symphony; Siemens Medical System, Erlangen, Germany by using a phased-array coil. Our population was subdivided into two groups: the first one, formed by patients at T1-T2-T3, N0, M0 stage, whose underwent MR before surgery; the second group included patients at Tx N1 M0 and T3-T4 Nx M0 stage, whose underwent preoperative MR before neoadjuvant chemoradiation therapy and again 4-6 wks after the end of the treatment for the re-staging of disease. Our gold standard was histopathology. Results MR showed 81% overall agreement with histological findings for T and N stage prediction; for T stage, this rate increased up to 95% for pts of group I (48/96, while for group II (48/96 it decreased to 75%. Preoperative MR prediction of histologically involved MRF resulted very accurate (sensitivity 100%; specificity 100% also after chemoradiation (sensitivity 100%; specificity 67%. Conclusions Phased-array MRI was able to clearly estimate the entire mesorectal fat and surrounding pelvic structures resulting the ideal technique for local preoperative rectal cancer staging.

  16. Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection.

    Science.gov (United States)

    Kallianos, Anastasios; Rapti, Aggeliki; Tsimpoukis, Sotirios; Charpidou, Andriani; Dannos, Ioannis; Kainis, Elias; Syrigos, Konstantinos

    2014-01-01

    Lung resection is still the only potentially curative therapy for patients with localized non-small lung cancer (NSCLC). However, the presence of cardiovascular comorbidities and underlying lung disease increases the risk of postoperative complications. Various studies have evaluated the use of different preoperative tests in order to identify patients with an increased risk for postoperative complications, associated with prolonged hospital stay and increased morbidity and mortality. In this topic review, we discuss the role of cardiopulmonary exercise testing (CPET) as one of the preoperative tests suggested for lung cancer patients scheduled for lung resection. We describe different types of exercise testing techniques and present algorithms of preoperative evaluation in lung cancer patients. Overall, patients with maximal oxygen consumption (VO2max) VO2max <15 mL/kg/min and both postoperative FEV1 and DLCO<40% predicted, are at high risk for perioperative death and postoperative cardiopulmonary complications, and thus should be offered an alternative medical treatment option. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Rex shunt preoperative imaging: diagnostic capability of imaging modalities.

    Directory of Open Access Journals (Sweden)

    Sharon W Kwan

    Full Text Available The purpose of this study was to evaluate the diagnostic capability of imaging modalities used for preoperative mesenteric-left portal bypass ("Rex shunt" planning. Twenty patients with extrahepatic portal vein thrombosis underwent 57 preoperative planning abdominal imaging studies. Two readers retrospectively reviewed these studies for an ability to confidently determine left portal vein (PV patency, superior mesenteric vein (SMV patency, and intrahepatic left and right PV contiguity. In this study, computed tomographic arterial portography allowed for confident characterization of left PV patency, SMV patency and left and right PV continuity in 100% of the examinations. Single phase contrast-enhanced CT, multi-phase contrast-enhanced CT, multiphase contrast-enhanced MRI, and transarterial portography answered all key diagnostic questions in 33%, 30%, 0% and 8% of the examinations, respectively. In conclusion, of the variety of imaging modalities that have been employed for Rex shunt preoperative planning, computed tomographic arterial portography most reliably allows for assessment of left PV patency, SMV patency, and left and right PV contiguity in a single study.

  18. Transabdominal ultrasonography in preoperative staging of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Sheng-Ri Liao; Ying Dai; Ling Huo; Kun Yan; Lin Zhang; Hui Zhang; Wen Gao; Min-Hua Chen

    2004-01-01

    AIM: To investigate the value of transabdominal ultrasonography (US) in the preoperative staging of gastric cancer.METHODS: A total of 198 patients with gastric cancer underwent preoperatively transabdominal US, depth of tumor infiltration was assessed in 125 patients, and lymph node metastasis was assessed in 106 patients.RESULTS: The staging accuracy of transabdominal US was 55.6%, 75.0%, 87.3% and 71.1% in T1, T2, T3 and T4 carcinomas, respectively. The overall accuracy was 77.6%.The detection rate for pancreatic invasion and liver invasion was 77.4%, 71.4%, respectively. The sensitivity, specificity,accuracy of transabdominal US in assessment of lymph node metastasis were 77.6%, 64.1%, 72.6%, respectively.Various shapes such as round, ovoid, spindle were encountered in benign and malignant lymph nodes. Majority of both benign and malignant lymph nodes were hyperechoic and had a distinct border. Benign lymph nodes were smaller than malignant lymph nodes in length and width (P = 0.000,0.005). Irregular shape, fusional shape, infiltrative signs,inhomogenous echo were seen mainly in malignant lymph nodes (P = 0.045, 0.006, 0.027, 0.006).CONCLUSION: Transabdominal US is useful for preoperative staging in gastric cancer, although it is difficult to differentiate benign from malignant lymph nodes.

  19. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Ricardo Hoelz de Oliveira; Penachim, Thiago Jose; Martins, Daniel Lahan; Andreollo, Nelson Adami; Caserta, Nelson Marcio Gomes, E-mail: rhobarros@hotmail.com [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil)

    2015-03-15

    Objective: To evaluate the role of multidetector computed tomography in the preoperative investigation of tumor invasion depth and lymph node and metastatic involvement according to the TNM classification, in patients with gastric adenocarcinoma. Materials and Methods: Fifty-four patients with biopsy-confirmed gastric cancer underwent preoperative staging with 64-channel multidetector computed tomography. Two independent radiologists analyzed the images and classified the findings. Sensitivity, specificity, accuracy and overall accuracy were calculated for each observer. The interobserver agreement was also evaluated. Results: The accuracy in the classification of categories T ranged from 74% to 96% for observer 1 and from 80% to 92% for observer 2. The overall accuracy was 70% for both observers. The weighted kappa index was 0.75, consistent with a significant interobserver agreement. The accuracy in the classification of lymph node involvement (category N) ranged from 55% to 79% for observer 1 and from 73% to 82% for observer 2. The evaluation of metastatic involvement showed an overall accuracy of 89.6% for both observers. Conclusion: 64-channel multidetector computed tomography demonstrated clinically relevant accuracy in the preoperative staging of gastric adenocarcinoma as regards invasion depth (T category) and metastatic involvement (M category). (author)

  20. The preoperative interview. Its effect on perioperative nurses' empathy.

    Science.gov (United States)

    Alverson, E

    1987-05-01

    Further studies need to be done to determine the impact preoperative visits have on the perioperative nurse's empathy level. The results of this study could be confirmed, or refuted, if a study with more subjects was conducted over a longer period of time. Also, subjects in both the control and experimental groups should be chosen randomly and should be from the same institution. To measure the long-term effect of preoperative visits on empathy levels, a study could be conducted that measures the levels at various times (eg, six months to a year following the first study). Other evaluations of empathy levels, such as observer rating and patient rating, could be used to supplement nurses self-rating scores to avoid using one standard instrument and rating scale. Few conclusions can be drawn from this limited study, but it does help nurses realize that preoperative interviews can help the nurse become more aware of the surgical patient as a human being. This increased awareness may help the nurse function more effectively and efficiently in helping the patient during intraoperative care.

  1. Parameters from preoperative overnight oximetry predict postoperative adverse events.

    Science.gov (United States)

    Chung, F; Zhou, L; Liao, P

    2014-10-01

    Continuous home monitoring of oxygen saturation has become a reliable and feasible practice. The objective of this study was to investigate the role of preoperative overnight oximetry in predicting postoperative adverse events. Following research ethics board approval, consented patients underwent a preoperative overnight monitoring of oxygen saturation with a portable oximeter. Parameters from the oximetry data were extracted and their predictive performance for postoperative adverse events was evaluated. A total of 573 patients were studied with age: 60±12 years and 45% male. Oxygen desaturation index (ODI), cumulative time percentage with SpO2 3.0 events/h, >9.2 events/h and > 28.5 events/h; CT90: >0.1%, >1.1% and >7.2%; mean SpO2: rate of postoperative adverse events. For ODI >28.5 vs. ODI ⋝28.5 events/h, the odds ratio adjusted with age, gender, body mass index and American Society of Anesthesiologists physical status was 2.2 (95% CI: 1.3-3.9). Patients with mean preoperative overnight SpO2 28.5 events/h or CT90 >7.2% are at higher risk for postoperative adverse events. Overnight oximetry could be a useful tool to stratify patients for the risk of postoperative adverse events.

  2. Preoperative staging of rectal cancer: the MERCURY research project.

    Science.gov (United States)

    Brown, G; Daniels, I R

    2005-01-01

    The development of a surgical technique that removes the tumour and all local draining nodes in an intact package, namely total mesorectal excision (TME) surgery, has provided the impetus for a more selective approach to the administration of preoperative therapy. One of the most important factors that governs the success of TME surgery is the relationship of tumour to the circumferential resection margin (CRM). Tumour involves the CRM in up to 20% of patients undergoing TME surgery, and results in both poor survival and local recurrence. It is therefore clear that the importance of the decision regarding the use of pre-operative therapy lies with the relationship of the tumour to the mesorectal fascia. In addition, a high-spatial-resolution MRI technique will identify tumours exhibiting other poor prognostic features, namely, extramural spread >5 mm, extramural venous invasion by tumour, nodal involvement, and peritoneal infiltration. The potential benefits of a selective approach using MRI-based selection criteria are evident. That is, over 50% of patients can be treated successfully with primary surgery alone without significant risk of local recurrence or systemic failure. Of the remainder, potentially dramatic improvements may be achieved through the use of intensive and targeted preoperative therapy aimed not only at reducing the size of the primary tumour and rendering potentially irresectable tumour resectable with tumour-free circumferential margins, but also at enabling patients at high risk of systemic failure to benefit from intensive combined modality therapy aimed at eliminating micrometastatic disease.

  3. Psychologists in preoperative programmes for children undergoing surgery.

    Science.gov (United States)

    Cuzzocrea, Francesca; Costa, Sebastiano; Gugliandolo, Maria Cristina; Larcan, Rosalba

    2016-06-01

    This study aimed to verify whether psychologists and game activities could reduce preoperative anxiety and promote compliance in paediatric patients. More specifically, we sought to evaluate whether it would be better to propose contextualized games or just distracting activities. A total of 104 children undergoing surgery were assigned to the following 4 conditions of treatment: (1) contextual games and psychological accompaniment, (2) only contextual games, (3) distracting activities, and (4) only psychological accompaniment. Observed children's anxiety was assessed using modified Yale Preoperative Anxiety Scale and compliant behaviours with modified form of Induction Compliance Checklist. Children in the first condition (complete intervention - contextual games and psychological accompaniment) were less anxious and more cooperative in the preoperative period and during the induction of anaesthesia than in the other three conditions. In particular, contextual activities (second condition) were found to be more efficient than psychological accompaniment (fourth condition), whereas the worst condition was proposing only distracting activities (third condition). In order to help young hospitalized patients in paediatric surgery structures, it is necessary to propose games that can prepare them for what will happen as well as the support of a psychologist.

  4. [Possibility of rice porridge for preoperative feeding in children].

    Science.gov (United States)

    Kushikata, T; Matsuki, A; Murakawa, T; Sato, K

    1996-08-01

    To determine the effect of rice porridge feeding before elective surgery on preoperative gastric fluid pH, volume and starvation, a prospective study was undertaken in pediatric patients. Twenty healthy children ranged in age from 5 to 12 years were allocated randomly to either a fasted or rice porridge group. The children of fasted group (control group) were allowed to take solid food until midnight before the operation. The rice porridge group (study group) patients received a small amount of rice porridge 5 hours 30 minutes before the induction of anesthesia. The patients of both groups were permitted to take clear fluid until 5 hours before the induction of anesthesia. After the induction of anesthesia, gastric fluid was aspirated through an orogastric tube. The mean gastric fluid volume was 0.43 +/- 0.32 ml.kg-1 in the control group and 0.5 +/- 0.6 ml.kg-1 in the study group. The mean gastric fluid pH was 1.43 +/- 0.27 ml.kg-1 in the control group and 1.89 +/- 0.75 ml.kg-1 in the study group. There were no significant differences between the two groups concerning the gastric fluid volume and pH. The patient of the study group complained of less hunger. Preoperative rice porridge feeding is a possible preoperative feeding for pediatric patients.

  5. Preoperative anemia, leukocytosis and thrombocytosis identify aggressive endometrial carcinomas.

    Science.gov (United States)

    Njølstad, Tormund S; Engerud, Hilde; Werner, Henrica M J; Salvesen, Helga B; Trovik, Jone

    2013-11-01

    The objective of this study is to investigate preoperative hematological parameters for anemia, leukocytosis and thrombocytosis in relation to established prognostic factors and survival in endometrial cancer. 557 patients treated for endometrial carcinoma were prospectively included in a study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathological characteristics and outcome. Preoperative anemia was present in 15.8%, leukocytosis in 11.2% and thrombocytosis in 12.1%. Among patients with localized disease (FIGO stage I/II), 18.1% had anemia and/or thrombocytosis at diagnosis. Patients with advanced disease (high FIGO stage and lymph-node metastasis) had significantly lower hemoglobin count, higher leukocyte count and higher platelet count (all pthrombocytosis had significantly shorter 5-year disease-specific survival of 61.3%, 66.0% and 61.0% respectively, compared to 87.7%, 86.3% and 87.3% for patients with normal counts (all pthrombocytosis in women with endometrial carcinoma is associated with advanced disease and poor disease-specific survival. © 2013.

  6. Exocrine drainage in vascularized pancreas transplantation in the new millennium

    Science.gov (United States)

    El-Hennawy, Hany; Stratta, Robert J; Smith, Fowler

    2016-01-01

    The history of vascularized pancreas transplantation largely parallels developments in immunosuppression and technical refinements in transplant surgery. From the late-1980s to 1995, most pancreas transplants were whole organ pancreatic grafts with insulin delivery to the iliac vein and diversion of the pancreatic ductal secretions to the urinary bladder (systemic-bladder technique). The advent of bladder drainage revolutionized the safety and improved the success of pancreas transplantation. However, starting in 1995, a seismic change occurred from bladder to bowel exocrine drainage coincident with improvements in immunosuppression, preservation techniques, diagnostic monitoring, general medical care, and the success and frequency of enteric conversion. In the new millennium, pancreas transplants are performed predominantly as pancreatico-duodenal grafts with enteric diversion of the pancreatic ductal secretions coupled with iliac vein provision of insulin (systemic-enteric technique) although the systemic-bladder technique endures as a preferred alternative in selected cases. In the early 1990s, a novel technique of venous drainage into the superior mesenteric vein combined with bowel exocrine diversion (portal-enteric technique) was designed and subsequently refined over the next ≥ 20 years to re-create the natural physiology of the pancreas with first-pass hepatic processing of insulin. Enteric drainage usually refers to jejunal or ileal diversion of the exocrine secretions either with a primary enteric anastomosis or with an additional Roux limb. The portal-enteric technique has spawned a number of newer and revisited techniques of enteric exocrine drainage including duodenal or gastric diversion. Reports in the literature suggest no differences in pancreas transplant outcomes irrespective of type of either venous or exocrine diversion. The purpose of this review is to examine the literature on exocrine drainage in the new millennium (the purported

  7. Implementation of a drainage information, analysis and management system

    Directory of Open Access Journals (Sweden)

    J.N. Meegoda

    2017-04-01

    Full Text Available An integrated drainage information, analysis and management system (DIAMS was developed and implemented for the New Jersey Department of Transportation (NJDOT. The purpose of the DIAMS is to provide a useful tool for managers to evaluate drainage infrastructure, to facilitate the determination of the present costs of preserving those infrastructures, and to make decisions regarding the optimal use of their infrastructure budgets. The impetus for DIAMS is the culvert information management system (CIMS, which is developed to manage the data for culvert pipes. DIAMS maintains and summarizes accumulated inspection data for all types of drainage infrastructure assets, including pipes, inlet/outlet structures, outfalls and manufactured treatment devices. DIAMS capabilities include identifying drainage infrastructure, maintaining inspection history, mapping locations, predicting service life based on the current condition states, and assessing present asset value. It also includes unit cost values of 72 standard items to estimate the current cost for new assets with the ability to adjust for future inflation. In addition, DIAMS contains several different repair, rehabilitation and replacement options to remedy the drainage infrastructure. DIAMS can analyze asset information and determine decisions to inspect, rehabilitate, replace or do nothing at the project and network levels by comparing costs with risks and failures. Costs may be optimized to meet annual maintenance budget allocations by prioritizing drainage infrastructure needing inspection, cleaning and repair. DIAMS functional modules include vendor data uploading, asset identification, system administration and financial analysis. Among the significant performance feature of DIAMS is its proactive nature, which affords decision makers the means of conducting a comprehensive financial analysis to determine the optimal proactive schedule for the proper maintenance actions and to prioritize them

  8. Nocturnal drainage wind characteristics in two converging air sheds

    Energy Technology Data Exchange (ETDEWEB)

    Gedayloo, T.; Clements, W.E.; Barr, S.; Archuleta, J.A.

