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  1. Reoperation versus clinical recurrence rate after ventral hernia repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2012-01-01

    OBJECTIVE:: To compare the clinical recurrence rate with reoperation rate for recurrence after ventral hernia repair. BACKGROUND:: Reoperation is often used as an outcome measure after ventral hernia repair, but it is unknown whether reoperation rate reflects the overall clinical risk for recurre...

  2. reoperation rates following intramedullary nailing versus external ...

    African Journals Online (AJOL)

    Reasons for reoperation among EF patients were infection. (2 patients) ... fixation. Keywords: Orthopaedic surgery, Tanzania, Intramedullary nail, External fixation, Open tibia fracture. INTRODUCTION ..... of surgical site infection. Infect Control ...

  3. Predictors of re-operation due to post-surgical bleeding in breast cancer patients

    DEFF Research Database (Denmark)

    Lietzen, Lone Winther; Cronin-Fenton, D; Garne, J P

    2012-01-01

    To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation.......To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation....

  4. Lower reoperation rates with the use of fibrin sealant versus tacks for mesh fixation

    DEFF Research Database (Denmark)

    Helvind, Neel Maria; Andresen, Kristoffer; Rosenberg, Jacob

    2013-01-01

    BACKGROUND: Groin hernia repair may be associated with long-term complications such as chronic pain, believed to result from damage to regional nerves by tissue penetrating mesh fixation. Studies have shown that mesh fixation with fibrin sealant reduces the risk of these long-term complications......, but data on recurrence and reoperation rates after the use of fibrin sealant compared with tacks are not available. This study aimed to determine whether fibrin sealant is a safe and feasible alternative to tacks with regard to reoperation rates after laparoscopic groin hernia repair. METHODS: The current...... study compared reoperation rates after laparoscopic groin hernia repair between fibrin sealant and tacks used for mesh fixation. The study used data collected prospectively from The National Danish Hernia Database and analyzed 8,314 laparoscopic groin hernia repairs for reoperation rates. Mesh fixation...

  5. A review: Reduced reoperation rate for multilevel lumbar laminectomies with noninstrumented versus instrumented fusions

    Directory of Open Access Journals (Sweden)

    Nancy Ellen Epstein

    2016-01-01

    Conclusions: Many studies document no benefit for adding instrumentation to laminectomies performed for degenerative disease, including spondylolisthesis. Reoperation rates for laminectomy alone/laminectomy with noninstrumented fusions vary from 1.3% to 5.6% whereas reoperation rates for ASD after instrumented PLIF was 80% at 5 postoperative years. This review should prompt spinal surgeons to reexamine when, why, and whether instrumentation is really necessary, particularly for treating degenerative lumbar disease.

  6. Complications and re-operation rate after tension-band wiring of olecranon fractures

    DEFF Research Database (Denmark)

    Romero, J M; Miran, A; Jensen, Claus Hjorth

    2000-01-01

    Tension-band wire fixation of olecranon fractures leads to a high re-operation rate because of the need to remove the metalware. This problem has commonly been thought to be related mainly to the backing-out of the Kirschner wires. A retrospective study was carried out in 55 patients with displaced...... olecranon fractures operated on with the tension-band wiring technique, in whom there was an overall 71.7% re-operation rate. Complications were few and minor in most patients. The main reason for the removal of the metalware was a direct complaint from the patient (in 61.3% of all removals). A literature...

  7. Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

    2006-01-01

    Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should......OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior...

  8. Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

    2006-01-01

    Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should......OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior...

  9. Reoperation for bleeding in cardiac surgery

    DEFF Research Database (Denmark)

    Kristensen, Katrine Lawaetz; Rauer, Line Juul; Mortensen, Poul Erik

    2012-01-01

    bleeding, we aim to identify risk factors that predict reoperation. A total of 1452 consecutive patients undergoing cardiac surgery using extracorporeal circulation (ECC) between November 2005 and December 2008 at OUH were analysed. Statistical tests were used to identify risk factors for reoperation. We...... after cardiac surgery was low ejection fraction, high EuroSCORE, procedures other than isolated CABG, elongated time on ECC, low body mass index, diabetes mellitus and preoperatively elevated s-creatinine. Reoperated patients significantly had a greater increase in postoperative s-creatinine and higher......At Odense University Hospital (OUH), 5-9% of all unselected cardiac surgical patients undergo reoperation due to excessive bleeding. The reoperated patients have an approximately three times greater mortality than non-reoperated. To reduce the rate of reoperations and mortality due to postoperative...

  10. Reoperation Rates in Ductal Carcinoma In Situ vs Invasive Breast Cancer After Wire-Guided Breast-Conserving Surgery

    DEFF Research Database (Denmark)

    Langhans, Linnea; Jensen, Maj-Britt; Talman, Maj-Lis M;

    2017-01-01

    the Danish National Patient Registry that were cross-checked with the Danish Breast Cancer Group database and the Danish Pathology Register. Main Outcomes and Measures: Reoperation rate after wire-guided BCS in patients with IBC or DCIS. Results: Wire-guided BCS was performed in 4118 women (mean [SD] age, 60......Importance: New techniques for preoperative localization of nonpalpable breast lesions may decrease the reoperation rate in breast-conserving surgery (BCS) compared with rates after surgery with the standard wire-guided localization. However, a valid reoperation rate for this procedure needs...... to be established for comparison, as previous studies on this procedure include a variety of malignant and benign breast lesions. Objectives: To determine the reoperation rate after wire-guided BCS in patients with histologically verified nonpalpable invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS...

  11. Reoperation for urinary incontinence

    DEFF Research Database (Denmark)

    Foss Hansen, Margrethe; Lose, Gunnar; Kesmodel, Ulrik Schiøler

    2016-01-01

    on a nationwide population. STUDY DESIGN: We used the Danish National Patient Registry to identify women who had surgery for urinary incontinence from 1998 through 2007 and the outcome was a reoperation within 5 years. Kaplan-Meier curves were used to estimate the rate of reoperation for 6 types of surgery...

  12. Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik

    2014-01-01

    IMPORTANCE: In Denmark approximately 10 000 groin hernias are repaired annually, of which 2% to 4% are femoral hernias. Several methods for repair of femoral hernias are used including sutured repair and different types of mesh repair with either open or laparoscopic techniques. The use of many...... laparoscopic vs open femoral hernia repair, analyzing data from a nationwide database. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted. Data on femoral hernia repairs registered in the Danish Hernia Database from January 1998 until February 2012 were extracted and analyzed. All...... repairs were followed in the database and analyzed for reports of reoperation, which were used as a proxy for recurrence. Femoral hernia recurrence and inguinal hernia occurrence after the index repair were analyzed. EXPOSURE: Repair of a femoral hernia. MAIN OUTCOMES AND MEASURES: Reoperation...

  13. Radiographic failure and rates of re-operation after acromioclavicular joint reconstruction: a comparison of surgical techniques.

    Science.gov (United States)

    Spencer, H T; Hsu, L; Sodl, J; Arianjam, A; Yian, E H

    2016-04-01

    To compare radiographic failure and re-operation rates of anatomical coracoclavicular (CC) ligament reconstructional techniques with non-anatomical techniques after chronic high grade acromioclavicular (AC) joint injuries. We reviewed chronic AC joint reconstructions within a region-wide healthcare system to identify surgical technique, complications, radiographic failure and re-operations. Procedures fell into four categories: (1) modified Weaver-Dunn, (2) allograft fixed through coracoid and clavicular tunnels, (3) allograft loop coracoclavicular fixation, and (4) combined allograft loop and synthetic cortical button fixation. Among 167 patients (mean age 38.1 years, (standard deviation (sd) 14.7) treated at least a four week interval after injury, 154 had post-operative radiographs available for analysis. Radiographic failure occurred in 33/154 cases (21.4%), with the lowest rate in Technique 4 (2/42 4.8%, p = 0.001). Half the failures occurred by six weeks, and the Kaplan-Meier survivorship at 24 months was 94.4% (95% confidence interval (CI) 79.6 to 98.6) for Technique 4 and 69.9% (95% CI 59.4 to 78.3) for the other techniques when combined. In multivariable survival analysis, Technique 4 had better survival than other techniques (Hazard Ratio 0.162, 95% CI 0.039 to 0.068, p = 0.013). Among 155 patients with a minimum of six months post-operative insurance coverage, re-operation occurred in 9.7% (15 patients). However, in multivariable logistic regression, Technique 4 did not reach a statistically significant lower risk for re-operation (odds ratio 0.254, 95% CI 0.05 to 1.3, p = 0.11). In this retrospective series, anatomical CC ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. Anatomical coracoclavicular ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. ©2016 The British Editorial

  14. Lower Reoperation Rate for Recurrence after Mesh versus Sutured Elective Repair in Small Umbilical and Epigastric Hernias. A Nationwide Register Study

    DEFF Research Database (Denmark)

    Christoffersen, Mette Willaume; Helgstrand, F; Rosenberg, J;

    2013-01-01

    Repair for a small (≤2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well...... documented. The aim of the present study was in a nationwide setup to investigate the reoperation rate for recurrence after small open umbilical and epigastric hernia repairs using either sutured or mesh repair....

  15. Intraoperative frozen section analysis of margins in breast conserving surgery significantly decreases reoperative rates: one-year experience at an ambulatory surgical center.

    Science.gov (United States)

    Jorns, Julie M; Visscher, Daniel; Sabel, Michael; Breslin, Tara; Healy, Patrick; Daignaut, Stephanie; Myers, Jeffrey L; Wu, Angela J

    2012-11-01

    Intraoperative frozen section (FS) margin evaluation is not common practice for patients undergoing breast conservation therapy (BCT), but offers a significant reduction in reoperation. In this study, a technique to allow for more effective freezing of breast tissue was developed to perform FS evaluation of lumpectomy margins (FSM) for all patients undergoing BCT at an ambulatory surgery center. FS evaluation of sentinel lymph node biopsy specimens was performed concurrently. One hundred eighty-one study and 188 control patients, with and without FS evaluation, were compared. Reexcision was reduced 34% (from 48.9% to 14.9%) and reoperation was reduced 36% (from 55.3% to 19.3%) with FS evaluation. Most of the decrease in reoperative rate was because of a decrease in the need for margin reexcision. The number of patients requiring 1, 2, or 3 operations to complete therapy was 84, 92, and 12, respectively, in the control group, and 146, 33, and 2, respectively, in the study group. Lobular subtype, multifocal disease, and larger tumor size (≥2 cm) were significantly associated with failure of FSM to prevent reoperation, but reoperation rates were still significantly decreased in this subgroup of patients (from 75.5% to 43.8%) with FSM. This study highlights an innovative yet simple and adaptable FS approach that resulted in a nearly 3-fold reduction in reoperation for patients undergoing BCT.

  16. Body mass index is not associated with reoperation rates in patients with a surgically treated perforated peptic ulcer

    DEFF Research Database (Denmark)

    Duch, Patricia; Møller, Morten Hylander

    2015-01-01

    INTRODUCTION: The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU). METHODS: This was a nationwide cohort study of all Danish patients who were...... surgically treated for benign gastric or duodenal PPU between 2011 and 2013. OUTCOME MEASURES: reoperation within 30 days of the primary surgical procedure and 90-day survival. The association between BMI and reoperation are presented as crude and adjusted odds ratios (OR) with 95% confidence intervals (CIs...

  17. Return to Function, Complication, and Reoperation Rates Following Primary Pectoralis Major Tendon Repair in Military Service Members.

    Science.gov (United States)

    Nute, Drew W; Kusnezov, Nicholas; Dunn, John C; Waterman, Brian R

    2017-01-04

    Pectoralis major tendon ruptures have become increasingly common injuries among young, active individuals over the past 30 years; however, there is presently a paucity of reported outcome data. We investigated the ability to return to full preoperative level of function, complications, reoperation rates, and risk factors for failure following surgical repair of the pectoralis major tendon in a cohort of young, highly active individuals. All U.S. active-duty military patients undergoing pectoralis major tendon repair between 2008 and 2013 were identified from the Military Health System using the Management Analysis and Reporting Tool (M2). Demographic characteristics, injury characteristics, and trends in preoperative and postoperative self-reported pain scale (0 to 10) and strength were extracted. The ability to return to the full preoperative level of function and rates of rerupture and reoperation were the primary outcome measures. Univariate analysis followed by multivariate analysis identified significant variables. A total of 257 patients with pectoralis major tendon repair were identified with a mean follow-up (and standard deviation) of 47.8 ± 17 months (range, 24 to 90 months). At the time of the latest follow-up, 242 patients (94%) were able to return to the full preoperative level of military function. Fifteen patients (5.8%) were unable to return to duty because of persistent upper-extremity disability. A total of 15 reruptures occurred in 14 patients (5.4%). Increasing body mass index and active psychiatric conditions were significant predictors of inability to return to function (odds ratio, 1.56 [p = 0.0001] for increasing body mass index; and odds ratio, 6.59 [p = 0.00165] for active psychiatric conditions) and total failure (odds ratio, 1.26 [p = 0.0012] for increasing body mass index; and odds ratio, 2.73 [p = 0.0486] for active psychiatric conditions). We demonstrate that 94% of patients were able to return to the full preoperative level of

  18. Late Corrective Arthrodesis in Nonplantigrade Diabetic Charcot Midfoot Disease Is Associated with High Complication and Reoperation Rates

    Directory of Open Access Journals (Sweden)

    Anica Eschler

    2015-01-01

    Full Text Available Introduction. Charcot arthropathy may lead to a loss of osteoligamentous foot architecture and consequently loss of the plantigrade alignment. In this series of patients a technique of internal corrective arthrodesis with maximum fixation strength was provided in order to lower complication rates. Materials/Methods. 21 feet with severe nonplantigrade diabetic Charcot deformity Eichenholtz stages II/III (Sanders/Frykberg II/III/IV and reconstructive arthrodesis with medial and additional lateral column support were retrospectively enrolled. Follow-up averaged 4.0 years and included a clinical (AOFAS score/PSS, radiological, and complication analysis. Results. A mean of 2.4 complications/foot occurred, of which 1.5/foot had to be solved surgically. 76% of feet suffered from soft tissue complications; 43% suffered hardware-associated complications. Feet with only 2 out of 5 high risk criteria according to Pinzur showed significantly lower complication counts. Radiographs revealed a correct restoration of all foot axes postoperatively with superior fixation strength medially. Conclusion. Late corrective arthrodesis with medial and lateral column stabilization in the nonplantigrade stages of neuroosteoarthropathy can provide reasonable reconstruction of the foot alignment. Nonetheless, overall complication/reoperation rates were high. With separation into low/high risk criteria a helpful guide in treatment choice is provided. This trial is registered with German Clinical Trials Register (DRKS under number DRKS00007537.

  19. High Re-Operation Rates Using Conserve Metal-On-Metal Total Hip Articulations

    DEFF Research Database (Denmark)

    Mogensen, S L; Jakobsen, Thomas; Christoffersen, Hardy;

    2016-01-01

    INTRODUCTION: Metal-on-metal hip articulations have been intensely debated after reports of adverse reactions and high failure rates. The aim of this study was to retrospectively evaluate the implant of a metal-on.metal total hip articulation (MOM THA) from a single manufacture in a two...

  20. Reoperative midface reconstruction.

    Science.gov (United States)

    Acero, Julio; García, Eloy

    2011-02-01

    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed.

  1. Infantile esotropia: risk factors associated with reoperation

    Directory of Open Access Journals (Sweden)

    Magli A

    2016-10-01

    Full Text Available Adriano Magli,1 Luca Rombetto,2 Francesco Matarazzo,2 Roberta Carelli1 1Department of Ophthalmology, Orthoptics and Pediatric Ophthalmology, University of Salerno, Salerno, 2Department of Ophthalmology, Federico II University, Naples, Italy Abstract: The aim of this study was to identify clinical and demographic factors associated with misalignment after first surgery performed on children affected by infantile esotropia to evaluate the reoperation rate. A retrospective study was carried out, analyzing data from 525 children who underwent bilateral medial recti recession, bilateral lateral recti resection, and inferior oblique recession and anteroposition by the same surgeon (AM. Postoperative evaluation included assessment of motor alignment at approximately 3 months, 6 months, 1 year, and 5 years. Statistical analysis was performed with a logistical regression model in which the dependent variable was the presence/absence of reoperation. We found that late surgery (after 3 years of age and a family history of strabismus are associated with a higher risk of reoperation, while some clinical factors, including some classically associated with worst motor outcome as preoperative angle, dissociated vertical deviation, and amblyopia, did not influence the incidence of reoperation in infantile esotropia. Male patients and patients with hyperopia in preoperative examinations have a significantly decreased reoperation rate. Keywords: infantile esotropia, risk factors, reoperation

  2. Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie); M.M.A. Tilanus-Linthorst (Madeleine); S. Spronk (Sandra); C.H.M. van Deurzen (Carolien); C. de Monyé (Cécile); M.G.M. Hunink (Myriam); M.B. Menke (Marian )

    2013-01-01

    textabstractOBJECTIVE. In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations. SUBJECTS AND METHODS. The study group consisted of 1

  3. Reoperation of biliary tract by laparoscopy: experiences with 39 cases.

    Science.gov (United States)

    Li, Li-Bo; Cai, Xiu-Jun; Mou, Yi-Ping; Wei, Qi

    2008-05-21

    To evaluate the safety and feasibility of biliary tract reoperation by laparoscopy for the patients with retained or recurrent stones who failed in endoscopic sphincterotomy. A retrospective analysis of data obtained from attempted laparoscopic reoperation for 39 patients in a single institution was performed, examining open conversion rates, operative times, complications, and hospital stay. Out of the 39 cases, 38 (97%) completed laparoscopy, 1 required conversion to open operation because of difficulty in exposing the common bile duct. The mean operative time was 135 min. The mean post-operative hospital stay was 4 d. Procedures included laparoscopic residual gallbladder resection in 3 cases, laparoscopic common bile duct exploration and primary duct closure at choledochotomy in 13 cases, and laparoscopic common bile duct exploration and choledochotomy with T tube drainage in 22 cases. Duodenal perforation occurred in 1 case during dissection and was repaired laparoscopically. Retained stones were found in 2 cases. Postoperative asymptomatic hyperamlasemia occurred in 3 cases. There were no complications due to port placement, postoperative bleeding, bile or bowel leakage and mortality. No recurrence or formation of duct stricture was observed during a mean follow-up period of 18 mo. Laparoscopic biliary tract reoperation is safe and feasible if it is performed by experienced laparoscopic surgeons, and is an alternative choice for patients with choledocholithiasis who fail in endoscopic sphincterectomy.

  4. Analysis of adjacent segment reoperation after lumbar total disc replacement

    OpenAIRE

    Rainey, Scott; Blumenthal, Scott L.; Zigler, Jack E.; Guyer, Richard D.; Ohnmeiss, Donna D.

    2012-01-01

    Background Fusion has long been used for treating chronic back pain unresponsive to nonoperative care. However, potential development of adjacent segment degeneration resulting in reoperation is a concern. Total disc replacement (TDR) has been proposed as a method for addressing back pain and preventing or reducing adjacent segment degeneration. The purpose of the study was to determine the reoperation rate at the segment adjacent to a level implanted with a lumbar TDR and to analyze the pre-...

  5. Accidental falls involving medical implant re-operation.

    Science.gov (United States)

    Ong, Kevin L; Lau, Edmund; Moore, Tara; Heller, Michelle F

    2009-10-01

    Implantation of medical devices is becoming more prevalent, and as a result, a greater number of patients who fall accidentally are expected to have a medical implant. The Nationwide Inpatient Sample (NIS) was used to evaluate hospital admissions following accidental falls involving re-operation of existing medical implants (hip, knee, spine, and fracture fixation) from 1990 to 2005. From 1990 to 2005, hospitalisations due to accidental falls on level surfaces increased by 306%, and hospitalisations due to falls from stairs increased by 310%. Falls involving orthopaedic revision surgery (re-operation) are relatively rare, but the incidence has increased by approximately 35%. Hospital stays after falls on level surfaces involving re-operation were 1.0 day (median) longer and cost 50% (median) more than those that did not involve re-operation in 2005. After staircase falls, hospital stays for patients undergoing re-operations were 2.0 days (median) longer and cost 108% (median) more. The greater hospital costs and hospital stay for patients needing re-operations indicate that additional medical treatment was required.

  6. Higher risk of reoperation for bipolar and uncemented hemiarthroplasty.

    Science.gov (United States)

    Leonardsson, Olof; Kärrholm, Johan; Åkesson, Kristina; Garellick, Göran; Rogmark, Cecilia

    2012-10-01

    Hemiarthroplasty as treatment for femoral neck fractures has increased markedly in Sweden during the last decade. In this prospective observational study, we wanted to identify risk factors for reoperation in modular hemiarthroplasties and to evaluate mortality in this patient group. We assessed 23,509 procedures from the Swedish Hip Arthroplasty Register using the most common surgical approaches with modular uni- or bipolar hemiarthroplasties related to fractures in the period 2005-2010. Completeness of registration (individual procedures) was 89-96%. The median age was 85 years and the median follow-up time was 18 months. 3.8% underwent reoperation (any further hip surgery), most often because of implant dislocation or infection. The risk of reoperation (Cox regression) was higher for uncemented stems (hazard ratio (HR) = 1.5), mainly because of periprosthetic femoral fractures. Bipolar implants had a higher risk of reoperation irrespective of cause (HR = 1.3), because of dislocation (1.4), because of infection (1.3), and because of periprosthetic fracture (1.7). The risk of reoperation due to acetabular erosion was lower (0.30) than for unipolar implants, but reoperation for this complication was rare (1.7 per thousand). Procedures resulting from failed internal fixation had a more than doubled risk; the risk was also higher for males and for younger patients. The surgical approach had no influence on the risk of reoperation generally, but the anterolateral transgluteal approach was associated with a lower risk of reoperation due to dislocation (HR = 0.7). At 1 year, the mortality was 24%. Men had a higher risk of death than women (1.8). We recommend cemented hemiarthroplasties and the anterolateral transgluteal approach. We also suggest that unipolar implants should be used, at least for the oldest and frailest patients.

