Sample records for relaxing incision lri

  1. A case of keratitis associated with limbal relaxing incision

    Aravind Haripriya


    Full Text Available We report a case of keratitis associated with limbal relaxing incision (LRI. The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD, he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site.

  2. A case of keratitis associated with limbal relaxing incision

    Haripriya, Aravind; Smita, Anand


    We report a case of keratitis associated with limbal relaxing incision (LRI). The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD), he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site. PMID:28112139

  3. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users

    Parvu Valentin


    Full Text Available Abstract Background Previous research has suggested that the silicon BD Atomic Edge™ knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI knife and superior performance characteristics when compared to a steel accurate depth knife when creating limbal relaxing incision. Methods Sixty-five ophthalmic surgeons with limbal relaxing incision experience created limbal relaxing incisions in ex-vivo porcine eyes with silicon and steel accurate depth knives and diamond LRI knives. The ophthalmic surgeons rated multiple performance characteristics of the knives on Visual Analog Scales. Results The observed differences between the silicon knife and diamond knife were found to be insignificant. The mean ratio between the performance of the silicon knife and the diamond knife was shown to be greater than 90% (with 95% confidence. The silicon knife's mean performance was significantly higher than the performance of the steel knife for all characteristics. (p-value Conclusions For experienced users, the silicon accurate depth knife was found to be equivalent in performance to the diamond LRI knife and superior to the steel accurate depth knife when making limbal relaxing incisions in ex vivo porcine eyes. Disposable silicon LRI knives may be an alternative to diamond LRI knives.

  4. A case of endophthalmitis associated with limbal relaxing incision

    Aravind Haripriya


    Full Text Available Limbal relaxing incisions (LRIs are considered a relatively safe procedure with rapid stabilization and absence of infectious complications. Do we need to readdress this last impression? We report a case of nocardia endophthalmitis associated with an exudate at the site of an LRI in a patient who underwent routine cataract surgery. This case, to the best of our knowledge, is the first report of its kind, stressing the need for a cautious approach to the adoption of this method of astigmatic correction.

  5. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users

    Parvu Valentin; Dugue Geoffrey; Albanese John; Bajart Ann M; Lee Edwin


    Abstract Background Previous research has suggested that the silicon BD Atomic Edge™ knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI) knife and superior performance characteristics when compared to a steel accurate dept...

  6. Comparison of clinical outcomes between limbal relaxing incisions and toric intraocular lenses in eyes with astigmatic corneas

    Giuliano de Oliveira Freitas


    Full Text Available Objective: To compare refractive and vectorial outcomes of limbal relaxing incisions (LRI versus toric intraocular lenses (IOL in the treatment of preexisting corneal astigmatism at the time of phacoemulsification. Methods: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism between 0.75 and 2.50 diopters in both eyes. Patients were randomly assorted in two groups: one assigned to receive AcrySof Toric™ IOL in both eyes, and another one assigned to have AcrySof Natural™ IOL associated with LRI, also in both eyes. All patients were re-evaluated, postoperatively, at 1, 3 and 6 months, when refractive astigmatism analysis was performed using vectorial methods proposed by Thibos. Variability of outcomes within each group and between groups were assessed and compared. Results: Manifest refractive cylinder, in diopters (D, as means ± standard deviation, in the LRI group for 1-month, 3-month and 6-month re-evalutions were respectively -0.66 ± 0.30; -0.70 ± 0.21 and -0.74 ± 0.26 when compared to -0.58 ± 0.24; -0.63 ± 0.20, and -0.62 ± 0.17 in the toric IOL group. (p value ≥ 0.06. Vectorial analysis evidenced greater astigmatism reduction in the toric IOL group in the 6th postoperative month, when postoperative mean astigmatic power vector was 0.31 D, when compared to 0.37 D in the LRI group (p value = 0.00. Conclusions: A trend of slightly better refractive outcomes favoring toric IOL group was seen, although such a trend was not statistically significant. Vectorial analysis, however, suggests that the use of toric IOL may constitute a more advantageous approach in the treatment of pre-existing corneal astigmatism, simultaneously with phacoemulsification.

  7. Relaxing incision for control of postoperative astigmatism following keratoplasty.

    Troutman, R C; Swinger, C


    A new technique has been presented which provides a second surgical approach to correct excessive residual astigmatism following keratoplasty. The relaxing incision procedure has advantages over wedge resection in that it can be performed at the slit lamp, it gives no initial overcorrection, and it has a much shorter postoperative course while giving rapid results without suturing. Since this technique does not appear to produce significant hyperopia and may produce a tendency toward myopia, the corneal surgeon would thus have alternative techniques from which to choose, depending, in part, on the spherical component of the refraction.

  8. Corneal relaxing incision combined with phacoemulsification and IOL implantation

    沈晔; 童剑萍; 李毓敏


    Objective: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. Methods: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation.Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. Results: CRI signifi-cantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29±0.17 D(range 0 to 0.5 D) at 1 week, 0.41±0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. Conclusions: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.

  9. Basal lamella relaxing incision improves endoscopic middle meatal access.

    Getz, Anne E; Hwang, Peter H


    Lateralization of the middle turbinate is a commonly cited factor leading to failure of functional endoscopic sinus surgery (FESS). Inadequate medialization during FESS may require repeat intraoperative attempts, and may lead to destabilization and mucosal trauma. A novel technique is described that increases middle meatal area and provides more definitive medialization at the outset of FESS. Twenty-nine middle turbinate medializations were prospectively evaluated in 18 consecutive patients undergoing primary ESS. Three intraoperative images of the middle meatus were obtained in the native position, after Freer medialization, and after basal lamella relaxing incision (BLRI). Measurements of middle meatal area were then calculated in a blinded and randomized fashion. Distances measured from the middle turbinate to the lateral nasal wall for each position ranged from 0 to 8 mm (median = 3.00 mm) for the native position, 0.5 to 10 mm (median = 5.00 mm) for standard Freer medialization, and 3 to 21 mm (median = 10.00 mm) for BLRI. Friedman's analysis of variance (ANOVA) showed that there was significant difference between the 3 measurements, and the post hoc Wilcoxon signed ranks tests showed that BLRI distance (median = 10; 95% confidence interval [CI], 7-11.2) was significantly larger than both standard Freer (median = 5; 95% CI, 4-6.2) and native (median = 3; 95% CI, 2-3) and that standard Freer was significantly larger than native (all p values BLRI is a safe, controlled technique that provides significantly greater medialization of the middle turbinate compared to standard medialization techniques. BLRI significantly enhances the operative space within the middle meatus. © 2013 ARS-AAOA, LLC.

  10. Relaxation incisions of venomous snake "Japanese mamushi" bites to the hand

    Sugamata A


    Full Text Available Akira Sugamata, Naoki Yoshizawa, Takahiro OkadaDepartment of Plastic and Reconstructive Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, JapanAbstract: Gloydius blomhoffii, commonly known as Japanese mamushi, is a venomous viper species found widely in Japan. The most frequently bitten regions are the fingers and toes, and severe swelling causes compression of peripheral arteries and/or compartment syndrome of the extremities. We experienced four cases of mamushi bites to the hand, and undertook relaxation incision in the hands of three of these patients. As a result, the patients who underwent relaxation incision did not show any skin necrosis or permanent sensory disturbance in the affected fingers. Relaxation incision can be useful to not only decompress subcutaneous and compartment pressure of the hand, but also to wash out the venom from the bitten region by improving venous and lymphatic drainage.Keywords: mamushi, snakebite, viper, relaxation incision

  11. Incisões relaxantes limbares durante a cirurgia de catarata: resultados após seguimento de um ano Limbal relaxing incisions during cataract surgery: one-year follow-up

    João Carlos Arraes


    ções pós-operatórias significativas.PURPOSE: To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI aiming to reduce the preoperative astigmatism. METHODS: Sixteen patients who underwent cataract surgery by the phacoemulsification technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm; 1-2D - 2 LRI of 6 mm; 2-3D - 2 LRI of 8 mm. They were done in the most curved meridians, determined by preoperative corneal topography. RESULTS: Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional, maintaining the reduction with no significant alteration until the 12th postoperative month. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. CONCLUSION: Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications.

  12. Incisões relaxantes limbares ou incisões no meridiano mais curvo associadas a facoemulsificação com implante de lente intra-ocular multifocal: relato de três casos Limbal relaxing incision or the more curved meridian incision associated to phacoemulsification with multifocal intraocular lens implant: three case reports

    Wilson Takashi Hida


    Full Text Available O implante de lentes intra-oculares (LIOs multifocais é um grande avanço na reabilitação de pacientes permitindo boa acuidade visual sem correção óptica para longe e perto. Contudo pacientes com alguns graus de astigmatismo corneano tem indicação limitada. Este artigo relata três pacientes que foram submetidas a facoemulsificação com implante de lentes intra-oculares multifocais (AcrySof® Restor®, Alcon Labs após incisão relaxante limbar (IRL no olho dominante e incisão no eixo mais curvo da topografia no olho contralateral. Não foi encontrado nenhuma análise relacionada a dominância ocular e relaxante limbar na literatura. Acredita-se que essa associação pode ampliar as indicações de implante das lentes intra-oculares multifocais em pacientes com astigmatismo corneano significativo, devendo-se confirmar esta possibilidade por meio de futuros estudos.The use of multifocal intraocular lenses (IOLs is a great advance in the treatment of patients with cataract allowing near and distance uncorrected visual acuity recovery. However patients with some degrees of corneal astigmatism have some limitations. We present 3 cases that were indicated for phacoemulsitfication and multifocal intraocular lens implant (AcrySof® Restor®, Alcon Labs after limbal relaxing incision (LRI in the dominant eye and axis topographic incision in the fellow eye. There was no similar case report in the literature. It is believed that this association can extend the indications for multifocal intraocular lens implants in patients with significant corneal astigmatism and this possibility should be confirmed by future studies.

  13. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

    Nino Hirnschall


    Full Text Available Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany, ORA (Ocular Response Analyzer, Reichert Ophthalmic Instruments, USA, and autorefraction (Autorefractometer RM 8800 Topcon were performed postoperatively. Results. Mean age of the study population n=74 was 73.5 years (±9.3; range: 53 to 90 and mean corneal astigmatism preoperatively was −1.82 D (±0.59; 1.00 to 4.50. Mean corneal astigmatism was reduced to 1.14 D (±0.67; 0.11 to 3.89 4 months postoperatively. A partial least squares regression showed that a high eccentricity of the cornea, a large deviation between keratometry and topography, and a high preoperative astigmatism resulted in a larger postoperative error concerning astigmatism. Conclusions. PCRI causes a reduction of preoperative astigmatism, though the prediction is difficult but several factors were found to be a relevant source of error.

  14. Long-term outcomes of limbal relaxing incisions during cataract surgery: aberrometric analysis

    Monaco G


    Full Text Available Gaspare Monaco, Antonio ScialdoneDepartment of Ophthalmology, Ospedale Fatebenefratelli e Oftalmico, Milan, ItalyPurpose: To compare the final changes in corneal wavefront aberration by limbal relaxing incisions (LRIs after cataract surgery.Methods: This prospective cumulative interventional nonrandomized case study included cataract and astigmatic patients undergoing LRIs and phaco with intraocular lens implantation. LRIs were planned using Donnenfeld nomogram. The root mean square of corneal wave aberration for total Z(n,i(1≤n≤8, astigmatism Z(2,±1, coma Z(3–5–7,±1, trefoil Z(3–5–7,±2, spherical Z(4–6–8,0, and higher-order aberration (HOA Z(3≤n≤8 was examined before and 3 years after surgery (optical path difference-Scan II [OPD-Scan II]. Uncorrected distance visual acuity and best-corrected distance visual acuity (CDVA for distance, keratometric cylinder, and variations in average corneal power were also analyzed.Results: Sixty-four eyes of 48 patients were included in the study. Age ranged from 42 to 92 years (70.6±8.4 years. After LRIs, uncorrected distance visual acuity and best-corrected distance visual acuity improved statistically (P<0.01. The keratometric cylinder value decreased by 40.1%, but analysis of KP90 and KP135 polar values did not show any decrease that could be statistically confirmed (P=0.22 and P=0.24. No significant changes were detected in root mean square of total (P=0.61 and HOAs (P=0.13 aberrations. LRIs did not induce alteration in central corneal power confirming a 1:1 coupling ratio.Conclusion: LRIs determined a nonsignificant alteration of corneal HOA. Therefore, LRIs can be still considered a qualitatively viable mean in those cases where toric intraocular lenses are contraindicated or not available. Yet, the authors raise the question of nonpersonalized nomograms, as in the present study, LRIs did not reach the preset target cylinder. Keywords: astigmatism, ocular wavefront, intraocular

  15. Toric Intraocular Lens vs. Peripheral Corneal Relaxing Inci-sions to Correct Astigmatism in Eyes Undergoing Cataract Surgery

    Zhiping Liu; Xiangyin Sha; Xuanwei Liang; Zhonghao Wang; Jingbo Liu; Danping Huang


    Purpose:.To compare toric intraocular lens implantation (Toric-IOL).with peripheral corneal relaxing incisions (PCRIs) for astigmatism correction in patients undergoing cataract surgery. Methods: 54 patients (54 eyes) with more than 0.75 diopter (D).of preexisting corneal astigmatism were classified as group A (0.75-1.50D) or group B (1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation..LogMAR uncorrected visual acuity (LogMAR UCVA), LogMAR best corrected vi sual acuity.(LogMAR BCVA),.error of vector (|EV|), surgery induced refraction correction. (|SIRC|),.and correction rates (CR) were measured 1 month and 6 months postoperatively. Results: At 6 months postoperatively, all 54 eyes had Log-MAR BCVA≤0.2. Patients who underwent PCRIs and Toric-IOL with LogMAR BCVA≤0.1 showed no significant differ-ences in group A (P=1.00) or in group B (P=0.59). Group A showed no significant differences in LogMAR UCVA (P=0.70), |EV| (P=0.13), |SIRC| (P=0.71), and CR (P=0.56) in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in LogMAR UCVA (P Conclusion:.The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients..Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients. PCRIs had the more refractive regression than Toric-IOL in 6 months.

  16. Effect of Relaxing Incisions on the Maxillary Growth after Primary Unilateral Cleft Palate Repair in Mild and Moderate Cases: A Randomized Clinical Trial

    Cotrina-Rabanal, Omar; Figallo-Hudtwalcker, Olga; Gonzalez-Vereau, Alicia


    Background: The purpose of this study was to evaluate the association between the use of relaxing incisions and maxillary growth disturbance after primary palatoplasty in patients with unilateral cleft lip and palate. Methods: This is a prospective, randomized, double-blind controlled trial study with ethical committee approval between 2 groups of patients with unilateral cleft lip and palate who were operated on using the two-flap and one-flap techniques from 2008 to 2011. Two groups of patients with unilateral cleft lip and palate were operated on using the mentioned techniques by the Outreach Surgical Center Program Lima since 2008. Data collection was accomplished by evaluation of maxillary arch dimensions and dental arch relationships (scored using the 5-year-olds’ index). Results: The mean score for the 5-year-olds’ index was 2.57 for two-flap technique and 2.80 for one-flap technique without statistical significant differences (P = 0.71). Our comparative study did not find statistically significant differences in maxillary arch dimensions between the studied techniques for unilateral cleft palate repair. Good levels of agreement were observed according to the κ statistics. Conclusions: The results arising from this clinical trial do not provide statistical evidence that one technique let us obtain better maxillary development than the other at 5 years. The use of relaxing incisions was not associated with maxillary growth impairment. A technique with limited relaxing incisions does not has better maxillary growth. Additional longer term study is necessary to confirm this preliminary report. PMID:28203502

  17. Use of a Toric Intraocular Lens and a Limbal-Relaxing Incision for the Management of Astigmatism in Combined Glaucoma and Cataract Surgery

    Gibbons, Allister


    Purpose We report the surgical management of a patient with glaucoma undergoing cataract surgery with high preexisting astigmatism. A combination of techniques was employed for her astigmatism management. Methods A 76-year-old female with 5.5 dpt of corneal astigmatism underwent surgery in her left eye consisting of one-site trabeculectomy, phacoemulsification, toric intraocular lens implantation and a single inferior limbal-relaxing incision. Results Intraocular pressure control was achieved with no medication at 11 mm Hg; before the filtering procedure, the pressure was 16 mm Hg on two topical drugs. Astigmatism was reduced to 0.75 dpt, and both corrected and uncorrected visual acuity improved. Conclusions Astigmatism management can have a good outcome in combined procedures. We encourage surgeons to address astigmatism in the preoperative planning of patients undergoing glaucoma surgery associated with phacoemulsification. PMID:27293408

  18. 网状减张缝合提高张力皮瓣存活率的实验研究%Experiment research on promoting survival rate of tension skin flap after meshed relaxing short incision suture


    Objective To observe effects of meshed relaxing short incisions on the level of superoxide dismutase and malondialdehyde in rat tension skin flap, and to investigate the mechanism of meshed relaxing short incisions (MRSI) on wound healing process of tension skin flap. Method An experimental model was designed to investingate the changes of superoxide dismutase (SOD) and malondialdehyde (MDA) in rat skin flap tissue each period of wound healing (12h, 24h, 48h, 72h after suture). In the meantime, the biochemical reaction were employed. Results Our results showed that SOD content in rat skin flap tissue from MRSI group were significant higher than that of hypertension group (P≤ 0.05), while MDA content was significantly lower (P≤ 0.05). Conclusion The decrease of MDA contents may be one of the causes that MRSI improves microcirculation of skin flap, and reduces edema and facilitates healing of skin flap.




    The current study presents data on the reliability and validity of the Life Regard Index (LRI), a 28-item scale which was designed to assess positive life regard, degree of experienced meaningfulness of one's life. The theoretical LRI structure, distinguishing two dimensions framework and fulfilment

  20. A nondeforming rhytidectomy incision.

    Talamas, I


    A new incision for facial rhytidectomy is presented that completely avoids deformation of the frame of the hair and allows the hair to be combed back without showing the scar, which becomes almost completely invisible in most patients if the incision is made at exactly the specified level. Several authors have tried to maintain the normal hairline, but some of their incisions deform the frame of the hair on the sides, higher than the level of the outer corner of the eye, and others go even higher than this point outside of the hairline, making the scar quite visible! The indications and contraindications for this operation and its designed incisions are discussed. These incisions encourage plastic surgeons not to remove any scalp in the rhytidectomy, but only the skin, because it is precisely the removal of scalp instead of skin that deforms the face, unless the amount of scalp tissue removed is very small. These same incisions are indicated for men.

  1. 网状减张小切口缝合法提高大鼠背部张力皮瓣存活机制%Mechanism research on promoted survival rate of tension skin flap after meshed relaxing short incision suture

    年申生; 吴岳嵩; 苏佳灿; 侯铁胜; 张春才


    Objective To observe effects of meshed relaxing short incisions (MRSI) on the content of endothelin (ET) in rat tension skin flap,and to investigate the mechanism of meshed relaxing short incisions(MRSI) on wound healing process of tension skin flap.Method We designed an experimental model to investigate the change of ET content caused by MRSI and observe the distribution of ET in rat skin flap tissue each period of wound healing.In the meantime,the immunohistochemistry and auto image analysis were employed.Results Our results showed:(1) ET positive immunologic reaction granules involved in small vascular endothelial cell in rat skin flap tissue increased with prolonging of time within 3 days;(2) the content of ET in MRSI group were significant lower than that of hypertension group (P< 0.05) .Conclusion The decrease of ET contents may be one of the causes that MRSI improves microcirculation of skin flap, and reduces edema and facilitates healing of skin flap.




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  3. Single incision laparoscopic surgery

    Arun; Prasad


    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  4. The inverted Batman incision: a new incision in transcolumellar incision for open rhinoplasty.

    Nakanishi, Yuji; Nagasao, Tomohisa; Shimizu, Yusuke; Miyamoto, Junpei; Fukuta, Keizo; Kishi, Kazuo


    Columellar and nostril shapes often present irregularity after transcolumellar incision for open rhinoplasty, because of the contracture of the incised wound. The present study introduces a new technique to prevent this complication, and verifies its efficacy in improving cosmetic appearance. In our new method, a zig-zag incision with three small triangular flaps is made on the columella and in the pericolumellar regions of the bilateral nostril rims. Since the shape of the incision resembles the contour of an inverted "batman", we term our new method the "Inverted Batman" incision. To verify the effectiveness of the Inverted Batman incision, aesthetic evaluation was conducted for 21 patients operated on using the conventional transcolumellar incision (Conventional Group) and 19 patients operated on using the Inverted Batman incision (Inverted Batman Group). The evaluation was performed by three plastic surgeons, using a four-grade scale to assess three separate items: symmetry of bilateral soft triangles, symmetry of bilateral margins of the columella, and evenness of the columellar surface. The scores of the two groups for these three items were compared using a non-parametric test (Mann-Whitney U-test). With all three items, the Inverted Batman group patients present higher scores than Conventional Group patients. The Inverted Batman incision is effective in preserving the correct anatomical structure of the columella, soft triangle, and nostril rims. Hence, we recommend the Inverted Batman incision as a useful technique for open rhinoplasty.

  5. Craniosynostosis incision: scalpel or cautery?

    Wood, Jeyhan S; Kittinger, Benjamin J; Perry, Victor L; Adenola, Adeyemi; van Aalst, John A


    There is an ongoing debate regarding the optimal instrument for scalp incisions: the scalpel or electrocautery. The argument generally focuses on improved healing after an incision made with a knife and decreased bleeding when using electrocautery. This study compares the use of scalpel and electrocautery in making coronal incisions for patients undergoing surgical correction of craniosynostosis. The outcome metric used is wound healing within 6 months after surgery. All patients presenting to the University of North Carolina Children's Hospital with craniosynostosis between July 1, 2007 and January 1, 2010 requiring a coronal incision for surgical correction were prospectively enrolled. In all of these patients, half of the coronal incision was made with knife; the other half, with needle tip cautery. Side of the incision was specified at the time of surgery in the operative report. Patients were excluded from the study if the instrument for incision was not specified or if only 1 modality was used for the entire incision. Sixty-eight patients underwent cranial vault reconstruction, of which 58 met inclusion criteria. Of the 58 matched pairs, 55 were analyzed statistically. The 3 excluded cases were those who had midline complications. There were 17 wound complications (15%): 8 in the knife group, 6 in the cautery group, and 3 at midline (with indeterminate side for the problem). We found no statistically significant difference in wound healing between incisions made with a knife or with electrocautery.

  6. Botulinum toxin type A combined with relaxation and repression in the facial plastic surgery incision%A型肉毒毒素联合减张压迫法在面部整形美容切口中的应用

    王长慧; 魏翠娥; 孙娆; 丁祥生; 王明明; 装永东


    目的:探讨A型肉毒毒素联合减张压迫法在面部整形美容切口中的应用效果.方法:随机选择30例面部整形美容手术治疗患者作为治疗组,另外选择30例为对照组,其中治疗组患者行整形美容术后即给予A型肉毒毒素注射并于拆线后用3M免缝胶布减张压迫切口,对照组术后不子A型肉毒毒素注射,拆线后即终止治疗.术后9个月对患者进行随访,并对术后切口进行评价,作统计学分析.结果:60例患者切口均为一期愈合.治疗组25例(83.3%)患者切口愈合为成熟期瘢痕,对治疗十分满意;5例(16.7%)患者切口瘢痕稍增宽,对治疗不太满意;治疗组患者表情均完全恢复,未发生A型肉毒毒素注射并发症.对照组仅7例(23.3%)患者切口为基本成熟瘢痕,对切口瘢痕较满意;23例(76.7%)患者切口瘢痕增宽,对治疗不太满意.结论:通过A型肉毒毒素联合减张压迫法在面部整形美容切口中的应用,术后切口愈合理想,患者满意度高,以期更好地促进整形美容术后切口的愈合并防治瘢痕增生.%Objective To evaluate the efficacy of botulinum toxin type A combined with relaxation and repression in the facial plastic surgery incision. Methods 30 cases of facial cosmetic surgery patients were randomized to treatment, the other 30 cases as control groups. Patients in the the treatment group were gived injections of botulinum toxin type Aafter plastic surgery and applied skin closure strips to their scars once the sutures were removed. Patients in the control group received no postoperation intervention.Scars of the patients were followed up after 9 months and evaluated for statistical analysis. Results All the incisions were one-stage healing.83.3% of the treatment group developed mature scars compared with 23.3% in the control group. Face of the patients in the treatment group were completely restored and did not occur complications of botulinum toxin type A. Conclusion By

  7. Heart bypass surgery incision (image)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  8. Channel incision and water quality

    Shields, F. D.


    Watershed development often triggers channel incision that leads to radical changes in channel morphology. Although morphologic evolution due to channel incision has been documented and modeled by others, ecological effects, particularly water quality effects, are less well understood. Furthermore, environmental regulatory frameworks for streams frequently focus on stream water quality and underemphasize hydrologic and geomorphic issues. Discharge, basic physical parameters, solids, nutrients (nitrogen and phosphorus), chlorophyll and bacteria were monitored for five years at two sites along a stream in a mixed cover watershed characterized by rapid incision of the entire channel network. Concurrent data were collected from two sites on a nearby stream draining a watershed of similar size and cultivation intensity, but without widespread incision. Data sets describing physical aquatic habitat and fish fauna of each stream were available from other studies. The second stream was impacted by watershed urbanization, but was not incised, so normal channel-floodplain interaction maintained a buffer zone of floodplain wetlands between the study reach and the urban development upstream. The incised stream had mean channel depth and width that were 1.8 and 3.5 times as large as for the nonincised stream, and was characterized by flashier hydrology. The median rise rate for the incised stream was 6.4 times as great as for the nonincised stream. Correlation analyses showed that hydrologic perturbations were associated with water quality degradation, and the incised stream had levels of turbidity and solids that were two to three times higher than the nonincised, urbanizing stream. Total phosphorus, total Kjeldahl N, and chlorophyll a concentrations were significantly higher in the incised stream, while nitrate was significantly greater in the nonincised, urbanizing stream (p Ecological engineering of stream corridors must focus at least as much energy on mediating hydrologic

  9. Incision for pleural tissue biopsy (image)

    ... the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate ...

  10. SMART micro-scissors based precise incision

    Park, Hyun-Cheol; Yeo, Chaebeom; Song, Cheol


    Hand tremor reduction is important to achieve stable micro manipulation of the tool tip. A micro-scissors can be used for cutting delicate tissues safely. Here, we implement an OCT distance sensor guided SMART micro-scissors which could incise micro-surgical targets precisely and horizontally. Compared to freehand incision, it demonstrates enhanced incision performance on dry phantoms with great tremor suppression.


    ABAID, Rafael Antoniazzi; CECCONELLO, Ivan; ZILBERSTEIN, Bruno


    Background Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. Aim To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. Technique In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. Conclusion Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result. PMID:25004296

  12. Modified tubularized incised plate urethroplasty

    Shivaji Mane


    Full Text Available Aim: To share our experience of doing tubularized incised plate urethroplasty with modifications. Materials and Methods: This is a single surgeon personal series from 2004 to 2009. One hundred patients of distal hypospadias were subjected for Snodgrass urethroplasty with preputioplasty. The age range was 1 to 5 year with mean age of 2.7 years. Selection criteria were good urethral plate, without chordee and torsion needing complete degloving. Main technical modification from original Snodgrass procedure was spongioplasty, preputioplasty, and dorsal slit when inability to retract prepuce during surgery. Results: Average follow-up period is 23 months. Seven (7% patients developed fistula and one patient had complete preputial dehiscence. Phimosis developed in three (3% patients and required circumcision. Dorsal slit was required in seven patients. One patient developed meatal stenosis in postoperative period. All other patients are passing single urinary stream and have cosmesis that is acceptable. Conclusions: Modified tubularized incised plate urethroplasty with preputioplasty effectively gives cosmetically normal looking penis with low complications.

  13. Supra-Pubic Single Incision Cholecystectomy

    Hagen, Monika E.; Wagner, Oliver J.; Thompson, Kari; Jacobsen, Garth; Spivack, Adam; Wong, Brian; Talamini, Mark; Horgan, Santiago


    Introduction Surgery is moving towards less invasive and cosmetically superior approaches such as single incision laparoscopy (SIL). While trans-umbilical SIL is gaining popularity, incisions may lead to post-operative deformations of the umbilicus and the possibility of an increased rate of incisional hernias. Access within the pubic hairline allows preservation of the umbilicus and results in a scar which is concealed within the pubic hair. Methods Supra-pubic single incision cholecystectom...

  14. Patient Satisfaction with Postaural Incision Site

    George Barrett


    Full Text Available Introduction. Controversy exists over the optimum incision placement when performing ear surgery via the postauricular approach. Little is known about the impact of incision placement on future comfort in wearing audio or visual aids or the effect on the minor auricular muscles cut in the approach. Objective. (1 To establish patient satisfaction with their postauricular surgical incision, and to establish the impact on comfort wearing hearing or visual aids. (2 To establish whether patients’ voluntary ear movements were affected by surgery. Materials and Methods. In January 2014, questionnaires were sent to 81 patients who underwent mastoid surgery requiring a postauricular incision between January 2004 and December 2012. The incision placement was broadly the same for all patients as they were operated on by the same surgeon (or under his supervision. The incision is sited far posteriorly at the hairline. Results. 42 (52% of the patients contacted responded. 80% of patients wearing glasses reported no discomfort or problems associated with their incision. 82% of patients who wear hearing aids were comfortable. Only 1 of the 5 patients who could move their ears preoperatively noticed a change afterwards. Conclusion. A hairline incision is well tolerated by most of the patients.

  15. Hillslope-derived blocks retard river incision

    Shobe, Charles M.; Tucker, Gregory E.; Anderson, Robert S.


    The most common detachment-limited river incision models ignore the effects of sediment on fluvial erosion, yet steep reaches of mountain rivers often host clusters of large (>1 m) blocks. We argue that this distribution of blocks is a manifestation of an autogenic negative feedback in which fast vertical river incision steepens adjacent hillslopes, which deliver blocks to the channel. Blocks inhibit incision by shielding the bed and enhancing form drag. We explore this feedback with a 1-D channel-reach model in which block delivery by hillslopes depends on the river incision rate. Results indicate that incision-dependent block delivery can explain the block distribution in Boulder Creek, Colorado. The proposed negative feedback may significantly slow knickpoint retreat, channel adjustment, and landscape response compared to rates predicted by current theory. The influence of hillslope-derived blocks may complicate efforts to extract base level histories from river profiles.




    Full Text Available Introduction: Hyperthrophic scar and keloid is a big problem after many operation. Hypertrophic scar depended on many factor one of them is Incision. Method: This is a randomized clinical trial and sequential sampling in Alzahra hospital and Kashani hospital. we selected two groups, one group we used S shape incision and observed group linear incision. Age was between 10-30 years and dermatological problems and cigaret smoking was Negative in two groups perforated and secondly skin closure was excluded in our study. patient divided in two group each group was twenty and fllowed for one year. Patients satisfaction and skin collor normality and itchiny was evaluated in two groups. Results: Appearance of scar was different in collor much and shape. Normality for collor of incision in s shape groups were 68.4% but in linar incision was 31.6% (Pvalue= 0.026 with statically meaningful. Mean of scar width: In 5-shape =1.33+0.49mm in Linear shape = 2.23+0.92. P = 0.001. Prevalence of itching was same in both groups. Discussion: patients overall satisfaction and itching were the same for both groups. skin color normality was 68.4% in 5 shape incision groups versus 31.6% in linear incision groups which has been shown to be statistically meaningful using chi-square test so it seems reasonable to conclude that calor mathing is more favorable in 5 shape incisions rather than linear incision. Mean of scare width in licear incision group was 2.23+0.92 mm versus 1.32+0.49 mm in 5 shape incision group. this difference is also statistically meaningful using T test. 50 it can be concluded that using 5 shape incision is better because post operative scar is smaller and exposure is like linear incision.

  17. Single Incision Laparoscopic Splenectomy: Our First Experiences

    Umut Barbaros


    Full Text Available Objective: Most laparoscopic surgeons have attempted to reduce incisional morbidity and improve cosmetic outcomes by using less and smaller trocars. Single incision laparoscopic splenectomy is a new laparoscopic procedure. Herein we would like to present our experiences.Material and Methods: Between January 2009 and June 2009, data of the 7 patients who underwent single incision laparoscopic splenectomy were evaluated retrospectively.Results: There were 7 patients (5 females and 2 males with a mean age of 29.9 years. The most common splenectomy indication was idiopathic thrombocytopenic purpura. Single incision laparoscopic splenectomy was performed successfully in 6 patients. In one patient the operation was converted to an open procedure.Conclusion: With surgeons experienced in minimally invasive surgery, single incision laparoscopic splenectomy could be performed successfully. However, in order to demonstrate the differneces between standard laparoscopic splenectomy and SILS splenetomy, prospective randomized comparative studies are required.

  18. Single-incision total laparoscopic hysterectomy

    Sinha Rakesh


    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  19. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Xin-Lei Xia; Hong-Li Wang; Fei-Zhou Lyu; Li-Xun Wang; Xiao-Sheng Ma; Jian-Yuan Jiang


    Background:The concept of minimally invasive techniques is to make every effort to reduce tissue damage.Certainly,reducing skin incision is an important part of these techniques.This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF) with a small single posterior median incision.Methods:During the period of March 2011 to March 2012,34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group).The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group.The perioperative conditions of patients in these two groups were statistically analyzed and compared.The Oswestry Disability Index (ODI) scores,Visual Analog Scale (VAS) scores,and sacrospinalis muscle damage evaluation indicators before operation and 3,12 months postoperation were compared.Results:A total of 31 and 35 cases in the single incision and double incision groups,respectively,completed at least 12 months of systemic follow-up.The differences in perioperative conditions between the two groups were not statistically significant.The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01).The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation.However,these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05).Conclusions:Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  20. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Xin-Lei Xia


    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  1. DNA Methylation Modulates Nociceptive Sensitization after Incision.

    Yuan Sun

    Full Text Available DNA methylation is a key epigenetic mechanism controlling DNA accessibility and gene expression. Blockade of DNA methylation can significantly affect pain behaviors implicated in neuropathic and inflammatory pain. However, the role of DNA methylation with regard to postoperative pain has not yet been explored. In this study we sought to investigate the role of DNA methylation in modulating incisional pain and identify possible targets under DNA methylation and contributing to incisional pain. DNA methyltranferase (DNMT inhibitor 5-Aza-2'-deoxycytidine significantly reduced incision-induced mechanical allodynia and thermal sensitivity. Aza-2'-deoxycytidine also reduced hindpaw swelling after incision, suggesting an anti-inflammatory effect. Global DNA methylation and DNMT3b expression were increased in skin after incision, but none of DNMT1, DNMT3a or DNMT3b was altered in spinal cord or DRG. The expression of proopiomelanocortin Pomc encoding β-endorphin and Oprm1 encoding the mu-opioid receptor were upregulated peripherally after incision; moreover, Oprm1 expression was further increased under DNMT inhibitor treatment. Finally, local peripheral injection of the opioid receptor antagonist naloxone significantly exacerbated incision-induced mechanical hypersensitivity. These results suggest that DNA methylation is functionally relevant to incisional nociceptive sensitization, and that mu-opioid receptor signaling might be one methylation regulated pathway controlling sensitization after incision.

  2. Natural relaxation

    Marzola, Luca; Raidal, Martti


    Motivated by natural inflation, we propose a relaxation mechanism consistent with inflationary cosmology that explains the hierarchy between the electroweak scale and Planck scale. This scenario is based on a selection mechanism that identifies the low-scale dynamics as the one that is screened from UV physics. The scenario also predicts the near-criticality and metastability of the Standard Model (SM) vacuum state, explaining the Higgs boson mass observed at the Large Hadron Collider (LHC). Once Majorana right-handed neutrinos are introduced to provide a viable reheating channel, our framework yields a corresponding mass scale that allows for the seesaw mechanism as well as for standard thermal leptogenesis. We argue that considering singlet scalar dark matter extensions of the proposed scenario could solve the vacuum stability problem and discuss how the cosmological constant problem is possibly addressed.

  3. Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery

    Nidhi Jauhari


    Full Text Available AIM:To determine the surgically induced astigmatism (SIA in Straight, Frown and Inverted V shape (Chevron incisions in manual small incision cataract surgery (SICS.METHODS:A prospective cross sectional study was done on a total of 75 patients aged 40y and above with senile cataract. The patients were randomly divided into three groups (25 each. Each group received a particular type of incision (Straight, Frown or Inverted V shape incisions. Manual SICS with intraocular lens (IOL implantation was performed. The patients were compared 4wk post operatively for uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA and SIA. All calculations were performed using the SIA calculator version 2.1, a free software program. The study was analyzed using SPSS version 15.0 statistical analysis software.RESULTS:The study found that 89.5% of patients in Straight incision group, 94.2% in Frown incision group and 95.7% in Inverted V group attained BCVA post-operatively in the range of 6/6 to 6/18. Mean SIA was minimum (-0.88±0.61D×90 degrees with Inverted V incision which was statistically significant.CONCLUSION:Inverted V (Chevron incision gives minimal SIA.

  4. Single incision laparoscopic colorectal resection: Our experience

    Chinnusamy Palanivelu


    Full Text Available Background: A prospective case series of single incision multiport laparoscopic colorectal resections for malignancy using conventional laparoscopic trocars and instruments is described. Materials and Methods: Eleven patients (seven men and four women with colonic or rectal pathology underwent single incision multiport laparoscopic colectomy/rectal resection from July till December 2010. Four trocars were placed in a single transumblical incision. The bowel was mobilized laparoscopically and vessels controlled intracorporeally with either intra or extracorporeal anastomosis. Results: Three patients had carcinoma in the caecum, one in the hepatic flexure, two in the rectosigmoid, one in the descending colon, two in the rectum and two had ulcerative pancolitis (one with high grade dysplasia and another with carcinoma rectum. There was no conversion to standard multiport laparoscopy or open surgery. The median age was 52 years (range 24-78 years. The average operating time was 130 min (range 90-210 min. The average incision length was 3.2 cm (2.5-4.0 cm. There were no postoperative complications. The average length of stay was 4.5 days (range 3-8 days. Histopathology showed adequate proximal and distal resection margins with an average lymph node yield of 25 nodes (range 16-30 nodes. Conclusion: Single incision multiport laparoscopic colorectal surgery for malignancy is feasible without extra cost or specialized ports/instrumentation. It does not compromise the oncological radicality of resection. Short-term results are encouraging. Long-term results are awaited.

  5. Sigmoid volvulus treated by mini-incision.

    Seow-En, I; Seow-Choen, F


    Definitive surgical management of sigmoid volvulus is usually via a midline laparotomy or laparoscopy. We report our experience with a series of five consecutive cases over a 10-year period. All patients had definitive surgery via a left iliac fossa mini-incision after prior decompression. For four patients, it was the first episode of sigmoid volvulus and one patient had a recurrent sigmoid volvulus after previous sigmoid colectomy. The latter patient had pan colonic megacolon diagnosed at initial surgery. All five cases were surgically treated successfully via a mini-incision on the left iliac fossa. There were no instances of recurrence at a median follow-up duration of 95 months (range 7-132 months). A left iliac fossa mini-incision is sufficient for the definitive management of non-perforated sigmoid volvulus. Larger studies are warranted to draw definitive conclusions.

  6. Single incision endoscopic surgery for lumbar hernia.

    Kawaguchi, Masahiko; Ishikawa, Norihiko; Shimizu, Satsuki; Shin, Hisato; Matsunoki, Aika; Watanabe, Go


    Single Incision Endoscopic Surgery (SIES) has emerged as a less invasive surgery among laparoscopic surgeries, and this approach for incisional hernia was reported recently. This is the first report of SIES for an incisional lumbar hernia. A 66-year-old Japanese woman was referred to our institution because of a left flank hernia that developed after left iliac crest bone harvesting. A 20-mm incision was created on the left side of the umbilicus and all three trocars (12, 5, and 5 mm) were inserted into the incision. The hernial defect was 14 × 9 cm and was repaired with intraperitoneal onlay mesh and a prosthetic graft. The postoperative course was uneventful. SIES for lumbar hernia offers a safe and effective outcome equivalent compared to laparoscopic surgery. In addition, SIES is less invasive and has a cosmetic benefit.

  7. Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

    Md Shafiqul Alam


    Full Text Available Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3% was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of

  8. Single-Incision Laparoscopic Total Colectomy

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


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

  9. Radiological findings after endoscopic incision of ureterocele

    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Cheon, Jung Eun [Chungmu General Hospital, Chungmu (Korea, Republic of); Seok, Eul Hye [Seran General Hospital, Seoul (Korea, Republic of); Cha, Joo Hee [Green General Hospital, Seoul(Korea, Republic of); Choi, Guk Myung [Halla General Hospital, Cheju (Korea, Republic of)


    Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required.

  10. Longitudinal incision in surgical release of De Quervain disease.

    Gundes, Hakan; Tosun, Bilgehan


    The objective of this paper is to contrast the use of a longitudinal incision in surgical decompression of De Quervain disease with a transverse incision. The advantages are ease in recognition of compartment variations and superficial branches of radial nerve and prevention of palmar tendon subluxation by permitting a more dorsal release of the compartment sheath. Since 2002, we have used a longitudinal skin incision instead of the classic transverse incision to release the first dorsal compartment.

  11. Comparison of three incisions to repair complete unilateral cleft lip.

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.


    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  12. Comparison of three incisions to repair complete unilateral cleft lip.

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.


    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  13. Neck incision planning for total laryngectomy: A finite element analysis.

    Feng, Allen L; Clark, James H; Agrawal, Nishant; Moussa, Walied; Richmon, Jeremy D


    Post-operative complications can be attributed to technical aspects of surgery, yet no studies have investigated the mechanics behind commonly used incisions for total laryngopharyngectomies (TLP). This procedure, seen in head and neck cancer patients, necessitates free tissue transfer to construct a neo-pharynx, creating an inherently greater risk of complications. We sought to investigate the impact of neck incision location on these post-operative complications for TLP using finite element analysis (FEA). A nonlinear hyperelastic 2-D finite element model was used to evaluate the stress and strain along the incision line of two separate neck incision models commonly used for TLP: low-neck apron (LNA) incisions that incorporate the patient׳s tracheostoma and mid-neck apron (MNA) incisions that do not communicate with the tracheostoma. A constant displacement was applied to the incision to simulate normal neck extension experienced during the post-operative phase. Each neck incision was also modeled at varying strain energy densities to simulate various stages of wound healing. For a constant displacement of 40mm, the principal von Mises stress of the LNA incision varied between 5.87 and 6.41MPa, depending on the hyperelastic properties of the healing incision. This stress was concentrated at the junction of the incision and the fixed tracheostomal edge. The MNA model demonstrated a principal von Mises stress that varied between 0.558 and 0.711MPa and was concentrated along the midline of the neck incision. MNA incisions for TL patients result in principal von Mises stresses which are up to 11 times lower than those seen in LNA incisions. These results coincided with clinical observations from a concurrent study that showed a decrease in rate of wound dehiscence for patients undergoing TLP with an MNA incision.

  14. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction.

    Djordjevic, Miroslav L; Kojovic, Vladimir


    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14-82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting.

  15. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction

    Miroslav L Djordjevic; Vladimir Kojovic


    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction.Between April 2005 and June 2011,62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction.Malleable and inflatable penile prostheses ware inserted in 49 and 13 cases,respectively.Penile prostheses were inserted into the corpora cavemosa using the standard ventral approach.After lifting the neurevascular bundle,the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis.Subsequently,the wide neurovascular bundle was replaced,and all incisions of the tunica albuginea were covered to prevent corporal grafting.In the median follow-up of 35 months (range 14-82 months),the penis was completely straightened in 59 (95%) patients.Numbness of the glans,which the patients found initially upsetting,decreased or disappeared spontaneously 3-6 months later.Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea witheut additional grafting.

  16. Minimally invasive "pocket incision" aortic valve surgery.

    Yakub, M A; Pau, K K; Awang, Y


    A minimally invasive approach to aortic valve surgery through a transverse incision ("pocket incision") at the right second intercostal space was examined. Sixteen patients with a mean age of 30 years underwent this approach. The third costal cartilage was either excised (n = 5) or dislocated (n = 11). The right internal mammary artery was preserved. Cardiopulmonary bypass (CPB) was established with aortic-right atrial cannulation in all except the first case. Aortic valve replacements (AVR) were performed in 15 patients and one had aortic valve repair with concomitant ventricular septal defect closure. There was no mortality and no major complications. The aortic cross-clamp, CPB and operative times were 72 +/- 19 mins, 105 +/- 26 mins and 3 hrs 00 min +/- 29 mins respectively. The mean time to extubation was 5.7 +/- 4.0 hrs, ICU stay of 27 +/- 9 hrs and postoperative hospital stay of 5.1 +/- 1.2 days. Minimally invasive "pocket incision" aortic valve surgery is technically feasible and safe. It has the advantages of central cannulation for CPB, preservation of the internal mammary artery and avoiding sternotomy. This approach is cosmetically acceptable and allows rapid patient recovery.

  17. The assessment of cold hyperalgesia after an incision.

    Scherer, Moritz; Reichl, Sylvia U; Augustin, Miriam; Pogatzki-Zahn, Esther M; Zahn, Peter K


    Although cold hypersensitivity is a well-documented phenomenon in animals and humans with inflammatory and neuropathic pain, little is known about the presence of cold hyperalgesia after surgery. Therefore, we studied primary cold hyperalgesia after a surgical incision in mice. Before and after plantar incision, inflammation with complete Freund adjuvant, and spared nerve ligation, unrestrained male animals were placed on a Peltier-cooled cold plate with a surface temperature of 0 degrees C and withdrawal latencies were measured. Additionally, incision-induced cold hyperalgesia was also assessed in female animals. Furthermore, skin temperature before and after plantar incision and inflammation were assessed by using infrared thermography (Varioscan LW 3011; Infratec, Dresden, Germany). Cold hyperalgesia to a noxious cold stimulus was observed after inflammation and nerve injury but not after a surgical incision. Similar results were demonstrated for female animals after incision. Furthermore, a significant increase in skin temperature was recorded after inflammation but not after incision, indicating that a surgery evokes only minor inflammatory effects. The present data give strong evidence that a surgical incision does not cause cold hyperalgesia. Furthermore, a lack of cold hyperalgesia in unrestrained male and female mice after incision was not due to increased skin temperature after incision. Finally, we demonstrated that in contrast to a surgical incision, inflammation and nerve injury generate intense cold hyperalgesia and an increase in skin temperature, suggesting that different mechanisms are involved in surgical and inflammatory or neuropathic pain.

  18. Closed incision management with negative pressure wound therapy (CIM): biomechanics.

    Wilkes, Robert Peyton; Kilpad, Deepak V; Zhao, Yabin; Kazala, Richard; McNulty, Amy


    A novel closed incision management with negative pressure wound therapy (CIM) has been developed for convenient use with closed incisions that has the potential to be beneficial for patients at risk for postoperative complications. Incisions are typically under lateral tension. This study explored the biomechanical mechanisms by which integrity of the incisional closure is enhanced by CIM. CIM was hypothesized to affect local stresses around closed incisions in a beneficial manner. Finite element analyses (FEA) indicated that application of CIM decreased the lateral stresses ~50% around the incision and changed the direction of the stresses to a distribution that is typical of intact tissue. Bench evaluations corroborated findings that CIM significantly increased the force required to disrupt the closed incision by ~50% as compared with closure alone. In conclusion, using 2 FEAs and bench modeling, CIM was shown to reduce and normalize tissue stresses and bolster appositional forces at the incision.

  19. The use of a surgical incision management system on vascular surgery incisions: a pilot study.

    Weir, Gregory


    Health care-associated infections in hospitals, including surgical site infections, contribute significantly to morbidity as well as mortality. Surgical incision management (SIM) using negative pressure wound therapy (Prevena™ Incision Management System, Kinetic Concepts, Inc., San Antonio, TX, USA) is designed to cover and protect closed surgical incisions from external factors including infectious sources and local trauma, while negative pressure removes fluid and infectious material from the surgical incision. A prospective case-control study assessed wound complications in patients undergoing vascular bypass procedures, where both femoral areas were incised to gain access to the femoral arteries. SIM was placed on one femoral area while a standard postoperative wound dressing was placed on the contralateral femoral area. Eight patients were included in this pilot study. All of them required bilateral femoral artery access. During the follow-up period patients were monitored for wound complications. All wound complications requiring surgical intervention were considered significant. No significant wound complications occurred in wounds treated with SIM, compared with three significant complications in control wounds. These preliminary data would suggest a potential reduction in wound complications and no observed increase in haemorrhage in high-risk patients with severe co-morbidities undergoing vascular surgery.

  20. Right Kocher’s incision: a feasible and effective incision for right hemicolectomy: a retrospective study

    Theodosopoulos Theodosios


    Full Text Available Abstract Background The choice of surgical incision is determined by access to the surgical field, particularly when an oncological resection is required. Special consideration is also given to other factors, such as postoperative pain and its sequelae, fewer complications in the early postoperative period and a lower occurrence of incisional hernias. The purpose of this study is to compare the right Kocher’s and the midline incision, for patients undergoing right hemicolectomy, by focusing on short- and longterm results. Methods Between 1995 and 2009, hospital records for 213 patients that had undergone a right hemicolectomy for a right- sided adenocarcinoma were retrospectively studied. 113 patients had been operated via a Kocher’s and 100 via a midline incision. Demographic details, operative data (explorative access to the peritoneal cavity, time of operation, recovery parameters (time with IV analgesic medication, time to first oral fluid intake, time to first solid meal, time to discharge, and oncological parameters (lymph node harvest, TNM stage and resection margins were analyzed. Postoperative complications were also recorded. The two groups were retrospectively well matched with respect to demographic parameters and oncological status of the tumor. Results The median length of the midline incision was slightly longer (12 vs. 10 cm, p  Conclusions The Kocher’s incision approach for right- sided colon cancer is technically feasible, safe and overall very well tolerated. It can achieve the same standards of tumor resection and surgical field accessibility as the midline approach, while reducing postoperative recovery.

  1. Relaxation Techniques for Health

    ... R S T U V W X Y Z Relaxation Techniques for Health Share: On This Page What’s the ... Bottom Line? How much do we know about relaxation techniques? A substantial amount of research has been done ...

  2. Clinical Use of a Drain Incision Placed Below and Bilaterial to Near Total Thyroidectomy Incision

    LIU Bao-guo; ZHAO Qi-kang; CHEN Rong-rui; LI Ming-qiang; WANG Jian-jun


    Objective:To design a new draining method for near total thyroidectomy at the lower two sides of the neck.Methods:Near total thyroidectomies in 63 cases were performed with new drain incisions at the lower two sides of the neck between December 1998 and July 2004. Results:All the draining operative procedures were performed smoothly,and all produced cosmetic scars were effective. The mean amount drained was 38 ml(minimum 10 ml,maximum 120 ml)and no patient developed wound infection. Conclusion:The drain incision for near total thyroidectomy placed at the lower sides of the neck results in a cosmetic scar which is easily covered by the collar,and was safe and efiective.We thereby recommend the use of this drain incision for near total thyroidectomy.


    刘宝国; 王斌; 张乃嵩


    Objective: To design a new draining method for hemithyroidectomy at the lower side of the neck. Methods:Hemithyroidectomies of 235 cases were performed with the new drain incision at the lower side of the neck between December 1998 and July 2003. Results: All the draining operative procedures were performed smoothly, and produced a cosmeticulous scar. The mean amount drained was 20 ml (minimum 5 ml, maximum 80 ml) and no patients developed wound infection. Conclusion: The drain incision for hemithyroidectomy placed at the lower side of the neck results in a cosmeticulous scar which is easily covered by the collar and was safe and effective. We thereby recommend the use of this drain incision for hemithyroidectomy.

  4. Latent Period of Relaxation.

    Kobayashi, M; Irisawa, H


    The latent period of relaxation of molluscan myocardium due to anodal current is much longer than that of contraction. Although the rate and the grade of relaxation are intimately related to both the stimulus condition and the muscle tension, the latent period of relaxation remains constant, except when the temperature of the bathing fluid is changed.

  5. Minimum-incision metatarsal ray resection: an observational case series.

    Roukis, Thomas S


    This report describes the results of 17 metatarsal ray resections performed through a minimal incision in 13 consecutive patients. Each patient underwent minimum-incision metatarsal ray resection for either definitive treatment or as the index incision and drainage procedure followed by transmetatarsal amputation. There were 10 male and 3 female patients with a mean age of 68.8 +/- 8.5 years (range, 59-83 years). Twelve patients had diabetes mellitus and 7 had critical limb ischemia. There were 11 right feet and 6 left feet involved, and 3 second, 3 third, 3 fourth, and 8 fifth minimum-incision metatarsal ray resections performed. Direct primary-incision closure was performed 7 times (1 with adjacent percutaneous metatarsal osteotomy), delayed primary closure was performed 4 times (1 with external fixation), and conversion to a transmetatarsal amputation was performed 2 times. Fourteen of 17 minimum-incision metatarsal ray resections were deemed successful. Two failures occurred when skin necrosis developed from excessive tension along the incision line requiring conversion to a transmetatarsal amputation, and the other occurred in a patient with unreconstructed critical limb ischemia who underwent multiple repeated incision and drainage procedures and vascular bypass with ultimate healing via secondary intent. When properly performed in patients with adequate vascular inflow, minimum-incision metatarsal ray resection as the definitive procedure or in conjunction with an incision and drainage for unsalvageable toe infection or gangrene represents a safe, simple, useful technique.

  6. A single incision transaxillary thoracoscopic sympathectomy

    Marić Nebojša


    Full Text Available Background/Aim. Primary hyperhidrosis causes are unknown. The disorder begins in early childhood. It intensifies in puberty and maturity. It is equally present in both sexes. The symptoms exacerbate when the body temperature rises and due to emotional stimuli affecting the sympathetic nerve system. The aim of this study was to demonstrate that videoassisted thoracoscopic surgery (VATS sympathectomy is a method for primary focal hyperhidrosis permanent treatment. The single incision method in properly selected patients maximizes the intervention effectiveness and minimizes aesthetic side effects. Methods. This prospective study analysed the findings in patients who had been operated on due to primary focal hyperhidrosis (face, palms, and armpits using a single small transaxilarry incision in the third inter-rib space at the level of the anterior axillary line with two 5 mm flexible ports. All the patients, with T2-T5 thoracoscopic sympathectomy of the sympathetic chain using a single small incision in the third inter-rib space in the anterior axillary line, were analysed in the period from September 2009 to November 2010 regarding the postoperative morbidity and outcomes of the operation (clinical evaluation and visual analogue scale with a view to assessing the effectiveness of the surgery conducted in this manner. Results. A total of 47 patients (18 men, 29 women, 18 to 48 years old (29 on average had underwent 94 bilateral video-assisted thoracoscopic sympathectomies. The sympathectomy was indicated in cases of facial blushing and sweating (6.38%, palmary sweating (34.04%, axillary sweating (14.89% or both palmary and axillary sweating (44.68%. The largest percentage of patients (98.6% had left the hospital the following day. The postoperative 30 day’s mortality was 0 and the conversion into open surgery was not necessary. As for complications, there had been an occurrence of partial pneumothorax in two patients treated by means of

  7. Small-incision lenticule extraction (SMILE)

    Hansen, Rasmus Søgaard; Lyhne, Niels; Grauslund, Jakob


    PURPOSE: To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. METHODS: Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany...... surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. CONCLUSIONS: In the short term, SMILE seemed...

  8. Transanal polypectomy using single incision laparoscopic instruments.

    Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C


    Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible.

  9. [Incisions for biaxial and coaxial microincision cataract surgery].

    Müller, M; Kohnen, T


    Microincision cataract surgery (MICS) represents a new level in the development of cataract surgery. Phacoemulsification with intraocular lens (IOL) implantation via incisions of phaco tip (C-MICS), or by the biaxial approach, with separation of the phaco tip and irrigation (B-MICS). Compared with standard small-incision cataract surgery, the advantages of MICS are less corneal astigmatism and fewer corneal surface irregularities, with favorable implications for visual quality and early rehabilitation. In the effort toward smaller incisions, special interest should be given to wound integrity, especially regarding the risk of endophthalmitis. With limited corneal elastic capacity, irreversible expansion of the incision with tissue laceration may occur. Smaller incisions are superior only if they cause less trauma. This requires an optimized relationship between incision size and manipulation during IOL implantation as well as attention to safety issues. MICS offers a platform for new benchmarks in phacoemulsification.