    1980-01-01

    During the short experimental period in the Grants Basin of Northeastern New Mexico a survey was conducted on the complex meteorology of this area. Emphasis was placed on the nocturnal drainage flow because of the potential hazards to the populated areas of Milan and Grants from the effluents of the uranium mining and milling operation in this area. This investigation has shown that the nocturnal drainage flow patterns agree with the winds predicted on the basis of the complex terrain of the area. Because of the surface cooling at night (over 25/sup 0/C during summer and about 20/sup 0/C during winter), air from elevated surrounding areas flows to the low lying regions consequently setting up a nocturnal drainage flow. This regime exists over 60% of the time during summer months and over 65% of the time during winter months with a depth generally less than 200 m. In the San Mateo air shed the drainage flow is east northeast, and in the Ambrosia Lake air shed it is from northwest. The confluence of these two air flows contributes mainly to the drainage flow through the channel formed by La Ja Mesa and Mesa Montanosa. The analysis of data collected by the recording Flats Station confirms the prediction that although the area south of the channel region broadens considerably causing a reduction in flow speed, contributions from the southside of La Jara Mesa and Mesa Montanosa partly compensate for this reduction. The position of this recording station is 15 to 20 km from the populated towns of Milan and Grants. A drainage flow speed of approximately 2.2 m s/sup -1/ and the duration of over 11 hours as recorded by this station indicates that air from the San Mateo and Ambrosia Lake regions may be transported southwards to these population centers during a nocturnal period. In order to test this prediction, a series of multi-atmospheric tracer experiments were conducted in the Grants Basin.

  9. Routine abdominal drainage versus no abdominal drainage for uncomplicated laparoscopic cholecystectomy.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Koti, Rahul; Davidson, Brian R

    2013-09-03

    Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Drains are used after laparoscopic cholecystectomy to prevent abdominal collections. However, drain use may increase infective complications and delay discharge. The aim is to assess the benefits and harms of routine abdominal drainage in uncomplicated laparoscopic cholecystectomy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until February 2013. We included all randomised clinical trials comparing drainage versus no drainage after uncomplicated laparoscopic cholecystectomy irrespective of language and publication status. We used standard methodological procedures defined by The Cochrane Collaboration. A total of 1831 participants were randomised to drain (915 participants) versus 'no drain' (916 participants) in 12 trials included in this review. Only two trials including 199 participants were of low risk of bias. Nine trials included patients undergoing elective laparoscopic cholecystectomy exclusively. One trial included patients undergoing laparoscopic cholecystectomy for acute cholecystitis exclusively. One trial included patients undergoing elective and emergency laparoscopic cholecystectomy, and one trial did not provide this information. The average age of participants in the trials ranged between 48 years and 63 years in the 10 trials that provided this information. The proportion of females ranged between 55.0% and 79.0% in the 11 trials that provided this information. There was no significant difference between the drain group (1/840) (adjusted proportion: 0.1%) and the 'no drain' group (2/841) (0.2%) (RR 0.41; 95% CI 0.04 to 4.37) in short-term mortality in the ten trials with 1681 participants reporting on this outcome. There was no significant difference between the drain group (7/567) (adjusted proportion: 1.1%) and the 'no drain' group (3/576) (0.5%) in the

  10. Drainage filter technologies to mitigate site-specific phosphorus losses

    DEFF Research Database (Denmark)

    Kjærgaard, Charlotte; Heckrath, Goswin Johann; Iversen, Bo Vangsø

    2014-01-01

    of implementing the drainage filter technologies including surface-flow constructed wetlands, subsurface flow constructed wetlands, and drainage well filters (www.supremetech.dk). We will present results on P retention from (i) controlled column experiments with permeable filter substrates, and (ii) a full......-scale surface-flow constructed wetland. In the former, various natural and industrial P filter substrates have been tested for their ability to reduce inlet P concentrations to below environmental threshold values (... on laboratory experiments and field scale monitoring, the different filter technology approaches will be compared and evaluated from a case study perspective....

  11. THE APPLICATION OF CATIONIC POLYACRYLAMIDE AS DRAINAGE AND RETENTION AIDS

    Institute of Scientific and Technical Information of China (English)

    JinWang; KefuChen; FushanChent; ChuanshanZhao; RendangYang

    2004-01-01

    Cationic polyacrylamide (CPAM) which was prepared through complex initiation system in laboratory and cationic polyacrylamide (Ciba) were used asretention and drainage aids for bleached wheat strawpulp. The influences of (polydiallyldimethlammonium chloride) PDADMAC and PDADMAC/CPAMon Zeta potential and drainability of pulp was investigated. The dual drainage and retention systems suchas CPAM/modified bentonite, CPAM/colloidal SiO2,as well as their comparison between the two systemswere discussed, and the optimal dosages of additiveswere determined. The results showed that: the complex systems can further enhance filler retention,drainability of pulp and strength properties of paper.

  12. Quaternary Reorganization of North American Mid-continent Drainage Systems

    Science.gov (United States)

    Carson, E. C.; Rawling, J. E., III; Attig, J. W.; Bates, B. R.

    2013-12-01

    Identification of ancestral drainage systems in the North American mid-continent has been a topic of research and debate among geologists since the middle of the 19th Century. Over time our understanding of the significance of Quaternary glaciations in reshaping drainage patterns has grown. The ancestral Teays River, which drained large areas of the central Appalachians and flowed westward across Indiana and western Illinois, was dammed multiple times by Quaternary glaciers before finally being rerouted to the course of the modern central Ohio River. Similarly, the northward-flowing ancestral Pittsburgh River was dammed by pre-Illinoian glaciers; subsequent stream piracy converted this river system into the modern Allegheny, Monongahela and uppermost Ohio Rivers. Deposits and geomorphic features along the westward-flowing lower Wisconsin River indicate that the modern upper Mississippi River and Wisconsin River may have experienced a similar history of ice blockage, stream piracy, and radical rerouting. Coring into the Bridgeport strath terrace along the lower Wisconsin River reveals that the bedrock surface dips to the east, indicating the valley was cut by an eastward-flowing river. We believe the most likely scenario following this interpretation is that an ancestral river flowing along the modern upper Mississippi River valley made a sharp bend at Prairie du Chien, WI, and flowed eastward along the valley occupied by the modern lower Wisconsin River. This river, referred to here as the Wyalusing River, likely flowed northeastward into the Great Lakes (St. Lawrence) drainage until that path was blocked by ice advancing from the northwest. Subsequent stream piracy immediately south of the modern confluence of the Mississippi and Wisconsin Rivers rerouted these streams, converting them to the headwaters of the greater Mississippi drainage. The combined rerouting of these river systems into entirely different drainage basins necessitates significant fundamental

  13. Spontaneous drainage in syringomyelia: magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Bogdanov, E.I.; Mendelevich, E.G. [Kazan State Medical Univ. (Russian Federation). Dept. of Neurology and Rehabilitation; Ibatullin, M.M. [Republic Medical Diagnostic Centre of Tatarstan, Kazan (Russian Federation). Department of Radiology

    2000-09-01

    We present five cases of syringomyelia associated with Chiari I or other causes of partial obstructions at the cervicomedullary junction, with spontaneous disruption of the wall of a cervical syrinx and formation of a communication between the cavity and the subarachnoid space, shown on axial MRI. MRI can be used to investigate the hydrodynamics, showing the liquid inside the disrupted syrinx wall and the pathway of drainage. The finding of spontaneous drainage may be important for understanding the pathogenesis of syringomyelia and may be helpful for choosing a surgical approach. (orig.)

  14. Addition of Molecular Adsorbent Recirculating System (MARS® Albumin Dialysis for the Preoperative Management of Jaundiced Patients with Hilar Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Jean-Marc Regimbeau

    2013-09-01

    Full Text Available The preoperative management of hilar cholangiocarcinoma (HC with jaundice focuses on decreasing the total serum bilirubin level (SBL by performing preoperative biliary drainage (PBD. However, it takes about 6-8 weeks for the SBL to fall at a sufficient extent. The objective of this preliminary study was to evaluate the impact of Molecular Adsorbent Recirculating System (MARS® dialysis (in association with PBD on SBL decrease. From January 2010 to January 2011, we prospectively selected all jaundiced patients admitted to our university hospital for resectable HC and requiring PBD prior to major hepatectomy. The PBD was followed by 3 sessions of MARS dialysis over a period of 72 h. A total of 10 patients with HC were screened and two of them were included (Bismuth-Corlette stage IIIa, gender ratio 1, median age 68 years. The initial SBL in the two patients was 328 and 242 μmol/l, respectively. After three MARS dialysis sessions, the SBL had fallen by 30 and 52%, respectively. After the end of each session, there was a SBL rebound of about 10 μmol/l. The MARS decreased the serum creatinine level, the platelet count and the prothrombin index, but did not modify the serum albumin level. Pruritus disappeared after one and two sessions, respectively. MARS-related morbidity included hypotension (n = 1, tachycardia (n = 1, thrombocytopenia (n = 2 and anaemia (n = 1. When combined with PBD, MARS dialysis appears to accelerate the decrease in SBL and thus may enable earlier surgery. This hypothesis must be validated in a larger study.

  15. Open Drainage and Detention Basin Combined System Optimization

    Directory of Open Access Journals (Sweden)

    M. E. Banihabib

    2017-01-01

    Full Text Available Introduction: Since flooding causes death and economic damages, then it is important and is one of the most complex and destructive natural disaster that endangers human lives and properties compared to any other natural disasters. This natural disaster almost hit most of countries and each country depending on its policy deals with it differently. Uneven intensity and temporal distribution of rainfall in various parts of Iran (which has arid and semiarid climate causes flash floods and leads to too much economic damages. Detention basins can be used as one of the measures of flood control and it detains, delays and postpones the flood flow. It controls floods and affects the flood directly and rapidly by temporarily storing of water. If the land topography allows the possibility of making detention basin with an appropriate volume and quarries are near to the projects for construction of detention dam, it can be used, because of its faster effect comparing to the other watershed management measures. The open drains can be used alone or in combination with detention basin instead of detention basin solitarily. Since in the combined system of open and detention basin the dam height is increasing in contrast with increasing the open drainage capacity, optimization of the system is essential. Hence, the investigation of the sensitivity of optimized combined system (open drainage and detention basin to the effective factors is also useful in appropriately design of the combined system. Materials and Methods: This research aims to develop optimization model for a combined system of open drainage and detention basins in a mountainous area and analyze the sensitivity of optimized dimensions to the hydrological factors. To select the dam sites for detention basins, watershed map with scale of 1: 25000 is used. In AutoCAD environment, the location of the dam sites are assessed to find the proper site which contains enough storage volume of the detention

  16. EFFECTIVENESS OF AUTOGENIC DRAINAGE VERSUS POSTURAL DRAINAGE ON OXYGEN SATURATION IN PATIENTS WITH CHRONIC BRONCHITIS WITH 15 MINUTES POST THERAPY

    Directory of Open Access Journals (Sweden)

    V. Kiran

    2014-12-01

    Full Text Available Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD and autogenic drainage (AD on level of oxygen saturation in blood, and amount of sputum recovery. Methodology: The study was done on 60 patients with COPD. Dividing Patients into two group and patients were treated with PD or AD in separate Groups. The effectiveness of the treatment was measured up to 6 days. Pulse oximetry was monitored and sputum was collected immediately after treatment and 15 minutes following each treatment. Results: The results of the study shown that there was significant difference in the amount of sputum recovered with AD (14.0±3.5 g vs PD (24.4±3.0 g and significant differences in Oxygen saturation; during PD fell from 93.3±0.7% to 91.2±0.8% (p<0.01 and required 15 min following treatment to return to baseline. Oxygen saturation did not fall during AD and increased to gradually following complete treatment days (baseline, 93.3±0.8%; p<0.01. Conclusion: Hence this study concludes that Autogenic drainage is more effective in improving spo2 in COPD & does not cause a sudden fall in spo2 as occurs in Postural drainage immediately after therapy. And it can be better tolerated by patients with COPD while producing fewer benefits in sputum clearance. In concern to mean amount of secretion removal Postural is found to be more effective

  17. Preoperative anxiety-an important but neglected issue: A narrative review

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

    Full Text Available Anxiety is an emotional state characterized by apprehension and fear resulting from the anticipation of a threatening event. The incidence of preoperative anxiety ranges from 11% to 80% in adult patients and also varies among different surgical groups. Preoperative anxiety may lead to various problems and a wide range of physiological and psychological responses. A variety of objective and subjective methods are available for measuring preoperative anxiety. Every patient scheduled for surgery should be assessed for the presence of anxiety in their routine preoperative anesthesia assessment, and counseling should be done by anesthesiologist in patients with a high level of anxiety. Surgery information reduces anxiety in the preoperative period.

  18. Determining potential for microbial atrazine degradation in agricultural drainage ditches.

    Science.gov (United States)

    Tyler, Heather L; Khalid, Sheza; Jackson, Colin R; Moore, Matthew T

    2013-01-01

    Passage of agricultural runoff through vegetated drainage ditches has been shown to reduce the amount of pesticides, such as atrazine, exiting out of agricultural watersheds. Previous studies have found that microbial communities in soil from fields treated with atrazine display enhanced rates of atrazine degradation. However, no studies have examined the potential for atrazine degradation in ditches used to drain these lands. The purpose of the current study was to determine the potential of the drainage ditch soil microbial community for atrazine degradation. Soil samples were collected from fields and adjacent drainage ditches and from nonagricultural land with no previous exposure to atrazine. Polymerase chain reaction analysis indicated widespread presence of atrazine degradation genes in fields and ditches. Potential for degradation was determined by following the decrease of atrazine in spiked soil samples over a 28-d incubation period. Greater than 95% of atrazine was degraded in field and ditch soils, whereas only 68.5 ± 1.3% was degraded in the nonagricultural control. Comparison with autoclaved soil samples indicated the primary mechanism of atrazine degradation in agricultural soils was microbially mediated, whereas its breakdown in nonagricultural soil appeared to be the byproduct of abiotic processes. Therefore, microbial communities in drainage ditch sediments have the potential to play a role in atrazine removal from agricultural runoff by breaking down atrazine deposited in sediments and limiting the amount of this herbicide carried into downstream ecosystems.