  7. Reoperation of the biliary tract by laparoscopy: an analysis of 39 cases.

    Science.gov (United States)

    Li, Libo; Cai, Xiujun; Mou, Yiping; Wei, Qi

    2008-10-01

    Previously, prior biliary tract surgery was considered a contraindication to laparoscopic biliary tract reoperation. In this paper, we present our experience with laparoscopic biliary tract reoperation for patients with the choledocholithiasis for whom the endoscopic sphincterotomy has failed or is contraindicated. A retrospective analysis was performed on data from the attempted laparoscopic reoperation of 39 patients, examining open conversion rates, operative times, complications, and length of hospital stay. Of 39 cases, 38 were completed laparoscopically: 1 case required a conversion to the open operation because of difficulty in exposing the common bile duct. Mean operative time was 135 minutes. Mean postoperative hospital stay was 4 days. Procedures included 3 cases of laparoscopic residual gallbladder resection, 13 cases of laparoscopic common bile duct exploration and primary duct closure of choledochotomy, and 22 cases of laparoscopic common bile duct exploration and choledochotomy with T-tube drainage. There was 1 case of duodenal perforation during dissection, which was repaired laparoscopically. There were 2 cases of retained stones. Postoperative asymptomatic hypermalasia occurred in 3 cases. There were no complications due to port placement, no postoperative bleeding, bile or bowel leakage, and no mortality. At a mean follow-up time of 18 months, there was no recurrence or formation of duct stricture. The laparoscopic biliary tract reoperation is safe and feasible for experienced laparoscopic surgeons and is an alternative choice for patients with choledocholithiasis for whom the endoscopic sphincterectomy has failed or is contraindicated.

  8. Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis

    Science.gov (United States)

    Hwang, Hee-Jong; Lee, Gwang-Soo; Heo, June-Young; Chang, Jae-Chil

    2016-01-01

    Objective The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation. Methods A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored. Results Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation. Conclusion Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS. PMID:28127375

  9. Impact of early reoperation following living-donor liver transplantation on graft survival.

    Directory of Open Access Journals (Sweden)

    Yoshikuni Kawaguchi

    Full Text Available BACKGROUND: The reoperation rate remains high after liver transplantation and the impact of reoperation on graft and recipient outcome is unclear. The aim of our study is to evaluate the impact of early reoperation following living-donor liver transplantation (LDLT on graft and recipient survival. METHODS: Recipients that underwent LDLT (n = 111 at the University of Tokyo Hospital between January 2007 and December 2012 were divided into two groups, a reoperation group (n = 27 and a non-reoperation group (n = 84, and case-control study was conducted. RESULTS: Early reoperation was performed in 27 recipients (24.3%. Mean time [standard deviation] from LDLT to reoperation was 10 [9.4] days. Female sex, Child-Pugh class C, Non-HCV etiology, fulminant hepatitis, and the amount of intraoperative fresh frozen plasma administered were identified as possibly predictive variables, among which females and the amount of FFP were identified as independent risk factors for early reoperation by multivariable analysis. The 3-, and 6- month graft survival rates were 88.9% (95%confidential intervals [CI], 70.7-96.4, and 85.2% (95%CI, 66.5-94.3, respectively, in the reoperation group (n = 27, and 95.2% (95%CI, 88.0-98.2, and 92.9% (95%CI, 85.0-96.8, respectively, in the non-reoperation group (n = 84 (the log-rank test, p = 0.31. The 12- and 36- month overall survival rates were 96.3% (95%CI, 77.9-99.5, and 88.3% (95%CI, 69.3-96.2, respectively, in the reoperation group, and 89.3% (95%CI, 80.7-94.3 and 88.0% (95%CI, 79.2-93.4, respectively, in the non-reoperation group (the log-rank test, p = 0.59. CONCLUSIONS: Observed graft survival for the recipients who underwent reoperation was lower compared to those who did not undergo reoperation, though the result was not significantly different. Recipient overall survival with reoperation was comparable to that without reoperation. The present findings enhance the importance of vigilant

  10. 机械瓣膜置换术后瓣膜故障再次手术换瓣临床分析%Clinical analysis of reoperation due to valve dysfunction after mechanical valve replacement

    Institute of Scientific and Technical Information of China (English)

    黄国晖; 张健群; 孙广龙; 迟立群; 穆军升

    2012-01-01

    Objective To observe the effect of the re-operation after mechanical valve replacement and to analyze dysfunction reason,operation time and operation effect of reoperation.Methods Thirty-three cases with reoperation of valve replacement were chosen from March 2003 to May 2010,including 17 cases of mitral valve replacement,9 aortic valve replacement,2 mitral valve and aortic valve replacement,2 mitral valve replacement and 3 tricuspid valve annuloplasty and 3 tricuspid valve replacement Heart function was compared before and after operation according to the New York Heart Association (NYHA).Results Among 33 cases of reoperation,1 case (3.0%)died and heart function of 32 survival cases improved significantly.The number of preoperative heart function grade Ⅰ,Ⅱ,Ⅲ,Ⅳ was 0,13 (39.4% ),15 (45.4%)and 5 (15.2% ).After 6 months,32 patients survived;the number of preoperative heart function grade Ⅰ, Ⅱ,Ⅲ,Ⅳ was 16 (50.0%),12 (37.5%),4 (12.5% )and 0.The proportion of the patients in grade Ⅰ,Ⅲ,Ⅳ showed statistical difference (P <0.05).Conclusion Reoperation is the main therapy method of treating valve dysfunction after mechanical valve replacement;we should pay attention to operation time,operation method and selection of valve type.%目的 观察机械瓣膜置换术后瓣膜故障再次手术换瓣临床效果,分析故障原因、手术时机选择及手术效果.方法 选择2003年3月至2010年5月行再次手术换瓣患者33例,其中二尖瓣置换术17例、主动脉瓣置换术9例、二尖瓣+主动脉瓣置换术2例、二尖瓣置换+三尖瓣成形术2例、三尖瓣置换术3例.治疗前后对患者行心功能评级,参照纽约心脏病协会(NYHA)心功能标准,进行比较分析.结果 33例再次手术换瓣患者中,死亡1例(3.0%),32例存活患者心功能明显改善.33例患者术前心功能分级Ⅰ级0例,Ⅱ级13例(39.4%),Ⅲ级15例(45.4%),Ⅳ级5例(15.2%);术后6个月复查,32例患

  11. Reoperations for occluded arterial bypasses in the lower limbs

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background We reviewed the outcomes of reoperations for 29 patients (30 limbs) who had undergone occluded arterial bypass in the lower limbs from May 1996 to September 2005. Methods The 30 lower limbs of the 29 patients with arteriosclerotic obstruction received 44 reoperations, including thrombectomy alone (group T, 27) and inflow or outflow reconstruction plus thrombectomy (group C, 17). Among the 17 operations in group C, 17.6% (3/17) were inflow reconstructions involving the axillary-femoral (1), aorta-iliac (1) and aorta-femoral (1) arteries, and 76.4% (13/17) outflow reconstructions involving the femoral-popliteal bypass-tibial (8), femoral-tibial (1), femoral-popliteal bypass-popliteal arteries below the knee (2), and the femoral-popliteal bypass-tibial-peroneal trunk (2). One patient (1 limb) underwent both inflow and outflow reconstructions with an iliac arterial stent and a graft-popliteal anastomosis patch. Polytetrafluoroethylene (PTFE) grafts were used in the inflow or outflow reconstructions abve the knee. Autovenous grafts or autovenously combined PTFE grafts were used in the outflow reconstructions below the knee. Results The percentages of Fontaine stage III and IV before primary operation and reoperation were 60% (18/30) and 86.7% (26/30), respectively (P0.05). Among 42 reoperations, 19 failed within 1 month in groups T (16) and C (3) (P0.05). The rate of limb salvage was 64.29% (18/28). Conclusions The percentages of Fontaine stage III and IV before reoperation may be much higher than those before primary operation. Thrombectomy plus inflow/outflow reconstruction creates patency better than thrombectomy alone for re-occluded bypass.

  12. The choice of reoperation after primary surgeries for uterine prolapse: A nationwide study

    Directory of Open Access Journals (Sweden)

    Ming-Ping Wu

    2015-11-01

    Conclusion: Our study offers a population-based nationwide observation that hysteropexy correlates with a higher reoperation rate, as compared with hysterectomy; but it is still as high as 30% in the surgical choice of the failed hysteropexy group.

  13. The benefit patients derive from aortocoronary reoperation.

    Science.gov (United States)

    Weinhold, C; Neumaier, P S; Klinner, W

    1988-10-01

    There is an increasing incidence of aorto coronary reoperation necessitated by intractable angina which averages 2% of 4676 initial bypass procedures. Graft obliteration, graft stenosis or progression of disease led to recurrence of symptoms in 96 patients (84 male, 12 female) who underwent a second operation. Not all occluded or stenotic bypasses were feasible for reoperation. Hospital mortality (30 days) was higher than after initial CABG, but could be reduced from 12.1% to 4.8%. Subjective and objective follow-up investigations were obtained in 77 of 84 survivors and demonstrate that successful reoperation is about 10% lower in patients with a malignant form of atherosclerosis (60%) than in patients who only suffer from occluded grafts or new proximal significant stenoses in previously unbypassed vessels (70%).

  14. Once is Rarely Enough: A Population-Based Study of Reoperations after Postmastectomy Breast Reconstruction.

    Science.gov (United States)

    Roberts, Amanda; Baxter, Nancy; Camacho, Ximena; Lau, Cindy; Zhong, Toni

    2015-10-01

    Postmastectomy breast reconstruction (PMBR) aims to surgically restore a breast mound following mastectomy. However, additional surgical procedures after PMBR can lead to increased postsurgical morbidity and healthcare utilization. The primary purpose of our study was to determine the overall population-based reoperation rates following PMBR in Ontario, Canada. We conducted a population-based retrospective cohort study that included women aged 18-65 years who underwent a prophylactic or therapeutic mastectomy with immediate or delayed PMBR between April 1, 2002 and March 31, 2008. Reoperations to the breast or donor site used for reconstruction were identified using the Ontario Health Insurance Plan billing codes submitted by general or plastic surgeons. Reoperations were categorized as anticipated, unanticipated major, unanticipated minor, or oncologic. Patients were followed from the date of their PMBR to March 31, 2013, or death. Overall, 3972 women underwent PMBR between April 1, 2002 and March 31, 2008. Among them, 3504 (88%) underwent at least one reoperation during an average follow-up of 5.1 years. The median number of procedures per patient was two (mean 2.4, range 0-26). One of ten patients had three or more unanticipated major reoperations during the follow-up period. Our results provide the first long-term population-level data on the current state of PMBR reoperation rates. The results from this study will inform patient-physician surgical decision-making and provide quantitative expectations of morbidity related to PMBR.

  15. The electron energy loss rate due to radiative recombination

    Science.gov (United States)

    Mao, Junjie; Kaastra, Jelle; Badnell, N. R.

    2017-02-01

    Context. For photoionized plasmas, electron energy loss rates due to radiative recombination (RR) are required for thermal equilibrium calculations, which assume a local balance between the energy gain and loss. While many calculations of total and/or partial RR rates are available from the literature, specific calculations of associated RR electron energy loss rates are lacking. Aims: Here we focus on electron energy loss rates due to radiative recombination of H-like to Ne-like ions for all the elements up to and including zinc (Z = 30), over a wide temperature range. Methods: We used the AUTOSTRUCTURE code to calculate the level-resolved photoionization cross section and modify the ADASRR code so that we can simultaneously obtain level-resolved RR rate coefficients and associated RR electron energy loss rate coefficients. We compared the total RR rates and electron energy loss rates of H i and He i with those found in the literature. Furthermore, we utilized and parameterized the weighted electron energy loss factors (dimensionless) to characterize total electron energy loss rates due to RR. Results: The RR electron energy loss data are archived according to the Atomic Data and Analysis Structure (ADAS) data class adf48. The RR electron energy loss data are also incorporated into the SPEX code for detailed modeling of photoionized plamsas. Full Tables 1 and 2 are available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/599/A10

  16. Associations between Reoperations and Psychological Factors after Contralateral Risk-Reducing Mastectomy: A Two-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Dmytro Unukovych

    2016-01-01

    Full Text Available Introduction. The aim of the study was to investigate associations between reoperations after contralateral risk-reducing mastectomies (CRRM and emotional problems, body image, sexuality, and health related quality of life (HRQoL in women with breast cancer and hereditary high risk. Patients and Methods. Patients scheduled for CRRM with breast reconstruction between 1998 and 2010 completed questionnaires, comprised of SF-36, the Hospital Anxiety and Depression Scale, the Body Image Scale, and the Sexual Activity Questionnaire, preoperatively and two years after CRRM. Data on reoperations was collected from medical charts. Results. A total of 80 women participated, with a response rate of 61 (76% preoperatively and 57 (71% at the two-year follow-up. At the two-year assessment, 44 (55% patients had undergone ≥1 reoperation (reoperation group, whereas 36 (45% had not (no reoperation group. No statistically significant differences between the groups were found for HRQoL, sexuality, anxiety, or depression. A higher proportion of patients in the “reoperation group” reported being dissatisfied with their bodies (81% versus 48%, p=0.01. Conclusion. The results suggest associations between reoperation following CRRM with breast reconstruction and body image problems. Special attention should be paid to body image problems among women who are subject to reoperations after CRRM.

  17. Migration rates of planets due to scattering of planetesimals

    CERN Document Server

    Ormel, Chris; Tanaka, Hidekazu

    2012-01-01

    Planets migrate due to the recoil they experience from scattering solid (planetesimal) bodies. To first order, the torques exerted by the interior and exterior disks cancel, analogous to the cancellation of the torques from the gravitational interaction with the gas (type I migration). Assuming the dispersion-dominated regime and power-laws characterized by indices {\\alpha} and {\\beta} for the surface density and eccentricity profiles, we calculate the net torque on the planet. We consider both distant encounters and close (orbit-crossing) encounters. We find that the close and distant encounter torques have opposite signs with respect to their {\\alpha} and {\\beta} dependences; and that the torque is especially sensitive to the eccentricity gradient ({\\beta}). Compared to type-I migration due to excitation of density waves, the planetesimal-driven migration rate is generally lower due to the lower surface density of solids in gas-rich disk, although this may be partially or fully offset when their eccentricit...

  18. Is the normal heart rate "chaotic" due to respiration?

    Science.gov (United States)

    Wessel, Niels; Riedl, Maik; Kurths, Jürgen

    2009-06-01

    The incidence of cardiovascular diseases increases with the growth of the human population and an aging society, leading to very high expenses in the public health system. Therefore, it is challenging to develop sophisticated methods in order to improve medical diagnostics. The question whether the normal heart rate is chaotic or not is an attempt to elucidate the underlying mechanisms of cardiovascular dynamics and therefore a highly controversial topical challenge. In this contribution we demonstrate that linear and nonlinear parameters allow us to separate completely the data sets of the three groups provided for this controversial topic in nonlinear dynamics. The question whether these time series are chaotic or not cannot be answered satisfactorily without investigating the underlying mechanisms leading to them. We give an example of the dominant influence of respiration on heart beat dynamics, which shows that observed fluctuations can be mostly explained by respiratory modulations of heart rate and blood pressure (coefficient of determination: 96%). Therefore, we recommend reformulating the following initial question: "Is the normal heart rate chaotic?" We rather ask the following: "Is the normal heart rate 'chaotic' due to respiration?"

  19. Culling Rate of Icelandic Horses due to Bone Spavin

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    Árnason Th

    2003-12-01

    Full Text Available A survival analysis was used to compare the culling rate of Icelandic horses due to the presence of radiographic and clinical signs of bone spavin. A follow-up study of 508 horses from a survey five years earlier was performed. In the original survey 46% of the horses had radiographic signs of bone spavin (RS and/or lameness after flexion test of the tarsus. The horse owners were interviewed by telephone. The owners were asked if the horses were still used for riding and if not, they were regarded as culled. The owners were then asked when and why the horses were culled. During the 5 years, 98 horses had been culled, 151 had been withdrawn (sold or selected for breeding and 259 were still used for riding. Hind limb lameness (HLL was the most common reason for culling (n = 42. The rate of culling was low up to the age of 11 years, when it rose to 0.05 for horses with RS. The risk ratio for culling was twice as high for horses with RS compared with horses without RS and 5.5 times higher for culling because of HLL. The risk of culling (prognostic value was highest for the combination of RS with lameness after flexion test, next highest for RS and lowest for lameness after flexion test as the only finding. It was concluded that bone spavin affects the duration of use of Icelandic horses and is the most common cause of culling due to disease of riding horses in the age range of 7–17 years.

  20. Functional results and the risk factors of reoperations after lumbar disc surgery.

    Science.gov (United States)

    Kara, Bilge; Tulum, Zeliha; Acar, Umit

    2005-02-01

    Factors such as driving motor vehicles, sedentary occupations, vibration, smoking, previous full-term pregnancies, physical inactivity, increased body mass index (BMI), and a tall stature are associated with symptomatic disc herniations. Fitness and strength is postulated to protect an individual from disc rupture. The objective of our study was to determine the pain levels and differences of functional and economic situations of patients who had undergone one or more than one operation due to lumbar disc herniation and to put forward the effect of risk factors that may be potential, especially from the aspect of undergoing reoperation. Patients who had undergone one (n=46) or more than one operation (n=34) due to lumbar disc herniation were included in the study. It was a prospective study with evaluation on the day the patients were discharged and at second and sixth months after lumbar disc operation. The Oswestry Disability Index (ODI) was used in determining the functional disability associated with back pain; the Prolo Functional Economic Rating Scale (Prolo scale) was used in determining the effect of back pain on functional and economic situations. In the ODI measurements made in the postoperative second and sixth months, significant differences appeared in favor of patients who had undergone one operation (p<0.05). According to the Prolo scale, it was found that the economic situation was better in the sixth month and the functional situation was better in the second and sixth months in patients having undergone one operation (p<0.05). The logistic regression analysis demonstrated that the lack of regular physical exercise was a significant predictor for reoperation (OR, 4.595; CI, 1.38-15.28), whereas gender, age, BMI, occupation, or smoking did not indicate so much significance as regular exercise.

  1. Re-operation for parotid gland cancer following non-standard surgical treatment

    Institute of Scientific and Technical Information of China (English)

    Xiangmin Zhang; Xiaolin Lan; Lianbin Liu; Rong Li; Fufu Xiao; Folin Liu

    2012-01-01

    Objective: The purpose of this study was to analyze the clinical disadvantages of non-standard surgical treatment for parotid gland cancer and probe the re-operative indication following non-standard surgical treatment.Methods: Data of 58 cases suffered parotid gland cancer who received non-standard operation at other hospital and received re-operation in tumor hospital of Ganzhou from June 1998 to October 2010 were retrospectively reviewed.Results: In all cases, parotid gland cancer were residual in 46 cases, the facial nerve remaining rate was 81.0% (47/58), facial nerve branches injury rate was 3.5% (2/58), facial nerve partial resection rate was 8.6% (5/58) and total resection rate was 6.9% (4/58).The sensitivity of residual tumor was 83.3%, scanned by contrast-enhanced CT and the CT positive predictive value was 86.9%.Conclusion: Consideration of the higher residual tumor rate in patients who received non-standard operations, the re-operations were necessary.Contrast-enhanced CT positive predictive value was high for residual tumor and it was important for re-operation.

  2. Comparison of the Efficacy of Reoperation, Percutaneous Radiofrequency Thermocoagulation When Microvascular Decompression of Trigeminal Neuralgia Is Invalid.

    Science.gov (United States)

    Zhang, Xin; Zhao, Hua; Tang, Yinda; Zhu, Jin; Wang, Xuhui; Li, Shiting

    2016-10-01

    To compare the curative effect of reoperation in short-term and percutaneous radiofrequency thermocoagulation (PRT) when trigeminal neuralgia patient after microvascular decompression (MVD) is invalid. Follow-up of 54 patients (30 patients with reoperation in the short term, 24 patients with PRT of primitive trigeminal neuralgia) when MVD is invalid between January 2008 and December 2014. To evaluate the degree of pain relief and facial numbness of patients after the treatment in short-term (1 month), in long-term (1 year). One month after surgery, the authors compared the reoperation group with PRT group. The ratio of cure rate P = 0.02, the ratio of effective rate P = 0.04, the ratio of facial numbness P = 0.01; 1 year after surgery, the authors compared the reoperation group with PRT group. The ratio of cure rate P = 0.004, the ratio of effective rate P = 0.006, the ratio of facial numbness P = 0.02, the ratio of recurrence P = 0.04. The short-term and long-term clinical efficacy in reoperation group was better than PRT group (P neuralgia when first MVD is invalid, reoperation is better than PRT, and a significantly lower incidence of facial numbness and recurrence than PRT.