  10. Vertical compared with transverse incisions in abdominal surgery

    Grantcharov, T P; Rosenberg, J


    OBJECTIVE: To reach an evidence-based consensus on the relative merits of vertical and transverse laparotomy incisions. DESIGN: Review of all published randomised controlled trials that compared the postoperative complications after the two main types of abdominal incisions, vertical and transverse......, and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less.......0001), and regarding late incisional hernia the pooled odds ratio was 1.68 (95% confidence interval 1.10 to 2.57. p = 0.02). CONCLUSIONS: Transverse incisions in abdominal surgery are based on better anatomical and physiological principles. They should be recommended, as the early postoperative period is associated...

  11. Single-incision laparoscopic bariatric surgery

    Huang Chih-Kun


    Full Text Available Background: Bariatric surgery has been established as the best option of treatment for morbid obesity. In recent years single-incision laparoscopic surgery (SILS has emerged as another modality of carrying out the bariatric procedures. While SILS represents an advance, its application in morbid obesity at present is limited. In this article, we review the technique and results of SILS in bariatric surgery. Methods: The PubMed database was searched and totally 11 series reporting SILS in bariatric surgery were identified and analyzed. The case reports were excluded. Since 2008, 114 morbidly obese patients receiving SILS bariatric surgeries were reported. Results: The procedures performed included SILS gastric banding, sleeve gastrectomy and gastric bypass. No mortality was reported in the literatures. Sixteen patients (14.05% needed an additional incision for a liver retractor, a trocar or for conversion. Only one complication of wound infection was reported in these series. All the surgeons reported that the patients were highly satisfied with the scar. Conclusion: Because of abundant visceral and subcutaneous fat and multiple comorbidities in morbid obesity, it is more challenging for surgeons to perform the procedures with SILS. It is clear that extensive development of new instruments and technical aspects of these procedures as well as randomized studies to compare them with traditional laparoscopy are essential before these procedures can be utilized in day-to-day clinical practice.

  12. Current Status of Single-incision Laparoscopic Surgery

    Ahmed, Irfan; Ciancio, Fabio; Ferrara, Vincenzo;


    Recent advances in minimally invasive surgery have centered on reducing the number of incisions required, which has led to the development of the single-incision laparoscopic technique. A panel of European single-incision laparoscopy experts met to discuss the current status of, and the future...... expectations for, the technique. The experts reached agreement on a number of statements and recommendations, which will support surgeons in adopting the technique. The panel agreed that the single-incision technique may offer a number of benefits to patients; however, further clinical data need...

  13. Laparoscopic vs mini-incision open appendectomy

    Fatih; ?ift?i


    AIM: To compare laparoscopic vs mini-incision open appendectomy in light of recent data at our centre.METHODS: The data of patients who underwen appendectomy between January 2011 and June 2013 were collected. The data included patients’ demographic data, procedure time, length of hospital stay, the need for pain medicine, postoperative visual analog scale o pain, and morbidities. Pregnant women and patients with previous lower abdominal surgery were excluded Patients with surgery converted from laparoscopic appendectomy(LA) to mini-incision open appendectomy(MOA) were excluded. Patients were divided into two groups: LA and MOA done by the same surgeon. The patients were randomized into MOA and LA groups a computer-generated number. The diagnosis of acute appendicitis was made by the surgeon with physica examination, laboratory values, and radiological tests(abdominal ultrasound or computed tomography). Al operations were performed with general anaesthesia The postoperative vision analog scale score was recorded at postoperative hours 1, 6, 12, and 24. Patients were discharged when they tolerated normal food and passed gas and were followed up every week for three weeks as outpatients.RESULTS: Of the 243 patients, 121(49.9%) underwen MOA, while 122(50.1%) had laparoscopic appendectomy There were no significant differences in operation time between the two groups(P = 0.844), whereas the visua analog scale of pain was significantly higher in the open appendectomy group at the 1st hour(P = 0.001), 6th hour(P = 0.001), and 12 th hour(P = 0.027). The need for analgesic medication was significantly higher in the MOA group(P = 0.001). There were no differences between the two groups in terms of morbidity rate(P = 0.599)The rate of total complications was similar between the two groups(6.5% in LA vs 7.4% in OA, P = 0.599). Al wound infections were treated non-surgically. Six ou of seven patients with pelvic abscess were successfully treated with percutaneous drainage; one

  14. Isolated subtalar arthrodesis through minimal incision surgery.

    Carranza-Bencano, A; Tejero-García, S; Del Castillo-Blanco, G; Fernández-Torres, J J; Alegrete-Parra, A


    In recent years there has been an increase in the use of minimally invasive techniques, such as arthroscopy, percutaneous, and minimally invasive incisions, for foot and ankle surgery. The purpose of this study was to analyze the fusion rate and clinical results of isolated subtalar arthrodesis (ISA) using the novel and original technique of minimal incision surgery (MIS). There were a total of 77 feet in 76 patients who underwent ISA and were followed for 50 months on average (range, 15-108). The first 30 cases were evaluated retrospectively, and 47 cases were evaluated prospectively. MIS without tourniquet was used in all cases and fusion was assessed radiographically and clinically. Clinical outcome measures used were the Angus and Cowell Scoring System, AOFAS Ankle-Hindfoot, the SF-36, and a patient satisfaction questionnaire 12 months after the intervention. Radiographic and clinical consolidation was achieved in 92% of cases. Main outcomes were "good" in 57 patients as determined by the Angus and Cowell criteria, with 13 "fair" and 7 "poor" results. In the prospective group, AOFAS scores improved by 47.6 points (95% CI: 50.7-42.5) 12 months after surgical intervention. SF-36 outcomes improved by 14.5 points (95% CI: 11.58-17.31) in the mental summary component and 4.2 points (95% CI: 2.2-6.1) in the physical summary component. We recorded no cases of early complications such as wound infections, neurovascular damage, or delayed wound healing. To our knowledge, the present series represents the largest study on subtalar arthrodesis using minimally invasive surgery. The data obtained showed a similar rate of bony union and clinical outcomes compared with the literature, but without early wound complications. ISA using the MIS technique was a good option for patients at greater risk of wound healing complications. Level IV, case series.

  15. Single-Incision Laparoscopic Surgery (SILS Assisted Sigma Resection Via Pfannenstiel Incision for Complicated Diverticulitis

    Arne Dietrich


    Results: The operation time ranged from 89 to 280 min. There were no conversions, and no additional trocars were used. The postoperative hospital stay ranged from 5 to 14 days. All patients were discharged without any intraoperative or postoperative complications. Conclusions: SILS sigma or anterior rectum resection for complicated diverticulitis can be performed via a Pfannenstiel incision. This approach provides direct visualization and access into the pelvis as well as the option to benefit from open surgery devices. The Pfannenstiel incision may generally be recommended for the favorable cosmetic effect and the very low rate of incisional hernias, as reported in the literature. [Arch Clin Exp Surg 2014; 3(1.000: 10-15

  16. Transurethral incision of urethral diverticulum in the female

    Miskowiak, J; Honnens de Lichtenberg, M


    A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time.......A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time....

  17. The stream channel incision syndrome and water quality

    Watershed development often triggers channel incision, which accounts for 60-90% of sediments leaving many disturbed watersheds. Impacts of such incision on water quality processes and the implication of such impairment on stream biota are relevant to issues associated with establishing total maxim...

  18. Cost assessment of instruments for single-incision laparoscopic cholecystectomy

    Henriksen, Nadia A; Al-Tayar, Haytham; Rosenberg, Jacob;


    Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed...... as conventional laparoscopic 4-port cholecystectomy or as single-incision laparoscopic cholecystectomy....

  19. Modeling the Evolution of Incised Streams: III. Model Application

    Incision and ensuing widening of alluvial stream channels is widespread in the midsouth and midwestern United States and represents an important form of channel adjustment. Two accompanying papers have presented a robust computational model for simulating the long-term evolution of incised and resto...

  20. SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy.

    Kim, Sungsoo; Kim, Yoo Seok; Min, Young-Don


    Superior mesenteric artery (SMA) syndrome is a mechanical duodenal obstruction by the SMA. The traditional approach to SMA syndrome was open bypass surgery. Nowadays, a conventional approach has been replaced by laparoscopic surgery. But single incision laparoscopic approach for SMA syndrome is rare. Herein, we report the first case of SMA syndrome patient who was treated by single incision laparoscopic duodenojejunostomy.

  1. Single incision laparoscopic right hemicolectomy:different approaches

    WONG Tak-man; DAY Weida; KWOK Shu-yan; LAU Ying-yu Patrick; YIP Wai-chun Andrew


    Background Single incision laparoscopic colectomy has been performed in recent years,and has been shown to be feasible and safe.This study was to assess the feasibility of single incision laparoscopic right hemicolectomy and to compare the differences in different approaches.Methods This retrospective study included eighteen patients with carcinoma of caecum and ascending colon,undergoing single incision laparoscopic right hemicolectomy.This study also compared single incision laparoscopic right hemicolectomy using different approaches:(1) single incision multiport,(2) single access port and (3) glove port.Results There was no statistical difference in surgical outcomes.Concerning the surgeon's satisfaction toward three methods,overcrowding and durability were similar but the single incision multiport was associated with the highest gas-leak and the "glove" port was associated with poor durability.However,the method of single incision multiport has the lowest average cost of the special trocar or port in each operation.The operative time and blood loss of the operations in this study were comparable to previous publications.Conclusion There was no significant difference between different approaches of single incision laparoscopic right hemicolectomy for colonic cancer in right side colon.

  2. First Canadian experience with robotic single-incision pyeloplasty: Comparison with multi-incision technique

    Law, Jeffrey; Rowe, Neal; Archambault, Jason; Nastis, Sofia; Sener, Alp; Luke, Patrick P.


    Introduction: We compared the outcomes of single-incision, robot-assisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system. Methods: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA). Results: Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups. Conclusions: Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated. PMID:27217850

  3. Influence of Incision Location on Transmitter Loss, Healing, Incision Lengths, Suture Retention, and Growth of Juvenile Chinook Salmon

    Panther, Jennifer L.; Brown, Richard S.; Gaulke, Greggory L.; Woodley, Christa M.; Deters, Katherine A.


    In this study, conducted by Pacific Northwest National Laboratory for the U.S. Army Corps of Engineers, Portland District, we measured differences in survival and growth, incision openness, transmitter loss, wound healing, and erythema among abdominal incisions on the linea alba, lateral and parallel to the linea alba (muscle-cutting), and following the underlying muscle fibers (muscle-sparing). A total of 936 juvenile Chinook salmon were implanted with both Juvenile Salmon Acoustic Tracking System transmitters (0.43 g dry) and passive integrated transponder tags. Fish were held at 12°C (n = 468) or 20°C (n = 468) and examined once weekly over 98 days. We found survival and growth did not differ among incision groups or between temperature treatment groups. Incisions on the linea alba had less openness than muscle-cutting and muscle-sparing incisions during the first 14 days when fish were held at 12°C or 20°C. Transmitter loss was not different among incision locations by day 28 when fish were held at 12°C or 20°C. However, incisions on the linea alba had greater transmitter loss than muscle-cutting and muscle-sparing incisions by day 98 at 12°C. Results for wound closure and erythema differed among temperature groups. Results from our study will be used to improve fish-tagging procedures for future studies using acoustic or radio transmitters.

  4. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Amedo AO


    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  5. Testing bedrock incision models: Holocene channel evolution, High Cascades, Oregon

    Sweeney, K. E.; Roering, J. J.; Fonstad, M. A.


    There is abundant field evidence that sediment supply controls the incision of bedrock channels by both protecting the bed from incision and providing tools to incise the bed. Despite several theoretical models for sediment-dependent bedrock abrasion, many investigations of natural channel response to climatic, lithologic, or tectonic forcing rely on the stream power model, which does not consider the role of sediment. Here, we use a well-constrained fluvial channel cut into a Holocene lava flow in the High Cascades, Oregon to compare incision predictions of the stream power model and of the full physics of theoretical models for saltation-abrasion incision by bedload and suspended load. The blocky andesite of Collier lava flow erupted from Collier Cone ~1500 years ago, paving over the existing landscape and erasing fine-scale landscape dissection. Since the eruption, a 6 km stream channel has been incised into the lava flow. The channel is comprised of three alluvial reaches with sediment deposits up to 2 m thick and two bedrock gorges with incision of up to 8 m, with larger magnitude incision in the upstream gorge. Abraded forms such as flutes are present in both gorges. Given the low magnitude and duration of modern snowmelt flow in the channel, it is likely that much of the incision was driven by sediment-laden outburst floods from the terminus of Collier Glacier, which is situated just upstream of the lava flow and has produced two outburst floods in the past 100 years. This site is well suited for comparing incision models because of the relatively uniform lithology of the lava flow and our ability to constrain the timing and depth of incision using the undissected lava surface above the channel as an initial condition. Using a simple finite difference scheme with airborne-Lidar-derived pre-incision topography as an initial condition, we predict incision in the two gorges through time with both stream power and sediment-dependent models. Field observations

  6. The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

    Hyunjic Lee


    Full Text Available Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP joints, and the proximal interphalangeal (PIP joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

  7. The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

    Hyunjic Lee


    Full Text Available Dupuytren’s contracture is a condition commonly encountered by hand surgeons, although itis rare in the Asian population. Various surgical procedures for Dupuytren’s contracture havebeen reported, and the outcomes vary according to the treatment modalities. We report thetreatment results of segmental fasciectomies with multiple transverse incisions for patientswith Dupuytren’s contracture. The cases of seven patients who underwent multiple segmentalfasciectomies with multiple transverse incisions for Dupuytren’s contracture from 2006 to 2011were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites wereperformed initially, and additional incisions to the metacarpophalangeal (MCP joints, and theproximal interphalangeal (PIP joints were performed if necessary. Segmental fasciectomiesby removing the fibromatous nodules or cords between the incision lines were performed andthe wound margins were approximated. The mean range of motion of the involved MCP jointsand PIP joints was fully recovered. During the follow-up periods, there was no evidence ofrecurrence or progression of disease. Multiple transverse incisions for Dupuytren’s contractureare technically challenging, and require a high skill level of hand surgeons. However, weachieved excellent correction of contractures with no associated complications. Therefore,segmental fasciectomies with multiple transverse incisions can be a good treatment option forDupuytren’s contracture.

  8. Indentation load relaxation test

    Hannula, S.P.; Stone, D.; Li, C.Y. (Cornell Univ., Ithaca, NY (USA))

    Most of the models that are used to describe the nonelastic behavior of materials utilize stress-strain rate relations which can be obtained by a load relaxation test. The conventional load relaxation test, however, cannot be performed if the volume of the material to be tested is very small. For such applications the indentation type of test offers an attractive means of obtaining data necessary for materials characterization. In this work the feasibility of the indentation load relaxation test is studied. Experimental techniques are described together with results on Al, Cu and 316 SS. These results are compared to those of conventional uniaxial load relaxation tests, and the conversion of the load-indentation rate data into the stress-strain rate data is discussed.

  9. Relaxation techniques for stress

    ... problems such as high blood pressure, stomachaches, headaches, anxiety, and depression. Using relaxation techniques can help you feel calm. These exercises can also help you manage stress and ease the effects of stress on your body.




    Full Text Available MATERIAL & METHODS : This randomized , prospective study was carried out on patient attending out patients department of ophthalmology L . L . R . hospital ( G S V M Medical College Kanpur during the time period of 2 years . Detailed history , general examination & ophthalmic examination done . Then they under went Dacryocystorhinostomy surgery . These patients divided into two groups the Group ‘A’ and Group ‘B’ . Group . A patients underwent the dacryocystorhinostomy surgery with manual scalpel incision and Group B patients underwent the surgery with radiofrequency tools . The subsequent follow up was done at the intervals at one week , 3 weeks , 6 weeks and 6 months . Some w ere followed more frequently whenever needed . RESULTS : The present study was conducted on 118 eyes of 102 patients , o f these 56 eyes ( 48 patients received skin incision with manual scalpel ( Group ‘A’ and 62 eyes ( 54 patients received skin incision with r adiofrequency knife ( Group ‘B’ . The intraoperative bleeding and mean surgical time per case was less with rad i frequency knife that is in group B . There was also faster wound healing with more numbers cases of excellent scar quality on postoperative follo w up in Group B . DISCUSSION : Intraoperative average numbers of gauze pieces used per case was less in Group B because of electrocoagulation action of radiofrequency tools . That is why the mean surgical time per case was less in Group B . Patients was compar ed for scar quality by giving them scores according to Manchester scar scale score and60% patients in Group B achieves excellent scar quality scores in comparison to group A in which only 48% patients achieves excellent scar quality scores . CONCLUSION : There is less intraoperative bleeding and less mean surgical time per case and faster healing with excellent scar quality postoperatively in early and late follow ups with radiofrequency tools than manual scalpel .

  11. Perturbations and quantum relaxation

    Kandhadai, Adithya


    We investigate whether small perturbations can cause relaxation to quantum equilibrium over very long timescales. We consider in particular a two-dimensional harmonic oscillator, which can serve as a model of a field mode on expanding space. We assume an initial wave function with small perturbations to the ground state. We present evidence that the trajectories are highly confined so as to preclude relaxation to equilibrium even over very long timescales. Cosmological implications are briefly discussed.

  12. Techniques for posterior lamellar keratoplasty through a scleral incision

    Melles, GRJ; Kamminga, N


    Purpose. To describe several techniques for posterior lamellar keratoplasty through a scleral incision, for management of corneal endothelial disorders like pseudophacic bullous keratopathy and Fuchs' endothelial dystrophy, and to report the mid-term clinical results. Methods. Three techniques have

  13. Single-incision laparoscopic management of a giant hepatic cyst.

    Willems, Kaitlin; Monsivais, Sharon; Vassaur, Hannah; Buckley, Francis P


    Large symptomatic hepatic cysts may warrant surgical management. Traditional multiport laparoscopic technique is typically preferred over open laparotomy, but the use of the single-incision laparoscopic approach for this diagnosis is not well documented. Here, we describe the case of a 68-year-old woman who underwent complete anterior wall fenestration, excision and cauterization of a simple hepatic cyst via a single-incision laparoscopic technique through an incision at the umbilicus. The objective of this case report is to document single-incision laparoscopy as a safe, feasible and cosmetically appealing approach for the management of a large hepatic cyst. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  14. Landscape evolution due to river incision in active mountains

    Lavé, L.; Attal, A.


    It is commonly accepted that fluvial network incision control the local base level for hillslopes and therefore controls the rate of landscape denudation, and thus the way the landscape will respond to tectonic or climatic forcings. For that reason, many studies have focused for the last ten years in quantifying fluvial incision rates and the mechanisms of fluvial incision into bedrock. In many morphotectonic settings the shear stress model has been widely used and provided satisfactory first order description of the river incision in active mountains. Across the Siwaliks range in front of the Himalaya, the shear stress model (that also includes bedload mean pebble size and explicit channel width variations), provides a good proxy to estimate incision and uplift rate, that can be measured independently from fluvial terraces studies. By transposition and after calibration to more resistant crystalline lithologies, this model helped to define the incision rate profiles across the whole Himalayan ranges. These profiles were found coherent with current seismotectonic model, sediment budget, fluvial terrace studies and geochronology results. More importantly, the incision model was found to provide good results in two other active regions: across the Nanga Parbat massif in Pakistan, and in the San Gabriel Ranges in California, with only minor required changes of the erodibility coefficient despite very different hydroclimatic setting. However, this semi-empirical model is not mechanically satisfying: in many settings, river bedload fluxes exert an important control on incision rates, by limiting bedrock exposure or by providing an efficient tool for river mechanical abrasion. A reappraisal of the former examples as thus conducted in order to test different models including the role of sediment fluxes. General results and models will be first discussed in light of their physical consistency with field and experimental data on pebble and bedrock abrasion, and second in

  15. Transumbilical single-incision laparoscopic hepatectomy: an initial report

    HU Ming-gen; ZHAO Guo-dong; XU Da-bing; LIU Rong


    Transumbilical single-incision laparoscopic surgeries have attracted the attention of surgeon. Here we report a patient with multiple hepatic hemagiomas and symptomatic cholelithiasis who underwent laparoscopic left lateral hepatecomy and left hepatic hemangioma enucleation with single incision followed by cholecystectomy. The duration of the operation was 155 minutes and the blood loss was 100 ml. There were no complications during or after the treatment. This surgical treatment yields a good cosmetic effect and rapid recovery.

  16. Usefulness of Ω-shaped Incision in Skin Tumor Excision

    Naoshige Iida, MD, PhD


    Full Text Available Summary: We devised the Ω-shaped incision as a technique for skin tumor resection on the areas of skin with an arc-shaped fold. With this technique, the dog-ear that is formed during 6 wound closure can be resected within the range of the first skin incision. We report this technique after performing it on the face or trunk of 18 patients and confirmed its usefulness.

  17. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision

    Yongqi He


    Full Text Available Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions. Methods. 120 patients (134 eyes underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry. Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively (=.84>.05, which showed no statistic significance difference. Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.

  18. Molecular Relaxation in Liquids

    Bagchi, Biman


    This book brings together many different relaxation phenomena in liquids under a common umbrella and provides a unified view of apparently diverse phenomena. It aligns recent experimental results obtained with modern techniques with recent theoretical developments. Such close interaction between experiment and theory in this area goes back to the works of Einstein, Smoluchowski, Kramers' and de Gennes. Development of ultrafast laser spectroscopy recently allowed study of various relaxation processes directly in the time domain, with time scales going down to picosecond (ps) and femtosecond (fs

  19. Ultrasonic incisions produce less inflammatory mediator response during early healing than electrosurgical incisions.

    Bindu Nanduri

    Full Text Available As the use of laparoscopic surgery has become more widespread in recent years, the need has increased for minimally-invasive surgical devices that effectively cut and coagulate tissue with reduced tissue trauma. Although electrosurgery (ES has been used for many generations, newly-developed ultrasonic devices (HARMONIC® Blade, HB have been shown at a macroscopic level to offer better coagulation with less thermally-induced tissue damage. We sought to understand the differences between ES and HB at a microscopic level by comparing mRNA transcript and protein responses at the 3-day timepoint to incisions made by the devices in subcutaneous fat tissue in a porcine model. Samples were also assessed via histological examination. ES-incised tissue had more than twice as many differentially-expressed genes as HB (2,548 vs 1,264 respectively, and more differentially-expressed proteins (508 vs 432 compared to control (untreated tissue. Evaluation of molecular functions using Gene Ontology showed that gene expression changes for the energized devices reflected the start of wound healing, including immune response and inflammation, while protein expression showed a slightly earlier stage, with some remnants of hemostasis. For both transcripts and proteins, ES exhibited a greater response than HB, especially in inflammatory mediators. These findings were in qualitative agreement with histological results. This study has shown that transcriptomics and proteomics can monitor the wound healing response following surgery and can differentiate between surgical devices. In agreement with clinical observations, electrosurgery was shown to incur a greater inflammatory immune response than an ultrasonic device during initial iatrogenic wound healing.

  20. Morphine reduces local cytokine expression and neutrophil infiltration after incision

    Li Xiangqi


    Full Text Available Abstract Background Inflammation and nociceptive sensitization are hallmarks of tissue surrounding surgical incisions. Recent studies demonstrate that several cytokines may participate in the enhancement of nociception near these wounds. Since opioids like morphine interact with neutrophils and other immunocytes, it is possible that morphine exerts some of its antinociceptive action after surgical incision by altering the vigor of the inflammatory response. On the other hand, keratinocytes also express opioid receptors and have the capacity to produce cytokines after injury. Our studies were directed towards determining if opioids alter cytokine production near incisions and to identify cell populations responsible for producing these cytokines. Results A murine incisional model was used to measure the effects of acute morphine administration (0.1–10 mg/kg on nociceptive thresholds, neutrophil infiltration and cytokine production in hind paw skin 30 minutes and 2 hours after incision. Incised hind paws displayed profound allodynia which was reduced by morphine (0.1–10 mg/kg in the 2 hours following incision. Skin samples harvested from these mice showed enhanced levels of 5 cytokines: IL-1β, IL-6, tumor necrosis factor alpha (TNFα, granulocyte colony stimulating factor (G-CSF and keratinocyte-derived cytokine (KC. Morphine reduced these incision-stimulated levels. Separate analyses measuring myeloperoxidase (MPO and using immunohistochemistry demonstrated that morphine dose-dependently reduced the infiltration of neutrophils into the peri-incisional tissue. The dose of morphine required for reduction of cytokine accumulation, however, was below that required for inhibition of peri-incisional neutrophil infiltration. Additional immunohistochemical studies revealed wound edge keratinocytes as being an important source of cytokines in the acute phase after incision. Conclusion Acute morphine administration of doses as low as 0.1 mg/kg reduces

  1. Lateral Erosion Encourages Vertical Incision in a Bimodal Alluvial River

    Gran, K. B.


    Sand can have a strong impact on gravel transport, increasing gravel transport rates by orders of magnitude as sand content increases. Recent experimental work by others indicates that adding sand to an armored bed can even cause armor to break-up and mobilize. These two elements together help explain observations from a bimodal sand and gravel-bedded river, where lateral migration into sand-rich alluvium breaks up the armor layer, encouraging further incision into the bed. Detailed bedload measurements were coupled with surface and subsurface grain size analyses and cross-sectional surveys in a seasonally-incised channel carved into the upper alluvial fan of the Pasig-Potrero River at Mount Pinatubo, Philippines. Pinatubo erupted in 1991, filling valleys draining the flanks of the volcano with primarily sand-sized pyroclastic flow debris. Twenty years after the eruption, sand-rich sediment inputs are strongly seasonal, with most sediment input to the channel during the rainy season. During the dry season, flow condenses from a wide braided planform to a single-thread channel in most of the upper basin, extending several km onto the alluvial fan. This change in planform creates similar unit discharge ranges in summer and winter. Lower sediment loads in the dry season drive vertical incision until the bed is sufficiently armored. Incision proceeds downstream in a wave, with increasing sediment transport rates and decreasing grain size with distance downstream, eventually reaching a gravel-sand transition and return to a braided planform. Incision depths in the gravel-bedded section exceeded 3 meters in parts of a 4 km-long study reach, a depth too great to be explained by predictions from simple winnowing during incision. Instead, lateral migration into sand-rich alluvium provides sufficient fine sediment to break up the armor surface, allowing incision to start anew and increasing the total depth of the seasonally-incised valley. Lateral migration is recorded in a

  2. Relationship of Incisive Papilla to Maxillary Incisors and Canines.

    Shrestha, Suraksha; Joshi, Sarita Pradhan; Yadav, Santosh Kumar


    The study was carried to find a relationship between the postextraction stable landmark, the incisive papilla, and the most labial position of the maxillary central incisor teeth, which occurred in Nepalese population. Casts of the subjects selected by nonprobability random sampling meeting the inclusion criteria were obtained. Each casts were standardized with respect to the occlusal plane and a photographic technique was used to measure the distance from the tangent of the labial surface of the central incisors to the posterior border of the incisive papilla. The measurements were made using Adobe Photoshop and results were analyzed by using appropriate statistical methods. Most appropriate software (SPSS) for the purpose was used to generate all desired values. The data obtained suggested that the distance from the labial surface of maxillary central incisors to the posterior border of the incisive papilla ranged from 9 to 15.9 mm with a mean of 11.59 mm (SD 1.3). Various other results were also found after evaluation of the arch forms in relation to sex and race. Within the limitations of the study, these results suggested that there is a relationship between the maxillary central incisors and the incisive papilla aiding in the anteroposterior positioning of the anterior tooth. The clinical relevance of the study lies in application of the incisive papilla as a starting point in the preliminary location of maxillary incisors and canines during construction of the denture in absence of preextraction records.

  3. Slide crown lengthening procedure using wide surface incisions and cyanoacrylate.

    Szymaitis, Dennis W


    This article introduces the slide crown lengthening procedure (SCLP), which incorporates surgical design features to overcome present crown lengthening procedure (CLP) shortcomings. The result is a 75% decrease in required surgery on adjacent teeth and a corresponding 75% reduction in surgical time. Other advantages include a reduction in surgical morbidity, improvement in terminal esthetics, and fewer teeth subject to papillae removal and apically repositioned gingiva. The 20 to 30 degree incision forming the slide is the pivotal feature; it allows effortless flap positioning. This incision angle enables wide surface incisions to adhere flaps together by producing stronger fibrin clots, decreasing tissue retraction angles, and reforming disrupted fibrin clots as incision sides slide while maintaining contact. This enhanced fibrin clot eliminates the need for sutures. The slide produced by the 20 to 30 degree incision functions for crown lengthening on all sites (facial, lingual, or palatal). This versatile surgical design introduces a new healing dimension that adapts to and provides benefits for other dental surgeries, such as gingival grafts, endodontic surgery, implants, and extractions.

  4. Modification of the Nuss Procedure: The Single-incision Technique

    Tetsushi Aizawa, MD


    Full Text Available Summary: The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

  5. Time between skin incision and delivery during cesarean.

    Rossouw, Jana N; Hall, David; Harvey, Justin


    To investigate factors influencing skin incision-to-delivery time (including sub-divisions thereof) and the effect of these surgical intervals on immediate neonatal outcome. A prospective cohort analysis was conducted of all women undergoing cesarean delivery at Tygerberg Hospital, Cape Town, South Africa, from May 24 to November 2, 2010. Three surgical intervals were evaluated: skin incision to myometrium, myometrium to delivery, and skin incision to delivery. Neonatal outcome was assessed by the 5-minute Apgar score. Of 1120 cesarean deliveries recorded during the study period, 77.2% were emergency procedures, which were performed more quickly at all surgical planes (Pdelivery time was significantly extended among repeat procedures (Pdeliveries. Repeat procedures, adhesions, and obesity prolonged the time taken for cesarean delivery. Nevertheless, the effect of these factors on the 5-minute Apgar score was minimal. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.


    刘宝国; 王成学; 张乃嵩


    Objective: To report the development of a technique for minimally invasive thyroid lobectomy. Method: The procedure was accepted by 200 patients with a nodule of the lobe of the thyroid. We performed hemithyroidectomys through a 2-4 cm low-collar horizontal skin incision by conventional instrumentation. Results: The recurrent laryngeal nerve and the parathyroid glands were easily identified and preserved. The amount of bleeding ranged from 5 to 50 ml (mean 15 ml). Mean Operation time was 52.2 minutes (ranged 32 to 80 minutes). No complication occurred. Mean postoperative stay was 5.5 days (ranged 4 to 7 days). The incision provided excellent cometic results because the small and lower incisions were completely hidden by clothing collar. Conclusion: The above technique is feasible, safe, minimally invasive, less time and cost consuming and cosmetical.

  7. Sharp compared with blunt fascial incision at cesarean delivery

    Aabakke, Anna J M; Hare, Kristine J; Krebs, Lone


    OBJECTIVE: To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control. STUDY DESIGN: Women undergoing primary cesarean delivery (n=34) were randomized...... to side distribution of sharp or blunt incision of the fascia (sharp right and blunt left or blunt right and sharp left) and followed three months postoperatively. The primary outcome was patient preference for the right or left side of the scar 3 months postoperatively and modeled by polytomous logistic...... difference was found in patient preference with regard to sharp or blunt incision of the fascia, nor was there a significant difference in postoperative pain scores. CLINICAL TRIAL REGISTRATION:;NCT01297725....

  8. Single-incision laparoscopy surgery: a systematic review

    far, Sasan Saeed; Miraj, Sepide


    Background Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body. Objective This systematic review is aimed to overview single-incision laparoscopy surgery. Methods This systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references. In this study, 54 studies were accepted for further screening and met all our inclusion criteria [in English, full text, therapeutic effects of single-incision laparoscopy surgery and dated mainly from the year 1990 to 2016]. The search terms were “single-incision,” “surgery,” and “laparoscopy.” Results Single-incision laparoscopy surgery is widely used for surgical operations in cholecystectomy, sleeve gastrectomy, cholecystoduodenostomy, hepatobiliary disease, colon cancer, obesity, appendectomy, liver surgery, rectosigmoid cancer, vaginal hysterectomy, vaginoplasty, colorectal lung metastases, pyloroplasty, endoscopic surgery, hernia repair, nephrectomy, rectal cancer, colectomy and uterus-preserving repair, bile duct exploration, ileo-ileal resection, lymphadenectomy, incarcerated inguinal hernia, anastomosis, congenital anomaly, colectomy for cancer. Conclusion Based on the findings, single-incision laparoscopy surgery is a scarless surgery with minimal access. Although it possesses lots of benefits, including less incisional pain and scars, cosmesis, and the ability to convert to standard multiport laparoscopic surgery, it has some disadvantages, for example, less freedom of movement, fewer number of ports that can be used, and the proximity of the instruments to each other during the operation. PMID:27957308

  9. Hair Dye and Hair Relaxers

    ... For Consumers Consumer Information by Audience For Women Hair Dye and Hair Relaxers Share Tweet Linkedin Pin it More sharing ... products. If you have a bad reaction to hair dyes and relaxers, you should: Stop using the ...

  10. Meta-analysis of the effectiveness of surgical scalpel or diathermy in making abdominal skin incisions.

    Ahmad, Nasir Zaheer


    BACKGROUND: Surgical scalpels are traditionally used to make skin incisions. Diathermy incisions on contrary are less popular among the surgeons. The aim of this meta-analysis was to compare the effectiveness of both techniques and address the common fallacies about diathermy incisions. METHODS: A literature search of MEDLINE and Cochrane databases was done, using the keywords diathermy, cold scalpel, and incisions. Eleven clinical trials comparing both methods of making skin incisions were selected for meta-analysis. The end points compared included postoperative wound infection, pain in first 24 hours after surgery, time taken to complete the incisions, and incision-related blood loss. RESULTS: Postoperative wound infection rate was comparable in both techniques (P = 0.147, odds ratio = 1.257 and 95% CI = 0.923-1.711). Postoperative pain was significantly less with diathermy incisions in first 24 hours (P = 0.031, weighted mean difference = 0.852 and 95% CI = 0.076-1.628). Similarly, the time taken to complete the incision and incision-related blood loss was significantly less with diathermy incisions (95% CI = 0.245-0.502 and 0.548-1.020, respectively). CONCLUSION: Diathermy incisions are equally prone to get wound infection, as do the incisions made with scalpel. Furthermore, lower incidence of early postoperative pain, swiftness of the technique, and a reduced blood loss are the encouraging facts supporting routine use of diathermy for abdominal skin incisions after taking careful precautions.

  11. Simulation of channel sandstone architecture in an incised valley

    Frykman, P.; Johannessen, P.; Andsbjerg, J.


    The present report describes a geostatistical modelling study that is aimed at reflecting the architecture of the channel sandstones in an incised valley fill. The example used for this study is a part of the Middle Jurassic sandy succession of the Bryne Formation in the Danish central Graben. The succession consists mainly of fluvial sediments in the lower part, overlain by tidal influenced sediments, which again is overlain by shallow marine sediments. The modelling study has been performed on a sequence of incised valley sediments in the upper part of the Bryne Formation overlying fluvial sediments. (au) EFP-96. 19 refs.

  12. Kinetic Actviation Relaxation Technique

    Béland, Laurent Karim; El-Mellouhi, Fedwa; Joly, Jean-François; Mousseau, Normand


    We present a detailed description of the kinetic Activation-Relaxation Technique (k-ART), an off-lattice, self-learning kinetic Monte Carlo algorithm with on-the-fly event search. Combining a topological classification for local environments and event generation with ART nouveau, an efficient unbiased sampling method for finding transition states, k-ART can be applied to complex materials with atoms in off-lattice positions or with elastic deformations that cannot be handled with standard KMC approaches. In addition to presenting the various elements of the algorithm, we demonstrate the general character of k-ART by applying the algorithm to three challenging systems: self-defect annihilation in c-Si, self-interstitial diffusion in Fe and structural relaxation in amorphous silicon.

  13. Nonlinear fractional relaxation

    A Tofighi


    We define a nonlinear model for fractional relaxation phenomena. We use -expansion method to analyse this model. By studying the fundamental solutions of this model we find that when → 0 the model exhibits a fast decay rate and when → ∞ the model exhibits a power-law decay. By analysing the frequency response we find a logarithmic enhancement for the relative ratio of susceptibility.


    Haridarshan Sira


    Full Text Available BACKGROUND Laparoscopic surgery has undergone several modifications since its advent. There has been a shift from a standard multiport approach to more minimalistic approaches. SILS is a major step in this evolutionary process. We present our experience with SILS using conventional laparoscopic instruments and without the need for a SILS port. METHODS 211 patients in Fortis Hospitals, Bangalore, India, who underwent SILS for various abdominal conditions from May 2009 to May 2011 were included in the study. Variables such as operating time, conversion to multi-port laparoscopy or open surgery, complications, analgesia requirements and hospital stay were included. RESULTS 211 patients underwent SILS using conventional laparoscopic instruments for Gallstones, Appendicitis, Morbid Obesity, Gynaecological conditions and Renal cysts. Average age group was 48.5 years; mean duration of hospital stay was 46.5 hours; 166 Laparoscopic cholecystectomies were done, out of which 47 were acute cholecystitis. There were no cases converted to open surgeries. CONCLUSION Single Incision Laparoscopic surgery is technically feasible and as effective as conventional laparoscopic surgery. It is a safe procedure and provides an advantage with regards to analgesia requirement, length of hospital stay and early return to work. Cosmetically, it is superior to multiport laparoscopy.

  15. Ultrasonic diagnosis and transurethral incision of ureterocele with hydronephrosis

    Waaddegaard, P; Miskowiak, J; Stage, P


    In a 65-year-old woman with right-sided loin pain, ultrasonography revealed a grossly dilated and obstructed right pyelogram due to a 50-mm ureterocele. After transurethral lateral incision of the ureterocele, there was complete recovery without vesicoureteric reflux. Ultrasonography...

  16. Ankle fusion using a 2-incision, 3-screw technique

    R.P.M. Hendrickx; G.M.M.J. Kerkhoffs; S.A.S. Stufkens; C.N. van Dijk; R.K. Marti


    Reliable fusion and optimal correction of the alignment of the ankle joint using a 2-incision, 3-screw technique. Symptomatic osteoarthritis of the ankle joint after insufficient other treatment, severe deformity of the osteoarthritic ankle joint, or salvation procedure after failed arthroplasty. Ac

  17. Tubularized incised plate technique for recurrent hypospadias: a ...

    primary techniques are unsatisfactory. ... TIP urethroplasty in the management of recurrent ... was used for quantitative data. .... erection and the risk of infection, especially in patients .... currently considered the best tool for complicated .... 10 Mustafa M. The concept of tubularized incised plate hypospadias repair for different ...

  18. Minimal incision surgery in strabismus: Modified fornix-based approach.

    Pérez-Flores, I


    To evaluate the modified fornix-based technique as an approach for minimal incision surgery in strabismus. The medical records of all consecutive patients that underwent strabismus surgery with fornix-based conjunctival incision between 2007 and 2012 were retrospectively reviewed. As a primary variable, an analysis was made of the wound size depending on the number of stitches. A descriptive study was performed on the variables related to patients and to the type of strabismus and surgery. Out of 153patients identified, 138 with 294 surgeries were included. In 200 (68%) interventions, the incision was sutured with one stitch, in 77 (26.2%) with 2, in 13 (4.4%) with 3, and in 4 (1.4%) with 4, with the mean number of stitches being 1.39±0.64. The mean age of the patients was 39years (2-80), and 36 (26.1%) had previous strabismus surgery, with topical anaesthesia being used in 35 (25.4%) cases. At 3months after surgery deviation was ≤10DP in 114 (82.6%) patients. There were no wound-related complications. The modified fornix-based technique is an effective and safe approach for minimal incision surgery in strabismus, in patients at all ages, with previous history of strabismus surgery and with topical anaesthesia. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Mesenchymal stem cells promote incision wound repair in a mouse ...

    Full-thickness cutaneous wounds (4 × 2 cm) were made by incision on the dorsal side of the mice. The wound was then ..... on age as well as the type and size of injury. In .... stem cells favour healing of the cutaneous radiation syndrome in a ...

  20. Fontan operation for the Cantrell syndrome using a clamshell incision.

    Ito, Hiroki; Ota, Noritaka; Murata, Masaya; Sakamoto, Kisaburo


    A median sternotomy could be difficult for a child with ectopia cordis and complex congenital cardiac anomalies. We report a patient with ectopia cordis, functionally single ventricle and bilateral superior vena cava, who underwent a staged Fontan procedure through a clamshell incision and the sternothoracotomy approach.

  1. Surgical removal of large central neurocytomas with small incision approach

    Shu-mao LU


    Full Text Available Objective To investigate the strategy and technique of small incision surgery through interhemispheric transcallosal approach for removal of large central neurocytomas in supratentorial ventricule. Methods Clinical data and therapy of 6 cases with central neurocytomas were retrospectively studied. All tumors were removed through small incision interhemispheric transcallosal approach, and the clinical data were analyzed. Results Total resection was achieved in all cases. Three cases experienced transient mutism and one case experienced hemiparalysis. All of them received nerve-nurturing treatment and recovered within 2 weeks. Five cases were followed-up from 6 months to 2 years and there was no recurrence. Conclusions The advantages of interhemispheric transcallosal approach include provision of sufficient surgical visual field and space, protection of normal brain tissue by natural cavity and shortest surgical pathway. Small incision surgery may not only reduce invalid brain exposure and hemorrhage during operation, but also decrease operation time. The small incision surgery through interhemispheric transcallosal approach is an effective choice for removal of central neurocytomas involved in supratentorial ventricule.

  2. Time from uterine incision to delivery and hypoxic neonatal outcomes.

    Spain, Janine E; Tuuli, Methodius; Stout, Molly J; Roehl, Kimberly A; Odibo, Anthony O; Macones, George A; Cahill, Alison G


    The objective of this study was to estimate the association between time from uterine incision to delivery and hypoxic neonatal outcomes in nonanomalous term infants. All women undergoing in-labor term cesarean deliveries (CDs) in the first 2 years of an ongoing prospective cohort study were included. The primary exposure was time in seconds from uterine incision to delivery. The primary outcome was a composite of hypoxia-associated neonatal outcomes, defined as at least one of: seizures, hypoxic ischemic encephalopathy, need for hypothermia treatment, and death within 7 days. Of 812 patients who underwent in-labor CD, the composite hypoxia outcome occurred in 18 (2.2%) neonates. There was no significant difference in the rate of hypoxic morbidity with increasing increments of 60 seconds from uterine incision to delivery (p = 0.35). There was a significantly increased risk of hypoxic morbidity in those delivered in the highest quintile (>240 seconds) compared with those in the lowest quintile (≤ 60 seconds) in cesareans performed for an indication other than nonreassuring fetal status (relative risk, 5.58; 95% confidence interval, 1.30-23.91). Overall, duration from uterine incision to delivery for in-labor cesareans of nonanomalous term infants was not associated with an increase in risk of hypoxia-associated morbidities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Single-Incision Cholecystectomy in about 200 Patients

    Roland Raakow


    Full Text Available Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments. Results. Single-incision surgery was successfully performed in 215 patients (98%. Three patients (1.4% required conversion to a three-port technique and two patients (0.9% to an open procedure. Average age of 142 women (65% and 78 men (35% was 47 years (range: 15–89, average ASA status 2 (range: 1–3 and BMI 28 (range: 15–49. Mean operative time was 62 minutes (range: 26–174 and 57 patients (26% had histopathological signs of acute cholecystitis. Eleven patients (5% developed to surgery-related complications and nine (4% of these required a reoperation. The mean followup was 331.5 (range: 11–590 days. Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique.

  4. Single incision laparoscopic liver resection: a case report

    CAI Xiu-jun; ZHU Zhi-yi; LIANG Xiao; YU Hong; WANG Yi-fan; HE Ji-kai; LI Zhe-yong


    Laparoscopic procedure as a minimally invasive surgery has been introduced into many abdominal surgeries. Smaller incisions of the abdominal wall reduce postoperative pain and the risk of wound complications,and provide an excellent cosmetic result compared with open surgery. Natural orifice transluminal endoscopic surgery (NOTES), a no-scar surgery, is a hot spot of modern surgery.

  5. Laparoskopisk rectumresektion med salpingo-ooforektomi gennem en enkelt incision

    Bulut, Orhan; Nielsen, Claus B.


    Single-Incision Laparoscopic Surgery (SILS) is an evolving alternative to conventional laparoscopic surgery. We present the case of a low anterior resection combined with left salpingo-oophorectomy performed as a SILS procedure. The patient was a 83-year-old woman, who had a T3N1 rectal cancer 10...

  6. Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

    Choi, Jong-Woo; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan


    Backgrounds/Aims Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. Methods During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. Results The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. Conclusions The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously. PMID:27621750

  7. Late Quaternary rates of stream incision in Northeast Peloponnese, Greece

    Karymbalis, Efthimios; Papanastassiou, Dimitrios; Gaki-Papanastassiou, Kalliopi; Ferentinou, Maria; Chalkias, Christos


    This study focuses on defining rates of fluvial incision for the last 580±5 kyr along valley systems of eight streams that drain the eastern part of the northern Peloponnese. The streams are developed on the uplifted block of the offshore-running Xylokastro normal fault, one of the main faults bounding the southern edge of the Gulf of Corinth half-graben, and have incised a set of ten uplifted marine terraces having an amphitheatric shape. These terraces range in age from 60±5 kyr to 580±5 kyr and have been mapped in detail and correlated with late Pleistocene oxygen-isotope stages of high sea-level stands by previous studies. The terraces were used in this paper as reference surfaces in order to define fluvial incision rates at the lower reaches of the studied streams. To evaluate incision rates, thirty-three topographic valley cross-sections were drawn using fieldwork measurements as well as using a highly accurate (2×2 cell size) Digital Elevation Model (DEM) at specific locations where streams cut down the inner edges of the marine terraces. For each cross-section the ratio of valley floor width to valley height (Vf) and long-term mean stream incision rates were estimated for the last 580±5 kyr, while rock uplift rates were estimated for the last 330±5 kyr. The geomorphic evolution of the valleys on the uplifted block of the Xylokastro fault has been mainly driven by the lithology of the bedrock, sea level fluctuations during the late Quaternary, and incision of the channels due to the tectonic uplift. Stream incision rates range from 0.10±0.1 mm/yr for the last 123±7 kyr to 1.14±0.1 mm/yr for the last 310±5 kyr and are gradually greater from east to west depending on the distance from the trace of the fault. Downcutting rates are comparable with the rock uplift rates, which range from 0.4±0.02 mm/yr to 1.49±0.12 mm/yr, over the last 330±5 kyr.

  8. The width of the incisive canal and labial alveolar bone of the incisive canal: an assessment on CT images

    Roh, Yang Gyun; Jang, Hyun Seon; Kim, Byung Ock; Kim, Jin Soo [Chosun Univ. College of Dentistry, Gwangju (Korea, Republic of)


    To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1. The statistical analyses were carried out using SPSS 12.0.1. When the maxillary central incisors remained, the mean labial alveolar bone width were 6.81{+-}1.41 mm, 6.46{+-}1.33 mm, and 7.91{+-}1.33 mm. When the maxillary central incisors were missed the mean width were 5.42{+-}2.20 mm, 6.23{+-}2.29 mm, and 7.89{+-}2.13 mm. The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to masal cavity revealed statistically significant difference (P<0.05)




    Full Text Available INTRODUCTION: Phacoemulsification and foldable IOLs allow modern day surgeon to aim at minimal induction of any astigmatic error as well a s correct any pre-operative refractive errors thus making patients’ life, spectacle free i.e. una ided emmetropia. But its high price and maintenance with a long learning curve for the surg eon make it unsuitable for the Indian camp scenario. Manual SICS in comparison needs a larger incision f or both nucleus removal and a rigid IOL insertion, but still provides for a sutureless and c onvenient alternative to phaco. Manual SICS does induce some amount of astigmatism by altering corneal curvatures (i.e., by coupling effect, while phaco surgery with 3 mm incision is astigmatic ally neutral. Manifold of studies have been done to compare Surgically Induced Astigmatism of ma nual SICS to phaco surgery but not much has been done to compare various techniques in manua l SICS itself. In this study an attempt has been made to analyze t he role of incision site depending on the pre operative keratometry readings in reducing su rgically induced astigmatism in manual small incision cataract surgery.

  10. Application of a cervical low incision in the functional neck dissection of thyroid papillary carcinoma

    Xu, Jiajie; Chen, Chao; Zheng,ChuanMing; Wang, Kejing; Shang, Jinbiao; FANG, XIANHUA; Ge, Minghua; TAN, ZHUO


    The present study aimed to discuss the advantage of the application of a cervical low incision for functional neck dissection in patients with thyroid papillary carcinoma. The study was a retrospective analysis of 87 thyroid papillary carcinoma patients; cervical low incision in the functional neck dissection was applied for 47 cases and the classic ‘L’ incision was applied for 40 cases. The different integrity, surgical time, blood loss and the aesthetic property of the incision were compare...

  11. Grueneisen relaxation photoacoustic microscopy

    Wang, Lidai; Zhang, Chi; Wang, Lihong V.


    The temperature-dependent property of the Grueneisen parameter has been employed in photoacoustic imaging mainly to measure tissue temperature. Here we explore this property using a different approach and develop Grueneisen-relaxation photoacoustic microscopy (GR-PAM), a technique that images non-radiative absorption with confocal optical resolution. GR-PAM sequentially delivers two identical laser pulses with a micro-second-scale time delay. The first laser pulse generates a photoacoustic signal and thermally tags the in-focus absorbers. Owing to the temperature dependence of the Grueneisen parameter, when the second laser pulse excites the tagged absorbers within the thermal relaxation time, a photoacoustic signal stronger than the first one is produced. GR-PAM detects the amplitude difference between the two co-located photoacoustic signals, confocally imaging the non-radiative absorption. We greatly improved axial resolution from 45 µm to 2.3 µm and at the same time slightly improved lateral resolution from 0.63 µm to 0.41 µm. In addition, the optical sectioning capability facilitates the measurement of the absolute absorption coefficient without fluence calibration. PMID:25379919

  12. Magnetoviscosity and relaxation in ferrofluids



    The increase in viscosity of a ferrofluid due to an applied magnetic field is discussed on the basis of a phenomenological relaxation equation for the magnetization. The relaxation equation was derived earlier from irreversible thermodynamics, and differs from that postulated by Shliomis. The two relaxation equations lead to a different dependence of viscosity on magnetic field, unless the relaxation rates are related in a specific field-dependent way. Both planar Couette flow and Poiseuille pipe flow in parallel and perpendicular magnetic field are discussed. The entropy production for these situations is calculated and related to the magnetoviscosity.

  13. [Death in a relaxation tank].

    Rupp, Wolf; Simon, Karl-Heinz; Bohnert, Michael


    Complete relaxation can be achieved by floating in a darkened, sound-proof relaxation tank filled with salinated water kept at body temperature. Under these conditions, meditation exercises up to self-hypnosis may lead to deep relaxation with physical and mental revitalization. A user manipulated his tank, presumably to completely cut off all optical and acoustic stimuli and accidentally also covered the ventilation hole. The man was found dead in his relaxation tank. The findings suggested lack of oxygen as the cause of death.

  14. Castration of dromedary camel through prescrotal midline incision

    S.A. Taleb


    Full Text Available A total of 165 camels of different ages were castrated through a small, prescrotal midline incision between January, 2010 and December, 2011. The incision was closed with one interrupted, horizontal mattress suture using USP-2 chromic catgut. In 14/165 animals (8.5% postoperative infection (sepsis developed, which healed in two to three weeks after open wound management. The remaining 151 animals had an uneventful recovery, but a slight edematous swelling of the scrotum was observed in 8 of the 151 animals (5.3%, which was self-limiting and of no significance. No primary or secondary postoperative bleeding was noticed in any of the animals. It was concluded that this technique was less time consuming with negligible postoperative care and complications when performed under standard surgical principles.

  15. Closed incision management with negative pressure wound therapy.

    Dohmen, Pascal M; Misfeld, Martin; Borger, Michael A; Mohr, Friedrich W


    Post-sternotomy mediastinitis is the most severe surgical site infection after sternotomy with an incidence between 1-4% related to the patient co-morbidity. This complication will increase morbidity and mortality and may also have an economic impact. There are guidelines to prevent surgical site infections; however, age and co-morbidities increase and therefore it is important to develop new tools to improve wound healing. This manuscript will give an overview of a new concept using negative pressure wound therapy over a closed incision (so-called, closed incision management) after surgery and will include the principles of negative pressure wound therapy and the positively applied mechanical forces as a permutation of Wolff's law. The use and indication of this therapy is supported by experimental studies divided into physiological and biomechanical property studies. Finally, an overview of clinical studies is given based on the evidence rating scale for therapeutic studies.

  16. Relaxing Behavioural Inheritance

    Nuno Amálio


    Full Text Available Object-oriented (OO inheritance allows the definition of families of classes in a hierarchical way. In behavioural inheritance, a strong version, it should be possible to substitute an object of a subclass for an object of its superclass without any observable effect on the system. Behavioural inheritance is related to formal refinement, but, as observed in the literature, the refinement constraints are too restrictive, ruling out many useful OO subclassings. This paper studies behavioural inheritance in the context of ZOO, an object-oriented style for Z. To overcome refinement's restrictions, this paper proposes relaxations to the behavioural inheritance refinement rules. The work is presented for Z, but the results are applicable to any OO language that supports design-by-contract.

  17. Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

    Tayar Claude


    Full Text Available Background: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH. Patients and Methods: From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure TM (Covidien-Valleylab. Boulder. USA, Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.. Results: Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min and the mean estimated blood loss was 57 ml (range: 25-150 ml. The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days. Pathology identified three benign and four malignant liver tumours with clear margins. Conclusion: SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.

  18. Open femoral hernia repair: one skin incision for all

    El-Masry Nabil S


    Full Text Available Abstract Background Femoral hernias are relatively uncommon, however they are the most common incarcerated abdominal hernia, with strangulation of a viscus carrying significant mortality. Classically three approaches are described to open femoral hernia repair: Lockwood's infra-inguinal, Lotheissen's trans-inguinal and McEvedy's high approach. Each approach describes a separate skin incision and dissection to access the femoral sac. The decision as to which approach to adopt, predominantly dependent on the suspicion of finding strangulated bowel, is often a difficult one and in our opinion an unnecessary one. Methods We propose a technique for open femoral hernia repair that involves a single skin incision 1 cm above the medial half of the inguinal ligament that allows all of the above approaches to the hernia sac depending on the operative findings. Thus the repair of simple femoral hernias can be performed from below the inguinal ligament. If found, inguinal hernias can be repaired. More importantly, resection of compromised bowel can be achieved by accessing the peritoneal cavity with division of the linea semilunaris 4 cm above the inguinal ligament. This avoids compromise of the inguinal canal, and with medial retraction of the rectus abdominis muscle enables access to the peritoneal cavity and compromised bowel. Discussion This simple technique minimises the preoperative debate as to which incision will allow the best approach to the femoral hernia sac, allow for alteration to a simple inguinal hernia repair if necessary, and more importantly obviate the need for further skin incisions if compromised bowel is encountered that requires resection.

  19. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Aram Baram


    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  20. Modelling of meander migration in an incised channel

    Jianchun HUANG; Blair P GREIMANN; Timothy J RANDLE


    An updated linear computer model for meandering rivers with incision has been developed. The model simulates the bed topography, flow field, and bank erosion rate in an incised meandering channel. In a scenario where the upstream sediment load decreases (e.g., after dam closure or soil conservation), alluvial river experiences cross section deepening and slope flattening. The channel migration rate might be affected in two ways:decreased channel slope and steeped bank height. The proposed numerical model combines the traditional one-dimensional (1D) sediment transport model in simulating the channel erosion and the linear model for channel meandering. A non-equilibrium sediment transport model is used to update the channel bed elevation and gradations. A linear meandering model was used to calculate the channel alignment and bank erosion/accretion, which in turn was used by the 1D sediment transport model. In the 1D sediment transport model, the channel bed elevation and gradations are represented in each channel cross section. In the meandering model, the bed elevation and gradations are stored in two dimensional (2D) cells to represent the channel and terrain properties (elevation and gradation). A new method is proposed to exchange information regarding bed elevations and bed material fractions between 1D river geometry and 2D channel and terrain. The ability of the model is demonstrated using the simulation of the laboratory channel migration of Friedkin in which channel incision occurs at the upstream end.