  19. Urban drainage models simplifying uncertainty analysis for practitioners

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Mikkelsen, Peter Steen; Deletic, Ana

    2013-01-01

    There is increasing awareness about uncertainties in the modelling of urban drainage systems and, as such, many new methods for uncertainty analyses have been developed. Despite this, all available methods have limitations which restrict their widespread application among practitioners. Here, a m...

  20. Renal lymphangiomatosis during pregnancy: management with percutaneous drainage

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-01-01

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

  1. Hydrogeochemistry and microbiology of mine drainage: An update

    Science.gov (United States)

    Nordstrom, D. Kirk; Blowes, D.W; Ptacek, C.J.

    2015-01-01

    The extraction of mineral resources requires access through underground workings, or open pit operations, or through drillholes for solution mining. Additionally, mineral processing can generate large quantities of waste, including mill tailings, waste rock and refinery wastes, heap leach pads, and slag. Thus, through mining and mineral processing activities, large surface areas of sulfide minerals can be exposed to oxygen, water, and microbes, resulting in accelerated oxidation of sulfide and other minerals and the potential for the generation of low-quality drainage. The oxidation of sulfide minerals in mine wastes is accelerated by microbial catalysis of the oxidation of aqueous ferrous iron and sulfide. These reactions, particularly when combined with evaporation, can lead to extremely acidic drainage and very high concentrations of dissolved constituents. Although acid mine drainage is the most prevalent and damaging environmental concern associated with mining activities, generation of saline, basic and neutral drainage containing elevated concentrations of dissolved metals, non-metals, and metalloids has recently been recognized as a potential environmental concern. Acid neutralization reactions through the dissolution of carbonate, hydroxide, and silicate minerals and formation of secondary aluminum and ferric hydroxide phases can moderate the effects of acid generation and enhance the formation of secondary hydrated iron and aluminum minerals which may lessen the concentration of dissolved metals. Numerical models provide powerful tools for assessing impacts of these reactions on water quality.

  2. Reduced adipose tissue lymphatic drainage of macromolecules in obese subjects

    DEFF Research Database (Denmark)

    Arngrim, N; Simonsen, L; Holst, Jens Juul

    2012-01-01

    The aim of this study was to investigate subcutaneous adipose tissue lymphatic drainage (ATLD) of macromolecules in lean and obese subjects and, furthermore, to evaluate whether ATLD may change in parallel with adipose tissue blood flow. Lean and obese male subjects were studied before and after ...... online publication, 3 July 2012; doi:10.1038/ijo.2012.98....

  3. DETERMINATION OF EFFICIENCY OF THE CIRCUMFERENTIAL DRAINAGE SYSTEM

    Directory of Open Access Journals (Sweden)

    Maciej Kroll

    2015-11-01

    Full Text Available One of the potential alternatives to improve the stability coefficient for an embankment structure is to flatten the filtration curve. As a result, we obtain lower body forces triggering the potential landslide and more advantageous soil strength parameters, which counteract landslide movements. In the case of waste dumps lowering the phreatic surface of waters is achieved thanks to the construction of auxiliary drainage systems, meeting the guidelines for their safe operation. The aim of this paper is to indicate a method facilitating the determination of the actual position of the phreatic surface within the deposited sediments and the assessment of efficiency of the circumferential drainage system in the waste dump. It was decided in this study to apply cone penetration test CPTU. The CPTU made it possible to measure dissipation of excess water pressure in pores identifying drainage conditions, which were compared with the results of piezometric measurements. The results of these tests made it possible to monitor changes in the position of the depression curve of supernatant waters in dams and to determine the efficiency of the circumferential drainage system.

  4. Sulfate Reduction at Low Ph To Remediate Acid Mine Drainage

    NARCIS (Netherlands)

    Sánchez-Andrea, I.; Sanz, J.L.; Bijmans, M.F.M.; Stams, A.J.M.

    2014-01-01

    Industrial activities and the natural oxidation of metallic sulfide-ores produce sulfate-rich waters with low pH and high heavy metals content, generally termed acid mine drainage (AMD). This is of great environmental concern as some heavy metals are highly toxic. Within a number of possibilities,

  5. Runway drainage characteristics related to tire friction performance

    Science.gov (United States)

    Yager, Thomas J.

    1991-01-01

    The capability of a runway pavement to rapidly drain water buildup during periods of precipitation is crucial to minimize tire hydroplaning potential and maintain adequate aircraft ground operational safety. Test results from instrumented aircraft, ground friction measuring vehicles, and NASA Langley's Aircraft Landing Dynamics Facility (ALDF) track have been summarized to indicate the adverse effects of pavement wetness conditions on tire friction performance. Water drainage measurements under a range of rainfall rates have been evaluated for several different runway surface treatments including the transversely grooved and longitudinally grinded concrete surfaces at the Space Shuttle Landing Facility (SLF) runway at NASA Kennedy Space Center in Florida. The major parameters influencing drainage rates and extent of flooding/drying conditions are identified. Existing drainage test data are compared to a previously derived empirical relationship and the need for some modification is indicated. The scope of future NASA Langley research directed toward improving empirical relationships to properly define runway drainage capability and consequently, enhance aircraft ground operational safety, is given.

  6. Sulfate Reduction at Low Ph To Remediate Acid Mine Drainage

    NARCIS (Netherlands)

    Sánchez-Andrea, I.; Sanz, J.L.; Bijmans, M.F.M.; Stams, A.J.M.

    2014-01-01

    Industrial activities and the natural oxidation of metallic sulfide-ores produce sulfate-rich waters with low pH and high heavy metals content, generally termed acid mine drainage (AMD). This is of great environmental concern as some heavy metals are highly toxic. Within a number of possibilities, b

  7. Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts

    DEFF Research Database (Denmark)

    Ng, Pui Yung; Nytoft Rasmussen, Ditlev; Vilmann, Peter;

    2013-01-01

    OBJECTIVE: Endoscopic ultrasound (EUS)-guided drainage is a widely used treatment modality for pancreatic pseudocysts (PPC). However, data on the clinical outcome and complication rates are conflicting. Our study aims to evaluate the rates of technical success, treatment success and complications...

  8. [Is suction drainage necessary in elective total hip arthroplasty?].

    Science.gov (United States)

    Major, Tibor; Bikov, András; Holnapy, Gergely; Bejek, Zoltán; Bakos, Bernadett; Szendrői, Miklós; Skaliczki, Gábor

    2016-07-01

    Several studies have been published which questioned the use of suction drain during elective hip arthroplasty. In this prospective study the authors examined how the use of suction drainage affected complications related to perioperative blood loss and hemorrhage in patients undergoing elective hip arthroplasty. Eighty-six patients undergoing elective hip arthroplasty were divided into two groups. In 54 patients ("drain" group) suction drains were used during operation, whereas in 32 patients no suction drain was applied. Perioperative blood loss, use of tranexamic acid, method of thrombosis prophylaxis, transfusion requirement, incidental postoperative hemorrhage, septic complications, and all other postoperative complications were recorded. Perioperative blood loss was affected with the use of tranexamic acid but not with the use of drainage (p = 0.94). Patients without the use of drain showed a tendency of lower transfusion requirement (p = 0.08). There was no correlation between any complications and the use of drainage. In accordance with published results the authors conclude that the routine use of suction drainage during elective hip arthroplasty is not definitely necessary. Orv. Hetil., 2016, 157(29), 1171-1176.

  9. Drainage water management effects on tile dicharge and water quality

    Science.gov (United States)

    Drainage water management (DWM) has received considerable attention as a potential best management practice for improving water quality in tile drained landscapes. However, only a limited number of studies have documented the effectiveness of DWM in mitigating nitrogen (N) and phosphorus (P) loads. ...

  10. Temporal abiotic variability structures invertebrate communities in agricultural drainage ditches

    NARCIS (Netherlands)

    Whatley, M.H.; Vonk, J.A.; van der Geest, H.G.; Admiraal, W.

    2015-01-01

    Abiotic variability is known to structure lotic invertebrate communities, yet its influence on lentic invertebrates is not clear. This study tests the hypothesis that variability of nutrients and macro-ions are structuring invertebrate communities in agricultural drainage ditches. This was determine

  11. Treating coal mine drainage with an artificial wetland. [USA - Ohio

    Energy Technology Data Exchange (ETDEWEB)

    Fennessy, M.S.; Mitsch, W.J. (Ohio State University Columbus, OH (USA). School of Natural Resources)

    A 0.22-ha constructed wetland dominated by Typha latofolia was evaluated for its ability to treat approximately 340 L/min of coal mine drainage from an underground seep in eastern Ohio. Loading of mine drainage to the wetland ranged from 15 to 35 cm/d. Conductivity, pH, manganese, and sulfate were little changed by the wetland. Iron decreased by 50 to 60%, with slightly higher decreases during the growing season. Comparisons are made to a volunteer Typha marsh receiving mine drainage where iron was found to decrease by approximately 89%. Design considerations of loading rates of created wetlands suggest that improved treatment of mine drainage is correlated with longer retention times and lower iron loading rates. Preliminary design criteria for construction of these types of Typha wetlands for removal of iron are suggested as 5 cm/d hydrologic loading and 2 to 40 g Fe/m{sup 2}.d for iron loading, depending on the treatment desired. 34 refs., 8 figs., 5 tabs.

  12. Internal hydraulics of an agricultural drainage denitrification bioreactor

    Science.gov (United States)

    Denitrification bioreactors to reduce the amount of nitrate-nitrogen in agricultural drainage are now being deployed across the U.S. Midwest. However, there are still many unknowns regarding internal hydraulic-driven processes in these "black box" engineered treatment systems. To improve this unders...

  13. Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Lyul; Cho, June Sik; Kwon, Soon Tae; Lee, Sang Jin; Rhee, Byung Chull [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1993-11-15

    Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as result of partial or complete obstruction of the bile duct, and may manifest clinically severe form of disease, rapidly deteriorating to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying cause were 12 benign disease(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis(n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients resulting in improvement of general condition and failed in three patients. The procedure were preterminated due to the patient's condition in two and biliary-proto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggest that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.

  14. Uncertainty Assessment in Urban Storm Water Drainage Modelling

    DEFF Research Database (Denmark)

    Thorndahl, Søren

    The object of this paper is to make an overall description of the author's PhD study, concerning uncertainties in numerical urban storm water drainage models. Initially an uncertainty localization and assessment of model inputs and parameters as well as uncertainties caused by different model...

  15. Drainage ditches facilitate frog movements in a hostile landscape

    Science.gov (United States)

    Mazerolle, M.J.

    2005-01-01

    Ditches are common in landscapes influenced by agricultural, forestry, and peat mining activities, and their value as corridors remains unassessed. Pond-breeding amphibians can encounter hostile environments when moving between breeding, summering, or hibernation sites, and are likely to benefit from the presence of ditches in the landscape. Within a system consisting of ditch networks in bogs mined for peat in eastern New Brunswick, Canada, I quantified the breeding, survival, and movements of green frogs (Rana clamitans melanota) in drainage ditches and also surveyed peat fields. Frogs rarely ventured on peat fields and most individuals frequented drainage ditches containing water, particularly in late summer. Though frogs did not breed in ditches, their survival rate in ditches was high (88%). Ditches did not hinder frog movements, as frogs moved independently of the current. Results indicate that drainage ditches containing water enable some movements between habitats isolated by peat mining, in contrast to peat surfaces, and suggest they function as amphibian movement corridors. Thus, such drainage ditches may mitigate the effects of peat extraction on amphibian populations. At the very least, these structures provide an alternative to hostile peat surfaces. This study highlights that small-scale corridors are potentially valuable in population dynamics. ?? Springer 2005.

  16. Burr Hole Drainage for Complicated Spontaneous Intracranial Hypotension Syndrome

    Directory of Open Access Journals (Sweden)

    Yu-Fang Liu

    2008-09-01

    Full Text Available Spontaneous intracranial hypotension is a potentially severe condition that is caused by continuous cerebrospinal fluid leakage. Clinically, most patients have a benign course and the condition remits after conservative management. We report two consecutive patients who presented with acute expansion of subdural collection and disturbed consciousness. Both patients recovered completely after undergoing burr hole drainage.

  17. 7th international conference on acid rock drainage

    Energy Technology Data Exchange (ETDEWEB)

    Barnhisel, R.I. (ed.)

    2006-07-01

    This meeting also serves as the 23rd annual meeting of the American Society of Mining and Reclamation. The papers discussed various aspects of acid mine drainage including its impact, sustainability issues, case studies, lessons learned, characterization, closure/land use issues, emerging technologies, forestry/ecology, abandoned mine lands, modelling, pit lakes/backfill, soils and overburden, and treatment.

  18. Temporal abiotic variability structures invertebrate communities in agricultural drainage ditches

    NARCIS (Netherlands)

    Whatley, M.H.; Vonk, J.A.; van der Geest, H.G.; Admiraal, W.

    2015-01-01

    Abiotic variability is known to structure lotic invertebrate communities, yet its influence on lentic invertebrates is not clear. This study tests the hypothesis that variability of nutrients and macro-ions are structuring invertebrate communities in agricultural drainage ditches. This was

  19. Self-similar solutions for the foam drainage equation

    NARCIS (Netherlands)

    Zitha, P.L.J.; Vermolen, F.J.

    2003-01-01

    The travelling wave solutions of the equation for foam drainage in porous media are developed taking into account the mass conservation criterion. The existence of traveling wave solutions is also discussed. Finally, numerical solutions are obtained using a finite difference scheme together with the

  20. Artificial neural networks as a tool in urban storm drainage

    DEFF Research Database (Denmark)

    Loke, E.; Warnaars, E.A.; Jacobsen, P.

    1997-01-01

    The introduction of Artificial Neural Networks (ANNs) as a tool in the field of urban storm drainage is discussed. Besides some basic theory on the mechanics of ANNs and a general classification of the different types of ANNs, two ANN application examples are presented: The prediction of runoff...

  1. Occurrence of amphibians in northern California coastal dune drainages

    Science.gov (United States)

    Halstead, Brian J.; Kleeman, Patrick M.

    2017-01-01

    Many coastal dune ecosystems have been degraded by non-native dune vegetation, but these systems might still provide valuable habitat for some taxa, including amphibians. Because restoration of degraded dune systems is occurring and likely to continue, we examined the occurrence of amphibians in drainages associated with a coastal dune ecosystem degraded by invasive plants (European Beachgrass, Ammophila arenaria, and Iceplant, Carpobrotus edulis). We found that occupancy of 3 amphibian species (California Red-legged Frog, Rana draytonii; Sierran Treefrog, Hyliola sierra; and Rough-skinned Newt, Taricha granulosa) among 21 coastal-dune drainages was high, with most coastal-dune drainages occupied by all 3 species. Furthermore, reproduction of Sierran Treefrogs and California Red-legged Frogs was estimated to occur in approximately ½ and ⅓ of the drainages, respectively. The probability of occurrence of Rough-skinned Newts and pre-metamorphic life stages of both anurans decreased during the study, perhaps because of ongoing drought in California or precipitation-induced changes in phenology during the final year of the study. Maintaining structural cover and moist features during dune restoration will likely benefit native amphibian populations inhabiting coastal-dune ecosystems.