  3. Clinical effect of laparoscopic reoperation combined with choledochoscope in treatment of intra- and extrahepatic bile duct stones: analysis of 35 cases

    Directory of Open Access Journals (Sweden)

    WU Liming

    2013-07-01

    Full Text Available ObjectiveTo investigate the feasibility and safety of laparoscopic reoperation combined with choledochoscope in the treatment of intra- and extrahepatic bile duct stones. MethodsThe 35 patients with intra- and extrahepatic bile duct stones who underwent laparoscopic bile duct reoperation from January 2008 to May 2012 were selected as a laparoscopic treatment group; 50 patients with recurrent intra- and extrahepatic bile duct stones who underwent open surgery in the same period were selected as an open surgery group. The t-test was used to compare the two groups in terms of off-bed activity early after operation, recovery of intestinal function, and length of hospital stay; the chi-square test was used to compare the incision infection rate between the two groups. ResultsAmong the 35 cases of intra- and extrahepatic bile duct stones, 32 completed laparoscopic surgery, 2 had the procedure converted to open surgery due to severe adhesion, and 1 had the procedure converted to open surgery due to subcutaneous emphysema. In the laparoscopic treatment group, the mean operative time of laparoscopic bile duct reoperation was 148 min (range, 105-200 min; there were no bleeding and bile leak in the perioperative period. All patients underwent T-tube drainage; postoperative peritoneal drainage was performed for 2-5 d; the mean length of hospital stay after operation was 5-8 d. No case of incision infection occurred in the laparoscopic treatment group. The laparoscopic treatment group had a significantly better outcome than the open surgery group in terms of time to off-bed activity early after operation, time to recovery of intestinal function, length of hospital stay after operation, and incision infection rate (P<0.05. In the laparoscopic treatment group, 3 cases had retained bile duct stones, and the stones were taken out through the sinus tract using a fiber choledochoscope at 2 months after operation. All cases were followed up for 6-24 months after

  4. Process Measurement Deviation Analysis for Flow Rate due to Miscalibration

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Eunsuk; Kim, Byung Rae; Jeong, Seog Hwan; Choi, Ji Hye; Shin, Yong Chul; Yun, Jae Hee [KEPCO Engineering and Construction Co., Deajeon (Korea, Republic of)

    2016-10-15

    An analysis was initiated to identify the root cause, and the exemption of high static line pressure correction to differential pressure (DP) transmitters was one of the major deviation factors. Also the miscalibrated DP transmitter range was identified as another major deviation factor. This paper presents considerations to be incorporated in the process flow measurement instrumentation calibration and the analysis results identified that the DP flow transmitter electrical output decreased by 3%. Thereafter, flow rate indication decreased by 1.9% resulting from the high static line pressure correction exemption and measurement range miscalibration. After re-calibration, the flow rate indication increased by 1.9%, which is consistent with the analysis result. This paper presents the brief calibration procedures for Rosemount DP flow transmitter, and analyzes possible three cases of measurement deviation including error and cause. Generally, the DP transmitter is required to be calibrated with precise process input range according to the calibration procedure provided for specific DP transmitter. Especially, in case of the DP transmitter installed in high static line pressure, it is important to correct the high static line pressure effect to avoid the inherent systematic error for Rosemount DP transmitter. Otherwise, failure to notice the correction may lead to indicating deviation from actual value.

  5. Surgical operation and re-operation for hepatocellular carcinoma with bile duct thrombosis

    Institute of Scientific and Technical Information of China (English)

    WANG Ya-dong; XUE Huan-zhou; JIANG Qing-feng; SHEN Quan; WANG Lian-cai; ZHANG Xiao; LU Bing; YU Miao; LI Ke

    2010-01-01

    Background Few reports have evaluated the efficacy of re-operation for relapse after initial surgery for hepatocellular carcinoma (HCC) with bile duct thrombosis (BDT).The aim of this study was to investigate the efficacy of initial surgery and subsequent re-operation for HCC with BDT, and their effects on prognosis.Methods The clinical data of 880 patients with HCC, including 28 patients with BDT, who underwent radical hepatectomy between 1998 and 2008 in our hospital, were reviewed.The effects of BDT and re-operation on prognosis were retrospectively analyzed.Results The 1-, 3- and 5-year survival rates were 89.3%, 46.4% and 21.4%, respectively, in 28 patients with BDT versus 91.4%, 52.9% and 20.9% in 852 patients without BDT (P >0.05).Six patients with BDT underwent re-operation after disease relapse, and their survival time was significantly longer than those who did not undergo re-operation (P <0.05).Multivariate analysis indicated that portal vein invasion and tumor size were independently associated with tumor relapse and prognosis (P<0.05).Univariate analysis and multivariate analyses showed that obstructive jaundice was not significantly correlated with tumor relapse or prognosis (P >0.05).Conclusions Hepatectomy plus BDT removal is an effective treatment option for HCC with BDT.Obstructive jaundice is not a contraindication for surgery.Re-operation after relapse can provide good outcomes if the cases are appropriately selected.

  6. Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Kautiainen Hannu

    2007-01-01

    Full Text Available Abstract Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 virgin lumbar disc herniation patients (mean age 42 years, 57% males were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected from patient files. Back and leg pain on visual analog scale and employment status were collected by questionnaires. Results The cumulative rate of re-operations for lumbar disc herniation was 10.2% (95% Cl 6.0 to 15.1. The rate of residives at initial site was 7.4% (95% Cl 3.7 to 11.3 and rate of lumbar disc herniations at other sites was 3.1% (95% Cl 0.6 to 6.2. The occurrence of residive lumbar disc herniations was evenly distributed across the 5 years. Neither age, gender, preoperative symptoms, physical activity nor employment had effect on the probability of re-operation. Conclusion Seven percent of the lumbar disc patients had a residive lumbar disc operation within five years of their first operation. No specific factors influencing the risk for re-operation were found.

  7. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

  8. Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Friis-Andersen, Hans; Rosenberg, Jacob

    2016-01-01

    BACKGROUND: Inguinal hernia repair is traditionally carried out as either open or laparoscopic repair. Laparoscopic repair has been shown to be superior in terms of pain and discomfort, but has a higher risk of reoperation. Quality of inguinal hernia repair is related to factors such as method...... of care. METHODS: This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. RESULTS...... reoperation rate compared with public centers: 5.36% versus 8.53%, P ≤ .0001. Type of center and center volume were both independent risk factors for reoperation in a Cox regression model. CONCLUSION: Hospital volume had an effect on the reoperation rate for recurrence after laparoscopic inguinal hernia...

  9. Risk factors for reoperation after initial burr hole trephination in chronic subdural hematomas.

    Science.gov (United States)

    Schwarz, Falko; Loos, Franz; Dünisch, Pedro; Sakr, Yasser; Safatli, Diaa Al; Kalff, Rolf; Ewald, Christian

    2015-11-01

    The optimal management of chronic subdural hematomas remains a challenge. Twist drill craniotomy or burr hole trephination are considered optimal initial treatments, but the reoperation rate for hematoma recurrence and other complications is still high. Therefore, evaluation of possible risk factors for initial treatment failure is crucial. In this context, we performed a study to define a possible subpopulation that may benefit from a more invasive initial treatment regime. We retrospectively reviewed the medical charts of 193 patients with 250 chronic subdural hematomas who had undergone burr hole trephination as first-line therapy in our institution between January 2005 and October 2012. To identify risk factors for reoperation, a multivariable logistic regression analysis was performed with reoperation as the dependent variable. Surgical complications, including acute rebleeding, infection and chronic hematoma recurrence, were analyzed separately using a logistic regression model. The mean age of the cohort was 71.4 years. The male/female ratio was 137:56. Reoperation was necessary in 56 cases (29%) for recurrent hematomas and surgical complications. Predictors for reoperation for surgical complications were midline shift (odds ratio [OR] (per mm) 1.16, 95% confidence interval [CI]: 1.05-1.29, p=0.006), arterial hypertension (OR 5.44, 95% CI: 1.45-20.41, p=0.012) and bilateral hematomas (OR 4.22, 95% CI: 1.22-14.58, p=0.023). There was a trend toward a higher risk of surgically-relevant hematoma recurrence in patients with prior treatment with vitamin K antagonists (OR 1.76, 95% CI: 0.75-4.13, p=0.191). Burr hole trephination is the therapy of choice in most chronic subdural hematomas, but the rate of recurrent hematomas is high. Every hematoma should be treated individually especially in relation to midline-shift and pre-existing conditions. Further prospective studies evaluating types of treatment and hematoma density are needed. Copyright © 2015 Elsevier B

  10. Surgical strategies of re-operation for non-anastomotic biliary duct stricture after liver transplantation

    Directory of Open Access Journals (Sweden)

    Shao-ping WANG

    2015-10-01

    Full Text Available Objective To investigate the re-operation timing and surgical modality for non-anastomotic biliary stricture (NABS after orthotopic liver transplantation (OLT. Methods The clinical data of 14 NABS patients hospitalized in our center from August 2003 to April 2014 were analyzed retrospectively. The patients were treated with different modalities of re-operation according to cholangiographic results, and the outcomes of re-operation were noted by postoperative follow-up. Results Among 421 OLT patients, NABS was seen in 14 (3.3%, 14/421, and it was accompanied by stenosis of hepatic artery in 4. Their total bilirubin, ALP and r-GGT levels were significantly higher in NABS patients than in non-NABS patients (P<0.01. According to cholangiographic findings, NABS was divided into 3 types: hepatic bile duct strictures (4 patients, type Ⅰ, multiple extrahepatic and intrahepatic biliary strictures (8 patients, type Ⅱ, intrahepatic biliary stricture (2 patients, type Ⅲ. The cure rate of interventional treatment in this study was 57.1% (8/14, and 6 patients eventually required surgical treatment again. The type Ⅰ patient was treated with Roux-en-Y anastomosis, and re-transplantation for other 5 patients (type Ⅱ in 4 and type Ⅲ in 1. Among these 5 patients receiving liver re-transplantation, 1 patient died of perioperative fungal infection. The blood loss (2570±851ml and operation time (492±173min in those re-transplantation patients were almost the same as their previous-transplantation (P> 0.05. More than half of type Ⅱ and Ⅲ patients needed re-transplantation, but the probability of re-transplantation was especially higher for those with hepatic artery stenosis (75%, 3/4. Cholangitis disappeared and the total bilirubin significantly reduced from 123.4µmol/L to 31.6µmol/L after resurgery. Conclusions For those NABS patients who may fail to be improved after a minimally invasive treatment, especially when it was combined with

  11. Losartan improves heart rate variability and heart rate turbulence in heart failure due to ischemic cardiomyopathy.

    Science.gov (United States)

    Ozdemir, Murat; Arslan, Uğur; Türkoğlu, Sedat; Balcioğlu, Serhat; Cengel, Atiye

    2007-12-01

    Heart rate variability (HRV) and heart rate turbulence are known to be disturbed and associated with excess mortality in heart failure. The aim of this study was to investigate whether losartan, when added on top of beta-blocker and angiotensin-converting enzyme inhibitor (ACEI) therapy, could improve these indices in patients with systolic heart failure. Seventy-seven patients (mean age 60.4 +/- 8.0, 80.5% male) with ischemic cardiomyopathy (mean ejection fraction 34.5 +/- 4.4%) and New York Heart Association Class II-III heart failure symptoms, already receiving a beta-blocker and an ACEI, were randomly assigned to either open-label losartan (losartan group) or no additional drug (control group) in a 2:1 ratio and the patients were followed for 12 weeks. The HRV and heart rate turbulence indices were calculated from 24-hour Holter recordings both at the beginning and at the end of follow-up. The baseline clinical characteristics, HRV, and heart rate turbulence indices were similar in the 2 groups. At 12 weeks of follow-up, all HRV parameters except pNN50 increased (SDNN: 113.2 +/- 34.2 versus 127.8 +/- 24.1, P = .001; SDANN: 101.5 +/- 31.7 versus 115.2 +/- 22.0, P = .001; triangular index: 29.9 +/- 11.1 versus 34.2 +/- 7.9, P = .008; RMSSD: 29.1 +/- 20.2 versus 34.3 +/- 23.0, P = .009; NN50: 5015.3 +/- 5554.9 versus 6446.7 +/- 6101.1, P = .024; NN50: 5.65 +/- 6.41 versus 7.24 +/- 6.99, P = .089; SDNNi: 45.1 +/- 13.3 versus 50.3 +/- 14.5, P = .004), turbulence onset decreased (-0. 61 +/- 1.70 versus -1.24 +/- 1.31, P = .003) and turbulence slope increased (4.107 +/- 3.881 versus 5.940 +/- 4.281, P = .004) significantly in the losartan group as compared with controls. A 12-week-long losartan therapy significantly improved HRV and heart rate turbulence in patients with Class II-III heart failure and ischemic cardiomyopathy already on beta-blockers and ACEI.

  12. Death rate due to horseshoe crab poisoning:summarization on Thai reports

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2015-01-01

    Horseshoe crab can be poisonous and intoxication due to intake of horseshoe crab is possible. Horseshoe crab intoxication can be seen in many countries with seacoasts including Thailand. Here, the authors summarized the death rate due to horseshoe crab poisoning in Thailand.

  13. Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Jørgensen, C. C.; Hansen, Torben Bæk

    2014-01-01

    of hospital stay was four days (interquartile range: 3 to 5), with a 90 days re-admission rate of 9.9%, re-operation rate of 3.5% and mortality rate of 0.2%. The age ranges of 51 to 55 years (p = 0.018), 76 to 80 years (p ...-admission. The age ranges of 76 to 80 years (p = 0.018) and the large partial revision subgroup (p = 0.073) were related to an increased risk of re-operation. The ages from 76 to 80 years (p 120 min (p hospital stay...... that a length of hospital stay ≤ four days and discharge home at that time is safe following aseptic knee revision surgery in Denmark....

  14. Rotator cuff injuries and factors associated with reoperation

    Directory of Open Access Journals (Sweden)

    Alexandre Litchina Carvalho

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the prevalence of rotator cuff tears and describe the profile of reoperated patients, causes of repeated tendon tears, tear evolution and range of times between surgical procedures. METHOD: This was a cross-sectional study involving 604 surgical procedures performed at two regional referral hospitals between January 2006 and December 2012. After approval by the ethics committee, data describing the patients' epidemiological profile were gathered at a single time, using Cofield's classification to measure the extent of the tears, all of which underwent arthroscopic surgery. The data were entered into Epi Info 3.5.3 and were analyzed using SPSS version 18.0. RESULTS: Among the 604 surgical procedures, females were affected in more cases (351; 58.1%. When the dominant limb was the right limb, it was affected in 90% of the cases (p < 0.05. The supraspinatus tendon was affected in 574 cases (95% and the tears were of medium size in 300 cases (49.7%. Eighteen reoperations were performed (2.98% and the upper right limb was the most affected (66.6%. The cause was non-traumatic in 12 patients. The repeated tears were mostly smaller (44%, and the length of time between the two surgical procedures ranged from 6 to 298 weeks. CONCLUSION: Female gender, smaller extent in the second procedure and non-traumatic cause were found in most of the cases analyzed.

  15. Short term Heart Rate Variability to predict blood pressure drops due to standing: a pilot study.

    Science.gov (United States)

    Sannino, G; Melillo, P; Stranges, S; De Pietro, G; Pecchia, L

    2015-01-01

    Standing from a bed or chair may cause a significant lowering of blood pressure (ΔBP), which may have severe consequences such as, for example, falls in older subjects. The goal of this study was to develop a mathematical model to predict the ΔBP due to standing in healthy subjects, based on their Heart Rate Variability, recorded in the 5 minutes before standing. Heart Rate Variability was extracted from an electrocardiogram, recorded from 10 healthy subjects during the 5 minutes before standing. The blood pressure value was measured before and after rising. A mathematical model aiming to predict ΔBP based on Heart Rate Variability measurements was developed using a robust multi-linear regression and was validated with the leave-one-subject-out cross-validation technique. The model predicted correctly the ΔBP in 80% of experiments, with an error below the measurement error of sphygmomanometer digital devices (± 4.5 mmHg), a false negative rate of 7.5% and a false positive rate of 10%. The magnitude of the ΔBP was associated with a depressed and less chaotic Heart Rate Variability pattern. The present study showes that blood pressure lowering due to standing can be predicted by monitoring the Heart Rate Variability in the 5 minutes before standing.

  16. Monte Carlo analysis of uncertainty propagation in a stratospheric model. 2: Uncertainties due to reaction rates

    Science.gov (United States)

    Stolarski, R. S.; Butler, D. M.; Rundel, R. D.

    1977-01-01

    A concise stratospheric model was used in a Monte-Carlo analysis of the propagation of reaction rate uncertainties through the calculation of an ozone perturbation due to the addition of chlorine. Two thousand Monte-Carlo cases were run with 55 reaction rates being varied. Excellent convergence was obtained in the output distributions because the model is sensitive to the uncertainties in only about 10 reactions. For a 1 ppby chlorine perturbation added to a 1.5 ppby chlorine background, the resultant 1 sigma uncertainty on the ozone perturbation is a factor of 1.69 on the high side and 1.80 on the low side. The corresponding 2 sigma factors are 2.86 and 3.23. Results are also given for the uncertainties, due to reaction rates, in the ambient concentrations of stratospheric species.

  17. On the Upper Ocean Turbulent Dissipation Rate due to Very Short Breaking Wind-Waves

    CERN Document Server

    Banner, Michael L

    2016-01-01

    Sutherland and Melville (2015a) investigated the relative contributions to the total dissipation rate in the ocean surface wave boundary layer of different breaking wave scales, from large-scale whitecaps to micro-breakers. Based on their measurements of geometric/kinematic properties of breaking waves for a wide range of wave ages, they inferred the dissipation rates from breaking as a function of scale. These results were compared with their complementary measurements of the total dissipation rate in the underlying wave boundary layer. They reported that the total depth-integrated dissipation rate in the water column agreed well with dissipation rate from breaking waves for young to very old wind seas. They also reported high observed levels of dissipation rate very near the sea surface. They concluded that this showed a large fraction of the total dissipation rate was due to non-air entraining micro-breakers and very small whitecaps. Because of its fundamental importance, both physically and for accurate a...

  18. REDUCING THE REJECTION RATE OF ENGINES MANUFACTURING DUE TO INJECTION TIMING VARIATION

    Directory of Open Access Journals (Sweden)

    Mrs. P.SIVASHANKARI

    2015-12-01

    Full Text Available The white paper is on HINO 6 cylinder engine and the aim is to reduce the rejection rate of engines during testing due to the problems occur in valve timing and injection timing. The concept of Six Sigma is mainly practiced as a design to eliminate the production defects by improving the process of manufacturing. In the observation, the injection timing mark (spill mark is not perfectly done and also the imperfection in flywheel marking machine locator pin increases engine rejection. The aim is to eliminate the engines getting rejected during engine test due to problems arising in the injection timing and valve timing. As there are a lot of problems arising in the test bed where the engine is tested, few of which are related to injection timing and valve timing. These problems mainly arise due to changes in the valve and injection timing variation.

  19. Seasonal Variations in the Risk of Reoperation for Surgical Site Infection Following Elective Spinal Fusion Surgery: A Retrospective Study Using the Japanese Diagnosis Procedure Combination Database.

    Science.gov (United States)

    Ohya, Junichi; Chikuda, Hirotaka; Oichi, Takeshi; Kato, So; Matsui, Hiroki; Horiguchi, Hiromasa; Tanaka, Sakae; Yasunaga, Hideo

    2017-07-15

    A retrospective study of data abstracted from the Diagnosis Procedure Combination (DPC) database, a national representative database in Japan. The aim of this study was to examine seasonal variations in the risk of reoperation for surgical site infection (SSI) following spinal fusion surgery. Although higher rates of infection in the summer than in other seasons were thought to be caused by increasing inexperience of new staff, high temperature, and high humidity, no studies have examined seasonal variations in the risk of SSI following spinal fusion surgery in the country where medical staff rotation timing is not in summer season. In Japan, medical staff rotation starts in April. We retrospectively extracted the data of patients who were admitted between July 2010 and March 2013 from the DPC database. Patients were included if they were aged 20 years or older and underwent elective spinal fusion surgery. The primary outcome was reoperation for SSI during hospitalization. We performed multivariate analysis to clarify the risk factors of primary outcome with adjustment for patient background characteristics. We identified 47,252 eligible patients (23,659 male, 23,593 female). The mean age of the patients was 65.4 years (range, 20-101 yrs). Overall, reoperation for SSI occurred in 0.93% of the patients during hospitalization. The risk of reoperation for SSI was significantly higher in April (vs. February; odds ratio, 1.93; 95% confidence interval, 1.09-3.43, P = 0.03) as well as other known risk factors. In subgroup analysis with stratification for type of hospital, month of surgery was identified as an independent risk factor of reoperation for SSI among cases in an academic hospital, although there was no seasonal variation among those in a nonacademic hospital. This study showed that month of surgery is a risk factor of reoperation for SSI following elective spinal fusion surgery, nevertheless, in the country where medical staff rotation timing is not in

  20. 质量管理工具在非计划再手术监管中的应用%Application of quality management tool in the non plan reoperation supervision

    Institute of Scientific and Technical Information of China (English)

    杨培鲜; 于剑波; 陈伟

    2014-01-01

    It should fundamentally intensify the supervision of non plan reoperation to reduce the incidence rate of non plan reoperation.This paper analyzed the main reasons of non plan reoperation,and makes the discussion of the application of quality management tool PDCA recyclable model in the non plan reoperation supervision.%降低非计划再手术的发生率,就要从根本上加大对非计划再手术的监管力度。本文主要分析了非计划再手术的主要原因,从质量管理工具PDCA循环模型在非计划再手术监管中的应用做出探讨。

  1. Reoperative coronary bypass grafting without cardiopulmonary bypass through a small thoracotomy

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    Background. The danger of coronary reoperations is mainly hidden in the reopening of the sternum and in the manipulation of the heart and the old grafts. Therefore, the minimally invasive direct coronary artery bypass procedure seems an ideal technique for coronary reoperations if only the left

  2. Testing the Rate of False Planetary Transits due to Binary Star Blending

    CERN Document Server

    Bakos, G K G

    2005-01-01

    We investigate the rate of false planetary transit detection due to blending with eclipsing binaries. Our approach is purely empirical and is based on the analysis of the artificially blended light curves of the eclipsing binary stars in the Large Magellanic Cloud from the archive of the Optical Gravitational Lensing Experiment (OGLE). Employing parameters that characterize the significance of the transit and the amplitude of the variation out of the transit, we can substantially limit the number of potential false positives. Further constraint comes from the expected length of the transit by a possible planetary companion. By the application of these criteria we are left only with 18 candidates from the full sample of 2495 stars. Visual inspection of these remaining variables eliminates all of them for obvious reasons (e.g., for visible fingerprints of orbital eccentricity). We draw the attention to the short-period stars, where the false alarm rate is especially low.