  1. Minimal incision access for pediatric and adult cochlear implantation

    Cui Danmo; Shi Ying; Su Qiaotong; Liu Ting; Han Demin; Li Yongxin


    Background Cochlear implant surgery is widely practiced.Minimal incision cochlear implant surgery has been developed with the aims of reducing the impact of surgery on the patient and improving cosmesis while maintaining the low morbidity of conventional wider access approaches.This study aimed to assess the surgical technique and complication rate of minimal incision cochlear implantation (MICI) for children and adults.Methods Data for this study were obtained via a retrospective analysis.Totally 378 patients were included in the study.All patients received minimal incision cochlear implantation,using the skin protector during the process of the operation.The surgical complications of MICI were recorded in a spreadsheet format.The incidence of major and minor complication were analyzed,and appropriate treatment was provided.Results A total of 40 (10.5%) complications were noted in the study.There were 0 life-threatening,9 major,and 31 minor complications.Of the nine major complications,five were device failures,one developed infection and extrusion,and three required receiver-stimulator repositioning.Conclusions MICI is as safe as standard cochlear implantation (SCI) and affords with it other benefits.Eliminating the scalp flap avoids devascularization and minimizes the opportunity of flap infection or necrosis.Complications not related to the flap are similar to SCI.

  2. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis


    Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8%) that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males) with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4). Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months). A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5%) and another patient (2.5%) presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353) and 2.5% (p = .552), respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58%) compared to palmar type (14, 35.89%) or axillary type (7, 17.94%). Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications. PMID:26770711

  3. Bedrock incision by bedload: insights from direct numerical simulations

    Aubert, Guilhem; Langlois, Vincent J.; Allemand, Pascal


    Bedload sediment transport is one of the main processes that contribute to bedrock incision in a river and is therefore one of the key control parameters in the evolution of mountainous landscapes. In recent years, many studies have addressed this issue through experimental setups, direct measurements in the field, or various analytical models. In this article, we present a new direct numerical approach: using the classical methods of discrete-element simulations applied to granular materials, we explicitly compute the trajectories of a number of pebbles entrained by a turbulent water stream over a rough solid surface. This method allows us to extract quantitatively the amount of energy that successive impacts of pebbles deliver to the bedrock, as a function of both the amount of sediment available and the Shields number. We show that we reproduce qualitatively the behaviour observed experimentally by Sklar and Dietrich (2001) and observe both a "tool effect" and a "cover effect". Converting the energy delivered to the bedrock into an average long-term incision rate of the river leads to predictions consistent with observations in the field. Finally, we reformulate the dependency of this incision rate with Shields number and sediment flux, and predict that the cover term should decay linearly at low sediment supply and exponentially at high sediment supply.

  4. A two-incision approach: promises and pitfalls.

    Rosenberg, Aaron G


    Is this an optimal procedure? Clearly, it is not for every patient, but it does serve patients who can benefit from rapid recovery as well as those patients truly interested in minimizing their down time. It also is clearly not for the occasional total hip surgeon. It is a technique that brings to the patient the maximum potential for speed of recovery. However, it is important to stress again that the surgical approach is just one factor facilitating the recovery curve. While the benefits are real, their importance must be weighed by both surgeon and patient relative to the risks. The risks are not insignificant, but generally decrease with time and experience. As opposed to several smaller incision modifications of routine approaches to THA, the two-incision approach does require a separate and distinctively different skill set, including alternative methods to make up for the lack of standard visualization and careful attention to details such as incision placement and location of the starting point in the intramedullary canal. However, in the rest of the medical world, that is what minimally invasive surgery is about.

  5. Progressive incision of the Channeled Scablands by outburst floods.

    Larsen, Isaac J; Lamb, Michael P


    The surfaces of Earth and Mars contain large bedrock canyons that were carved by catastrophic outburst floods. Reconstructing the magnitude of these canyon-forming floods is essential for understanding the ways in which floods modify planetary surfaces, the hydrology of early Mars and abrupt changes in climate. Flood discharges are often estimated by assuming that the floods filled the canyons to their brims with water; however, an alternative hypothesis is that canyon morphology adjusts during incision such that bed shear stresses exceed the threshold for erosion by a small amount. Here we show that accounting for erosion thresholds during canyon incision results in near-constant discharges that are five- to ten-fold smaller than full-to-the-brim estimates for Moses Coulee, a canyon in the Channeled Scablands, which was carved during the Pleistocene by the catastrophic Missoula floods in eastern Washington, USA. The predicted discharges are consistent with flow-depth indicators from gravel bars within the canyon. In contrast, under the assumption that floods filled canyons to their brims, a large and monotonic increase in flood discharge is predicted as the canyon was progressively incised, which is at odds with the discharges expected for floods originating from glacial lake outbursts. These findings suggest that flood-carved landscapes in fractured rock might evolve to a threshold state for bedrock erosion, thus implying much lower flood discharges than previously thought.

  6. Progressive incision of the Channeled Scablands by outburst floods

    Larsen, Isaac J.; Lamb, Michael P.


    The surfaces of Earth and Mars contain large bedrock canyons that were carved by catastrophic outburst floods. Reconstructing the magnitude of these canyon-forming floods is essential for understanding the ways in which floods modify planetary surfaces, the hydrology of early Mars and abrupt changes in climate. Flood discharges are often estimated by assuming that the floods filled the canyons to their brims with water; however, an alternative hypothesis is that canyon morphology adjusts during incision such that bed shear stresses exceed the threshold for erosion by a small amount. Here we show that accounting for erosion thresholds during canyon incision results in near-constant discharges that are five- to ten-fold smaller than full-to-the-brim estimates for Moses Coulee, a canyon in the Channeled Scablands, which was carved during the Pleistocene by the catastrophic Missoula floods in eastern Washington, USA. The predicted discharges are consistent with flow-depth indicators from gravel bars within the canyon. In contrast, under the assumption that floods filled canyons to their brims, a large and monotonic increase in flood discharge is predicted as the canyon was progressively incised, which is at odds with the discharges expected for floods originating from glacial lake outbursts. These findings suggest that flood-carved landscapes in fractured rock might evolve to a threshold state for bedrock erosion, thus implying much lower flood discharges than previously thought.

  7. Magnetic relaxation in anisotropic magnets

    Lindgård, Per-Anker


    The line shape and the kinematic and thermodynamic slowing down of the critical and paramagnetic relaxation in axially anisotropic materials are discussed. Kinematic slowing down occurs only in the longitudinal relaxation function. The thermodynamic slowing down occurs in either the transverse or...

  8. Complications from a Distal Bicep Repair: A Meta-Analysis of a Single Incision Versus Double Incision Surgical Technique

    Toossi, Nader; Amin, Nirav Hasmukh; Cerynik, Douglas L.; Jones, Morgan H.


    Objectives: Anatomical reinsertion of the distal biceps is critical for restoring elbow flexion and forearm supination strength. Surgical techniques utilizing one and two incisions have been reported in the literature, describing complications and outcomes. However, which technique is associated with a lower complication rate remains unclear. Methods: A systematic review was conducted using the PubMed, Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SPORTSDiscus, a...

  9. In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions

    Church D


    Full Text Available Majid Moshirfar, Monette T Lependu, Dane Church, Marcus C Neuffer John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA Introduction: Descemet’s stripping automated endothelial keratoplasty (DSAEK venting incisions may induce irregular corneal astigmatism. The study examines in vivo and in vitro astigmatic effects of venting incisions. Patients and methods: In vivo analysis examined eleven eyes of eleven patients who had received DSAEK with venting incisions. A chart review of the eleven eyes including assessment of pre and postoperative refraction and topography was performed. In vitro analysis examined three cadaver eyes which received topographic imaging followed by venting incisions at 4 mm, 6 mm, and 7 mm optical zones. Topographic imaging was then performed again after the incisions. Results: Postoperative topographies of eleven eyes demonstrated localized flattening at incision sites and cloverleaf pattern astigmatism. There was a significant difference in corneal irregularity measurement (P = 0.03, but no significant difference in shape factor or change of topographic cylinder. The cloverleaf pattern was found in cadaver eyes with incisions placed at 4 mm and 6 mm optical zones but not at the 7 mm zone. Conclusion: DSAEK venting incisions can cause irregular corneal astigmatism that may affect visual outcomes. The authors recommend placement of venting incisions near the 7 mm optical zone. Keywords: DSAEK, venting incisions, endothelial keratoplasty, astigmatism, endothelium, endothelial transplant

  10. The clinical significance of abdominal right lower paramedian incision inrectal cancer operation

    Chong Shu Wang; Shou Jiang Wei; Jing Dong Li


    AIM The incision in rectal cancer operation is adopted commonly in the left mid-lower abdomen. But thereare some defects for the incision, which is close to the artificial colotomy, readily be contaminated by feces,difficult to treat the lesions in hepatic and cholecystic area at the same time and in the weakened area ofabdominal wall. So, we employed the abdominal right lower paramedian incision to solve these problems.METHODS The abdominal right lower paramedian incision is from publc tubercle upward to 3 cm- 4 cmabove navel. The incision should be extended upward if individual need of performing hepatic and cholecysticoperation, or placing catheter or pump in hepatic artery or portal vein for chemotherapy at the same time.RESULTS One hundred and eighty three cases with rectal cancer were adopted this incision in differentoperation procedure, and out of them 41 patients were taken different operation on hepatic and cholecysticlesions and place a catheter or pump to hepatic artery or portal vein. Operators feel that the incision dose nothinder exploring and operating in all of the patients.CONCLUSION The right lower paramedian incision of abdomen is far away from the artificial colotomy,and it can reduce the feces contamination, lower down the rate of incision hernia and paramedian hernia orfistula. Furthermore, it is easy to treat the complicated hepatic and cholecystic lesion. So, authors suggestthat this incision is useful for the operation of rectal cancer, and it is worth to populize in clinical practice.

  11. Can Black Hole Relax Unitarily?

    Solodukhin, S. N.


    We review the way the BTZ black hole relaxes back to thermal equilibrium after a small perturbation and how it is seen in the boundary (finite volume) CFT. The unitarity requires the relaxation to be quasi-periodic. It is preserved in the CFT but is not obvious in the case of the semiclassical black hole the relaxation of which is driven by complex quasi-normal modes. We discuss two ways of modifying the semiclassical black hole geometry to maintain unitarity: the (fractal) brick wall and the worm-hole modification. In the latter case the entropy comes out correctly as well.

  12. Can Black Hole Relax Unitarily?

    Solodukhin, Sergey N.


    We review the way the BTZ black hole relaxes back to thermal equilibrium after a small perturbation and how it is seen in the boundary (finite volume) CFT. The unitarity requires the relaxation to be quasi-periodic. It is preserved in the CFT but is not obvious in the case of the semiclassical black hole the relaxation of which is driven by complex quasi-normal modes. We discuss two ways of modifying the semiclassical black hole geometry to maintain unitarity: the (fractal) brick wall and the...

  13. Can Black Hole Relax Unitarily?

    Solodukhin, S N


    We review the way the BTZ black hole relaxes back to thermal equilibrium after a small perturbation and how it is seen in the boundary (finite volume) CFT. The unitarity requires the relaxation to be quasi-periodic. It is preserved in the CFT but is not obvious in the case of the semiclassical black hole the relaxation of which is driven by complex quasi-normal modes. We discuss two ways of modifying the semiclassical black hole geometry to maintain unitarity: the (fractal) brick wall and the worm-hole modification. In the latter case the entropy comes out correctly as well.

  14. Standardized technique for single-incision laparoscopicassisted stoma creation

    Norikatsu Miyoshi; Shiki Fujino; Masayuki Ohue; Masayoshi Yasui; Shingo Noura; Yuma Wada; Ryuichiro Kimura; Keijiro Sugimura; Akira Tomokuni; Hirofumi Akita; Shogo Kobayashi; Hidenori Takahashi; Takeshi Omori; Yoshiyuki Fujiwara; Masahiko Yano


    To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

  15. Conjunctival inclusion cysts following small incision cataract surgery

    Narayanappa Shylaja


    Full Text Available The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

  16. Canyon incision, volcanic fill, and re-incision rates in southwest Peru: proxies for quantifying uplift in the Central Andes

    Thouret, Jean-Claude; Gunnell, Yanni; de La Rupelle, Aude


    Using zircon and apatite fission tracks and apatite (U-Th)/He to constrain 26 rock cooling histories of Cretaceous diorites and 40Ar-39Ar to date 45 Neogene ignimbrites and lavas, we have estimated incision and topographic uplift rates of the Western Cordillera in southwest Peru. Rock cooling patterns confirm that continental denudation declined rapidly during the early Cenozoic. Topographic paleoelevations provided by 24.5 Ma forearc marine sediments now occurring at 1.8 km a.s.l. indicate that the Andean orogenic plateau did not begin to rise before Miocene time. A suite of marker horizons consisting of Huaylillas ignimbrite (14.3-12.7 Ma) on the plateau, and of Sencca ignimbrite (3.8 Ma) and Barroso lavas (2.27 Ma) near the Rio Cotahuasi and Rio Ocoña valley floors, respectively, have helped to bracket accelerated uplift between 13 Ma and 3.8-2.27 Ma. In-canyon (U-Th)/He bedrock cooling ages decrease upstream from ~13 Ma to 2-4 Ma, implying that uplift-driven valley incision began after 14 Ma and that downcutting was neither steady nor uniform along the 209 km-long canyon system. Whereas ~9 Ma Caraveli ignimbrites filled broad, shallow valleys, V-shaped downcutting occurred after 9-6 Ma. Argon-dated in-canyon lava flows and ignimbrites reveal three pulses of bedrock incision: 8.8-5.8 Ma, 5.8-3.6 Ma, 3.6-1.36 Ma, followed by post-1.36 Ma re-incision into unconsolidated valley fill. Accordingly, ample variations belie the 14 Myr-averaged incision rate of 170 m Myr-1: 130-190 m Myr-1 between 13 and 9 Ma, rising to 250-400 m/Myr-1 between 9 and 3.8 Ma and to >1000 m Myr-1 of reincision after 1.36 Ma. Rapid bedrock incision ended before 3.76 Ma in the upper, and before 2.27 Ma in the lower canyon reaches. The 3.76 to 1.36 Ma pyroclastic and mass-flow deposits filled the valley to ~75% and ~60% of its height in its upper and lower reaches, respectively. Post-1.36 Ma re-incision removed 75% of these deposits, thus exhuming most of the bedrock paleocanyon. The upper

  17. An Exact Relaxation of Clustering

    Mørup, Morten; Hansen, Lars Kai


    of clustering problems such as the K-means objective and pairwise clustering as well as graph partition problems, e.g., for community detection in complex networks. In particular we show that a relaxation to the simplex can be given for which the extreme solutions are stable hard assignment solutions and vice......Continuous relaxation of hard assignment clustering problems can lead to better solutions than greedy iterative refinement algorithms. However, the validity of existing relaxations is contingent on problem specific fuzzy parameters that quantify the level of similarity between the original...... versa. Based on the new relaxation we derive the SR-clustering algorithm that has the same complexity as traditional greedy iterative refinement algorithms but leading to significantly better partitions of the data. A Matlab implementation of the SR-clustering algorithm is available for download....

  18. The relaxation & stress reduction workbook

    Davis, Martha; Eshelman, Elizabeth Robbins; McKay, Matthew


    "The Relaxation & Stress Reduction Workbook broke new ground when it was first published in 1980, detailing easy, step-by-step techniques for calming the body and mind in an increasingly overstimulated world...

  19. Relaxation Dynamics in Heme Proteins.

    Scholl, Reinhard Wilhelm

    A protein molecule possesses many conformational substates that are likely arranged in a hierarchy consisting of a number of tiers. A hierarchical organization of conformational substates is expected to give rise to a multitude of nonequilibrium relaxation phenomena. If the temperature is lowered, transitions between substates of higher tiers are frozen out, and relaxation processes characteristic of lower tiers will dominate the observational time scale. This thesis addresses the following questions: (i) What is the energy landscape of a protein? How does the landscape depend on the environment such as pH and viscosity, and how can it be connected to specific structural parts? (ii) What relaxation phenomena can be observed in a protein? Which are protein specific, and which occur in other proteins? How does the environment influence relaxations? (iii) What functional form best describes relaxation functions? (iv) Can we connect the motions to specific structural parts of the protein molecule, and are these motions important for the function of the protein?. To this purpose, relaxation processes after a pressure change are studied in carbonmonoxy (CO) heme proteins (myoglobin-CO, substrate-bound and substrate-free cytochrome P450cam-CO, chloroperoxidase-CO, horseradish peroxidase -CO) between 150 K and 250 K using FTIR spectroscopy to monitor the CO bound to the heme iron. Two types of p -relaxation experiments are performed: p-release (200 to ~eq40 MPa) and p-jump (~eq40 to 200 MPa) experiments. Most of the relaxations fall into one of three groups and are characterized by (i) nonexponential time dependence and non-Arrhenius temperature dependence (FIM1( nu), FIM1(Gamma)); (ii) exponential time dependence and non-Arrhenius temperature dependence (FIM0(A_{i}to A_{j})); exponential time dependence and Arrhenius temperature dependence (FIMX( nu)). The influence of pH is studied in myoglobin-CO and shown to have a strong influence on the substate population of the

  20. Anterior ilioinguinal incision for drainage of high-located perianal abscess.

    Peng, K-T; Hsieh, M-C; Hsu, W-H; Li, Y-Y; Yeh, C-H


    Most perianal abscesses originate from infected anal glands at the base of the anal crypts. Most abscesses below are usually drained through perianal incision and can be treated successfully. However, when perianal abscesses extend to the high intrapelvic cavity, it may be inadequate treatment through a single route incision through a perianal approach. The aim of this technical note is to show that combined anterior ilioinguinal and perianal incisions may provide optimal surgical field and multiple drainages. Here, we report a 56-year-old male patient with perianal-originating parapsoas abscesses. Residual abscess still remained after initial perianal incision and drainage after 1-month treatment. We presented combined anterior ilioinguinal and perianal incision technique methods for proper drainage in this complicated case. No recurrent or residual abscess remained after 2 weeks of operation. So, combined anterior ilioinguinal incision is feasible for high-located perianal abscess.

  1. Negative magnetic relaxation in superconductors

    Krasnoperov E.P.


    Full Text Available It was observed that the trapped magnetic moment of HTS tablets or annuli increases in time (negative relaxation if they are not completely magnetized by a pulsed magnetic field. It is shown, in the framework of the Bean critical-state model, that the radial temperature gradient appearing in tablets or annuli during a pulsed field magnetization can explain the negative magnetic relaxation in the superconductor.

  2. Magnetic resonance imaging evaluation of incision healing after cesarean sections

    Dicle, O. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Kuecuekler, C. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Pirnar, T. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Erata, Y. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey); Posaci, C. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey)


    The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs.

  3. Single incision laparoscopic liver resection (SILL – a systematic review

    Benzing, Christian


    Full Text Available Background: Today, minimally invasive liver resections for both benign and malignant tumors are routinely performed. Recently, some authors have described single incision laparoscopic liver resection (SILL procedures. Since SILL is a relatively young branch of laparoscopy, we performed a systematic review of the current literature to collect data on feasibility, perioperative results and oncological outcome.Methods: A literature research was performed on Medline for all studies that met the eligibility criteria. Titles and abstracts were screened by two authors independently. A study was included for review if consensus was obtained by discussion between the authors on the basis of predefined inclusion criteria. A thorough quality assessment of all included studies was performed. Data were analyzed and tabulated according to predefined outcome measures. Synthesis of the results was achieved by narrative review. Results: A total of 15 eligible studies were identified among which there was one prospective cohort study and one randomized controlled trial comparing SILL to multi incision laparoscopic liver resection (MILL. The rest were retrospective case series with a maximum of 24 patients. All studies demonstrated convincing results with regards to feasibility, morbidity and mortality. The rate of wound complications and incisional hernia was low. The cosmetic results were good.Conclusions: This is the first systematic review on SILL including prospective trials. The results of the existing studies reporting on SILL are favorable. However, a large body of scientific evidence on the field of SILL is missing, further randomized controlled studies are urgently needed.

  4. Endoscopy-assisted cerebral falx incision via unilateral

    DONG Ji-rong


    Full Text Available 【Abstract】Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treat-ing these patients by minimally invasive surgery. Methods: Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control. Results: Seventeen cases (54.8% in the unilateral operation group survived and were in good condition, 8 (25.8% had moderate disability, 4 (12.9% had severe disability, 1 (3.2% was in vegetative state, and 1 (3.2% died. Compared with the control group, the Glasgow Out-come Scale score was not significantly different in the uni-lateral operation group, but the operation time, blood trans-fusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group. Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dis-symmetric bilateral frontal contusion. It can obviously di-minish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation. Key words: Brain injuries; Intracranial hemorrage, traumatic; Endoscopy; Surgically procedures, minimally invasive

  5. Avoiding Facial Incisions with Midface Free Tissue Transfer

    Stalder, Mark W.; Sosin, Michael; Urbinelli, Leo J.; Mayo, James L.; Dorafshar, Amir H.; Hilaire, Hugo St.; Borsuk, Daniel E.


    Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions. Results: The pathology included palatal defects due to mucoepidermoid carcinoma and ischemic necrosis from cocaine abuse, maxillary defects secondary to fibrous dysplasia and avascular necrosis from traumatic blast injury, and a residual posttraumatic bony deformity of the zygoma. Reconstructions were performed with a free ulnar forearm flap, a free vastus lateralis muscle flap, a deep circumflex iliac artery myoosseous flap, a free fibula flap, and a deep circumflex iliac artery osseous flap, respectively. The facial artery and vein were used as recipient vessels for microvascular anastomosis for all cases. Mean follow-up was 12.2 months. All free tissue transfers were successful, and each patient had a satisfactory aesthetic outcome with no associated facial scars. Conclusion: This technique can be employed during reconstruction of an array of bony or soft-tissue midface deficits with minimal morbidity. This small series effectively demonstrates the varied pathologies and tissue deficiencies that can be successfully reconstructed with free tissue transfer using an entirely intraoral approach to the recipient facial vessels, resulting in no visible scars on the face and an improvement in the overall aesthetic outcome. PMID:28280662

  6. [Our experience with prostatic incision (TUIP) with local anesthesia].

    Del Boca, C; Colloi, D; Guardamagna, A; Bolis, C; Giuberti, A C; Tzoumas, S; Ferrari, C


    The Authors present their experience in the treatment of prostatic obstruction with bladder neck incision (TUIP) performed under local anesthesia. An Hulbert 6 Fr endoscopic needle is used to infiltrate the prostatic area submitted to TUIP with 200 mg of Lidocaine 2%. The TUIP was done with a single deep incision at 7 hours using a 24 Fr Iglesias resector with Collins device. 28 patients with an age range from 69 to 85 years (mean 74) affected by IPB in an obstructed fase were submitted to this procedure. Various parameters were achieved for the selection of the patients: urodynamic diagnosis of low urinary tract obstruction, prostatic volume less than 50 ml without important prostatic median lobe, high anesthesiological risk, absence of correlated vesical complications. A clinical follow up was done at 1-6 and 12 months. The results obtained showed a good compliance of the patients treated with satisfactory urodynamic patterns. The Authors conclude that this less invasive approach, in selected cases, is the treatment of choice not only for low invasivity and morbidity rate but also for the reduced time of catheterization, hospitalization and costs.

  7. Pain-related mediators underlie incision-induced mechanical nociception in the dorsal root ganglia

    Xiuhong Yuan; Xiangyan Liu; Qiuping Tang; Yunlong Deng


    Approximately 50-70% of patients experience incision-induced mechanical nociception after sur-gery. However, the mechanism underlying incision-induced mechanical nociception is stil unclear. Interleukin-10 and brain-derived neurotrophic factor are important pain mediators, but whether in-terleukin-10 and brain-derived neurotrophic factor are involved in incision-induced mechanical no-ciception remains uncertain. In this study, forty rats were divided randomly into the incision surgery (n=32) and sham surgery (n=8) groups. Plantar incision on the central part of left hind paw was performed under anesthesia in rats from the surgery group. Rats in the sham surgery group re-ceived anesthesia, but not an incision. Von Frey test results showed that, compared with the sham surgery group, incision surgery decreased the withdrawal threshold of rats at 0.5, 3, 6 and 24 hours after incision. Immunofluorescence staining in the dorsal root ganglia of the spinal cord (L 3-5 ) showed that interleukin-10 and brain-derived neurotrophic factor were expressed mainly on smal-and medium-sized neurons (diameter40μm) at 6 and 24 hours after incision surgery, which corresponded to the decreased mechanical withdrawal threshold of rats in the surgery group. These experimental findings suggest that expression pattern shift of interleukin-10 and brain-derived neurotrophic factor induced by inci-sion surgery in dorsal root ganglia of rats was closely involved in lowering the threshold to me-chanical stimulus in the hind paw fol owing incision surgery. Pain-related mediators induced by in-cision surgery in dorsal root ganglia of rats possibly underlie mechanical nociception in ipsilateral hind paws.

  8. Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision

    Hamid Gharaee


    Full Text Available Purpose: To assess the relationship between corneal endothelial cell loss after phacoemulsification and the location of the clear corneal incision. Methods: A total of 92 patients (92 eyes with senile cataracts who met the study criteria were included in this cross sectional study and underwent phacoemulsification. The incision site was determined based on the steep corneal meridian according to preoperative keratometry. Endothelial cell density was measured using specular microscopy in the center and 3 mm from the center of the cornea in the meridian of the incisions (temporal, superior, and superotemporal. Phacoemulsification was performed by a single surgeon using the phaco chop technique through a 3.2 mm clear cornea incision. Endothelial cell loss (ECL was evaluated 1 week, and 1 and 3 months postoperatively. Results: At all time points during follow-up, ECL was comparable among the 3 incision sites, both in the central cornea and in the meridian of the incision (P > 0.05 for all comparisons. However, 3 months postoperatively, mean central ECL with superior incisions and mean sectoral ECL with temporal incisions were slightly higher. Superotemporal incisions entailed slightly less ECL than the other 2 groups. Overall, one month after surgery, mean central ECL was 10.8% and mean ECL in the sector of the incisions was 14.0%. Axial length and effective phaco time (EFT were independent predictors of postoperative central ECL (P values 0.005 and < 0.0001, respectively. Conclusion: A superotemporal phacoemulsification incision may entail less ECL as compared to other incisions (although not significantly different. The amount of central ECL may be less marked in patients with longer axial lengths and with procedures utilizing less EFT.

  9. Rapid incision of the Colorado River in Glen Canyon - insights from channel profiles, local incision rates, and modeling of lithologic controls

    Cook, K.L.; Whipple, K.X.; Heimsath, A.M.; Hanks, T.C.


    The Colorado River system in southern Utah and northern Arizona is continuing to adjust to the baselevel fall responsible for the carving of the Grand Canyon. Estimates of bedrock incision rates in this area vary widely, hinting at the transient state of the Colorado and its tributaries. In conjunction with these data, we use longitudinal profiles of the Colorado and tributaries between Marble Canyon and Cataract Canyon to investigate the incision history of the Colorado in this region. We find that almost all of the tributaries in this region steepen as they enter the Colorado River. The consistent presence of oversteepened reaches with similar elevation drops in the lower section of these channels, and their coincidence within a corridor of high local relief along the Colorado, suggest that the tributaries are steepening in response to an episode of increased incision rate on the mainstem. This analysis makes testable predictions about spatial variations in incision rates; these predictions are consistent with existing rate estimates and can be used to guide further studies. We also present cosmogenic nuclide data from the Henry Mountains of southern Utah. We measured in situ 10Be concentrations on four gravel-covered strath surfaces elevated from 1 m to 110 m above Trachyte Creek. The surfaces yield exposure ages that range from approximately 2??5 ka to 267 ka and suggest incision rates that vary between 350 and 600 m/my. These incision rates are similar to other rates determined within the high-relief corridor. Available data thus support the interpretation that tributaries of the Colorado River upstream of the Grand Canyon are responding to a recent pulse of rapid incision on the Colorado. Numerical modeling of detachment-limited bedrock incision suggests that this incision pulse is likely related to the upstream-dipping lithologic boundary at the northern edge of the Kaibab upwarp. ?? 2009 John Wiley & Sons, Ltd.

  10. In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions.

    Moshirfar, Majid; Lependu, Monette T; Church, Dane; Neuffer, Marcus C


    Descemet's stripping automated endothelial keratoplasty (DSAEK) venting incisions may induce irregular corneal astigmatism. The study examines in vivo and in vitro astigmatic effects of venting incisions. In vivo analysis examined eleven eyes of eleven patients who had received DSAEK with venting incisions. A chart review of the eleven eyes including assessment of pre and postoperative refraction and topography was performed. In vitro analysis examined three cadaver eyes which received topographic imaging followed by venting incisions at 4 mm, 6 mm, and 7 mm optical zones. Topographic imaging was then performed again after the incisions. Postoperative topographies of eleven eyes demonstrated localized flattening at incision sites and cloverleaf pattern astigmatism. There was a significant difference in corneal irregularity measurement (P = 0.03), but no significant difference in shape factor or change of topographic cylinder. The cloverleaf pattern was found in cadaver eyes with incisions placed at 4 mm and 6 mm optical zones but not at the 7 mm zone. DSAEK venting incisions can cause irregular corneal astigmatism that may affect visual outcomes. The authors recommend placement of venting incisions near the 7 mm optical zone.

  11. Thoracoscopic reoperation for recurrent pneumothorax after single-incision thoracoscopic surgery.

    Sano, Atsushi; Kawashima, Mitsuaki


    An 18-year-old male patient who had undergone single-incision thoracoscopic surgery for left spontaneous pneumothorax was diagnosed with bilateral recurrent pneumothorax. We performed thoracoscopic reoperation and observed adhesions between the previous incision and the left lung. A bulla that was thought to be the cause of the recurrent left pneumothorax was found on the mediastinal side of previously ligated lesions. Longer incisions during single-incision thoracoscopic surgery may be more likely to cause adhesions. Despite the restricted view during surgery, care must be taken to identify all bullae. Use of reinforcement techniques is also important to prevent recurrence.

  12. First Report: Linear Incision for Placement of a Magnetically Coupled Bone-Anchored Hearing Implant.

    Barry, Jonnae Y; Reghunathan, Saranya; Jacob, Abraham


    Discuss use of a linear incision for placement of a magnetically coupled bone anchored hearing implant. Case series. Two patients underwent placement of magnetically coupled bone-anchored hearing implants (BAHI) through linear incisions. The first, a 40-year-old female with congenital single-sided deafness, previously had successful implantation of a percutaneous bone anchored hearing implant through a linear incision; unfortunately, she developed pain and intermittent drainage at her abutment site with time, resulting in a request for removal of her device. As an alternative to complete removal, we offered to replace the percutaneous implant with a magnetically coupled BAHI, employing the same linear incision previously. The second patient, a 53-year-old obese female with limited neck mobility and mixed hearing loss, underwent primary placement of a magnetically coupled BAHI through a linear incision. Limitations in neck mobility and patient body habitus precluded use of a traditional C-shaped incision. Both patients underwent surgery successfully, healed without incident, had their devices activated 6 weeks after their procedures, and are able to wear their implants more than 8 hours per day without discomfort. Surgical techniques for bone-anchored implants continue to evolve. Though manufacturers of magnetically coupled devices recommend using C-shaped incisions with large skin flaps, our first reported cases suggest that a small linear incision immediately overlying the implant magnet may be an acceptable alternative. Potential benefits include a smaller incision, less hair removal, smaller flap, decreased surgical time, and less postoperative pain.

  13. Histomorphological and immunofluorescence evaluation of bimanual and coaxial phacoemulsification incisions in rabbits.

    Johar, S R Kaid; Vasavada, Abhay R; Praveen, Mamidipudi R; Pandita, Deepak; Nihalani, Bharati; Patel, Udayan; Vemuganti, Geeta


    To compare the changes in the histomorphology and immunofluorescence of collagen type I in clear corneal incisions (CCIs) at the end of bimanual and coaxial phacoemulsification in rabbits. Iladevi Cataract and IOL Research Centre, Ahmedabad, India. In this randomized study, the left eye of 30 rabbits had bimanual phacoemulsification through 1.2 mm CCIs for phaco tip access accompanied by an additional 1.4 mm incision for irrigating chopper access or coaxial phacoemulsification through a 2.6 mm single-plane CCI. The right eyes acted as controls. Samples collected at the end of surgery were processed for histomorphology using periodic acid-Schiff-hematoxylin staining and immunofluorescence localization of type I collagen. Incisions exposed to bimanual phacoemulsification had loss of epithelium, stromal fiber shrinkage, keratocyte nuclei fragmentation and condensation, ragged tunnel margins, and Descemet membrane and endothelial cell loss. The changes were minimal or absent in incisions exposed to coaxial phacoemulsification. Immunofluorescence showed a loss of parallel arrangement of type I collagen fibers in bimanual phacoemulsification incisions, while the fibers were well preserved in coaxial phacoemulsification incisions. The changes were more prominent in the roof of the incision tunnel than in the floor. Corneal incisions for bimanual phacoemulsification were more prone to damage than those for coaxial phacoemulsification. This may be attributed to the absence of a sleeve, which places the incision tunnel in direct contact with the metal phaco tip.

  14. Midline versus transverse incision for cesarean delivery in low-income countries

    Maaløe, Nanna; Aabakke, Anna J M; Secher, Niels J


    While transverse incision is the recommended entry technique for cesarean delivery in high-income countries, it is our experience that midline incision is still used routinely in many low-income settings. Accordingly, international guidelines lack uniformity on this matter. Although evidence...... is limited, the literature suggests important advantages of the transverse incision, with lower risk of long-term disabilities such as wound disruption and hernia. Also, potential extra time spent on this incision appears not to impact neonatal outcome. Therefore, we suggest that it is time for a change...


    刘宝国; 刘伟; 顾晋


    To investigate the feasibility and advantages of the unilateral big hockey stick incision in thyroid carcinoma. Method: Neck dissection using the unilateral big hockey stick incision was performed on 23 patients with thyroid carcinoma. Results: The big hockey stick incision results in a cosmetic scar which is barely visible and easily covered by hair or clothing, while it provides sufficient exposure of the operation field. A small area of marginal necrosis is occasionally seen at the apex of the skin flap due to preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.

  16. Safety of cesarean delivery through placental incision in patients with anterior placenta previa.

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa; Jeong, Eun-Hwan


    To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique.

  17. Brain derived neurotrophic factor (BDNF contributes to the pain hypersensitivity following surgical incision in the rats

    Zhang Jian-Yi


    Full Text Available Abstract Background The pathogenic role of brain derived neurotrophic factor (BDNF in the incisional pain is poorly understood. The present study explores the role of the BDNF in the incision-induced pain hypersensitivity. Methods A longitudinal incision was made in one plantar hind paw of isoflurane-anesthetized rats. Dorsal root ganglias (DRG and spinal cords were removed at various postoperative times (1–72 h. Expression pattern of BDNF was determined by immunohistochemistry and double-labeling immunofluorescence. Lidocaine-induced blockade of sciatic nerve function was used to determine the importance of afferent nerve activity on BDNF expression in the DRG and spinal cord after incision. BDNF antibody was administered intrathecally (IT or intraperitoneal (IP to modulate the spinal BDNF or peripheral BDNF after incision. Results After hind-paw incision, the BDNF was upregulated in the ipsilateral lumbar DRG and spinal cord whereas thoracic BDNF remained unchanged in response to incision. The upregulated BDNF was mainly expressed in the large-sized neurons in DRG and the neurons and the primary nerve terminals in the spinal cord. Sciatic nerve blockade prevented the increase of BDNF in the DRG and spinal cord. IT injection of BDNF antibody greatly inhibited the mechanical allodynia induced by incision whereas IP administration had only marginal effect. Conclusion The present study showed that incision induced the segmental upregulation of BDNF in the DRG and spinal cord through somatic afferent nerve transmission, and the upregulated BDNF contributed to the pain hypersensitivity induced by surgical incision.

  18. Differential diagnosis and management of giant fibroadenoma: comparing excision with reduction mammoplasty incision and excision with inframammary incision.

    Ugburo, Andrew O; Olajide, Thomas O; Fadeyibi, Idowu O; Mofikoya, Bolaji O; Lawal, Abdulrazzaq O; Osinowo, Adedapo O


    Giant fibroadenoma (GFA) may present with breast asymmetry and can be excised with an inframammary incision (IFI) or reduction mammoplasty incision (RMI). This study investigated the clinical presentation and compared excision with the IFI and RMI. All patients with benign breast tumours greater than 5 cm underwent core needle biopsy and a histopathological diagnosis. All confirmed GFA had their clinical details documented and randomised into two groups for excision with an IFI or RMI. Twenty-two patients were studied. The age range was 12-46 years, mean 21.18 ± 2.22 years. The patients were divided into two groups: a juvenile group (n = 16) (73%) aged 12-18 years, mean age 14.06 ± 0.42 years, and a perimenopausal group (n = 5) aged 28-46 years. The juvenile group showed cyclic increases in breast size monthly with menstruation while the perimenopausal showed an initial slow growth of 6-24 months followed by a rapid growth. Fifteen patients (68%) had excision biopsy with IMI and seven patients with RMI. Seven of the patients treated with IFI had minimal preoperative asymmetry and satisfactory aesthetic outcome. Among the patients with severe preoperative asymmetry treated with IFI (n = 8) and RMI (n = 7), those treated with IFI had persistent postoperative skin redundancy and asymmetry, which was not found in those treated with RMI. In conclusion, for patients with significant asymmetry, excision with the IFI was associated with persistent asymmetry while excision with RMI was associated with restoration of symmetry.

  19. Comparison of the incisions for the open surgical treatment of gluteal muscle contracture.

    Xu, Jian; Geng, Xiang; Muhammad, Hassan; Wang, Xu; Huang, Jia-Zhang; Zhang, Chao; Ma, Xin


    Gluteal muscle contracture is not very common, but cases are still seen in China. Open surgical treatment is considered as an efficient method to treat this disease. However, the type of incision that can provide best results is yet to be determined. The authors therefore compared various incisions to determine the better one. In this retrospective study, patients who underwent surgery with a traverse straight incision, a curved incision, a longitudinal straight incision, or an 'S'-shaped incision above the greater trochanter were enrolled and divided into four groups: A, B, C, and D. In each group, the patients were divided into different levels according to a specific standard. The four groups were compared in terms of incision length, postoperative drainage amounts, wound healing rates, visual analog scale scores, and improvement in the degree of range of motion (ROM). During the follow-up period, the validity of the results, complications, and recurrent cases were evaluated. In our study, incision length and visual analog scale score of the four groups showed no significant differences (P>0.05). Wound healing rates, drainage amount, improvement in ROM, validity of the results, and recurrences in group D were significantly the best (P<0.05). No significant differences in wound healing rates, drainage amount, and improvement in ROM were found in groups A, B, and C. In terms of validity of the results and 1-year recurrence, no significant difference was observed between groups A and B; however, these factors were better than those in group C. We concluded that the 'S'-shaped incision above the greater trochanter is the most efficient among the incisions described in this study. This incision has the following advantages: clear exposure, less damage, high safety rate, excellent results, and low recurrence rate.

  20. Our First Experience With Negative Pressure Incision Management System Implemented on the Clean Surgical Incision in the Renal Transplantation Recipient: A Case Report.

    Bozkurt, B; Tokac, M; Dumlu, E G; Yalcin, A; Kilic, M


    Multiple comorbidities and environmental factors increase the complications of incisional wounds in patients. It was demonstrated in previous prospective and randomized studies that negative pressure wound therapy (NPWT) reduced wound infection and other complications in clean, closed surgical incisions. In this case report, the Prevena incision management system was implemented on the clean, closed surgical incision of a 52-year-old female patient, who was given a renal transplantation from cadaver postoperatively in the operating theater. It was removed from the patient on the fifth day after the operation. Following the removal of Prevena, the wound and surrounding skin of the patient were observed. Wound healing was complete, and no skin lesion or tool-related complication was found around the wound due to NPWT. The Prevena NPWT system can be conveniently and safely implemented on the operational incision in renal transplant recipients in order to prevent surgical wound complications.

  1. Incisiones verticales en SARPE Vertical incisions in SARPE

    J. Gonzalez Lagunas


    Full Text Available La expansión rápida de paladar asistida quirúrgicamente (SARPE es una de las opciones terapeuticas de los transtornos transversales del maxilar superior. Presentamos nuestra experiencia inicial con una variante técnica consistente en una corticotomía de la pared lateral del maxilar combinada con una osteotomía palatina media transincisal, y efectuadas a través de tres pequeñas incisiones verticales.Surgically assisted rapid palatal expansion (SARPE is one of the therapeutic options for the correction of transverse maxillary collapse. We present our initial experience with a technique consisting in a lateral corticotomy of the maxilla plus a transincisal midpalatal osteotomy, both performed through minimal vertical incisions.

  2. Repair of congenital diaphragmatic hernias through umbilical skin incisions.

    Uehara, Shuichiro; Usui, Noriaki; Kamiyama, Masafumi; Masahata, Kazunori; Nara, Keigo; Ueno, Takehisa; Soh, Hideki; Oue, Takaharu; Fukuzawa, Masahiro


    The use of thoracoscopy and laparoscopy in the treatment of congenital diaphragmatic hernias (CDHs) has been recently reported; however, the use of these procedures still remains controversial due to CO2 insufflation and limited working space. In addition, because of difficult techniques, it has not been widely accepted. Among CDH patients, mild cases whose lung is not hypoplastic, and not associated with persistent pulmonary hypertension of the neonate (PPHN) often develop small defects in the diaphragm that can be repaired using "direct closure." Because direct closure does not require as wide an operative field as that needed for patch closure, we repaired CDH through umbilical skin windows in two neonates with mild CDH to minimize the wounds. With the creation of additional radical small incisions, the surgeries were successfully performed without any intra- or postoperative complications, and the wounds were cosmetically pleasing. The repair of CDHs through umbilical skin windows is a feasible and useful approach in neonates with mild CDH.

  3. Single incision laparoscopic splenectomy, technical aspects and feasibility considerations.

    Cabras, Francesco; Fabrizio, Lazzara; Bracale, Umberto; Andreuccetti, Jacopo; Pignata, Giusto


    Minimally invasive techniques have been introduced to reduce morbidity related to standard laparoscopic procedures. One such approach is laparoendoscopic single-site surgery. The aim of the study was to present our initial clinical experience of using this technique for elective splenectomy. We carried out single access laparoscopic splenectomy (SALS) for an 8 cm cystic lesion of the spleen, involving the hilum, on a 38-year-old woman. The procedure was performed with a single-port device (4-channel) via a 2.5-cm umbilical incision. A flexible 5-mm optic and straight laparoscopic instruments were used. The operative time was 75 min. There was no blood loss. No complications were observed. The postoperative period was uneventful. Although substantial development of the instruments and skills is needed, this SALS technique appears to be feasible and safe. Nevertheless, further experience and observations are necessary.

  4. Single-incision laparoscopic splenectomy with innovative gastric traction suture

    Srikanth G


    Full Text Available Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up.

  5. Nucleus management in manual small incision cataract surgery by phacosection

    Ravindra M


    Full Text Available Nucleus management is critical in manual small incision cataract surgery (MSICS, as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

  6. Transcriptomic analysis of incised leaf-shape determination in birch.

    Mu, Huaizhi; Lin, Lin; Liu, Guifeng; Jiang, Jing


    Plant researchers have focused much attention on leaf shape because of its importance in the identification. To evaluate the impact of intraspecies leaf-shape variation on the transcriptome, a series of Betula pendula 'Dalecarlica' and B. pendula saplings were generated through tissue culture. The leaf shapes and transcriptomes of B. pendula 'Dalecarlica' clones were compared with those of B. pendula clones. The leaf shape of B. pendula 'Dalecarlica' was incised and that of B. pendula was ovate. Transcriptome data revealed numerous changes in gene expression between B. pendula 'Dalecarlica' and B. pendula, including upregulation of 8767 unigenes and downregulation of 8379 unigenes in B. pendula 'Dalecarlica'. A pathway analysis revealed that the transport and signal transduction of auxin were altered in 'Dalecarlica', which may have contributed to its altered leaf shape. These results shed light on variation in birch leaf shape and help identify important genes for the genetic engineering of birch trees. © 2013.

  7. Single-incision retroperitoneoscopic adrenalectomy: a North American experience.

    Sho, Shonan; Yeh, Michael W; Li, Ning; Livhits, Masha J


    Endoscopic adrenalectomy is currently performed using multiple ports placed either transabdominally or retroperitoneally. We report our initial experience with single-incision retroperitoneoscopic adrenalectomy (SIRA). A prospective database of patients undergoing adrenalectomy from December 2013 through March 2016 was analyzed. We adopted conventional retroperitoneoscopic adrenalectomy (CORA) in December 2013 and transitioned to SIRA in March 2015. SIRA was performed using three trocars placed through a single 2-cm incision below the 12th rib. Clinical characteristics and outcomes were compared between patients undergoing SIRA and CORA. One hundred and five adrenalectomies were performed in 102 patients: 34 laparoscopic transperitoneal, 24 CORA, 37 SIRA and 7 open. The SIRA and CORA groups were similar with respect to clinical characteristics (SIRA vs. CORA: mean BMI 27.0 vs. 28.8 kg/m(2), maximum BMI 38.9 vs. 44.3 kg/m(2); mean nodule size 3.2 vs. 3.2 cm, maximum nodule size 8.0 vs. 6.0 cm). One patient undergoing SIRA required placement of an additional 5-mm port because of extensive adhesions. No patients who underwent SIRA or CORA required conversion to open adrenalectomy. There were no deaths, and blood loss remained CORA (105 vs. 92 min, P = 0.26). In multivariable linear regression analysis, nodule size > 5 cm (effect = 1.75, P CORA and may be applied to technically challenging cases involving obese patients or large nodules. The use of three ports allows for two-handed dissection, which may shorten the learning curve for many surgeons.

  8. Evolution of cataract surgery: Smaller incision - less complications

    Draganić Vladimir


    Full Text Available Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS. Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ≥ 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  9. [Evolution of cataract surgery: smaller incision--less complications].

    Draganić, Vladimir; Vukosavljević, Miroslav; Milivojević, Milorad; Resan, Mirko; Petrović, Nenad


    Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/forceps IOL implantation, phacoemulsification/injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Uncorrected visual aquity 30 days postoperatively was > or = 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  10. Dynamical theory of spin relaxation

    Field, Timothy R.; Bain, Alex D.


    The dynamics of a spin system is usually calculated using the density matrix. However, the usual formulation in terms of the density matrix predicts that the signal will decay to zero, and does not address the issue of individual spin dynamics. Using stochastic calculus, we develop a dynamical theory of spin relaxation, the origins of which lie in the component spin fluctuations. This entails consideration of random pure states for individual protons, and how these pure states are correctly combined when the density matrix is formulated. Both the lattice and the spins are treated quantum mechanically. Such treatment incorporates both the processes of spin-spin and (finite temperature) spin-lattice relaxation. Our results reveal the intimate connections between spin noise and conventional spin relaxation.

  11. A mixed relaxed clock model


    Over recent years, several alternative relaxed clock models have been proposed in the context of Bayesian dating. These models fall in two distinct categories: uncorrelated and autocorrelated across branches. The choice between these two classes of relaxed clocks is still an open question. More fundamentally, the true process of rate variation may have both long-term trends and short-term fluctuations, suggesting that more sophisticated clock models unfolding over multiple time scales should ultimately be developed. Here, a mixed relaxed clock model is introduced, which can be mechanistically interpreted as a rate variation process undergoing short-term fluctuations on the top of Brownian long-term trends. Statistically, this mixed clock represents an alternative solution to the problem of choosing between autocorrelated and uncorrelated relaxed clocks, by proposing instead to combine their respective merits. Fitting this model on a dataset of 105 placental mammals, using both node-dating and tip-dating approaches, suggests that the two pure clocks, Brownian and white noise, are rejected in favour of a mixed model with approximately equal contributions for its uncorrelated and autocorrelated components. The tip-dating analysis is particularly sensitive to the choice of the relaxed clock model. In this context, the classical pure Brownian relaxed clock appears to be overly rigid, leading to biases in divergence time estimation. By contrast, the use of a mixed clock leads to more recent and more reasonable estimates for the crown ages of placental orders and superorders. Altogether, the mixed clock introduced here represents a first step towards empirically more adequate models of the patterns of rate variation across phylogenetic trees. This article is part of the themed issue ‘Dating species divergences using rocks and clocks’. PMID:27325829

  12. Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis.

    Keus, F.; Gooszen, H.G.; Laarhoven, C.J.H.M. van


    BACKGROUND: Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking. AIM: To compare the effects of open, small-incision and laparoscopic cholecystectomy techniques for patients wit

  13. Incisional hernia after upper abdominal surgery: A randomised controlled trial of midline versus transverse incision

    J.A. Halm (Jens); H. Lip (Harm); P.I.M. Schmitz (Paul); J. Jeekel (Hans)


    textabstractObjectives: To determine whether a transverse incision is an alternative to a midline incision in terms of incisional hernia incidence, surgical site infection, postoperative pain, hospital stay and cosmetics in cholecystectomy. Summary background data: Incisional hernias after midline i

  14. Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis

    Keus, F; Gooszen, H G; Van Laarhoven, C J H M


    Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking.......Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking....

  15. Systematic review : open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis

    Keus, F.; Gooszen, H. G.; Van Laarhoven, C. J. H. M.


    Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking. To compare the effects of open, small-incision and laparoscopic cholecystectomy techniques for patients with symptomatic cho

  16. Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy

    Jørgensen, Lars Nannestad; Rosenberg, J; Al-Tayar, H;


    BACKGROUND: There are no randomized studies that compare outcomes after single-incision (SLC) and conventional multi-incision (MLC) laparoscopic cholecystectomy under an optimized perioperative analgesic regimen. METHODS: This patient- and assessor-blinded randomized three-centre clinical trial c...

  17. Double incision wound healing bioassay using Hamelia patens from El Salvador.

    Gomez-Beloz, Alfredo; Rucinski, James C; Balick, Michael J; Tipton, Camille


    Hamelia patens Jacq. (Rubiaceae) has received little attention in the laboratory for its wound healing ability even though it is commonly used as a treatment for wounds throughout Central America. A double incision wound healing bioassay was carried out with a crude extract of Hamelia patens collected from El Salvador. Animals were divided into three groups. Group I (n = 14) had the left incision treated with 5% (w/w) Hamelia patens and the contralateral side with petroleum jelly (PJ). Group II (n = 14) had the left incision treated with 10% (w/w) ointment and the contralateral side with petroleum jelly. Group III (n = 10) had the left incision treated with petroleum jelly and the contralateral side left untreated. Breaking strength of the incisions was measured on day 7 and day 12. For Groups I and II, there was no significant difference between treatment and control incisions at day 7. On day 12, there was a significant difference between the treated and control incisions for Groups I and II. There was no significant difference between petroleum jelly and untreated incisions for Group III on day 7 and day 12. Hamelia patens does increase breaking strength of wounds significantly more than the control group. Further wound healing studies of this plant are warranted.

  18. Performance of fast-absorbable suture and histo-glue in closing incisions in Brown trout

    Jepsen, Niels; Larsen, Martin Hage; Aarestrup, Kim


    , growth, tag expulsion rate and incision healing was compared among three groups of dummy transmitter-tagged wild brown trout Salmo trutta where incisions were closed with two types of suture material (absorbable vs. fast absorbable) and Histo-glue. The tagged fish were kept in semi-natural ponds for 20...


    IGA Prima Dewi AP


    Full Text Available Aromatherapy is a kind of treatment that used aroma with aromatherapy essential oil. Extraction process from essential oil generally doing in three methods, there are distilling with water (boiled, distilling with water and steam, and distilling with steam. One of the most favorite aroma is lavender. The main content from lavender is linalyl acetate and linalool (C10H18O. Linalool is main active contents in lavender which can use for anti-anxiety (relaxation. Based on some research, the conclusion indicates that essential oil from lavender can give relaxation (carminative, sedative, reduce anxiety level and increasing mood.

  20. Statistical mechanics of violent relaxation

    Spergel, David N.; Hernquist, Lars


    We propose a functional that is extremized through violent relaxation. It is based on the Ansatz that the wave-particle scattering during violent dynamical processes can be approximated as a sequence of discrete scattering events that occur near a particle's perigalacticon. This functional has an extremum whose structure closely resembles that of spheroidal stellar systems such as elliptical galaxies. The results described here, therefore, provide a simple framework for understanding the physical nature of violent relaxation and support the view that galaxies are structured in accord with fundamental statistical principles.

  1. Active optomechanics through relaxation oscillations

    Princepe, Debora; Frateschi, Newton


    We propose an optomechanical laser based on III-V compounds which exhibits self-pulsation in the presence of a dissipative optomechanical coupling. In such a laser cavity, radiation pressure drives the mechanical degree of freedom and its back-action is caused by the mechanical modulation of the cavity loss rate. Our numerical analysis shows that even in a wideband gain material, such dissipative coupling couples the mechanical oscillation with the laser relaxation oscillations process. Laser self-pulsation is observed for mechanical frequencies below the laser relaxation oscillation frequency under sufficiently high optomechanical coupling factor.

  2. Thermal relaxation and mechanical relaxation of rice gel

    丁玉琴; 赵思明; 熊善柏


    Rice gel was prepared by simulating the production processes of Chinese local rice noodles,and the properties of thermal relaxation and mechanical relaxation during gelatinization were studied by differential scanning calorimetry(DSC) measurement and dynamic rheometer.The results show that during gelatinization,the molecular chains of rice starch undergo the thermal relaxation and mechanical relaxation.During the first heating and high temperature holding processes,the starch crystallites in the rice slurry melt,and the polymer chains stretch and interact,then viscoelastic gel forms.The cooling and low temperatures holding processes result in reinforced networks and decrease the viscoelasticity of the gel.During the second heating,the remaining starch crystallites further melt,the network is reinforced,and the viscoelasticity increases.The viscoelasticity,the molecular conformation and texture of the gel are adjusted by changing the temperature,and finally construct the gel with the textural characteristics of Chinese local rice noodle.

  3. Vertical intra-areolar incision in dual-plane breastaugmentation mammaplasty

    LONG Xiao; ZENG Ang; ZHANG Hai-lin; QIAO Qun


    Objective To investigate the use of vertical intra-areolar incision in dual plane breast augmentation.Methods Fifteen cases received dual plane breast augmentation with vertical intra-areola incision in our hospital from January 2008 to December 2008.Breast gland was cut vertically in the upper part and pectoralis major muscle was separated according to the direction of the muscle fiber.Then the pectoralis major muscle was partially amputated at the starting point.Finally the implant was placed partially under the breast gland and partially under the pectoralis major muscle.Results The follow-up of more than one year showed all cases healed well and the incisions were concealed except one case who suffered delayed healing of the wound and depigmentation of the incision.Conclusion Vertical intra-areolar incision in dual plane breast augmentation is an easily-performed and feasible method and leaves less scar post operation.

  4. The lazy lateral incision: an innovative approach to the skin-sparing mastectomy.

    Dutton, Walter; Ghareeb, Paul A; McClellan, W Thomas


    The skin-sparing mastectomy has many advantages over a simple mastectomy, including preservation of the native breast skin, inframammary fold, and improved aesthetics for immediate reconstruction. The traditional transverse elliptical access incision is anterior on the breast mound, requires a second incision for previous biopsy sites, and provides restricted access to the axilla. We describe a novel mastectomy incision that improves scar appearance, improves access to the axillary contents, and reduces skin flap retraction. This incision starts at the nipple-areolar complex and extends laterally in a curvilinear fashion toward the axilla incorporating the biopsy scar along the way. This simple sinusoidal design results in an aesthetically superior alternative to the traditional linear mastectomy incision.

  5. Comparison of Modifications in Flap Anastomosis Patterns and Skin Incision Types for External Dacryocystorhinostomy: Anterior-Only Flap Anastomosis with W Skin Incision versus Anterior and Posterior Flap Anastomosis with Linear Skin Incision

    Burcu Dirim


    Full Text Available Purpose. To compare the outcomes of external dacryocystorhinostomy (E-DCR by using two different flap anastomosis patterns and skin incision types. Methods. This study included 79 patients (88 eyes with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A underwent E-DCR by suturing anterior and posterior flaps (H-flap of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B DCR was performed by suturing only anterior flaps (U-flap with W skin incision. Results. The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%. In terms of groups, patency was 44 eyes (88.0% in group A and 34 eyes (89.5% in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores. Conclusion. Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation.

  6. Dielectric relaxation of samarium aluminate

    Sakhya, Anup Pradhan; Dutta, Alo; Sinha, T.P. [Bose Institute, Department of Physics, Kolkata (India)


    A ceramic SmAlO{sub 3} (SAO) sample is synthesized by the solid-state reaction technique. The Rietveld refinement of the X-ray diffraction pattern has been done to find the crystal symmetry of the sample at room temperature. An impedance spectroscopy study of the sample has been performed in the frequency range from 50 Hz to 1 MHz and in the temperature range from 313 K to 573 K. Dielectric relaxation peaks are observed in the imaginary parts of the spectra. The Cole-Cole model is used to analyze the dielectric relaxation mechanism in SAO. The temperature-dependent relaxation times are found to obey the Arrhenius law having an activation energy of 0.29 eV, which indicates that polaron hopping is responsible for conduction or dielectric relaxation in this material. The complex impedance plane plot of the sample indicates the presence of both grain and grain-boundary effects and is analyzed by an electrical equivalent circuit consisting of a resistance and a constant-phase element. The frequency-dependent conductivity spectra follow a double-power law due to the presence of two plateaus. (orig.)