  2. Early and late assessment of internal drainage of chronic dacryocystitis

    NARCIS (Netherlands)

    Mansour, K; Janssen, A. G.; van Bijsterveld, OP

    2003-01-01

    To evaluate the efficacy of internal drainage of a lacrimal abscess, we treated 10 patients with pyocele of the lacrimal sac, who did not want to undergo operative intervention. A temporary nasolacrimal stent was placed in the nasolacrimal duct, and the pussy material was collected for microbiologic

  3. Maintenance and Drainage Guidance for the Scott Base Transition, Antarctica

    Science.gov (United States)

    2014-10-01

    12 12 Shake plates and clean off rock help shake dust and mud off vehicles and keep them clean prior to...water drilling to drain the retention ponds ......................................................................... 24 20 Drill sites for drainage...large cuts and chasms of ice melt and erosion will result. In addition, water and melting on the Land Transition results in mud , which invariably ends

  4. Computed tomography diagnosis of partial anomalous pulmonary venous drainage.

    Science.gov (United States)

    Posniak, H V; Dudiak, C M; Olson, M C

    1993-01-01

    A case of the rarely occurring partial anomalous pulmonary venous drainage of the right upper lobe into the azygos arch is presented. Computed tomography (CT) clearly demonstrated the abnormal vessel coursing through the right upper lobe and draining into the azygos arch.

  5. HANDBOOK FOR CONSTRUCTED WETLANDS RECEIVING ACID MINE DRAINAGE

    Science.gov (United States)

    In the summer of 1987, a pilot constructed wetland was built at the Big Five Tunnel in Idaho Springs, Colorado. This report details the theory, design and construction of wetlands receiving acid mine drainages, based on the second and third year of operation of this wetland, whic...

  6. Robust options to remove nitrate and phosphate from tile drainage

    NARCIS (Netherlands)

    Jansen, Stefan; Gerritse, Jan; Stuurman, Roelof; Chardon, W.J.; Talens, René

    2016-01-01

    Diffuse emission from agricultural land is a major, persistent source of nitrogen and phosphorus in surface waters. In this contribution, we present field experiments of a series of robust options to remove nitrate and phosphorus at
    field drainage level. Nitrate removal was enhanced by stimulati

  7. The heat budget of the Ross drainage basin

    NARCIS (Netherlands)

    Oerlemans, J.

    1987-01-01

    Integration of the thermodynamic equation over an entire drainage basin yields a fairly simple expression for the steady-state heat balance. This stems from the fact that dissipative heating can be calculated directly from the release of gravitational energy. When mass balance, surface temperature a

  8. Determining potential for microbial atrazine degradation in agricultural drainage ditches

    Science.gov (United States)

    Passage of agricultural runoff through vegetated drainage ditches has been shown to reduce the amount of pesticides, such as atrazine, exiting agricultural watersheds. Previous studies found that microbial communities in soil from fields treated with atrazine display enhanced rates of atrazine degr...

  9. Oscillatory subglacial drainage in the absence of surface melt

    Directory of Open Access Journals (Sweden)

    C. Schoof

    2013-11-01

    Full Text Available The presence of strong diurnal cycling in basal water pressure records obtained during the melt season is well-established for many glaciers. The behaviour of the drainage system outside the melt season is less well understood. Here we present borehole observations from a surge-type valley glacier in the St Elias Mountains, Yukon Territory, Canada. These indicate the onset of strongly correlated multi-day oscillations in water pressure in multiple boreholes straddling a main drainage axis, starting several weeks after the disappearance of a dominant diurnal mode in August 2011 and persisting until at least January 2012, when multiple data loggers suffered power failure. Jökulhlaups provide a template for understanding spontaneous water pressure oscillations not driven by external supply variability. Using a subglacial drainage model, we show that water pressure oscillations can also be driven on a much smaller scale by the interaction between conduit growth and distributed water storage in smaller water pockets, basal crevasses and moulins, and that oscillations can be triggered when water supply drops below a critical value. We suggest this in combination with a steady background supply of water from groundwater or englacial drainage as a possible explanation for the observed wintertime pressure oscillations.

  10. Percutaneous drainage of abscess in the treatment of emphysematous pyelonephritis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Yong; Jeong, Yong Yeon; Kim, Jae Kyu; Park, Seung Jei; Park, Jin Gyoon; Kang, Heoung Keun [Chonnam Univ. School of Medicine, Kwangju (Korea, Republic of); Roh, Byung Suk [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    1997-02-01

    To assess the usefulness of percutaneous drainage of abscess in the treatment of emphysematous pyelonephritis. Ten cases of nine patients with emphysematous pyelonephritis were percutaneously drained. All were suffering from diabetes mellitus. The procedure was performed under fluoroscopic guidance in nine cases and US guidance in one case in which bilateral multiloculated abscesses were present in the perirenal space. The results were classified as cure, partial success, recurrence, or failure. The mean drainage period and complication were analyzed. Eight cases were cured, and there was one case success. In one case, who had diffuse renal parenchymal destruction without perirenal fluid collection, the treatment failed. The longest drainage period was 45 days, in a case of re-insertion due to incidental catheter removal; the mean was 23 days. Bacteremia in one case was cured with antibiotic therapy which lasted two days. In diabetic patients, percutaneous drainage of obscess is thought to be a safe and effective method for the treatment of emphysematous pyelonephritis, and is one that does not involve diffuse destruction of renal parenchyma.

  11. Integrating Local Scale Drainage Measures in Meso Scale Catchment Modelling

    Directory of Open Access Journals (Sweden)

    Sandra Hellmers

    2017-01-01

    Full Text Available This article presents a methodology to optimize the integration of local scale drainage measures in catchment modelling. The methodology enables to zoom into the processes (physically, spatially and temporally where detailed physical based computation is required and to zoom out where lumped conceptualized approaches are applied. It allows the definition of parameters and computation procedures on different spatial and temporal scales. Three methods are developed to integrate features of local scale drainage measures in catchment modelling: (1 different types of local drainage measures are spatially integrated in catchment modelling by a data mapping; (2 interlinked drainage features between data objects are enabled on the meso, local and micro scale; (3 a method for modelling multiple interlinked layers on the micro scale is developed. For the computation of flow routing on the meso scale, the results of the local scale measures are aggregated according to their contributing inlet in the network structure. The implementation of the methods is realized in a semi-distributed rainfall-runoff model. The implemented micro scale approach is validated with a laboratory physical model to confirm the credibility of the model. A study of a river catchment of 88 km2 illustrated the applicability of the model on the regional scale.

  12. Continuous Passive Sampling of Solutes from Agricultural Subsurface Drainage Tubes

    Science.gov (United States)

    Lindblad Vendelboe, Anders; de Jonge, Hubert; Rozemeijer, Joachim; Wollesen de Jonge, Lis

    2015-04-01

    Agricultural subsurface tube drain systems play an important role in water and solute transport. One study, focusing on lowland agricultural catchments, showed that subsurface tube drainage contributed up to 80% of the annual discharge and 90% of the annual NO3 load from agricultural fields to the receiving water bodies. Knowledge of e.g. nutrient loads and drainage volumes, based on measurements and modelling, are important for adequate water quality management. Despite the importance of tube drain transport of solutes, monitoring data are scarce. This scarcity is a result of the existing monitoring techniques for flow and contaminant load from tube drains being expensive and labor-extensive. The study presented here aimed at developing a cheap, simple, and robust method to monitor solute loads from tube drains. The method is based on the newly developed Flowcap, which can be attached to existing tube drain outlets and can measure total flow, contaminant load and flow-averaged concentrations of solutes in the drainage. The Flowcap builds on the existing Sorbicell principle, a passive sampling system that measures average concentrations over longer periods of time (days to months) for various compounds. The Sorbicell consists of two compartments permeable to water. One compartment contains an adsorbent and one contains a tracer. When water passes through the Sorbicell the compound of interest is absorbed while a tracer is released. Using the tracer loss to calculate the volume of water that has passed the Sorbicell it is possible to calculate the average concentration of the compound. When mounting Sorbicells in the Flowcap, a flow-proportional part of the drainage is sampled from the main stream. To accommodate the wide range of drainage flow rates two Flowcaps with different capacities were tested in the laboratory: one with a capacity of 25 L min-1 (Q25) and one with a capacity of 256 L min-1 (Q256). In addition, Sorbicells with two different hydraulic

  13. A newly developed open-end intracranial hematoma drainage tube

    Institute of Scientific and Technical Information of China (English)

    Chao He; Nongnaphat Wanussakul; Dong Yang; Tianya Wu; Ming Zhao

    2016-01-01

    Methods:The newly developed device consists of two parts:the plunger and barrel. On one side, the barrel is bullet shaped with an opening tip. The plunger is located in the middle cavity of the tube barrel and extended out at the open-end. It was designed for strengthening the tube barrel and for convenience in performing the drainage procedure. It can be used by inserting the drainage tube into the lesion and pulling out the plunger, whereby blood will forcefully rise up inside the barrel, providing a satisfactory outcome. It is made for effusion drainage purposes. During the procedure, the drainage tip is placed at the deepest part of the intracranial hematoma to completely drain the blood. Moreover, the plunger fits tightly in the tube, preventing leakage during the operation. With the use of the device, brain can be separated. In addition, the device can help reduce the risk of cerebral damage because of the small operating area. The barrel sidewall has matching opening holes bilaterally and equally for exchanging substances between the inner and outer parts. The overlapping ratio in each horizontal pair is around 1/3–1/2. Each pair on the opposite side will form a different pressure. Thus, the opening holes will not easily get blocked with blood clot. Results: Blood and accumulated liquid from the deepest part of the intracranial hematoma can be directly drawn through the drainage tube without damaging a large area. The tube does not get blocked easily and allows for complete removal of the hematoma. Conclusions:The device is asuitable instrument for clinical application.

  14. Non-drainage scleral buckling with solid silicone elements

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2014-01-01

    Full Text Available Background: With the increasing number of cataract surgeries, incidence of posterior segment complications including rhegmatogenous retinal detachment (RRD is likely to rise. Scleral buckling (SB surgery is an effective and less expensive option. The primary advantage of non-drainage procedure is avoidance of possible complications associated with trans-choroidal drainage. The aim of present study is to describe the clinical profile of subjects undergoing non-drainage SB surgery with solid silicone elements for RRD and analyze their treatment outcomes. Materials and Methods: This was a retrospective, non-randomized, interventional study at a tertiary care center. Three hundred and six eyes of 298 patients undergoing non-drainage SB surgery with solid silicone elements from year 2000 to 2006 were included. Inclusion criteria were primary RRD, peripheral depressible retinal break, media clarity affording peripheral retinal view and proliferative vitreo-retinopathy (PVR up to grade C2. Uni- and multivariate analyses was done to analyze factors affecting anatomical and visual outcomes. Statistical analysis was performed using SPSS Version 10. Results: Mean follow-up was 303 ± 393.33 days. Primary anatomical success was obtained in 279 (91.2% eyes; primary functional success in 286 (93.5% eyes. PVR (grade B or C, intraocular pressure <10 mm Hg and the inability to find a retinal break were significantly associated with final anatomical failure. Baseline vision ≤3/60 was significantly associated with poor visual recovery. Conclusions: SB surgery is reasonably safe and highly efficacious. Solid silicone elements are effective in non-drainage SB surgery. However, case selection is important.

  15. Modeling Antarctic subglacial lake filling and drainage cycles

    Directory of Open Access Journals (Sweden)

    C. F. Dow

    2015-11-01

    Full Text Available The growth and drainage of active subglacial lakes in Antarctica has previously been inferred from analysis of ice surface altimetry data. We use a subglacial hydrology model applied to a synthetic Antarctic ice stream to determine internal controls on the filling and drainage of subglacial lakes and their impact on ice stream dynamics. Our model outputs suggest that the highly constricted subglacial environment of the ice stream, combined with relatively high rates of water flow funneled from large catchments, can combine to create a system exhibiting slow-moving pressure waves. Over a period of years, the accumulation of water in the ice stream onset region results in a buildup of pressure creating temporary channels, which then evacuate the excess water. This increased flux of water through the ice stream drives lake growth. As the water body builds up, it too steepens the hydraulic gradient and allows greater flux out of the overdeepened lake basin. Eventually this flux is large enough to create channels that cause the lake to drain. Due to the presence of the channels, the drainage of the lake causes high water pressures around 50 km downstream of the lake rather than immediately in the vicinity of the overdeepening. Following lake drainage, channels again shut down. Lake drainage depends on the internal hydrological development in the wider system and therefore does not directly correspond to a particular water volume or depth. This creates a highly temporally and spatially variable system, which is of interest for assessing the importance of subglacial lakes in ice stream hydrology and dynamics.

  16. Providing Preoperative Information for Children Undergoing Surgery: A Randomized Study Testing Different Types of Educational Material to Reduce Children's Preoperative Worries

    Science.gov (United States)

    Fernandes, S. C.; Arriaga, P.; Esteves, F.

    2014-01-01

    This study developed three types of educational preoperative materials and examined their efficacy in preparing children for surgery by analysing children's preoperative worries and parental anxiety. The sample was recruited from three hospitals in Lisbon and consisted of 125 children, aged 8-12 years, scheduled to undergo outpatient surgery. The…

  17. Providing Preoperative Information for Children Undergoing Surgery: A Randomized Study Testing Different Types of Educational Material to Reduce Children's Preoperative Worries

    Science.gov (United States)

    Fernandes, S. C.; Arriaga, P.; Esteves, F.

    2014-01-01

    This study developed three types of educational preoperative materials and examined their efficacy in preparing children for surgery by analysing children's preoperative worries and parental anxiety. The sample was recruited from three hospitals in Lisbon and consisted of 125 children, aged 8-12 years, scheduled to undergo outpatient surgery.…

  18. Preoperative preparation of patients with pituitary gland disorders.

    Science.gov (United States)

    Malenković, Vesna; Gvozdenović, Ljiljana; Milaković, Branko; Sabljak, Vera; Ladjević, Nebojsa; Zivaljević, Vladan

    2011-01-01

    This paper presents the most common disorders of pituitary function: acromegaly, hypopituitarism, diabetes insipidus and syndrome similar to diabetes insipidus, in terms of their importance in preoperative preparation of patients. Pituitary function manages almost the entire endocrine system using the negative feedback mechanism that is impaired by these diseases. The cause of acromegaly is a pituitary adenoma, which produces growth hormone in adults. Primary therapy of acromegaly is surgical, with or without associated radiotherapy. If a patient with acromegaly as comorbidity prepares for non-elective neurosurgical operation, then it requires consultation with brain surgeons for possible delays of that operation and primary surgical treatment of pituitary gland. If operative treatment of pituitary gland is carried out, the preoperative preparation (for other surgical interventions) should consider the need for perioperative glucocorticoid supplementation. Panhypopituitarism consequences are different in children and adults and the first step in diagnosis is to assess the function of target organs. Change of electrolytes and water occurs in the case of pituitary lesions in the form of central or nephrogenic diabetes insipidus as a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Preoperative preparation of patients with pituitary dysfunction should be multidisciplinary, whether it is a neurosurgical or some other surgical intervention. The aim is to evaluate the result of insufficient production of pituitary hormones (hypopituitarism), excessive production of adenohypophysis hormones (acromegaly, Cushing's disease and hyperprolactinemia) and the influence of pituitary tumours in surrounding structures (compression syndrome) and to determine the level of perioperative risk. Pharmacological suppressive therapy of the hyperfunctional pituitary disorders can have significant interactions with drugs used in the perioperative period.

  19. [Design of a preoperative predictive score for choledocholithiasis].