  3. A unified numerical model of collisional depolarization and broadening rates due to hydrogen atom collisions

    CERN Document Server

    Derouich, M; Barklem, P S

    2015-01-01

    Interpretation of solar polarization spectra accounting for partial or complete frequency redistribution requires data on various collisional processes. Data for depolarization and polarization transfer are needed but often missing, while data for collisional broadening are usually more readily available. Recent work by Sahal-Br\\'echot and Bommier concluded that despite underlying similarities in the physics of collisional broadening and depolarization processes, relationships between them are not possible to derive purely analytically. We aim to derive accurate numerical relationships between the collisional broadening rates and the collisional depolarization and polarization transfer rates due to hydrogen atom collisions. Such relationships would enable accurate and efficient estimation of collisional data for solar applications. Using earlier results for broadening and depolarization processes based on general (i.e. not specific to a given atom), semi-classical calculations employing interaction potentials...

  4. Heating rate and spin flip lifetime due to near field noise in layered superconducting atom chips

    CERN Document Server

    Fermani, Rachele; Zhang, Bo; Lim, Michael J; Dumke, Rainer

    2009-01-01

    We theoretically investigate the heating rate and spin flip lifetimes due to near field noise for atoms trapped close to layered superconducting structures. In particular, we compare the case of a gold layer deposited above a superconductor with the case of a bare superconductor. We study a niobium-based and a YBCO-based chip. For both niobium and YBCO chips at a temperature of 4.2 K, we find that the deposition of the gold layer can have a significant impact on the heating rate and spin flip lifetime, as a result of the increase of the near field noise. At a chip temperature of 77 K, this effect is less pronounced for the YBCO chip.

  5. The time aspect of bioenergy. Climate impacts of bioenergy due to differences in carbon uptake rates

    Energy Technology Data Exchange (ETDEWEB)

    Zetterberg, Lars [IVL Swedish Environmental Research Institute, Stockholm (Sweden); Chen, Deliang [Dept. of Earth Sciences, Univ. of Gothenburg, Gothenburg (Sweden)

    2011-07-01

    This paper investigates the climate impacts from bioenergy due to how they influence carbon stocks over time and more specifically how fast combustion related carbon emissions are compensated by uptake of atmospheric carbon. A set of fuel types representing different uptake rates are investigated, namely willow, branches and tops, stumps and coal. Net emissions are defined as emissions from utilizing the fuel minus emissions from a reference case of no utilisation. In the case of forest residues, the compensating 'uptake' is avoided emissions from the reference case of leaving the residues to decompose on the ground. Climate impacts are estimated using the measures radiative forcing and global average surface temperature, which have been calculated by an energy balance climate model. We conclude that there is a climate impact from using bioenergy due to how fast the emission pulse is compensated by uptake of atmospheric carbon (or avoided emissions). Biofuels with slower uptake rates have a stronger climate impact than fuels with a faster uptake rate, assuming all other parameters equal. The time perspective over which the analysis is done is crucial for the climate impact of biofuels. If only biogenic fluxes are considered, our results show that over a 100 year perspective branches and tops are better for climate mitigation than stumps which in turn are better than coal. Over a 20 year time perspective this conclusion holds, but the differences between these fuels are relatively smaller. Establishing willow on earlier crop land may reduce atmospheric carbon, provided new land is available. However, these results are inconclusive since we haven't considered the effects, if needed, of producing the traditional agricultural crops elsewhere. The analysis is not a life cycle assessment of different fuels and does therefore not consider the use of fossil fuels for logging, transportation and refining, other greenhouse gases than carbon or energy

  6. Risk Factors for Reoperation and Performance-Based Outcomes After Operative Fixation of Foot Fractures in the Professional Athlete: A Cross-Sport Analysis.

    Science.gov (United States)

    Singh, Sameer; Larkin, Kevin; Kadakia, Anish; Hsu, Wellington

    2017-09-01

    Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population. Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on post-operative performance or league participation. However, National Football League (NFL) athletes would have a significantly greater decline in performance, due to the high impact nature of the sport. Case series. Level 4. Athletes in the National Basketball League (NBA), NFL, Major League Baseball (MLB), and National Hockey League (NHL) undergoing operative fixation of a foot fracture were identified through a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were collected for each sport. League participation and game performance data were collected before and after surgery. Statistical analysis was performed, with significance accepted as P ≤ 0.05. A total of 77 players undergoing 84 procedures met the inclusion criteria. Overall, 98.7% (76/77) of players were able to return to play, with a median time to return across all sports of 137 days. Players returned to preoperative performance levels within 1 season of surgery. Six players (7.8%) sustained refracture requiring reoperation, all of whom were in the NBA. Percentage of games started during the season after primary operative treatment was a predictive factor for reinjury (99% vs 40%, P = 0.001). Athletes returned to play at a high rate after foot fracture fixation, with excellent postoperative performance levels, regardless of sport and fracture location. NBA athletes sustaining fifth metatarsal and navicular fractures are at greater risk of reinjury compared with

  7. Rapid Enhancement in General Relativistic Precession Rates due to Kozai Mechanism in Solar System Bodies

    Science.gov (United States)

    Sekhar, Aswin; Asher, David; Morbidelli, Alessandro; Werner, Stephanie; Vaubaillon, Jeremie; Li, Gongjie

    2017-06-01

    Two well known phenomena in orbital dynamics associated with low perihelion distance bodies are general relativistic (GR) precession and Lidov-Kozai (LK) oscillations.In this work, we are interested to identify bodies evolving in the near future (i.e. thousands of years in this case) into rapid sungrazing and sun colliding phases and undergoing inclination flips, due to LK like oscillations and being GR active at the same time. We find that LK mechanism leads to secular lowering of perihelion distance which in turn leads to a huge increase in GR precession of the argument of pericentre depending on the initial orbital elements. This in turn gives feedback to the LK mechanism as the eccentricity, inclination and argument of pericentre in Kozai cycles are closely correlated. In this work, we find real examples of solar system bodies which show rapid enhancement in GR precession rates due to LK like oscillations and there are cases where GR precession rate peaks to about 60 times that of the GR precession of Mercury thus showing the strength and complementary nature between these two dynamical phenomena.An analytical treatment is done on few bodies to understand the difference in their orbital evolution in the context of LK mechanism with and without GR precession term by incorporating suitable Hamiltonian dynamics. This result is subsequently matched using numerical integrations to find direct correlations. Real solar system bodies showing both GR precession and LK like oscillations are identified using compiled observational records from IAU-Minor Planet Center, Cometary Catalogue, IAU-Meteor Data Center and performing analytical plus numerical tests on them. This intermediate state (where GR and LK effects are comparable and co-exist) brings up the interesting possibility of drastic changes in GR precession rates during orbital evolution due to sungrazing and sun colliding phases induced by the LK like mechanism, thus combining both these important effects in a

  8. Prediction of Spring Rate and Initial Failure Load due to Material Properties of Composite Leaf Spring

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Sung Ha [Maxoft Inc., Seongnam (Korea, Republic of); Choi, Bok Lok [Gangneung-Wonju National University, Gangneung (Korea, Republic of)

    2014-12-15

    This paper presented analysis methods for adapting E-glass fiber/epoxy composite (GFRP) materials to an automotive leaf spring. It focused on the static behaviors of the leaf spring due to the material composition and its fiber orientation. The material properties of the GFRP composite were directly measured based on the ASTM standard test. A reverse implementation was performed to obtain the complete set of in-situ fiber and matrix properties from the ply test results. Next, the spring rates of the composite leaf spring were examined according to the variation of material parameters such as the fiber angles and resin contents of the composite material. Finally, progressive failure analysis was conducted to identify the initial failure load by means of an elastic stress analysis and specific damage criteria. As a result, it was found that damage first occurred along the edge of the leaf spring owing to the shear stresses.

  9. Reoperation After Combined Injury of the Index Finger: Repair Versus Immediate Amputation.

    Science.gov (United States)

    Wilkens, Suzanne C; Claessen, Femke M A P; Ogink, Paul T; Moradi, Ali; Ring, David

    2016-03-01

    To identify factors associated with unplanned reoperation of severely injured index fingers and to address the number of amputations after initial repair. In this retrospective study, we included all patients older than 18 years of age who had repair or immediate amputation for combined index finger injury at 2 level I trauma centers and 1 community hospital tied to a level I trauma center between January 2004 and February 2014. Twelve patients were excluded because of inadequate follow-up. Bivariate and multivariable analyses sought factors associated with unplanned reoperation after repair and immediate amputation. Among 114 patients with combined injury, 75 were treated with repair and 39 with immediate amputation. A total of 41 patients had an unplanned reoperation, 33 after repair (44%) and 8 after immediate amputation (21%). In multivariable analysis, patients who had a reoperation for fingers other than the index finger were at risk for unplanned reoperation after repair. Women were more likely to have an unplanned reoperation than men, and patients who had a ray amputation were at risk for unplanned reoperation after immediate amputation. Six patients (18%) had amputation after initial repair. Surgeons may counsel patients that they are twice as likely to have an unplanned reoperation after a repair for combined injury of the index finger compared with an immediate amputation. Unplanned reoperations were more common among patients with injuries involving multiple fingers. Effective shared decision making is particularly important in this setting given that 1 in 5 repaired index fingers were eventually amputated. Therapeutic IV. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. Simple expressions of the nuclear relaxation rate enhancement due to quadrupole nuclei in slowly tumbling molecules

    Energy Technology Data Exchange (ETDEWEB)

    Fries, Pascal H., E-mail: pascal-h.fries@cea.fr [Université Grenoble Alpes, INAC-SCIB, RICC, F-38000 Grenoble (France); CEA, INAC-SCIB, RICC, F-38000 Grenoble (France); Belorizky, Elie [Université Grenoble Alpes, LIPHY, F-38000 Grenoble (France); CEA, Leti-Clinatec, F-38000 Grenoble (France)

    2015-07-28

    For slowly tumbling entities or quasi-rigid lattices, we derive very simple analytical expressions of the quadrupole relaxation enhancement (QRE) of the longitudinal relaxation rate R{sub 1} of nuclear spins I due to their intramolecular magnetic dipolar coupling with quadrupole nuclei of arbitrary spins S ≥ 1. These expressions are obtained by using the adiabatic approximation for evaluating the time evolution operator of the quantum states of the quadrupole nuclei S. They are valid when the gyromagnetic ratio of the spin S is much smaller than that of the spin I. The theory predicts quadrupole resonant peaks in the dispersion curve of R{sub 1} vs magnetic field. The number, positions, relative intensities, Lorentzian shapes, and widths of these peaks are explained in terms of the following properties: the magnitude of the quadrupole Hamiltonian and the asymmetry parameter of the electric field gradient (EFG) acting on the spin S, the S-I inter-spin orientation with respect to the EFG principal axes, the rotational correlation time of the entity carrying the S–I pair, and/or the proper relaxation time of the spin S. The theory is first applied to protein amide protons undergoing dipolar coupling with fast-relaxing quadrupole {sup 14}N nuclei and mediating the QRE to the observed bulk water protons. The theoretical QRE agrees well with its experimental counterpart for various systems such as bovine pancreatic trypsin inhibitor and cartilages. The anomalous behaviour of the relaxation rate of protons in synthetic aluminium silicate imogolite nano-tubes due to the QRE of {sup 27}Al (S = 5/2) nuclei is also explained.

  11. Evaluation of 118 Thyroid Cancer Patients Who Underwent a Re-operation after Local Resection

    Institute of Scientific and Technical Information of China (English)

    Jianping Hang; Dong Meng; Liqi Li

    2005-01-01

    OBJECTIVE To evaluate the incidence of residual thyroid cancer and cervical lymph node metastasis following a previous local resection for thyroid cancer, and to discuss methods of a reoperation.METHODS From 1994~2005, 118 patients with thyroid cancer who had previously been treated with a nodule-resection or subtotal Iobectomy in other hospitals underwent a surgical re-operation.RESULTS The incidence of residual cancer at the primary site was 38.1%. The lymph node metastasis rate at the central area was 39.8%.The rate of lymph node metastasis in patients with enlarged lymph nodes in the ipsilateral internal jugular chain was 37.5%. The rate of laryngeal recurrent nerve injury was 15.2% in other hospitals while that of the second operation in our hospital was 1.6%.CONCLUSION Nodule-resection or subtotal Iobectomy alone is not indicated for patients with thyroid cancer because of the high rate of local residual cancer. It is important to be familiar with the anatomy of the laryngeal recurrent nerve for thyroid surgery. Exploration to the central area is necessary for differentiated thyroid cancer.

  12. 原发性腹膜后脂肪肉瘤再手术36例临床分析%Primary retroperitoneal liposarcoma reoperation of 36 cases

    Institute of Scientific and Technical Information of China (English)

    游建; 金鑫; 何鑫; 肖飞; 李鸣

    2012-01-01

    Objective To investigate the primary retroperitoneal liposarcoma reasons for re-operation, strategy and operation points. Methods From June 2000 to June 2010 36 re-operation cases of retroperitoneal liposarcoma were retrospectively analyzed Results The main reasons of primary retro-peritoneal liposarcoma reoperation are incomplete surgical resection and tumor biological characteristics. The 5-year survival rate for complete resection and incomplete resection was 79. 3% and 34. 5% respectively. Bleeding and intestinal fistula were the major complications after reoperation. Conclusion The reasons of reoperation of primary retroperitoneal liposarcoma are variable. Reoperation is the effective strategy for recurrent cases. Intraoperative complete resection is the key of reoperation success.%目的 探讨原发性腹膜后脂肪肉瘤再手术的原因、处理策略及手术要点.方法 对2000年6月至2010年6月间36例腹膜后脂肪肉瘤再手术的临床资料进行回顾性分析.结果 原发性腹膜后脂肪肉瘤再手术的主要原因是手术切除不彻底和肿瘤的生物学特性.完全切除与不完全切除5年生存率分别为79.3%和34.5%.再手术后并发症以出血及肠瘘为主.结论 原发性腹膜后脂肪肉瘤再手术既有肿瘤本身原因,也与手术相关.再次手术治疗是治疗该病术后复发病例的积极手段.把握好手术时机、术中彻底切除是再手术成功的关键.

  13. Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Sonne-Holm, Stig;

    2007-01-01

    BACKGROUND: Reoperations after intertrochanteric fractures are often necessitated by fracture displacement following mobilization of the patient. The biomechanical complexity of the fracture, the position of the implant, and the patient's characteristics are known to influence postoperative outco...

  14. Enhancement of fusion rates due to quantum effects in the particles momentum distribution in nonideal media

    CERN Document Server

    Fisch, N J; Petrushevich, Yu V; Quarati, Piero; Starostin, A N

    2011-01-01

    This study concerns a situation when measurements of the nonresonant cross-section of nuclear reactions appear highly dependent on the environment in which the particles interact. An appealing example discussed in the paper is the interaction of a deuteron beam with a target of deuterated metal Ta. In these experiments, the reaction cross section for d(d,p)t was shown to be orders of magnitude greater than what the conventional model predicts for the low-energy particles. In this paper we take into account the influence of quantum effects due to the Heisenberg uncertainty principle for particles in a non-ideal medium elastically interacting with the medium particles. In order to calculate the nuclear reaction rate in the non-ideal environment we apply both the Monte Carlo technique and approximate analytical calculation of the Feynman diagram using nonrelativistic kinetic Green's functions in the medium which correspond to the generalized energy and momentum distribution functions of interacting particles. We...

  15. Analysis of reoperations and their impact on the results of pancreas transplantation.

    Science.gov (United States)

    Genzini, T; Crescentini, F; Carneiro, A; Rangel, E B; Antunes, I; Sakuma, H; Ferreira, F Y; Perosa de Miranda, M

    2010-03-01

    Many factors, including the advances in surgical techniques and immunosuppression, have been brought significant improvement to graft and patient survivals of patients undergoing pancreatic transplantations. However, one third of these patients require reoperations (ReOps). We sought to evaluate the distribution of ReOps in the early or late postoperative period and analyze their impact on patient and graft survivals. This unicenter, retrospective study was performed using data from 182 patient charts after pancreas transplantation from January 2000 through December 2007. We performed 88 ReOps on 73 patients; 43 early and 41 late operations. The simultaneous pancreas-kidney transplantation group showed a greater incidence of premature ReOps. The group undergoing early ReOp showed a lower survival rate (87.2%) compared with the nonoperated group, but a similar survival rate (97.5%) to the late ReOp group. In relation to the survival of pancreatic grafts after 1 year, the early ReOp group showed inferior survival to the late ReOp group, both of which were significantly worse results then those of the group without ReOp. ReOps were related to the success of the procedure. When they were performed in the first 3 months they had a negative impact on patient and graft survival. Copyright (c) 2010. Published by Elsevier Inc.

  16. Due-Window Assignment and Scheduling with Multiple Rate-Modifying Activities under the Effects of Deterioration and Learning

    Directory of Open Access Journals (Sweden)

    Zhanguo Zhu

    2011-01-01

    Full Text Available This paper discusses due-window assignment and scheduling with multiple rate-modifying activities. Multiple types of rate-modifying activities are allowed to perform on a single machine. The learning effect and job deterioration are also integrated concurrently into the problem which makes the problem more realistic. The objective is to find jointly the optimal location to perform multiple rate-modifying activities, the optimal job sequence, and the optimal location and size of the due window to minimize the total earliness, tardiness, and due-window-related costs. We propose polynomial time algorithms for all the cases of the problem under study.

  17. 短肠综合征肠道再手术分析%Reoperation for short bowel syndrome with intestinal disorders

    Institute of Scientific and Technical Information of China (English)

    李幼生; 李宁; 李元新; 任建安; 朱维铭; 赵允召; 王剑; 郭明晓; 黎介寿

    2011-01-01

    Objective To review the reoperation for short bowel syndrome patients with intestinal disorders. Methods From January 2001 to December 2010, a consecutive series of 198 patients with short bowel syndrome was reviewed, retrospective. Of the 198 patients, 76 patients with intestinal disorders underwent reoperation. They included 56 men and 16 women (median age, 37.98± 13.75 years; range, 5-62 years).The remaining small intestine length was 72.53±41.83(0 - 150)cm. Results Seventy-six patients underwent 124(1.63±0.46)reoperations, including takedown of enterostomy, drainage for intra-abdominal infections, intestinal resection and anastomosis including obstruction, fistula, protein-losing enteropathy, intestinal per formation and necrosis). The reoperation rate of SBS for intestinal disorders was 38.4% (76/198). Conclusion The reoperation rate of SBS for intestinal disorders was so high. Reasonable surgical procedures in the paimary operation have the potential to reduce reoperation rate for small bowel syndrome.%目的分析手术后短肠综合征(SBS)病人再手术,降低SBS再手术率.方法回顾性总结2001年1月至2010年12月南京军区南京总医院解放军普通外科研究所收治的短肠综合征病人198例,其中因肠道原因而再次手术治疗病人76例(男59例,女17例),年龄5~62(37.98±13.75)岁,残存小肠长度0~150(72.53±41.83)cm.结果 76例SBS接受再次手术124(1.63±0.4)例次,再次手术以肠造口还纳(43例次)、腹腔感染引流(28例次)及病变肠袢切除吻合(肠梗阻13例次、肠瘘12例次,蛋白质丢失病7例次、肠穿孔/肠坏死5例次)为主.SBS病人因肠道原因再手术率为38.4%.结论 SBS病人因肠道原因再手术率较高,选择合理的首次手术方式,有助于降低再手术率.

  18. Therapeutic effect analysis of reoperation in the treatment of upper gastrointestinal bleeding after gastrectomy%胃切除术后上消化道大出血的再手术治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    杨文斌

    2016-01-01

    Objective:To analyze the clinical therapeutic effect of reoperation in the treatment of upper gastrointestinal bleeding after gastrectomy.Methods:46 cases of patients with upper gastrointestinal bleeding after gastrectomy were treated with reoperation.The curative effect of reoperation was observed.Results:After reoperation,31 cases were cured,13 cases were effective and the total effective rate was 95.65%.The incidence rate of postoperative complication was 4.35%.Conclusion:Reoperation was the effective method in the treatment of upper gastrointestinal bleeding after gastrectomy.%目的:分析再手术治疗胃切除术后上消化道大出血的临床疗效。方法:收治胃切除术后上消化道大出血患者46例,均行再次手术治疗。观察再次手术治疗效果。结果:再次手术后,痊愈31例,有效13例,总有效率95.65%。术后并发症发生率4.35%。结论:再手术是治疗胃切除术后上消化道大出血的有效方法。

  19. Change in General Relativistic precession rates due to Lidov-Kozai oscillations in the Solar System

    Science.gov (United States)

    Sekhar, Aswin; Asher, David J.; Werner, Stephanie C.; Vaubaillon, Jeremie; Li, Gongjie

    2017-04-01

    permissible in nature. A real solar system body in this intermediate state is identified using compiled observational records from IAU-Minor Planet Center, Cometary Catalogue, IAU-Meteor Data Center and performing analytical plus numerical tests on them. This intermediate state brings up the interesting possibility of drastic changes in GR precession rates (at some points peaking to about 60 times that of Mercury's GR precession) during orbital evolution due to sungrazing and sun colliding phases induced by the LK mechanism, thus combining both these important effects in a unique and dynamically interesting way. Comet 96P/Machholz 1 stands out as the only real body identified (from our simulations) to be exhibiting these interesting traits, as well as inclination flips, in the near future. Both these phenomena complimenting and co-existing at the same time has interesting implications in the long term impact studies of small bodies in general.