  7. Choosing a skeletal muscle relaxant.

    See, Sharon; Ginzburg, Regina


    Skeletal muscle relaxants are widely used in treating musculoskeletal conditions. However, evidence of their effectiveness consists mainly of studies with poor methodologic design. In addition, these drugs have not been proven to be superior to acetaminophen or nonsteroidal anti-inflammatory drugs for low back pain. Systematic reviews and meta-analyses support using skeletal muscle relaxants for short-term relief of acute low back pain when nonsteroidal anti-inflammatory drugs or acetaminophen are not effective or tolerated. Comparison studies have not shown one skeletal muscle relaxant to be superior to another. Cyclobenzaprine is the most heavily studied and has been shown to be effective for various musculoskeletal conditions. The sedative properties of tizanidine and cyclobenzaprine may benefit patients with insomnia caused by severe muscle spasms. Methocarbamol and metaxalone are less sedating, although effectiveness evidence is limited. Adverse effects, particularly dizziness and drowsiness, are consistently reported with all skeletal muscle relaxants. The potential adverse effects should be communicated clearly to the patient. Because of limited comparable effectiveness data, choice of agent should be based on side-effect profile, patient preference, abuse potential, and possible drug interactions.

  8. Onsager relaxation of toroidal plasmas

    Samain, A.; Nguyen, F.


    The slow relaxation of isolated toroidal plasmas towards their thermodynamical equilibrium is studied in an Onsager framework based on the entropy metric. The basic tool is a variational principle, equivalent to the kinetic equation, involving the profiles of density, temperature, electric potential, electric current. New minimization procedures are proposed to obtain entropy and entropy production rate functionals. (author). 36 refs.

  9. Relaxation properties in classical diamagnetism

    Carati, A.; Benfenati, F.; Galgani, L.


    It is an old result of Bohr that, according to classical statistical mechanics, at equilibrium a system of electrons in a static magnetic field presents no magnetization. Thus a magnetization can occur only in an out of equilibrium state, such as that produced through the Foucault currents when a magnetic field is switched on. It was suggested by Bohr that, after the establishment of such a nonequilibrium state, the system of electrons would quickly relax back to equilibrium. In the present paper, we study numerically the relaxation to equilibrium in a modified Bohr model, which is mathematically equivalent to a billiard with obstacles, immersed in a magnetic field that is adiabatically switched on. We show that it is not guaranteed that equilibrium is attained within the typical time scales of microscopic dynamics. Depending on the values of the parameters, one has a relaxation either to equilibrium or to a diamagnetic (presumably metastable) state. The analogy with the relaxation properties in the Fermi Pasta Ulam problem is also pointed out.

  10. Correction of low corneal astigmatism in cataract surgery

    Pia; Leon; Marco; Rocco; Pastore; Andrea; Zanei; Ingrid; Umari; Meriem; Messai; Corrado; Negro; Daniele; Tognetto


    · AIM: To evaluate and compare aspheric toric intraocular lens(IOL) implantation and aspheric monofocal IOL implantation with limbal relaxing incisions(LRI) to manage low corneal astigmatism(1.0-2.0 D) in cataract surgery.· METHODS: A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes(102 patients) with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions. Outcomes considered were: visual acuity, postoperative residual astigmatism, endothelial cell count, the need for spectacles, and patient satisfaction. To determine the postoperative toric axis, all patients who underwent the toric IOL implantation were further evaluated using an OPD Scan III(Nidek Co, Japan). Follow-up lasted 6mo.· RESULTS: The mean uncorrected distance visual acuity(UCVA) and the best corrected visual acuity(BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up the UCVA was statistically better in the patients with toric IOL implants compared to those patients who underwent implantation of monofocal IOL plus LRI. The mean residual refractive astigmatism was of 0.4 D for the toric IOL group and 1.1 D for the LRI group(P <0.01). No difference was observed in the postoperative endothelial cell count between the two groups.· CONCLUSION: The two surgical procedures demonstrated a significant decrease in refractive astigmatism. Toric IOL implantation was more effective and predictable compared to the limbal relaxing incision.

  11. Single transverse extended incision for radical neck dissection.

    Chagas, José Francisco Sales; Pascoal, Maria Beatriz Nogueira; Aquino, José Luís Braga; Brandi, Luís Antônio; Previtale, Evandro Von Zuben; Trillo, Ana Sofia Pontes; Curioni, Otávio Alberto; Rapoport, Abrão; Dedivitis, Rogério Aparecido


    to assess the efficacy of the single transverse extended cervical incision in radical neck dissection. we conducted a prospective study, from January 2008 to January 2009, with 18 patients undergoing surgical treatment of malignant tumors of the upper aero-digestive tract. The primary lesion was located in the oral cavity in eight cases, in the oropharynx in three, in the hypopharynx in three, in the larynx in two, in the maxillary sinus, and in one case, the primary injury was hidden. There were 29 neck dissections, eight bilateral and 10 unilateral (26 radical and three selective). Staging revealed nine patients with T4 tumor, one T3, six T2, one T1 and one Tx. Five patients were N0, nine N2b, one N2c and three N3. The average number of dissected lymph nodes was 34.25. We performed the neck dissection through a single incision located in the middle neck, coincident with the skinfold, with a length of about 2 to 3 cm behind the anterior edge of the trapezius muscle and 3 to 4 cm from the midline for the unilateral neck dissections. as complications, there were myocutaneous flap necrosis in one patient with prior radiation therapy, one lymphatic fistula, one dehiscence of the tracheostomy, one cervical abscess, one salivary fistula and one suture dehiscence. the single extended incision provides adequate exposure of the neck structures, without compromising surgical time, even in bilateral dissections. It does not compromise the resection of all cervical lymph nodes; it has excellent aesthetic and functional results and is easily associated with other approaches to resection of the primary tumor. verificar a eficácia da incisão cervical única, transversa e estendida, para o esvaziamento cervical radical. estudo prospectivo, de janeiro de 2008 a janeiro de 2009, de 18 pacientes submetidos a tratamento cirúrgico de tumores malignos da via aero-digestiva superior. A lesão primária se situava na cavidade oral em oito casos, na orofaringe em três, no seio

  12. Extensive adipose tissue necrosis following pfannenstiel incision for endometrial cancer.

    Lavoie, Maryse Céline; Plante, Marie; Lemieux, Marie-Carine; Roberge, Céline; Renaud, Marie-Claude; Grégoire, Jean; Roy, Michel; Sebastianelli, Alexandra


    Contexte : Les hématomes sont des complications postopératoires qui peuvent en venir à se manifester à la suite du recours à des incisions de Pfannenstiel. Habituellement, ils se résorbent de façon spontanée ou font l’objet d’un drainage (en fonction de leur ampleur). Des facteurs de risque importants (comme l’obésité et le diabète) pourraient mener à des complications surajoutées et aggraver davantage l’issue. Cas : Dix jours après avoir subi une hystérectomie abdominale totale par incision de Pfannenstiel en raison d’un cancer de l’endomètre, une femme de 73 ans a présenté un gros hématome sous-cutané. L’hématome en question a évolué et a mené à une nécrose étendue du tissu adipeux sous-cutané. La mise en œuvre d’un débridement de grande envergure s’est avérée nécessaire et la plaie a été traitée par pression négative au moyen de gaze afin de permettre une cicatrisation par deuxième intention. Une guérison satisfaisante a été constatée après 82 jours de traitement, sans greffe cutanée. Conclusion : Ce cas souligne l’utilité du traitement de plaie par pression négative au moyen de gaze, ainsi que la nécessité d’avoir recours à une approche multidisciplinaire au moment d’assurer la prise en charge de complications de plaie d’une telle complexité.

  13. Equivalent Relaxations of Optimal Power Flow

    Bose, S; Low, SH; Teeraratkul, T; Hassibi, B


    Several convex relaxations of the optimal power flow (OPF) problem have recently been developed using both bus injection models and branch flow models. In this paper, we prove relations among three convex relaxations: a semidefinite relaxation that computes a full matrix, a chordal relaxation based on a chordal extension of the network graph, and a second-order cone relaxation that computes the smallest partial matrix. We prove a bijection between the feasible sets of the OPF in the bus injection model and the branch flow model, establishing the equivalence of these two models and their second-order cone relaxations. Our results imply that, for radial networks, all these relaxations are equivalent and one should always solve the second-order cone relaxation. For mesh networks, the semidefinite relaxation and the chordal relaxation are equally tight and both are strictly tighter than the second-order cone relaxation. Therefore, for mesh networks, one should either solve the chordal relaxation or the SOCP relaxation, trading off tightness and the required computational effort. Simulations are used to illustrate these results.

  14. Development of a New Type of Incisal Table for Prosthetic Articulators

    Alessandro Tasora


    Full Text Available This study illustrates the effectiveness of an advanced incisal table surface, featuring adjustable curvature, in the sake of more accurate articulator kinematics in anterior teeth reconstruction. Prosthetic articulators, used by dental technicians in reconstructive dentistry, are adjustable instruments that simulate the motion of mastication between dental casts: usually, the forward motion (protrusion of the mandible is guided by sliding a pin over a flat table in order to recreate those movements when incisal teeth are missing. However, such protrusion is an approximation of the exact motion, since flat incisal tables have a limited set of adjustments. Customized software has been developed in order to simulate the kinematics of articulators in three-dimensional space: animations and measures of the envelope of teeth profiles show the unfeasibility of reconstructing with good approximation the profile of incisive teeth, when a simple ‘flat’ incisal table is used. A new incisal table with an adjustable curvature has been proposed, simulated, and built, and computer simulations demonstrated the superior precision of the new design when compared to a conventional articulator which uses a flat incisal table.

  15. Percutaneous bone-anchored hearing implant surgery: dermatome versus linear incision technique.

    Strijbos, Ruben M; Bom, Steven J H; Zwerver, Stefan; Hol, Myrthe K S


    The objective of this historical cohort study is to identify if there are differences in soft tissue reactions and skin thickening between implantation of the percutaneous bone-anchored hearing implant (BAHI) using the dermatome or linear incision technique. All adult patients who received a BAHI between August 2005 and January 2013 were selected. One surgeon performed all procedures and only the dermatome and linear incision technique were used. A total of 132 patients/implants were included and significantly more patients with risk factors were seen in the linear incision cohort. A soft tissue reaction Holgers ≥1 was present in 18 patients (40.9 %) in the dermatome compared to 36 patients (40.9 %) in the linear incision group. A Holgers ≥2 was noticed in 9 (20.5 %) and 19 (21.6 %) patients, respectively. Skin thickening was described in 14 (31.8 %) and 11 patients (12.5 %) in, respectively, the dermatome and linear incision cohort, which was a significant difference (p = 0.001). Nevertheless, therapeutic interventions were effective. In conclusion, there was no significant difference in (adverse) soft tissue reactions; however, skin thickening was more present in the dermatome technique. In addition, significantly more patients with risk factors were allocated to the linear incision technique. Based on these results, the linear incision is advocated as preferred technique.

  16. [Dentascan computed tomography of the mandibular incisive canal. Its radiologic anatomy and the therapeutic implications].

    Calgaro, A; Bison, L; Bellis, G B; Pozzi Mucelli, R


    To stress the importance of CT depiction of the mandibular incisive canal. This anatomical structure contains a major neurovascular bundle and is thus very important in the planning of mandibular implants in the canine-incisive area. January through December 1998, sixty patients unselected by age and gender were submitted to mandibular CT. Axial slices were acquired with 1-1.5 mm thickness and 1 mm table feed, and the images were then reformatted with a dedicated dental software. Both the conventional and the Helical techniques were used. The incisive canal appears on Dentascan transverse reconstructions as a round low-density area within mandibular trabecular bone, which is surrounded by a higher-density rim representing the canal walls. This anatomical structure originates from the mental foramen and continues mesially to the mental symphysis. The mandibular canal was visualized in 95% of cases bilaterally (57/60); the incisive canal was depicted on the left side in 41.6% of cases (25/60) and on the right side in 51.6% (31/60). The importance of careful assessment of the mandibular canal course before implantology is now widely recognized. The same holds true for the canine-incisive region in the jaw, to detect the incisive canal if present and prevent any complications from its accidental damage. CT with a dedicated software showed the incisive canal in a large number of patients, which calls for precise reporting of its presence, course, and relationships with teeth.

  17. Incision properties and thermal effects of CO2 lasers in soft tissue

    Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Liaw, Lih-Huei L.; Berns, Michael W.


    Thermal and histological events resulting from soft tissue incision using CO2 lasers at 9.3 (mu) or 10.6 (mu) , fitted with a hollow wave guide or an articulated arm delivery system respectively, were investigated. In 9 fresh pigs' mandibles, standardized incisions 3 cm in length were made in the oral mucosa. Incisions were performed in the cw mode at 1 W, 4 W, and 12 W. Thermal events were measured in adjacent soft tissues using thermocouples. Incisions were dissected out, fixed, embedded in paraffin wax, sectioned and stained with Serius Red. The Students' t-test for paired data was used to compare zones of necrosis, zones of collagen damage and thermal events. No significant temperature rise was measured during irradiation at any timepoints or power settings (p < 0.05). Results were very similar for the two lasers with significantly different results obtained only at the 12 W setting (p < 0.05). Vertical incision depths and horizontal incision widths did not differ significantly (p < 0.0001) at 12 W and 4 W. Horizontal and vertical zones of necrosis did not differ significantly (p < 0.0001) either between the two lasers at 12 W and 4 W. Thus the thermal and histological events occurring during soft tissue incision were similar using these two lasers, despite the difference in wavelength and delivery system.

  18. Nuclear management in manual small incision cataract surgery by snare technique

    Bhattacharya Debasish


    Full Text Available Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber becomes a useful option in these cases. In the snare technique, a stainless steel wire loop when lassoed around the nucleus in the anterior chamber constricts from the equator, easily dividing the hardest of the nuclei into two halves. The wire loop constricts in a controlled way when the second cannula of snare is pulled. The divided halves can easily be brought out by serrated crocodile forceps. This nuclear management can be safely performed through a smaller sclerocorneal flap valve incision where the corneal valve action is retained within the limbus without sutures, and the endothelium or the incision is not disturbed. However, the technique requires space in the anterior chamber to maneuver the wire loop and anterior chamber depth more than 2.5 mm is recommended. Much evidence to this wonderful technique is not available in literature, as its popularity grew through live surgical workshops and small interactive conferences.

  19. De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

    Arefah Dehghani Tafti


    Full Text Available AbstractObjectives: De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.Methods: This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.Results: During a three month follow-up, a significant difference was shown between the two methods (p=0.03. Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars, but there were 13 postoperative complaints with transverse incision.Conclusion: According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.

  20. Scar Assessment After Breast Augmentation Surgery with Axillary Incision versus Inframammary Fold Incision: Long-Term Follow-Up in Chinese Patients.

    Sun, Jingjing; Mu, Dali; Liu, Chunjun; Ji, Kai; Chen, Lin; Liu, Wenyue; Luan, Jie


    The inframammary fold (IMF) incision is widely used in Western countries for breast augmentation surgery, whereas the axillary incision is the dominant approach used in China, because many Chinese surgeons believe that the Asian population has a higher risk of developing hypertrophic scars. However, comparative data of scar assessment through different incisions in Chinese patients are scarce. The aims of the study were as follows: (1) to evaluate the outcomes of scar assessment using the Vancouver scar scale (VSS), combined with patient satisfaction scoring, in the scar assessment after breast augmentation surgery; (2) to compare the long-term cosmetic effects of surgical scars between axillary and IMF incisions. Consecutive patients coming to our department for follow-up care at least 1 year after primary breast augmentation surgeries with axillary and IMF incisions between January 1, 2014 and December 31, 2014 were included in the research. Internal consistency, inter-rater reliability, and convergent validity were examined for the VSS and patient satisfaction scoring. The baseline characteristics and scar scores were tested using the Mann-Whitney U-test and Student's t test between the two groups. Sixty-one patients underwent implantation surgeries through the axillary incisions, and 17 patients through the IMF incisions. There were no significant differences in age, follow-up time, body mass index, implant volume, or implant projection between groups. Reliability and validity of the VSS and patient satisfaction scoring were satisfactory. The scores of pigmentation were higher in the IMF group than those in the axilla group with statistical significance (P IMF group (P IMF can achieve comparable cosmetic effects and patient satisfaction in Chinese women. Chinese patients with proper indications can receive breast augmentation surgery through the IMF incision, with fewer risks and less trauma, and get satisfactory scar appearance as through the axillary

  1. Organic semiconductors: What makes the spin relax?

    Bobbert, Peter A.


    Spin relaxation in organic materials is expected to be slow because of weak spin-orbit coupling. The effects of deuteration and coherent spin excitation show that the spin-relaxation time is actually limited by hyperfine fields.

  2. Relaxation Techniques to Manage IBS Symptoms

    ... the Day Art of IBS Gallery Contact Us Relaxation Techniques to Manage IBS Symptoms Details Content Last Updated: ... Topic Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS You’ve been to the doctor ...

  3. Single-Incision Laparoscopic Sterilization of the Cheetah (Acinonyx jubatus).

    Hartman, Marthinus J; Monnet, Eric; Kirberger, Robert M; Schmidt-Küntzel, Anne; Schulman, Martin L; Stander, Jana A; Stegmann, George F; Schoeman, Johan P


    To describe laparoscopic ovariectomy and salpingectomy in the cheetah (Acinonyx jubatus) using single-incision laparoscopic surgery (SILS). Prospective cohort. Female cheetahs (Acinonyx jubatus) (n = 21). Cheetahs were randomly divided to receive either ovariectomy (n = 11) or salpingectomy (n = 10). The use and complications of a SILS port was evaluated in all of cheetahs. Surgery duration and insufflation volumes of carbon dioxide (CO2 ) were recorded and compared across procedures. Laparoscopic ovariectomy and salpingectomy were performed without complications using a SILS port. The poorly-developed mesosalpinx and ovarian bursa facilitated access to the uterine tube for salpingectomy in the cheetah. The median surgery duration for ovariectomy was 24 minutes (interquartile range 3) and for salpingectomy was 19.5 minutes (interquartile range 3) (P = .005). The median volume of CO2 used for ovariectomy was 11.25 L (interquartile range 3.08) and for salpingectomy was 4.90 L (interquartile range 2.52), (P = .001) CONCLUSIONS: Laparoscopic ovariectomy and salpingectomy can be performed in the cheetah using SILS without perioperative complications. Salpingectomy is faster than ovariectomy and requires less total CO2 for insufflation. © Copyright 2015 by The American College of Veterinary Surgeons.

  4. [Intraocular pressure decrease after manual small incision cataract surgery].

    Nganga Ngabou, C G F; Makita, C; Ndalla, S S; Nkokolo, F; Madzou, M


    We decided to evaluate the decrease in intraocular pressure six months after cataract surgery. We evaluated patients' IOP using an applanation tonometer. The patients then underwent cataract surgery. Six months after cataract surgery, we reevaluated the IOP by the same method, and we determined the post-operative change. Among the 147 operated eyes, 123 eyes or 83.67% exhibited a decrease in IOP. The mean preoperative IOP for the operative eye was 15.61±4.5mmHg; the mean post-operative IOP was 12.57±3.5mmHg; the mean IOP decrease after surgery was 3.16±4mmHg, for a mean decrease of 20%. This decrease is statistically significant, Pdecrease in IOP varies proportionally to the initial IOP. In glaucomatous patients, the mean preoperative IOP was 23.16±5.68mmHg and mean post-operative IOP was 14.5±2.7mmHg, a decrease of 37.39%. The decrease in IOP after cataract surgery was generally moderate. However, this IOP decreased proportionally to the initial IOP, thus giving significant decreases for higher IOPs. This decrease in IOP, well known after phacoemulsification, was also obtained after Manual Small Incision Cataract Surgery, a surgical technique which is increasingly employed in developing countries. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus

    Xia, En-Lan; Li, Tin-Chiu; Choi, Sze-Ngar Sylvia; Zhou, Qiao-Yun


    Background: The pregnancy outcome of the unicornuate uterus is associated with an increased risk of miscarriage, cervical incompetence, and a number of obstetric complications. However, at present, there is no accepted treatment method for women with unicornuate uterus, other than expectant measures. The aim of this study was to evaluate the reproductive outcome of transcervical uterine incision (TCUI) in patients with unicornuate uterus. Methods: Thirty-three patients with unicornuate uterus presented to our tertiary center for infertility or miscarriage. All 33 patients underwent TCUI and were followed up for 10–52 months. The pregnancy outcomes (first-trimester miscarriage, second-trimester miscarriage, preterm, term, intrauterine death, ongoing pregnancy, and live birth) before and after TCUI were compared by t-test. Results: Among 31 patients who attempted to conceive after TCUI, twenty conceived including one termination of pregnancy, one second-trimester miscarriage, one ectopic pregnancy, five preterm deliveries, 11 term delivery, and one ongoing pregnancy. There were 16 live births in total. There was significant reduction in the first-trimester miscarriage rate (t = 4.890; P pregnancy outcome in women with unicornuate uterus presenting with infertility or miscarriage. PMID:28139506

  6. Computer guidance system for single-incision bimanual robotic surgery.

    Carbone, Marina; Turini, Giuseppe; Petroni, Gianluigi; Niccolini, Marta; Menciassi, Arianna; Ferrari, Mauro; Mosca, Franco; Ferrari, Vincenzo


    The evolution of surgical robotics is following the progress of developments in Minimally Invasive Surgery (MIS), which is moving towards Single-Incision Laparoscopic Surgery (SILS) procedures. The complexity of these techniques has favored the introduction of robotic surgical systems. New bimanual robots, which are completely inserted into the patient's body, have been proposed in order to enhance the surgical gesture in SILS procedures. However, the limited laparoscopic view and the focus on the end-effectors, together with the use of complex robotic devices inside the patient's abdomen, may lead to unexpected collisions, e.g., between the surrounding anatomical organs not involved in the intervention and the surgical robot. This paper describes a computer guidance system, based on patient-specific data, designed to provide intraoperative navigation and assistance in SILS robotic interventions. The navigator has been tested in simulations of some of the surgical tasks involved in a cholecystectomy, using a synthetic anthropomorphic mannequin. The results demonstrate the usability and efficacy of the navigation system, underlining the importance of avoiding unwanted collisions between the robot arms and critical organs. The proposed computer guidance software is able to integrate any bimanual surgical robot design.

  7. Plasmon-mediated energy relaxation in graphene

    Ferry, D. K. [School of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona 85287-5706 (United States); Somphonsane, R. [Department of Physics, King Mongkut' s Institute of Technology, Ladkrabang, Bangkok 10520 (Thailand); Ramamoorthy, H.; Bird, J. P. [Department of Electrical Engineering, University at Buffalo, the State University of New York, Buffalo, New York 14260-1500 (United States)


    Energy relaxation of hot carriers in graphene is studied at low temperatures, where the loss rate may differ significantly from that predicted for electron-phonon interactions. We show here that plasmons, important in the relaxation of energetic carriers in bulk semiconductors, can also provide a pathway for energy relaxation in transport experiments in graphene. We obtain a total loss rate to plasmons that results in energy relaxation times whose dependence on temperature and density closely matches that found experimentally.

  8. Towards achieving small-incision cataract surgery 99.8% of the time.

    Thomas R


    Full Text Available A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon.

  9. Collisionless Relaxation of Stellar Systems

    Kandrup, H E


    The objective of the work summarised here has been to exploit and extend ideas from plasma physics and accelerator dynamics to formulate a unified description of collisionless relaxation that views violent relaxation, Landau damping, and phase mixing as (manifestations of) a single phenomenon. This approach embraces the fact that the collisionless Boltzmann equation (CBE), the basic object of the theory, is an infinite-dimensional Hamiltonian system, with the distribution function f playing the role of the fundamental dynamical variable, and that, interpreted appropriately, an evolution described by the other Hamiltonian system. Equilibrium solutions correspond to extremal points of the Hamiltonian subject to the constraints associated with Liouville's Theorem. Stable equilibria correspond to energy minima. The evolution of a system out of equilibrium involves (in general nonlinear) phase space oscillations which may -- or may not -- interfere destructively so as to damp away.

  10. Collisionless Relaxation of Stellar Systems

    Kandrup, Henry E.


    The objective of the work summarized here has been to exploit and extend ideas from plasma physics and accelerator dynamics to formulate a unified description of collisionless relaxation of stellar systems that views violent relaxation, Landau damping, and phase mixing as (manifestations of) a single phenomenon. This approach embraces the fact that the collisionless Boltzmann equation (CBE), the basic object of the theory, is an infinite-dimensional Hamiltonian system, with the distribution function f playing the role of the fundamental dynamical variable, and that, interpreted appropriately, an evolution described by the CBE is no different fundamentally from an evolution described by any other Hamiltonian system. Equilibrium solutions f0 correspond to extremal points of the Hamiltonian subject to the constraints associated with Liouville's Theorem. Stable equilibria correspond to energy minima. The evolution of a system out of equilibrium involves (in general nonlinear) phase space oscillations which may - or may not - interfere destructively so as to damp away.

  11. Kinetic activation-relaxation technique

    Béland, Laurent Karim; Brommer, Peter; El-Mellouhi, Fedwa; Joly, Jean-François; Mousseau, Normand


    We present a detailed description of the kinetic activation-relaxation technique (k-ART), an off-lattice, self-learning kinetic Monte Carlo (KMC) algorithm with on-the-fly event search. Combining a topological classification for local environments and event generation with ART nouveau, an efficient unbiased sampling method for finding transition states, k-ART can be applied to complex materials with atoms in off-lattice positions or with elastic deformations that cannot be handled with standard KMC approaches. In addition to presenting the various elements of the algorithm, we demonstrate the general character of k-ART by applying the algorithm to three challenging systems: self-defect annihilation in c-Si (crystalline silicon), self-interstitial diffusion in Fe, and structural relaxation in a-Si (amorphous silicon).

  12. Kinetic activation-relaxation technique.

    Béland, Laurent Karim; Brommer, Peter; El-Mellouhi, Fedwa; Joly, Jean-François; Mousseau, Normand


    We present a detailed description of the kinetic activation-relaxation technique (k-ART), an off-lattice, self-learning kinetic Monte Carlo (KMC) algorithm with on-the-fly event search. Combining a topological classification for local environments and event generation with ART nouveau, an efficient unbiased sampling method for finding transition states, k-ART can be applied to complex materials with atoms in off-lattice positions or with elastic deformations that cannot be handled with standard KMC approaches. In addition to presenting the various elements of the algorithm, we demonstrate the general character of k-ART by applying the algorithm to three challenging systems: self-defect annihilation in c-Si (crystalline silicon), self-interstitial diffusion in Fe, and structural relaxation in a-Si (amorphous silicon).

  13. Brief relaxation training program for hospital employees.

    Balk, Judith L; Chung, Sheng-Chia; Beigi, Richard; Brooks, Maria


    Employee stress leads to attrition, burnout, and increased medical costs. We aimed to assess if relaxation training leads to decreased stress levels based on questionnaire and thermal biofeedback. Thirty-minute relaxation training sessions were conducted for hospital employees and for cancer patients. Perceived Stress levels and skin temperature were analyzed before and after relaxation training.

  14. POS Tagging Using Relaxation Labelling

    Padro, L


    Relaxation labelling is an optimization technique used in many fields to solve constraint satisfaction problems. The algorithm finds a combination of values for a set of variables such that satisfies -to the maximum possible degree- a set of given constraints. This paper describes some experiments performed applying it to POS tagging, and the results obtained. It also ponders the possibility of applying it to word sense disambiguation.

  15. Spin relaxation in metallic ferromagnets

    Berger, L.


    The Elliott theory of spin relaxation in metals and semiconductors is extended to metallic ferromagnets. Our treatment is based on the two-current model of Fert, Campbell, and Jaoul. The d→s electron-scattering process involved in spin relaxation is the inverse of the s→d process responsible for the anisotropic magnetoresistance (AMR). As a result, spin-relaxation rate 1/τsr and AMR Δρ are given by similar formulas, and are in a constant ratio if scattering is by solute atoms. Our treatment applies to nickel- and cobalt-based alloys which do not have spin-up 3d states at the Fermi level. This category includes many of the technologically important magnetic materials. And we show how to modify the theory to apply it to bcc iron-based alloys. We also treat the case of Permalloy Ni80Fe20 at finite temperature or in thin-film form, where several kinds of scatterers exist. Predicted values of 1/τsr and Δρ are plotted versus resistivity of the sample. These predictions are compared to values of 1/τsr and Δρ derived from ferromagnetic-resonance and AMR experiments in Permalloy.

  16. Arresting relaxation in Pickering Emulsions

    Atherton, Tim; Burke, Chris


    Pickering emulsions consist of droplets of one fluid dispersed in a host fluid and stabilized by colloidal particles absorbed at the fluid-fluid interface. Everyday materials such as crude oil and food products like salad dressing are examples of these materials. Particles can stabilize non spherical droplet shapes in these emulsions through the following sequence: first, an isolated droplet is deformed, e.g. by an electric field, increasing the surface area above the equilibrium value; additional particles are then adsorbed to the interface reducing the surface tension. The droplet is then allowed to relax toward a sphere. If more particles were adsorbed than can be accommodated by the surface area of the spherical ground state, relaxation of the droplet is arrested at some non-spherical shape. Because the energetic cost of removing adsorbed colloids exceeds the interfacial driving force, these configurations can remain stable over long timescales. In this presentation, we present a computational study of the ordering present in anisotropic droplets produced through the mechanism of arrested relaxation and discuss the interplay between the geometry of the droplet, the dynamical process that produced it, and the structure of the defects observed.

  17. Relaxation response in femoral angiography.

    Mandle, C L; Domar, A D; Harrington, D P; Leserman, J; Bozadjian, E M; Friedman, R; Benson, H


    Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.

  18. Capturing molecular multimode relaxation processes in excitable gases based on decomposition of acoustic relaxation spectra

    Zhu, Ming; Liu, Tingting; Wang, Shu; Zhang, Kesheng


    Existing two-frequency reconstructive methods can only capture primary (single) molecular relaxation processes in excitable gases. In this paper, we present a reconstructive method based on the novel decomposition of frequency-dependent acoustic relaxation spectra to capture the entire molecular multimode relaxation process. This decomposition of acoustic relaxation spectra is developed from the frequency-dependent effective specific heat, indicating that a multi-relaxation process is the sum of the interior single-relaxation processes. Based on this decomposition, we can reconstruct the entire multi-relaxation process by capturing the relaxation times and relaxation strengths of N interior single-relaxation processes, using the measurements of acoustic absorption and sound speed at 2N frequencies. Experimental data for the gas mixtures CO2-N2 and CO2-O2 validate our decomposition and reconstruction approach.

  19. Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight instruments: how I do it?

    Hongyi Cui


    Single incision laparoscopic surgery (SILS) is a novel minimally invasive surgical technique that is gaining popularity around the world.One of the most commonly performed procedures is single incision laparoscopic cholecystectomy (SILC).Most reported techniques utilize special purpose-made access port and articulating instruments,rendering the procedure costly and difficult to learn.This article provides a stepwise description of SILC technique using all straight instruments without the need for a special port.It aims to shorten the learning curve for surgeons wishing to adopt a safe and cost-effective SILC technique to their practice.

  20. Time of relaxation in dusty plasma model

    Timofeev, A. V.


    Dust particles in plasma may have different values of average kinetic energy for vertical and horizontal motion. The partial equilibrium of the subsystems and the relaxation processes leading to this asymmetry are under consideration. A method for the relaxation time estimation in nonideal dusty plasma is suggested. The characteristic relaxation times of vertical and horizontal motion of dust particles in gas discharge are estimated by analytical approach and by analysis of simulation results. These relaxation times for vertical and horizontal subsystems appear to be different. A single hierarchy of relaxation times is proposed.

  1. Phacoemulsification versus small incision cataract surgery in patients with uveitis

    Rahul Bhargava


    Full Text Available AIM: To compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS in patients with uveitic cataract.METHODS:In aprospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI. A P value of <0.05 was considered statistically significant.RESULTS:One hundred and twenty-six of 139 patients (90.6% completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1 or inability implant an intraocular lens (IOL because of insufficient capsular support following posterior capsule rupture (n=5. There was significant improvement in vision after both the procedures (paired t-test; P<0.001. On first postoperative day, uncorrected distance visual acuity (UDVA was 20/63 or better in 31 (47% patients in Phaco group and 26 (43.3% patients in SICS group (P=0.384. The mean surgically induced astigmatism (SIA was 0.86±0.34 dioptres (D in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002. At 6mo, corrected distance visual acuity (CDVA


    Udaya Kumar


    Full Text Available The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side ports, aspiration by J cannula, iris massage manoeuver, ice cream scoop manoeuver are various techniques of cortical matter aspiration. We acquired the technique of aspiration of subincisional cortex without using side port in all cases by paying attention on type of cataract, status of pupil, use of Adrenalin mixed BSS intraoperatively, Tunnel construction, Capsulorhexis size and capsular rim size at 12 o’clock. MATERIAL AND METHODS In this retrospective study of 1 year from 2013 to 2014, 60 patients (60 eyes aged 40 years or older attending the General Ophthalmic Department were included in the study group with another group of 60 patients (60 eyes as controls. The study was on age related cataracts which are basically. 1 Cortical cataract 2 Nuclear cataract 3 Subcapsular cataract. Proper assessment of cortical cataract based on its maturity such as a Immature b Mature c Hyper mature and d Morgagnian cataract, nucleus for its opalescence and color, size of posterior subcapsular opacity and pupillary status (Dilating well or not with mydriatics were taken into consideration. Eyes with pseudoexfoliation having poor pupillary dilation were also included. Eyes with congenital anomalies, congenital cataract, gross corneal and retinal pathologies, and glaucoma were excluded. RESULTS Among 60 study eyes in the study group 35 presented with cortical, 20 with nuclear cataract and 5 with posterior subcapsular cataracts. In 58(96.6% cases, sideport was not required; 3(5% eyes


    Riparian wet meadow complexes in the mountains of the central Great Basin are scarce, ecologically important systems that are threatened by stream incision. Our interdisciplinary group has investigated 1) the interrelationships of geomorphology, hydrology, and vegetation; and 2) ...

  4. A Single-Incision Fasciotomy for Compartment Syndrome of the Lower Leg.

    Ebraheim, Nabil A; Siddiqui, Saaid; Raberding, Craig


    Lower leg fasciotomy may be performed with a single lateral incision with or without fibulectomy, or by a double incision technique, with most surgeons preferring the later. The aim of this article is to describe a variation of an existing single-incision technique that will allow for the release of all four compartments with 1 incision. Our approach uses a paratibial route to release the deep posterior compartment (DPC) rather than a transfibular or parafibular route that has already been discussed in the literature. We approach the DPC from the anterior compartment, whereas the parafibular approach uses the posterior aspect of the fibula to reach the DPC. This affords a faster fasciotomy with a smaller flap, avoids potential damage to neurovascular bundle and among other advantages, makes its especially pragmatic for bedside fasciotomy, without the risk of injury to the peroneal nerves, which is common with dissection at the posterior aspect of the fibula.

  5. Clinical evaluation of a modified marginal sulcular incision technique in endodontic surgery.

    Kreisler, Matthias; Gockel, Ricarda; Schmidt, Irina; Kühl, Sebastian; d'Hoedt, Bernd


    The authors evaluated periodontal parameters following apical surgery using a new marginal sulcular incision. In 65 cases, surgical access was achieved by means of a sulcular incision technique without the involvement of the adjacent periodontia and the interproximal papillae and in 33 cases by means of a submarginal trapezoidal technique. Periodontal parameters (probing pocket depth, gingival recession, clinical attachment loss, and tooth mobility [periotest]) were recorded at baseline and after 6 months. Scar formation and the loss of papilla height were evaluated photographically. No significant changes in the attachment level and no loss of papilla height were found in either group. A slight gingival recession (0.2 +/- 0.4 mm) corresponding to the decrease in pocket depths occurred on the buccal aspect with the sulcular incision. Tooth mobility was significantly increased in both groups immediately and 6 months after surgery. Scar formation was more unfavorable with the submarginal incision.

  6. Cochlear implantation with Pulsar Med El: a novel small incision technique.

    Cuda, D


    Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. Overall, 30 teen-age and adult patients were operated upon with a novel small incision (4-5 cm). Full insertion of the electrode array was achieved in all cases. No major intra-operative complications occurred. At follow-up, no flap-related complications and no migration of the receiver-stimulator were observed in the "device suture" (14 patients) or "no device suture" groups (16 patients). All patients are full-time users of the device. In conclusion, a small incision for the Pulsar Med-El cochlear implant is feasible, safe and reproducible. Ligature fixation of the device is not critical with this operation. Also with this device, in adult and teen-age patients, it is, therefore, possible to retain several typical advantages of small incision approaches.

  7. Laparoscopic vs. small incision cholecystectomy : Implications for pulmonary function and pain. A randomized clinical trial

    Keus, F.; Ali, U. Ahmed; Noordergraaf, G. J.; Roukema, J. A.; Gooszen, H. G.; Van Laarhoven, C. J. H. M.


    Background: Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post-operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. The small-incision cholecystectomy (SIC), a procedure which does not re

  8. Single-incision laparoscopic-assisted ileal resection for adult intussusception

    Hong Yu


    Full Text Available Adult intussuception is rare and laparotomy is required in most of the cases due to the potential pathologic underlying reasons. Although it is technically challenging, single-incision laparoscopic surgery can work as an alternative to laparotomy. Here we report the case of a 45-year-old man with intermittent right lower quadrant abdominal pain for 1 month. Abdominal enhanced computed tomography (CT scan was performed and ileo-ileal intussusception was found, with lipoma as a likely leading point. Ileal resection was performed using the single-incision laparoscopic-assisted technique. Multiple trocars in the umbilical incision technique and conventional instruments were used. After identification of the ileo-ileal intussusception, the involved small bowel was extracted from the umbilical incision, and resection and anastomosis were performed extracoporeally. The operation time was 65 min and the post-operative hospital stay was 2 days. The patient recovered uneventfully, with better cosmetic results.


    刘宝国; 赵振生; 李明强; 陈荣鋭; 王建军; 张乃嵩


    Objective: To investigate for the feasibility and advantages performed by the unilateral big hockey stick incision (BHSI) in head and neck carcinoma. Methods: Neck dissection by using the unilateral big hockey stick incision (BHSI) was performed on 93 patients with head and neck carcinoma. Results: The big hockey stick incision has a cosmetic scar and not scar contraction and is barely visible and easily covered in hair and clothing; sufficient exposure of the operation field; a small area of marginal necrosis was occasionally seen at the apex of the skin flap due to having preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.

  10. Laparoscopic vs. small incision cholecystectomy : Implications for pulmonary function and pain. A randomized clinical trial

    Keus, F.; Ali, U. Ahmed; Noordergraaf, G. J.; Roukema, J. A.; Gooszen, H. G.; Van Laarhoven, C. J. H. M.

    Background: Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post-operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. The small-incision cholecystectomy (SIC), a procedure which does not

  11. Laparoscopic vs. small incision cholecystectomy: Implications for pulmonary function and pain. A randomized clinical trial.

    Keus, F.; Ali, U Ahmed; Noordergraaf, G.J.; Roukema, J.A.; Gooszen, H.G.; Laarhoven, C.J.H.M. van


    BACKGROUND: Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post-operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. The small-incision cholecystectomy (SIC), a procedure which does not

  12. Secondary rhinoplasty: reconstitution of the allar cartillages by a rhinoplasty with an external incision

    Jorge Ishida

    Full Text Available Presentation of 62 cases of secondary nasal deformities treated by external incision. Several types of endonasal deformities were observed, properly classified and repaired. When excessive ressection was observed, local cartillage graft, septonasal or conchal types were employed.

  13. Effects of incision and irradiation on regional lymph node metastasis in carcinoma of the hamster tongue

    Ohtake, K.; Shingaki, S.; Nakajima, T. (Nigata Univ. (Japan))


    The effects of incision and irradiation on regional lymph node metastasis in DMBA-induced squamous cell carcinomas of the hamster tongue are reported. Metastasis to the submandibular lymph nodes was confirmed histologically in 48.0% of the animals. The incidence of lymph node metastasis was significantly increased (65.9%) after repeated incisions of tongue carcinomas. Three gray whole-body irradiation also increased the rate of metastasis from 31.0% to 46.3%. Higher incidences of lymphatic vessel invasion after incision and concomitant lymph node metastasis in the lymphatic invasion-positive group indicated a stepwise relationship leading to an increase in lymph node metastasis after incision. Because of the high incidence of metastases and close resemblance to human carcinomas in the tumor cell deposition and establishment of metastatic foci, DMBA-induced tongue carcinoma with invasion may serve as an experimental model of human oral carcinomas.

  14. Single incision laparoscopic total abdominal colectomy with ileorectal anastomosis for synchronous colon cancer.

    Bardakcioglu, O; Ahmed, S


    Single incision laparoscopy is currently performed mostly for basic laparoscopic procedures involving single abdominal quadrants. The aim of this case report is to show that single incision laparoscopic techniques can be utilized for complex abdominal laparoscopic procedures with a large target organ and a working space involving all quadrants of the abdominal cavity. A single incision laparoscopic total abdominal colectomy with an ileorectal anastomosis and intraoperative CO(2) colonoscopy was performed for a patient with synchronous adenocarcinoma of the cecum and the sigmoid colon. The patient was discharged home on postoperative day 4 and had no immediate postoperative complications. Single incision laparoscopy is feasible for complex colorectal procedures. Some of the techniques used may be adapted further to achieve colonic resection via a natural orifice in the future.

  15. A Prospective, Randomized Study of Component Position in Two-Incision MIS Total Hip Arthroplasty: A Preliminary Study.

    Meneghini, R Michael; Smits, Shelly A


    Controversy exists regarding the ability to position the implants reliably in minimally invasive surgery (MIS) total hip arthroplasty (THA). This study compared the ability to accurately position components in the MIS two-incision versus single-incision approaches. Twenty-four patients were randomized to THA through one of three approaches, including the two-incision approach. Component position was measured with computed tomography. The mean deviation from the target acetabular anteversion was 14.8 degrees in the two-incision MIS group versus 6.4 degrees in the other two approaches (p = 0.006). A mean of 9.8 degrees deviation from the target femoral anteversion in the two-incision MIS approach group was observed compared with 5.3 degrees in the single-incision groups (p = 0.05). These results suggest there is a decreased ability to accurately position the components in the two-incision approach.

  16. Feasibility of single-incision laparoscopic cholecystectomyfor acute cholecystitis


    AIM To assess the safety of single-incision laparoscopiccholecystectomy (SILC) for acute cholecystitis.METHODS: All patients who underwent SILC atSano Hospital (Kobe, Japan) between January 2010and December 2014 were included in this retrospectivestudy. Clinical data related to patient characteristics andsurgical outcomes were collected from medical records.The parameters for assessing the safety of the procedureincluded operative time, volume of blood loss,achievement of the critical view of safety, use of additionaltrocars, conversion to laparotomy, intraoperative and postoperativecomplications, and duration of postoperativehospital stay. Patient backgrounds were statisticallycompared between those with and without conversion tolaparotomy.RESULTS: A total of 100 patients underwent SILCfor acute cholecystitis during the period. Preoperativeendoscopic treatment was performed for suspectedcholedocholithiasis in 41 patients (41%). The mean timefrom onset of acute cholecystitis was 7.7 d. According tothe Updated Tokyo Guidelines (TG13) for the severity ofcholecystitis, 86 and 14 patients had grade Ⅰ and gradeⅡ acute cholecystitis, respectively. The mean operativetime was 87.4 min. The mean estimated blood loss was80.6 mL. The critical view of safety was obtained in 89 patients (89%). Conversion laparotomy was performedin 12 patients (12%). Postoperative complications ofClavien-Dindo grade Ⅲ or greater were observed in4 patients (4%). The mean duration of postoperativehospital stay was 5.7 d. Patients converted from SILC tolaparotomy tended to have higher days after onset.CONCLUSION: SILC is feasible for acute cholecystitis;in addition, early surgical intervention may reduce therisk of laparotomy conversion.

  17. Single-Incision Laparoscopic Repair of Spigelian Hernia

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.


    Introduction: Spigelian hernias represent only 1% to 2% of all abdominal wall hernias. The treatment, however, remains controversial but depends on institutional expertise. This case series reports the first experience with single-incision laparoscopic totally extraperitoneal (SILTEP) repair of Spigelian hernias with telescopic extraperitoneal dissection in combination with inguinal hernia repair. Methods: From February 2013 to April 2014, all patients referred with inguinal or Spigelian hernias, without histories of extraperitoneal intervention, underwent SILTEP repair with telescopic extraperitoneal dissection. A single-port device, 5.5 mm/52 cm/30° angled laparoscope, and conventional straight dissecting instruments were used for all cases. Extraperitoneal dissection was performed under direct vision with preservation of preperitoneal fascia overlying retroperitoneal nerves. Inguinal herniorrhaphy was performed with lightweight mesh that covered low-lying Spigelian defects. High-lying Spigelian defects were repaired with additional mesh. Results: There were 131 patients with 186 (92 direct) inguinal hernias and 7 patients with 8 Spigelian hernias (6 incidental, including 1 bilateral and 2 preoperatively diagnosed), with a mean age of 51.3 years and a mean body mass index of 25.1 kg/m2. An additional piece of mesh was used for 3 hernias. All Spigelian hernias were associated with direct inguinal hernias, and 8 combined inguinal and Spigelian hernias were successfully repaired with SILTEP repair with telescopic extraperitoneal dissection as day cases. There were no clinical recurrences during a mean follow-up period of 6 months (range, 1–15 months). Conclusions: Combined Spigelian and inguinal hernias can be successfully treated with SILTEP herniorrhaphy with telescopic extraperitoneal dissection. The high incidence of Spigelian hernias associated with direct inguinal hernias suggests a high index of suspicion for Spigelian hernias during laparoscopic inguinal

  18. Teaching Incision and Drainage: Perceived Educational Value of Abscess Models.

    Adams, Cynthia M; Nigrovic, Lise E; Hayes, Gavin; Weinstock, Peter H; Nagler, Joshua


    Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. A combined didactic and practical skills workshop was developed for use at 2 national conferences. The didactic content was created through an iterative process. To facilitate hands-on training, 2 versions of an abscess model were created: 1 constructed from a negative mold and the other using a 3-dimensional printer. Participants were surveyed regarding prior experience with I&D, procedural confidence, and perceptions of the educational utility of the models. Seventy physicians and 75 nurse practitioners participated in the study. Procedural confidence improved after training using each version of the model, with the greatest improvements noted among novice learners. Ninety-four percent of physicians, and 99% of nurse practitioners rated the respective models as either "educational" or "very educational," and 97% and 100%, respectively, would recommend the abscess models to others. A combined didactic and practical skills educational workshop using novel abscess models was effective at improving learners' confidence. Our novel models provide an effective strategy for teaching procedural skills such as I&D and demonstrate a novel use of 3-dimensional printers in medical education. Further study is needed to determine if these educational gains translate into improvement in clinical performance or patient outcomes.

  19. Manual small incision cataract surgery in eyes with white cataracts

    Venkatesh Rengaraj


    Full Text Available PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC. MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye using irrigating vectis. Intraoperative and postoperative findings (according to OCTET classification as well as postoperative visual outcomes were used as main measures to report the safety and efficacy of the surgery. RESULTS: Of the 100 eyes, 16 had intumescent, 67 had mature and 17 had hypermature cataract. Intraoperatively CCC was incomplete in 4 eyes (4% and had to be converted to canopener capsulotomy. None of the eyes had posterior capsular rupture or zonular dialysis and no eyes were converted to conventional Extra Capsular Cataract Extraction (ECCE. Postoperatively, 6 eyes (6% developed corneal oedema with >10 Descemets folds and 7 eyes (7% had corneal oedema with < 10 Descemets folds. Mild iritis was seen in 6 eyes (6% and moderate iritis with fibrin membrane was seen in 3 eyes (3%. Iridodialysis was observed in 1 eye (1%. Of the 99 patients (99% categorised under good visual outcomes category, 94 patients (94% had a best-corrected visual acuity of 6/9 or better on the 40th post-operative day. CONCLUSION: In developing countries like India where phacoemulsification may not be affordable to a majority of those requiring cataract surgery, MSICS proves to be a safe and efficacious alternative for white cataracts especially with the adjunctive use of trypan blue dye.

  20. Channel Incision and Suspended Sediment Delivery at Caspar Creek, Mendocino County, California.

    Dewey, N. J.; Lisle, T. E.; Reid, L. M.


    Tributary and headwater valleys in the Caspar Creek watershed, in coastal Mendocino County, California, show signs of incision along much of their lengths. An episode of incision followed initial-entry logging which took place between 1860 and 1906. Another episode of incision cut into skid-trails created for second-entry logging in the 1970's. Gullies resulting from both of these episodes of incision are sensitive to hydrologic fluctuations and feature active headcuts, deepening plungepools, and unstable banks, which continue to contribute sediment to the Caspar Creek channel network. Headcuts are numerous in each channel. In some cases headcuts define the upstream extent of an incised reach; in many cases headcuts migrate up previously incised reaches, increasing the depth of incision. Surveys indicate that bank retreat, plunge pool deepening, and headcut retreat all contributed sediment to the channels between 2000 and 2003. Since bank walls have considerably more surface area than headwalls per given length of channel, and headcuts have largely migrated into positions temporarily constrained by resistant lips, bankwall retreat appears to be a more significant chronic source of sediment than headwall retreat. Stream gage records show that some channels consistently deliver higher levels of suspended sediment than others. In comparing channels, ongoing levels of suspended sediment delivery correlate well with total amount of exposed channel bank (depth of incision integrated over length of channel) in the reaches upstream of stream gages. On an annual to decadal time-scale, rates of suspended sediment delivery per unit area of catchment correlate better with the amount of exposed bank area in reaches upstream of stream gages, than with the volume of sediment delivered by landslide events, with total catchment area, or with peak storm flow per unit area. The correlation between amount of exposed bank area and ongoing levels of suspended sediment delivery is

  1. Microsurgical open mini uniskin incision technique in the surgical treatment of carpal tunnel syndrome

    Keramettin Aydin; Cengiz Cokluk; Nilgun Cengiz; Ayhan Bilgici


    Background: Patients who undergo carpal tunnel surgery sometimes complain of the restriction of the grip and pinch function, palmar tenderness, cosmetic problems, and scar formation at the site of the incision. Aims: We used a modified mini uni-skin incision with appropriate hand position for microscopic view in the surgical treatment of carpal tunnel syndrome to prevent cosmetic problems related with scar formation after surgery. Settings and Design: In this study we used two different ...

  2. Acute Compartment Syndrome in the Forearm with Trans-Ulnar Single Incision.

    Suzuki, Taku; Inaba, Naoto; Sato, Kazuki


    We report a case of ulnar nerve palsy caused by diaphyseal fractures of the forearm and acute compartment syndrome. Trans-ulnar single incision with a fasciotomy of the volar and dorsal compartments was used to fix the ulna. Full recovery of the ulnar nerve was achieved six months after the surgery. In cases of acute compartment syndrome with ulnar fracture, a trans-ulnar incision with compartment release is effective for the fixation of the ulna.

  3. Prime Incision and Modified Moving Window: A Minimally Invasive Access for Breast Cancer Surgical Treatment

    E. Bromberg, Silvio; Giordano, Roberto


    BACKGROUND Conservative surgical treatment has been the treatment of choice for early breast cancer. It allows feasible oncological treatment with a satisfactory cosmetic approach and fast recovery. However, in some cases mastectomy is necessary. This study proposes a surgical approach with only one surgical access through the same incision, which is in line with precepts mentioned above. It is called the prime incision and modified moving window techniques. METHODS Thirty one patients with a...

  4. Spontaneous alignment of crowded inferior incisives after the extractionof temporary canines

    Orellana Manrique, Tomás Oriel; Departamento Académico de Estomatología Pediátrica. Facultad de Odontología UNMSM. Lima Perú.; Calderón Cortez, Iván; Estudiante de pre grado. Facultad de Odontología UNMSM. Lima Perú.; Orellana Manrique, Martín; Estudiante de Maestría. Facultad de Odontología UNMSM. Lima Perú.


    This investigation evaluated the behavior of permanent inferior incisives after the primary canine’s extractions. The study was carried out in the Pediatric Clinic of Dental Faculty of San Marcos University. The sample was conformed by 10 patients, male and female children, between 8 and 9 years of age, with good general health, having Class I malocclusion and severe crowding of the inferior incisives. It was taken Cephalometric and Panoramic radiographies, as well as models to make the ortho...

  5. Do height and weight affect the feasibility of single-incision laparoscopic cholecystectomy?

    Meillat, Hélène; Birnbaum, David Jérémie; FARA, Régis; Mancini, Julien; Berdah, Stéphane; BEGE, Thierry


    Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. Single-incision laparoscopic surgery has recently emerged as a less invasive potential alternative to conventional three- or four-port laparoscopy. However, the feasibility of single-incision laparoscopic cholecystectomy (SILC) remains unclear, and there are no rigorous criteria in the literature. Identifying patients at risk of failure of this new technique is essen...

  6. Single laser incision for treatment of congenital bladder neck sclerosis: new technique.

    Mattioli, Stefano; Picinotti, Alessandro; Burgio, Andreina


    The primary bladder neck obstruction (PBNO) has been recognized in 41-45% of young men suffering from a chronic lower urinary tract symptom (LUTS). Few studies are published in the literature about the use of laser devices in the surgical treatment of PBNO and none about the use of Thulium laser. The aim of our study is to report the results of our follow-up in the endoscopic treatment of PBNO with Thulium laser. From January 2012 to January 2015, we treated 214 patients using Thulium laser for primary bladder neck sclerosis. All patients had symptoms suggestive of LUTS or prostatism: filling or irritative symptoms and voiding or obstructive symptoms. In 157 patients, the incision was performed unilaterally at 7 o'clock of the bladder neck. In 57 cases, bilateral incision was performed at 5 and 7 o' clock without vaporizing the tissue between the two incisions. We chose to make the incision bilaterally in cases wherein a single incision was not enough to solve the obstruction from the bladder neck and prevent a recurrence. Bladder irrigation was used overnight in all cases, and the catheter was removed after 24 hours. One hundred ninety-six patients enrolled completed 1-year follow-up: 157 patients underwent unilaterally incision and 39 bilateral incision. In 179 cases (91.3%), there was unchanged antegrade ejaculation, while reduced semen volume was reported by 14 men (7.1%) and retrograde ejaculation by only 3 (1.5%), but these patients underwent bilateral incision. The quality of orgasm and sexual satisfaction was not permanently changed by the operation. In patients with PBNO, it is possible to perform endoscopic treatment with Thulium laser that we think is an effective and safe procedure, not affecting sexual functioning and particularly retrograde ejaculation.

  7. Two-incision approach for video-assisted thoracoscopic sleeve lobectomy.

    Peña, Emilio; Blanco, Montserrat; Ovalle, Juan Pablo


    The video-assisted thoracoscopic approach for bronchoplasty procedures is not standardized. Although 3 to 4 incisions are usually made, with adequate surgical technique, the operation can be successfully carried out using only 2 incisions. We describe the technique of video-assisted thoracoscopic surgery for a right upper lobe sleeve lobectomy for a carcinoid tumor in the right upper bronchus, using only 2 ports.

  8. 5 Things To Know About Relaxation Techniques for Stress

    ... X Y Z 5 Things To Know About Relaxation Techniques for Stress Share: When you’re under stress, ... creating the relaxation response through regular use of relaxation techniques could counteract the negative effects of stress. Relaxation ...

  9. Whether superficial abdominal reflex is affected by subcostal transverse abdominal incisions? A prospective, observational early experience

    Jitin Bajaj


    Full Text Available Introduction: Superficial abdominal reflex (SAR is an important part of the neurologic assessment. It is normally present and may be present or absent in various physiological as well as pathological conditions. The presence of an abdominal incision creates a dilemma in the mind of the clinician for it affecting this reflex. As there is no literature on this, we decided to study the effect of abdominal incisions on SAR. Materials and Methods: It was a prospective, observational study. We evaluated the patients requiring transverse subcostal incision (range 3–12 cm both preoperatively and postoperatively, for their abdominal reflexes. Patients with preoperative normal and symmetrical abdominal reflexes were included in the study. Postoperatively, we compared the change of SAR with the preoperative status and analyzed the data. Results: A total of 94 patients underwent surgeries, out of which 54 patients came under inclusion criteria, comprising 36 males and 18 females. Subcostal transverse abdominal incisions were made for surgeries including both gastrointestinal and ventriculoperitoneal shunts. SAR was found unaffected by the incisions in all patients. Conclusions: Although the study was small, subcostal transverse abdominal incisions were not found to affect SAR.