    Science.gov (United States)

    Bueno Lledó, Jose; Ibáñez Cirión, Jose Luis; Torregrosa Gallud, Antonio; López Andújar, Rafael

    2014-11-01

    Choledocholithiasis is the most common cause of obstructive jaundice and occurs in 5-10% of patients with cholelithiasis. To design a preoperative predictive score for choledocholithiasis. A prospective study was carried out in 556 patients admitted to our department for biliary disease. Preoperative clinical, laboratory, and ultrasound variables were compared between patients without choledocholithiasis and 65 patients with this diagnosis. A multivariate logistic analysis was performed to obtain a predictive model of choledocholithiasis, determining sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Predictors of choledocholithiasis were the presence of a prior history of biliary disease (history of biliary colic, acute cholecystitis, choledocholithiasis or acute biliary pancreatitis) (p=0.021, OR=2.225, 95% CI: 1.130-4.381), total bilirubin values >4mg/dl (p=0.046, OR=2.403, 95% CI: 1.106-5.685), alkaline phosphatase values >150mg/dl (p=0.022 income, OR=2.631, 95%: 1.386-6.231), gamma-glutamyltransferase (GGT) values >100mg/dl (p=0.035, OR=2.10, 95% CI: 1.345-5.850), and an ultrasound finding of biliary duct >8mm (p=0.034, OR=3.063 95% CI: 1086-8649). A score superior to 5 had a specificity and PPV of 100% for detecting choledocholithiasis and a score less than 3 had a sensitivity and NPV of 100% for excluding this diagnosis. The preoperative score can exclude or confirm the presence of choledocholithiasis and allows patients to directly benefit from laparoscopic cholecystectomy (LC) or prior endoscopic retrograde cholangiopancreatography (ERCP). Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  20. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Yoshimi Iwasaki; Tokihiko Sawada; Shozo Mori; Yukihiro Iso; Masato Katoh; Kyu Rokkaku; Junji Kita; Mitsugi Shimoda; Keiichi Kubota

    2009-01-01

    AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy. METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared. RESULTS: There were 37 patients (18.8%) withabnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients ( P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality ( P = 0.0936 and P = 0.0875, respectively). CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

  1. Anaesthesiologists H attitude towards preoperative patients education needs in 2005

    Directory of Open Access Journals (Sweden)

    R. Esmaeeli

    2006-01-01

    Full Text Available Background and purpose: lack of information about anaesthisia and fear of post operation contiousness, pain, nausea and vomiting increases the patientsH anxiety. There are various reports about patiensH desire for preoperation information in Iran and other countries. However, there is no study related to anaesthesiologistsH view about patientsH needs before anaesthesia and operation in the literature.Materials and Methods: This descriptive (cross- sectional study was done in 2005 on 110 anaesthesiologists working in hospitals of Mazandaran province. Questionnaire containing 4 questions about demographic and 18 questions related to anaesthesia was prepared. Attitude of the anaesthesiologists was divided into 5 categories based on Likert rating scale as follows: completely agreed, agreed, partially agreed, not agreed, completely not agreed. Chi-square test was used for the statistical analysis of the data.Results: Results of this study showed that the most positive attitude of anaesthesiologists about patient teaching was related to the proper explanation about duration of N.P.O before operation (%97.3. %52.7 of anaes the siologists were against giving explanation of the duration of N.P.O and post operation possible problems. In this regard no significant difference was observed between educational and non educational hospitals (P<0.018. No significant difference in terms of attitude was observed between anaesthesiologists at different level of education (P<0.07.Conclusion: Considering the positive attitude of the anaesthesiologists towards education and preoperation of the patients, it is recommended that such education be implemented and the patients be charged for preoperation consultation in order to give explanation about anaesthesia at proper time, when needed.

  2. Can preoperative MR imaging predict optic nerve invasion of retinoblastoma?

    Energy Technology Data Exchange (ETDEWEB)

    Song, Kyoung Doo, E-mail: kdsong0308@gmail.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Eo, Hong, E-mail: rtombow@gmail.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Kim, Ji Hye, E-mail: jhkate.kim@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Yoo, So-Young, E-mail: sy1131.yoo@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Jeon, Tae Yeon, E-mail: hathor97.jeon@samsung.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)

    2012-12-15

    Purpose: To evaluate the accuracy of pre-operative MRI for the detection of optic nerve invasion in retinoblastoma. Materials and methods: Institutional review board approval and informed consent were waived for this retrospective study. A total of 41 patients were included. Inclusion criteria were histologically proven retinoblastoma, availability of diagnostic-quality preoperative MR images acquired during the 4 weeks before surgery, unilateral retinoblastoma, and normal-sized optic nerve. Two radiologists retrospectively reviewed the MR images independently. Five imaging findings (diffuse mild optic nerve enhancement, focal strong optic nerve enhancement, optic sheath enhancement, tumor location, and tumor size) were evaluated against optic nerve invasion of retinoblastoma. The predictive performance of all MR imaging findings for optic nerve invasion was also evaluated by the receiver operating characteristic curve analysis. Results: Optic nerve invasion was histopathologically confirmed in 24% of study population (10/41). The differences in diffuse mild enhancement, focal strong enhancement, optic sheath enhancement, and tumor location between patients with optic nerve invasion and patients without optic nerve invasion were not significant. Tumor sizes were 16.1 mm (SD: 2.2 mm) and 14.9 mm (SD: 3.6 mm) in patients with and without optic nerve involvement, respectively (P = 0.444). P-Values from binary logistic regression indicated that all five imaging findings were not significant predictors of tumor invasion of optic nerve. The AUC values of all MR imaging findings for the prediction of optic nerve invasion were 0.689 (95% confidence interval: 0.499–0.879) and 0.653 (95% confidence interval: 0.445–0.861) for observer 1 and observer 2, respectively. Conclusion: Findings of MRI in patients with normal-sized optic nerves have limited usefulness in preoperatively predicting the presence of optic nerve invasion in retinoblastoma.

  3. Preoperative embolization in carotid body tumor surgery: is it required?

    Science.gov (United States)

    Zeitler, Daniel M; Glick, Joelle; Har-El, Gady

    2010-05-01

    We compared estimated blood loss (EBL) in patients who underwent surgical excision of carotid body tumors (CBTs) after preoperative superselective angiography with embolization (PSE) with that in patients who underwent excision of CBTs without PSE. We performed a retrospective chart review of a consecutive case series in a single surgeon's practice within an academic tertiary care medical center. Twenty-five patients underwent surgical resection of a CBT from 1989 to 2009. From 1989 to 1996, 10 consecutive patients had PSE of the CBT, whereas the subsequent 15 patients (1996 to 2009) had no PSE. Demographic data including age, sex, and tumor size were collected. The EBL was obtained from intraoperative records and operative notes dictated at the time of surgery. Tumor size was based on preoperative radiographic measurements by a senior radiologist and the surgeon. In the 10 patients with PSE, the mean age was 41 years (range, 22 to 72 years) and the mean tumor size was 4.8 cm (range, 2.9 to 8.3 cm). The mean EBL was 305 mL (range, 50 to 1,000 mL); 2 patients had an EBL of more than 400 mL. In the 15 patients without PSE, the mean age was 43.7 years (range, 20 to 75 years) and the mean tumor size was 4.4 cm (range, 2.8 to 7.9 cm). The mean EBL was 265.6 mL (range, 40 to 900 mL); 2 patients had an EBL of more than 400 mL. There were no significant differences between the 2 groups with regard to age, tumor size, or EBL. Preoperative superselective angiography with embolization of a CBT does not lead to a significant reduction in intraoperative EBL.

  4. Evaluation healing of jejunal anastomosis in preoperative dexamethasone treated dogs

    Directory of Open Access Journals (Sweden)

    A.S. Al-Qadhi

    2015-06-01

    Full Text Available The objective of this study is to evaluate the healing process of jejunal anastomosis by the aid of histopathology and measurement of bursting pressure of anastomosis site in thirty two adult preoperatively with dexamethasone. The animals were randomly divided into 2 equal groups: Group 1: consists of 16 dogs underwent apposition end-to-end jejunal anastomosis using simple interrupted suture technique which in turn divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. Subgroup B: control group consists of 8 dogs not treated with dexamethasone. Group 2: consists of 16 dogs underwent inverted end-to-end jejunal anastomosis using continuous Lembert suture pattern that also divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. subgroup B: control group consists of 8 dogs not treated with dexamethasone. The result of bursting pressure measurement showed higher tensile strength in the control groups (445±9.6 in comparison with the steroidal groups (255±25.3 for both techniques. The histopathological study showed that the healing was good in all groups but the rupture that occur due to shedding the pressure lead to non discrimination between which is better in terms of healing. Massonʼs trichrome showed that collagen content of subgroups taking dexamethasone was lower than that of subgroups not treated with dexamethasone.

  5. Systematic review and meta-analysis of closed suction drainage versus non-drainage in primary hip arthroplasty.

    Science.gov (United States)

    Kelly, Enda G; Cashman, James P; Imran, Farrah H; Conroy, Ronán; O'Byrne, John

    2014-03-01

    The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA. The hypothesis of this systematic review is that closed suction drainage does not infer a benefit and increase transfusion requirements of primary total hip arthroplasty patients. A systematic review and meta-analysis was conducted adhering to the PRISMA guidelines. A search of the available literature was performed on PubMed, Cochrane Central Registry of Controlled Trials, MEDLINE (OVID) and EMBASE using a combination of MeSH terms and Boolean operators. All data analysis was performed using the Cochrane Collaboration's Review Manager 5.1. Sixteen studies (n=2705) were included in the analysis. Post-operative closed suction drainage was found to increase total blood loss and blood transfusion requirements (psuction drainage systems post primary hip arthroplasty is not supported by this meta-analysis. However, the heterogeneity between studies does limit the accuracy of the meta-analysis.

  6. Systematic review and meta-analysis of closed suction drainage versus non-drainage in primary hip arthroplasty.

    LENUS (Irish Health Repository)

    Kelly, Enda G

    2014-03-01

    The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA. The hypothesis of this systematic review is that closed suction drainage does not infer a benefit and increase transfusion requirements of primary total hip arthroplasty patients. A systematic review and meta-analysis was conducted adhering to the PRISMA guidelines. A search of the available literature was performed on PubMed, Cochrane Central Registry of Controlled Trials, MEDLINE (OVID) and EMBASE using a combination of MeSH terms and Boolean operators. All data analysis was performed using the Cochrane Collaboration\\'s Review Manager 5.1. Sixteen studies (n=2705) were included in the analysis. Post-operative closed suction drainage was found to increase total blood loss and blood transfusion requirements (p<0.05). Surgical site infection demonstrated no significant difference between the two groups (p=0.82). No significant difference in haematoma formation between groups (p=0.19) was elicited. The routine use of closed suction drainage systems post primary hip arthroplasty is not supported by this meta-analysis. However, the heterogeneity between studies does limit the accuracy of the meta-analysis.

  7. Efficacy of incision and drainage versus percutaneous catheter drainage in treatment of severe acute pancreatitis complicated by pancreatic abscess

    Directory of Open Access Journals (Sweden)

    YANG Feng

    2016-03-01

    Full Text Available ObjectiveTo investigate the clinical features and treatment of severe acute pancreatitis (SAP complicated by pancreatic abscess (PA. MethodsThe clinical data of 17 SAP patients with PA who were admitted to Affiliated Hospital of Luzhou Medical College from January 1, 2005 to August 25, 2015 were analyzed retrospectively. The clinical manifestations, therapeutic methods, and outcome were summarized. ResultsOf all the 17 patients, 12 patients underwent surgical operation, among whom 9 were cured, 1 experienced postoperative intestinal fistula, and 2 experienced recurrence of abscess and underwent the surgery again (1 died of multiple organ failure, and the mean hospital stay was (108.29±52.37 d; 5 patients underwent percutaneous catheter drainage, among whom 4 were cured, and 1 underwent surgical treatment due to inadequate drainage, and the mean hospital stay was (53.03±6.71 d. ConclusionAdequate drainage should be performed once a confirmed diagnosis of PA is made, and appropriate drainage methods should be selected based on the patient′s actual condition. Minimally invasive treatment has a good effect, a short length of hospital stay, and few complications, and holds promise for clinical application.

  8. Preoperative staging of nodal status in gastric cancer

    Science.gov (United States)

    Berlth, Felix; Chon, Seung-Hun; Chevallay, Mickael; Jung, Minoa Karin

    2017-01-01

    An accurate preoperative staging of nodal status is crucial in gastric cancer, because it has a great impact on prognosis and therapeutic decision-making. Different staging methods have been evaluated for gastric cancer in order to predict nodal involvement. So far, no technique could meet the necessary requirements, which include a high detection rate of infiltrated lymph nodes and a low frequency of false-positive results. This article summarizes different staging methods used to assess lymph node status in patients with gastric cancer, evaluates the evidence, and proposes to establish new methods. PMID:28217758

  9. Inadequate preoperative colonic evaluation for synchronous colorectal cancer

    DEFF Research Database (Denmark)

    Achiam, M P; Burgdorf, S K; Wilhelmsen, M

    2009-01-01

    BACKGROUND AND AIMS: Synchronous cancers (SC) are well known (2-11%) in patients with colorectal carcinoma (CRC). One study has shown that intraoperative palpation can miss up to 69% of the SC while other studies have shown altered planned surgical procedure due to preoperatively diagnosed......-operation and one patient had pulmonary embolism as a complication to re-operation. CONCLUSIONS: The results show that many patients (78%) never underwent FPCE, but also that many of these patients never had a full postoperative colonic evaluation. SC being overlooked can lead to increased morbidity...... and the possibility of advanced staging of the cancer which is also exemplified in this study....

  10. [Valvular heart disease: preoperative assessment and postoperative care].

    Science.gov (United States)

    Nägele, Reto; Kaufmann, Beat A

    2013-10-30

    Patients with valvular heart disease or with a prosthetic heart valve replacement are seen with increasing frequency in clinical practice. The medical care and evaluation of patients with valvular heart disease before valve surgery, but also the post-operative treatment is complex and managed by general practitioners, cardiologists and cardiac surgeons. In this mini-review we will first discuss the preoperative assessment of the two most common valvulopathies, aortic stenosis and mitral regurgitation. Then we will discuss the post-operative care, which includes the management of anticoagulation, serial follow up and as well as the diagnostic assessment of complications such as thromboembolism, hemolysis, endocarditis and valve dysfunction.

  11. [Preoperative fasting period of fluids in bariatric surgery].

    Science.gov (United States)

    Simon, P; Pietsch, U-C; Oesemann, R; Dietrich, A; Wrigge, H

    2017-07-01

    Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation. The prospective observational clinical study was approved by the ethics committee of the University of Leipzig. In the liberal fasting group (Glib) patients undergoing bariatric surgery were asked to drink 1000 ml of tea up to 2 h before surgery. Patients assigned to the restrictive fasting group (Gres) who were undergoing nonbariatric abdominal surgery were asked to drink no more than 400 ml of water up to 2 h preoperatively. Right after anaesthesia induction and intubation a gastric tube was placed, gastric residual volume was measured and the pH level of gastric fluid was determined. Moreover, the occurrence of aspiration was monitored. In all, 98 patients with a body mass index (BMI) of Glib 51.1 kg/m(2) and Gres 26.5 kg/m(2) were identified. The preoperative fasting period of liquids was significantly different (Glib 170 min vs. Gres 700 min, p Gres 5 ml, p = 0.355). The pH of gastric fluid was nearly similar (Glib 4.0; Gres 3.0; p = 0.864). Aspiration did not occur in any patient. There is evidence suggesting that a liberal fluid fasting regimen (1000 ml of fluid) in the preoperative period is safe in patients undergoing bariatric surgery.