  20. Reoperation on aortic disease in patients with previous aortic valve surgery

    Institute of Scientific and Technical Information of China (English)

    SUN Xiao-gang; ZHANG Liang; YU Cun-tao; QIAN Xiang-yang; CHANG Qian

    2013-01-01

    Background Aortic valve replacement (AVR) is a safe and effective method in the treatment of aortic valve diseases.This study aimed to increase the understanding on re-treatment of aortic diseases after aortic valve surgery through a retrospective analysis of 47 related cases.Methods Forty-seven patients (38 males and 9 females) with previous aortic valve surgery have received reoperation on aorta from January 2003 to June 2012,and the mean interval time of re-intervention to aortic disease was 6 years ((6.0± 3.8) years).The secondary aortic surgery included aortic root replacement (14 cases),ascending aorta replacement (10 cases),aortic root/ascending aorta plus total arch replacement with stented elephant trunk implantation (21 cases),and total thoracoabdominal aorta replacement (2 cases).All these patients have received outpatient re-exams or follow-up by phone calls.Results After the initial aortic valve replacement,patients suffered from aortic dissection (25 cases,53%),ascending aortic aneurysm (12 cases,26%) or aortic root aneurysm (10 cases,21%).Diameter in ascending aorta increased (5.2±7.1) mm per year and aortic sinus (3.3±3.1) mm per year.The annual growth value of diameter in ascending aorta was higher in patients with rheumatic heart disease than that in Marfan syndrome (P<0.05).All 47 patients have received reoperation on aorta.One patient died in operating room because aortic dissection seriously involved right coronary artery.Seven patients had renal insufficiency after operation; neurological complications occurred in 14 patients including 7 patients with stroke and the others with transient brain dysfunction.All patients were followed up,the mean survival time was (97.25±17.63) months,95% confidence interval was 55.24-73.33 months.Eight cases were died during follow-up and five-year survival rate was 83%.Conclusion To reduce the aortic adverse events after first aortic valve surgery,it is necessary to actively treat and strictly

  1. Dynamic magnetic resonance angiography for localization of hyperfunctioning parathyroid glands in the reoperative neck

    Energy Technology Data Exchange (ETDEWEB)

    Aschenbach, R., E-mail: rene.aschenbach@helios-kliniken.de [HELIOS Hospital Erfurt, Department of Diagnostic and Interventional Radiology and Neuroradiology, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Tuda, S. [HELIOS Hospital Erfurt, Department of Diagnostic and Interventional Radiology and Neuroradiology, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Lamster, E.; Meyer, A. [HELIOS Hospital Erfurt, Department of Endocrinology, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Roediger, H.; Stier, A. [HELIOS Hospital Erfurt, Department of Visceral Surgery, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Conrad, E. [HELIOS Hospital Erfurt, Department of Nuclear Medicine, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Basche, S.; Klisch, J. [HELIOS Hospital Erfurt, Department of Diagnostic and Interventional Radiology and Neuroradiology, Nordhaeuser Str. 74, 99089 Erfurt (Germany); Vogl, T.J. [University Hospital Frankfurt/Main, Center of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)

    2012-11-15

    Objectives: To evaluate the use of dynamic magnetic resonance angiography for localization of hyperfunctioning parathyroid glands in the reoperative neck. Methods: We retrospectively evaluated the head-neck MRIs of 30 patients with a history of hyperparathyroidism, prior head-neck surgery, and intraoperative proven adenomas. The protocol included conventional imaging with T2-weighted STIR sequences, T1w axial and coronal prior to and after contrast media administration, and dynamic magnetic resonance angiography. We compared the results from MRI, dynamic magnetic resonance angiography with 99m-Tc-Sestamibi with intraoperative findings as the gold standard. Results: In conventional MRI 19/30 true positives were detected with a sensitivity and specificity of 63.3% and 100%, respectively. However, by adding dynamic magnetic resonance angiography the detection rate increased to 28/30 true positives. Based on intraoperative findings, the sensitivity and specificity of dynamic magnetic resonance angiography were 93.3% and 100%, respectively. 99m-Tc-Sestamibi detected 24/30 true positives, sensitivity was 80%. Conclusion: The diagnostic value of MRI including dynamic magnetic resonance angiography is superior to MRI alone and superior to that of 99m-Tc-Sestamibi in the diagnostic workup of hyperfunctioning parathyroid glands when compared against intraoperative findings.

  2. Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery.

    Science.gov (United States)

    Stephens, Elizabeth H; Han, Jiho; Ginns, Jonathan; Rosenbaum, Marlon; Chai, Paul; Bacha, Emile; Kalfa, David

    2017-05-01

    Adults with congenital heart disease (ACHD) undergoing systemic atrioventricular valve (SAVV) surgery are a complex, understudied population. We assessed midterm outcomes and prognostic factors in ACHD undergoing SAVV surgery. We performed retrospective evaluation of ACHD undergoing SAVV surgery from January 2005 to February 2016: 14 (33%) patients with congenital mitral valve stenosis/regurgitation, 15 (35%) with atrioventricular septal defect (AVSD), and 14 (33%) with congenitally corrected transposition of the great arteries (ccTGA) with systemic tricuspid valve regurgitation. Adverse events were defined as mortality, reoperation on SAVV, and late more-than-moderate (> moderate) SAVV regurgitation. Statistical analysis was performed using Fisher's exact test and one-way analysis of variance as well as univariate and multivariate risk factor analysis. Fifteen (35%) patients had preoperative systemic ventricular dysfunction, including 13 patients with ccTGA (93%, P moderate SAVV regurgitation, and SAVV reoperation rates were 5% (n = 2), 2% (n = 1), 9% (n = 3), and 7% (n = 3), respectively. On multivariate analysis, predischarge SAVV regurgitation grade was the only significant predictor of adverse events (odds ratio = 8.2, 95% confidence interval: 1.1-63.8, P = .045). Overall outcomes in this challenging population are good. The single factor associated with adverse events was predischarge SAVV regurgitation grade.

  3. Differential Dropout Rates of Minority and Majority Job Candidates Due to "Time Lags" between Selection Procedures

    Science.gov (United States)

    Arvey, Richard D.; And Others

    1975-01-01

    This research investigated whether or not "time lags" are related to the dropout rates of job applicants. The effect of duration of these time lags, periods between initial job application and psychological testing, on differential dropout rates of minority and majority candidates was also examined. (Author/RK)

  4. [Abdominal unplanned reoperations in the Service of General Surgery, University Hospital of Puebla].

    Science.gov (United States)

    León-Asdrúbal, Samuel Báez; Juárez-de la Torre, Juan Carlos; Navarro-Tovar, Fernando; Heredia-Montaño, Mónica; Quintero-Cabrera, José Eduardo

    2016-01-01

    The reoperation is considered as the access to the abdominal cavity before complete healing of the surgical wound from a previous operation within the first 60 days after the first procedure. It occurs in 0.5 to 15% of patients undergoing abdominal surgery and generates significant increase in morbidity and mortality in patients undergoing abdominal surgery. Identify the number of unplanned abdominal surgical reoperations and identify the causes of these unplanned reoperations were performed in our department. This is a retrospective study conducted at the University Hospital of Puebla in the period between April 2009 to February 2012, a total of 1,709 abdominal surgeries performed by the Service of General Surgery were included. Ninety-seven cases of reoperation of which 50 cases were not planned surgery cases were identified; 72% (36 cases) from emergency operations, and 28% of elective surgery. The incidence found in our study is low compared to similar studies. Prospective studies and focus on risk factors and causes of unplanned reoperations are required, in order to know them in detail and, consequently, reduce its incidence and morbidity and mortality they add.

  5. Counting losses due to saturation effects of scintillation counters at high count rates

    CERN Document Server

    Hashimoto, K

    1999-01-01

    The counting statistics of a scintillation counter, with a preamplifier saturated by an overloading input, are investigated. First, the formulae for the variance and the mean number of counts, accumulated within a given gating time, are derived by considering counting-loss effects originating from the saturation and a finite resolving time of the electronic circuit. Numerical examples based on the formulae indicate that the saturation makes a positive contribution to the variance-to-mean ratio and that the contribution increases with count rate. Next the ratios are measured under high count rates when the preamplifier saturation can be observed. By fitting the present formula to the measured data, the counting-loss parameters can be evaluated. Corrections based on the parameters are made for various count rates measured in a nuclear reactor. As a result of the corrections, the linearity between count rate and reactor power can be restored.

  6. Direct costs and benefits of multiple mating: Are high female mating rates due to ejaculate replenishment?

    Science.gov (United States)

    Worthington, Amy M; Kelly, Clint D

    2016-03-01

    Females often mate more than is necessary to ensure reproductive success even when they incur significant costs from doing so. Direct benefits are hypothesized to be the driving force of high female mating rates, yet species in which females only receive an ejaculate from their mate still realize increased fitness from multiple mating. Using the Texas field cricket, Gryllus texensis, we experimentally test the hypothesis that multiple mating via monandry or polyandry increases female fitness by replenishing ejaculates, thereby allowing females to produce more offspring for a longer period of time. We found that higher rates of female mating significantly increased lifetime fecundity and oviposition independent of whether females mated with one or two males. Further, although interactions with males significantly increased rates of injury or death, females that replenished ejaculates experienced an increased rate and duration of oviposition, demonstrating that the immediate benefits of multiple mating may greatly outweigh the long-term costs that mating poses to female condition and survival. We suggest that ejaculate replenishment is a driving factor of high mating rates in females that do not receive external direct benefits from mating and that a comparative study across taxa will provide additional insight into the role that ejaculate size plays in the evolution of female mating rates.

  7. Modification of atomic physics rates due to nonlocal electron parallel heat transport in divertor plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Allais, F. [INRS-Energie, Materiaux et Telecommunications, 1650 boul. Lionel Boulet, Varennes, Quebec, J3X 1S2 (Canada); Matte, J.P. [INRS-Energie, Materiaux et Telecommunications, 1650 boul. Lionel Boulet, Varennes, Quebec, J3X 1S2 (Canada)]. E-mail: matte@inrs-emt.uquebec.ca; Alouani-Bibi, F. [INRS-Energie, Materiaux et Telecommunications, 1650 boul. Lionel Boulet, Varennes, Quebec, J3X 1S2 (Canada); Kim, C.G. [INRS-Energie, Materiaux et Telecommunications, 1650 boul. Lionel Boulet, Varennes, Quebec, J3X 1S2 (Canada); Stotler, D.P. [Princeton Plasma Physics Laboratory, Princeton, NJ (United States); Rognlien, T.D. [Lawrence Livermore National Laboratory, Livermore, CA (United States)

    2005-03-01

    The effect of steep temperature gradients on the rate of ionization of atomic hydrogen is studied numerically with the electron kinetic code 'FPI' [Phys. Rev. Lett. 72 (1994) 1208]. A set of cross sections ['Atomic and Plasma-Material Interaction data for fusion'. Supplement to the journal Nucl. Fusion 4 (1993)] has been used which gives the same rates of radiation, ionization and recombination as in the well known edge modeling codes 'UEDGE' and 'DEGAS' for Maxwellian electron energy distribution functions. For this purpose, 30 energy levels are included in the computation, as stepwise ionization is dominant. The enhancement of the ionization rate by non-Maxwellian effects in the colder part of the plasma is significant.

  8. New model of propagation rates of long crack due to structure fatigue

    Institute of Scientific and Technical Information of China (English)

    Jian-tao LIU; Ping-an DU; Ming-jing HUANG; Qing ZHOU

    2009-01-01

    By comparison of the characteristics of existing models for long fatigue crack propagation rates,a new model,called the generalized passivation-lancet model for long fatigue crack propagation rates (GPLFCPR),and a general formula for characterizing the process of crack growth rates are proposed based on the passivation-lancet theory.The GPLFCPR model overcomes disadvantages of the existing models and can describe the rules of the entire fatiguc crack growth process from the cracking threshold to the critical fracturing point effectively with explicit physical meaning. It also reflects the influence of material characteristics,such as strength parameters,fracture parameters and heat treatment. Experimental results obtained by testing LZ50 steel,AlZnMgCu0.5,0.5Cr0.5Mo0.25V steel,etc.,show good consistency with the new model. The GPLFCPR model is valuable in theoretical research and practical applications.

  9. Intervention analysis of introduction of rotavirus vaccine on hospital admissions rates due to acute diarrhea

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Teixeira Masukawa

    2014-10-01

    Full Text Available The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.

  10. Primary and revision anterior supine total hip arthroplasty: an analysis of complications and reoperations.

    Science.gov (United States)

    Berend, Keith R; Kavolus, Joseph J; Morris, Michael J; Lombardi, Adolph V

    2013-01-01

    Anterior total hip arthroplasty (THA) has been touted by some as a muscle-sparing, less invasive procedure. Reports have focused on the high intraoperative and postoperative complication rates, the increased transfusion risk, and its questionable clinical benefits. The senior author's experience regarding complications and reoperations that occurred after primary and revision THA using an anterior supine intermuscular approach has been generally favorable. An electronic database was used to identify 906 patients treated with 1,035 consecutive anterior supine intermuscular THAs performed by a single surgeon between January 2007 and December 2010, which included 986 primary THAs, 2 resurfacings, 2 conversions of failed open reduction and internal fixation for fracture, and 45 revision THAs. The surgical technique used an anterior approach with a modified Smith-Petersen interval and was performed with the patient supine on a standard operating table without traction. The transfusion rate was 5%. There were three intraoperative calcar cracks and one canal perforation, which was treated with cerclage cables. Four wound complications required débridement, four hips had substantial lateral femoral cutaneous nerve paresthesias that had not resolved by the 12-month follow-up, and one femoral nerve palsy was reported. At up to 40 month's follow-up, there have been 25 revisions (2.4%), including 9 periprosthetic femoral fractures; 1 stem subsidence; 4 hips with aseptic loosening; 5 metal-on-metal bearing complications; 1 cup malpositioning, which was corrected the same day; 4 dislocations; and 1 infection. This 4-year experience with primary and revision anterior THAs has showed acceptable rates of perioperative transfusion, complications, and revisions.

  11. Causes and Timing of Nonelective Reoperations After Bariatric Surgery: A Review of 1304 Cases at a Single Institution.

    Science.gov (United States)

    Thompson, Erin; Ferrigno, Lisa; Grotts, Jonathon; Knox, Jenna; Sobelman, Samantha; Thoman, David; Bounoua, Farida; Zerey, Marc

    2015-10-01

    As the number of patients undergoing bariatric procedures for weight loss increases, an understanding of the causes and timing of complications requiring reoperation is critical. The aim of our study was to characterize the type and timing of nonelective (NE) reoperations in these patients. Over five years, 1304 patients undergoing index procedures were identified: 769 laparoscopic Roux-en-Y gastric bypasses (LRYGB), 301 laparoscopic sleeve gastrectomies, and 234 laparoscopic adjustable gastric bands. We identified 117 NE reoperations, which were grouped by index procedure as well as whether they occurred early (≤90 days) or late (>90 days). In the laparoscopic adjustable gastric bands group, slipped gastric band was the most common indication for early (n = 2) and late (n = 2) reoperations. Biliary disease was the most common cause for early reoperations (n = 4), and the only cause for late reoperations (n = 2) after laparoscopic sleeve gastrectomies. For LRYGB, diagnoses differed between the early and late groups, with the most common early indications being bowel obstruction (n = 8) and anastomotic leak (n = 4) of the 18 early reoperations, and internal hernia (n = 36) and biliary disease (n = 17) of the 82 late reoperations. The vast majority of NE reoperations were performed laparoscopically (92%), with conversions and primarily open procedures only occurring in the LRYGB group.

  12. Determination of Rate of Degradation of Iron Plates Due To Rust Using Image Processing -A Review

    Directory of Open Access Journals (Sweden)

    Priyanka Choudhary

    2014-03-01

    Full Text Available Abstract: most of industries and bridges around us make use of iron for manufacturing their products. On the other hand corrosion is a natural process that deteriorates the integrity of iron surface. Therefore, rusting of iron takes place. To avoid unwanted accidents in industries and bridges, it is necessary to detect rusting in earlier stage, so that it can be prevented. Digital image processing for the detection of the rusting provides fast, accurate and objectives results. In this research paper, we have done a systematic review of algorithms that help us to detect the rust area from a metal (iron.it has been found that most of researches are bring their images, processing series in usage for this purpose due to its simplicity in implementing and due to fact the images help capturing the visual inspection process easily and due to the ground teeth. The image processing techniques explored by other peoples based on in-depth analysis, we have also proposed a novel technique to overcome the limitation.

  13. Determination of Rate of Degradation of Iron Plates due to Rust using Image Processing

    Directory of Open Access Journals (Sweden)

    Priyanka Choudhary

    2015-02-01

    Full Text Available Most of industries and bridges around us make use of iron for manufacturing their products. On the other hand corrosion is a natural process that deteriorates the integrity of iron surface. Therefore, rusting of iron takes place. To avoid unwanted accidents in industries and bridges, it is necessary to detect rusting in earlier stage, so that it can be prevented. Digital image processing for the detection of the rusting provides fast, accurate and objectives results. In this research paper, we have done a systematic review of algorithms that help us to detect the rust area from a metal (iron.it has been found that most of researches are bring their images, processing series in usage for this purpose due to its simplicity in implementing and due to fact the images help capturing the visual inspection process easily and due to the ground teeth. The image processing techniques explored by other peoples based on in-depth analysis, we have also proposed a novel technique to overcome the limitation.

  14. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands.

    NARCIS (Netherlands)

    Fracheboud, J.; Otto, S.J.; Dijck, J.A.A.M. van; Broeders, M.J.M.; Verbeek, A.L.M.; Koning, H.J. de

    2004-01-01

    The effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Can

  15. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Net

  16. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The

  17. Recent pause in the growth rate of atmospheric CO2 due to enhanced terrestrial carbon uptake

    Science.gov (United States)

    Keenan, Trevor F.; Prentice, I. Colin; Canadell, Josep G.; Williams, Christopher A.; Wang, Han; Raupach, Michael; Collatz, G. James

    2016-11-01

    Terrestrial ecosystems play a significant role in the global carbon cycle and offset a large fraction of anthropogenic CO2 emissions. The terrestrial carbon sink is increasing, yet the mechanisms responsible for its enhancement, and implications for the growth rate of atmospheric CO2, remain unclear. Here using global carbon budget estimates, ground, atmospheric and satellite observations, and multiple global vegetation models, we report a recent pause in the growth rate of atmospheric CO2, and a decline in the fraction of anthropogenic emissions that remain in the atmosphere, despite increasing anthropogenic emissions. We attribute the observed decline to increases in the terrestrial sink during the past decade, associated with the effects of rising atmospheric CO2 on vegetation and the slowdown in the rate of warming on global respiration. The pause in the atmospheric CO2 growth rate provides further evidence of the roles of CO2 fertilization and warming-induced respiration, and highlights the need to protect both existing carbon stocks and regions, where the sink is growing rapidly.

  18. Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study.

    Science.gov (United States)

    Vida, Vladimiro L; Zanotto, Lorenza; Zanotto, Lucia; Stellin, Giovanni; Padalino, Massimo; Sarris, Georges; Protopapas, Eleftherios; Prospero, Carol; Pizarro, Christian; Woodford, Edward; Tlaskal, Thomas; Berggren, Hakan; Kostolny, Martin; Omeje, Ikenna; Asfour, Boulos; Kadner, Alexander; Carrel, Thierry; Schoof, Paul H; Nosal, Matej; Fragata, Josè; Kozłowski, Michał; Maruszewski, Bohdan; Vricella, Luca A; Cameron, Duke E; Sojak, Vladimir; Hazekamp, Mark; Salminen, Jukka; Mattila, Ilkka P; Cleuziou, Julie; Myers, Patrick O; Hraska, Viktor

    2017-09-01

    We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Measurements with a Ge detector and Monte Carlo computations of dose rate yields due to cosmic muons.

    Science.gov (United States)

    Clouvas, A; Xanthos, S; Antonopoulos-Domis, M; Silva, J

    2003-02-01

    The present work shows how portable Ge detectors can be useful for measurements of the dose rate due to ionizing cosmic radiation. The methodology proposed converts the cosmic radiation induced background in a Ge crystal (energy range above 3 MeV) to the absorbed dose rate due to muons, which are responsible for 75% of the cosmic radiation dose rate at sea level. The key point is to observe in the high energy range (above 20 MeV) the broad muon peak resulting from the most probable energy loss of muons in the Ge detector. An energy shift of the muon peak was observed, as expected, for increasing dimensions of three Ge crystals (10%, 20%, and 70% efficiency). Taking into account the dimensions of the three detectors the location of the three muon peaks was reproduced by Monte Carlo computations using the GEANT code. The absorbed dose rate due to muons has been measured in 50 indoor and outdoor locations at Thessaloniki, the second largest town of Greece, with a portable Ge detector and converted to the absorbed dose rate due to muons in an ICRU sphere representing the human body by using a factor derived from Monte Carlo computations. The outdoor and indoor mean muon dose rate was 25 nGy h(-1) and 17.8 nGy h(-1), respectively. The shielding factor for the 40 indoor measurements ranges from 0.5 to 0.9 with a most probable value between 0.7-0.8.