  10. Evaluation of four suture materials for surgical incision closure in Siberian sturgeon

    Boone, S. Shaun; Hernandez, Sonia M.; Camus, Alvin C.; Peterson, Douglas C.; Jennings, Cecil A.; Shelton, James L.; Divers, Stephen J.


    The visual and microscopic tissue reactions to the absorbable monofilament Monocryl, absorbable monofilament triclosan-coated Monocryl-Plus, absorbable multifilament Vicryl, and nonabsorbable monofilament Prolene were evaluated for their use of surgical closure in Siberian Sturgeon Acipenser baerii. Postoperative assessments were conducted at 1, 2, 8, 12, and 26 and 55 weeks to visually evaluate the surgical incision for suture retention, incision healing, erythema, and swelling. Incisions were also assessed microscopically at 1, 2, and 8 weeks for necrosis, inflammation, hemorrhage, and fibroplasia. The results indicated that incisions closed with either Vicryl or Prolene suture materials were more likely to exhibit more erythema or incomplete healing compared with those closed with Monocryl or Monocryl-Plus. The surgical implantation of a transmitter in the coelomic cavity did not significantly affect the response variables among the four suture materials. Monocryl or Monocryl-Plus were equally effective and superior to other suture materials used for closing surgical incisions in Siberian Sturgeon or closely related species of sturgeon. Furthermore, Monocryl or Monocryl-Plus may decrease the risk of transmitter expulsion through the incision, as surgical wounds appear to heal faster and exhibit less erythema compared with those closed with Vicryl.

  11. Watershed-scale modeling of streamflow change in incised montane meadows

    Essaid, Hedeff I.; Hill, Barry R.


    Land use practices have caused stream channel incision and water table decline in many montane meadows of the Western United States. Incision changes the magnitude and timing of streamflow in water supply source watersheds, a concern to resource managers and downstream water users. The hydrology of montane meadows under natural and incised conditions was investigated using watershed simulation for a range of hydrologic conditions. The results illustrate the interdependence between: watershed and meadow hydrology; bedrock and meadow aquifers; and surface and groundwater flow through the meadow for the modeled scenarios. During the wet season, stream incision resulted in less overland flow and interflow and more meadow recharge causing a net decrease in streamflow and increase in groundwater storage relative to natural meadow conditions. During the dry season, incision resulted in less meadow evapotranspiration and more groundwater discharge to the stream causing a net increase in streamflow and a decrease in groundwater storage relative to natural meadow conditions. In general, for a given meadow setting, the magnitude of change in summer streamflow and long-term change in watershed groundwater storage due to incision will depend on the combined effect of: reduced evapotranspiration in the eroded meadow; induced groundwater recharge; replenishment of dry season groundwater storage depletion in meadow and bedrock aquifers by precipitation during wet years; and groundwater storage depletion that is not replenished by precipitation during wet years.

  12. Effect of lateral temporal corneal incision for intraocular pressure and tear film stability in cataract patients

    Ying Wang


    Full Text Available AIM: To investigate therapeutic effect of lateral temporal corneal incision phacoemulsification combined with intraocular lens(IOLon cataract and its effect on intraocular pressure(IOPand tear film. METHODS: The clinical data of patients with cataract who received treatment in our hospital from March 2014 to December 2015 were retrospectively analyzed. According to the location of the incision, they were divided into temporal corneal incision group and upper corneal incision group. We observed the incidence of complications of the two groups, compared the intraocular pressure, visual acuity, refraction and tear film break-up time of the two groups before and after surgery. RESULTS: The operation time and postoperative pain score of the two groups had no significant difference(P>0.05. The IOP and visual acuity between the two groups before operation had no significant difference(P>0.05. At the intraocular pressure of the two groups was lower than that before operation, and the visual acuity was higher than before operation, and the changes of the anterior lateral incision group were more obvious(PPCONCLUSION: The temporal corneal incision phacoemulsification combined with intraocular lens implantation has a good therapeutic effect on cataract patients, can effectively improve the intraocular pressure and tear film stability, improve eye function, promote the recovery of the body after surgery.

  13. Quality of linear incisions performed by dental students using Er:YAG laser in soft tissue

    Novelli, Moacyr Domingos; Vasques, Mayra Torres; Meneguzzo, Daiane Thaís; Aranha, Ana Cecília Corrêa; Corrêa, Luciana


    Introduction: New technologies in dental practice, such as laser, have enabled new strategies to be established in dental education. The aim of this study was to analyze the difficulties that dental students encountered with performing surgical incisions using Er:YAG laser (LE), and the morphology of these incisions. Material and Methods: Sixteen undergraduate dental students and ten dental professionals (DP) enrolled at The Master of Science Program in Laser Dentistry were asked to perform 15 incisions using an LE and 15 with a conventional scalpel. The incisions were compared, based on the shape factor (relation between area and perimeter), which was obtained by a digital image system and by a morphometry software. Data was submitted to statistical analysis of variance (p 0.05). Results: Considering the incisions performed by scalpel, DP showed statistically significant differences (p cutting speed, and absence of suction and water jet appliances. None of the groups performed adequate incisions using LE. Conclusion: Greater emphasis is required in relating laser therapy practice to the physical properties of laser, particularly for dental professionals that specialize in laser.

  14. [The treatment of otosclerosis using laser assisted stapedotomy with mini incision in external auditory meatus].

    Hao, Xinping; Chen, Shubin; Yu, Zilong; Liang, Fenghe; Li, Yongxin


    To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.

  15. Compaction and relaxation of biofilms

    Valladares Linares, R.


    Operation of membrane systems for water treatment can be seriously hampered by biofouling. A better characterization of biofilms in membrane systems and their impact on membrane performance may help to develop effective biofouling control strategies. The objective of this study was to determine the occurrence, extent and timescale of biofilm compaction and relaxation (decompaction), caused by permeate flux variations. The impact of permeate flux changes on biofilm thickness, structure and stiffness was investigated in situ and non-destructively with optical coherence tomography using membrane fouling monitors operated at a constant crossflow velocity of 0.1 m s−1 with permeate production. The permeate flux was varied sequentially from 20 to 60 and back to 20 L m−2 h−1. The study showed that the average biofilm thickness on the membrane decreased after elevating the permeate flux from 20 to 60 L m−2 h−1 while the biofilm thickness increased again after restoring the original flux of 20 L m−2 h−1, indicating the occurrence of biofilm compaction and relaxation. Within a few seconds after the flux change, the biofilm thickness was changed and stabilized, biofilm compaction occurred faster than the relaxation after restoring the original permeate flux. The initial biofilm parameters were not fully reinstated: the biofilm thickness was reduced by 21%, biofilm stiffness had increased and the hydraulic biofilm resistance was elevated by 16%. Biofilm thickness was related to the hydraulic biofilm resistance. Membrane performance losses are related to the biofilm thickness, density and morphology, which are influenced by (variations in) hydraulic conditions. A (temporarily) permeate flux increase caused biofilm compaction, together with membrane performance losses. The impact of biofilms on membrane performance can be influenced (increased and reduced) by operational parameters. The article shows that a (temporary) pressure increase leads to more

  16. Plasma Relaxation in Hall Magnetohydrodynamics

    Shivamoggi, B K


    Parker's formulation of isotopological plasma relaxation process in magnetohydrodynamics (MHD) is extended to Hall MHD. The torsion coefficient alpha in the Hall MHD Beltrami condition turns out now to be proportional to the "potential vorticity." The Hall MHD Beltrami condition becomes equivalent to the "potential vorticity" conservation equation in two-dimensional hydrodynamics if the Hall MHD Lagrange multiplier beta is taken to be proportional to the "potential vorticity" as well. The winding pattern of the magnetic field lines in Hall MHD then appears to evolve in the same way as "potential vorticity" lines in 2D hydrodynamics.

  17. Spectral Estimation of NMR Relaxation

    Naugler, David G.; Cushley, Robert J.


    In this paper, spectral estimation of NMR relaxation is constructed as an extension of Fourier Transform (FT) theory as it is practiced in NMR or MRI, where multidimensional FT theory is used. nD NMR strives to separate overlapping resonances, so the treatment given here deals primarily with monoexponential decay. In the domain of real error, it is shown how optimal estimation based on prior knowledge can be derived. Assuming small Gaussian error, the estimation variance and bias are derived. Minimum bias and minimum variance are shown to be contradictory experimental design objectives. The analytical continuation of spectral estimation is constructed in an optimal manner. An important property of spectral estimation is that it is phase invariant. Hence, hypercomplex data storage is unnecessary. It is shown that, under reasonable assumptions, spectral estimation is unbiased in the context of complex error and its variance is reduced because the modulus of the whole signal is used. Because of phase invariance, the labor of phasing and any error due to imperfect phase can be avoided. A comparison of spectral estimation with nonlinear least squares (NLS) estimation is made analytically and with numerical examples. Compared to conventional sampling for NLS estimation, spectral estimation would typically provide estimation values of comparable precision in one-quarter to one-tenth of the spectrometer time when S/N is high. When S/N is low, the time saved can be used for signal averaging at the sampled points to give better precision. NLS typically provides one estimate at a time, whereas spectral estimation is inherently parallel. The frequency dimensions of conventional nD FT NMR may be denoted D1, D2, etc. As an extension of nD FT NMR, one can view spectral estimation of NMR relaxation as an extension into the zeroth dimension. In nD NMR, the information content of a spectrum can be extracted as a set of n-tuples (ω1, … ωn), corresponding to the peak maxima

  18. Relaxing Chosen-Ciphertext Security

    Canetti, Ran; Krawczyk, Hugo; Nielsen, Jesper Buus


    Security against adaptive chosen ciphertext attacks (or, CCA security) has been accepted as the standard requirement from encryption schemes that need to withstand active attacks. In particular, it is regarded as the appropriate security notion for encryption schemes used as components within...... “for most practical purposes.” We propose a relaxed variant of CCA security, called Replayable CCA (RCCA) security. RCCA security accepts as secure the non-CCA (yet arguably secure) schemes mentioned above; furthermore, it suffices for most existing applications of CCA security. We provide three...

  19. Obesity and single-incision laparoscopic appendectomy in children.

    Litz, Cristen N; Farach, Sandra M; Danielson, Paul D; Chandler, Nicole M


    Single-incision laparoscopic appendectomy (SILA) has emerged as a less-invasive alternative to conventional laparoscopy. The purpose of this study was to assess the impact of body habitus on outcomes after SILA in the pediatric population. A retrospective review of 413 patients who underwent SILA from 2012 to 2015 was performed. Body mass index (BMI) was calculated, and the BMI percentile was obtained per Center for Disease Control guidelines. Standard definitions for overweight (BMI 85th-94th percentile) and obese (BMI > 95th percentile) were used. General demographic and outcome data were analyzed. SILA was performed in 413 patients during the study period, of which 66.3% were normal weight, 16% were overweight, and 17.7% were obese. There were no significant differences in age at presentation, time to diagnosis, or intraoperative classification of appendicitis. There were no significant differences in operative time (27.0 ± 9.1 versus 27 ± 9.8 versus 28.4 ± 9.4 min, P = 0.514), postoperative length of stay (0.97 ± 1.65 versus 1.53 ± 4.15 versus 1.14 ± 2.27 d, P = 0.214), 30-d surgical site infections (6.9% versus 12.1% versus 8.2%, P = 0.377), emergency department visits (8.4% versus 10.6% versus 11%, P = 0.726), or readmissions (4.7% versus 4.1% versus 4.5%, P = 0.967) among normal, overweight, and obese groups. Our results indicate that obesity does not significantly impact outcomes after SILA. SILA can be performed in overweight and obese children with no significant difference in operative time, length of stay, or incidence of surgical site infection. SILA should continue to be offered to overweight and obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Je Hwan Yoon


    Full Text Available Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes. The outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA 1 and 3 months, post-operatively. Results: At 1 month, the mean SIA was 0.81 diopter (D for the temporal incisions and 0.92 D for nasal incisions (P = 0.139. At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309. The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. Conclusion: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less would be favorable for astigmatism-neutral cataract surgery.

  1. [Improvement of vaginal relaxation by vaginal narrowing technique with double suturing].

    Liu, Sanhu; Cen, Ying; Liu, Quan


    To investigate the surgical procedures and outcomes of curing the mild and medium vaginal relaxation by double suturing vaginal muscularis. From May 2005 to November 2008, 8 patients (aged 30-45 years old) with mild and medium vaginal relaxation were treated. All the patients were married and had reproductive history of natural childbirth. The double semiring suture was performed in the region 4 cm and 0.5 cm away from the vaginal orifice, respectively, forming the first and the second semicircle to make vagina outside 1/3 segments and vagina muscles tighten. The time of operation was 20-30 minutes (average 25 minutes). There was no obvious bleeding and injury of the rectum and urethra during operation. All the incisions healed by first intention. The vagina accommodated 2 fingers without scar on its mucosa 1-2 months after operation. Eight patients were followed up for 6-24 months and the patients resumed their sexual life 4-8 weeks after operation with satisfied improvement. The technique of double suturing vaginal muscularis is easy and simple to perform with mild injury, fast postoperative recovery, and less postoperative complications. It is one of the effective methods to treat mild and medium vaginal relaxation.

  2. Relaxation of liquid bridge after droplets coalescence

    Jiangen Zheng


    Full Text Available We investigate the relaxation of liquid bridge after the coalescence of two sessile droplets resting on an organic glass substrate both experimentally and theoretically. The liquid bridge is found to relax to its equilibrium shape via two distinct approaches: damped oscillation relaxation and underdamped relaxation. When the viscosity is low, damped oscillation shows up, in this approach, the liquid bridge undergoes a damped oscillation process until it reaches its stable shape. However, if the viscous effects become significant, underdamped relaxation occurs. In this case, the liquid bridge relaxes to its equilibrium state in a non-periodic decay mode. In depth analysis indicates that the damping rate and oscillation period of damped oscillation are related to an inertial-capillary time scale τc. These experimental results are also testified by our numerical simulations with COMSOL Multiphysics.

  3. Cross relaxation in nitroxide spin labels

    Marsh, Derek


    Cross relaxation, and mI -dependence of the intrinsic electron spin-lattice relaxation rate We , are incorporated explicitly into the rate equations for the electron-spin population differences that govern the saturation behaviour of 14N- and 15N-nitroxide spin labels. Both prove important in spin-label EPR and ELDOR, particularly for saturation recovery studies. Neither for saturation recovery, nor for CW-saturation EPR and CW-ELDOR, can cross relaxation be described simply by increasing the value of We , the intrinsic spin-lattice relaxation rate. Independence of the saturation recovery rates from the hyperfine line pumped or observed follows directly from solution of the rate equations including cross relaxation, even when the intrinsic spin-lattice relaxation rate We is mI -dependent.

  4. Percutaneous bone-anchored hearing implant surgery: inside or outside the line of incision?

    Strijbos, Ruben M; den Besten, Christine A; Mylanus, Emmanuel A M; Hol, Myrthe K S


    The objective of this historical cohort study was to compare soft tissue reactions in adults after bone-anchored hearing implant (BAHI) surgery when the percutaneous implant is placed inside or outside the line of incision. All adult patients who received a percutaneous BAHI between 1 January 2010 and 31 January 2014 in our tertiary referral centre were identified. Patients were selected if operated by two surgeons, who perform the same standardised linear incision technique with one of them placing the implant outside the incision while the other prefers placement inside the line of incision. A total of 202 patients and 211 implants were included in the case analysis. The results showed the registration of a soft tissue reaction Holgers ≥1 in 47 implants (49.0 %) placed outside the incision compared to 70 implants (60.9 %) which were placed inside the line of incision. An adverse soft tissue reaction, Holgers ≥2, was noticed in 17 implants (17.7 %), respectively, 20 implants (17.4 %). No significant differences were found between the two groups for both the presence of soft tissue reactions Holgers ≥1 (p = 0.322) and a Holgers score ≥2 (p = 0.951). During the follow-up three implants were lost (1.4 %) and in 18 of 211 implants one or multiple revisions were performed (8.5 %). In conclusion, this study did not show any differences in the presence of postsurgical (adverse) soft tissue reactions between placement of the percutaneous BAHI inside or outside the line of incision.

  5. Utilizing RELAX NG Schemas in XML Editors

    Schmied, Martin


    This thesis explores the possibilities of utilizing RELAX NG schemata in the process of editing XML documents. The ultimate goal of this thesis is to prototype a system supporting user while editing XML document with bound RELAX NG schema inside the Eclipse IDE. Such a system comprises two major components -- an integration of RELAX NG validator and an autocompletion engine. Design of the autocompletion engine represents the main contribution of this thesis, because similar systems are almost...

  6. Temperature relaxation in dense plasma mixtures

    Faussurier, Gérald; Blancard, Christophe


    We present a model to calculate temperature-relaxation rates in dense plasma mixtures. The electron-ion relaxation rates are calculated using an average-atom model and the ion-ion relaxation rates by the Landau-Spitzer approach. This method allows the study of the temperature relaxation in many-temperature electron-ion and ion-ion systems such as those encountered in inertial confinement fusion simulations. It is of interest for general nonequilibrium thermodynamics dealing with energy flows between various systems and should find broad use in present high energy density experiments.

  7. Baryogenesis via Elementary Goldstone Higgs Relaxation

    Gertov, Helene; Pearce, Lauren; Yang, Louis


    We extend the relaxation mechanism to the Elementary Goldstone Higgs frame- work. Besides studying the allowed parameter space of the theory we add the minimal ingredients needed for the framework to be phenomenologically viable. The very nature of the extended Higgs sector allows to consider very flat scalar potential directions along which the relaxation mechanism can be implemented. This fact translates into wider regions of applicability of the relaxation mechanism when compared to the Standard Model Higgs case. Our results show that, if the electroweak scale is not fundamental but radiatively generated, it is possible to generate the observed matter-antimatter asymmetry via the relaxation mechanism.

  8. Dielectric relaxation studies in polyvinyl butyral

    Mehendru, P. C.; Kumar, Naresh; Arora, V. P.; Gupta, N. P.


    Dielectric measurements have been made in thick films (˜100 μm) of polyvinyl butyral (PVB) having degree of polymerization n=1600, in the frequency range 100 Hz-100 KHz and temperature range 300-373 K. The results indicated that PVB was in the amorphous phase and observed dielectric dispersion has been assigned as the β-relaxation process. The β relaxation is of Debye type with symmetrical distribution of relaxation times. The dielectric relaxation strength Δɛ and the distribution parameters β¯ increase with temperature. The results can be qualitatively explained by assuming the hindered rotation of the side groups involving hydroxyl/acetate groups.

  9. Relaxation and Visualization Strategies for Story Telling



    The importance of training students to tell or retell story is self - evident for mastering English language. The following activity introduces relaxation and visualization strategies for story telling.

  10. Climate-sensitive feedbacks between hillslope processes and fluvial erosion in sediment-driven incision models

    Skov, Daniel S.; Egholm, David L.


    Surface erosion and sediment production seem to have accelerated globally as climate cooled in the Late Cenozoic, [Molnar, P. 2004, Herman et al 2013]. Glaciers emerged in many high mountain ranges during the Quaternary, and glaciation therefore represents a likely explanation for faster erosion in such places. Still, observations and measurements point to increases in erosion rates also in landscapes where erosion is driven mainly by fluvial processes [Lease and Ehlers (2013), Reusser (2004)]. Flume experiments and fieldwork have shown that rates of incision are to a large degree controlled by the sediment load of streams [e.g. Sklar and Dietrich (2001), Beer and Turowski (2015)]. This realization led to the formulation of sediment-flux dependent incision models [Sklar and Dietrich (2004)]. The sediment-flux dependence links incision in the channels to hillslope processes that supply sediment to the channels. The rates of weathering and soil transport on the hillslopes are processes that are likely to respond to changing temperatures, e.g. because of vegetation changes or the occurrence of frost. In this study, we perform computational landscape evolution experiments, where the coupling between fluvial incision and hillslope processes is accounted for by coupling a sediment-flux-dependent model for fluvial incision to a climate-dependent model for weathering and hillslope sediment transport. The computational experiments first of all demonstrate a strong positive feedback between channel and hillslope processes. In general, faster weathering leads to higher rates of channel incision, which further increases the weathering rates, mainly because of hillslope steepening. Slower weathering leads to the opposite result. The experiments also demonstrate, however, that the feedbacks vary significantly between different parts of a drainage network. For example, increasing hillslope sediment production may accelerate incision in the upper parts of the catchment, while at

  11. [Transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis: a novel surgical approach].

    Lin, Min; Tu, Yuan-rong; Lai, Fan-cai; Li, Xu; Chen, Jian-feng; Luo, Rong-gang; Lin, Jian-bo


    To evaluate the cosmetic effect and safety of transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis (PH). Retrospective study was conducted for 326 PH cases undergoing transaxillary concealing single incision endoscopic thoracic bilateral sympathectomy during January 2009 and March 2011. All operations were successfully performed without severe complication and mortality. No conversion into open technique was necessary. The mean unilateral operative duration was 5.8 (5-8) min. It was calculated from the time of skin incision to the application of dressing over wound. The mean follow-up period was 25 (8-38) months. All patients achieved excellent cosmetic effects with undetectable incision. Transaxillary concealing single incision endoscopic thoracic sympathectomy is a safe and effective procedure for treating primary PH. Incision is undetectable with excellent cosmetic effect. It is worthy of wider popularization.

  12. Chronic morphine administration enhances nociceptive sensitivity and local cytokine production after incision

    Angst Martin S


    Full Text Available Abstract Background - The chronic use of opioids prior to surgery leads to lowered pain thresholds and exaggerated pain levels after these procedures. Several mechanisms have been proposed to explain this heightened sensitivity commonly termed opioid-induced hyperalgesia (OIH. Most of these proposed mechanisms involve plastic events in the central or peripheral nervous systems. Alterations in the abundance of peripheral mediators of nociception have not previously been explored. Results - In these experiments mice were treated with saline (control or ascending daily doses of morphine to generate a state of OIH followed by hind paw incision. In other experiments morphine treatment was initiated at the time of incision. Both mechanical allodynia and peri-incisional skin cytokine levels were measured. Myeloperoxidase (MPO assays were used to determine neutrophil activity near the wounds. The cytokine production inhibitor pentoxifylline was used to determine the functional significance of the excess cytokines in previously morphine treated animals. Mice treated chronically treated with morphine prior to incision were found to have enhanced skin levels of IL-1β, IL-6, G-CSF, KC and TNFα after incision at one or more time points compared to saline pretreated controls. The time courses of individual cytokines followed different patterns. There was no discernable effect of chronic morphine treatment on wound area neutrophil infiltration. Pentoxifylline reduced cytokine levels and reversed the excess mechanical sensitization caused by chronic morphine administration prior to incision. Morphine treatment initiated at the time of incision did not lead to a generalized enhancement of cytokine production or nociceptive sensitization in excess of the levels observed after incision alone. Conclusion - The enhanced level of nociceptive sensitization seen after incision in animals chronically exposed to morphine is associated with elevated levels of several

  13. C-shaped Incision for Far-Lateral Suboccipital Approach: Anatomical Study and Clinical Correlation.

    Lau, Tsz; Reintjes, Stephen; Olivera, Raul; van Loveren, Harry R; Agazzi, Siviero


    Background The standard incision for far-lateral suboccipital approaches has been the classic "reverse hockey stick." Although that incision provides ample exposure, concern has been raised that excessive muscle dissection and skin elevation might lead to accumulation of cerebrospinal fluid (CSF) under the flap with increased risk of CSF leak. We hypothesize that the C-shaped incision can minimize the amount of muscle dissection and provide optimal exposure and surgical outcomes. Objective To describe the anatomical dissection for the C-shaped incision and clinical application of the C-shaped incision for the far-lateral approach. Methods A retrospective analysis of all the patients operated on at our center using this approach for the treatment of aneurysm of the posterior inferior cerebellar artery (PICA) from 2005 to 2011. Results of clinical and operative outcome are evaluated. Surgical techniques are described in detail. Cadaveric dissections using the C-shaped incision were performed to assess the exposure of the far-lateral suboccipital area. Results Eleven consecutive patients who had undergone this procedure were selected. All patients underwent clipping of PICA aneurysms. Nine patients (82%) presented with ruptured aneurysms and subarachnoid hemorrhage. All of them underwent suboccipital craniectomy and C1 laminectomy. The dura mater was closed in a watertight fashion in 10 patients (91%). No CSF leak or pseudomeningocele were reported. In nine SAH patients, two (22%) had postoperative dysphagia and required long-term percutaneous endoscopic gastrostomy tube placement. One patient (11%) had chronic respiratory failure and required a tracheostomy. Three patients (33%) developed hydrocephalus and required a ventriculoperitoneal shunt. Conclusions The C-shaped incision is a valid alternative to the classic reverse hockey-stick incision to gain exposure for far-lateral craniotomies. Knowing the anatomy and dissection techniques can provide an easy

  14. Controls on aggradation and incision in the NE Negev, Israel, since the middle Pleistocene

    Matmon, A.; Elfassi, S.; Hidy, A.; Geller, Y.; Porat, N.


    We investigated the mid-Pleistocene to recent aggradation-incision pattern of two drainage systems (Nahal Peres and Nahal Tahmas) in the hyperarid north eastern Negev desert, southern Israel. Although these drainage systems drain into the tectonically active Dead Sea basin, lake level fluctuations cannot account for the aggradation-incision pattern as bedrock knickpoints disconnect the investigated parts of these drainage systems from base level influence. We applied geomorphic mapping, soil stratigraphy, optically stimulated luminescence (OSL) and cosmogenic (in situ 10Be) exposure dating to reconstruct cycles of aggradation and incision of alluvial terraces and to study their temporal association with regional periods of humidity and aridity and global glacial-interglacial cycles. The spatial and temporal relationships between the alluvial units suggest changes in the drainage system behavior since the middle Pleistocene, and show a pattern in which prolonged periods of sediment aggradation alternated with short periods of rapid and intense degradation through erosion and incision into sediment and bedrock. We obtain ages for several Pleistocene-Holocene periods of incision: ~ 1.1 Ma, ~ 300 ka, ~ 120 ka, ~ 20 ka, ~ 12 ka and ~ 2 ka. Although broadly synchronous, the Nahal Peres and Nahal Tahmas systems exhibit temporal differences in aggradation and incision. Hyperarid conditions have persisted in the region at least since the middle Pleistocene, as evidenced by gypsic-salic soils that ubiquitously cap the investigated alluvial terraces. This observation is consistent with other observations throughout the Negev indicating prolonged aridity. Thus, alternation between sediment aggradation and degradation cannot be correlated in a simple and straightforward way to climatic changes. We explain the temporal differences in aggradation and incision between Nahal Peres and Nahal Tahmas as resulting from the differences in stream gradient, basin hypsometry, and drainage

  15. Nuclear relaxation via paramagnetic impurities

    Dzheparov, F S; Jacquinot, J F


    First part of the work contains a calculation of the kinetics of nuclear relaxation via paramagnetic impurities for systems with arbitrary (including fractal) space dimension d basing on ideas, which run current for 3d objects now. A new mean-field-type theory is constructed in the second part of the work. It reproduces all results of the first part for integer d and gives a possibility to describe the process for longer time, when a crossover to Balagurov-Waks asymptotics starts to develop. Solutions of the equations of the new theory are constructed for integer d. To obtain the solutions a method of calculation of the low-energy and long-wave asymptotics for T matrix of potential scattering out of the mass shell for singular repulsive potentials is developed

  16. Relaxing Chosen-Ciphertext Security

    Canetti, Ran; Krawczyk, Hugo; Nielsen, Jesper Buus


    Security against adaptive chosen ciphertext attacks (or, CCA security) has been accepted as the standard requirement from encryption schemes that need to withstand active attacks. In particular, it is regarded as the appropriate security notion for encryption schemes used as components within...... general protocols and applications. Indeed, CCA security was shown to suffice in a large variety of contexts. However, CCA security often appears to be somewhat too strong: there exist encryption schemes (some of which come up naturally in practice) that are not CCA secure, but seem sufficiently secure...... “for most practical purposes.” We propose a relaxed variant of CCA security, called Replayable CCA (RCCA) security. RCCA security accepts as secure the non-CCA (yet arguably secure) schemes mentioned above; furthermore, it suffices for most existing applications of CCA security. We provide three...

  17. Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures

    钟来平; 陈关福


    Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures.Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation.Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation.Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar,sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

  18. Radical Nephrectomy Using a Chevron Incision to Treat Complicated Renal Carcinoma: a Report of 15 Cases

    Ning Kang; Junhui Zhang; Yinong Niu; Nianzeng Xing


    OBJECTIVE To investigate the outcome and indications for radical nephrectomy with a Chevron incision to treat complicated renal carcinoma.METHODS Large renal carcinomas were found in 15 patients during a preoperative CT and/or MRI examination. A tumor thrombus in the renal vein or inferior vena cava was found in 5 cases, and a complication of metastasis in the contralateral adrenalgl and was found in 2 patients. All of the 15 patients underwent a radical nephrectomy by a chevron incision and the postoperative pathological results noted.RESULTS Of the 15 patients who underwent a radical nephrectomy and lymphadenectomy, 5 also received a thrombectomy, and 2 a contralateral adrenalectomy. All surgical operations were safe and successful. The mean operation time was (4.45±0.83) h, and the intraoperative blood loss was (785±910) ml. All patients recovered well after the surgery. Multimodal therapy was conducted in these cases, with rigorous follow-up.CONCLUSION In determining the type of incision for surgery of renal carcinoma, a chevron incision is suitable for cases with a large tumor, local nodal metastasis, thrombus of the renal vein or inferior vena cava and complicated metastasis to the contralateral adrenal gland. The incision produces a clear operating field with less intra- and post-operative complications.

  19. A Semicircular Incision in the Superior Umbilical Fold for SILS Preserves the Umbilical Profile

    S. C. Blackburn


    Full Text Available Background. Single Incision Laparoscopic Surgery (SILS has been highlighted in the recent literature as a means of performing a range of common, minimal access, paediatric surgical procedures. The primary attraction is the absence of visible scarring. Aim. This study aims to describe a cosmetically advantageous means of SILS port placement in children, which preserves the umbilical profile. Methods. We describe a paediatric case series utilising a semicircular incision in the superior umbilical fold for SILS procedures. The linea alba is exposed over 2 cm just superior to the umbilical ring and stay sutures are applied. A vertical incision is made over this distance without entering the umbilical ring. Data were recorded prospectively in a Microsoft Excel database. Results. Twenty-one cases were performed in a 1-year period. Ten appendicectomies, 5 ovarian/paraovarian cystectomies, 2 Palomo procedures, 3 nephrectomy/heminephrectomies, and 1 Meckel’s diverticulectomy were performed. There was 1 wound infection. No incisional hernias occurred. Discussion. We believe that our technique, which maintains the integrity of the umbilical ring and allows preservation of the umbilical profile, offers a distinct cosmetic advantage over other incisions for SILS which distort it. Conclusion. We have demonstrated the aesthetic benefits of utilising a superior umbilical-fold incision for SILS in children.

  20. Force modeling for incisions into various tissues with MRF haptic master

    Kim, Pyunghwa; Kim, Soomin; Park, Young-Dai; Choi, Seung-Bok


    This study proposes a new model to predict the reaction force that occurs in incisions during robot-assisted minimally invasive surgery. The reaction force is fed back to the manipulator by a magneto-rheological fluid (MRF) haptic master, which is featured by a bi-directional clutch actuator. The reaction force feedback provides similar sensations to laparotomy that cannot be provided by a conventional master for surgery. This advantage shortens the training period for robot-assisted minimally invasive surgery and can improve the accuracy of operations. The reaction force modeling of incisions can be utilized in a surgical simulator that provides a virtual reaction force. In this work, in order to model the reaction force during incisions, the energy aspect of the incision process is adopted and analyzed. Each mode of the incision process is classified by the tendency of the energy change, and modeled for realistic real-time application. The reaction force model uses actual reaction force information with three types of actual tissues: hard tissue, medium tissue, and soft tissue. This modeled force is realized by the MRF haptic master through an algorithm based on the position and velocity of a scalpel using two different control methods: an open-loop algorithm and a closed-loop algorithm. The reaction forces obtained from the proposed model are compared with a desired force in time domain.

  1. A modified two-incision technique for primary total hip arthroplasty

    Bal B


    Full Text Available Background: Minimally invasive surgery can be technically demanding but minimizes surgical trauma, pain and recovery. Two-incision minimally invasive surgery allows only intermittent visualization and may require fluoroscopy for implant positioning. We describe a modified technique for primary total hip arthroplasty, using two small incisions with a stepwise approach and adequate visualization to reliably and reproducibly perform the surgery without fluoroscopy. Materials and Methods: One hundred and two patients with an average age of 60 years underwent modified two-incision minimally invasive technique for primary THA without fluoroscopy. The M/L taper femoral stem (Zimmer, Warsaw, IN and Trilogy (Zimmer hemispherical titanium shell, with a highly cross-linked polyethylene liner, was used. Operative time, blood loss, postoperative hospital stay, radiographic outcomes and complications were recorded. Results: The mean operating time was 77 min. The mean blood loss was 335 cc. The mean hospital stay was 2.4 days. Mean cup abduction angle was 43.8°. Mean leg length discrepancy was 1.7 mm. Thirteen patients had lateral thigh numbness and two patients had wound complications that resolved without any treatment. Conclusion: A modified two-incision technique without fluoroscopy for primary total hip arthroplasty has the advantage of preserving muscles and tendons, shorter recovery and return to function with minimal complications. Provided that the surgeon has received appropriate training, primary total hip arthroplasty can be performed safely with the modified two-incision technique.

  2. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)


    The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  3. Ultrasonic phacoemulsification using a 1.4 mm incision: clinical results.

    Tsuneoka, Hiroshi; Shiba, Takuya; Takahashi, Yoko


    To evaluate the intraoperative complications and postoperative results of bimanual phacoemulsification and aspiration using a sleeveless phaco tip inserted through an ultra-small incision. Department of Ophthalmology, Jikei University, Tokyo, Japan. This study comprised 637 eyes having cataract extraction using conventional phacoemulsification equipment. A 20-gauge phaco tip with the sleeve removed was inserted through a 19-gauge corneal incision. A 20-gauge hooked cannula with the wall thinned to increase the inner diameter was used for infusion. After the crystalline lens was removed, the incision was widened to 2.8 to 4.1 mm and and an intraocular lens (IOL) was implanted. Study parameters were operating time, amount of infusion solution used, incidence of intraoperative complications, and early postoperative results. The mean operating time was 8 minutes 42 seconds. Although the nuclear hardness was grade 4 or above in 35 eyes, there were no cases of thermal burn. The amount of infusion solution and the rate of postoperative decrease in corneal endothelial cell density did not differ greatly from results of conventional methods. This technique induced considerably less corneal astigmatism than surgery using conventional corneal incisions. A sleeveless phaco tip was used to perform successful bimanual phacoemulsification using conventional phaco machines and familiar surgical techniques. The cataracts were safely removed through an incision of 1.4 mm or smaller that was widened for IOL insertion.

  4. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano


    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region. PMID:27672611

  5. Single high scrotal incision orchidopexy for unilateral palpable testis: A randomised controlled study

    Almoutaz A. Eltayeb


    Full Text Available Background: Bianchi and Squire introduced single high trans-scrotal incision for mobilisation of palpable undescended testes to decrease the potential morbidity of the traditional inguinal approach. This incision has not gained widespread acceptance and there is still a considerable debate about its efficacy. This study evaluated the outcome of high single scrotal incision in comparison to the classic inguinal exploration for unilateral palpable testes regardless to its pre-operative location to assure its validity and safety. Patients and Methods: This was a randomised controlled study conducted on seventy males with palpable unilateral undescended testicles from November 2009 to October 2013. They were divided into two equal groups; group I had high single scrotal incision and group II had the classic inguinal approach. The comparative parameters between both groups were the operative time, intra-and post-operative complications, post-operative pain and scar. Results: There was statistical significant difference between both groups regarding the operative time (P < 0.001. The high scrotal approach (Group I was not completed in three cases and were converted to the classic inguinal approach. No statistical significant difference between both groups regarding the post-operative complications. Conclusions: Single high scrotal incision orchidopexy for palpable undescended testis is safe, has shorter operative time but may not be suitable for proximally lying testis.

  6. Tibetan plateau river incision inhibited by glacial stabilization of the Tsangpo gorge.

    Korup, Oliver; Montgomery, David R


    A considerable amount of research has focused on how and when the Tibetan plateau formed in the wake of tectonic convergence between India and Asia. Although far less enquiry has addressed the controls on river incision into the plateau itself, widely accepted theory predicts that steep fluvial knick points (river reaches with very steep gradients) in the eastern Himalayan syntaxis at the southeastern plateau margin should erode rapidly, driving a wave of incision back into the plateau. Preservation of the plateau edge thus presents something of a conundrum that may be resolved by invoking either differential rock uplift matching erosional decay, or other mechanisms for retarding bedrock river incision in this region where high stream power excludes the potential for aridity as a simple limit to dissection of the plateau. Here we report morphologic evidence showing that Quaternary depression of the regional equilibrium line altitude, where long-term glacier mass gain equals mass loss, was sufficient to repeatedly form moraine dams on major rivers: such damming substantially impeded river incision into the southeastern edge of the Tibetan plateau through the coupled effects of upstream impoundment and interglacial aggradation. Such glacial stabilization of the resulting highly focused river incision centred on the Tsangpo gorge could further contribute to initiating and accentuating a locus of rapid exhumation, known as tectonic anaeurysm.

  7. Circumareolar incision-subdermal tunneling dissection for excision of multiple breast fibroadenomata

    S O Agodirin


    Full Text Available Excision of multiple fibroadenomas (MF in separate breast quadrants presents difficulties of number and location of incision(s and extent of tissue dissection and may be associated with more complications and poorer cosmetic outcome. This is a report of excision of MF in multiple quadrants of the breast using a modification of subcutaneous dissection technique dubbed the circumareolar incision and subdermal tunneling (CAST dissection. After exposure of the superficial fascia with circumareolar incision, subdermal cone-wise dissection was made to allow mobilization of the segment bearing the lump(s. The lump(s were enucleated and removed. MF were removed from four breasts in three young unmarried females. The first patient had multiple adenomas removed from three quadrants of both breasts: 14 on the right and six on the left. The second patient had excision of three lumps in three separate quadrants, and the third patient had excision of two lumps in two separate quadrants. All patients had edema and bruising. One breast had wound infection and dehiscence. There were no skin necrosis, no nipple loss, and no breast distortion. All ensuing scars were camouflaged. CAST dissection was used for excision of MF in multiple quadrants of the breast with preservation of excellent cosmetic outcome of a single circumareolar incision.

  8. Internal Structure of the Incised Valley Fill in the Hangzhou Bay,Eastern China and Its Geological Implications

    LIN Chunming; LI Guangyue; WANG Baichang; GU Lianxing; ZHUO Hongchun


    This paper presents the sedimentary facies and formation of the Qiantangjiang and Taihu incised valleys, and the characteristics of shallow gas reservoir distribution, based on a large number of data of drilling, static sounding and chemical analysis obtained from the present Hangzhou Bay coastal plain. The incised valleys were formed during the last glacial maximum and were subsequently filled with fluvial facies during the post-glacial period. All commercial gases are stored in the flood plain sand lenses of the incised valleys.

  9. Steady incision of Grand Canyon at the million year timeframe: A case for mantle-driven differential uplift

    Crow, Ryan; Karlstrom, Karl; Darling, Andrew; Crossey, Laura; Polyak, Victor; Granger, Darryl; Asmerom, Yemane; Schmandt, Brandon


    The Grand Canyon region provides an excellent laboratory to examine the interplay between river incision, magmatism, and the geomorphic and tectonic processes that shape landscapes. Here we apply U-series, Ar-Ar, and cosmogenic burial dating of river terraces to examine spatial variations in incision rates along the 445 km length of the Colorado River through Grand Canyon. We also analyze strath terrace sequences that extend to heights of several hundred meters above the river, and integrate these with speleothem constrained maximum incision rates in several reaches to examine any temporal incision variations at the million-year time frame. This new high-resolution geochronology shows temporally steady long-term incision in any given reach of Grand Canyon but significant variations along its length from 160 m/Ma in the east to 101 m/Ma in the west. Spatial and temporal patterns of incision, and the long timescale of steady incision rule out models where geomorphic controls such as climate oscillations, bedrock strength, sediment load effects, or isostatic response to differential denudation are the first order drivers of canyon incision. The incision pattern is best explained by a model of Neogene and ongoing epeirogenic uplift due to an eastward propagating zone of increased upper mantle buoyancy that we infer from propagation of Neogene basaltic volcanism and a strong lateral gradient in modern upper mantle seismic structure.

  10. Steady incision of Grand Canyon at the million year timeframe: a case for mantle-driven differential uplift

    Crow, Ryan S; Karl Karlstrom,; Laura Crossey,; Richard Young,; Michael Ort,; Yemane Asmerom,; Victor Polyak,; Andrew Darling,


    The Grand Canyon region provides an excellent laboratory to examine the interplay between river incision, magmatism, and the geomorphic and tectonic processes that shape landscapes. Here we apply U-series, Ar–Ar, and cosmogenic burial dating of river terraces to examine spatial variations in incision rates along the 445 km length of the Colorado River through Grand Canyon. We also analyze strath terrace sequences that extend to heights of several hundred meters above the river, and integrate these with speleothem constrained maximum incision rates in several reaches to examine any temporal incision variations at the million-year time frame. This new high-resolution geochronology shows temporally steady long-term incision in any given reach of Grand Canyon but significant variations along its length from 160 m/Ma in the east to 101 m/Ma in the west. Spatial and temporal patterns of incision, and the long timescale of steady incision rule out models where geomorphic controls such as climate oscillations, bedrock strength, sediment load effects, or isostatic response to differential denudation are the first order drivers of canyon incision. The incision pattern is best explained by a model of Neogene and ongoing epeirogenic uplift due to an eastward propagating zone of increased upper mantle buoyancy that we infer from propagation of Neogene basaltic volcanism and a strong lateral gradient in modern upper mantle seismic structure.

  11. European Hernia Society guidelines on the closure of abdominal wall incisions

    Muysoms, F E; Antoniou, S A; Bury, K


    BACKGROUND: The material and the surgical technique used to close an abdominal wall incision are important determinants of the risk of developing an incisional hernia. Optimising closure of abdominal wall incisions holds a potential to prevent patients suffering from incisional hernias...... and for important costs savings in health care. METHODS: The European Hernia Society formed a Guidelines Development Group to provide guidelines for all surgical specialists who perform abdominal incisions in adult patients on the materials and methods used to close the abdominal wall. The guidelines were developed...... using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II...

  12. Modified Scleral Flap Incision to Reduce Corneal Astigmatisn after Intraocular Lens Implantation

    YizhiLiu; ShaozhenLi


    Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.

  13. Prevention and Control of Perioperative Incision Infection in Patients Undergoing Day Cataract Surgery

    Chunyan Yang; Aihuan Chen; Yinghuan Wang; Xiaoqun Fang; Ronghua Ye; Jingyi Lin


    Purpose:.To explore the effects of the prevention and control of perioperative incision infection on the quality of day cataract surgery.Methods:.The nursing care and efficacy of 5087 patients un-dergoing day cataract surgery between October 2012 and Oc-tober 2013 were retrospectively reviewed. The disinfection and isolation guidance was established for perioperative prevention and control of infection,.topical administration of ocular a-gents, reexamination and healthcare instruction, and alterna-tive measures were taken.Results: All 5087 patients successfully underwent day surgery of phacoemulsification combined with intraocular lens im-plantation. All cases recovered without incision infection.Conclusion: Preoperative preparation, and intraoperative and postoperative prevention and control of infection serve as vital measures for effectively avoiding the incidence of incision in-fection in patients undergoing day cataract surgery. (Eye Science 2014; 29:182-185)

  14. Superparamagnetic relaxation of weakly interacting particles

    Mørup, Steen; Tronc, Elisabeth


    The influence of particle interactions on the superparamagnetic relaxation time has been studied by Mossbauer spectroscopy in samples of maghemite (gamma-Fe2O3) particles with different particle sizes and particle separations. It is found that the relaxation time decreases with decreasing particl...

  15. Postextrasystolic relaxation in the dog heart

    Kuijer, P.J.P.; Heethaar, R.M.; Herbschleb, J.N.; Zimmerman, A.N.E.; Meijler, F.L.


    Left ventricular relaxation was studied in 8 dogs using parameters derived from the left ventricular pressure: the fastest pressure fall and the time constant of pressure decline. Effects of extrasystolic rhythm interventions were examined on the relaxation parameters of the post-relative to the pre

  16. Superparamagnetic relaxation in alpha-Fe particles

    Bødker, Franz; Mørup, Steen; Pedersen, Michael Stanley;


    The superparamagnetic relaxation time of carbon-supported alpha-Fe particles with an average size of 3.0 Mm has been studied over a large temperature range by the use of Mossbauer spectroscopy combined with AC and DC magnetization measurements. It is found that the relaxation time varies with tem...

  17. Cross relaxation in nitroxide spin labels

    Marsh, Derek


    -label EPR and ELDOR, particularly for saturation recovery studies. Neither for saturation recovery, nor for CW-saturation EPR and CW-ELDOR, can cross relaxation be described simply by increasing the value of We, the intrinsic spin-lattice relaxation rate. Independence of the saturation recovery rates from...

  18. Magnetization Transfer Induced Biexponential Longitudinal Relaxation

    Prantner, Andrew M.; Bretthorst, G. Larry; Neil, Jeffrey J.; Garbow, Joel R.; Ackerman, Joseph J.H.


    Longitudinal relaxation of brain water 1H magnetization in mammalian brain in vivo is typically analyzed on a per voxel basis using a monoexponential model, thereby assigning a single relaxation time constant to all 1H magnetization within a given voxel. This approach was tested by obtaining inversion recovery data from grey matter of rats at 64 exponentially-spaced recovery times. Using Bayesian probability for model selection, brain water data were best represented by a biexponential function characterized by fast and slow relaxation components. At 4.7 T, the amplitude fraction of the rapidly relaxing component is 3.4 ± 0.7 % with a rate constant of 44 ± 12 s-1 (mean ± SD; 174 voxels from 4 rats). The rate constant of the slow relaxing component is 0.66 ± 0.04 s-1. At 11.7 T, the corresponding values are 6.9 ± 0.9 %, 19 ± 5 s-1, and 0.48 ± 0.02 s-1 (151 voxels from 4 rats). Several putative mechanisms for biexponential relaxation behavior were evaluated, and magnetization transfer between bulk water protons and non-aqueous protons was determined to be the source of biexponential longitudinal relaxation. MR methods requiring accurate quantification of longitudinal relaxation may need to take this effect explicitly into account. PMID:18759367

  19. Windowing Waveform Relaxation of Initial Value Problems

    Yao-lin Jiang


    We present a windowing technique of waveform relaxation for dynamic systems. An effective estimation on window length is derived by an iterative error expression provided here. Relaxation processes can be speeded up if one takes the windowing technique in advance. Numerical experiments are given to further illustrate the theoretical analysis.

  20. The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

    Affonso H. Camargo


    Full Text Available INTRODUCTION: Compare the outcomes between kidney morcellation and two types of open specimen extraction incisions, several covariates need to be taken into consideration that have not yet been studied. MATERIALS AND METHODS: We retrospectively reviewed 153 consecutive patients who underwent laparoscopic nephrectomy at our institution, 107 who underwent specimen morcellation and 46 with intact specimen removal, either those with connected port sites with a muscle-cutting incision and those with a remote, muscle-splitting incision. Operative time, postoperative analgesia requirements, and incisional complications were evaluated using univariate and multivariate analysis, comparing variables such as patient age, gender, body mass index (BMI, laterality, benign versus cancerous renal conditions, estimated blood loss, specimen weight, overall complications, and length of stay. RESULTS: There was no significant difference for operative time between the 2 treatment groups (p = 0.65. Incision related complications occurred in 2 patients (4.4% from the intact specimen group but none in the morcellation group (p = 0.03. Overall narcotic requirement was lower in patients with morcellated (41 mg compared to intact specimen retrieval (66 mg on univariate (p = 0.03 and multivariate analysis (p = 0.049. Upon further stratification, however, there was no significant difference in mean narcotic requirement between the morcellation and muscle-splitting incision subgroup (p = 0.14. CONCLUSION: Morcellation does not extend operative time, and is associated with significantly less postoperative pain compared to intact specimen retrieval overall, although this is not statistically significant if a remote, muscle-splitting incision is made. Morcellation markedly reduces the risk of incisional-related complications.

  1. Reliability of Incision Biopsy for Diagnosis of Oral Verrucous Carcinoma: A Multivariate Clinicopathological Study.

    Gokavarapu, Sandhya; Chandrasekhara Rao, L M; Patnaik, Sujit Chau; Parvataneni, Nagendra; Raju, K V V N; Chander, Ravi; Kumar, K A Jeevan


    Studies have reported 20 % of conventional squamous cell carcinoma in patients with verrucous carcinoma (VC), later these cancers were termed as hybrid VC. It is important to distinguish both while planning treatment since hybrid VC requires addressing regional lymphatics in addition to respective surgery. Information on odds of missing the foci of invasion on routine incision biopsy might be useful in this regard. Records of all the patients surgically treated for oral cancer from Jan 2010 to Oct 2013 in a Tertiary Cancer Centre was analyzed. Patients diagnosed with primary VC or Verrucous Hyperplasia on incision biopsy were included in the study. Proportion of patients undiagnosed for invasive component on incision biopsy was calculated, multivariate analysis of the sample was performed to find associated cofounders. Fifty-five patients who reported with the diagnosis of VC (n = 53) or Verrucous Hyperplasia (n = 2) on incision biopsy were included in the study. Twenty-seven were diagnosed as VC and 28 as hybrid VC after excision. This corresponded to 51 % (n = 28) of cases missing invasive component on incision biopsy. VC was significantly more commonly seen in lip and in buccal mucosa, hybrid VC was more commonly seen in tongue and gingiva and this association was statistically significant (p = 0.031) in our study. Incision biopsy is extremely unreliable to diagnose and differentiate oral Hybrid VC from VC or Verrucous Hyperplasia. Caution is required while planning treatment of these patients regarding possibility of presence of conventional squamous cell carcinoma within these tumors.

  2. Stress Relaxation in Entangled Polymer Melts

    Hou, Ji-Xuan; Svaneborg, Carsten; Everaers, Ralf


    We present an extensive set of simulation results for the stress relaxation in equilibrium and step-strained bead-spring polymer melts. The data allow us to explore the chain dynamics and the shear relaxation modulus, G(t), into the plateau regime for chains with Z=40 entanglements and into the t......We present an extensive set of simulation results for the stress relaxation in equilibrium and step-strained bead-spring polymer melts. The data allow us to explore the chain dynamics and the shear relaxation modulus, G(t), into the plateau regime for chains with Z=40 entanglements...... and into the terminal relaxation regime for Z=10. Using the known (Rouse) mobility of unentangled chains and the melt entanglement length determined via the primitive path analysis of the microscopic topological state of our systems, we have performed parameter-free tests of several different tube models. We find...

  3. Stress and Relaxation in Relation to Personality

    Harish Kumar Sharma


    Full Text Available Relaxation plays a significant role in facing stress. The aim of the present study is to see whether personality patterns determine an individual’s ability to relax. As a reaction to stress, coping is the best way to handle stress, which requires rational and conscious thinking. Does this ability to relax anyway facilitate coping reactions? A study was conducted on 100 college students. Results revealed that extraverts relax easily than introverts. In addition, if intelligence level is average or above average, relaxation does play a role in facilitating coping reactions. It suggests that in designing techniques of stress management, the personality and intelligence level must be taken into consideration to make techniques effective.

  4. Meta-analysis of negative-pressure wound therapy for closed surgical incisions

    Hyldig, N; Birke-Sorensen, H; Kruse, M


    BACKGROUND: Postoperative wound complications are common following surgical procedures. Negative-pressure wound therapy (NPWT) is well recognized for the management of open wounds and has been applied recently to closed surgical incisions. The evidence base to support this intervention is limited....... RESULTS: Ten studies met the inclusion criteria, reporting on 1311 incisions in 1089 patients. NPWT was associated with a significant reduction in wound infection (relative risk (RR) 0·54, 95 per cent c.i. 0·33 to 0·89) and seroma formation (RR 0·48, 0·27 to 0·84) compared with standard care...

  5. Single-incision laparoscopic cholecystectomy:Single institution experience and literature review

    Yasumitsu; Hirano; Toru; Watanabe; Tsuneyuki; Uchida; Shuhei; Yoshida; Kanae; Tawaraya; Hideaki; Kato; Osamu; Hosokawa


    Single-incision laparoscopic surgery is a rapidly evolving field as a bridge between traditional laparoscopic surgery and natural orifice transluminal endoscopic surgery.We report one of the initial clinical experiences in Japan with this new technique.Four cases of gallbladder diseases were selected for this new technique.A single curved intra-umbilical 25-mm incision was made by pulling out the umbilicus.A 12-mm trocar was placed through an open approach,and the abdominal cavity was explored with a 10-mm ...

  6. Medial canthopexy using Y-V epicanthoplasty incision in the correction of telecanthus.

    Kim, Tae-Gon; Chung, Kyu-Jin; Kim, Yong-Ha; Lim, Jong-Hyo; Lee, Jun-Ho


    Telecanthus occurs because of the disruption of the medial canthal tendon (MCT). The deformity of medial canthus can result from nasoorbitoethmoid fractures, tumor resection, craniofacial exposure, congenital malposition, or aging. Repair of the MCT using transnasal wiring is regarded as a method of choice to treat telecanthus. We have introduced an oblique transnasal wiring using Y-V epicanthoplasty incision rather than the well-known classical bicoronal approach. Eight patients with telecanthus were treated with this method. Through the medial canthal horizontal and periciliary incision, we could have an access to the medial orbital wall and the MCT. An oblique transnasal wiring was performed with the following steps: (1) after slit skin incision on the nasal recession of the contralateral frontoglabella area, 2 drill holes were made from this point to the superior and posterior region of the lacrimal fossa of the affected orbit; (2) a 2-0 wire was passed through the MCT and the holes; (3) the wire was pulled and tightened until the MCT was ensured and was twisted in the contralateral side. After the repositioning of the MCT, the skin was simply sutured. The excess skin was trimmed, and then the skin was sutured with nylon 7-0. The remaining "dog ear" in the lateral portion can be removed by additional periciliary skin incision and excision. All the patients achieved an improvement and a prompt recovery. The interepicanthal distance was decreased by 6.3 mm on average compared with that in the preoperative condition. All patients had no complication associated with surgeries. Of posttraumatic telecanthus, 5 patients were much satisfied with the outcomes, and 1 patient had recurrence on postoperative month 3. In cases of congenital anomaly or neoplasm, the telecanthus was also improved. An oblique transnasal wiring using Y-V epicanthoplasty incision could be a simple, safe method to correct the telecanthus with the following advantages: first, we could fix the MCT

  7. A New Device of Needlescopic Thoracic Sympathectomy Through a Skin Incision.

    Yamamoto, Hidehiro; Okada, Masayoshi


    We describe a new technique of performing sympathectomy with a new device. A single skin incision 3 mm long was made in the armpit. The device enables complete resection of the sympathetic segment through a single skin incision, whereas sympathectomy is limited by the use of the conventional needle technique. Even if sympathetic nerves and blood vessels were overlapping, separation of the two organs was performed safely. This device increases the possibility of planning surgical procedures for patients with difficult anatomies. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Bedrock control on the Assu Incised Valley morphology and sedimentation in the Brazilian Equatorial Shelf

    Moab Praxedes Gomes; Helenice Vital; Karl Stattegger; Klaus Schwarzer


    The Assu Incised Valley (AIV) is a new example of an incised-valley system located on the Brazilian Equatorial continental shelf. This valley extends over 40 km from the present-day shoreline to the shelf break, in a passive margin setting, on a shallow (~70 m), narrow (43 km) and flat («1°) shelf, with mixed carbonate–siliciclastic sedimentation and a low terrigenous sediment supply. To investigate the mor-phology of the incised valley and the surrounding shelf area, we analyzed LandSat images and bathy-metric, shallow seismic and sedimentological data. The results indicate that the AIV is a coastal-plain incised valley. The incision was mainly forced by the magnitude of the last fall in sea level, which created the specific geometry of valley, atypically widening landward due to lithological and structural control. The AIV is a broad N–S-trending valley with a negative relief of approximately 12 m below the mean shelf topography and low-angle valley walls (~3°), surrounded by a highly planar shelf. The valley is asymmetric in cross-section and subdivided into three segments along the shelf:the landward segment is wide (up to 8 km), shallow (<9 m deep), and 25 km long; the middle segment is narrow (~2 km wide), only slightly deeper than the inner segment (<15 m deep) and 10 km long;the outer segment is very narrow (<1 km), has incised relief up to 30 m deep and is 8 km long. The incised valley changes near the shelf break abruptly to a deeper (300 m) and wider submarine canyon (3 km). The three valley-segments are bounded by transfer faults of W–E orientation. In addition, the accommodation-space response to the last deglacial sea-level rise provided a 30 m thick sedimentary fill above a Pleistocene/Holocene regional unconformity and a morphologically controlled stratigraphic organization. The ante-cedent valley topography controls the sedimentation and hydrodynamics of the modern shelf. Further-more, the morphology of the AIV is a key example of the

  9. [Choice of surgical procedure and management of postoperative incision for anal fistula].