  12. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

  13. Ranitidine improves postoperative suppression of antibody response to preoperative vaccination

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F

    1992-01-01

    The effect of the histamine-2 receptor antagonist ranitidine (100 mg intravenously every 12 hours for 72 hours) on postoperative serum antibody responses to preoperative immunization with six limit of flocculation tetanus toxoid and six limit of flocculation diphtheria toxoid was assessed...... and antidiphtheria toxoid were drawn before skin incision and on postoperative days 1, 3, 5, 7, 10, 14, 21, and 28. Ranitidine significantly increased the postoperative antibody response to tetanus toxoid, (p less than 0.01) and insignificantly increased that to diphtheria toxoid vaccination (p less than 0...

  14. Effect of Preoperative Play Interventions on Post Surgery Anxiety

    OpenAIRE

    Narges Alirezaei; Bahar Ashjaei; Zahra Shahrivar; Fatemeh Moharari; Javad Mahmoudi-gharaei; Jaleh Parizad

    2008-01-01

    "n "nObjective: Many studies have shown that the level of postoperative distress and anxiety in children is associated with the amount of anxiety during the pre operative period. In this study, we compared the effect of pre-operational attending in a playroom and using play activities on the level of anxiety increment after surgery in an intervention and a control group of Iranian children. "n "nMethod: In a clinical trial, 75 children aged 5 to 12 enrolled in the intervention and the control...

  15. Preoperative arterial embolization in heterotopic ossification: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Balzer, J. [Dept. of Radiology, University of Frankfurt (Germany); Wolff, J.D. [Dept. of Cardiothoracic Surgery, University of Frankfurt (Germany); Skripitz, R. [Dept. of Orthopaedic Surgery, University of Frankfurt (Germany)

    2001-06-01

    We report a case of preoperative embolization in a 64-year-old patient suffering from total stiffness of the right hip joint due to heterotopic ossification following brain injury and pertrochanteric fracture of the right femur. A previous attempt of operative treatment could not be performed successfully due to bleeding complications. After the embolization of the correlating hypervascularisation, the surgical procedure was redone and finished with good result and minimal bleeding complications during the operation and a tolerable drop of the haemoglobin concentration postoperatively. (orig.)

  16. Preoperative methylprednisolone enhances recovery after endovascular aortic repair

    DEFF Research Database (Denmark)

    de la Motte, Louise; Kehlet, Henrik; Vogt, Katja

    2014-01-01

    /kg of methylprednisolone (MP) (n = 77) or placebo (n = 76) preoperatively. Primary outcome was a modified version of the systemic inflammatory response syndrome. Secondary outcome measures were the effect on inflammatory biomarkers, morbidity, and time to meet discharge criteria. RESULTS: Of 153 randomized patients, 150....... Glucocorticoids may reduce postoperative inflammatory responses and enhance recovery, but with limited information on EVAR. METHODS: A single-center, randomized, double-blind, placebo-controlled trial of 153 patients undergoing elective EVAR between November 2009 and January 2013. Patients received 30 mg...... (98%) were evaluated for the primary outcome. MP reduced systemic inflammatory response syndrome from 92% to 27% (P

  17. [Chronic medications in the preoperative period: should they be stopped?].

    Science.gov (United States)

    López-Álvarez, A; Román-Fernández, A; Fernández-Vieitez, M B; Fossati-Puertas, S

    2014-03-01

    As different specialists are becoming increasingly involved in the preoperative management of our patients (for two main reasons; Primary Care doctors have to perform minor surgical procedures, and as coordination between Primary Care and In-hospital Care is more and more necessary in order to improve their outcomes), we believe that an update is needed as regards the management of chronic medications in this period. We will try to review the current literature dealing with the recommendations about withdrawing or continuing these drugs. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. Inadequate preoperative colonic evaluation for synchronous colorectal cancer

    DEFF Research Database (Denmark)

    Achiam, M P; Burgdorf, S K; Wilhelmsen, M

    2009-01-01

    synchronous lesions in 11-44%. The purpose of this study was to review all patients having surgery for CRC in our department since 2001, and to evaluate the extent of the perioperative colonic evaluation. MATERIALS AND METHODS: The records of all patients operated for CRC between Jan. 2001 and Dec. 2007...... in our department were reviewed. Only patients with CRC were included. Information regarding pre-, per- and postoperative colonic evaluation were obtained and occurrences of SC were evaluated. RESULTS: Of the 534 patients included 124 (23%) patients had an impassable stenosis. Full preoperative colonic...

  19. Visual drainage assessment: A standardised visual soil assessment method for use in land drainage design in Ireland

    Directory of Open Access Journals (Sweden)

    Tuohy P.

    2016-06-01

    Full Text Available The implementation of site-specific land drainage system designs is usually disregarded by landowners in favour of locally established ‘standard practice’ land drainage designs. This is due to a number of factors such as a limited understanding of soil–water interactions, lack of facilities for the measurement of soil’s physical or hydrological parameters and perceived time wastage and high costs. Hence there is a need for a site-specific drainage system design methodology that does not rely on inaccessible, time-consuming and/or expensive measurements of soil physical or hydrological properties. This requires a standardised process for deciphering the drainage characteristics of a given soil in the field. As an initial step, a new visual soil assessment method, referred to as visual drainage assessment (VDA, is presented whereby an approximation of the permeability of specific soil horizons is made using seven indicators (water seepage, pan layers, texture, porosity, consistence, stone content and root development to provide a basis for the design of a site-specific drainage system. Across six poorly drained sites (1.3 ha to 2.6 ha in size in south-west Ireland a VDA-based design was compared with (i an ideal design (utilising soil physical measurements to elucidate soil hydraulic parameters and (ii a standard design (0.8 m deep drains at a 15 m spacing by model estimate of water table control and rainfall recharge/drain discharge capacity. The VDA method, unlike standard design equivalents, provided a good approximation of an ideal (from measured hydrological properties design and prescribed an equivalent land drainage system in the field. Mean modelled rainfall recharge/drain discharge capacity for the VDA (13.3 mm/day and ideal (12.0 mm/day designs were significantly higher (P < 0.001, s.e. 1.42 mm/day than for the standard designs (0.5 mm/day, when assuming a design minimum water table depth of 0.45 m.

  20. 46 CFR 116.1120 - Drainage of cockpit vessels, well deck vessels, and open boats.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Drainage of cockpit vessels, well deck vessels, and open boats. 116.1120 Section 116.1120 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL... Drainage of cockpit vessels, well deck vessels, and open boats. Drainage of cockpit vessels, well...

  1. 46 CFR 178.450 - Calculation of drainage area for cockpit and well deck vessels.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Calculation of drainage area for cockpit and well deck....450 Calculation of drainage area for cockpit and well deck vessels. (a) The drainage area required on... cockpit deck; DR=total deck area of the cockpit or well deck in the after 2/3 of the vessel length...

  2. Evaluation of urban drainage network based geographycal information system (GIS) in Sumenep City

    Science.gov (United States)

    Agrianto, F.; Hadiani, R.; Purwana, Y. M.

    2017-02-01

    Sumenep City frequently hit by floods. Drainage network conditions greatly affect the performance of her maid, especially those aspects that affect the capacity of the drainage channel. Aspects that affect the capacity of the drainage channel in the form of sedimentation rate and complementary buildings on drainage channels, for example, the presence of street inlet and trash rack. The method used is a drainage channel capacity level approach that level assessment of each segment drainage network conditions by calculating the ratio of the channel cross-sectional area that is filled with sediment to the total cross-sectional area wet and the existence of complementary buildings. Having obtained the condition index value of each segment, the subsequent analysis is spatial analysis using ArcGIS applications to obtain a map of the drainage network information. The analysis showed that the level condition of drainage network in the city of Sumenep in 2016 that of the total 428 drainage network there are 43 sections belonging to the state level “Good”, 198 drainage network belong to the state level “Enough”, 115 drainage network belong to the state “Mild Damaged”, 50 sections belonging to the state “Heavy Damage” and 22 drainage network belong to the state of “Dysfunction”.

  3. Drainage of the ice-dammed Lake Tinninilik, West Greenland; implication on bedrock uplift

    DEFF Research Database (Denmark)

    Kjeldsen, Kristian Kjellerup; Khan, Shfaqat Abbas; Bjørk, Anders Anker;

    Drainage of ice-dammed lakes is regularly observed along the margin of the Greenland Ice Sheet. However, the speed of the drainage events and implications can vary depending on the size of the lakes and the local settings. Here, we assess the drainage pattern of Lake Tinninilik, dammed...

  4. Integration of Drainage, Water Quality and Flood Management in Rural, Urban and Lowland Areas

    NARCIS (Netherlands)

    Vlotman, W.F.; Wong, T.; Schultz, E.

    2007-01-01

    Managing drainage in rural and peri-urban environments has become an essential part of integrated water management. Drainage has become a science of control, storage and (re)use while meeting triple bottom-line requirements (environment, social and economic assessments). Controlled drainage in rural

  5. Assessment and synthesis of 50 years of published drainage phosphorus losses

    Science.gov (United States)

    The prevalence of artificial drainage systems in intensively cropped areas across North America combined with the importance of freshwater resources in these regions has created a critical intersection where understanding drainage phosphorus (P) transport is vital. In this study, drainage nutrient ...

  6. 25 CFR 162.611 - Payment of fees and drainage and irrigation charges.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Payment of fees and drainage and irrigation charges. 162... AND PERMITS Non-Agricultural Leases § 162.611 Payment of fees and drainage and irrigation charges. (a) Any lease covering lands within an irrigation project or drainage district shall require the lessee to...

  7. Population genetics of invasive common carp Cyprinus carpio L. in coastal drainages in eastern Australia.

    Science.gov (United States)

    Haynes, G D; Gilligan, D M; Grewe, P; Moran, C; Nicholas, F W

    2010-10-01

    The common carp Cyprinus carpio introduced in two drainages in eastern Australia are largely descended from European common carp, and in a third drainage they descend largely from East Asian common carp. The partial genetic differentiation among the species in those drainages is consistent with their origins.

  8. Etheostoma erythrozonum, a new species of darter (teleostei: Percidae) from the Meramec River drainage, missouri

    Science.gov (United States)

    Switzer, J.F.; Wood, R.M.

    2009-01-01

    A new species of darter, Etheostoma erythrozonum, is described from the Meramec River drainage of Missouri, USA. Etheostoma erythrozonum is the first known fish species endemic to the Meramec River drainage. It differs morphologically and genetically from populations of its sister species, Etheostoma tetrazonum, from the Gasconade River, Osage River, and Moreau River drainages. Copyright ?? 2009 ?? Magnolia Press.

  9. Percutaneous drainage in the treatment of emphysematous pyelonephritis: 10-year experience

    Energy Technology Data Exchange (ETDEWEB)

    Chen, M.; Huang, C.; Chou, Y.; Huang, Ch.; Chiang, C.; Liu, G. [Chung-Ho Memorial Hospital, Kaohsiung Medical College, Taiwan (China)

    1997-11-01

    CT is an efficient imaging method for diagnosis, guiding the drainage procedures and monitoring response to percutaneous drainage of emphysematous pyelonephritis. Antibiotic therapy combined with CT guided percutaneous drainage of emphysematous pyelonephritis is an acceptable alternative to antibiotic therapy with surgical intervention. (authors)

  10. Role of multimodality cardiac imaging in preoperative cardiovascular evaluation before noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Fathala Ahmed

    2011-01-01

    Full Text Available The preoperative cardiac assessment of patients undergoing noncardiac surgery is common in the daily practice of medical consultants, anesthesiologists, and surgeons. The number of patients undergoing noncardiac surgery worldwide is increasing. Currently, there are several noninvasive diagnostic tests available for preoperative evaluation. Both nuclear cardiology with myocardial perfusion single photon emission computed tomography (SPECT and stress echocardiography are well-established techniques for preoperative cardiac evaluation. Recently, some studies demonstrated that both coronary angiography by gated multidetector computed tomography and stress cardiac magnetic resonance might potentially play a role in preoperative evaluation as well, but more studies are needed to assess the role of these new modalities in preoperative risk stratification. A common question that arises in preoperative evaluation is if further preoperative testing is needed, which preoperative test should be used. The preferred stress test is the exercise electrocardiogram (ECG. Stress imaging with exercise or pharmacologic stress agents is to be considered in patients with abnormal rest ECG or patients who are unable to exercise. After reviewing this article, the reader should develop an understanding of the following: (1 the magnitude of the cardiac preoperative morbidity and mortality, (2 how to select a patient for further preoperative testing, (3 currently available noninvasive cardiac testing for the detection of coronary artery disease and assessment of left ventricular function, and (4 an approach to select the most appropriate noninvasive cardiac test, if needed.

  11. Fishes of the Blackwater River Drainage, Tucker County, West Virginia

    Science.gov (United States)

    Cincotta, Daniel A.; Welsh, Stuart; Wegman, Douglas P.; Oldham, Thomas E.; Hedrick, Lara B.

    2015-01-01

    The Blackwater River, a tributary of the upper Cheat River of the Monongahela River, hosts a modest fish fauna. This relatively low diversity of fish species is partly explained by its drainage history. The Blackwater was once part of the prehistoric, northeasterly flowing St. Lawrence River. During the Pleistocene Epoch, the fauna was significantly affected by glacial advance and by proglacial lakes and their associated overflows. After the last glacial retreat, overflow channels, deposits, and scouring altered drainage courses and connected some of the tributaries of the ancient Teays and Pittsburgh drainages. These major alterations allowed the invasion of fishes from North America's more species-rich southern waters. Here we review fish distributions based on 67 surveys at 34 sites within the Blackwater River drainage, and discuss the origin and status of 37 species. Within the Blackwater River watershed, 30 species (20 native, 10 introduced) have been reported from upstream of Blackwater Falls, whereas 29 (26 native, 3 introduced) have been documented below the Falls. Acid mine drainage, historic lumbering, and human encroachment have impacted the Blackwater's ichthyofauna. The fishes that have been most affected are Salvelinus fontinalis (Brook Trout), Clinostomus elongatus (Redside Dace), Nocomis micropogon (River Chub), Hypentelium nigricans (Northern Hog Sucker), Etheostoma flabellare (Fantail Darter), and Percina maculata(Blackside Darter). The first two species incurred range reductions, whereas the latter four were probably extirpated. In the 1990s, acid remediation dramatically improved the water quality of the river below Davis. Recent surveys in the lower drainage revealed 15 fishes where none had been observed since at least the 1940s; seven of these (Cyprinella spiloptera [Spotfin Shiner], Luxilus chrysocephalus [Striped Shiner], Notropis photogenis [Silver Shiner], N. rubellus [Rosyface Shiner];Micropterus dolomieu

  12. Acute gallbladder torsion - a continued pre-operative diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Desrochers Randal

    2011-04-01

    Full Text Available Abstract Acute gallbladder volvulus continues to remain a relatively uncommon process, manifesting itself usually during exploration for an acute surgical abdomen with a presumptive diagnosis of acute cholecystitis. The pathophysiology is that of mechanical organo-axial torsion along the gallbladder's longitudinal axis involving the cystic duct and cystic artery, and with a pre-requisite of local mesenteric redundancy. The demographic tendency is septua- and octo-genarians of the female sex, and its overall incidence is increasing, this being attributed to increasing life expectancy. We discuss two cases of elderly, fragile women presenting to the emergency department complaining of sudden onset right upper quadrant abdominal pain. Their subsequent evaluation suggested acute cholecystitis. Ultimately both were taken to the operating room where the correct diagnosis of gallbladder torsion was made. Pre-operative diagnosis continues to be a major challenge with only 4 cases reported in the literature diagnosed with pre-operative imaging; the remainder were found intra-operatively. Consequently, a delay in diagnosis can have devastating patient outcomes. Herein we propose a necessary high index of suspicion for gallbladder volvulus in the outlined patient demographic with symptoms and signs mimicking acute cholecystitis.