  20. Analysis of the components of residual deformity in clubfeet presenting for reoperation.

    Science.gov (United States)

    Tarraf, Y N; Carroll, N C

    1992-01-01

    We reviewed the records and radiographs of 125 children with 159 clubfeet reoperated for residual deformity after operative repair (210 reoperations). We concluded that residual forefoot adduction and supination were the most common persistent deformities (present in 95% of the feet) and that these deformities resulted from undercorrection at the time of primary operation. Although not then apparent, the persistent deformities became more evident with growth, and additional treatment became necessary. Undercorrection resulted from not releasing the calcaneocuboid joint and plantar fascia and failure to recognize residual forefoot adduction on the interoperative radiographs at primary operation.

  1. Rovibrational Collisional Rates of SiO due to Molecular Hydrogen

    Science.gov (United States)

    Yang, Benhui H.; Stancil, Phillip C.; Wang, Xiaohong; Bowman, J.; Zhang, Peng; Naduvalath, Balakrishnan; Forrey, Robert C.

    2016-06-01

    SiO has been detected in a variety of astronomical sources and is a potential diagnostic of dust formation and destruction in star-forming regions and evolved stars. Its rovibrational level populations are perturbed by collisions with He, H and H2 requiring a non-LTE analysis. However, the necessary collisional rate coefficients, and their temperature dependence, are largely unknown. Scattering calculations are the primary source of such rate coefficients. In this work a full-dimensional (6D) potential energy surface (PES) for the SiO-H2 complex was computed using the high-level CCSD(T)-F12B method and fitted using an invariant polynomial approach in 6D. The first full dimensional quantum close-coupling scattering calculations of SiO in collision with H2 on the 6D PES have been performed for the pure state-to-state rotational excitations from SiO(v=0, j=0-10). For rovibrational transitions, state-to-state and total quenching rate coefficients from several low-lying rotational levels of SiO(v=1) are studied for both para-H2 and ortho-H2 collisions.Work at UGA and Emory are supported by NASA grant No. NNX12AF42G, at UNLV by NSF Grant No. PHY-1505557, and at Penn State by NSF Grant No. PHY-1503615.

  2. 烧伤外科病人再手术原因分析与预防%Reason Analysis and Precautions of Reoperation in Burns Surgical Patients

    Institute of Scientific and Technical Information of China (English)

    倪俊; 顾海峰; 许献荣; 陈瑞彩; 张杏梅

    2012-01-01

    Objective To analyze the causes of reoperation in burns surgical patients and to explore the effective preventive measures so as to make an improvement in operation quality of burns surgery. Method 202 patients undergoing operation in burns ward from January 2006 to December 2011 were analyzed retrospectively. Results There were 91 reoperations done in 60 patients in this group, included 54 times of planned reoperation and 37 times of non-planned reoperation. The causes of non-planned reoperation were postoperative complications (21 times) and operation did not achieve the desired effects (16 times) . The highest rate of non-planned reoperation was in non-burn refractory wound patients, and the lowest was in burns deformed plastic patients. It was significantly higher of the non-planned reoperation rate in the non-burn plastic patients, comparing with the burned plastic deformity patients ( P 0. 05 ) . Conclusions Active prevention and treatment of complications, emphasis on the treatment of trauma and refractory wound, improving the level of diagnosis and treatment of surgeons and reducing surgical mistakes are effective measures to decrease the incidence of non-planned reoperations in burns surgical patients.%目的 分析烧伤外科病人再手术的原因,探讨有效预防措施,以提高烧伤外科手术治疗水平.方法 对我科2006年1月至2011年12月间收治的202例烧伤外科手术病人再手术情况进行回顾性分析.结果 60例行再手术91次,包括计划再手术54次和非计划再手术37次.非计划再手术中,术后出现并发症21次,手术未达到预期疗效16次.非计划再手术率在非烧伤难愈性创面病人中最高,达22.73%,在烧伤后畸形整形病人中最低,为0.非烧伤整形病人的非计划再手术率为20.90%,明显高于烧伤整形病人的10.18% (P <0.05),难愈性创面病人的非计划再手术率为18.52%,虽高于非难愈性创面病人的10.38%,但无统计学差异(P>0.05).

  3. Single stage dorsal inlay buccal mucosal graft with tubularized incised urethral plate technique for hypospadias reoperations

    Institute of Scientific and Technical Information of China (English)

    Wei-Jing Ye; Ping Ping; Yi-Dong Liu; Zheng Li; Yi-Ran Huang

    2008-01-01

    Aim: To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods: From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old(average 11.62 ± 7.18 years) with failed previous hypospadias surgery were included in the present study. Indica- tions included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corporacavemosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results: The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion: Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations. (Asain J Androl 2008 Jul; 10: 682- 686)

  4. Rates of thoracic trauma and mortality due to accidents in Brazil

    Directory of Open Access Journals (Sweden)

    Cury Francisco

    2009-01-01

    Full Text Available Aim: To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. Materials and Methods: This prospective study was performed at the Regional Trauma Center in Sγo Josι do Rio Preto over a 1-year period, from 1 st July 2004 to 30 th June 2005. We included all patients attending the center′s emergency room with thoracic trauma and an anatomic injury scale (AIS ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis. Results:There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12% deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4% car crashes, 75 (20.1% falls, 46 (12.3% motorbike accidents, 40 (10.7% stabbings, 22 (5.9% accidents involving pedestrians, 21 (5.6% bicycle accidents, 17 (4.6% shootings, and 54 (14.5% other types of accident. The severity of the injuries was classified according to the AIS: 224 (60% were grade 2, 101 (27% were grade 3, 27 (7.2% were grade 4, 18 (4.9% were grade 5, and 3 were (0.8% grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. Conclusion: Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

  5. Rates of thoracic trauma and mortality due to accidents in Brazil.

    Science.gov (United States)

    Cury, Francisco; Baitello, André Luciano; Echeverria, Rodrigo Florêncio; Espada, Paulo César; Pereira de Godoy, José Maria

    2009-01-01

    To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. This prospective study was performed at the Regional Trauma Center in São José do Rio Preto over a 1-year period, from 1(st) July 2004 to 30(th) June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis. There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

  6. High turnover rates of copepod fecal pellets due to Noctiluca scintillans grazing

    DEFF Research Database (Denmark)

    Kiørboe, Thomas

    2003-01-01

    Copepod fecal pellet production and vertical flux, as well as vertical distributions of copepods, fecal pellets and the heterotrophic dinoflagellate Noctiluca scintillans were monitored in an upwelling plume off the coast of Brazil during 5 d in austral spring. Less than half (20 to 45......%) of the pellets produced in the overlying water column reached sediment traps positioned at 30 to 60 m depth, and specific sinking losses computed from steady-state considerations varied inversely with trap depth between 0.3 and 2.9 d-1. Total specific losses varied between 0.6 and 16 d-1, and the major part...... as the latter aged, up to 5 x 105 cells m-2, and fecal pellets occurred commonly in the food vacuoles of N. scintillans. Specific fecal pellet remineralization rates were linearly related to the abundance of N. scintillans. This relation can be quantitatively accounted for if N. scintillans clears the water...

  7. Bit Error Rate Due to Misalignment of Earth Station Antenna Pointing to Satellite

    Directory of Open Access Journals (Sweden)

    Wahyu Pamungkas

    2010-04-01

    Full Text Available One problem causing reduction of energy in satellite communications system is the misalignment of earth station antenna pointing to satellite. Error in pointing would affect the quality of information signal to energy bit in earth station. In this research, error in pointing angle occurred only at receiver (Rx antenna, while the transmitter (Tx antennas precisely point to satellite. The research was conducted towards two satellites, namely TELKOM-1 and TELKOM-2. At first, measurement was made by directing Tx antenna precisely to satellite, resulting in an antenna pattern shown by spectrum analyzer. The output from spectrum analyzers is drawn with the right scale to describe swift of azimuth and elevation pointing angle towards satellite. Due to drifting from the precise pointing, it influenced the received link budget indicated by pattern antenna. This antenna pattern shows reduction of power level received as a result of pointing misalignment. As a conclusion, the increasing misalignment of pointing to satellite would affect in the reduction of received signal parameters link budget of down-link traffic.

  8. Thermokarst Rates Intensify Due to Climate Change and Forest Fragmentation in an Alaskan Boreal Forest Lowland

    Science.gov (United States)

    Lara, M. J.; Genet, H.; McGuire, A. D.; Euskirchen, E. S.; Zhang, Y.; Brown, D. N.; Jorgenson, T.; Romanovsky, V. E.; Breen, A. L.; Bolton, W. R.

    2015-12-01

    Lowland boreal forest ecosystems in Alaska are dominated by wetlands comprised of a complex mosaic of fens, collapse scar-bogs, low shrub/scrub, and forests growing on elevated ice rich permafrost soils. Thermokarst has affected the lowlands of the Tanana Flats in central Alaska for centuries, as thawing permafrost collapses forests that transition to wetlands. Located within the discontinuous permafrost zone, this region has significantly warmed over the past half-century, and much of these carbon-rich permafrost soils are now within ~0.5o C of thawing. Increases in the collapse of lowland boreal forests in response to warming may have consequences for the climate system. This study evaluates the trajectories and potential drivers of 60 years of forest change in a landscape subjected to permafrost thaw in unburned dominant forest types (paper birch and black spruce) associated with location on elevated permafrost plateau and across multiple time periods (1949, 1978, 1986, 1998 and 2009) using historical and contemporary aerial and satellite images for change detection. We developed (i) a deterministic statistical model to evaluate the potential climatic controls on forest change using gradient boosting and regression tree analysis, and (ii) a 30x30 m land cover map of the Tanana Flats to estimate the potential landscape-level losses of forest area due to thermokarst from 1949 to 2009. Over the 60-year period, we observed a nonlinear loss of birch forests and a relatively continuous gain of spruce forest associated with thermokarst and forest succession, respectively. Gradient boosting and regression tree models identify precipitation and forest fragmentation as the primary factors controlling birch and spruce forest change, respectively. Between 1950-2009 landscape-level analysis estimates a transition of ~15 km² of birch forest area to wetlands on the Tanana Flats, where the greatest change followed warm periods. This work highlights the vulnerability of lowland

  9. The Study of Wound Infection Rate Due to Midsternatomy after Heart Surgeries

    Directory of Open Access Journals (Sweden)

    R. Safiarian

    2011-01-01

    Full Text Available Introduction & Objective: Sternal wound infection and dehiscence are feared complications observed in 0.4-5% of cardiac operations. Even nowadays the mortality remains as high as 20-40%. The aim of the current study was to determine the rate of sternal wound infection. Material and Methods: The outcomes of 388 patients undergoing cardiac surgery during a 7 month follow up were analyzed and their risk factors such as obesity, diabetes, cigarette smoking, blood transfusion, renal failure, hypertension, COPD, preoperative ejection fraction, aortic clamping time, and time of cardio pulmonary bypass were evaluated. The data was analyzed by t-test & 2 statistical tests. Results: The present study revealed that 3 patients developed wound infection and dehiscence and its incidence was 0.74% (P=0.042. There was not any significant relationship between wound infection and the other risk factors (P>0.05. Conclusions: Our results indicate that ejection fraction preoperatively is very important in sternal wound infection. (Sci J Hamadan Univ Med Sci 2011;17(4:39-42

  10. Changes in the halo formation rates due to features in the primordial spectrum

    CERN Document Server

    Hazra, Dhiraj Kumar

    2012-01-01

    Features in the primordial scalar power spectrum provide a possible roadway to describe the outliers at the low multipoles in the WMAP data. Apart from the CMB angular power spectrum, these features can also alter the matter power spectrum and, thereby, the formation of the large scale structure. Carrying out a complete numerical analysis, we investigate the effects of primordial features on the formation rates of the halos. We consider a few different inflationary models that lead to features in the scalar power spectrum and an improved fit to the CMB data, and analyze the corresponding imprints on the formation of halos. Performing a Markov Chain Monte Carlo analysis with the WMAP seven year data and the SDSS halo power spectrum from LRG DR7 for the models of our interest, we arrive at the parameter space of the models allowed by the data. We illustrate that, inflationary potentials, such as the quadratic potential with sinusoidal modulations and the axion monodromy model, which generate certain repeated, o...

  11. Rate-dependent activation failure in isolated cardiac cells and tissue due to Na+ channel block.

    Science.gov (United States)

    Varghese, Anthony; Spindler, Anthony J; Paterson, David; Noble, Denis

    2015-11-15

    While it is well established that class-I antiarrhythmics block cardiac sodium channels, the mechanism of action of therapeutic levels of these drugs is not well understood. Using a combination of mathematical modeling and in vitro experiments, we studied the failure of activation of action potentials in single ventricular cells and in tissue caused by Na(+) channel block. Our computations of block and unblock of sodium channels by a theoretical class-Ib antiarrhythmic agent predict differences in the concentrations required to cause activation failure in single cells as opposed to multicellular preparations. We tested and confirmed these in silico predictions with in vitro experiments on isolated guinea-pig ventricular cells and papillary muscles stimulated at various rates (2-6.67 Hz) and exposed to various concentrations (5 × 10(-6) to 500 × 10(-6) mol/l) of lidocaine. The most salient result was that whereas large doses (5 × 10(-4) mol/l or higher) of lidocaine were required to inhibit action potentials temporarily in single cells, much lower doses (5 × 10(-6) mol/l), i.e., therapeutic levels, were sufficient to have the same effect in papillary muscles: a hundredfold difference. Our experimental results and mathematical analysis indicate that the syncytial nature of cardiac tissue explains the effects of clinically relevant doses of Na(+) channel blockers.

  12. Maintenance of mesenchymal stem cells culture due to the cells with reduced attachment rate

    Directory of Open Access Journals (Sweden)

    Shuvalova N. S.

    2013-01-01

    Full Text Available Aim. The classic detachment techniques lead to changes in cells properties. We offer a simple method of cultivating the population of cells that avoided an influence on the surface structures. Methods. Mesenchymal stem cells (MSC from human umbilical cord matrix were obtained and cultivated in standard conditions. While substituting the culture media by a fresh portion, the conditioned culture medium, where the cells were maintained for three days, was transferred to other culture flacks with addition of serum and growth factors. Results. In the flacks, one day after medium transfer, we observed attached cells with typical MSC morphology. The cultures originated from these cells had the same rate of surface markers expression and clonogenic potential as those replated by standard methods. Conclusions. MSC culture, derived by preserving the cells with reduced attachment ability, actually has the properties of «parent» passage. Using this method with accepted techniques of cells reseeding would allow maintaining the cells that avoided an impact on the cell surface proteins.

  13. Optimal Reoperation of Multi-Reservoirs for Integrated Watershed Management with Multiple Benefits

    Directory of Open Access Journals (Sweden)

    Xinyi Xu

    2014-04-01

    Full Text Available Constructing reservoirs can make more efficient use of water resources for human society. However, the negative impacts of these projects on the environment are often ignored. Optimal reoperation of reservoirs, which considers not only in socio-economic values but also environmental benefits, is increasingly important. A model of optimal reoperation of multi-reservoirs for integrated watershed management with multiple benefits was proposed to alleviate the conflict between water use and environmental deterioration. The social, economic, water quality and ecological benefits were respectively taken into account as the scheduling objectives and quantified according to economic models. River minimum ecological flows and reservoir water levels based on flood control were taken as key constraint conditions. Feasible search discrete differential dynamic programming (FS-DDDP was used to run the model. The proposed model was used in the upstream of the Nanpan River, to quantitatively evaluate the difference between optimal reoperation and routine operation. The results indicated that the reoperation could significantly increase the water quality benefit and have a minor effect on the benefits of power generation and irrigation under different hydrological years. The model can be readily adapted to other multi-reservoir systems for water resources management.

  14. Heart rate modulates the slow enhancement of contraction due to sudden left ventricular dilation.

    Science.gov (United States)

    Tucci, P J; Murad, N; Rossi, C L; Nogueira, R J; Santana, O

    2001-05-01

    In isovolumic blood-perfused dog hearts, left ventricular developed pressure (DP) was recorded while a sudden ventricular dilation was promoted at three heart rate (HR) levels: low (L: 52 +/- 1.7 beats/min), intermediate (M: 82 +/- 2.2 beats/min), and high (H: 117 +/- 3.5 beats/min). DP increased instantaneously with chamber expansion (Delta(1)DP), and another continuous increase occurred for several minutes (Delta(2)DP). HR elevation did not alter Delta(1)DP (32.8 +/- 1.6, 33.6 +/- 1.5, and 34.3 +/- 1.2 mmHg for L, M, and H, respectively), even though it intensified Delta(2)DP (17.3 +/- 0.9, 20.7 +/- 1.0, and 26.8 +/- 1.2 mmHg for L, M, and H, respectively), meaning that the treppe phenomenon enhances the length dependence of the contraction component related to changes in intracellular Ca(2+) concentration. Frequency increments reduced the half time of the slow response (82 +/- 3.6, 67 +/- 2.6, and 53 +/- 2.0 s for L, M, and H, respectively), while the number of beats included in half time increased (72 +/- 2.9, 95 +/- 2.9, and 111 +/- 3.2 beats for L, M, and H, respectively). HR modulation of the slow response suggests that L-type Ca(2+) channel currents and/or the Na(+)/Ca(2+) exchanger plays a relevant role in the stretch-triggered Ca(2+) gain when HR increases in the canine heart.

  15. Thermokarst rates intensify due to climate change and forest fragmentation in an Alaskan boreal forest lowland.

    Science.gov (United States)

    Lara, Mark J; Genet, Hélène; McGuire, Anthony D; Euskirchen, Eugénie S; Zhang, Yujin; Brown, Dana R N; Jorgenson, Mark T; Romanovsky, Vladimir; Breen, Amy; Bolton, William R

    2016-02-01

    Lowland boreal forest ecosystems in Alaska are dominated by wetlands comprised of a complex mosaic of fens, collapse-scar bogs, low shrub/scrub, and forests growing on elevated ice-rich permafrost soils. Thermokarst has affected the lowlands of the Tanana Flats in central Alaska for centuries, as thawing permafrost collapses forests that transition to wetlands. Located within the discontinuous permafrost zone, this region has significantly warmed over the past half-century, and much of these carbon-rich permafrost soils are now within ~0.5 °C of thawing. Increased permafrost thaw in lowland boreal forests in response to warming may have consequences for the climate system. This study evaluates the trajectories and potential drivers of 60 years of forest change in a landscape subjected to permafrost thaw in unburned dominant forest types (paper birch and black spruce) associated with location on elevated permafrost plateau and across multiple time periods (1949, 1978, 1986, 1998, and 2009) using historical and contemporary aerial and satellite images for change detection. We developed (i) a deterministic statistical model to evaluate the potential climatic controls on forest change using gradient boosting and regression tree analysis, and (ii) a 30 × 30 m land cover map of the Tanana Flats to estimate the potential landscape-level losses of forest area due to thermokarst from 1949 to 2009. Over the 60-year period, we observed a nonlinear loss of birch forests and a relatively continuous gain of spruce forest associated with thermokarst and forest succession, while gradient boosting/regression tree models identify precipitation and forest fragmentation as the primary factors controlling birch and spruce forest change, respectively. Between 1950 and 2009, landscape-level analysis estimates a transition of ~15 km² or ~7% of birch forests to wetlands, where the greatest change followed warm periods. This work highlights that the vulnerability and resilience of

  16. Thermokarst rates intensify due to climate change and forest fragmentation in an Alaskan boreal forest lowland

    Science.gov (United States)

    Lara, M.; Genet, Helene; McGuire, Anthony; Euskirchen, Eugénie S.; Zhang, Yujin; Brown, Dana R. N.; Jorgenson, M.T.; Romanovsky, V.; Breen, Amy L.; Bolton, W.R.

    2016-01-01

    Lowland boreal forest ecosystems in Alaska are dominated by wetlands comprised of a complex mosaic of fens, collapse-scar bogs, low shrub/scrub, and forests growing on elevated ice-rich permafrost soils. Thermokarst has affected the lowlands of the Tanana Flats in central Alaska for centuries, as thawing permafrost collapses forests that transition to wetlands. Located within the discontinuous permafrost zone, this region has significantly warmed over the past half-century, and much of these carbon-rich permafrost soils are now within ~0.5 °C of thawing. Increased permafrost thaw in lowland boreal forests in response to warming may have consequences for the climate system. This study evaluates the trajectories and potential drivers of 60 years of forest change in a landscape subjected to permafrost thaw in unburned dominant forest types (paper birch and black spruce) associated with location on elevated permafrost plateau and across multiple time periods (1949, 1978, 1986, 1998, and 2009) using historical and contemporary aerial and satellite images for change detection. We developed (i) a deterministic statistical model to evaluate the potential climatic controls on forest change using gradient boosting and regression tree analysis, and (ii) a 30 × 30 m land cover map of the Tanana Flats to estimate the potential landscape-level losses of forest area due to thermokarst from 1949 to 2009. Over the 60-year period, we observed a nonlinear loss of birch forests and a relatively continuous gain of spruce forest associated with thermokarst and forest succession, while gradient boosting/regression tree models identify precipitation and forest fragmentation as the primary factors controlling birch and spruce forest change, respectively. Between 1950 and 2009, landscape-level analysis estimates a transition of ~15 km² or ~7% of birch forests to wetlands, where the greatest change followed warm periods. This work highlights that the vulnerability and resilience of

  17. Gamma ray heating rates due to chromium isotopes in stellar core during late stages of high mass stars (>10M⊙

    Directory of Open Access Journals (Sweden)

    Nabi Jameel-Un

    2017-01-01

    Full Text Available Gamma ray heating rates are thought to play a crucial role during the pre-supernova stage of high mass stars. Gamma ray heating rates, due to β±-decay and electron (positron capture on chromium isotopes, are calculated using proton-neutron quasiparticle random phase approximation theory. The electron capture significantly affects the lepton fraction (Ye and accelerates the core contraction. The gamma rays emitted as a result of weak processes heat the core and tend to hinder the cooling and contraction due to electron capture and neutrino emission. The emitted gamma rays tend to produce enormous entropy and set the convection to play its role at this stage. The gamma heating rates, on 50-60Cr, are calculated for the density range 10 < ρ (g.cm-3 < 1011 and temperature range 107 < T (K < 3.0×1010.