    Chen, Chaowen; Peng, Bo


    Anal fistula is a common disease in general surgery. It is difficult to heal without intervention and surgical treatment is the major treatment. Method of surgical treatment and management of postoperative incision are based on features and classifications of anal fistula. Choosing the appropriate approach in accordance with specific conditions of patients can obtain effective healing and proper protection against anal sphincter, along with the improvement of life quality. Comprehensive evaluation on methods of surgical treatment and managements of postoperative incision for anal fistula is presented in this paper.

  10. [Minimally invasive technique for harvesting a saphenous vein via one small incision].

    Sato, M; Suenaga, E; Koga, S; Matsuyama, S


    We report a minimally invasive technique for harvesting a saphenous vein graft (SVG) via 1 small skin incision. The expected advantages of this technique are better cosmetic results and fewer wound complications than the conventional open technique or the bridging technique. The SVG, 10-15 cm in length, can be harvested by about 3 cm-long single small skin incision. SaphLITE Retractor System (Genzyme Srugical Products, Cambridge), SLS Hematostatic Clip System (Vitalitec International, Plymouth), and curved scissors were necessary instruments for this technique. It is feasible for cases that require a shorter length of SVG.

  11. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure

    Agrawal Amit


    Full Text Available Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to describe our experience with transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure.

  12. Magnetic Resonance Fingerprinting with short relaxation intervals.

    Amthor, Thomas; Doneva, Mariya; Koken, Peter; Sommer, Karsten; Meineke, Jakob; Börnert, Peter


    The aim of this study was to investigate a technique for improving the performance of Magnetic Resonance Fingerprinting (MRF) in repetitive sampling schemes, in particular for 3D MRF acquisition, by shortening relaxation intervals between MRF pulse train repetitions. A calculation method for MRF dictionaries adapted to short relaxation intervals and non-relaxed initial spin states is presented, based on the concept of stationary fingerprints. The method is applicable to many different k-space sampling schemes in 2D and 3D. For accuracy analysis, T1 and T2 values of a phantom are determined by single-slice Cartesian MRF for different relaxation intervals and are compared with quantitative reference measurements. The relevance of slice profile effects is also investigated in this case. To further illustrate the capabilities of the method, an application to in-vivo spiral 3D MRF measurements is demonstrated. The proposed computation method enables accurate parameter estimation even for the shortest relaxation intervals, as investigated for different sampling patterns in 2D and 3D. In 2D Cartesian measurements, we achieved a scan acceleration of more than a factor of two, while maintaining acceptable accuracy: The largest T1 values of a sample set deviated from their reference values by 0.3% (longest relaxation interval) and 2.4% (shortest relaxation interval). The largest T2 values showed systematic deviations of up to 10% for all relaxation intervals, which is discussed. The influence of slice profile effects for multislice acquisition is shown to become increasingly relevant for short relaxation intervals. In 3D spiral measurements, a scan time reduction of 36% was achieved, maintaining the quality of in-vivo T1 and T2 maps. Reducing the relaxation interval between MRF sequence repetitions using stationary fingerprint dictionaries is a feasible method to improve the scan efficiency of MRF sequences. The method enables fast implementations of 3D spatially resolved

  13. Papilla base incision: a new approach to recession-free healing of the interdental papilla after endodontic surgery.

    Velvart, P


    The purpose of the present study was to describe and evaluate a new incision technique: the papilla base incision. Twenty healthy patients referred for surgical treatment of persisting apical periodontitis, who were free of periodontal disease and had intact interdental papillae were included in the study. The preoperative papilla height was recorded by measuring the distance between the contact point and the most coronal point of the papilla. The papilla base flap, consisting of the papilla base incision and two releasing incisions, was used to expose the bone. The papilla base incision consisted of a shallow first incision at the base of the papilla and a second incision directed to the crestal bone, creating a split thickness flap in the area of the papilla base. Further apically a full thickness flap was raised. Following standard root-end resection and filling, flap closure was achieved with microsurgical sutures. The papilla base incision was sutured with 2-3 interrupted sutures, which were removed 3-5 days after the surgery. The experimental sites were evaluated at the conclusion of the surgery, at suture removal and after 1 month, and compared to the preoperative findings. The healing pattern, complications and postoperative recession were recorded. The experimental sites were observed with a x 3 magnification and graded as to whether a visible scar resulting from the incision could be detected. Twenty experimental sites were analysed. Complete closure of the wound was achieved in all cases after surgery. Except for four patients with delayed healing at suture removal, all other patients displayed rapid healing. No noticeable space was created beneath the contact point area. The change in distance between the reference point and the most coronal point of the papilla comparing the preoperative and the one-month postoperative situation was 0.05 +/- 0.39 mm. The probing depth remained within normal limits. One month postoperatively, observation of the incision

  14. Domain Relaxation in Langmuir Films

    Bernoff, Andrew J.; Alexander, James C.; Mann, Elizabeth K.; Mann, J. Adin; Zou, Lu; Wintersmith, Jacob R.


    We report on an experimental, theoretical and computational study of a molecularly thin polymer Langmuir layer domain on the surface of a subfluid. When stretched (by a transient stagnation flow), the Langmuir layer takes the form of a bola consisting of two roughly circular reservoirs connected by a thin tether. This shape relaxes to the circular minimum energy configuration. The tether is never observed to rupture, even when it is more than a hundred times as long as it is thin. We model these experiments as a free boundary problem where motion is driven by the line tension of the domain and damped by the viscosity of the subfluid. We process the digital images of the experiment to extract the domain shape, use one of these shapes as an initial condition for the numerical solution of a boundary-integral model of the underlying hydrodynamics, and compare the subsequent images of the experiment to the numerical simulation. The numerical evolutions verify that our hydrodynamical model can reproduce the observed dynamics. They also allow us to deduce the magnitude of the line tension in the system, often to within 1%.

  15. Supervised Discrete Hashing With Relaxation.

    Gui, Jie; Liu, Tongliang; Sun, Zhenan; Tao, Dacheng; Tan, Tieniu


    Data-dependent hashing has recently attracted attention due to being able to support efficient retrieval and storage of high-dimensional data, such as documents, images, and videos. In this paper, we propose a novel learning-based hashing method called ''supervised discrete hashing with relaxation'' (SDHR) based on ''supervised discrete hashing'' (SDH). SDH uses ordinary least squares regression and traditional zero-one matrix encoding of class label information as the regression target (code words), thus fixing the regression target. In SDHR, the regression target is instead optimized. The optimized regression target matrix satisfies a large margin constraint for correct classification of each example. Compared with SDH, which uses the traditional zero-one matrix, SDHR utilizes the learned regression target matrix and, therefore, more accurately measures the classification error of the regression model and is more flexible. As expected, SDHR generally outperforms SDH. Experimental results on two large-scale image data sets (CIFAR-10 and MNIST) and a large-scale and challenging face data set (FRGC) demonstrate the effectiveness and efficiency of SDHR.

  16. Spin relaxation in organic semiconductors

    Bobbert, Peter


    Intriguing magnetic field effects in organic semiconductor devices have been reported: anomalous magnetoresistance in organic spin valves and large effects of small magnetic fields on the current and luminescence of organic light-emitting diodes. Influences of isotopic substitution on these effects points at the role of hyperfine coupling. We performed studies of spin relaxation in organic semiconductors based on (i) coherent spin precession of the electron spin in an effective magnetic field consisting of a random hyperfine field and an applied magnetic field and (ii) incoherent hopping of charges. These ingredients are incorporated in a stochastic Liouville equation for the dynamics of the spin density matrix of single charges as well as pairs of charges. For single charges we find a spin diffusion length that depends on the magnetic field, explaining anomalous magnetoresistance in organic spin valves. For pairs of charges we show that the magnetic field influences formation of singlet bipolarons, in the case of like charges, and singlet and triplet excitons, in the case of opposite charges. We can reproduce different line shapes of reported magnetic field effects, including recently found effects at ultra-small fields.

  17. Compare of Saber incision and Supraclavicular incision treatment of clavicular fracture efficacy%Saber切口与锁骨上切口治疗锁骨骨折的临床疗效

    于新忠; 杨恩广; 宋爽; 杨建军; 贾立军


    目的 比较Saber切口与锁骨上切口治疗锁骨骨折的临床疗效.方法 选取138例锁骨骨折患者,分为锁骨上切口者56例,Saber切口者82例,观察两组患者术中及术后情况.结果 两组患者的切口长度,手术时间,出血量,并发症比较,差异均有统计学意义(P<0.05),Saber切口组优于锁骨上切口组.结论 锁骨骨折患者术中使用Saber切口优于使用锁骨上切口.%Objective To compare Compare of Saber incision and Supraclavicular incision treatment of clavicular fracture efficacy.Methods 136 patients with Clavicle fracture.divided into Supraclavicular incision group(56cases)and Saber incision group(82cases).observed the condition of two groups’patients during and after operation.Results Saber incision group was higher than the supraclavicular incision group.Conclusion clavicular fracture patiens during operation ues Supraclavicular incision better than ues Saber incision.

  18. Relaxation of a 1-D gravitational system

    Valageas, P


    We study the relaxation towards thermodynamical equilibrium of a 1-D gravitational system. This OSC model shows a series of critical energies $E_{cn}$ where new equilibria appear and we focus on the homogeneous ($n=0$), one-peak ($n=\\pm 1$) and two-peak ($n=2$) states. Using numerical simulations we investigate the relaxation to the stable equilibrium $n=\\pm 1$ of this $N-$body system starting from initial conditions defined by equilibria $n=0$ and $n=2$. We find that in a fashion similar to other long-range systems the relaxation involves a fast violent relaxation phase followed by a slow collisional phase as the system goes through a series of quasi-stationary states. Moreover, in cases where this slow second stage leads to a dynamically unstable configuration (two peaks with a high mass ratio) it is followed by a new sequence ``violent relaxation/slow collisional relaxation''. We obtain an analytical estimate of the relaxation time $t_{2\\to \\pm 1}$ through the mean escape time of a particle from its potent...

  19. Plasma Relaxation Dynamics Moderated by Current Sheets

    Dewar, Robert; Bhattacharjee, Amitava; Yoshida, Zensho


    Ideal magnetohydrodynamics (IMHD) is strongly constrained by an infinite number of microscopic constraints expressing mass, entropy and magnetic flux conservation in each infinitesimal fluid element, the latter preventing magnetic reconnection. By contrast, in the Taylor-relaxed equilibrium model all these constraints are relaxed save for global magnetic flux and helicity. A Lagrangian is presented that leads to a new variational formulation of magnetized fluid dynamics, relaxed MHD (RxMHD), all static solutions of which are Taylor equilibrium states. By postulating that some long-lived macroscopic current sheets can act as barriers to relaxation, separating the plasma into multiple relaxation regions, a further generalization, multi-relaxed MHD (MRxMHD), is developed. These concepts are illustrated using a simple two-region slab model similar to that proposed by Hahm and Kulsrud--the formation of an initial shielding current sheet after perturbation by boundary rippling is calculated using MRxMHD and the final island state, after the current sheet has relaxed through a reconnection sequence, is calculated using RxMHD. Australian Research Council Grant DP110102881.

  20. Clinical outcomes of and patient satisfaction with different incision methods for donor hepatectomy in living donor liver transplantation.

    Suh, Suk-Won; Lee, Kwang-Woong; Lee, Jeong-Moo; Choi, YoungRok; Yi, Nam-Joon; Suh, Kyung-Suk


    With the decrease in the average donor age and the increase in the proportion of female donors, both donor safety and cosmetic appearance are major concerns for some living donors in living donor liver transplantation (LDLT) because a large abdominal incision is needed that may influence the donor's quality of life. In all, 429 donors who underwent donor hepatectomy for LDLT from April 2010 to February 2013 were included in the study. Donors were divided into 3 groups based on the type of incision: conventional inverted L incision (n = 268; the C group), upper midline incision (n = 147; the M group), and transverse incision with laparoscopy (n = 14; the T group). Demographics, perioperative outcomes, postoperative complications for donors and recipients, and questionnaire-derived donor satisfaction with cosmetic appearance were compared. The mean age was lower (P self-confidence were noted in the M and T groups versus the C group. In conclusion, the use of a minimal incision is technically feasible for some donor hepatectomy cases with a favorable safety profile. The patient satisfaction levels were greater with improved cosmetic outcomes in cases of minimal incision versus cases of conventional incision.

  1. Le Chatelier's principle with multiple relaxation channels

    Gilmore, R.; Levine, R. D.


    Le Chatelier's principle is discussed within the constrained variational approach to thermodynamics. The formulation is general enough to encompass systems not in thermal (or chemical) equilibrium. Particular attention is given to systems with multiple constraints which can be relaxed. The moderation of the initial perturbation increases as additional constraints are removed. This result is studied in particular when the (coupled) relaxation channels have widely different time scales. A series of inequalities is derived which describes the successive moderation as each successive relaxation channel opens up. These inequalities are interpreted within the metric-geometry representation of thermodynamics.

  2. Neural control of muscle relaxation in echinoderms.

    Elphick, M R; Melarange, R


    Smooth muscle relaxation in vertebrates is regulated by a variety of neuronal signalling molecules, including neuropeptides and nitric oxide (NO). The physiology of muscle relaxation in echinoderms is of particular interest because these animals are evolutionarily more closely related to the vertebrates than to the majority of invertebrate phyla. However, whilst in vertebrates there is a clear structural and functional distinction between visceral smooth muscle and skeletal striated muscle, this does not apply to echinoderms, in which the majority of muscles, whether associated with the body wall skeleton and its appendages or with visceral organs, are made up of non-striated fibres. The mechanisms by which the nervous system controls muscle relaxation in echinoderms were, until recently, unknown. Using the cardiac stomach of the starfish Asterias rubens as a model, it has been established that the NO-cGMP signalling pathway mediates relaxation. NO also causes relaxation of sea urchin tube feet, and NO may therefore function as a 'universal' muscle relaxant in echinoderms. The first neuropeptides to be identified in echinoderms were two related peptides isolated from Asterias rubens known as SALMFamide-1 (S1) and SALMFamide-2 (S2). Both S1 and S2 cause relaxation of the starfish cardiac stomach, but with S2 being approximately ten times more potent than S1. SALMFamide neuropeptides have also been isolated from sea cucumbers, in which they cause relaxation of both gut and body wall muscle. Therefore, like NO, SALMFamides may also function as 'universal' muscle relaxants in echinoderms. The mechanisms by which SALMFamides cause relaxation of echinoderm muscle are not known, but several candidate signal transduction pathways are discussed here. The SALMFamides do not, however, appear to act by promoting release of NO, and muscle relaxation in echinoderms is therefore probably regulated by at least two neuronal signalling systems acting in parallel. Recently, other

  3. Stress Relaxation in Entangled Polymer Melts

    Hou, Ji-Xuan; Svaneborg, Carsten; Everaers, Ralf


    and into the terminal relaxation regime for Z=10. Using the known (Rouse) mobility of unentangled chains and the melt entanglement length determined via the primitive path analysis of the microscopic topological state of our systems, we have performed parameter-free tests of several different tube models. We find......We present an extensive set of simulation results for the stress relaxation in equilibrium and step-strained bead-spring polymer melts. The data allow us to explore the chain dynamics and the shear relaxation modulus, G(t), into the plateau regime for chains with Z=40 entanglements...

  4. Spin relaxation in nanowires by hyperfine coupling

    Echeverria-Arrondo, C. [Department of Physical Chemistry, Universidad del Pais Vasco UPV/EHU, 48080 Bilbao (Spain); Sherman, E.Ya. [Department of Physical Chemistry, Universidad del Pais Vasco UPV/EHU, 48080 Bilbao (Spain); IKERBASQUE Basque Foundation for Science, 48011 Bilbao, Bizkaia (Spain)


    Hyperfine interactions establish limits on spin dynamics and relaxation rates in ensembles of semiconductor quantum dots. It is the confinement of electrons which determines nonzero hyperfine coupling and leads to the spin relaxation. As a result, in nanowires one would expect the vanishing of this effect due to extended electron states. However, even for relatively clean wires, disorder plays a crucial role and makes electron localization sufficient to cause spin relaxation on the time scale of the order of 10 ns. (copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  5. Compact vs. Exponential-Size LP Relaxations

    Carr, R.D.; Lancia, G.


    In this paper we introduce by means of examples a new technique for formulating compact (i.e. polynomial-size) LP relaxations in place of exponential-size models requiring separation algorithms. In the same vein as a celebrated theorem by Groetschel, Lovasz and Schrijver, we state the equivalence of compact separation and compact optimization. Among the examples used to illustrate our technique, we introduce a new formulation for the Traveling Salesman Problem, whose relaxation we show equivalent to the subtour elimination relaxation.

  6. Relaxation time in disordered molecular systems

    Rocha, Rodrigo P. [Departamento de Física, Universidade Federal de Santa Catarina, 88040-900 Florianópolis-SC (Brazil); Freire, José A., E-mail: [Departamento de Física, Universidade Federal do Paraná, 81531-990 Curitiba-PR (Brazil)


    Relaxation time is the typical time it takes for a closed physical system to attain thermal equilibrium. The equilibrium is brought about by the action of a thermal reservoir inducing changes in the system micro-states. The relaxation time is intuitively expected to increase with system disorder. We derive a simple analytical expression for this dependence in the context of electronic equilibration in an amorphous molecular system model. We find that the disorder dramatically enhances the relaxation time but does not affect its independence of the nature of the initial state.

  7. Nuclear magnetic resonance relaxation in multiple sclerosis

    Larsson, H B; Barker, G J; MacKay, A


    OBJECTIVES: The theory of relaxation processes and their measurements are described. An overview is presented of the literature on relaxation time measurements in the normal and the developing brain, in experimental diseases in animals, and in patients with multiple sclerosis. RESULTS...... AND CONCLUSION: Relaxation time measurements provide insight into development of multiple sclerosis plaques, especially the occurrence of oedema, demyelination, and gliosis. There is also evidence that normal appearing white matter in patients with multiple sclerosis is affected. What is now needed are fast...

  8. Forensic aspects of incised wounds and bruises in pigs established post-mortem.

    Barington, Kristiane; Jensen, Henrik Elvang


    Recognizing post-mortem (PM) changes is of crucial importance in veterinary forensic pathology. In porcine wounds established PM contradicting observations regarding infiltration of leukocytes have been described. In the present study, skin, subcutis and muscle tissue sampled from experimental pigs with PM incised wounds (n=8), PM bruises (n=8) and no lesions, i.e. controls (n=4), were examined for signs of vitality over time. All tissue samples were subjected to gross and histopathological evaluation. Hemorrhages were present along the edges of PM incised wounds but deposits of fibrin were never observed. PM bruise led to hemorrhage in the subcutis visible on cross section of the skin in 3 out of 8 pigs. Histologically, hemorrhages in the subcutaneous tissue and disrupted muscle fibers were observed in PM bruises and could not be differentiated from similar lesions in ante-mortem (AM) bruises. Vital reactions, i.e. infiltrating leukocytes, hyper-leukocytosis and pavement of leukocytes, were absent in all incised wounds and bruises regardless of the time of sampling after traumatization. In conclusion, a vital reaction was not present in PM incised wounds, regardless of the time of sampling. Moreover, it was found that AM bruises free of leukocyte infiltration cannot be distinguished from PM bruises, an observation which is of crucial importance when timing bruises in forensic cases.

  9. Randomized clinical trial of small-incision and laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis

    Keus, Frederik; Werner, Johanna E. M.; Gooszen, Hein G.; Oostvogel, Henk J. M.; van Laarhoven, Cornelis J. H. M.


    Objective: To evaluate the primary and clinical outcomes in laparoscopic and small-incision cholecystectomy. Design: Blinded randomized single-center trial emphasizing methodologic quality and generalizability. Setting: General teaching hospital in the Netherlands Patients: A total of 257 patients u

  10. Effect of surgical incision management on wound infections in a poststernotomy patient population.

    Grauhan, Onnen; Navasardyan, Artashes; Tutkun, Baris; Hennig, Felix; Müller, Peter; Hummel, Manfred; Hetzer, Roland


    Skin breakdown and infiltration of skin flora are key causative elements in poststernotomy wound infections. We hypothesised that surgical incision management (SIM) using negative pressure wound therapy over closed surgical incisions for 6-7 days would reduce wound infections in a comprehensive poststernotomy patient population. 'All comers' undergoing median sternotomy at our institution were analysed prospectively from 1 September to 15 October 2013 (study group, n = 237) and retrospectively from January 2008 to December 2009 (historical control group, n = 3508). The study group had SIM (Prevena™ Therapy) placed immediately after skin suturing and applied at -125 mmHg for 6-7 days, whereas control group received conventional sterile wound tape dressings. Primary endpoint was wound infection within 30 days. Study group had a significantly lower infection rate than control group: 1·3% (3 patients) versus 3·4% (119 patients), respectively (P incision was primarily closed in 234 of 237 patients (98·7%). SIM over clean, closed incisions for the first 6-7 postoperative days significantly reduced the incidence of wound infection after median sternotomy. Based on these data SIM may be cost-effective in patients undergoing cardiac surgery.


    The composition of riparian meadow vegetation is controlled by access to groundwater. Depth to groundwater is controlled by meadow architecture and water source, and changes in either meadow architecture or water source through stream incision or changes in annual precipitation c...

  12. Iodine-impregnated incision drape and bacterial recolonization in simulated total knee arthroplasty

    Milandt, Nikolaj; Nymark, Tine; Jørn Kolmos, Hans;


    Background and purpose - Iodine-impregnated incision drapes (IIIDs) are used to prevent surgical site infection (SSI). However, there is some evidence to suggest a potential increase in SSI risk as a result of IIID use, possibly from promotion of skin recolonization. A greater number of viable...

  13. Perinipple Broken Line Incision:a Novel Approach for Breast Augmentation

    Zhi-fei Liu


    Objective To investigate reliability of the infra-nipple broken line incision for breast augmentation. Methods From January 2012 to January 2013, 15 patients underwent primary bilateral retromuscular breast augmentation with round textured silicone-gel implants and a novel infra-nipple broken line incision. Preoperatively, a semicircular incision was marked along the inferior base of the nipple. It was then extended bilaterally using two transverse right-angled geometric broken lines within the pigmented areolar skin. Follow-up was performed to evaluate the sensation of nipple-areolar complex, the scar, and the shape and texture of the breasts. Results The average follow-up was 6.7 months. Most of the patients complained of paresthesia of the nipple or breast skin, but transient decreased sensation improved within 3 months. No patients showed permanent sensory changes of the nipple areolar complex at a minimum follow-up of 4 months. The scars were imperceptible in all patients. Conclusion We believe that for selected patients, the infra-nipple broken line incision is a practical and reliable method to achieve aesthetic result.

  14. Mucosal Incision and Forceps Biopsy for Reliable Tissue Sampling of Gastric Subepithelial Tumors

    Shin, Sa Young; Lee, Sang Jin; Jun, Jae Hyuck; Park, Jong Kyu; Seo, Hyun Il; Han, Koon Hee; Kim, Young Don; Jeong, Woo Jin; Cheon, Gab Jin


    Background/Aims The diagnostic efficacy of current tissue sampling techniques for gastric subepithelial tumors (SETs) is limited. Better tissue sampling techniques are needed to improve pathological diagnosis. The aim of this study was to evaluate the safety and efficacy of a new technique, mucosal incision and forceps biopsy, for reliable tissue sampling of gastric SETs. Methods This study enrolled 12 consecutive patients who underwent mucosal incision and forceps biopsy of gastric SETs between November 2011 and September 2014 at Gangneung Asan Hospital. The medical records of patients were reviewed retrospectively. The safety and diagnostic yield of this method were evaluated. Results By performing mucosal incision and forceps biopsy, we were able to provide a definitive histological diagnosis for 11 out of 12 cases. The pathological diagnoses were leiomyoma (3/11), gastrointestinal stromal tumor (GIST; 2/11), lipoma (2/11), schwannoma (1/11), and ectopic pancreas (3/11). In cases of leiomyoma (n=3) and GIST (n=2), tissue samples were of sufficient size to allow immunohistochemical staining. In addition, the mitotic index was evaluated in two cases of GIST. There were no procedure-related complications. Conclusions Mucosal incision and forceps biopsy can be used as one of several methods to obtain adequate tissue samples from gastric SETs. PMID:26942580

  15. The 'French Fry' VAC technique: hybridisation of traditional open wound NPWT with closed incision NPWT.

    Chopra, Karan; Tadisina, Kashyap K; Singh, Devinder P


    Surgical site occurrences (SSO), specifically surgical site infections represent a significant burden in the US health care system. It has been hypothesised that postoperative dressing can help drive down SSO. We describe the successful use of a novel technique combining both closed incision and open negative pressure wound therapy in the management of a high-risk wound associated with lymphoedema of obesity.

  16. Surgical results in carpal tunnel syndrome by mid-palmar mini-incision technique

    Huseyin Balkarli


    Conclusion: Decompression of median nerve by mini-incision at the mid-palmar region protects the cutaneous branches of ulnar and median nerves, and it is a safe, effective and easy applicable method. [Hand Microsurg 2012; 1(3.000: 79-83

  17. Outcomes of single-stage total arch replacement via clamshell incision

    Ishizaka Toru


    Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

  18. Abdominoinguinal incision in adenocarcinoma of the sigmoid or cecum: report of two cases.

    Karakousis, C P; Cheng, C; Udobi, K; Lascola, R J


    This study illustrates a technique allowing resection of a sigmoid adenocarcinoma with lateral fixation and a cecal adenocarcinoma with involvement of the psoas muscle and ureter. The abdominoinguinal incision, an incision used in the resection of a sarcoma of the lower abdominal quadrants, was applied in the case of a sigmoid adenocarcinoma with posterolateral fixation and infiltration of the anterior abdominal wall and in a case of a cecal adenocarcinoma involving the right psoas muscle and ureter. In the first case, resection of the tumor mass en bloc with resection of the sigmoid and lower anterior abdominal wall muscles, including the inguinal ligament, was performed. Reconstruction of the muscular fascial defect was done with the rotation of a right rectus abdominis flap. The patient was well 12 months later. In the second case, the cecal carcinoma was resected en bloc with the right psoas and ureter; a right nephrectomy was also performed. This patient was well eight months later. The abdominoinguinal incision may provide the exposure needed to allow the resection of a sigmoid or a cecal adenocarcinoma with posterolateral fixation, often considered unresectable with conventional abdominal incisions.

  19. Single Incision, Laparoscopic-Assisted Ovariohysterectomy for Mucometra and Pyometra in Dogs.

    Wallace, Mandy L; Case, J Brad; Singh, Ameet; Ellison, Gary W; Monnet, Eric


    To describe a single-incision, laparoscopic-assisted technique for ovariohysterectomy and its application for treatment of mucometra and pyometra in dogs. Prospective case series. Seven dogs. Dogs were included if they had an open or closed pyometra or mucometra and an approximate uterine body diameter of less than 5 cm based on ultrasound or abdominal radiographs. Each dog underwent a laparoscopic-assisted ovariohysterectomy through a single-incision laparoscopic port. The procedure was performed in 6 dogs with pyometra and 1 dog with mucometra. Conversion to an open procedure was necessary in 1 dog with uterine rupture. A 2nd port was necessary in 1 dog to exteriorize the uterine body. Median uterine body diameter was 2.2 cm (range 2-3.9). The median surgical time was 85 minutes (range 40-110). Six of 7 dogs were released from the hospital at 1 day postoperative. Follow up ranged from 7 to 421 days and no complications were reported. A single-incision, laparoscopic-assisted technique for pyometra was feasible in dogs, given restricted case selection and experience with single-incision laparoscopy. © Copyright 2015 by The American College of Veterinary Surgeons.

  20. Understanding and managing the morphology of Rhine Delta branches incising into sand-clay deposits

    Sloff, C.J.; Van Spijk, A.; Stouthamer, E.; Sieben, A.


    In the Rhine-Meuse delta in the south-western part of the Netherlands, the morphology of the river branches is highly dependent on the erodibility of the subsoil. Erosion processes that were initiated after closure of the Haringvliet estuary branch by a dam (in 1970), caused a strong incision of sev

  1. The influence of incisal malocclusion on the social attractiveness of young adults in Finland.

    Kerosuo, H; Hausen, H; Laine, T; Shaw, W C


    The aim of this study was to investigate the importance of dentofacial appearance on the perceived social attractiveness of young adults in Finland. The dental arrangements studied were incisal crowding, median diastema, protruding incisors, and ideal incisal occlusion. Facial photographs of six young adults were obtained and modified, so that for each face, four different dental arrangements could be portrayed. The photographs were shown to 1007 Finnish students to estimate social and personal characteristics of the person in the photograph. Dental arrangement had a significant influence on the perceived beauty and success of the persons. Test faces with incisal crowding and median diastema were ranked as significantly less intelligent, beautiful and sexually attractive, and judged to belong to lower social class than the same faces with ideal occlusion. Protruded incisors did not affect the ratings compared to ideal occlusion. On the average, female test faces were judged more favourably than the male ones. The results indicate that among Finnish students conspicuous incisal crowding or spacing represent a social disadvantage compared to normal or protruded incisors.

  2. Minimal incisions for laparoscopic radical cystectomy with extracorporeal-assisted urinary diversion

    Chih-Chin Yu


    Conclusion: Our experience shows that LRC with extracorporeal-assisted urinary diversion using minimal incisions is a safe and feasible surgical technique with less blood loss. Further reports with a longer follow-up period and large number of cases are necessary to validate our findings.

  3. Dual daughter strand incision is processive and increases the efficiency of DNA mismatch repair

    N. Hermans (Nicolaas); C. Laffeber; M. Cristovao (Michele); Artola-Borán, M. (Mariela); Mardenborough, Y. (Yannicka); P. Ikpa (Pauline); Jaddoe, A. (Aruna); H.H.K. Winterwerp (Herrie); C. Wyman (Claire); J. Jiricny (Josef); R. Kanaar (Roland); P. Friedhoff (Peter); J.H.G. Lebbink (Joyce)


    textabstractDNA mismatch repair (MMR) is an evolutionarily-conserved process responsible for the repair of replication errors. In Escherichia coli, MMR is initiated by MutS and MutL, which activate MutH to incise transiently-hemimethylated GATC sites. MMR efficiency depends on the distribution of th

  4. [3 1/2 years experiences with ECCE with tunnel incision].

    Häberle, H; Anders, N; Antoni, H J; Pham, D T; Wollensak, J


    Since January 1992 planned extracapsular cataract extraction (ECCE) is performed routinely with the no-stitch technique at our clinic. To minimize surgically induced astigmatism further, modified wound constructions for planned ECCE with on 1.1-mm tunnel width were evaluated. The follow-up time was up to 3 years postoperatively. For 250 eyes wound closure was performed prospectively either sutureless (n = 70), with a single perpendicular suture (n = 100) or cross sutures (n = 40) at the 12 o'clock position or sutureless in the temporal position (n = 40). The complication rate was 4% (filtering bleb, iris prolapse or transient hypotonia). There were no wound ruptures, but once endophthalmitis was observed. Late mean astigmatism after up to 3 years follow-up for vertical incision was 2.05 +/- 1.16 D (1.01 +/- 0.96 D preoperatively) for sutureless wound closure, 1.63 +/- 1.08 D (0.86 +/- 0.95 D) for perpendicular and 1.76 +/- 0.88 D (0.73 +/- 0.55 D) for cross-sutures. A temporal incision resulted in 0.78 +/- 0.52 D (1.0 +/- 0.69 D) of astigmatism and was only performed on eyes with against the rule astigmatism preoperatively. Surgically induced astigmatism was stabilized early. For with the rule astigmatism preoperatively, a 12 o'clock incision with a perpendicular single suture is recommended and for against the rule astigmatism, a temporal incision.

  5. Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy

    Sato, Norihiro; Yabuki, Kei; Shibao, Kazunori; Mori, Yasuhisa; Tamura, Toshihisa; Higure, Aiichiro; Yamaguchi, Koji


    Background: A prolonged operative time is associated with adverse post-operative outcomes in laparoscopic surgery. Although a single-incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown.

  6. Laparoscopic versus small-incision cholecystectomy for patients with symptomatic cholecystolithiasis

    Keus, F.; de Jong, J. A. F.; Gooszen, H. G.; van Laarhoven, C. J. H. M.


    Background Cholecystectomy is one of the most frequently performed operations. Open cholecystectomy has been the gold standard for over 100 years. Small-incision cholecystectomy is a less frequently used alternative. Laparoscopic cholecystectomy was introduced in the 1980s. Objectives To compare the

  7. Right parasternal incision: a uniform minimally invasive approach for valve operations.

    Lazzara, R R; Kidwell, F E


    The right parasternal incision can be used for replacing or repairing cardiac valves. A specialized retractor system produces excellent exposure and helps avoid groin cannulation. The approach reduces surgical dissection and trauma, does not require sacrifice of mammary arteries, prevents rib spreading, avoids sternotomy, reduces the risk of cardiac injury at subsequent redo operations, and does not require specialized video or thoracoscopic equipment.

  8. Groundwater lowering and stream incision rates in the Central Appalachian Mountains of West Virginia, USA

    Gregory S. Springer


    Full Text Available Surface channel incision rates are of broad geomorphological interest because they set the boundary conditions for landscape change by affecting changes in local relief and hillslope angles. We report groundwater table lowering rates associated with subsurface Buckeye Creek and the surface channel of Spring Creek in southeastern West Virginia, USA. The mountainous watersheds have drainage areas of 14 km2 and 171 km2, respectively. The lowering rates are derived from U/Th-dating of stalagmites and the paleomagnetostratigraphy of clastic sediments in Buckeye Creek Cave. The oldest stalagmites have a minimum age of 0.54 Ma and we use a minimum age of 0.778 Ma for clastic cave sediments deposited during a period of reversed magnetic polarity. The water table at Buckeye Creek has lowered at a rate of ≤40 m Ma-1. Based on the relative elevations of Buckeye and Spring creeks, the water table at Spring Creek has lowered at a rate of ≤47 m Ma-1. These values are consistent with previously published rates obtained from caves in the region, although those rates were reported as surface channel incision rates, based on the assumption local groundwaters drained to the surface channel of interest. However, the rates we report are almost certainly not simple bedrock incision rates because of autogenic processes within the cave and surrounding, well-developed fluviokarst. Caveats aside, incision rates of ≤47 m Ma-1 now appear typical of landscapes of the Appalachian Mountains and Plateau.

  9. Full-Thickness Retinochoroidal Incision in the Management of Central Retinal Vein Occlusion

    San-Ni Chen


    Full Text Available Purpose. To evaluate the clinical outcomes in patients with central retinal vein occlusion (CRVO treated with full-thickness retinochoroidal incisions and to compare whether there is difference in treatment response in ischemic and nonischemic CRVO. Methods. Retrospective study of patients of CRVO receiving full-thickness retinochoroidal incisions in Changhua Christian Hospital. Fluorescein angiography (FA, slit-lamp biomicroscopy, indirect funduscopy, best corrected visual acuity, and central macular thickness (CMT measured by optical coherence tomography were performed pre- and postoperatively. Patients were divided into an ischemic and nonischemic group according to the findings of FA. Patients were followed up for at least 1 year. Results. Twenty-eight eyes (14 ischemic and 14 nonischemic CRVO were included. Functional retinochoroidal venous anastomosis (RCVA was achieved in 48 of the 65 retinochoroidal incisions (73.8%. Central macular thickness (CMT and retinal hemorrhage decreased significantly after the surgery. Significant visual gain was observed postoperatively in the nonischemic group, but not in the ischemic group. Postoperative complications included vitreous hemorrhage (17.8%, neovascular glaucoma (7.1%, and preretinal fibrovasular membrane (10.7%, all of which were in the ischemic group. Conclusions. RCVA formation induced by retinochoroidal incisions could improve venous flow, and decrease CMT and retinal hemorrhage. However, only eyes with nonischemic CRVO showed visual improvement.

  10. 1H relaxation dispersion in solutions of nitroxide radicals: Influence of electron spin relaxation

    Kruk, D.; Korpała, A.; Kubica, A.; Kowalewski, J.; Rössler, E. A.; Moscicki, J.


    The work presents a theory of nuclear (1H) spin-lattice relaxation dispersion for solutions of 15N and 14N radicals, including electron spin relaxation effects. The theory is a generalization of the approach presented by Kruk et al. [J. Chem. Phys. 137, 044512 (2012)], 10.1063/1.4736854. The electron spin relaxation is attributed to the anisotropic part of the electron spin-nitrogen spin hyperfine interaction modulated by rotational dynamics of the paramagnetic molecule, and described by means of Redfield relaxation theory. The 1H relaxation is caused by electron spin-proton spin dipole-dipole interactions which are modulated by relative translational motion of the solvent and solute molecules. The spectral density characterizing the translational dynamics is described by the force-free-hard-sphere model. The electronic relaxation influences the 1H relaxation by contributing to the fluctuations of the inter-molecular dipolar interactions. The developed theory is tested against 1H spin-lattice relaxation dispersion data for glycerol solutions of 4-oxo-TEMPO-d16-15N and 4-oxo-TEMPO-d16-14N covering the frequency range of 10 kHz-20 MHz. The studies are carried out as a function of temperature starting at 328 K and going down to 290 K. The theory gives a consistent overall interpretation of the experimental data for both 14N and 15N systems and explains the features of 1H relaxation dispersion resulting from the electron spin relaxation.

  11. Hydrogen sulfide and vascular relaxation

    SUN Yan; TANG Chao-shu; DU Jun-bao; JIN Hong-fang


    Objective To review the vasorelaxant effects of hydrogen sulfide (H2S) in arterial rings in the cardiovascular system under both physiological and pathophysiological conditions and the possible mechanisms involved.Data sources The data in this review were obtained from Medline and Pubmed sources from 1997 to 2011 using the search terms "hydrogen sulfide" and ""vascular relaxation".Study selection Articles describing the role of hydrogen sulfide in the regulation of vascular activity and its vasorelaxant effects were selected.Results H2S plays an important role in the regulation of cardiovascular tone.The vasomodulatory effects of H2S depend on factors including concentration,species and tissue type.The H2S donor,sodium hydrosulfide (NarS),causes vasorelaxation of rat isolated aortic rings in a dose-dependent manner.This effect was more pronounced than that observed in pulmonary arterial rings.The expression of KATP channel proteins and mRNA in the aortic rings was increased compared with pulmonary artery rings.H2S is involved in the pathogenesis of a variety of cardiovascular diseases.Downregulation of the endogenous H2S pathway is an important factor in the pathogenesis of cardiovascular diseases.The vasorelaxant effects of H2S have been shown to be mediated by activation of KATP channels in vascular smooth muscle cells and via the induction of acidification due to activation of the CI/HCO3 exchanger.It is speculated that the mechanisms underlying the vasoconstrictive function of H2S in the aortic rings involves decreased NO production and inhibition of cAMP accumulation.Conclusion H2S is an important endogenous gasotransmitter in the cardiovascular system and acts as a modulator of vascular tone in the homeostatic regulation of blood pressure.

  12. Comparison of stromal hydration techniques for clear corneal cataract incisions: conventional hydration versus anterior stromal pocket hydration.

    Mifflin, Mark D; Kinard, Krista; Neuffer, Marcus C


    Anterior stromal pocket hydration was compared with conventional hydration for preventing wound leak after 2.8 mm uniplanar clear corneal incisions (CCIs) in patients having routine cataract surgery. Conventional hydration involves hydration of the lateral walls of the main incision with visible whitening of the stroma. The anterior stromal pocket hydration technique involves creation of an additional supraincisional stromal pocket overlying the main incision, which is then hydrated instead of the main incision. Sixty-six eyes of 48 patients were included in the data analysis with 33 assigned to each study group. The anterior stromal pocket hydration technique was significantly better than conventional hydration in preventing wound leak due to direct pressure on the posterior lip of the incision. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. River longitudinal profiles and bedrock incision models: Stream power and the influence of sediment supply

    Sklar, Leonard; Dietrich, William E.

    The simplicity and apparent mechanistic basis of the stream power river incision law have led to its wide use in empirical and theoretical studies. Here we identify constraints on its calibration and application, and present a mechanistic theory for the effects of sediment supply on incision rates which spotlights additional limitations on the applicability of the stream power law. On channels steeper than about 20%, incision is probably dominated by episodic debris flows, and on sufficiently gentle slopes, sediment may bury the bedrock and prevent erosion. These two limits bound the application of the stream power law and strongly constrain the possible combination of parameters in the law. In order to avoid infinite slopes at the drainage divide in numerical models of river profiles using the stream power law it is commonly assumed that the first grid cell is unchanneled. We show, however, that the size of the grid may strongly influence the calculated equilibrium relief. Analysis of slope-drainage area relationships for a river network in a Northern California watershed using digital elevation data and review of data previously reported by Hack reveal that non-equilibrium profiles may produce well defined slope-area relationships (as expected in equilibrium channels), but large differences between tributaries may point to disequilibrium conditions. To explore the role of variations in sediment supply and transport capacity in bedrock incision we introduce a mechanistic model for abrasion of bedrock by saltating bedload. The model predicts that incision rates reach a maximum at intermediate levels of sediment supply and transport capacity. Incision rates decline away from the maximum with either decreasing supply (due to a shortage of tools) or increasing supply (due to gradual bed alluviation), and with either decreasing transport capacity (due to less energetic particle movement) or increasing transport capacity (due less frequent particle impacts per unit bed

  14. Anesthetic doses blocking adrenergic (stress) and cardiovascular responses to incision--MAC BAR.

    Roizen, M F; Horrigan, R W; Frazer, B M


    The reaction to stress, while vital to the conscious animal, may be detrimental to the surgical patient. To assess the stress-ablating action of different anesthetics (halothane, enflurane, morphine, and spinal) and anesthetic doses, we studied the responses in plasma norepinephrine, muscle movement, pupil diameter, heart rate, and blood pressure to induction of anesthesia and incision in 170 unpremedicated healthy adults. The age-adjusted dose (mean +/- SD) of anesthesia that blocked the adrenergic response in 50 per cent of individuals who had a skin incision (MAC BAR) was 1.45 +/- 0.08 MAC for halothane, 1.60 +/- 0.13 MAC for enflurane, or 1.13 +/- 0.09 +/- mg/kg for morphine sulfate (each anesthetic was given with 60 per cent nitrous oxide). No patient with a level of spinal anesthesia that blocked the pain of incision had an adrenergic response to incision. Increasing doses of halothane and morphine were associated with less of a cardiovascular response to incision (as measured by rate-pressure product); this was not true for enflurane. No patient with an adequate level of spinal anesthesia had a cardiovascular response to skin incision. The changes in heart rate, blood pressure, rate-pressure product, and plasma norepinephrine content that occurred with induction of anesthesia tended to equalize these values between patients, regardless of anesthetic dose, and for all individual and combined anesthetics. That is, if a patient's heart rate while awake was below 63 beats/min, heart rate tended to rise 58 per cent of the difference between heart rate while awake and 63 beats/min, and vice versa. Similarly, the change in blood pressure with induction averaged 75 per cent of the difference between systolic blood pressure while awake and 88 torr. The average for the change in rate-pressure product with induction was 79 per cent of the difference between rate-pressure product while awake and 5917 It was concluded that all the anesthetics tested can

  15. Rock slope response to fluvial incision in the central Swiss Alps

    Leith, Kerry; Fox, Matthew; Moore, Jeffrey R.


    The longitudinal profile of rivers intersecting the Rhone Valley in the central Swiss Alps suggests the development of topography throughout much of this region has been dominated by interglacial fluvial incision and ongoing tectonic uplift with only minimal glacial erosion since the mid-Pleistocene transition. Evidence indicates bedrock river incision during this period reflects a base level fall of between 500 m and 800 m (depending on the degree of overdeepening following an early period of enhanced glacial incision). This observation raises important questions regarding the preservation, or development of hillslope morphologies through multiple glacial-interglacial cycles. Since the pioneering works of Richter (1900) and Penck and Brückner (1909), Alpine geomorphologists have commented on a sequence of between three and five moderately dipping matched terraces that converge toward inferred paleo-river channels up to 800 m above the axis of many valleys. Here, we use a combination of integral analysis, forward streampower models, and a new method of topographic analysis based on high resolution LiDAR DEMs in order to test the correspondence of valley morphologies in this formerly glaciated landscape, with hillslope processes initiated by fluvial incision up to 700,000 years ago. Results indicate topography adjacent to reaches subjected to transient fluvial incision is characterized by a coherent region of consistently steep slopes, while narrow gorges correspond to rapid incision close to the Rhone valley since MIS 5. A majority of hillslopes converge to our initial fluvial valley floor, or the location of propagating knickpoints. The correspondence between intermediate-level terraces and modeled stages of river incision is, however, currently unclear. These results offer a unique insight into the long-term response of bedrock slopes to varying rates of base level fall, and the cumulative impact of glacial erosion on Alpine valley walls since MIS 11. Penck, A

  16. A model to quantify sediment mixing across alluvial piedmonts with cycles of aggradation and incision

    Malatesta, Luca C.; Berger, Quentin; Avouac, Jean-Philippe


    The accurate interpretation of clastic sedimentary records hinges on a good understanding of the timescale and mode of sediment transport from source to sink. An environmental signal can be accurately recorded in the stratigraphy if it is transported quickly without being mixed with older sediments, or it can be entirely shredded by a slow transport and significant mixing along the way. Both transformations can happen in alluvial piedmonts by successive episodes of aggradation and incision. For example, in the Tian Shan the sediment flux reaching the foreland basin is mixed with sediments of up to 0.5 Ma age, mixing and blurring the environmental signals it carries. We present here a numerical model that reproduces cycles of aggradation and incision on an alluvial fan and keeps track of the age composition in the sediment outflow. The model is based on three fundamental time- and length-scales: the period of aggradation-incision cycles, the depth of incision with respect to net aggradation, and the pattern of lateral migration. All three parameters can be reasonably easily surveyed in the field and with remote sensing. For simple geometries, we replace the numerical model with a probabilistic light analytical model. The output of both models quantifies sediment mixing in terms of the probability of finding a given minimum proportion of sediments of age T or older in the output flux. We apply and test the analytical and numerical models to the Eastern Tian Shan where we can rely on independent measurements of mixing and buffering. There, rivers repeatedly aggraded and incised 100's of meters every 20 to 30 kyr with two main effects: 1) the delivery of coarse sediments to the basin is delayed by at least 7 to 14 kyrs between being first evacuated from the mountain and later re-eroded and transported basinward; 2) the outflux of coarse sediments from the piedmont contains a significant amount of recycled material that was deposited on the piedmont as early as the

  17. “I think relax, relax and it flows a lot easier”: Exploring client-generated relax strategies

    Dianne Cirone


    Full Text Available Background. Some adult stroke survivors participating in Cognitive Orientation to daily Occupational Performance (CO-OP treatment programs self-generated relax strategies that have not been explored in previous CO-OP publications. The objective of this study was to describe the process by which adults with stroke used relax strategies and to explore the outcomes associated with their use. Methods. Secondary analysis of transcripts of intervention sessions from five participants was conducted. Results. All five participants applied relax strategies after initially observing a breakdown in performance that was attributed to increased fatigue or tension. The relax strategies used by the participants during their occupations included general relaxation, physical modifications to reduce tension, mental preparation, and pacing. The application of these strategies seemed to result in improved skill performance, reduced fatigue, and transfer to other activities. Conclusion. The relax strategy warrants further investigation as a potentially important therapeutic tool to improve occupational performance in individuals who have had a stroke.

  18. Comparison of different approaches to the surgical treatment of penile fractures: quicker return to sexual function with longitudinal incisions.

    Xu, M X; Zhou, Z; Yao, H J; Zhang, K; Da, J; Zhang, M; Wang, Z; Lu, M J


    The objective of this study was to compare the long-term clinical outcomes from longitudinal incisions and subcoronal circumferential degloving incisions in the surgical treatment of penile fractures. From July 2001 to July 2014, 23 patients were identified with penile fractures. Fourteen patients underwent longitudinal incisions after ultrasound localization; nine patients underwent subcoronal circumferential degloving incisions. Sexual function was evaluated preoperatively and postoperatively using an abridged International Index of Erectile Function (IIEF) questionnaire. The mean (±s.d.) operative time was 19.1 (±3.9) min in the longitudinal incision group and was 45.1 (±6.5) min in the subcoronal circumferential degloving incision group (P<0.05). The mean (±s.d.) times required to recover sexual function were 35.6 (±6.0) days in the longitudinal incision group and 54.0 (±5.8) days in the circumferential incision group (P<0.05). Six months postoperatively, the erectile functions of all cases were comparable to the level preoperatively except three patients. One patient from each group reported symptoms associated with mild ED, but they experienced satisfying sexual orgasms after psychotherapy for 2 months. Another patient's score on the IIEF-5 declined from 25 to 24 points in the circumferential incision group 10 months postoperatively, and this was associated with maintaining an erection after vaginal penetration. In conclusion, the longitudinal incision may allow quicker return to sexual function but not necessarily improved the long-term clinical outcomes. Furthermore, postoperative psychosocial nursing and psychotherapy should receive more attention.

  19. Bilayered negative-pressure wound therapy preventing leg incision morbidity in coronary artery bypass graft patients

    Yu, Yongchao; Song, Zhigang; Xu, Zhiyun; Ye, Xiaofei; Xue, Chunyu; Li, Junhui; Bi, Hongda


    Abstract Backgrounds: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. Methods: A single-center, pilot randomized controlled trial was conducted. From December 2013 to March 2014, a total of 72 coronary heart disease patients (48 men and 24 women) received CABG therapy, with great saphenous veins were selected as grafts. Patients were equally randomized into a treatment and a control group. After the harvesting of the great saphenous veins and direct closure of the wound with sutures, b-NPWT was used for the thigh incision in the treatment group for 5 days (treatment thigh). Traditional surgical pads were applied to both the shank incisions of the treatment group patients (treatment shank) and the entire incisions of the control group (control thigh, control shank). Postoperative complications were recorded and statistically analyzed based on outcomes of thigh treatment, shank treatment, thigh control, and shank control groups. Results: The incidence rates of early complications, such as lymphorrhagia, lymphoedema, infection, wound dehiscence, and skin flap necrosis, of the vascular donor site in the thigh treatment group was significantly lower than those in the 3 other groups. Conclusions: The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting. Trial registration: The unique registration number is NCT02010996. PMID:28099357

  20. Mini-incision microdissection testicular sperm extraction: a useful technique for men with cryptozoospermia.

    Alrabeeah, K; Witmer, J; Ruiz, S; AlMalki, A; Phillips, S; Zini, A


    Microdissection testicular sperm extraction (micro-TESE) was developed to minimize the testicular injury associated with multiple open TESEs. We sought to evaluate a mini-incision micro-TESE in men with cryptozoospermia and non-obstructive azoospermia (NOA). We conducted a retrospective study of 26 consecutive men with NOA and cryptozoospermia who underwent a primary (first) micro-TESE between March 2015 and August 2015. Final assessment of sperm recovery (reported on the day of intra-cytoplasmic sperm injection (ICSI)) was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a mini-incision micro-TESE (with limited unilateral micro-dissection) or standard/extensive (with unilateral or bilateral micro-dissection) was guided by the intra-operative identification of sperm recovery (≥5 spermatozoa) from the first testicle. Overall, sperm recovery was successful in 77% (20/26) of the men. In 37% of the men (8/26), the mini-incision micro-TESE was successful (positive sperm recovery). The remaining 18 men required a standard (extensive) microdissection: 61% (11/18) underwent a unilateral and 39% (7/18) a bilateral micro-TESE. We found that 90% (9/10) of the men with cryptozoospermia and 63% (10/16) of the men with NOA underwent a unilateral (mini or standard micro-TESE). The mini-incision micro-TESE allowed for successful sperm recovery in 60% (6/10) of the men with cryptozoospermia and 13% (2/16) of the men with NOA. The data demonstrate that a mini-incision micro-TESE together with rapid intra-operative assessment and identification of spermatozoa recovery can be useful in men undergoing microTESE, particularly, men with cryptozoospermia.

  1. Surgical management of stage I and II vulvar cancer:The role of the separated incision

    Andrijono Andrijono


    Full Text Available Vulvar cancer is a gynecological cancer whose incidence rate is relatively low. Patients generally were admitted at advanced stage, and radiation therapy at advanced stage does not provide favorable prognosis. Two main modalities in the treatment of vulvar cancer are surgery and radiation therapy. However, radiation can be performed in early stage vulvar cancer but surgery is thought to have more benefits, such as in side effect on the ovary/ reproductive function disorder, patient's hygiene factor, and the ease in performing therapy if recurrence occurs. There are various techniques of vulvar cancer surgery, such as radical vulvectomy with butterfly incision (RVBI and radical vulvectomy with separated incision (RVSI. The objective of this study was to identify the benefits of radical vulvectomy with separated incision in comparison with radical vulvectomy with butterfly incision in terms of the length of surgery, wound recovery, infection incidence, length of hospital stay. This study was a clinical trial performed during the period of 1990-2000. Fifteen cases of vulvar cancer were found and underwent surgery. Fourteen cases were at stage II and 14 cases were histologically defined as squamous-cell carcinoma and 1 case was adenocarcinoma. The average length of surgery in RVSI was 168 minutes, this was shorter than that in VRBI which reached an average of 275 minutes. The incidence of infection in RVSI group was 3 of 11 cases (27.27%, while in RVBI group all cases had infection in surgical wound. Failure of surgical wound approximation was 1 of 12 cases (9.99%, while in RVBI all cases experienced the failure such that cosmetic surgery was required. Length of postoperative care in RVSI group was 12.3 days, while in RVBI 21.5 days. Thus, complications in VRBI were lower, and length of surgery and length of postoperative care were shorter. (Med J Indones 2003; 12: 103-8 Keywords: vulvar cancer, separated incision

  2. Single-Incision Laparoscopic Cholecystectomy - can we Afford that? Cost Comparison of Different Surgical Techniques

    Matyja Maciej


    Full Text Available One of the most commonly performed surgeries in general surgery wards with laparoscopic technique as a method of choice is gall-bladder excision. In addition to -the commonly used conventional laparoscopic cholecystectomy single incision laparoscopic cholecystectomy is getting more and more attention. Despite many works and studies comparing these methods, there is still a shortage of results assessing efficiency of this new surgical technique. The aim of the study was to evaluate cost-effectiveness of this method in Polish financial reality. We have analyzed costs of three different surgical techniques: conventional (multi- incision laparoscopic cholecystectomy, SILC and ‘no -port’ SILC. Material and methods. We conducted a retrospective study that compared three groups of patients who underwent treatment with conventional laparoscopic cholecystectomy (n=20, SILC (n=20 and no-port SILC (n=20. These groups were matched by age, sex and BMI. Following parameters were analyzed: complication rate, operative time, operative costs, length of hospital stay, hospitalization costs. The SILC cases were performed with one of the three-trocar SILC ports available on the market. The ‘no- port’ SILC cases were performed by single skin incision in the umbilicus, insertion of one 10 mm trocar for the operating instrument, another instrument and scope were inserted directly thorough small incisions in the aponeurosis without a dedicated port Results. The average operative cost was significantly higher in the SILC group comparing to the conventional laparoscopy group and the no-port SILC group. There was no significant difference in complication rate, operative time, length of hospital stay, or hospitalization costs between the three groups Conclusions. Currently the cost of the dedicated SILC port does not allow a regular use of this procedure in Polish financial reality. According to our experience improved cosmesis is the only advantage of the single

  3. Slow spin relaxation in dipolar spin ice.

    Orendac, Martin; Sedlakova, Lucia; Orendacova, Alzbeta; Vrabel, Peter; Feher, Alexander; Pajerowski, Daniel M.; Cohen, Justin D.; Meisel, Mark W.; Shirai, Masae; Bramwell, Steven T.