  13. A more cost-effective method of preoperative computerized imaging.

    Science.gov (United States)

    Webber, W B

    1989-07-01

    Stimulated by the explosive expansion of the computerized desk top publishing industry during the past few years, microcomputer hardware and software are evolving at a staggering rate. Memory is rapidly increasing, and prices are declining. I have found that with the hardware and software described in this paper, I was able to obtain, in a much more cost-effective manner, as useful preoperative information for my practice as I could obtain with more expensive "turnkey" (only one use) computerized imaging systems. This type of microcomputer, of course, is not limited to just the imaging system, but can be used for a variety of other programs as well, such as word processing, slide labeling and production, spreadsheet functions, billing and filing, and numerous business and other applications. The ease of use with readily available 35-mm slides of my patients has greatly enhanced the appeal of this system. Computerized imaging, when used as an educational tool, can be very helpful in preoperative planning, resident teaching, and for illustration and discussion of a patient's proposed surgery. The electronic imaging disclaimer compiled by the American Society of Plastic and Reconstructive Surgeons has been extremely helpful in clarifying the limits of computerized imaging and reducing any false expectations that my patients might have. All of us are experiencing the dawn of a very exciting evolution.

  14. Usefulness of CT in preoperative examinations for middle ear surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Toshimitsu; Okitsu, Takuji; Sakurai, Tokio; Ikeda, Katsuhisa; Taniguchi, Kazuhiko; Takahashi, Kuniaki; Kusakari, Jun

    1985-02-01

    The usefulness of CT in preoperative examinations for middle ear surgery was evaluated on the basis of whether or not it can provide a surgon with useful information not available from the other preoperative examinations, such as microscopic examination, pure tone audiometry, impedance audiometry, equilibrium tests, conventional X-ray films, etc. The findings of CT were compared with those obatained during operations and the following conclusions were reached: CT is especially useful for the three purposes indicated below. (1) to determine the patency of the attic air route to the mastoid antrum. (2) to make differential diagnoses of middle ear diseases in the presence of obstructive pathology of the external auditory meatus. (3) to make a rough estimate of the extent of cholesteatoma growth in the middle ear cleft, and to diagnose labyrinthine fistulae. CT proved less effective or useless for the following three purposes. (1) to secure detailed information on the status of the ossicular chain. (2) to determine the precise extent of the growth of cholesteatoma. (3) to evaluate the postoperative status of the ear. (author).

  15. Preoperative subtyping of meningiomas by perfusion MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hao [University Medical Center Groningen, University of Groningen (Netherlands); Shanghai Jiaotong University affiliated First People' s Hospital, Department of Radiology, Shanghai (China); Department of Radiology, University of Groningen (Netherlands); Roediger, Lars A.; Oudkerk, Matthijs [University Medical Center Groningen, University of Groningen (Netherlands); Department of Radiology, University of Groningen (Netherlands); Shen, Tianzhen [Fudan University Huashan Hospital, Department of Radiology, Shanghai (China); Miao, Jingtao [Shanghai Jiaotong University affiliated First People' s Hospital, Department of Radiology, Shanghai (China)

    2008-10-15

    This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Thirty-seven meningiomas with peritumoral edema (15 meningothelial, ten fibrous, four angiomatous, and eight anaplastic) underwent perfusion MR imaging by using a gradient echo echo-planar sequence. The maximal rCBV (compared with contralateral normal white matter) in both tumoral parenchyma and peritumoral edema of each tumor was measured. The mean rCBVs of each two histological subtypes were compared using one-way analysis of variance and least significant difference tests. A p value less than 0.05 indicated a statistically significant difference. The mean rCBV of meningothelial, fibrous, angiomatous, and anaplastic meningiomas in tumoral parenchyma were 6.93{+-}3.75, 5.61{+-}4.03, 11.86{+-}1.93, and 5.89{+-}3.85, respectively, and in the peritumoral edema 0.87{+-}0.62, 1.38{+-}1.44, 0.87{+-}0.30, and 3.28{+-}1.39, respectively. The mean rCBV in tumoral parenchyma of angiomatous meningiomas and in the peritumoral edema of anaplastic meningiomas were statistically different (p<0.05) from the other types of meningiomas. Perfusion MR imaging can provide useful functional information on meningiomas and help in the preoperative diagnosis of some subtypes of meningiomas. (orig.)

  16. [Preoperative fasting 2008: medical behaviour between empiricism and science].

    Science.gov (United States)

    Weiss, G; Jacob, M

    2008-09-01

    Preoperative fasting aims at minimizing the risk of pulmonary aspiration. However, perioperative safety does not directly increase with the duration of total abstinence from food and liquids. The traditional principle "nil per os from midnight on", is based on insufficient data, overinterpretation and expert opinion. In fact, the total perioperative risk of a clinically relevant regurgitation of gastric content is low. Clear liquids are not stored within the stomach for a long time and in the healthy, a fasting period of 6 h allows the total passage of solid food. Identifying those patients with an increased risk of perioperative aspiration is still difficult. In particular, the impact of pregnancy, adipositas and diabetes, trauma, smoking, opioids and renal insufficiency has not been clarified. This lack of knowledge is reflected by national and international guidelines concerning preoperative fasting, which mention the "patient at risk" without defining it exactly. Abstention from clear liquids 2 h before and of solids 6 h before induction of anesthesia, is becoming increasingly more accepted. Feeding babies with breast milk appears to be tolerated 4 h before anesthesiological procedures.

  17. Preoperative mechanical preparation of the colon: the patient's experience

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    Arodell Malin

    2007-05-01

    Full Text Available Abstract Background Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials. Methods As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 – 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary. Results 60 patients received mechanical bowel preparation (MBP and 45 patients did not (No-MBP. In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03. Conclusion Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

  18. [Subjective verbal methods in preoperative measurement of anxiety].

    Science.gov (United States)

    Höfling, S; Hutner, G; Ott, H; Fichte, K; Doenicke, A

    1988-06-01

    The role of preoperative anxiety in perioperative adaptation is viewed in two different ways. Janis suggested that anxiety is a drive that evokes the cognitive work of worrying. Leventhal stresses the importance of coping behavior for adaptation, while anxiety may or may not accompany this coping process. Both theories have empirical support. The aim of this study was to determine whether both theories could show empirical support because the scientists chose different methods: Janis used interviews, Leventhal and Lazarus anxiety scales. The study analyzed the pre- and postoperative emotional reactions of surgical patients with three different methods of anxiety measurement: an anxiety scale, a fear thermometer, and a psychoanalytic interview (Gottschalk-Gleser content analysis method). The different methods were compared and related to the adaptation behavior (Table 3). The data showed a clear interaction between the selected methods and respective theories about the effects of preoperative anxiety on intra- and postoperative adaptation. The anxiety scales showed no correlation with adaptation behavior (blood pressure and heart rate during surgery; postoperative pain medication) and were not related to the anxiety scores obtained from the interview (content analysis). On the other hand, the interview anxiety measurements showed a clear relationship between separation anxiety (and also shame anxiety), physiological excitement during surgery (increase in heart rate), and postoperative medication (increased analgesics and tranquilizers). The patients who worried about the risks of surgery (Verletzungsangst, see Fig. 3) had very good perioperative adjustment, so that the quality of anxiety measured in the interview was very important for the prediction of adaptation.

  19. Preoperative management of children with esophageal atresia: current perspectives

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    Parolini F

    2017-01-01

    Full Text Available Filippo Parolini,1 Anna Lavinia Bulotta,1 Sonia Battaglia,1 Daniele Alberti1,2 1Department of Pediatric Surgery, “Spedali Civili” Children’s Hospital, 2Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy Abstract: Esophageal atresia remains one of the most challenging congenital anomalies of the newborn. In recent years, because of the advances in prenatal diagnosis, neonatal critical care, and surgical procedures, overall outcomes have improved substantially, including for premature children. Nowadays, most of the research is focused on medium- and long-term morbidity, with particular reference to respiratory and gastroesophageal problems; the high frequency of late sequelae in esophageal atresia warrants regular and multidisciplinary checkups throughout adulthood. Surprisingly, there are few studies on the impact of prenatal diagnosis and there is continuing debate over the prenatal and preoperative management of these complex patients. In this review, we analyze the literature surrounding current knowledge on the management of newborns affected by esophageal atresia, focusing on prenatal management and preoperative assessment. Keywords: prenatal diagnosis, esophageal atresia, tracheoesophageal fistula, ultrasound scan, tracheobronchoscopy

  20. Preoperative Strength Training for Elderly Patients Awaiting Total Knee Arthroplasty

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    D. M. van Leeuwen

    2014-01-01

    Full Text Available Objective. To investigate the feasibility and effects of additional preoperative high intensity strength training for patients awaiting total knee arthroplasty (TKA. Design. Clinical controlled trial. Patients. Twenty-two patients awaiting TKA. Methods. Patients were allocated to a standard training group or a group receiving standard training with additional progressive strength training for 6 weeks. Isometric knee extensor strength, voluntary activation, chair stand, 6-minute walk test (6MWT, and stair climbing were assessed before and after 6 weeks of training and 6 and 12 weeks after TKA. Results. For 3 of the 11 patients in the intensive strength group, training load had to be adjusted because of pain. For both groups combined, improvements in chair stand and 6MWT were observed before surgery, but intensive strength training was not more effective than standard training. Voluntary activation did not change before and after surgery, and postoperative recovery was not different between groups (P>0.05. Knee extensor strength of the affected leg before surgery was significantly associated with 6-minute walk (r=0.50 and the stair climb (r−=0.58, P<0.05. Conclusion. Intensive strength training was feasible for the majority of patients, but there were no indications that it is more effective than standard training to increase preoperative physical performance. This trial was registered with NTR2278.

  1. Preoperative Assessment of Different Treatment Modalities in Bronchial Asthma Patients

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    Kawther A. Azzam M.D. and **Sahar S. Khattab MD

    2003-06-01

    Full Text Available This study was performed to assess the effectiveness of acupuncture and medical therapies of bronchial asthma preoperatively. Sixty patients suffered from mild to moderate bronchial asthma and coming for elective operations were chozen from the outpatient clinic of Al-Zahraa University Hospital. Patients were randomly divided into three equal groups (n=20 each. Group I patients (drug group received oral theophylline and Salbutamol (ventolin inhaler according to the needs. Group II patients (drug +ear acupuncture group received same medical treatment as in group I and added ear acupuncture. Group III patients (drug + ear and body acupuncture group received same medical treatment as in group I and II and added ear and body acupuncture. Ventilatory function tests through spirometer and interleukin-13 estimation were performed before treatment and after two weeks of treatment. Improvement of subjective and objective parameters had occurred with significant decrease in the mean serum level of interleukin-13 and decrease in the mean number of using b-agonist puffs after two weeks of treatment in the three groups, with the best results being in group III than in group II and then in group I. Conclusion: Interleukin-13 estimation togheter with ventilatory function tests is a useful parameter for pre-operative assessment and evaluation of asthmatic patients. Also medication was significantly reduced when combined with acupuncture.

  2. Analgesic Effect of Preoperative Pentazocine for Laparoscopic Cholecystectomy

    Science.gov (United States)

    Wang, Na; Wang, Lei; Gao, Yang; Zhou, Honglan

    2016-01-01

    Objective: To assess whether preoperative pentazocine can reduce intraoperative hemodynamic changes and postoperative pain. Methods: Fifty patients undergoing laparoscopic cholecystectomy were randomized into two groups. Group P received intravenous 0.5 mg/kg pentazocine 10 min before surgery, and Group C received normal saline as a placebo. A standardized general anesthesia was conducted in all patients. Mean blood pressure (MBP), heart rate (HR), and visual analog scale (VAS) scores at various time points were recorded. The tramadol consumption during the study period was recorded. Results: Group P had lower VAS scores at two, four, and eight hours postoperatively compared with Group C. MBP and HR rose significantly because of pneumoperitoneum within Group C, and no significant changes were detected in MBP and HR within Group P. Tramadol doses given were statistically fewer in Group P. Conclusion: Preoperative intravenous pentazocine can decrease intraoperative hemodynamic changes and postoperative pain. PMID:28168126

  3. Preoperative thrombocytosis predicts prognosis in stage II colorectal cancer patients

    Science.gov (United States)

    Lee, Yong Sun; Suh, Kwang Wook

    2016-01-01

    Purpose Thrombocytosis is known to be a poor prognostic factor in several types of solid tumors. The prognostic role of preoperative thrombocytosis in colorectal cancer remains limited. The aim of this study is to investigate the prognostic role of preoperative thrombocytosis in stage II colorectal cancer. Methods Two hundred eighty-four patients with stage II colorectal cancer who underwent surgical resection between December 2003 and December 2009 were retrospectively reviewed. Thrombocytosis was defined as platelet > 450 × 109/L. We compared patients with thrombocytosis and those without thrombocytosis in terms of survival. Results The 5-year disease-free survival (DFS) rates were lower in patients with thrombocytosis compared to those without thrombocytosis in stage II colorectal cancer (73.3% vs. 89.6%, P = 0.021). Cox multivariate analysis demonstrated that thrombocytosis (hazard ratio, 2.945; 95% confidence interval, 1.127–7.697; P = 0.028) was independently associated with DFS in patients with stage II colorectal cancer. Conclusion This study showed that thrombocytosis is a prognostic factor predicting DFS in stage II colorectal cancer patients. PMID:27274508

  4. Italian validation of the Amsterdam Preoperative Anxiety and Information Scale.

    Science.gov (United States)

    Buonanno, Pasquale; Laiola, Anna; Palumbo, Chiara; Spinelli, Gianmario; Terminiello, Virginia; Servillo, Giuseppe

    2017-07-01

    Preoperative anxiety is usually experienced by patients awaiting surgical procedures and it can negatively impact patient's outcome. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a questionnaire created to identify anxious patients and their need for information: it has been translated and validated in many languages because of its reliability and ease of completion. To date, no Italian version of the APAIS has been produced; our aim was to translate and validate the APAIS in Italian. We produced an Italian version of the APAIS and we administered it to 110 patients undergoing elective surgery; we explored its structure by factor analysis and its reliability by Cronbach's alpha. We analyzed its external validity by confronting it to the Spielberg's State-Trait Anxiety Inventory (STAI). Sensitivity, specificity, and positive and negative predictive values of the Italian version of the APAIS were determined. The Italian version of the APAIS confirmed the original structure of the questionnaire and its internal consistency; it well correlated with the STAI-Y1, the subscale of the STAI which explore the anxiety "state." An APAIS score of 14 was found as best cutoff to distinguish anxious and non-anxious patients. The Italian translation of the APAIS showed psychometric properties similar to the original version. Its reliability and its efficiency make it a powerful tool even in Italian population to detect anxiety and need for information.