  18. Factors affecting reoperations after anterior cervical discectomy and fusion within and outside of a Federal Drug Administration investigational device exemption cervical disc replacement trial.

    Science.gov (United States)

    Singh, Kern; Phillips, Frank M; Park, Dan K; Pelton, Miguel A; An, Howard S; Goldberg, Edward J

    2012-05-01

    The excellent clinical results of five US Federal Drug Administration (FDA) trials approved for cervical total disc replacement (TDR) (Prestige [Medtronic Sofamor Danek, Memphis, TN, USA], Bryan [Medtronic Sofamor Danek], ProDisc-C [Synthes, West Chester, PA, USA], Kineflex|C [SpinalMotion, Mountain View, CA, USA], and Mobi-C [LDR Spine, Austin, TX, USA]) have recently been published. In these prospective randomized studies, superiority or equivalency of TDR was claimed, citing an 8.7% (23/265), 9.5% (21/221), 8.5% (9/106), 12.2% (14/115), and 6.2% (5/81) (mean = 9.02%) rate of additional related cervical surgical procedures within 2 years in control anterior cervical discectomy and fusion (ACDF) patients, respectively, compared with 1.8% (5/276), 5.8% (14/242), 1.9% (2/103), 11% (15/136), and 1.2% (2/164) (mean = 4.34%) in patients receiving the cervical TDR. The rate of reoperation within 2 years after ACDF seems unusually high. To assess the rate of and specific indications for early reoperation after ACDF in a cohort of patients receiving the ACDF as part of their customary care. These results are contrasted with similar patients receiving ACDF as the control arm of five FDA investigational device exemption (IDE) studies. Multisurgeon retrospective clinical series from a single institution. One hundred seventy-six patients with spondylotic radiculopathy or myelopathy underwent ACDF by three surgeons between 2001 and 2005 as part of their clinical practices. All patients had at least 2 years of follow-up with final follow-up within 6 months of completion of this study. Cervical reoperation rates at 2-year follow-up and at 3.5-year follow-up. Review of medical records and telephone conversations were completed to determine the number of patients who had undergone a revision cervical procedure. At final follow-up, complete data were available for 159 ACDF patients. Of the 48 patients who underwent single-level ACDF and met criteria for inclusion in the IDE studies

  19. Scattering rates due to electron-phonon interaction in CdS1-xSex quantum dots

    Science.gov (United States)

    Alcalde, Augusto M.; Weber, Gerald

    2000-11-01

    We calculate electron-LO-confined and surface phonon scattering rates in CdS1-xSex spherical quantum dots. The phonon modes are described in the frame of the two-mode dielectric continuum model, and the standard k.p formalism is used for treating the electronic band structure. We include the effects of inhomogeneous broadening due to statistical dot size distribution, which can create a wide channel of efficient relaxation. We demonstrate that changes in the concentration can generate variations of more than one order of magnitude in the relaxation rates.

  20. Calculations of Solar Shortwave Heating Rates due to Black Carbon and Ozone Absorption Using in Situ Measurements

    Science.gov (United States)

    Gao, R. S.; Hall, S. R.; Swartz, W. H.; Spackman, J. R.; Watts, L. A.; Fahey, D. W.; Aikin, K. C.; Shetter, R. E.; Bui, T. P.

    2008-01-01

    Results for the solar heating rates in ambient air due to absorption by black-carbon (BC) containing particles and ozone are presented as calculated from airborne observations made in the tropical tropopause layer (TTL) in January-February 2006. The method uses airborne in situ observations of BC particles, ozone and actinic flux. Total BC mass is obtained along the flight track by summing the masses of individually detected BC particles in the range 90 to 600-nm volume-equivalent diameter, which includes most of the BC mass. Ozone mixing ratios and upwelling and partial downwelling solar actinic fluxes were measured concurrently with BC mass. Two estimates used for the BC wavelength-dependent absorption cross section yielded similar heating rates. For mean altitudes of 16.5, 17.5, and 18.5 km (0.5 km) in the tropics, average BC heating rates were near 0.0002 K/d. Observed BC coatings on individual particles approximately double derived BC heating rates. Ozone heating rates exceeded BC heating rates by approximately a factor of 100 on average and at least a factor of 4, suggesting that BC heating rates in this region are negligible in comparison.

  1. Scoliosis surgery in the elderly: Complications, readmissions, reoperations and mortality.

    Science.gov (United States)

    Drazin, Doniel; Al-Khouja, Lutfi; Lagman, Carlito; Ugiliweneza, Beatrice; Shweikeh, Faris; Johnson, J Patrick; Kim, Terrence T; Boakye, Maxwell

    2016-12-01

    The operative management of scoliosis in the elderly remains controversial. The authors of this study sought to evaluate outcomes in elderly patients with scoliosis undergoing deformity correction. Patient data was obtained from a 5% sample of the Medicare Provided Analysis and Review database (MEDPAR). Patients over 65years of age with scoliosis undergoing corrective surgery were identified between the years 2005 to 2011. A total of 453 patients were analyzed: 262 (57%) between ages 66 to 74years, and 191 (42%) over the age of 75years. Female predominance (78%) was observed in this sample. Pre-diagnosis follow-up averaged 118months. Post-surgery follow-up averaged 33months. Patients between 66 and 74years old were mostly discharged home, while patients over the age of 75years were discharged to skilled nursing facilities (SNFs) (38.55% versus 34.04%, p value=0.0011). Readmission rates were lower in patients between 66 and 74years old when compared to patients over the age of 75years (9.92% versus 17.28%, p value=0.0217). Complication rates 30-days after discharge were less in patients between 66 and 74years, compared to those over 75years (21% versus 26.6%, respectively), but this was not statistically significant. These findings suggest varying outcomes following scoliosis surgery in the elderly, but interpretation of these results is weakened by the inherent limitations of database utilization. Future prospective studies are needed to understand risk factors and other confounding variables, such as discharge disposition, that may influence outcomes.

  2. Gamow-Teller strength distributions and neutrino energy loss rates due to chromium isotopes in stellar matter

    CERN Document Server

    Nabi, Jameel-Un; Fayaz, Muhammad

    2016-01-01

    Gamow-Teller transitions in isotopes of chromium play a consequential role in the presupernova evolution of massive stars. $\\beta$-decay and electron capture rates on chromium isotopes significantly affect the time rate of change of lepton fraction ($\\dot{Y_{e}}$). Fine-tuning of this parameter is one of the key for simulating a successful supernova explosion. The (anti)neutrinos produced as a result of electron capture and $\\beta$-decay are transparent to stellar matter during presupernova phases. They carry away energy and this result in cooling the stellar core. In this paper we present the calculations of Gamow-Teller strength distributions and (anti)neutrino energy loss rates due to weak interactions on chromium isotopes of astrophysical importance. We compare our results with measured data and previous calculations wherever available.

  3. Complications, Reoperations, and Nutrient Deficiencies Two Years after Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Nicole Pech

    2012-01-01

    Full Text Available Background. The aim of this study was to investigate patient outcomes and nutritional deficiencies following sleeve gastrectomy (SG during a follow-up of two years. Methods. Over a period of 56 months, all consecutive patients who underwent SG were documented in this prospective, single-center, observational study. The study endpoints included operative time, complication rates, nutritional deficiencies and percentage of excess weight loss (%EWL. Results. From September 26, 2005 to May 28, 2009, 82 patients (female : male = 48 : 34 with a mean age of 43.3 years (range: 22–64 and a preoperative BMI of 52.5 kg/m² (range: 36.8–77.0 underwent SG. Major complications were observed in 9.8% of the patients, with 1 death. During follow up 51.2% of patients were supplemented with iron, 36.6% with zinc, 37.8% with calcium, 26.8% with vitamin D, 46.3% with vitamin B12 and 41.5% with folic acid. %EWL was 54.3, 65.3 and 62.6% after 6, 12 and 24 months. Conclusion. SG as a single step procedure is an effective bariatric intervention. Nutritional deficiencies after SG can be detected by routine nutritional screening. Our results show that Vitamin B12 supplementation should suggest routinely after SG.

  4. Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Sonne-Holm, Stig

    2007-01-01

    -six fractures of the lateral femoral wall occurred during the operative procedure itself. A fracture of the lateral femoral wall occurred in only 3% (three) of the 103 patients with an AO/OTA type-31-A1.1, A1.2, A1.3, or A2.1 intertrochanteric fracture compared with 31% (thirty-one) of the ninety......-nine with an AO/OTA type 31-A2.2 or A2.3 fracture (p fracture of the lateral femoral wall was found to be the main predictor for a reoperation after an intertrochanteric fracture. Consequently, we concluded that patients with preoperative or intraoperative fracture......BACKGROUND: Reoperations after intertrochanteric fractures are often necessitated by fracture displacement following mobilization of the patient. The biomechanical complexity of the fracture, the position of the implant, and the patient's characteristics are known to influence postoperative outcome...

  5. Tidal radii and destruction rates of globular clusters in the Milky Way due to bulge-bar and disk shocking

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, Edmundo; Pichardo, Bárbara [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apdo. Postal 70-264, 04510 México, D. F. (Mexico); Velázquez, Héctor [Observatorio Astronómico Nacional, Universidad Nacional Autónoma de México, Apdo. Postal 877, 22800 Ensenada (Mexico)

    2014-10-01

    We calculate orbits, tidal radii, and bulge-bar and disk shocking destruction rates for 63 globular clusters in our Galaxy. Orbits are integrated in both an axisymmetric and a nonaxisymmetric Galactic potential that includes a bar and a three-dimensional model for the spiral arms. With the use of a Monte Carlo scheme, we consider in our simulations observational uncertainties in the kinematical data of the clusters. In the analysis of destruction rates due to the bulge-bar, we consider the rigorous treatment of using the real Galactic cluster orbit instead of the usual linear trajectory employed in previous studies. We compare results in both treatments. We find that the theoretical tidal radius computed in the nonaxisymmetric Galactic potential compares better with the observed tidal radius than that obtained in the axisymmetric potential. In both Galactic potentials, bulge-shocking destruction rates computed with a linear trajectory of a cluster at its perigalacticons give a good approximation of the result obtained with the real trajectory of the cluster. Bulge-shocking destruction rates for clusters with perigalacticons in the inner Galactic region are smaller in the nonaxisymmetric potential than those in the axisymmetric potential. For the majority of clusters with high orbital eccentricities (e > 0.5), their total bulge+disk destruction rates are smaller in the nonaxisymmetric potential.

  6. A Review on Level of Specific Absorption Rate Due to High Power Transmission Lines: Analysis toward Human Position Posture

    Directory of Open Access Journals (Sweden)

    Ghazali Z.

    2016-01-01

    Full Text Available The main contribution of this project is the development of a homogeneous model of a man to presents the specific absorption rate (SAR due to high power transmission line. As a low frequency application under high power transmission line of 50 Hz in electrical engineering, to studies the influence of human’s posture on specific absorption rate. This project designs two types of human body which one design uses most cylinder block and another design use brick block where both blocks have a different value of mesh cells. For each design has four types of posture are standing, sitting, arms up and arms out by using Computer Simulation Technology (CST Studio Software. This analysis does toward for four types of the human position postures because each posture has different value of specific absorption rate (SAR based on the size of the mesh cells of the design. Based on two designs of the human body, the lowest of the mesh cells value will reduce time to simulate SAR. For each posture has different value of SAR for each part of the human body because the whole human body has different types of tissues. Therefore, the CST studio software uses extremely to simulate the SAR value toward human position posture due to high power transmission line.

  7. Reoperation for early postoperative complications after gastric cancer surgery in a Chinese hospital

    Institute of Scientific and Technical Information of China (English)

    Birendra; Kumar; Sah

    2010-01-01

    AIM:To investigate the occurrence of postoperative complications of gastric cancer surgery,and analyze the potential causes of reoperation for early postoperative complications. METHODS:A total of 1639 patients who underwent radical or palliative gastrectomies for gastric cancer were included in the study.The study endpoint was the analysis of postoperative complications in inpatients. RESULTS:About 31%of patients had early postoperative complications,and complications of infection occurred most frequently....

  8. The role of presurgical EEG parameters and of reoperation for seizure outcome in temporal lobe epilepsy.

    Science.gov (United States)

    Schmeiser, B; Zentner, J; Steinhoff, B J; Brandt, A; Schulze-Bonhage, A; Kogias, E; Hammen, T

    2017-10-01

    After surgery for intractable mesiotemporal lobe epilepsy (mTLE) seizures recur in 30-40%. One predictor for seizure recurrence is the distribution of seizure onset and interictal epileptiform discharges (IED). Our study focused on lateralization and extent of epileptiform activity regarding postoperative seizure persistence and the effect of reoperation. This study comprises 426 consecutive patients operated for intractable mTLE. Impact of preoperative seizure onset and IED on the persistence of seizures and results of reoperation were analyzed. One year after surgery, 27% of patients with mTLE experienced persistent seizures (Engel II-IV). Preoperative bilateral seizure onset in EEG was predictive for postoperative seizure recurrence (Engel II-IV: 64%). Seizure foci and IED exceeding the temporal lobe in the ipsilateral hemisphere were not found to be associated with worse seizure outcome (Engel I: 72% and 75%) compared to patients with seizure foci confined to the ipsilateral temporal lobe (Engel I: 75% and 76%). Moreover, IED exceeding the affected temporal lobe in the ipsilateral hemisphere or even bilateral IED did not negatively affect seizure freedom if seizure onset was strictly limited to the affected temporal lobe (Engel I: 85% and 65%, respectively). 60% of patients reoperated in the ipsilateral temporal lobe for persistent seizures became seizure free. Preoperative bilateral ictal foci are a negative predictor for seizure outcome. Contrarily, IED exceeding the affected temporal lobe in the ipsilateral hemisphere or even bilateral IED had favorable seizure outcome if seizure onset is strictly limited to the affected temporal lobe. Reoperation for seizure persistence constitutes a promising therapeutic option. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  9. Reduced spin-down rate of PSR J0738-4042 explained as due to an asteroid disruption event

    Science.gov (United States)

    Yu, Yong-Bo; Huang, Yong-Feng

    2016-05-01

    Long term observations by Brook et al. reveal that the derivative of rotational frequency of PSR J0738-4042 changed abruptly in 2005. Originally, the spin-down rate was relatively stable, with the rotational frequency derivative being -1.14×10-14 s-2. After September 2005, the derivative began to rise. About 1000 days later, it arrived at another relatively stable value of about -0.98 × 10-14 s-2, indicating that the pulsar is spinning-down relatively slowly. To explain the observed change in spin-down rate, we resort to an asteroid disrupted by PSR J0738-4042. In our model, the orbital angular momentum of the asteroid is assumed to be parallel to that of the rotating pulsar, so that the pronounced reduction in the spin-down rate can be naturally explained as due to the transfer of angular momentum from the disrupted material to the central pulsar. The derived magnetospheric radius is about 7.0 × 109 cm, which is smaller than the tidal disruption radius (8.7 × 1010 cm). Our model is self-consistent. It is shown that the variability in the spin-down rate of PSR J0738-4042 can be quantitatively accounted for by accretion from the asteroid disrupted by the central pulsar.

  10. Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination.

    Science.gov (United States)

    Melillo, Paolo; Bracale, Marcello; Pecchia, Leandro

    2011-11-07

    This study investigates the variations of Heart Rate Variability (HRV) due to a real-life stressor and proposes a classifier based on nonlinear features of HRV for automatic stress detection. 42 students volunteered to participate to the study about HRV and stress. For each student, two recordings were performed: one during an on-going university examination, assumed as a real-life stressor, and one after holidays. Nonlinear analysis of HRV was performed by using Poincaré Plot, Approximate Entropy, Correlation dimension, Detrended Fluctuation Analysis, Recurrence Plot. For statistical comparison, we adopted the Wilcoxon Signed Rank test and for development of a classifier we adopted the Linear Discriminant Analysis (LDA). Almost all HRV features measuring heart rate complexity were significantly decreased in the stress session. LDA generated a simple classifier based on the two Poincaré Plot parameters and Approximate Entropy, which enables stress detection with a total classification accuracy, a sensitivity and a specificity rate of 90%, 86%, and 95% respectively. The results of the current study suggest that nonlinear HRV analysis using short term ECG recording could be effective in automatically detecting real-life stress condition, such as a university examination.

  11. Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination

    Directory of Open Access Journals (Sweden)

    Melillo Paolo

    2011-11-01

    Full Text Available Abstract Background This study investigates the variations of Heart Rate Variability (HRV due to a real-life stressor and proposes a classifier based on nonlinear features of HRV for automatic stress detection. Methods 42 students volunteered to participate to the study about HRV and stress. For each student, two recordings were performed: one during an on-going university examination, assumed as a real-life stressor, and one after holidays. Nonlinear analysis of HRV was performed by using Poincaré Plot, Approximate Entropy, Correlation dimension, Detrended Fluctuation Analysis, Recurrence Plot. For statistical comparison, we adopted the Wilcoxon Signed Rank test and for development of a classifier we adopted the Linear Discriminant Analysis (LDA. Results Almost all HRV features measuring heart rate complexity were significantly decreased in the stress session. LDA generated a simple classifier based on the two Poincaré Plot parameters and Approximate Entropy, which enables stress detection with a total classification accuracy, a sensitivity and a specificity rate of 90%, 86%, and 95% respectively. Conclusions The results of the current study suggest that nonlinear HRV analysis using short term ECG recording could be effective in automatically detecting real-life stress condition, such as a university examination.

  12. Enhancement of fusion rates due to quantum effects in the particles momentum distribution in nonideal plasma media

    Science.gov (United States)

    Fisch, N. J.; Gladush, M. G.; Petrushevich, Y. V.; Quarati, P.; Starostin, A. N.

    2012-06-01

    This study concerns a situation when measurements of the nonresonant cross-section of nuclear reactions appear highly dependent on the environment in which the particles interact. An appealing example discussed in the paper is the interaction of a deuteron beam with a target of deuterated metal Ta. In these experiments, the reaction cross section for d(d, p)t was shown to be orders of magnitude greater than what the conventional model predicts for the low-energy particles. In this paper we take into account the influence of quantum effects due to the Heisenberg uncertainty principle for particles in a non-ideal plasma medium elastically interacting with the medium particles. In order to calculate the nuclear reaction rate in the non-ideal environment we apply both the Monte Carlo technique and approximate analytical calculation of the Feynman diagram using nonrelativistic kinetic Green's functions in the medium which correspond to the generalized energy and momentum distribution functions of interacting particles. We show a possibility to reduce the 12-fold integral corresponding to this diagram to a fivefold integral. This can significantly speed up the computation and control accuracy. Our calculations show that quantum effects significantly influence reaction rates such as p +7Be, 3He +4He, p +7Li, and 12C +12C. The new reaction rates may be much higher than the classical ones for the interior of the Sun and supernova stars. The possibility to observe the theoretical predictions under laboratory conditions is discussed.

  13. Tidal radii and destruction rates of globular clusters in the Milky Way due to bulge-bar and disk shocking

    CERN Document Server

    Moreno, Edmundo; Velazquez, Hector

    2014-01-01

    We calculate orbits, tidal radii, and bulge-bar and disk shocking destruction rates for 63 globular clusters in our Galaxy. Orbits are integrated in both an axisymmetric and a non-axisymmetric Galactic potential that includes a bar and a 3D model for the spiral arms. With the use of a Monte Carlo scheme, we consider in our simulations observational uncertainties in the kinematical data of the clusters. In the analysis of destruction rates due to the bulge-bar, we consider the rigorous treatment of using the real Galactic cluster orbit, instead of the usual linear trajectory employed in previous studies. We compare results in both treatments. We ?nd that the theoretical tidal radius computed in the nonaxisymmetric Galactic potential compares better with the observed tidal radius than that obtained in the axisymmetric potential. In both Galactic potentials, bulge-shocking destruction rates computed with a linear trajectory of a cluster at its perigalacticons give a good approximation to the result obtained with...

  14. Determination of corrosion rate of reinforcement with a modulated guard ring electrode; analysis of errors due to lateral current distribution

    Energy Technology Data Exchange (ETDEWEB)

    Wojtas, H

    2004-07-01

    The main source of errors in measuring the corrosion rate of rebars on site is a non-uniform current distribution between the small counter electrode (CE) on the concrete surface and the large rebar network. Guard ring electrodes (GEs) are used in an attempt to confine the excitation current within a defined area. In order to better understand the functioning of modulated guard ring electrode and to assess its effectiveness in eliminating errors due to lateral spread of current signal from the small CE, measurements of the polarisation resistance performed on a concrete beam have been numerically simulated. Effect of parameters such as rebar corrosion activity, concrete resistivity, concrete cover depth and size of the corroding area on errors in the estimation of polarisation resistance of a single rebar has been examined. The results indicate that modulated GE arrangement fails to confine the lateral spread of the CE current within a constant area. Using the constant diameter of confinement for the calculation of corrosion rate may lead to serious errors when test conditions change. When high corrosion activity of rebar and/or local corrosion occur, the use of the modulated GE confinement may lead to significant underestimation of the corrosion rate.