    Spin relaxation in dipolar spin ice Dy2Ti2O7 and Ho2Ti2O7 was investigated using the magnetocaloric effect and susceptibility. The magnetocaloric behavior of Dy2Ti2O7 at temperatures where the orientation of spins is governed by ``ice rules`` (T Tice) revealed thermally activated relaxation; however, the resulting temperature dependence of the relaxation time is more complicated than anticipated by a mere extrapolation of the corresponding high temperature data [1]. A susceptibility study of Ho2Ti2O7 was performed at T > Tice and in high magnetic fields, and the results suggest a slow relaxation of spins analogous to the behavior reported in a highly polarized cooperative paramagnet [2]. [1] J. Snyder et al., Phys. Rev. Lett. 91 (2003) 107201. [2] B. G. Ueland et al., Phys. Rev. Lett. 96 (2006) 027216.

  4. Energy landscape of relaxed amorphous silicon

    Valiquette, Francis; Mousseau, Normand


    We analyze the structure of the energy landscape of a well-relaxed 1000-atom model of amorphous silicon using the activation-relaxation technique (ART nouveau). Generating more than 40 000 events starting from a single minimum, we find that activated mechanisms are local in nature, that they are distributed uniformly throughout the model, and that the activation energy is limited by the cost of breaking one bond, independently of the complexity of the mechanism. The overall shape of the activation-energy-barrier distribution is also insensitive to the exact details of the configuration, indicating that well-relaxed configurations see essentially the same environment. These results underscore the localized nature of relaxation in this material.

  5. Precession Relaxation of Viscoelastic Oblate Rotators

    Frouard, Julien


    Various perturbations (collisions, close encounters, YORP) destabilise the rotation of a small body, leaving it in a non-principal spin state. Then the body experiences alternating stresses generated by the inertial forces. The ensuing inelastic dissipation reduces the kinetic energy, without influencing the angular momentum. This yields nutation relaxation, i.e., evolution of the spin towards rotation about the maximal-inertia axis. Knowledge of the timescales needed to damp the nutation is crucial in studies of small bodies' dynamics. In the past, nutation relaxation has been described by an empirical quality factor introduced to parameterise the dissipation rate and to evade the discussion of the actual rheological parameters and their role in dissipation. This approach is unable to describe the dependence of the relaxation rate upon the nutation angle, because we do not know the quality factor's dependence on the frequency (which is a function of the nutation angle). This leaves open the question of relax...

  6. Two-Body Relaxation in Cosmological Simulations

    Binney, J; Binney, James; Knebe, Alexander


    The importance of two-body relaxation in cosmological simulations is explored with simulations in which there are two species of particles. The cases of mass ratio sqrt(2):1 and 4:1 are investigated. Simulations are run with both a fixed softening length and adaptive softening using the publicly available codes GADGET and MLAPM, respectively. The effects of two-body relaxation are detected in both the density profiles of halos and the mass function of halos. The effects are more pronounced with a fixed softening length, but even in this case they are not so large as to suggest that results obtained with one mass species are significantly affected by two-body relaxation. The simulations that use adaptive softening are slightly less affected by two-body relaxation and produce slightly higher central densities in the largest halos. They run about three times faster than the simulations that use a fixed softening length.

  7. Structural relaxation in annealed hyperquenched basaltic glasses

    Guo, Xiaoju; Mauro, John C.; Potuzak, M.


    The enthalpy relaxation behavior of hyperquenched (HQ) and annealed hyperquenched (AHQ) basaltic glass is investigated through calorimetric measurements. The results reveal a common onset temperature of the glass transition for all the HQ and AHQ glasses under study, indicating that the primary r...... relaxation is activated at the same temperature regardless of the initial departure from equilibrium. The analysis of secondary relaxation at different annealing temperatures provides insights into the enthalpy recovery of HQ glasses.......The enthalpy relaxation behavior of hyperquenched (HQ) and annealed hyperquenched (AHQ) basaltic glass is investigated through calorimetric measurements. The results reveal a common onset temperature of the glass transition for all the HQ and AHQ glasses under study, indicating that the primary...

  8. Vibrational energy relaxation in liquid oxygen

    Everitt, K. F.; Egorov, S. A.; Skinner, J. L.


    We consider theoretically the relaxation from the first excited vibrational state to the ground state of oxygen molecules in neat liquid oxygen. The relaxation rate constant is related in the usual way to the Fourier transform of a certain quantum mechanical force-force time-correlation function. A result from Egelstaff allows one instead to relate the rate constant (approximately) to the Fourier transform of a classical force-force time-correlation function. This Fourier transform is then evaluated approximately by calculating three equilibrium averages from a classical molecular dynamics simulation. Our results for the relaxation times (at two different temperatures) are within a factor of 5 of the experimental relaxation times, which are in the ms range.

  9. Analytical representations for relaxation functions of glasses

    Hilfer, R.


    Analytical representations in the time and frequency domains are derived for the most frequently used phenomenological fit functions for non-Debye relaxation processes. In the time domain the relaxation functions corresponding to the complex frequency dependent Cole-Cole, Cole-Davidson and Havriliak-Negami susceptibilities are also represented in terms of $H$-functions. In the frequency domain the complex frequency dependent susceptibility function corresponding to the time dependent stretche...

  10. Vibrational relaxation in very high temperature nitrogen

    Hansen, C. Frederick


    Vibrational relaxation of N2 molecules is considered at temperatures up to 40,000 K in gas mixtures that contain electrons as well as heavy collision partners. The theory of vibrational relaxation due to N2-N2 collisions is fit to experimental data to 10,000 K by choice of the shape of the intermolecular potential and size of the collision cross section. These values are then used to extrapolate the theory to 40,000 K.

  11. Anomalous enthalpy relaxation in vitreous silica

    Yue, Yuanzheng


    scans. It is known that the liquid fragility (i.e., the speed of the viscous slow-down of a supercooled liquid at its Tg during cooling) has impact on enthalpy relaxation in glass. Here, we find that vitreous silica (as a strong system) exhibits striking anomalies in both glass transition and enthalpy...... the fragile ones do in a structurally independent fashion. We discuss the origin of the anomalous enthalpy relaxation in the HQ vitreous silica....

  12. Message passing with relaxed moment matching

    Qi, Yuan; Guo, Yandong


    Bayesian learning is often hampered by large computational expense. As a powerful generalization of popular belief propagation, expectation propagation (EP) efficiently approximates the exact Bayesian computation. Nevertheless, EP can be sensitive to outliers and suffer from divergence for difficult cases. To address this issue, we propose a new approximate inference approach, relaxed expectation propagation (REP). It relaxes the moment matching requirement of expectation propagation by addin...

  13. Protein dynamics from nuclear magnetic relaxation.

    Charlier, Cyril; Cousin, Samuel F; Ferrage, Fabien


    Nuclear magnetic resonance is a ubiquitous spectroscopic tool to explore molecules with atomic resolution. Nuclear magnetic relaxation is intimately connected to molecular motions. Many methods and models have been developed to measure and interpret the characteristic rates of nuclear magnetic relaxation in proteins. These approaches shed light on a rich and diverse range of motions covering timescales from picoseconds to seconds. Here, we introduce some of the basic concepts upon which these approaches are built and provide a series of illustrations.

  14. Lagrange relaxation and Dantzig-Wolfe decomposition

    Vidal, Rene Victor Valqui


    The paper concerns a large-scale linear programming problem having a block-diagonal structure with coupling constraints. It is shown that there are deep connections between the Lagrange relaxation techniques and the Dantzig-Wolfe decomposition methods......The paper concerns a large-scale linear programming problem having a block-diagonal structure with coupling constraints. It is shown that there are deep connections between the Lagrange relaxation techniques and the Dantzig-Wolfe decomposition methods...

  15. Lagrange relaxation and Dantzig-Wolfe decomposition

    Vidal, Rene Victor Valqui


    The paper concerns a large-scale linear programming problem having a block-diagonal structure with coupling constraints. It is shown that there are deep connections between the Lagrange relaxation techniques and the Dantzig-Wolfe decomposition methods......The paper concerns a large-scale linear programming problem having a block-diagonal structure with coupling constraints. It is shown that there are deep connections between the Lagrange relaxation techniques and the Dantzig-Wolfe decomposition methods...

  16. Orientational relaxation in semiflexible dendrimers.

    Kumar, Amit; Biswas, Parbati


    The orientational relaxation dynamics of semiflexible dendrimers are theoretically calculated within the framework of optimized Rouse-Zimm formalism. Semiflexibility is modeled through appropriate restrictions in the direction and orientation of the respective bond vectors, while the hydrodynamic interactions are included via the preaveraged Oseen tensor. The time autocorrelation function M(i)(1)(t) and the second order orientational autocorrelation function P(i)(2)(t) are analyzed as a function of the branch-point functionality and the degree of semiflexibility. Our approach of calculating M(i)(1)(t) is completely different from that of the earlier studies (A. Perico and M. Guenza J. Chem. Phys., 1985, 83, 3103; J. Chem. Phys., 1986, 84, 510), where the expression of M(i)(1)(t) obtained from earlier studies does not demarcate the flexible dendrimers from the semiflexible ones. The component of global motion of the time autocorrelation function exhibits a strong dependence on both degree of semiflexibility and branch-point functionality, while the component of pulsation motion depends only on the degree of semiflexibility. But it is difficult to distinguish the difference in the extent of pulsation motion among the compressed (0 qualitative behavior of P(i)(2)(t) obtained from our calculations closely matches with the expression for P(exact)(2)(t) in the earlier studies. Theoretically calculated spectral density, J(ω), is found to depend on the degree of semiflexibility and the branch-point functionality for the compressed and expanded conformations of semiflexible dendrimers as a function of frequency, especially in the high frequency regime, where J(ω) decays with frequency for both compressed and expanded conformations of semiflexible dendrimers. This decay of the spectral density occurs after displaying a cross-over behavior with the variation in the degree of semiflexibility in the intermediate frequency regime. The characteristic area increases with the

  17. Dielectric relaxation spectroscopy of phlogopite mica

    Kaur, Navjeet; Singh, Mohan; Singh, Anupinder [Department of Physics, Guru Nanak Dev University, Amritsar, Punjab 143005 (India); Awasthi, A.M. [Thermodynamics Laboratory, UGC-DAE Consortium for Scientific Research, Indore 452001 (India); Singh, Lakhwant, E-mail: [Department of Physics, Guru Nanak Dev University, Amritsar, Punjab 143005 (India)


    An in-depth investigation of the dielectric characteristics of annealed phlogopite mica has been conducted in the frequency range 0.1 Hz-10 MHz and over the temperature range 653-873 K through the framework of dielectric permittivity, electric modulus and conductivity formalisms. These formalisms show qualitative similarities in relaxation processes. The frequency dependence of the M Double-Prime and dc conductivity is found to obey an Arrhenius law and the activation energy of the phlogopite mica calculated both from dc conductivity and the modulus spectrum is similar, indicating that same type of charge carriers are involved in the relaxation phenomena. The electric modulus and conductivity data have been fitted with the Havriliak-Negami function. Scaling of M Prime , M Double-Prime , ac conductivity has also been performed in order to obtain insight into the relaxation mechanisms. The scaling behaviour indicates that the relaxation describes the same mechanism at different temperatures. The relaxation mechanism was also examined using the Cole-Cole approach. The study elaborates that the investigation regarding the temperature and frequency dependence of dielectric relaxation in the phlogopite mica will be helpful for various cutting edge applications of this material in electrical engineering.

  18. Dielectric relaxation of gamma irradiated muscovite mica

    Kaur, Navjeet [Department of Physics, Guru Nanak Dev University, Amritsar, Punjab 143005 (India); Singh, Mohan, E-mail: [Department of Physics, Guru Nanak Dev University, Amritsar, Punjab 143005 (India); Singh, Lakhwant [Department of Physics, Guru Nanak Dev University, Amritsar, Punjab 143005 (India); Awasthi, A.M. [Thermodynamics Laboratory, UGC-DAE Consortium for Scientific Research, Indore 452001 (India); Lochab, S.P. [Inter-University Accelerator Centre, Aruna Asaf Ali Marg, New Delhi 110067 (India)


    Highlights: • The present article reports the effect of gamma irradiation on the dielectric relaxation characteristics of muscovite mica. • Dielectric and electrical relaxations have been analyzed in the framework of dielectric permittivity, electric modulus and Cole–Cole formalisms. • The frequency dependent electrical conductivity has been rationalized using Johnsher’s universal power law. • The experimentally measured electric modulus and conductivity data have been fitted using Havriliak–Negami dielectric relaxation function. - Abstract: In the present research, the dielectric relaxation of gamma irradiated muscovite mica was studied in the frequency range of 0.1 Hz–10 MHz and temperature range of 653–853 K, using the dielectric permittivity, electric modulus and conductivity formalisms. The dielectric constants (ϵ′ and ϵ′′) are found to be high for gamma irradiated muscovite mica as compared to the pristine sample. The frequency dependence of the imaginary part of complex electric modulus (M′′) and dc conductivity data conforms Arrhenius law with single value of activation energy for pristine sample and two values of activation energy for gamma irradiated mica sample. The experimentally assessed electric modulus and conductivity information have been interpreted by the Havriliak–Negami dielectric relaxation explanation. Using the Cole–Cole framework, an analysis of real and imaginary characters of the electric modulus for pristine and gamma irradiated sample was executed which reflects the non-Debye relaxation mechanism.

  19. Rounded stretched exponential for time relaxation functions.

    Powles, J G; Heyes, D M; Rickayzen, G; Evans, W A B


    A rounded stretched exponential function is introduced, C(t)=exp{(tau(0)/tau(E))(beta)[1-(1+(t/tau(0))(2))(beta/2)]}, where t is time, and tau(0) and tau(E) are two relaxation times. This expression can be used to represent the relaxation function of many real dynamical processes, as at long times, t>tau(0), the function converges to a stretched exponential with normalizing relaxation time, tau(E), yet its expansion is even or symmetric in time, which is a statistical mechanical requirement. This expression fits well the shear stress relaxation function for model soft soft-sphere fluids near coexistence, with tau(E)Cole-Cole plots for dielectric and shear stress relaxation (both the modulus and viscosity forms). It is shown that both the dielectric spectra and dynamic shear modulus imaginary parts approach the real axis with a slope equal to 0 at high frequency, whereas the dynamic viscosity has an infinite slope in the same limit. This indicates that inertial effects at high frequency are best discerned in the modulus rather than the viscosity Cole-Cole plot. As a consequence of the even expansion in time of the shear stress relaxation function, the value of the storage modulus derived from it at very high frequency exceeds that in the infinite frequency limit (i.e., G(infinity)).

  20. Stress relaxation in viscous soft spheres.

    Boschan, Julia; Vasudevan, Siddarth A; Boukany, Pouyan E; Somfai, Ellák; Tighe, Brian P


    We report the results of molecular dynamics simulations of stress relaxation tests in athermal viscous soft sphere packings close to their unjamming transition. By systematically and simultaneously varying both the amplitude of the applied strain step and the pressure of the initial condition, we access both linear and nonlinear response regimes and control the distance to jamming. Stress relaxation in viscoelastic solids is characterized by a relaxation time τ* that separates short time scales, where viscous loss is substantial, from long time scales, where elastic storage dominates and the response is essentially quasistatic. We identify two distinct plateaus in the strain dependence of the relaxation time, one each in the linear and nonlinear regimes. The height of both plateaus scales as an inverse power law with the distance to jamming. By probing the time evolution of particle velocities during relaxation, we further identify a correlation between mechanical relaxation in the bulk and the degree of non-affinity in the particle velocities on the micro scale.

  1. On convex relaxation of graph isomorphism.

    Aflalo, Yonathan; Bronstein, Alexander; Kimmel, Ron


    We consider the problem of exact and inexact matching of weighted undirected graphs, in which a bijective correspondence is sought to minimize a quadratic weight disagreement. This computationally challenging problem is often relaxed as a convex quadratic program, in which the space of permutations is replaced by the space of doubly stochastic matrices. However, the applicability of such a relaxation is poorly understood. We define a broad class of friendly graphs characterized by an easily verifiable spectral property. We prove that for friendly graphs, the convex relaxation is guaranteed to find the exact isomorphism or certify its inexistence. This result is further extended to approximately isomorphic graphs, for which we develop an explicit bound on the amount of weight disagreement under which the relaxation is guaranteed to find the globally optimal approximate isomorphism. We also show that in many cases, the graph matching problem can be further harmlessly relaxed to a convex quadratic program with only n separable linear equality constraints, which is substantially more efficient than the standard relaxation involving n2 equality and n2 inequality constraints. Finally, we show that our results are still valid for unfriendly graphs if additional information in the form of seeds or attributes is allowed, with the latter satisfying an easy to verify spectral characteristic.

  2. River Incision, Sediment Storage, and Sediment Residence Times at the Western Tibetan Plateau Margin

    Bloethe, J. H.; Munack, H.; Fülling, A.; Resentini, A.; Garzanti, E.; Kubik, P.; Korup, O.


    Intermediate sediment storage protects underlying bedrock from incision, buffers sediment delivery from adjacent hillslopes and provides the source for potentially catastrophic sediment release. Along the western Tibetan plateau margin, broad alluviated valleys host large valley fills. Besides sediment storage in major valleys, deeply incised bedrock gorges also have the potential to store sediment for > 104 yrs, even though they are typically portrayed as conveyor belts for incoming sediment. Here we report on cyclic aggradation and re-incision of fluvial terraces near the Tibetan plateau margin in the Ladakh and Zanskar Ranges, NW Himalaya, India. Recently reported 10Be-derived bedrock incision rates of up to 3 mm/yr suggest locally focused fast incision that contrasts with the low (~0.02 mm/yr) denudation rates of this dry high-altitude mountain desert. We combine Optically Stimulated Luminescence (OSL) and 10Be dating techniques, provenance analyses and morphometric analyses of digital elevation models (DEMs), in order to understand the Quaternary evolution of the region and to estimate sediment storage and residence times. We present the first OSL-derived dataset of fluvial fill terrace ages in the lower Zanskar gorge, a major tributary of the upper Indus River. These data are complemented by new 10Be exposure ages from fluvially polished surfaces and a 10Be depth profile of a fluvial terrace situated at the Zanskar-Indus confluence. Our data indicate at least two cycles of aggradation and re-incision. OSL ages from a terrace level 35 m above the river point to a phase of aggradation between 50 ka and 20 ka, which we attribute either to a late- or postglacial sediment pulse from the Zanskar headwaters, and/or to natural damming downstream. Preliminary results for the 10Be depth profile from the top of a terrace ~160 m above river level suggest a deposition age of > 100 ka, dating an older aggradation cycle. This higher terrace level is also present in the

  3. Comparation on the Modiifed Abdominal Transerse Incision and Longitudinal Incision for Caesarean Section%改良腹式横切口与纵切口子宫下段剖宫产效果对比



    目的探究改良腹式横切口与纵切口子宫下段剖宫产效果的对比。方法选取我院2012年3月~2015年9月收治的160例剖宫产产妇,根据剖宫手术切口不同可分为横切口组和纵切口组,分别采用改良腹式横切口和传统腹式纵切口进行剖宫产,比较两组临床效果。结果不同腹式切口下,横切口组平均开腹出血量、手术时间、术中出血量及术后排气时间均低于纵切口组,差异具有统计学意义(P<0.05)。结论相比较传统腹式纵切口,采用改良腹式横切口进行子宫下段剖宫产的手术效果更好。%Objective To compare the clinical effects of the modified abdominal transerse incision and longitudinal incision for caesarean section.Methods 160 parturient women were divided into two groups and given modified abdominal transverse incision and longitudinal incision of caesarean section respectively, who were treated in our hospital from March 2012 and September 2015, the clinical effects in the two groups were compared.Results Under different abdominal incision, the abdominal bleeding, operative time, blood loss and postoperative time in transverse incision group were signiifcantly reduced compared with the longitudinal incision group (P<0.05).Conclusion Compared with longitudinal incision, modified abdominal transverse incision of caesarean section is more effective.

  4. Late Quaternary fluvial incision rates in a marine terraced landscape, southeastern Crete, Greece

    Karymbalis, Efthimios; Papanastassiou, Dimitris; Valkanou, Kanella; Gaki-Papanastassiou, Kalliopi


    Along the southern coast of the island of Crete, a series of five east-west oriented Late Pleistocene marine terraces exist, demonstrating the significant coastal uplift of this area. These terraces, ranging in elevation from 10 to 160m, are deformed by the vertical movements of the NNE-SSW trending and dipping west normal fault of Ierapetra. This study focuses on defining rates of fluvial incision for the last 410 Ka along valley systems that drain the tectonically uplifting area of Ierapetra, south Crete. The studied streams have a N-S flow direction and discharge into the Libyan Sea. Some of them are developed on the uplifted block of the Ierapetra normal fault whereas others drain the subsiding area west of the fault. The lower reaches of the study streams cut down through these marine terraces, which have been recognized, mapped in detail and correlated with Late Pleistocene Oxygen-Isotope Stages of high sea-level stands following the global sea-level fluctuations. These terraces of known age were used as reference surfaces in order to determine fluvial incision rates as the lower reaches of the streams cut down through these platforms. To evaluate incision rates, thirty five topographic valley cross-sections were drawn through fieldwork measurements as well as using a digital elevation model (DEM) produced by detailed topographic diagrams at the scale of 1:5,000. Cross valley profiles were constructed at specific locations where streams cut down the inner edges of the marine terraces because these points correspond precisely to the age of the palaeo-shoreline during the interglacial stage. For each cross-section the ratio of valley floor width to valley height (Vf) and long-term mean stream incision rates were estimated for the last 410 Ka. The geomorphic evolution of the valleys has been mainly affected by the lithology of the bedrock, sea level fluctuations during the late Quaternary, the head-ward erosion and incision of the channels, as well as both the

  5. Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats

    Karina Genaro


    Full Text Available Background: Pain involves different brain regions and is critically determined by emotional processing. Among other areas, the rostral anterior cingulate cortex (rACC is implicated in the processing of affective pain. Drugs that interfere with the endocannabinoid system are alternatives for the management of clinical pain. Cannabidiol (CBD, a phytocannabinoid found in Cannabis sativa, has been utilized in preclinical and clinical studies for the treatment of pain. Herein, we evaluate the effects of CBD, injected either systemically or locally into the rACC, on mechanical allodynia in a postoperative pain model and on the negative reinforcement produced by relief of spontaneous incision pain. Additionally, we explored whether CBD underlies the reward of pain relief after systemic or rACC injection.Methods and Results: Male Wistar rats were submitted to a model of incision pain. All rats had mechanical allodynia, which was less intense after intraperitoneal CBD (3 and 10 mg/kg. Conditioned place preference (CPP paradigm was used to assess negative reinforcement. Intraperitoneal CBD (1 and 3 mg/kg inverted the CPP produced by peripheral nerve block even at doses that do not change mechanical allodynia. CBD (10 to 40 nmol/0.25 μL injected into the rACC reduced mechanical allodynia in a dose-dependent manner. CBD (5 nmol/0.25 μL did not change mechanical allodynia, but reduced peripheral nerve block-induced CPP, and the higher doses inverted the CPP. Additionally, CBD injected systemically or into the rACC at doses that did not change the incision pain evoked by mechanical stimulation significantly produced CPP by itself. Therefore, a non-rewarding dose of CBD in sham-incised rats becomes rewarding in incised rats, presumably because of pain relief or reduction of pain aversiveness.Conclusion: The study provides evidence that CBD influences different dimensions of the response of rats to a surgical incision, and the results establish the rACC as a

  6. Experimental investigation of fluvial incision on Titan by low-velocity sediment impacts

    Polito, P. J.; Zygielbaum, B. R.; Sklar, L. S.; Collins, G.


    Images returned by the Cassini-Huygens mission reveal evidence for widespread fluvial incision in the polar regions of Titan. Dendritic channel networks draining to large lakes and the absence of cratering suggest active incision into Titan's water-ice bedrock surface. Previous work using the saltation-abrasion bedrock incision model suggests that a terrestrial channel transposed to Titan conditions would incise at remarkably similar rates, because the effects of Titan's lower gravity and less-dense sediments are offset by a much lower resistance to abrasion for ice than rock of similar strength. Here we report new laboratory measurements of ice erosion by low-velocity sediment impacts, part of a larger study investigating the temperature dependence of the material properties that control ice erodibility. We measure the energy required to erode a unit volume of ice using drop tests, in which a 110-150 g ice clast falls 5-10 cm onto a 20 cm diameter ice disk, and differences in mass and measurements of ice density are used to calculate the volume eroded. We construct the 10cm thick ice disks using 2-4 mm seed crystals and near-freezing distilled water. After freezing at 253 K a disk is placed in the bottom of a steel cylinder surrounded by dry ice and liquid nitrogen is pumped into the cylinder from below, chilling the ice to near-Titan temperatures for several hours but never submerging the samples (all drop test trials are completed in air). Our preliminary drop test results show that 4 J and 25 J are required to erode 1 cm3 of ice at temperatures of 205 K and110 K respectively, suggesting that ice may be no more than 2-3 times more erodible than previously-tested rocks of similar tensile strengths. A key limitation of this experimental method is the small size of our target disks, which fail catastrophically by through-cracking after several hundred drops. To avoid through-cracking and obtain direct measurements of ice surface erosion, we are preparing new

  7. Caesarean section: could different transverse abdominal incision techniques influence postpartum pain and subsequent quality of life? A systematic review.

    Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Di Gangi, Stefania; Quaranta, Michela; Cosmi, Erich; D'Antona, Donato; Nardelli, Giovanni Battista; Ambrosini, Guido


    The choice of the type of abdominal incision performed in caesarean delivery is made chiefly on the basis of the individual surgeon's experience and preference. A general consensus on the most appropriate surgical technique has not yet been reached. The aim of this systematic review of the literature is to compare the two most commonly used transverse abdominal incisions for caesarean delivery, the Pfannenstiel incision and the modified Joel-Cohen incision, in terms of acute and chronic post-surgical pain and their subsequent influence in terms of quality of life. Electronic database searches formed the basis of the literature search and the following databases were searched in the time frame between January 1997 and December 2013: MEDLINE, EMBASE Sciencedirect and the Cochrane Library. Key search terms included: "acute pain", "chronic pain", "Pfannenstiel incision", "Misgav-Ladach", "Joel Cohen incision", in combination with "Caesarean Section", "abdominal incision", "numbness", "neuropathic pain" and "nerve entrapment". Data on 4771 patients who underwent caesarean section (CS) was collected with regards to the relation between surgical techniques and postoperative outcomes defined as acute or chronic pain and future pregnancy desire. The Misgav-Ladach incision was associated with a significant advantage in terms of reduction of post-surgical acute and chronic pain. It was indicated as the optimal technique in view of its characteristic of reducing lower pelvic discomfort and pain, thus improving quality of life and future fertility desire. Further studies which are not subject to important bias like pre-existing chronic pain, non-standardized analgesia administration, variable length of skin incision and previous abdominal surgery are required.

  8. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

    Hasan Razmjoo


    Full Text Available Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.

  9. Seismic facies of incised-channel fill deposits of paleo-Seomjin River in the South Sea, Korea

    Bae, Sung Ho; Kong, Gee Soo; Choul Kim, Dae; Lee, Gwang Soo; Yoo, Dong Geun


    High-resolution (Chirp and Sparker system) seismic profiles and piston core samples were analyzed to investigate the depositional environment of paleo-channel in the continental shelf of South Sea. Approximately 1,940 line-km data of chirp and sparker profiles was acquired. Along with seismic profiles, 20 piston core and 10 box core samples collected in 2015. The paleo-channel of Seomjin River is distributed in the continental shelf, with approximately 109 km long, 800-5,000 m wide, and more than 890 km2. The paleo-channel of meandering and straight type is dominant in the inner shelf while changed to braided type in the outer shelf. The paleo-channels in sparker seismic data formed presumably as fluvial systems when the shelf was exposed during the Last Glacial Maximum (LGM). The seismic facies of incision fill divided into five types basis of an erosional surface and internal seismic reflectors: (1) transparent to semi-transparent incised channel fill, (2) parallel to sub-parallel incised channel fill, (3) complex incised channel fill, (4) divergent incised channel fill, and (5) chaotic incised channel fill. The chaotic incised channel fill deposits are consists of gravel with shell fragments in the outer shelf and indicate the LGM to early transgressive (fluvial lag deposits). The complex incised channel fill deposits are dominated by sand and gravel with shell fragments in the mid to outer shelf. The cores which were obtained above the transparent to semi-transparent and parallel to sub-parallel incised channel fill deposits are dominated by mud. These types are dominant in the upstream (inner shelf). The acoustically transparent zones of this type with low-energy, passively infilling depositional environment, suggest the presence of basin muddy deposits. These muddy sediments were likely deposited during a more advanced stage of the Holocene transgression. Thus, the paleo-channel of Seomjin River is strongly controlled by sea-level change and sediment

  10. The use of (double) relaxation oscillation SQUIDs as a sensor

    Duuren, van M.J.; Brons, G.C.S.; Kattouw, H.; Flokstra, J.; Rogalla, H.


    Relaxation Oscillation SQUIDs (ROSs) and Double Relaxation Oscillation SQUIDs (DROSs) are based on relaxation oscillations that are induced in hysteretic dc SQUIDs by an external L-R shunt. The relaxation frequency of a ROS varies with the applied flux Φ, whereas the output of a DROS is a dc voltage

  11. The use of (double) relaxation oscillation SQUIDs as a sensor

    van Duuren, M.J.; Brons, G.C.S.; Kattouw, H.; Flokstra, Jakob; Rogalla, Horst


    Relaxation Oscillation SQUIDs (ROSs) and Double Relaxation Oscillation SQUIDs (DROSs) are based on relaxation oscillations that are induced in hysteretic dc SQUIDs by an external L-R shunt. The relaxation frequency of a ROS varies with the applied flux Φ, whereas the output of a DROS is a dc

  12. Time scales of relaxation dynamics during transient conditions in two-phase flow: RELAXATION DYNAMICS

    Schlüter, Steffen [School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis Oregon USA; Department Soil Physics, Helmholtz-Centre for Environmental Research-UFZ, Halle Germany; Berg, Steffen [Shell Global Solutions International B.V., Rijswijk Netherlands; Li, Tianyi [School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis Oregon USA; Vogel, Hans-Jörg [Department Soil Physics, Helmholtz-Centre for Environmental Research-UFZ, Halle Germany; Institut für Agrar- und Ernährungswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle Germany; Wildenschild, Dorthe [School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis Oregon USA


    The relaxation dynamics toward a hydrostatic equilibrium after a change in phase saturation in porous media is governed by fluid reconfiguration at the pore scale. Little is known whether a hydrostatic equilibrium in which all interfaces come to rest is ever reached and which microscopic processes govern the time scales of relaxation. Here we apply fast synchrotron-based X-ray tomography (X-ray CT) to measure the slow relaxation dynamics of fluid interfaces in a glass bead pack after fast drainage of the sample. The relaxation of interfaces triggers internal redistribution of fluids, reduces the surface energy stored in the fluid interfaces, and relaxes the contact angle toward the equilibrium value while the fluid topology remains unchanged. The equilibration of capillary pressures occurs in two stages: (i) a quick relaxation within seconds in which most of the pressure drop that built up during drainage is dissipated, a process that is to fast to be captured with fast X-ray CT, and (ii) a slow relaxation with characteristic time scales of 1–4 h which manifests itself as a spontaneous imbibition process that is well described by the Washburn equation for capillary rise in porous media. The slow relaxation implies that a hydrostatic equilibrium is hardly ever attained in practice when conducting two-phase experiments in which a flux boundary condition is changed from flow to no-flow. Implications for experiments with pressure boundary conditions are discussed.

  13. Anomalous Enthalpy Relaxation in Vitreous Silica

    Yuanzheng eYue


    Full Text Available It is a challenge to calorimetrically determine the glass transition temperature (Tg of vitreous silica. Here we demonstrate that this challenge mainly arises from the extreme sensitivity of the Tg to the hydroxyl content in vitreous silica, but also from the irreversibility of its glass transition when repeating the calorimetric scans. It is known that the liquid fragility (i.e., the speed of the viscous slow-down of a supercooled liquid at its Tg during cooling has impact on enthalpy relaxation in glass. Here we find that vitreous silica (as a strong system exhibits striking anomalies in both glass transition and enthalpy relaxation compared to fragile oxide systems. The anomalous enthalpy relaxation of vitreous silica is discovered by performing the hperquenching-annealing-calorimetry experiments. We argue that the strong systems like vitreous silica and vitreous Germania relax in a structurally cooperative manner, whereas the fragile ones do in a structurally independent fashion. We discuss the origin of the anomalous enthalpy relaxation in the HQ vitreous silica.

  14. Motional Spin Relaxation in Large Electric Fields

    Schmid, Riccardo; Filippone, B W


    We discuss the precession of spin-polarized Ultra Cold Neutrons (UCN) and $^{3}\\mathrm{He}$ atoms in uniform and static magnetic and electric fields and calculate the spin relaxation effects from motional $v\\times E$ magnetic fields. Particle motion in an electric field creates a motional $v\\times E$ magnetic field, which when combined with collisions, produces variations of the total magnetic field and results in spin relaxation of neutron and $^{3}\\mathrm{He}$ samples. The spin relaxation times $T_{1}$ (longitudinal) and $T_{2}$ (transverse) of spin-polarized UCN and $^{3}\\mathrm{He}$ atoms are important considerations in a new search for the neutron Electric Dipole Moment at the SNS \\emph{nEDM} experiment. We use a Monte Carlo approach to simulate the relaxation of spins due to the motional $v\\times E$ field for UCN and for $^{3}\\mathrm{He}$ atoms at temperatures below $600 \\mathrm{mK}$. We find the relaxation times for the neutron due to the $v\\times E$ effect to be long compared to the neutron lifetime, ...

  15. Doppler effect induced spin relaxation boom

    Zhao, Xinyu; Huang, Peihao; Hu, Xuedong


    We study an electron spin qubit confined in a moving quantum dot (QD), with our attention on both spin relaxation, and the product of spin relaxation, the emitted phonons. We find that Doppler effect leads to several interesting phenomena. In particular, spin relaxation rate peaks when the QD motion is in the transonic regime, which we term a spin relaxation boom in analogy to the classical sonic boom. This peak indicates that a moving spin qubit may have even lower relaxation rate than a static qubit, pointing at the possibility of coherence-preserving transport for a spin qubit. We also find that the emitted phonons become strongly directional and narrow in their frequency range as the qubit reaches the supersonic regime, similar to Cherenkov radiation. In other words, fast moving excited spin qubits can act as a source of non-classical phonons. Compared to classical Cherenkov radiation, we show that quantum dot confinement produces a small but important correction on the Cherenkov angle. Taking together, these results have important implications to both spin-based quantum information processing and coherent phonon dynamics in semiconductor nanostructures.

  16. Umbilical incision laparoscopic surgery with one assist port for an elderly patient with recurrent sigmoid volvulus.

    Matsuoka, Tasuku; Osawa, Naoshi; Yoh, Taiho; Hirakawa, Kosei


    Single-port access laparoscopic surgery has recently emerged as a method to improve morbidity and cosmetic benefit of conventional laparoscopic surgery. Herein, we report the experience of transumbilical incision laparoscopic sigmoidectomy with one assist port in a 71-year-old man who had developed recurrent sigmoid volvulus in these several years since his first visit to the hospital. The patient presented abdominal distension and severe constipation. A plain x-ray film and CT of the abdomen showed grossly distended sigmoid colon loops and stenosis of recto-sigmoid colon. Sigmoid volvulus associated with megacolon was diagnosed and emergence endoscopic decompression was performed. After his condition improved, transumbilical incision laparoscopic sigmoidectomy was carried out as the minimally invasive approach, due to the several risk of patient such as aging and pulmonary disorder. Postoperative course was uneventful and on postoperative visit to the hospital he reported resolution of abdominal distension.

  17. Vaginal Delivery After Dührssen Incisions in a Patient With Bladder Exstrophy and Uterine Prolapse.

    Lachica, Ruben; Chan, Yen; Uquillas, Kristen R; Lee, Richard H


    Bladder exstrophy is a rare congenital anomaly affecting the lower abdominal wall, pelvis, and genitourinary structures. Pregnant women with bladder exstrophy present a unique challenge to the obstetrician. The patient is a 35-year old pregnant woman with bladder exstrophy, an extensive surgical history, and uterine prolapse with an abnormal, rubbery consistency to her cervix. Prenatally, she was counseled on the potential use of Dührssen incisions to facilitate vaginal delivery. Labor was induced at 36 4/7 weeks of gestation after her pregnancy was complicated by recurrent pyelonephritis. Vaginal delivery was achieved 8 minutes after the creation of Dührssen incisions. The care of pregnant women with bladder exstrophy requires multidisciplinary management and careful delivery planning. Successful vaginal delivery can be attained in these patients.

  18. Trans-tragal incision for improved exposure of diacapitular and condylar neck fractures.

    Pau, M; Feichtinger, M; Reinbacher, K E; Ivancic, P; Kärcher, H


    The authors present a modification of the preauricular approach that improves the exposure of the condyle whilst reducing diacapitular and condylar neck fractures. The incision is a combination of the hockey-stick and endaural incisions. Its inferior part runs within the ear on the posterior face of the tragus; the tragal cartilage is transected together with the retrotragal skin and included in the anterior skin flap. Between May 2009 and December 2010, 16 patients with diacapitular or condylar neck fractures were treated with this approach. All patients showed good occlusion postoperatively and satisfactory aesthetic results. No infection or cartilage necrosis was observed in this series. This approach improves the exposure of the condylar head during the reduction of diacapitular and condylar neck fractures, ensuring easier internal fixation and good cosmetic results.

  19. Clinical evaluation of a two-incision fistula technique for the treatment of oral ranulas.

    Wang, Shaoyi; Zhang, Zhiyuan; Yang, Chi


    Oral ranulas are caused by extravasation of mucus from the sublingual glands, and the preferred treatment varies. We have developed a two-incision fistula operation for their treatment, and in this clinical study we have evaluated the efficacy and safety of this approach. Twelve patients with oral ranulas confirmed by fine needle aspiration cytology were enrolled and gave their consent to be treated by our new technique. The clinical outcomes and complications were evaluated during a period that ranged from 8-24 months. Nine ranulas became smaller and gradually disappeared, and there were no complications or injury to Wharton's duct. Three ranulas recurred, but disappeared after a second operation. The two-incision fistula operation can be effective and safe as an initial treatment for oral ranulas, and the method may become the preferred management for retention cysts.

  20. OSL dating of fluvial terraces for incision rate estimation and indication of neotectonic activity in Pamir

    Fuchs, M. C.; Gloaguen, R.; Krbetschek, M.; Szulc, A.


    ThePamir owes its special attraction for geo-scientists to being among Earth's largest intra-continental orogens and to display some of the highest uplift rates as well as to host among the most powerful river systems on the planet. The evolution of the drainage network as a proxy for the landscape's response to tectonic signals provides a powerful tool to study neotectonics. The relation between tectonic forcing and surface response is indicated by structural anomalies (e.g. river-capture, river-reversal or -deflection) and spatial differences of process rates (e.g. incision rates). We combine OSL dating with remote sensing tectonic geomorphology in order to determine the zones of active deformation in the Quaternary. The local drainage system of the study region aligns mainly to the east-west-trending belts of shortening, which results from the ongoing northward propagation of the Indian plate. In contrast the major trunk river, the Panj, is unusual in that it deflects northwards and then doubles back to the southwest, cutting the southern and central Pamir doming and several other major Cenozoic deformation zones. We use fluvial terraces along the deflected north-south orientated part including the doubled back prolongation of the more or less normal orientated Panj. These sediment bodies are used as a geomorphic record to reveal changes in the balance between sediment flux and discharge. Dating these fluvial terraces by OSL provides the burial ages of the sediments indicating periods of sedimentation. The remains of those periods are far from equally distributed and mark the time of local conditions for sedimentation as especially the close neighbourhood of most of the terraces from the two youngest periods demonstrate. Precise measurements of the heights of the dated terraces with respect to the present river level based on relative kinematic GPS quantify the total vertical incision of the river subsequent to the sedimentation and abandonment. Incision rates

  1. Reduced-Complexity Semidefinite Relaxations of Optimal Power Flow Problems

    Andersen, Martin Skovgaard; Hansson, Anders; Vandenberghe, Lieven


    We propose a new method for generating semidefinite relaxations of optimal power flow problems. The method is based on chordal conversion techniques: by dropping some equality constraints in the conversion, we obtain semidefinite relaxations that are computationally cheaper, but potentially weaker......, than the standard semidefinite relaxation. Our numerical results show that the new relaxations often produce the same results as the standard semidefinite relaxation, but at a lower computational cost....

  2. Transpapillary incision of refractory circumscript pancreatic duct stricture using wire-guided snare forceps

    Takao; Itoi; Atsushi; Sofuni; Fumihide; Itokawa; Toshio; Kurihara; Takayoshi; Tsuchiya; Kentaro; Ishii; Shujiro; Tsuji; Nobuhito; Ikeuchi; Fuminori; Moriyasu


    Endoscopic therapy of pancreatic duct(PD)strictures using balloon dilation and pancreatic duct stent(PS) placement has been reported to improve the severity of abdominal pain in selected patients with chronic pancreatitis(CP).However,some strictures are refractory and require frequent PS exchange to control symptoms.We describe two cases of successful endoscopic PD incision for difficult PD stricture using a wireguided snare.The snare is partially opened within the strictured pancreatic duct while applying ...

  3. Differential uplift and incision of the Yakima River terraces, central Washington State

    Bender, Adrian M; Amos, Colin B.; Bierman, Paul R.; Rood, Dylan; Staisch, Lydia; Kelsey, Harvey M.; Sherrod, Brian


    The fault-related Yakima folds deform Miocene basalts and younger deposits of the Columbia Plateau in central Washington State. Geodesy implies ~2 mm/yr of NNE directed shortening across the folds, but until now the distribution and rates of Quaternary deformation among individual structures has been unclear. South of Ellensburg, Washington, the Yakima River cuts a ~600 m deep canyon across several Yakima folds, preserving gravel-mantled strath terraces that record progressive bedrock incision and related rock uplift. Here we integrate cosmogenic isochron burial dating of the strath terrace gravels with lidar analysis and field mapping to quantify rates of Quaternary differential incision and rock uplift across two folds transected by the Yakima River: Manastash and Umtanum Ridge. Isochron burial ages from in situ produced 26Al and 10Be at seven sites across the folds date episodes of strath terrace formation over the past ~2.9 Ma. Average bedrock incision rates across the Manastash (~88 m/Myr) and Umtanum Ridge (~46 m/Myr) anticlines are roughly 4 to 8 times higher than rates in the intervening syncline (~14 m/Myr) and outside the canyon (~10 m/Myr). These contrasting rates demonstrate differential bedrock incision driven by ongoing Quaternary rock uplift across the folds at rates corresponding to ~0.13 and ~0.06 mm/yr shortening across postulated master faults dipping 30 ± 10°S beneath the Manastash and Umtanum Ridge anticlines, respectively. The reported Quaternary shortening across the anticlines accounts for ~10% of the ~2 mm/yr geodetic budget, suggesting that other Yakima structures actively accommodate the remaining contemporary deformation.

  4. Impact of rock uplift on rates of late Cenozoic Rocky Mountain river incision

    Riihimaki, Catherine A.; Anderson, Robert S.; Safran, Elizabeth B.


    The high relief of the modern Rocky Mountain landscape formed in the late Cenozoic by downcutting of a fluvial network that links a series of easily eroded sedimentary basins across relatively resistant crystalline cores of adjacent ranges. Using a numerical model of fluvial erosion and the flexural isostatic response to the associated unloading, we first calculate the expected pattern and pace of incision caused by rock uplift related to migration of the Yellowstone hot spot and to growth of the northern portion of the Rio Grande rift. Calculated incision rates are <60 m/Myr, and total depth of erosion of sedimentary basins is <300 m, well below the long-term incision rates and amounts of erosion interpreted from the geologic record. Broad-scale tilting of the region toward the east, accomplished by a gradient in rock uplift of ˜1 km along the north-south axis of the central Rockies, declining to zero 1000 km to the east, can account for the additional erosion needed to match observations. In each modeling scenario, stream incision is nonsteady, with rock uplift outpacing erosion for <1 Myr in perimeter basins and 1-5 Myr in interior basins. Three factors dominate the spatial and temporal pattern of regional landscape evolution: (1) the time since uplift began, (2) the uplift pattern, and (3) the distribution of relatively resistant bedrock within the region. Our results suggest that the spatial variability in late Cenozoic exhumation can be explained by a long-lived transience in the stream network response to these various late Cenozoic geophysical events.

  5. Holographic interferometry of intact and radially incised human eye-bank corneas.

    Smolek, M K


    Many methods to measure corneal elasticity destroy the tissue and thereby produce erroneous results. Holographic interferometry, a highly precise nondestructive optical comparison technique, was used to evaluate corneal elasticity of intact eye-bank eyes. A double-pulse holographic interferometer operating at 632.8 nm was used to measure corneal deformation in 20 whole-globe eyes from donors 45 to 83 years of age for intraocular pressures from 16 mm Hg to 21 mm Hg. Stress was computed from LaPlace's law, and arc length strain was derived from z-axis distention of the central cornea. The stress-strain relationship in the normal physiological range of intraocular pressure was linear with a Young's elastic modulus of 1.03 gigapascals for the central cornea (r = 0.999). During interferometry of radial keratotomy of the cornea, interference fringe patterns developed in association with each incision as it was made. When four incisions were placed deep along each of the primary semimeridians, the fringe pattern developed as expected, based on current keratotomy models. When incisions were shallow (approximately 50% depth) and placed asymmetrically along the nasal, temporal, and superior semimeridians, the resulting surface strain was symmetrical about the central cornea, forming an annular pattern of interference fringes. These results indicate that when the cornea was stressed at physiological pressures as part of the intact whole globe, it was less elastic than excised corneal tissue tested by strip extensiometry. Radially incised corneas demonstrated strain patterns suggestive of inherent structural anisotropy with a possible inferior quadrant weakness.

  6. Use of tubularized incised plate urethroplasty for secondary hypospadias repair or repair in circumcised patients


    PURPOSE: To retrospectively review our experience of the tubularized incised plate (TIP) urethroplasty in a series of re-operative hypospadias repairs or circumcised children. MATERIALS AND METHODS: Between September 2001 and September 2007, 17 children (mean 4.6 years, range 7 months to 15 years), were referred for hypospadias re-operation. Some of these patients had previously undergone circumcision and missed hypospadias. In all cases, the TIP urethroplasty was covered with an additional l...

  7. Tunica vaginalis flap following ′Tubularised Incised Plate′ urethroplasty to prevent urethrocutaneous fistulaa


    Introduction: Surgery for hypospadias has been continuously evolving, implying thereby that no single technique is perfect and suitable for all types of hypospadias. Snodgrass technique is presently the most common surgical procedure performed for hypospadias. Materials and Methods: We analysed the results of tunica vaginalis flap (TVF) as an additional cover to the tubularised incised plate (TIP) repair. Results: A total of 35 patients of hypospadias were repaired using TIP urethroplasty and...

  8. Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population.

    Hugoson, A; Bergendal, T; Ekfeldt, A; Helkimo, M


    The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.

  9. [Modified limited L incision with distraction bone block arthrodesis for subtalar osteoarthritis].

    Li, Yi; Zhao, Hong-Mou; Liang, Xiao-Jun; Liu, Cheng; Zhao, Kai; Yang, Jie


    To evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis. From March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation. There was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01). The modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

  10. Comparison of Minimal Skin Incision Technique in Living Kidney Transplantation and Conventional Kidney Transplantation

    Sang-Dong Kim; Ji-II Kim; In-Sung Moon; Sun-Cheol Park


    Background:Recently,the most common incision for kidney transplantation (KT) is an inverted J-shaped incision known as the "hockey-stick." However,demands for minimally invasive surgery in KT are increasing as in other various fields of surgery.Hence,we evaluated whether there is difference between minimal skin incision technique in kidney transplantation (MIKT) and conventional KT (CKT).Methods:Between June 2006 and March 2013,a total of 452 living kidney transplant patients were enrolled.The MIKT group included 17 young unmarried women whose body mass index was <25 kg/m2 and had no anatomic variation.The CKT group included 435 patients.The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed.We compared the baseline clinical characteristics and postoperative results between two groups.For proper comparison,propensity score matching was implemented.Results:There was no difference in graft function,survival,and postoperative complication rate between MIKT and CKT groups (all P > 0.05).The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups,respectively (P =0.786).Conclusions:Our results indicated that MIKT showed more favorable cosmetic results,and there were no statistical differences in various postoperative factors including graft function,survival,and complications compared with CKT.Hence,we suggested that MIKT is an appropriate method for selected patients in living KT.

  11. Radiofrequency catheter ablation of atrial tachycardias related to myocardial scar or incision

    Jianqiang HU; Jiang CAO; Shengqiang WANG; Yongwen QIN; Bingyan ZHOU


    Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was <30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences <30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

  12. White ring sign for uneventful lenticule separation in small-incision lenticule extraction.

    Jacob, Soosan; Nariani, Ashiyana; Figus, Michele; Agarwal, Amar; Agarwal, Athiya


    We describe the white ring sign, which differentiates the posterior and anterior lenticular planes in small-incision lenticule extraction. The sign identifies the plane of dissection by the anteroposterior relationship between the dissecting instrument and the circular white light reflected from the lenticular side cut. Differentiating the planes enables the surgeon to dissect the anterior plane before the posterior plane, which facilitates smooth lenticule extraction and prevents complications such as cap tears, partial lenticule dissection, and a torn lenticule.

  13. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure

    Agrawal Amit; Malleswara Rao G.


    Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to de...

  14. Single-incision and NOTES cholecystectomy, are there clinical or cosmetic advantages when compared to conventional laparoscopic cholecystectomy? A case-control study comparing single-incision, transvaginal, and conventional laparoscopic technique for cholecystectomy

    Boezem, P.B. van den; Velthuis, S.; Lourens, H.J.; Cuesta, M.A.; Sietses, C.


    BACKGROUND: The aim of the present study was to compare the clinical and cosmetic results of transvaginal hybrid cholecystectomy (TVC), single-port cholecystectomy (SPC), and conventional laparoscopic cholecystectomy (CLC). Recently, single-incision laparoscopic surgery and natural orifice translumi

  15. Mozart versus new age music: relaxation states, stress, and ABC relaxation theory.

    Smith, Jonathan C; Joyce, Carol A


    Smith's (2001) Attentional Behavioral Cognitive (ABC) relaxation theory proposes that all approaches to relaxation (including music) have the potential for evoking one or more of 15 factor-analytically derived relaxation states, or "R-States" (Sleepiness, Disengagement, Rested / Refreshed, Energized, Physical Relaxation, At Ease/Peace, Joy, Mental Quiet, Childlike Innocence, Thankfulness and Love, Mystery, Awe and Wonder, Prayerfulness, Timeless/Boundless/Infinite, and Aware). The present study investigated R-States and stress symptom-patterns associated with listening to Mozart versus New Age music. Students (N = 63) were divided into three relaxation groups based on previously determined preferences. Fourteen listened to a 28-minute tape recording of Mozart's Eine Kleine Nachtmusik and 14 listened to a 28-minute tape of Steven Halpern's New Age Serenity Suite. Others (n = 35) did not want music and instead chose a set of popular recreational magazines. Participants engaged in their relaxation activity at home for three consecutive days for 28 minutes a session. Before and after each session, each person completed the Smith Relaxation States Inventory (Smith, 2001), a comprehensive questionnaire tapping 15 R-States as well as the stress states of somatic stress, worry, and negative emotion. Results revealed no differences at Session 1. At Session 2, those who listened to Mozart reported higher levels of At Ease/Peace and lower levels of Negative Emotion. Pronounced differences emerged at Session 3. Mozart listeners uniquely reported substantially higher levels of Mental Quiet, Awe and Wonder, and Mystery. Mozart listeners reported higher levels, and New Age listeners slightly elevated levels, of At Ease/Peace and Rested/Refreshed. Both Mozart and New Age listeners reported higher levels of Thankfulness and Love. In summary, those who listened to Mozart's Eine Kleine Nachtmusik reported more psychological relaxation and less stress than either those who listened to

  16. The supraorbital keyhole approach with eyebrow incisions for treating lesionsin the anterior fossa and sellar region

    张懋植; 王磊; 张伟; 齐巍; 王嵘; 韩小弟; 赵继宗


    Background Keyhole surgery has developed since the 1990s as a less invasive therapeutic strategy for intracranial lesions, initially for the treatment of intracranial aneurysms. The purpose of this study was to describe and evaluate the results of surgical treatment of lesions in the anterior fossa and sellar region via a supraorbital keyhole approach using eyebrow incisions. Methods Between April 1994 and July 2003, 54 patients with lesions in the anterior fossa and sellar region were operated on via the supraorbital keyhole approach. The surgical results were studied retrospectively and compared with that of patients with lesions at the same locations but treated via a conventional subfrontal approach.Results No significant difference in curative effect was found between the conventional subfrontal approach and the supraorbital keyhole approach. However, the supraorbital approach required a much smaller skin incision, causing less surgical trauma, while achieving excellent surgical exposure and good recovery.Conclusion The supraorbital keyhole approach using an eyebrow incision is safe, effective, and both suitable and convenient for treating lesions in the anterior fossa and sellar region, with almost no adverse consequences on the facial features of patients.

  17. Clinical Trial of Manual Small Incision Surgery and Standard Extracapsular Surgery

    Parikshit Gogate


    Full Text Available Introduction. Manual small incision cataract surgery (MSICS is used increasingly for cataract extraction and intraocular lens implantation. It is thought that the small wound heals faster than a conventional incision, leading to less astigmatism and a better uncorrected visual acuity. This is important as many patients do not wear or cannot afford spectacles after surgery, which means that their uncorrected visual acuity is what they rely on to carry out their every day functions. Often this is less than 6/18 on the Snellen’s chart, which would fall below the WHO ‘good outcome’ category for post-operative visual impairment. A post-operative vision of 6/18 or better without spectacles is a goal which appears to be within the reach of small incision techniques for cataract surgery. However, there are concerns that the method used to remove the nucleus in MSICS may be more traumatic to the corneal endothelium than conventional ECCE surgery.

  18. A case of rapid rock riverbed incision in a coseismic uplift reach and its implications

    Huang, Ming-Wan; Pan, Yii-Wen; Liao, Jyh-Jong


    During the 1999 Chi-Chi earthquake (Mw = 7.6) in Taiwan, the coseismic displacement induced fault scarps and a pop-up structure in the Taan River. The fault scarps across the river experienced maximum vertical slip of 10 m, which disturbed the dynamic equilibrium of the fluvial system. As a result, rapid incision in the weak bedrock, with a maximum depth of 20 m, was activated within a decade after its armor layer was removed. This case provides an excellent opportunity for closely tracking and recording the progressive evolution of river morphology that is subjected to coseismic uplift. Based on multistaged orthophotographs and digital elevation model (DEM) data, the process of morphology evolution in the uplift reach was divided into four consecutive stages. Plucking is the dominant mechanism of bedrock erosion associated with channel incision and knickpoint migration. The astonishingly high rate of knickpoint retreat (KPR), as rapid as a few hundred meters per year, may be responsible for the rapid incision in the main channel. The reasons for the high rate of KPR are discussed in depth. The total length of the river affected by the coseismic uplift is 5 km: 1 km in the uplift reach and 4 km in the downstream reach. The downstream reach was affected by a reduction in sediment supply and increase in stream power. The KPR cut through the uplift reach within roughly a decade; further significant flooding in the future will mainly cause widening instead of deepening of the channel.

  19. The intramedullary nailing using a single knee incision for treatment of extraarticular floating knee (nine cases

    Omar Dahmani


    Full Text Available Context: Floating knee injuries are uncommon and complex injuries. Management of this injury has been variously described in the literature. Aims: We present the outcome of the intramedullary nailing using a single knee incision for treatment of extraarticular floating knee. Materials and Methods: We report a retrospective series of nine patients with extraarticular floating knee. Results: There were seven men and two women with an average age of 35 years. At least one of the fractures was open in three cases. The average Injury Severity Score was 17. According to Fraser′s classification, 100% of the cases are type I. All our patients were treated by the intramedullary nailing using a single knee incision. The mean operating time was 146 min. The mean follow-up is 19 months. According to the Karlstrφm criteria, the end results were excellent in two cases, good in four, acceptable in two, and poor in one. Bone union was achieved in eight cases with an average period of 93 days. Conclusions: The intramedullary nailing using a single knee incision has shown in this series better results.