  5. Preoperative diagnosis of pelvic actinomycosis by clinical cytology

    Directory of Open Access Journals (Sweden)

    Matsuda K

    2012-09-01

    Full Text Available Katsuya Matsuda,1 Hisayoshi Nakajima,2 Khaleque N Khan,1 Terumi Tanigawa,1 Daisuke Hamaguchi,1 Michio Kitajima,1 Koichi Hiraki,1 Shingo Moriyama,3 Hideaki Masuzaki11Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 2Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 3Shimabara Maternity Clinic, Nagasaki, JapanBackground: The purpose of this work was to investigate whether clinical cytology could be useful in the preoperative diagnosis of pelvic actinomycosis.Methods: This study involved the prospective collection of samples derived from the endometrium and the uterine cervix, and retrospective data analysis. Nine patients with clinically diagnosed pelvic actinomycosis were enrolled. The clinical and hematological characteristics of patients were recorded, and detection of actinomyces was performed by cytology, pathology, and bacteriological culture of samples and by imprint intrauterine contraceptive device (IUD cytology.Results: The detection rate of actinomyces was 77.7% by combined cervical and endometrial cytology, 50.0% by pathology, and 11.1% by bacterial culture.Conclusion: The higher detection rate of actinomyces by cytology than by pathology or bacteriology suggests that careful cytological examination may be clinically useful in the preoperative diagnosis of pelvic actinomycosis.Keywords: actinomycosis, cytology, pathology, intrauterine contraceptive device, pelvic inflammatory disease

  6. Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation

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    Pervez Sultan

    2014-01-01

    Full Text Available Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing (CPET—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio (NLR and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold (AT and malignancy. In a first cohort of 240 colorectal patients, AT was identified as the sole factor associated with higher NLR (P=0.03 and absolute and relative lymphopenia (P=0.01. Preoperative leukocyte subsets and monocyte CD14+ expression (downregulated by endotoxin and indicative of chronic inflammation were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte CD14+ expression was lower in gastrointestinal patients (n=43 compared to age-matched orthopaedic patients (n=31. The circulating CD14+CD16− monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome.

  7. Clinicopathological studies on three preoperative combined treatments for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yuji; Ichikawa, Daisuke; Iizuka, Ryouji; Hagiwara, Akeo; Sawai, Kiyoshi; Yamaguchi, Toshiharu; Takahashi, Toshio [Kyoto Prefectural Univ. of Medicine (Japan)

    1995-09-01

    To prevent postoperative local recurrence of rectal cancer, we treated patients using preoperative hyperthermia (5-6 times), irradiation (total 30 Gy) and 5-fluorouracil suppository (2,000-2,500 mg). The subjects were 31 patients given combined treatments and 28 patients given surgery alone. The results were as follows: Histologically, therapeutic effects were recognized in 80.6% of patients receiving combined treatments. The mean distance from the adventitia to the site of cancer infiltration was 6.54 mm in the combined treatments group and 3.35 mm in the surgery alone group. The difference between the two was significant (p<0.05). The rate of local recurrence in the combined treatments group was less than that in the surgery alone group. No systemic side effects nor severe complications were observed during hospitalization in the combined treatments group. The survival rate of the combined treatments group was higher than that of the surgery alone group. It was considered that combined preoperative treatments for rectal cancer were beneficial to survival and local control. (author).

  8. Distributed models coupling soakaways, urban drainage and groundwater

    DEFF Research Database (Denmark)

    Roldin, Maria Kerstin

    , and how these can be modeled in an integrated environment with distributed urban drainage and groundwater flow models. The thesis: 1. Identifies appropriate models of soakaways for use in an integrated and distributed urban water and groundwater modeling system 2. Develops a modeling concept that is able...... of the literature and on modeling studies, a new modeling concept is proposed which fulfills the need for integrated models coupling distributed urban drainage with groundwater. The suggested solution consists of a base equation for soakaway infiltration and additional components for clogging, upscaling......Alternative methods for stormwater management in urban areas, also called Water Sensitive Urban Design (WSUD) methods, have become increasingly important for the mitigation of urban stormwater management problems such as high runoff volumes, combined sewage overflows, poor water quality...

  9. Risk of infection after placement of an extraventricular drainage catheter

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    Novak Vesna

    2012-01-01

    Full Text Available Introduction. The occurrence of infection after the placement of an extraventricular drainage (EVD catheter can be a very serious problem in neurosurgery. Objective. The aim of this study was to confirm that the use of special catheters with impregnated antibiotics decreased the percentage of infection. Methods. The prospective study conducted at the Clinic of Neurosurgery in Niš in the period 2006-2009 is presented. Group 1 comprised of 43 patients in whom a commonly used system for EVD was applied. Group 2 comprised of 39 patients in whom the Rifampycin and Clindamycin impregnated EVD catheters were applied (Bactiseal catheters. Results. In Group 1 infection occurred in nine patients, mainly caused by bacteria of Staphylococcus genus. In Group 2 only two patients developed infections caused by Acinetobacter. Conclusion. The use of Bactiseal EVD catheters considerably decreased the percentage of infection occurrence with prolonged EVD catheter drainage period.

  10. The effect of climate change on urban drainage

    DEFF Research Database (Denmark)

    Grum, M.; Jørgensen, A.T.; Johansen, R.M.

    2006-01-01

    and consequences of climate change on urban drainage and urban runoff pollution issues. This study uses predictions from a regional climate model to look at the effects of climate change on extreme precipitation events. Results are presented in terms of point rainfall extremes. The analysis involves three steps......: Firstly, hourly rainfall intensities from 16 point rain gauges are averaged to create a rain gauge equivalent intensity for a 25 X 25 km square corresponding to one grid cell in the climate model. Secondly, the differences between present and future in the climate model is used to project the hourly......That we are in a period of extraordinary rates of climate change is today evident. These climate changes are likely to impact local weather conditions with direct impacts on precipitation patterns and urban drainage. In recent years several studies have focused on revealing the nature, extent...

  11. Impact assessment of subsurface drainage on waterlogged and saline lands.

    Science.gov (United States)

    Ghumman, Abdul R; Ghazaw, Yousry Mahmoud; Niazi, Muhammed F; Hashmi, Hashim N

    2011-01-01

    Waterlogging and salinity due to seepage from canals have polluted land and environment in various parts of Pakistan. A sustainable environment requires urgent remedial measures for this problem. The research in this paper presents the impacts of the Fourth Drainage Project, Faisalabad on the twin problem of waterlogging and salinity. Monitoring of the project was made on regular basis. The key performance indicators for the project include the lowering of water table, improvement of water quality and soil salinity, increase in area under cultivation, cropping intensity, and socioeconomic status of the project population. Data regarding water levels and discharge from the drain pipes were collected to monitor the impact on waterlogging. Soil samples were tested to evaluate the impact of drainage on land. It has been found that the percentage of the contaminated land in the project area has considerably been decreased, while the cropping intensities have been increased.

  12. The use of postoperative suction drainage in total hip arthroplasty.

    Science.gov (United States)

    Acus, R W; Clark, J M; Gradisar, I A; Kovacik, M W

    1992-11-01

    Two hundred eight primary total hip arthroplasties were reviewed to evaluate the effect of closed suction drainage. This review included 45 hips in which closed drains were used and 163 hips in which drains were not used. These two groups were compared for possible differences in wound problems, temperature elevations, changes in Hgb/Hct, and the need for transfusions. There was no statistically significant difference in postoperative temperatures or decrease in Hgb. However, there were four superficial wound infections in the drained group and three superficial wound infections in the non-drained group (P < .025). There were no deep infections in either group. These findings suggest closed suction drainage provides no apparent advantage in uncomplicated primary total hip arthroplasty.

  13. Evaluation of closed-suction drainage for treating auricular hematomas.

    Science.gov (United States)

    Swaim, S F; Bradley, D M

    1996-01-01

    The principal and dynamics of closed-suction wound drainage lend themselves to use on auricular hematomas. This type of drainage was evaluated in the treatment of 10 auricular hematomas on nine animals. Seven animal owners rated the results of the procedure as "good," and two rated them as "fair." The two rating the procedure as having "fair" results owned dogs with allergic dermatitis, and the auricular hematomas recurred. In both dogs, auricular hematomas again recurred after other means of treatment were used. If the pocket for the vacuum tube is not secure and the animal is quite active, or if it molests the bandage, or both, it is possible for the tube to break or the needle to come off of the tubing.

  14. Pollen transport in the Shiyang River drainage, arid China

    Institute of Scientific and Technical Information of China (English)

    ZHU Yan; XIE Yaowen; CHENG Bo; CHEN Fahu; ZHANG Jiawu

    2003-01-01

    In order to assess the contribution of the pollen transported by wind and fluvial flows to the pollen spectra in Shiyang River drainage, a typical small endorheic drainage in arid lands of northwest China, preliminary studies on modern pollen rain along two transects with 91 surface soil samples, 8 atmospheric samples, 30 modern fluvial flow samples and 50 riverbed mud samples, were carried out. Results show that dispersal agents (air, flowing water) have dissimilareffects on transport of pollen and the structure of pollen spectra. Fluvial flow has a stronger capacity than wind to transport large quantities of pollen overlong distances. Pollen transported by fluvial flow makes a large contribution to the pollen spectra of riverbed alluvial sediments. Paleoenvironmental reconstructions undertaken using pollen spectra from fluvial sediments in arid lands arestrongly influenced by pollen transport. Therefore, the sources, the transportation agents and the depositional condition of pollen should be systematically investigated before pollen assemblages are used to derive the environmental significance in such settings.

  15. Risk analysis of sustainable urban drainage and irrigation

    Science.gov (United States)

    Ursino, Nadia

    2015-09-01

    Urbanization, by creating extended impervious areas, to the detriment of vegetated ones, may have an undesirable influence on the water and energy balances of urban environments. The storage and infiltration capacity of the drainage system lessens the negative influence of urbanization, and vegetated areas help to re-establish pre-development environmental conditions. Resource limitation, climate, leading to increasing water scarcity, demographic and socio-institutional shifts promote more integrated water management. Storm-water harvesting for landscape irrigation mitigates possible water restrictions for the urban population in drought scenarios. A new probabilistic model for sustainable rainfall drainage, storage and re-use systems was implemented in this study. Risk analysis of multipurpose storage capacities was generalized by the use of only a few dimensionless parameters and applied to a case study in a Mediterranean-type climate, although the applicability of the model is not restricted to any particular climatic type.

  16. The effect of preoperative nutritional face-to-face counseling about child's fasting on parental knowledge, preoperative need-for-information, and anxiety, in pediatric ambulatory tonsillectomy.

    Science.gov (United States)

    Klemetti, Seija; Kinnunen, Ilpo; Suominen, Tarja; Antila, Heikki; Vahlberg, Tero; Grenman, Reidar; Leino-Kilpi, Helena

    2010-07-01

    The objective of this study was to define how preoperative nutritional face-to-face counseling on child's fasting affects parental knowledge, preoperative need-for-information, and anxiety, in pediatric ambulatory tonsillectomy. The participants in the prospective, randomly allocated study were parents (intervention 62/control 62) with children (4-10 years) admitted for ambulatory tonsillectomy. Data were collected by the knowledge test designed for the study and with The Amsterdam preoperative anxiety and information scale (APAIS). The intervention group was invited to a preoperative visit to receive written and verbal face-to-face counseling. They were initiated into the child's active preoperative nutrition. The parents of the control group received current information without face-to-face counseling. The parents followed the instructions. Their knowledge about the child's fast increased (p=0.003), and need-for-information and anxiety decreased (ppreoperative face-to-face counseling with written information improves parental knowledge about the child's fasting and active preoperative nutrition, and relieves their need-for-information and anxiety. The primary responsibility remains with the health care professionals when the active preoperative nutrition of the child and counseling on it are introduced into nursing practice. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  17. Relationship between Preoperative Clinicopathologic Characteristics and Lymph Node Metastasis in Early Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    LIU Cai-Gang; LU Ping; LU Yang; ZHANG Rui-shan; JIN Feng; XU Hui-mian; WANG Shu-bao; CHEN Jun-qing

    2007-01-01

    Objective: To investigate the features of the preoperative clinicopathologic characteristics in correlation with lymph node metastasis. Methods: The preoperative clinicopathologic characteristics and lymph node metastasis of 265 patients with early gastric carcinoma were analyzed retrospectively. Results: The three clinicopathologic characteristics, maximum cancer diameter >2cm under endoscope, poor differentiation and excavated type were significant high risk independent preoperative clinicopathologic characteristics(P<0.05). The patients who had none of the three preoperative clinicopathologic characteristics had no lymph node metastasis, while 27.27% of the patients who had all the three preoperative clinicopathologic characteristics had N2 lymph node metastasis. Conclusion: The three preoperative clinicopathologic characteristics, maximum cancer diameter under endoscope, cell differentiation and gross type were very useful to evaluate the extent of lymph node metastasis.

  18. Translation and validation of the Amsterdam preoperative anxiety and information scale (APAIS) for use in Japan.

    Science.gov (United States)

    Nishimori, Mina; Moerman, Nelly; Fukuhara, Shunichi; van Dam, F S A M; Muller, M J; Hanaoka, Kazuo; Yamada, Yoshitsugu

    2002-06-01

    Preoperative anxiety is a very common phenomenon that adversely affects a patient's physical and psychological outcome. To evaluate subjective complaints such as anxiety, use of a validated psychological instrument is essential. In this study, we translated, culturally adapted and validated the Amsterdam preoperative anxiety and information scale (APAIS) for use in Japan. One hundred and twenty-six preoperative patients participated in this cross-sectional study. The psychometric properties of the APAIS evaluated by factor analysis, correlation with the state-trait anxiety inventory (STAI) and Cronbach's alpha were very similar to those of the original Dutch and English versions. Female gender and a high information requirement were associated with high preoperative anxiety. In conclusion, the Japanese version of the APAIS is a valid and reliable instrument for screening Japanese patients for preoperative anxiety and information requirements. Female gender and high information requirement may be associated with high preoperative anxiety.

  19. The effects on surgery and preoperative patients with non-small cell lung cancer by preoperative bronchial artery infusion chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Shuhong Tang; Jilai Bian; Mingwu Li

    2008-01-01

    Objective: To study the efficiency, safety and feasibility of preoperative bronchial artery infusion (BAI) chemotherapy on operation in patients with locally advanced (stage Ⅲ) non-small cell lung cancer (NSCLC).Methods: 92 cases with locally advanced NSCLC patients were randomly divided into two groups: (1) BAI chemotherapy group: 39 cases were received BAI chemotherapy for 2 courses and followed surgery; (2) surgery alone group: 51 cases were treated by operation alone.The complete resection rate and preoperative complications were compared between these two groups.Results: In BAI chemotherapy group, the rate of clinical efficiency was 68.3% with slight toxicity.In BAI chemotherapy group the surgery complete resection rate was 89.7%, which was significantly higher than that in surgery alone group (72.5%, P<0.05).No significant differences of blood loss, operative complications and mortality were observed between these two groups.Conclusion: BAI neoadjuvant chemotherapy was safe and effective, which can increase the complete resection rate of the tumor and did not increase the operative complications and mortality.

  20. Laparo-endoscopic Assisted Percutaneous Drainage Gastrostomy and Feeding Jejunostomy

    Directory of Open Access Journals (Sweden)

    Vishwanath Golash

    2010-07-01

    Full Text Available Acquired tracheo-esophageal Fistula (TEF is a rare but serious complication of prolonged endotracheal intubation. Patients of TEF are usually very critically ill and prone to repeated aspiration and pneumonia. The first stage of treatment involves the diversion of salivary and gastric contents away from the fistula site, improving the nutritional status and control of sepsis. A drainage gastrostomy and feeding jejunostomy is often required to divert the gastric contents away from the fistula and for nutrition.