  20. Transtibial technique versus two incisions in anterior cruciate ligament reconstruction: tunnel positioning, isometricity and functional evaluation

    Ricardo Hideki Yanasse


    Full Text Available ABSTRACT OBJECTIVE: To compare the transtibial and two-incision techniques for anterior cruciate ligament (ACL reconstruction using a single band. METHODS: A prospective and randomized study was conducted in blocks. Patients underwent ACL reconstruction by means of two techniques: transtibial (group 1: 20 patients or two incisions (group 2: 20 patients. The radiographic positioning of the tunnel, inclination of the graft, graft isometricity and functional results (IKDC and Lysholm were evaluated. RESULTS: The positioning of the femoral tunnel on the anteroposterior radiograph, expressed as a mean percentage relative to the medial border of the tibial plateau, was 54.6% in group 1 and 60.8% in group 2 (p 0.05. Group 2 had better results from the pivot-shift maneuver (p < 0.05. CONCLUSION: The technique of two incisions allowed positioning of the femoral tunnel that was more lateralized and anteriorized, such that the graft was more inclined and there was a clinically better result from the pivot-shift maneuver. There was no difference in isometricity and no final functional result over the short follow-up time evaluated.

  1. [Laparoscopic cholecystectomy with three-port and 25 millimeters long incision.

    Gómez Tagle-Morales, Enrique David


    Background: three-port and 25 mm total incision laparoscopic cholecystectomy has shown benefits compared to conventional laparoscopy. The aim was to examine the safety and feasibility of this technique. Methods: a three-port laparoscopic cholecystectomy trial was conducted through Cinvestav metasearcher, Seriunam and Rencis. The eligibility criteria were: three port laparoscopic cholecystectomy, 25 mm total incision, and score = 17 on Data Review System. Trials which employed instruments smaller than 5 mm in diameter were excluded. The comparative variables were documented and results obtained in the selected trials were described. Results: four trials were selected, comprising 1767 cases (1329 females and 438 males), average age was 44.3 years. Chronic cholecystitis was documented in 84.3 %, and acute cholecystitis in 14.7 %. Average surgical time was 54.5 minutes. An additional port was required in 4.8 % and 1.4 % was converted to open technique. Bile duct injury was presented in 0.11 %. The success rate was 94.9 %. Conclusions: three port and 25 mm total incision in laparoscopic cholecystectomy is safe and feasible.

  2. Single incision laparoscopic TAPP with standard laparoscopic instruments and suturing of flaps: A continuing study

    Rajeev Sinha


    Full Text Available Background: Single incision laparoscopic surgery, especially transumbilical, should be the closest to replicate the minimal access results achieved by natural orifice endoscopic surgery (NOTES. This study of single incision transabdominal preperitoneal (SITAPP inguinal hernia repair is a continuing study exploring the peroperative variables and short and long term complications of this procedure. Patients and Methods: All the 183 patients were operated by the same surgeon through a horizontal transumbilical incision positioned across the lower third of the umbilicus. Port access was through three separate transfacial punctures. Routine rigid instruments were used and the peritoneal flaps were either tacked or sutured into place. Patients with irreducible hernia and obstructed hernia were included, while those with strangulated hernia were excluded. Results: All the patients were male with an average age of 41.4 years. Twenty four patients had bilateral hernia, 15 patients had irreducible and 6 patients had obstructed hernia. The mean operating time was 38.3 mins for unilateral hernias completed with tackers and 42.8 mins in those with intracorporeal suturing. The corresponding operating time for bilateral hernias was 53.2 and 62.7 minutes. There was minimal serous discharge from the umbilicus in 8 patients, port site infection in 1 patient and recurrence in 2 patients over a 36 months period. Conclusions: SITAPP for groin hernias, performed with conventional instruments is feasible, easy to learn, has a very high patient acceptance and is cosmetically superior to conventional TAPP. The use of tackers reduces the operating time significantly.

  3. Outcomes for single-incision laparoscopic colectomy surgery in obese patients: a case-matched study.

    Keller, Deborah S; Ibarra, Sergio; Flores-Gonzalez, Juan Ramon; Ponte, Oscar Moreno; Madhoun, Nisreen; Pickron, T Bartley; Haas, Eric M


    Single-incision laparoscopic surgery (SILS) is safe and feasible for benign and malignant colorectal diseases. SILS offers several patient-related benefits over multiport laparoscopy. However, its use in obese patients has been limited from concerns of technical difficulty, oncologic compromise, and higher complication and conversion rates. Our objective was to evaluate the feasibility and efficacy of SILS for colectomy in obese patients. Review of a prospective database identified patients undergoing elective colectomy using SILS from 2009 to 2014. They were stratified into obese (BMI ≥ 30 kg/m(2)) and non-obese cohorts (BMI obese cohort had significantly higher BMI (p obese. There were no significant differences in conversion rates (p = 0.682), final incision length (p = 0.088), LOS (p = 0.332), postoperative complications (p = 0.430), or readmissions (p = 1.000) in the obese versus non-obese. Further, in malignant cases, lymph nodes harvested (p = 0.757) and negative distal margins (p = 1.000) were comparable across cohorts. Single-incision laparoscopic colectomy in obese patients had significantly longer operative times, but comparable conversion rates, oncologic outcomes, lengths of stay, complication, and readmission rates as the non-obese cohorts. In the obese, where higher morbidity rates are typically associated with surgical outcomes, SILS may be the ideal platform to optimize outcomes in colorectal surgery. With additional operative time, the obese can realize the same clinical and quality benefits of minimally invasive surgery as the non-obese.

  4. Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery.

    Verspyck, Eric; Douysset, Xavier; Roman, Horace; Marret, Stephane; Marpeau, Loïc


    To compare maternal outcomes after transection and after avoiding incision of the anterior placenta previa during cesarean delivery. In a retrospective study, records were reviewed for women who had anterior placenta previa and delivered by cesarean after 24 weeks of pregnancy at a tertiary center in Rouen, France. During period A (January 2000 to December 2006), the protocol was to systematically transect the placenta when it was unavoidable. During period B (January 2007 to December 2010), the technique was to avoid incision by circumventing the placenta and passing a hand around its margin. Logistic regression was used to identify independent risk factors associated with maternal transfusion of packed red blood cells. Eighty-four women were included (period A: n=43; period B: n=41). During period B, there was a reduction in frequency of intraoperative hemorrhage (>1000 mL) (P=0.02), intraoperative hemoglobin loss (P=0.005), and frequency of blood transfusion (P=0.02) as compared with period A. In multivariable analysis, period B was associated with a reduced risk of maternal transfusion (odds ratio 0.27; 95% confidence interval 0.09-0.82; P=0.02). Avoiding incision of the anterior placenta previa was found to reduce frequency of maternal blood transfusion during or after cesarean delivery. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Characteristics of Bone Injuries Resulting from Knife Wounds Incised with Different Forces.

    Humphrey, Caitlin; Kumaratilake, Jaliya; Henneberg, Maciej


    The aim of this research was to experimentally determine the characteristics of incised bone wounds, which are commonly found in defense injuries. A specially constructed pivoting arm device was used to inflict wounds with controlled forces and direction. Five knives were selected to inflict the wounds on porcine forelimbs. Eight incised wounds were made per knife per force. A larger knife and a greater force caused longer and wider bone wounds. Comparisons of individual knives at the two forces produced varying results in the bone wounds. A correlation was seen between the force and the length (r = 0.69), width (r = 0.63), and depth (r = 0.57) of bone wounds. Serrated-edge and nonserrated knives can be distinguished from the appearance of the wound. The outcomes may be applicable in forensic investigations to ascertain the forces associated with incised wounds and identify the specific knife used. © 2017 American Academy of Forensic Sciences.

  6. Multiple parallel skin markers for minimal incision lumbar disc surgery; a technical note

    Chen Po-Quang


    Full Text Available Abstract Background Spinal surgery depends on accurate localization to prevent incorrect surgical approaches. The trend towards minimally invasive surgery that minimizes surgical exposure and reduces postoperative pain increasingly requires surgeons to accurately determine the operative level before an incision is made. Preoperative localization with a C-arm image intensifier is popular, but the exposure of both patients and theatre staff to radiation is a disadvantage, as well as being time-consuming. Methods We describe a simple surgical tool developed to help localize exact spinal levels in conjunction with a simple AP X-ray film immediately before surgery. Multiple parallel skin markers were made using a circular oven rack comprising multiple 1.5 cm spaced parallel wires attached to a circular outside rim. The longest line was placed on the line of the postero-superior iliac spine (PSIS over the junction of the L5-S1 region. Results and conclusions Based on the film taken, the incision can be accurately made at the intended level. The incision wound can be minimized to 3.0 cm even when using conventional disc surgery instruments.

  7. Manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts

    J Yang


    Full Text Available Aims: To report the technique and outcomes of sutureless manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts. Materials and Methods: This retrospective study comprised of 112 eyes of 83 patients with mature cataract who all had manual cataract extraction via a subconjunctival limbus oblique incision. A transconjunctival tunnel is fashioned with a 3.0 mm keratome, 0.5 mm behind the limbal vascular arcades. A limbal tunnel, with a transverse extent of 9 mm in the cornea and 7.0 mm in the limbus, is created beneath the conjunctival/Tenon′s tissue using an angled bevel-up crescent blade. Outcome measures included visual acuity, intraoperative complications, surgically induced astigmatism, endothelial cell loss rate and surgery time. Results: Self-sealing wound was achieved in 112 eyes (98.2%. The nucleus was delivered in whole in 108 eyes (96.4%. Intraoperative complications included hyphema in 3 eyes (2.7%, iridodialysis in 2 eyes 1.8%, posterior capsular rupture and zonular dialysis in 2 eyes (1.8%. At the 3-month follow-up, 91% patients achieved a best-corrected visual acuity of 20/20 or better, the mean of surgically induced astigmatism was -0.62 ± 0.41 Diopters and endothelial cell loss was 4.2%. Average surgical time was 3.75 min per case. Conclusion: This subconjunctival limbus oblique incision has the potential to serve as safe and effective technique for mature cataracts.

  8. Chemical weathering as a mechanism for the climatic control of bedrock river incision

    Murphy, Brendan P.; Johnson, Joel P. L.; Gasparini, Nicole M.; Sklar, Leonard S.


    Feedbacks between climate, erosion and tectonics influence the rates of chemical weathering reactions, which can consume atmospheric CO2 and modulate global climate. However, quantitative predictions for the coupling of these feedbacks are limited because the specific mechanisms by which climate controls erosion are poorly understood. Here we show that climate-dependent chemical weathering controls the erodibility of bedrock-floored rivers across a rainfall gradient on the Big Island of Hawai‘i. Field data demonstrate that the physical strength of bedrock in streambeds varies with the degree of chemical weathering, which increases systematically with local rainfall rate. We find that incorporating the quantified relationships between local rainfall and erodibility into a commonly used river incision model is necessary to predict the rates and patterns of downcutting of these rivers. In contrast to using only precipitation-dependent river discharge to explain the climatic control of bedrock river incision, the mechanism of chemical weathering can explain strong coupling between local climate and river incision.

  9. Asymptotic representation of relaxation oscillations in lasers

    Grigorieva, Elena V


    In this book we analyze relaxation oscillations in models of lasers with nonlinear elements controlling light dynamics. The models are based on rate equations taking into account periodic modulation of parameters, optoelectronic delayed feedback, mutual coupling between lasers, intermodal interaction and other factors. With the aim to study relaxation oscillations we present the special asymptotic method of integration for ordinary differential equations and differential-difference equations. As a result, they are reduced to discrete maps. Analyzing the maps we describe analytically such nonlinear phenomena in lasers as multistability of large-amplitude relaxation cycles, bifurcations of cycles, controlled switching of regimes, phase synchronization in an ensemble of coupled systems and others. The book can be fruitful for students and technicians in nonlinear laser dynamics and in differential equations.

  10. On topological relaxations of chromatic conjectures

    Simonyi, Gábor


    There are several famous unsolved conjectures about the chromatic number that were relaxed and already proven to hold for the fractional chromatic number. We discuss similar relaxations for the topological lower bound(s) of the chromatic number. In particular, we prove that such a relaxed version is true for the Behzad-Vizing conjecture and also discuss the conjectures of Hedetniemi and of Hadwiger from this point of view. For the latter, a similar statement was already proven in an earlier paper of the first author with G. Tardos, our main concern here is that the so-called odd Hadwiger conjecture looks much more difficult in this respect. We prove that the statement of the odd Hadwiger conjecture holds for large enough Kneser graphs and Schrijver graphs of any fixed chromatic number.

  11. Vibrational and Rotational Energy Relaxation in Liquids

    Petersen, Jakob

    the intramolecular dynamics during photodissociation is investigated. The apparent agreement with quantum mechanical calculations is shown to be in contrast to the applicability of the individual approximations used in deriving the model from a quantum mechanical treatment. In the spirit of the Bersohn-Zewail model......, the vibrational energy relaxation of I2 subsequent to photodissociation and recombination in CCl4 is studied using classical Molecular Dynamics simulations. The vibrational relaxation times and the time-dependent I-I pair distribution function are compared to new experimental results, and a qualitative agreement...... is found in both cases. Furthermore, the rotational energy relaxation of H2O in liquid water is studied via simulations and a power-and-work analysis. The mechanism of the energy transfer from the rotationally excited H2O molecule to its water neighbors is elucidated, i.e. the energy-accepting degrees...

  12. Relaxation and Diffusion in Complex Systems

    Ngai, K L


    Relaxation and Diffusion in Complex Systems comprehensively presents a variety of experimental evidences of universal relaxation and diffusion properties in complex materials and systems. The materials discussed include liquids, glasses, colloids, polymers, rubbers, plastic crystals and aqueous mixtures, as well as carbohydrates, biomolecules, bioprotectants and pharmaceuticals. Due to the abundance of experimental data, emphasis is placed on glass-formers and the glass transition problem, a still unsolved problem in condensed matter physics and chemistry. The evidence for universal properties of relaxation and diffusion dynamics suggests that a fundamental physical law is at work. The origin of the universal properties is traced to the many-body effects of the interaction, rigorous theory of which does not exist at the present time. However, using solutions of simplified models as guides, key quantities have been identified and predictions of the universal properties generated. These predictions from Ngai’...

  13. Substrate stress relaxation regulates cell spreading

    Chaudhuri, Ovijit; Gu, Luo; Darnell, Max; Klumpers, Darinka; Bencherif, Sidi A.; Weaver, James C.; Huebsch, Nathaniel; Mooney, David J.


    Studies of cellular mechanotransduction have converged upon the idea that cells sense extracellular matrix (ECM) elasticity by gauging resistance to the traction forces they exert on the ECM. However, these studies typically utilize purely elastic materials as substrates, whereas physiological ECMs are viscoelastic, and exhibit stress relaxation, so that cellular traction forces exerted by cells remodel the ECM. Here we investigate the influence of ECM stress relaxation on cell behaviour through computational modelling and cellular experiments. Surprisingly, both our computational model and experiments find that spreading for cells cultured on soft substrates that exhibit stress relaxation is greater than cells spreading on elastic substrates of the same modulus, but similar to that of cells spreading on stiffer elastic substrates. These findings challenge the current view of how cells sense and respond to the ECM.

  14. Nonlinear Model of non-Debye Relaxation

    Zon, Boris A


    We present a simple nonlinear relaxation equation which contains the Debye equation as a particular case. The suggested relaxation equation results in power-law decay of fluctuations. This equation contains a parameter defining the frequency dependence of the dielectric permittivity similarly to the well-known one-parameter phenomenological equations of Cole-Cole, Davidson-Cole and Kohlrausch-Williams-Watts. Unlike these models, the obtained dielectric permittivity (i) obeys to the Kramers-Kronig relation; (ii) has proper behaviour at large frequency; (iii) its imaginary part, conductivity, shows a power-law frequency dependence \\sigma ~ \\omega^n where n1 is also observed in several experiments. The nonlinear equation proposed may be useful in various fields of relaxation theory.

  15. Excited-state relaxation of some aminoquinolines


    Full Text Available The absorption and fluorescence spectra, fluorescence quantum yields and lifetimes, and fluorescence rate constants ( k f of 2-amino-3-( 2 ′ -benzoxazolylquinoline (I, 2-amino-3-( 2 ′ -benzothiazolylquinoline (II, 2-amino-3-( 2 ′ -methoxybenzothiazolyl-quinoline (III, 2-amino-3-( 2 ′ -benzothiazolylbenzoquinoline (IV at different temperatures have been measured. The shortwavelength shift of fluorescence spectra of compounds studied (23–49 nm in ethanol as the temperature decreases (the solvent viscosity increases points out that the excited-state relaxation process takes place. The rate of this process depends essentially on the solvent viscosity, but not the solvent polarity. The essential increasing of fluorescence rate constant k f (up to about 7 times as the solvent viscosity increases proves the existence of excited-state structural relaxation consisting in the mutual internal rotation of molecular fragments of aminoquinolines studied, followed by the solvent orientational relaxation.

  16. Improved memristor-based relaxation oscillator

    Mosad, Ahmed G.


    This paper presents an improved memristor-based relaxation oscillator which offers higher frequency and wider tunning range than the existing reactance-less oscillators. It also has the capability of operating on two positive supplies or alternatively a positive and negative supply. Furthermore, it has the advantage that it can be fully integrated on-chip providing an area-efficient solution. On the other hand, The oscillation concept is discussed then a complete mathematical analysis of the proposed oscillator is introduced. Furthermore, the power consumption of the new relaxation circuit is discussed and validated by the PSPICE circuit simulations showing an excellent agreement. MATLAB results are also introduced to demonstrate the resistance range and the corresponding frequency range which can be obtained from the proposed relaxation oscillator. © 2013 Elsevier Ltd.

  17. Interactive Image Enhancement by Fuzzy Relaxation

    Shang-Ming Zhou; John Q.Can; Li-Da Xu; Robert John


    In this paper, an interactive image enhancement (HE) technique based on fuzzy relaxation is presented, which allows the user to select different intensity levels for enhancement and intermit the enhancement process according to his/her preference in applications. First, based on an analysis of the convergence of a fuzzy relaxation algorithm for image contrast enhancement, an improved version of this algorithm, which is called FuzzIIE Method 1, is suggested by deriving a relationship between the convergence regions and the parameters in the transformations defined in the algorithm. Then a method called FuzzIIE Method 2 is introduced by using a different fuzzy relaxation function, in which there is no need to re-select the parameter values for interactive image enhancement. Experimental results are presented demonstrating the enhancement capabilities of the proposed methods under different conditions.

  18. Relaxation Dynamics of Semiflexible Fractal Macromolecules

    Jonas Mielke


    Full Text Available We study the dynamics of semiflexible hyperbranched macromolecules having only dendritic units and no linear spacers, while the structure of these macromolecules is modeled through T-fractals. We construct a full set of eigenmodes of the dynamical matrix, which couples the set of Langevin equations. Based on the ensuing relaxation spectra, we analyze the mechanical relaxation moduli. The fractal character of the macromolecules reveals itself in the storage and loss moduli in the intermediate region of frequencies through scaling, whereas at higher frequencies, we observe the locally-dendritic structure that is more pronounced for higher stiffness.

  19. Dynamics of cosmological relaxation after reheating

    Choi, Kiwoon; Sekiguchi, Toyokazu


    We examine if the cosmological relaxation mechanism, which was proposed recently as a new solution to the hierarchy problem, can be compatible with high reheating temperature well above the weak scale. As the barrier potential disappears at high temperature, the relaxion rolls down further after the reheating, which may ruin the successful implementation of the relaxation mechanism. It is noted that if the relaxion is coupled to a dark gauge boson, the new frictional force arising from dark gauge boson production can efficiently slow down the relaxion motion, which allows the relaxion to be stabilized after the electroweak phase transition for a wide range of model parameters, while satisfying the known observational constraints.

  20. Synthetic aperture radar autofocus via semidefinite relaxation.

    Liu, Kuang-Hung; Wiesel, Ami; Munson, David C


    The autofocus problem in synthetic aperture radar imaging amounts to estimating unknown phase errors caused by unknown platform or target motion. At the heart of three state-of-the-art autofocus algorithms, namely, phase gradient autofocus, multichannel autofocus (MCA), and Fourier-domain multichannel autofocus (FMCA), is the solution of a constant modulus quadratic program (CMQP). Currently, these algorithms solve a CMQP by using an eigenvalue relaxation approach. We propose an alternative relaxation approach based on semidefinite programming, which has recently attracted considerable attention in other signal processing problems. Experimental results show that our proposed methods provide promising performance improvements for MCA and FMCA through an increase in computational complexity.

  1. Depicting Vortex Stretching and Vortex Relaxing Mechanisms

    符松; 李启兵; 王明皓


    Different from many existing studies on the paranetrization of vortices, we investigate the effectiveness of two new parameters for identifying the vortex stretching and vortex relaxing mechanisms. These parameters are invariants and identify three-dimensional flow structures only, i.e. they diminish in two-dimensional flows. This is also unlike the existing vortex identification approaches which deliver information in two-dimensional flows. The present proposals have been successfully applied to identify the stretching and relaxing vortices in compressible mixing layers and natural convection flows.

  2. Incised-valley morphologies and sedimentary-fills within the inner shelf of the northern Bay of Biscay

    Chaumillon, Eric; Ménier, David; Weber, Nicolas


    This study is a first synthesis focused on incised-valleys located within the inner shelf of the Bay of Biscay. It is based on previously published results obtained during recent seismic surveys and coring campaigns. The morphology of the valleys appears to be strongly controlled by tectonics and lithology. The Pleistocene sedimentary cover of the shelf is very thin and discontinuous with a maximum thickness ranging between 30 and 40 m in incised-valley fills. Thus the incised bedrock morphology plays a key-role by controlling hydrodynamics and related sediment transport and deposition that explains some variations of those incised-valley fills with respect to the previously published general models.

  3. Surgical site wound infection in relation to antibiotic prophylaxis given before skin incision and after cord clamping during cesarean delivery.

    Shrestha, B; Marhatha, R; Giri, A; Jaisi, S; Maskey, U


    Surgical site infection is one of the most common complications following Lower Segment Cesarean Section, which accounts for prolonged hospital stay thereby increasing expense. Prophylactic antibiotics in cesarean section reduces surgical site infection significantly. The best protection is provided when tissue level of antibiotics are adequate before incision, without prejudice to neonatal infectious morbidity. The objective of this study was to compare the incidence of surgical site wound infection with prophylactic antibiotics given before skin incision and after cord clamping following delivery of baby. This was a prospective, hospital based study, in which hundred cases of cesarean deliveries who received antibiotics prophylaxis one hour before the skin incision were compared with another 100 cases where antibiotic was given after cord clamping following delivery of the baby. Surgical site infection occurred in 3% of women who received antibiotics prophylaxis before skin incision as compared to 6% in whom antibiotic was given after cord clamping. It was statistically not significant (p = 0.465).

  4. Randomized clinical trial of small-incision and laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis: primary and clinical outcomes.

    Keus, F.; Werner, J.E.; Gooszen, H.G.; Oostvogel, H.J.M.; Laarhoven, C.J.H.M. van


    OBJECTIVE: To evaluate the primary and clinical outcomes in laparoscopic and small-incision cholecystectomy. DESIGN: Blinded randomized single-center trial emphasizing methodologic quality and generalizability. SETTING: General teaching hospital in the Netherlands. PATIENTS: A total of 257 patients

  5. Anaesthesiological considerations in small-incision and laparoscopic cholecystectomy in symptomatic cholecystolithiasis : implications for pulmonary function. A randomized clinical trial

    Keus, F.; Ali, U. Ahmed; Noordergraaf, G. J.; Roukema, J. A.; Gooszen, H. G.; van Laarhoven, C. J. H. M.


    Background: Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post-operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. Small-incision cholecystectomy (SIC), a procedure that does not require

  6. Autogenic incision and terrace formation resulting from abrupt late-glacial base-level fall, lower Chippewa River, Wisconsin, USA

    Faulkner, Douglas J.; Larson, Phillip H.; Jol, Harry M.; Running, Garry L.; Loope, Henry M.; Goble, Ronald J.


    A paucity of research exists regarding the millennial-scale response of inland alluvial streams to abrupt base-level fall. Studies of modern systems indicate that, over short time scales, the response is a diffusion-like process of upstream-propagating incision. In contrast, evidence from the lower Chippewa River (LCR), located in the upper Midwest of the USA, suggests that autogenic controls operating over time scales of several millennia can overwhelm diffusion, resulting in incision that is prolonged and episodic. During the Last Glacial Maximum, the LCR drained the Chippewa Lobe of the Laurentide Ice Sheet to the glacial upper Mississippi River (UMR). As a meltwater stream, it aggraded and filled its valley with glacial outwash, as did its largest tributaries, which were also meltwater streams. Its nonglacial tributaries aggraded, too, filling their valleys with locally derived sediment. During deglaciation, the UMR incised at least twice, abruptly lowering the LCR's base level - ~ 15 m at 16 ka or earlier and an additional 40 m at ca. 13.4 ka. Each of these base-level falls initiated incision of the LCR, led by upstream migrating knickpoints. The propagation of incision has, however, been a lengthy process. The optically stimulated luminescence (OSL) ages of terrace alluvium indicate that, by 13.5 ka, incision had advanced up the LCR only 15 km, and by 9 ka, only 55 km. The process has also been episodic, resulting in the formation of fill-cut terraces (inferred from GPR surveys and exposures of terrace alluvium) that are younger and more numerous in the upstream direction. Autogenic increases in sediment load and autogenic bed armoring, the result of periodic tributary-stream rejuvenation and preferential winnowing of fines by the incising river, may have periodically caused knickpoint migration and incision to slow and possibly stop, allowing lateral erosion and floodplain formation to dominate. A decline in sediment flux from stabilizing incised tributary

  7. Deformation and incision of the western margin of the Central Andean Plateau, S. Peru and N. Chile

    Schildgen, T.


    The western margin of the Central Andean Plateau in southern Peru and northern Chile hosts a rich geologic and geomorphic record of crustal deformation and river incision that developed during a period of regional plateau uplift. Significant growth of topography likely occurred in the western Central Andes starting at ca. 30 Ma, when the regionally extensive silts and sandstones of the Moquegua and Azapa Group sediments gave way to coarse sandstones and conglomerates. Apatite (U-Th)/He thermochronology, 3D thermal modeling, and infilling volcanic flows show that a subsequent major phase of canyon incision started in the middle reaches of Ocoña Canyon (southern Peru) between 11 and 8 Ma, with ca. 2-km of incision occurring between ca. 11 and 5 Ma. Surface uplift coeval with this incision has been documented in northern Chile, where rotated forearc basin deposits reveal 1 to 2 km of differential uplift between the Coastal Cordillera and the plateau margin that started after 11 to 10 Ma. In contrast with the 11 to 8 Ma onset of incision in the middle reaches of Ocoña Canyon, the currently 1-km-high coastal/piedmont region appears not to have been affected by incision until after 5 Ma, as documented by the 50-km-wide alluvial and colluvial plain that remained occupied by rivers until at least 5 Ma. Apatite (U-Th)/He thermochronology pointing to a final 1-km of incision in the middle reaches of Ocoña Canyon after ca. 5 Ma is supported by apatite 4He/3He thermochonometry, which documents the passage of a km-scale knickpoint through the same region between ca. 7 and 4 Ma. Although river incision provides only a minimum time constraint for the start of surface uplift, the broadly coincident start of incision with the rotation of forearc basin deposits in northern Chile implies a close temporal coupling between the start of surface uplift and the onset of incision in Ocoña Canyon. Furthermore, the delayed incision of the coastal/piedmont region until after 5 Ma shows

  8. Bathymetry of Lake Lisan controls late Pleistocene and Holocene stream incision in response to base level fall

    Davis, Michael; Matmon, Ari; Zilberman, Ezra; Porat, Naomi; Gluck, Daniel; Enzel, Yehouda


    This paper examines the millennial-scale evolution of the longitude profile of Nahal (Wadi) Zin in the Dead Sea basin in the northern Arava valley, Israel. Nahal Zin has incised ~ 50 m into relatively soft late Pleistocene Lake Lisan sediments. Incision was forced by the regressive (> 10 km) lake level fall of a total of > 200 m of Lake Lisan from its highest stand at ~ 25 ka and exposure of the lake-floor sediments to fluvial and coastal processes. Alluvial cut terraces of the incising channel are well preserved along the 17.5 km of the lowermost reach of Nahal Zin. At its outlet into the Dead Sea basin, Nahal Zin deposited a Holocene alluvial fan at the base of a 10-80 m high escarpment in unconsolidated sediments. The escarpment is associated with the Amazyahu fault, which forms the southern structural boundary of the present Dead Sea basin. Geomorphic mapping, optically stimulated luminescence (OSL) ages, and soil stratigraphy allowed correlation of terrace remnants and reconstruction of several past longitudinal profiles of Nahal Zin and its incision history. Together with the published lake level chronology, these data provide an opportunity to examine stream incision related to base level lowering at a millennial scale. OSL ages of the terraces fit relatively well with the established lake level chronology and follow its regression and fall. For a few thousands of years the longitudinal profile response to the lake level fall was downstream lengthening onto the exposed former lake bed. Most of the incision (~ 40 m) occurred later, when the lake level reached the top of the Amazyahu fault escarpment and continued to drop. The incision was a relatively short episode at about 17 ka and cut through this escarpment almost to its base. The fast incision, its timing, and the profiles of the incising channels indicate that the escarpment was an underwater feature and was not formed after the lake retreated. This fairly simple scenario of regressive lake level fall

  9. Timing of European fluvial terrace formation and incision rates constrained by cosmogenic nuclide dating

    Schaller, Mirjam; Ehlers, Todd A.; Stor, Tomas; Torrent, Jose; Lobato, Leonardo; Christl, Marcus; Vockenhuber, Christof


    Age constraints of late Cenozoic fluvial terraces are important for addressing surface process questions related to the incision rates of rivers, or tectonic and climate controls on denudation and sedimentation. Unfortunately, absolute age constraints of fluvial terraces are not always possible, and many previous studies have often dated terraces with relative age constraints that do not allow for robust interpretations of incision rates and timing of terrace formation. However, in situ-produced cosmogenic nuclides allow absolute age determination, and hence incision rates, of fluvial deposits back to 5 Ma. Here we present, cosmogenic depth profile dating and isochron burial dating of four different river systems in Europe spanning 12° of latitude. We do this to determine river incision rates and spatial variations in the timing of terrace formation. Isochron burial age constraints of four selected terraces from the Vltava river (Czech Republic) range between 1.00 ± 0.21 to 1.99 ± 0.45Ma. An isochron burial age derived for the Allier river (Central France) is 2.00 ± 0.17Ma. Five terrace levels from the Esla river (NW Spain) were dated between 0.08 + 0.04 / - 0.01Ma and 0.59 + 0.13 / - 0.20Ma with depth profile dating. The latter age agrees with an isochron burial age of 0.52 ± 0.20Ma. Two terrace levels from the Guadalquivir river (SW Spain) were dated by depth profile dating to 0.09 + 0.03 / - 0.02Ma and 0.09 + 0.04 / - 0.03Ma. The one terrace level from the Guadalquivir river dated by isochron burial dating resulted in an age of 1.79 ± 0.18Ma. Results indicate that the cosmogenic nuclide-based ages are generally older than ages derived from previous relative age constraints leading to a factor 2-3 lower incision rates than previous work. Furthermore, the timing of terrace formation over this latitudinal range is somewhat obscured by uncertainties associated with dating older terraces and not clearly synchronous with global climate variations.

  10. Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis.

    Ranganathan, Hemalatha; Ganapathy, Dhanraj M; Jain, Ashish R


    Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. This was an experimental, single-blinded, in vitro trial. Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

  11. Cervical and incisal marginal discrepancy in ceramic laminate veneering materials: A SEM analysis

    Hemalatha Ranganathan


    Full Text Available Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

  12. Surgical incision-induced nociception causes cognitive impairment and reduction in synaptic NMDA receptor 2B in mice.

    Zhang, Xiaoqin; Xin, Xin; Dong, Yuanlin; Zhang, Yiying; Yu, Buwei; Mao, Jianren; Xie, Zhongcong


    Postoperative cognitive dysfunction (POCD) is associated with impairments in daily functioning, and increased morbidity and mortality. However, the causes and neuropathogenesis of POCD remain largely unknown. Uncontrolled pain often occurs postoperatively. We therefore set out to determine the effects of surgical incision-induced nociception on the cognitive function and its underlying mechanisms in 3- and 9-month-old mice. The mice had surgical incision in the hindpaw and then were tested for nociceptive threshold, learning, and memory. Brain levels of NMDA receptor and cyclin-dependent kinase 5 (CDK5) were also assessed. We found that surgical incision-induced nociception in mice led to a decreased freezing time in the tone test (which assesses the hippocampus-independent learning and memory function), but not the context test, of Fear Conditioning System at 3 and 7 d, but not 30 d post incision in 9-month-old, but not 3-month-old mice. Consistently, the surgical incision selectively decreased synaptic NMDA receptor 2B levels in the medial prefrontal cortex, and increased levels of tumor necrosis factor-α and CDK5 in the cortex, but not hippocampus, of the mice. Finally, eutectic mixture of local anesthetics and CDK5 inhibitor, roscovitine, attenuated the surgical incision-induced reduction in the synaptic NMDA receptor 2B levels and learning impairment. These results suggested that surgical incision-induced nociception reduced the synaptic NMDA receptor 2B level in the medial prefrontal cortex of mice, which might lead to hippocampus-independent learning impairment, contributing to POCD. These findings call for further investigation to determine the role of surgical incision-induced nociception in POCD.

  13. The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy

    Brian E. Brocato


    Full Text Available Objective. To assess the risk of classical hysterotomy and surgical morbidity among women with a body mass index (BMI greater than 40 kg/m2 who underwent a supraumbilical incision at the time of cesarean delivery. Methods. We conducted a retrospective cohort study in women having a BMI greater than 40 kg/m2 who underwent a cesarean delivery of a live, singleton pregnancy from 2007 to 2011 at a single tertiary care institution. Intraoperative and postoperative outcomes were compared between patients undergoing supraumbilical vertical (cohort, or Pfannenstiel (controls, skin incisions. Results. Women undergoing supraumbilical incisions had a higher risk of classical hysterotomy (OR, 24.6; 95% CI, 9.0–66.8, surgical drain placement (OR, 6.5; 95% CI, 2.6–16.2, estimated blood loss greater than 1 liter (OR, 3.4; 95% CI, 1.4–8.4, and longer operative time (97 ± 38 minutes versus 68 ± 30 minutes; when compared to subjects with Pfannenstiel incisions (controls. There was no difference in the risk of wound complication between women undergoing supraumbilical or Pfannenstiel incisions (OR, 2.7; 95% CI, 0.9–8.0. Conclusion. In women with a BMI above 40 kg/m2, supraumbilical incision at the time of cesarean delivery is associated with a greater risk of classical hysterotomy and operative morbidity.

  14. A step-by-step oncoplastic breast conservation surgical atlas of reproducible dissection techniques and anatomically ideal incision placement.

    Mitchell, Sunny D


    To develop an atlas for oncoplastic surgery (OPS) with template dissection techniques via anatomically ideal incisions for breast conservation surgery. The evolution of breast conservation techniques has evolved from placing an incision directly over the lesion to the incorporation of a thoughtful decision making process utilizing oncoplastic surgical (OPS) techniques to combining OPS with incision placement in anatomically advantageous sites. The high survival rates of breast cancer and effect of breast surgery on quality of life reinforce emphasis of optimal oncologic as well as aesthetic outcome. OPS results in greater patient satisfaction, fewer surgeries, and is oncologically safe. Today's breast surgeon is tasked with optimizing both oncologic and aesthetic outcomes. Presentation of reproducible dissection techniques and incision placement strategies to afford surgeons a step-by-step approach of OPS via anatomically ideal incisions in breast conservation surgery. Demonstration of reproducible techniques to facilitate the decision making process of optimal breast conservation surgery, eliminate knowledge gaps for surgeons, optimize outcome for individuals undergoing breast conservation surgery, and decrease disparity of care. Adoption of OPS techniques utilizing an anatomically ideal incision in breast conservation surgery is a feasible and reproducible practice for breast surgeons. Application of these techniques results in maintained optimal shape, size, and contour without the typical overlying skin envelope scars. OPS techniques performed under the skin envelope result in expected OPS oncologic and aesthetic outcomes with the addition of the resulting scar(s) in anatomically discrete position(s).

  15. Incision Decisions.

    Michener, Olivia H.; And Others


    Survey forms sent to a random sample of 5,271 school board members elicited responses from 1,096 (21 percent) board members. Lists the demographics of school board service, the specific budget cuts board members made last year, and choices they would make if further cuts were needed in the current budget. (MLF)

  16. Collection Development: Relaxation & Meditation, September 1, 2010

    Lettus, Dodi


    One of the first books to document the relationship between stress and physical and emotional health was "The Relaxation Response" by Herbert Benson, M.D., with Miriam Z. Klipper. Originally published in 1975, the book grew out of Benson's observations as a cardiologist and his research as a fellow at Harvard Medical School. Benson's study of…

  17. BRIEF REPORT: The colour relaxation equation

    Xiaofei, Zhang; Jiarong, Li


    Colour diffusion in quark - gluon plasma (QGP) is investigated from the transport equations of QGP. The pure non-Abelian collision term describing the colour diffusion in QGP is obtained, the expression for colour relaxation time is derived and the physical picture of the colour diffusion in QGP is shown.

  18. Control linearity and jitter of relaxation oscillators

    Gierkink, Sander Laurentius Johannes


    The body of this thesis (chapters 3,4 and 5) deals with the analysis and improvement of a specific class of voltage- or current controlled oscillators (VCO’s respectively CCO’s) called relaxation oscillators. Before going into detail on this particular class of oscillators, first the function and ap

  19. Relaxation for Children. (Revised and Expanded Edition.)

    Rickard, Jenny

    Intended as a guide to reduce negative stress in children, this book suggests relaxation and meditation techniques to help children cope with stressful events. Part 1 provides an introduction to the format of the book. Part 2 contains summaries of the 10 sessions that make up the program. Each session has six sequential stages in which students…

  20. Relaxation Processes in Nonlinear Optical Polymer Films

    S.N. Fedosov


    Full Text Available Dielectric properties of the guest-host polystyrene/DR1 system have been studied by the AC dielectric spectroscopy method at frequencies from 1 Hz to 0,5 MHz and by the thermally stimulated depolarization current (TSDC method from – 160 to 0 °C. The relaxation peaks at infra-low frequencies from 10 – 5to 10–2 Hz were also calculated using the Hamon’s approximation. Three relaxation processes, namely, α, β and δ ones were identified from the TSDC peaks, while the ε''(fdependence showed a non-Debye ρ-peak narrowing with temperature. The activation energy of the α-relaxation appeared to be 2,57 eV, while that of the γ-process was 0,52 eV. Temperature dependence of the relaxation time is agreed with the Williams-Landel-Ferry model. The ε''(fpeaks were fitted to Havriliak-Negami’s expression and the corresponding distribution parameters were obtained.

  1. Relaxation of polarized nuclei in superconducting rhodium

    Knuuttila, T.A.; Tuoriniemi, J.T.; Lefmann, K.


    Nuclear spin lattice relaxation rates were measured in normal and superconducting (sc) rhodium with nuclear polarizations up to p = 0.55. This was sufficient to influence the sc state of Rh, whose T, and B-c, are exceptionally low. Because B-c

  2. Collection Development: Relaxation & Meditation, September 1, 2010

    Lettus, Dodi


    One of the first books to document the relationship between stress and physical and emotional health was "The Relaxation Response" by Herbert Benson, M.D., with Miriam Z. Klipper. Originally published in 1975, the book grew out of Benson's observations as a cardiologist and his research as a fellow at Harvard Medical School. Benson's study of…

  3. Redheffer representations and relaxed commutant lifting

    ter Horst, S.


    It is well known that the solutions of a (relaxed) commutant lifting problem can be described via a linear fractional representation of the Redheffer type. The coefficients of such Redheffer representations are analytic operator-valued functions defined on the unit disc D of the complex plane. In th

  4. Vibrational relaxation of pure liquid water

    Lindner, J; Vohringer, P; Pshenichnikov, MS; Cringus, D; Wiersma, DA; Mostovoy, M; Vöhringer, Peter; Pshenichnikov, Maxim S.


    Multicolor infrared ultrafast spectroscopy is applied to investigate the vibrational relaxation dynamics in liquid water at room temperature. In a sequence of experiments, both the stretching and the bending mode are photoexcited and probed. A unified model, capable of the reproduction of as much as

  5. Relaxation Treatment for Insomnia: A Component Analysis.

    Woolfolk, Robert L.; McNulty, Terrence F.


    Compared four relaxation treatments for sleep onset insomnia with a waiting-list control. Treatments varied in presence or absence of muscular tension-release instructions and in foci of attention. Results showed all treatment conditions reduced latency of sleep onset and fatigue; visual focusing best reduced the number of nocturnal awakenings.…

  6. Generalized approach to non-exponential relaxation

    R M Pickup; R Cywinski; C Pappas; P Fouquet; B Farago; P Falus


    Non-exponential relaxation is a universal feature of systems as diverse as glasses, spin glasses, earthquakes, financial markets and the universe. Complex relaxation results from hierarchically constrained dynamics with the strength of the constraints being directly related to the form of the relaxation, which changes from a simple exponential to a stretched exponential and a power law by increasing the constraints in the system. A global and unified approach to non-exponentiality was first achieved by Weron and was further generalized by Brouers and Sotolongo-Costa, who applied the concept of non-extensive entropy introduced by Tsallis to the relaxation of disordered systems. These concepts are now confronted with experimental results on the classical metallic spin glasses CuMn, AuFe and the insulating system EuSrS. The revisited data have also be complemented by new results on several compositions of the classical CuMn spin glass and on systems, like CoGa and CuCo, the magnetic behaviour of which is believed to arise from magnetic clusters and should be characteristic for superparamagnetism.

  7. Relaxation dynamics of multilayer triangular Husimi cacti

    Galiceanu, Mircea; Jurjiu, Aurel


    We focus on the relaxation dynamics of multilayer polymer structures having, as underlying topology, the Husimi cactus. The relaxation dynamics of the multilayer structures is investigated in the framework of generalized Gaussian structures model using both Rouse and Zimm approaches. In the Rouse type-approach, we determine analytically the complete eigenvalues spectrum and based on it we calculate the mechanical relaxation moduli (storage and loss modulus) and the average monomer displacement. First, we monitor these physical quantities for structures with a fixed generation number and we increase the number of layers, such that the linear topology will smoothly come into play. Second, we keep constant the size of the structures, varying simultaneously two parameters: the generation number of the main layer, G, and the number of layers, c. This fact allows us to study in detail the crossover from a pure Husimi cactus behavior to a predominately linear chain behavior. The most interesting situation is found when the two limiting topologies cancel each other. For this case, we encounter in the intermediate frequency/time domain regions of constant slope for different values of the parameter set (G, c) and we show that the number of layers follows an exponential-law of G. In the Zimm-type approach, which includes the hydrodynamic interactions, the quantities that describe the mechanical relaxation dynamics do not show scaling behavior as in the Rouse model, except the limiting case, namely, a very high number of layers and low generation number.

  8. Noise in (double) relaxation oscillation SQUIDs

    Adelerhof, Derk Jan; Adelerhof, Derk Jan; Flokstra, Jakob; Rogalla, Horst


    We have modelled the effect of two intrinsic noise sources on the flux noise spectral density of (Double) Relaxation Oscillation SQUIDs ((D)ROSs) based on hysteretic Josephson tunnel junctions. An important noise source is the spread in the critical current of the SQUID due to thermal fluctuations.

  9. Reactor flush time correction in relaxation experiments

    den Otter, M.W.; Bouwmeester, Henricus J.M.; Boukamp, Bernard A.; Verweij, H.


    The present paper deals with the analysis of experimental data from conductivity relaxation experiments. It is shown that evaluation of the chemical diffusion and surface transfer coefficients for oxygen by use of this technique is possible only if accurate data for the conductivity transient can be

  10. Collisionless relaxation in beam-plasma systems

    Backhaus, Ekaterina Yu. [Univ. of California, Berkeley, CA (United States)


    This thesis reports the results from the theoretical investigations, both numerical and analytical, of collisionless relaxation phenomena in beam-plasma systems. Many results of this work can also be applied to other lossless systems of plasma physics, beam physics and astrophysics. Different aspects of the physics of collisionless relaxation and its modeling are addressed. A new theoretical framework, named Coupled Moment Equations (CME), is derived and used in numerical and analytical studies of the relaxation of second order moments such as beam size and emittance oscillations. This technique extends the well-known envelope equation formalism, and it can be applied to general systems with nonlinear forces. It is based on a systematic moment expansion of the Vlasov equation. In contrast to the envelope equation, which is derived assuming constant rms beam emittance, the CME model allows the emittance to vary through coupling to higher order moments. The CME model is implemented in slab geometry in the absence of return currents. The CME simulation yields rms beam sizes, velocity spreads and emittances that are in good agreement with particle-in-cell (PIC) simulations for a wide range of system parameters. The mechanism of relaxation is also considered within the framework of the CME system. It is discovered that the rapid relaxation or beam size oscillations can be attributed to a resonant coupling between different modes of the system. A simple analytical estimate of the relaxation time is developed. The final state of the system reached after the relaxation is complete is investigated. New and accurate analytical results for the second order moments in the phase-mixed state are obtained. Unlike previous results, these connect the final values of the second order moments with the initial beam mismatch. These analytical estimates are in good agreement with the CME model and PIC simulations. Predictions for the final density and temperature are developed that show

  11. Load Relaxation of Olivine Single Crystals

    Cooper, R. F.; Stone, D. S.; Plookphol, T.


    Single crystals of ferromagnesian olivine (San Carlos, AZ, peridot; Fo90-92) have been deformed in both uniaxial creep and load relaxation under conditions of ambient pressure, T = 1500ºC and pO2 = 10-10 atm; creep stresses were in the range 40 ≤ σ1 (MPa) ≤ 220. The crystals were oriented such that the applied stress was parallel to [011]c, which promotes single slip on the slowest slip system in olivine, (010)[001]. The creep rates at steady state match well the results of earlier investigators, as does the stress sensitivity (a power-law exponent of n = 3.6). Dislocation microstructures, including spatial distribution of low-angle (subgrain) boundaries, additionally confirm previous investigations. Inverted primary creep (an accelerating strain rate with an increase in stress) was observed. Load-relaxation, however, produced a singular response—a single hardness curve—regardless of the magnitude of creep stress or total accumulated strain preceding relaxation. The log-stress v. log-strain rate data from load-relaxation and creep experiments overlap to within experimental error. The load-relaxation behavior is distinctly different that that described for other crystalline solids, where the flow stress is affected strongly by work hardening such that a family of distinct hardness curves is generated, which are related by a scaling function. The response of olivine for the conditions studied, thus, indicates flow that is rate-limited by dislocation glide, reflecting specifically a high intrinsic lattice resistance (Peierls stress).

  12. The effect of music relaxation versus progressive muscular relaxation on insomnia in older people and their relationship to personality traits.

    Ziv, Naomi; Rotem, Tomer; Arnon, Zahi; Haimov, Iris


    A large percentage of older people suffer from chronic insomnia, affecting many aspects of life quality and well-being. Although insomnia is most often treated with medication, a growing number of studies demonstrate the efficiency of various relaxation techniques. The present study had three aims: first, to compare two relaxation techniques--music relaxation and progressive muscular relaxation--on various objective and subjective measures of sleep quality; second, to examine the effect of these techniques on anxiety and depression; and finally, to explore possible relationships between the efficiency of both techniques and personality variables. Fifteen older adults took part in the study. Following one week of base-line measurements of sleep quality, participants followed one week of music relaxation and one week of progressive muscular relaxation before going to sleep. Order of relaxation techniques was controlled. Results show music relaxation was more efficient in improving sleep. Sleep efficiency was higher after music relaxation than after progressive muscular relaxation. Moreover, anxiety was lower after music relaxation. Progressive muscular relaxation was related to deterioration of sleep quality on subjective measures. Beyond differences between the relaxation techniques, extraverts seemed to benefit more from both music and progressive muscular relaxation. The advantage of non-pharmacological means to treat insomnia, and the importance of taking individual differences into account are discussed.

  13. 硅胶半管切口引流在肝胆疾病开放手术切口中的应用%Silicone Half Tube Incision Drainage in Open Operation Incision in Hepatobiliary Disease

    何清雄; 孔德平


    目的:探讨硅胶半管切口引流在肝胆疾病开放手术切口中的临床应用效果。方法回顾性总结我院收治的相关病例资料共计308例。结果158例应用硅胶半管切口内引流的患者有6例发生切口感染,切口感染率为3.8﹪;150例未应用硅胶半管切口内引流的患者有30例发生切口感染,切口感染率为20﹪,差异有统计学意义(<0.05)。结论硅胶半管切口引流在肝胆疾病开放手术切口中具有更优秀的临床效果。%Objective To explore the clinical application of silicone half tube incision drainage ef ect in hepatobiliary disease in open operation incision. Methods Retrospective analysis of our hospital were col ected a total of 308 cases of cor elation. Results 158 cases of application of silicone half tube incision drainage in patients with 6 cases of infection of incision, incision infection rate was 3.8﹪;150 patients without the use of silicone half tube incision drainage in patients with 30 cases of wound infection, wound infection rate of 20%, the dif erence was statistical y significant ( <0.05). Conclusion Silicone half pipe drainage has bet er clinical ef ect in hepatobiliary disease open operation incision.

  14. Transverse Skin Crease versus Vertical Midline Incision versus Laparoscopy for Right Hemicolectomy: A Systematic Review—Current Status of Right Hemicolectomy

    Alberto Santoro


    Full Text Available Purpose. The right hemicolectomy may be conducted through laparoscopic or laparotomic surgery, transverse or midline incisions. The transverse laparotomy offers some advantages compared to the midline laparotomy and laparoscopy. A literature review was performed to evaluate the possible advantages of the transverse incision versus midline incision or laparoscopic right hemicolectomy. Methods. A systematic research was performed in Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, BioMed Central, and the Science Citation Index. Results. Laparotomic right hemicolectomy with transverse incision is preferable to laparotomic hemicolectomy with midline incision. A transverse incision offers a lessened postoperative pain following physical activity, a lessened need to administer analgesic therapy during the post-operative time, better aesthetic results, and a better post-operative pulmonary function. Open surgery with transverse or midline incision ensured a shorter operative time, lower costs and a greater length of the incision compared to the laparoscopic. However, there are no differences in the oncological outcomes. Conclusions. It was not possible to identify significant differences between the open right hemicolectomy with transverse incision versus the open right hemicolectomy with midline incision or laparoscopic hemicolectomy.

  15. Transumbilical single incision laparoscopic cholecystectomy with conventional instruments: A continuing study

    Rajeev Sinha


    Full Text Available Introduction: The feasibility of the single incision, multiport transumbilical approach(SILC for the treatment of symptomatic gallbladder calculus disease has been established. Aims: The study examines both short and long term morbidity of the SILC approach. Materials and Methods: All the 1338 patients were operated by the same surgeon through a transversely placed umbilical incision in the upper third of the umbilicus.Three conventional ports,10,5 and 5 mm were introduced through the same skin incision but through separate transfascial punctures.The instruments were those used for standard laparoscopic cholecystectomy(SLC.Patients with acute cholecystitis and calculous pancreatitis were included,while those with choledocholithiasis were excluded.Results were compared with those of SLC. Results: Forty patients had difficult gall bladders, 214 had acute cholecystitis, and 16 had calculous pancreatitis.The mean operating time was 24.7 mins as compared to 18.4 mins in SLC. Intracorporeal knotting was required in four patients. Conversion to SLC was required in 12 patients.Morrisons pouch drain was left in 3 patients.Injectable analgesics were required in 85% vs 90% (SILC vs SLC on day 1 and 25% vs 45% on day 2 and infection was seen in 6(0. 45% patients.Port site hernia was seen in 2 patients. The data was compared with that of SLC and significance calculated by the student ′t′ test. A p value less than 0.05 was considered as significant. Conclusions: Trans umbilical SILC gives comparable results to SLC, and is a superior alternative when cosmesis and postoperative pain are considered, but the operative time is significantly more.

  16. Wound temperature profiles of coaxial mini-incision versus sleeveless microincision phacoemulsification.

    Belkin, Avner; Abulafia, Adi; Michaeli, Adi; Ofir, Shay; Assia, Ehud I


    Temperature profiles at the corneal wound of coaxial mini-incision (2.4 mm) cataract surgery and sleeveless microincision (1.1 mm) cataract surgery were compared. Prospective, controlled, paired-eye clinical trial conducted in a tertiary care hospital. Twenty patients with mild-to-moderate bilateral nuclear sclerotic cataract. Twenty patients underwent bilateral cataract surgery within a 1-month period. One eye was operated on by conventional coaxial mini-incision (2.4 mm) phacoemulsification. The second eye underwent microincision surgery by using a naked phacoemulsification tip and a specialized 19-gauge anterior chamber maintainer as the sole fluid source (three-port microincision cataract surgery technique). Patients had moderate bilateral cataracts with no other anterior segment pathology. Temperature at the corneal wound was constantly recorded by using infrared thermal imaging. Temperatures at the corneal wound. Mean temperatures at the corneal surgical wound were not significantly different between the coaxial and sleeveless groups (31.1 °C ± 2.3 vs. 31.0 °C ± 2. 0; P = 0.89). There was also no difference in maximum temperatures reached during phaco-emulsification. Temperatures did not rise above 40 °C during any surgery, and there were no corneal burns. Final visual acuity and intraoperative and postoperative complication rates were similar between the two groups. The temperature profile at the surgical wound using a microincisional sleeveless phacoemulsification technique is comparable with that of the conventional coaxial mini-incision method. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  17. Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne


    Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, “chopsticks” and “inline” dissection, 5.5 mm/52 cm/30° angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM. PMID:25392643

  18. Small-Incision Laparoscopy-Assisted Surgery Under Abdominal Cavity Irrigation in a Porcine Model

    Ishii, Takuro; Aoe, Tomohiko; Yu, Wen-Wei; Ebihara, Yuma; Kawahira, Hiroshi; Isono, Shiro; Naya, Yukio


    Abstract Background: Laparoscopic and robot-assisted surgeries are performed under carbon dioxide insufflation. Switching from gas to an isotonic irrigant introduces several benefits and avoids some adverse effects of gas insufflation. We developed an irrigating device and apparatus designed for single-incision laparoscopic surgery and tested its advantages and drawbacks during surgery in a porcine model. Materials and Methods: Six pigs underwent surgical procedures under general anesthesia. A 30-cm extracorporeal cistern was placed over a 5–6-cm abdominal incision. The abdomen was irrigated with warm saline that was drained via a suction tube placed near the surgical field and continuously recirculated through a closed circuit equipped with a hemodialyzer as a filter. Irrigant samples from two pigs were cultured to check for bacterial and fungal contamination. Body weight was measured before and after surgery in four pigs that had not received treatments affecting hemodynamics or causing diuresis. Results: One-way flow of irrigant ensured laparoscopic vision by rinsing blood from the surgical field. Through a retroperitoneal approach, cystoprostatectomy was successfully performed in three pigs, nephrectomy in two, renal excision in two, and partial nephrectomy in one, under simultaneous ultrasonographic monitoring. Through a transperitoneal approach, liver excision and hemostasis with a bipolar sealing device were performed in three pigs, and bladder pedicle excision was performed in one pig. Bacterial and fungal contamination of the irrigant was observed on the draining side of the circuit, but the filter captured the contaminants. Body weight increased by a median of 2.1% (range, 1.2–4.4%) of initial weight after 3–5 hours of irrigation. Conclusions: Surgery under irrigation is feasible and practical when performed via a cistern through a small abdominal incision. This method is advantageous, especially in the enabling of continuous and free

  19. Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

    Jeon In-Ho


    Full Text Available Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77 years and average follow up period was 23.9 months (range: 12-60 months. The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I , 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

  20. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus

    Praveenraj Palanivelu


    Full Text Available Background: The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. Material and Methods: A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11 and with corrugated drain (2.09 needlescopic method (1.2, Umbilical tape sling (1.95, crural stitch method (2.5. Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. Conclusions: The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.