  15. Measurement of HO{sub x}{center_dot} production rate due to radon decay in air

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Huiling

    1993-08-01

    Radon in indoor air may cause the exposure of the public to excessive radioactivity. Radiolysis of water vapor in indoor air due to radon decay could produce ({center_dot}OH and HO{sub 2} {center_dot}) that may convert atmospheric constituents to compounds of lower vapor pressure. These lower vapor pressure compounds might then nucleate to form new particles in the indoor atmosphere. Chemical amplification was used to determine HO{sub x}{center_dot} production rate in indoor air caused by radon decay. Average HO{sub x}{center_dot} production rate was found to be (4.31{plus_minus}0.07) {times} 10{sup 5} HO{sub x}{center_dot} per Rn decay per second (Bq) 3.4 to 55.0% at 22C. This work provided G{sub (HO{sub x}{center_dot})}-value, 7.86{plus_minus}0.13 No./100 eV in air by directly measuring [HO{sub x}{center_dot}] formed from the radiolysis procedure. This G value implies that HO{sub x}{center_dot} produced by radon decay in air might be formed by multiple processes and may be result of positive ion-molecule reactions, primary radiolysis, and radical reactions. There is no obvious relation between HO{sub x}{center_dot} production rate and relative humidity. A laser-induced fluorescence (LIF) system has been used for {center_dot}OH production rate measurement; it consists of an excimer laser, a dye laser, a frequency doubler, a gaseous fluorescence chamber, and other optical and electronic parts. This system needs to be improved to eliminate the interferences of light scattering and artificial {center_dot}OH produced from the photolysis of O{sub 3}/H{sub 2}O.

  16. Summary of information on low-speed lateral-directional derivatives due to rate of change of sideslip beta prime

    Science.gov (United States)

    Coe, P. L., Jr.; Graham, A. B.; Chambers, J. R.

    1975-01-01

    The results presented show that the magnitudes of the aerodynamic stability derivatives due to rate of change of sideslip become quite large at high angles of attack for swept- and delta-wing configurations, and that such derivatives have large effects on the calculated dynamic stability of these configurations at high angles of attack. The wind-tunnel test techniques used to measure the beta prime derivatives and various approaches used to predict them are discussed. Both the conventional oscillating-airfoil theory and the lag-of-the-sidewash theory are shown to be inadequate for predicting the vertical-tail contribution to the acceleration-in-sideslip derivative; a flow-field-lag theory, which is discussed, appears to give qualitative agreement with experimental data for a current twin-jet fighter configuration.

  17. Superior bit error rate and jitter due to improved switching field distribution in exchange spring magnetic recording media.

    Science.gov (United States)

    Suess, D; Fuger, M; Abert, C; Bruckner, F; Vogler, C

    2016-06-01

    We report two effects that lead to a significant reduction of the switching field distribution in exchange spring media. The first effect relies on a subtle mechanism of the interplay between exchange coupling between soft and hard layers and anisotropy that allows significant reduction of the switching field distribution in exchange spring media. This effect reduces the switching field distribution by about 30% compared to single-phase media. A second effect is that due to the improved thermal stability of exchange spring media over single-phase media, the jitter due to thermal fluctuation is significantly smaller for exchange spring media than for single-phase media. The influence of this overall improved switching field distribution on the transition jitter in granular recording and the bit error rate in bit-patterned magnetic recording is discussed. The transition jitter in granular recording for a distribution of Khard values of 3% in the hard layer, taking into account thermal fluctuations during recording, is estimated to be a = 0.78 nm, which is similar to the best reported calculated jitter in optimized heat-assisted recording media.

  18. A Control Allocation System for Automatic Detection and Compensation of Phase Shift Due to Actuator Rate Limiting

    Science.gov (United States)

    Yildiz, Yidiray; Kolmanovsky, Ilya V.; Acosta, Diana

    2011-01-01

    This paper proposes a control allocation system that can detect and compensate the phase shift between the desired and the actual total control effort due to rate limiting of the actuators. Phase shifting is an important problem in control system applications since it effectively introduces a time delay which may destabilize the closed loop dynamics. A relevant example comes from flight control where aggressive pilot commands, high gain of the flight control system or some anomaly in the system may cause actuator rate limiting and effective time delay introduction. This time delay can instigate Pilot Induced Oscillations (PIO), which is an abnormal coupling between the pilot and the aircraft resulting in unintentional and undesired oscillations. The proposed control allocation system reduces the effective time delay by first detecting the phase shift and then minimizing it using constrained optimization techniques. Flight control simulation results for an unstable aircraft with inertial cross coupling are reported, which demonstrate phase shift minimization and recovery from a PIO event.

  19. Expanded calculation of weak-interaction mediated neutrino cooling rates due to $^{56}$Ni in stellar matter

    CERN Document Server

    Nabi, Jameel-Un

    2014-01-01

    Accurate estimate of the neutrino cooling rates is required in order to study the various stages of stellar evolution of massive stars. Neutrino losses from proto-neutron stars play a crucial role in deciding whether these stars would be crushed into black holes or explode as supernovae. Both pure leptonic and weak-interaction processes contribute to the neutrino energy losses in stellar matter. At low temperatures and densities, characteristic of the early phase of presupernova evolution, cooling through neutrinos produced via the weak-interaction is important. Proton-neutron quasi-particle random phase approximation (pn-QRPA) theory has recently being used for calculation of stellar weak-interaction rates of $fp$-shell nuclide with success. The lepton-to-baryon ratio ($Y_{e}$) during early phases of stellar evolution of massive stars changes substantially alone due to electron captures on $^{56}$Ni. The stellar matter is transparent to the neutrinos produced during the presupernova evolution of massive star...

  20. Long-term efficacy of lymph node reoperation for persistent papillary thyroid cancer.

    Science.gov (United States)

    Al-Saif, Osama; Farrar, William B; Bloomston, Mark; Porter, Kyle; Ringel, Matthew D; Kloos, Richard T

    2010-05-01

    The objective of the study was to determine the outcome of surgical resection of metastatic papillary thyroid cancer (PTC) in cervical lymph nodes after failure of initial surgery and I(131) therapy. This was a retrospective clinical study. The study was conducted at a university-based tertiary cancer hospital. A cohort of 95 consecutive patients with recurrent/persistent PTC in the neck underwent initial reoperation during 1999-2005. All had previous thyroidectomy (+/-nodal dissection) and I(131) therapy. Twenty-five patients with antithyroglobulin (Tg) antibodies were subsequently excluded. Biochemical complete remission (BCR) was stringently defined as undetectable TSH-stimulated serum Tg. A total of 107 lymphadenectomies were undertaken in these 70 patients through January 2010. BCR was initially achieved in 12 patients (17%). Of the 58 patients with detectable postoperative Tg, 28 had a second reoperation and BCR was achieved in five (18%), seven had a third reoperation, and none achieved BCR. No patient achieving BCR had a subsequent recurrence after a mean follow-up of 60 months (range 4-116 months). In addition, two more patients achieved BCR during long-term follow-up without further intervention. In total, 19 patients (27%) achieved BCR and 32 patients (46%) achieved a TSH-stimulated Tg less than 2.0 ng/ml. Patients who did not achieve BCR had significant reduction in Tg after the first (P operations. No patient developed detectable distant metastases or died from PTC. Surgical resection of persistent PTC in cervical lymph nodes achieves BCR, when most stringently defined, in 27% of patients, sometimes requiring several surgeries. No biochemical or clinical recurrences occurred during follow-up. In patients who do not achieve BCR, Tg levels were significantly reduced. The long-term durability and impact of this intervention will require further investigation.

  1. Complications of rhBMP-2 utilization for posterolateral lumbar fusions requiring reoperation: a single practice, retrospective case series report.

    Science.gov (United States)

    Hoffmann, Martin F; Jones, Clifford B; Sietsema, Debra L

    2013-10-01

    Recombinant human bone morphogenetic protein-2 (rhBMP-2) (INFUSE, Medtronic, Memphis, TN, USA) has been used off-label for posterolateral lumbar fusions for many years. The goal of this study was to evaluate the complications requiring reoperation associated with rhBMP-2 application for posterolateral lumbar fusions. During a 7-year period of time (2002-2009), all patients undergoing lumbar posterolateral fusion using rhBMP-2 (INFUSE) were retrospectively evaluated within a large orthopedic surgery private practice. A total of 1,158 consecutive patients were evaluated with 468 (40.4%) males and 690 (59.6%) females. Complications related to rhBMP were defined as reoperation secondary to symptomatic failed fusion (nonunion), symptomatic seroma formation, symptomatic reformation of foraminal bone, and infection. Inclusion criteria were posterolateral fusion with rhBMP-2 implant and age equal to or older than 18 years. Surgical indications and treatment were performed in accordance with the surgeon's best knowledge, discretion, and experience. Patients consented to lumbar decompression and arthrodesis using rhBMP-2. All patients were educated and informed of the off-label utilization of rhBMP-2. Patient follow-up was performed at regular intervals of 2 weeks, 6 weeks, 12 weeks, 6 months, 1 year, and later if required or indicated. Average age was 59.2 years, and body mass index was 30.7 kg/m². Numbers of levels fused were 1 (414, 35.8%), 2 (469, 40.5%), 3 (162, 14.0%), 4 (70, 6.0%), 5 (19, 1.6%), 6 (11, 0.9%), 7 (7, 0.6%), 8 (4, 0.3%), and 9 (2, 0.2%). Patients having complications requiring reoperation were 117 of 1,158 (10.1%): symptomatic nonunion requiring redo fusion and instrumentation 41 (3.5%), seroma with acute neural compression 32 (2.8%), excess bone formation with delayed neural compression 4 (0.3%), and infection requiring debridement 26 (2.2%). Nonunion was related to male sex and previous BMP exposure. Seroma formation was significantly higher in

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

    Science.gov (United States)

    Sano, Atsushi; Kawashima, Mitsuaki

    2015-11-01

    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.

  3. [The longitudinal increase of the internal jugular vein and the upper v. cava as measured between the mastoid to the heart: parameter for timing the re-operation after ventriculocardiostomy (author's transl)].

    Science.gov (United States)

    Müke, R; Glashoff, M

    1976-04-01

    Some time after ventriculo-cardiostomy in children with hydrocephalus the cardiac catheter is retracting out of the right atrium into the upper veins due to the increase of body length during growth. This might endanger proper functioning of the valve. Therefore most authors are in favour of a prophylactic elongation of the catheter by re-operation. In order to roughly predict the time for re-operation we measured course of the catheter in 4120 children. As a basis for long time supervision of children with this shunt operation we thus propose a curve of length increase of the blood vessels concerned, based on our data, in connection with the known curve of length increase of the body.

  4. Combination of poroelasticity theory and constant strain rate test in modelling land subsidence due to groundwater extraction

    Science.gov (United States)

    Pham, Tien Hung; Rühaak, Wolfram; Sass, Ingo

    2017-04-01

    Extensive groundwater extraction leads to a drawdown of the ground water table. Consequently, soil effective stress increases and can cause land subsidence. Analysis of land subsidence generally requires a numerical model based on poroelasticity theory, which was first proposed by Biot (1941). In the review of regional land subsidence accompanying groundwater extraction, Galloway and Burbey (2011) stated that more research and application is needed in coupling of stress-dependent land subsidence process. In geotechnical field, the constant rate of strain tests (CRS) was first introduced in 1969 (Smith and Wahls 1969) and was standardized in 1982 through the designation D4186-82 by American Society for Testing and Materials. From the reading values of CRS tests, the stress-dependent parameters of poroelasticity model can be calculated. So far, there is no research to link poroelasticity theory with CRS tests in modelling land subsidence due to groundwater extraction. One dimensional CRS tests using conventional compression cell and three dimension CRS tests using Rowe cell were performed. The tests were also modelled by using finite element method with mixed elements. Back analysis technique is used to find the suitable values of hydraulic conductivity and bulk modulus that depend on the stress or void ratio. Finally, the obtained results are used in land subsidence models. Biot, M. A. (1941). "General theory of three-dimensional consolidation." Journal of applied physics 12(2): 155-164. Galloway, D. L. and T. J. Burbey (2011). "Review: Regional land subsidence accompanying groundwater extraction." Hydrogeology Journal 19(8): 1459-1486. Smith, R. E. and H. E. Wahls (1969). "Consolidation under constant rates of strain." Journal of Soil Mechanics & Foundations Div.

  5. Persistent pain after excision of an interdigital neuroma. Results of reoperation.

    Science.gov (United States)

    Johnson, J E; Johnson, K A; Unni, K K

    1988-06-01

    Thirty-four patients (thirty-seven feet) had a reoperation for pain that persisted after excision of a plantar interdigital (Morton) neuroma. A longitudinal plantar incision was used in thirty-three feet and the previous dorsal web-space incision was used in four feet. Of the thirty-nine pathological specimens that were obtained intraoperatively, twenty-six (67 per cent) contained elements either of primary interdigital neuroma tissue or of an interdigital neuroma in association with an amputation-stump neuroma, indicating that the recurrent pain in these patients had probably resulted from an incomplete initial excision. All but one of the thirty-four patients were available for follow-up at an average of seventy-six months (range, ten to 124 months) postoperatively. Twenty-two patients (67 per cent) had complete relief from or marked improvement in pain, three (9 per cent) had improvement but had persistent pain, and eight (24 per cent) had no improvement or had worse pain. The longitudinal plantar incision was satisfactory in all but one patient and did not result in a painful plantar scar. The number of previously unsuccessful attempts that had been made to excise the neuroma did not adversely affect the results of reoperation in this group of patients.

  6. Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele.

    Science.gov (United States)

    Dupepe, Esther B; Hopson, Betsy; Johnston, James M; Rozzelle, Curtis J; Jerry Oakes, W; Blount, Jeffrey P; Rocque, Brandon G

    2016-11-01

    OBJECTIVE It is generally accepted that cerebrospinal fluid shunts fail most frequently in the first years of life. The purpose of this study was to describe the risk of shunt failure for a given patient age in a well-defined cohort with shunted hydrocephalus due to myelomeningocele (MMC). METHODS The authors analyzed data from their institutional spina bifida research database including all patients with MMC and shunted hydrocephalus. For the entire population, the number of shunt revisions in each year of life was determined. Then the number of patients at risk for shunt revision during each year of life was calculated, thus enabling them to calculate the rate of shunt revision per patient in each year of life. In this way, the timing of all shunt revision operations for the entire clinic population and the likelihood of having a shunt revision during each year of life were calculated. RESULTS A total of 655 patients were enrolled in the spina bifida research database, 519 of whom had a diagnosis of MMC and whose mean age was 17.48 ± 11.7 years (median 16 years, range 0-63 years). Four hundred seventeen patients had had a CSF shunt for the treatment of hydrocephalus and thus are included in this analysis. There were 94 shunt revisions in the 1st year of life, which represents a rate of 0.23 revisions per patient in that year. The rate of shunt revision per patient-year initially decreased as age increased, except for an increase in revision frequency in the early teen years. Shunt revisions continued to occur as late as 43 years of age. CONCLUSIONS These data substantiate the idea that shunt revision surgeries in patients with MMC are most common in the 1st year of life and decrease thereafter, except for an increase in the early teen years. A persistent risk of shunt failure was observed well into adult life. These findings underscore the importance of routine follow-up of all MMC patients with shunted hydrocephalus and will aid in counseling patients and

  7. Clinical analysis of 13 cases of unplanned reoperation in obstetrics and gynecology department%妇产科非计划再次手术13例临床分析

    Institute of Scientific and Technical Information of China (English)

    王相岩; 干宁

    2016-01-01

    目的 分析妇产科非计划再次手术的原因,为提高医疗质量、降低非计划再次手术的发生率提供依据.方法 对安徽医科大学附属巢湖医院妇产科13例非计划再次手术患者的临床资料进行回顾分析.结果 2012年1月至2013年12月安徽医科大学附属巢湖医院妇产科住院手术共4193例,非计划再次手术13例(0.31%).13例全部治愈出院,术后切口愈合不良,泌尿系损伤、肠管损伤、肠梗阻、出血、感染是发生非计划再次手术的主要原因.结论 加强围手术期的管理,充分医患沟通,加强专业学习,提高临床技能,规范手术操作,提高快速病理诊断准确率可减少非计划再次手术的发生.%Objective To analyze the causes of non-planned reoperation in Obstetrics and Gynecology Department ,in order to pro-vide evidence for improving the quality of medical care and reducing the incidence of unplanned reoperation .Methods The clinical data of 13 cases unplanned reoperation in our department were retrospectively analyzed .Results There were 4193 cases of hospitalization from Jan-uary 2012 to December 2013,and the rate of non-planned reoperation was 0.31%.Thirteen cases of patients were cured and discharged .The postoperative poor wound healing ,urinary system injury ,intestinal injury ,intestinal obstruction ,bleeding and infection were the reasons for the occurrence of non-planned reoperation .Conclusion We should strengthen the preoperative management ,strengthen the communication be-tween doctors and patients ,strengthen professional learning ,improve clinical skills,standardize operation,and improve the accuracy of rapid pathological diagnosis so as to decrease the incidence of non-planed reoperation .

  8. Reoperation for rhegmatogenous retinal detachment as quality indicator for disease management

    DEFF Research Database (Denmark)

    Hajari, Javad N; Christensen, Ulrik; Kiilgaard, Jens F;

    2015-01-01

    PURPOSE: To establish a quality indicator that could be used in optimizing treatment for rhegmatogenous retinal detachment (RRD). METHODS: The Danish National Patient Registry was used to identify surgery conducted in Denmark for RRD in the period 01 January 2001-31 December 2009. Cases were...... identified by diagnosis and surgical codes. RESULTS: A total of 6522 cases were operated for a primary RRD in the study period, and 22% (1434 patients) were reoperated for a redetachment. A Cox regression analysis showed that the risk of redetachment was equal to or less than detachment on the fellow eye 1...... year after primary surgery with techniques not using silicone oil. The same was true 1.5 years after surgery for techniques using silicone oil. Based on this, we established a quality indicator defining failure as the need for operation for redetachment within 1 year from initial surgery when using...

  9. Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE, contract to updata FEMA data due 2009, Published in unknown, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE dataset as of unknown. It is described as 'contract to updata FEMA data due 2009'. Data by...

  10. Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE, contract to updata FEMA data due 2009, Published in 2009, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE dataset as of 2009. It is described as 'contract to updata FEMA data due 2009'. Data by...

  11. Reasons for reoperation after epilepsy surgery: a review based on a complex clinical case with three operations

    Directory of Open Access Journals (Sweden)

    José F Téllez-Zenteno

    2010-07-01

    Full Text Available José F Téllez-Zenteno1, Farzad Moien-Afshari1, Lizbeth Hernández-Ronquillo1, Robert Griebel2, Venkat Sadanand21Department of Medicine, Division of Neurology, University of Saskatchewan, Saskatoon, Canada; 2Department of Surgery, Division of Neurosurgery, University of Saskatchewan, Saskatoon, CanadaAbstract: The results of surgical treatment of epileptic seizures have gradually improved in the past decade, approaching 60% to 90% seizure-free outcome in temporal lobe epilepsy and 45% to 66% in extratemporal lobe epilepsy. Unfortunately some patients continue with seizures after epilepsy surgery and the studies have shown that approximately the 3% to 15% of patients with a previous failed surgical procedure are reoperated. Selected patients may be candidates for further surgery, potentially leading to a significant decrease in the frequency and severity of seizures. In patients with intractable partial epilepsy there are many possible factors, alone or in combination, that could be related to the failure of resection. Some of the factors could be genetic or acquired predisposition to epileptogenicity. In this article we report a case with intractable epilepsy that required three interventions to render seizure free. We analyzed our specific case in the light of previous reports on reoperation and enumerate the potential reasons or reoperation that could apply to all patients with failure of an initial procedure.Keywords: intractable epilepsy, reoperation, epilepsy surgery, surgical failure

  12. Clinical and Epidemiological Clinical and Epidemiological Characteristics of Colloid Goiter Patients Undergoing Reoperation for Recurrent Thyroid Disease

    Directory of Open Access Journals (Sweden)

    Gladys Iglesias Díaz

    2015-11-01

    Full Text Available Background: thyroid disease is one of the most prevalent medical conditions and thyroid cancer is the most common endocrine neoplasm. Thyroid reoperations are more common than it might seem.Objective: to establish the clinical and epidemiological characteristics of patients operated on for colloid goiter undergoing reoperation for recurrent thyroid disease.Methods: a case-series study was conducted at the León Cuervo Rubio Clinical-Surgical Hospital in Pinar del Rio. The sample included all patients (n = 29 who underwent thyroid operation and were reoperated on for recurrent thyroid disease in 2010, 2011 and 2012. The information was obtained from medical records and the register of histopathological diagnoses.Results: most patients (27.6% were in the 40-49 age group and females (79.3% were most affected. Recurrence was observed 5 to 9 years after surgery. Mixed nodules (55.2% followed by cysts (17.2% were the most frequent ultrasound diagnoses. Recurrent thyroid disease was malignant in 9% of patients.Conclusions: patients reoperated on for thyroid disease were mostly females in the fourth and fifth decade of life. The disease recurred in a period of 10 years after the first surgery in a greater number of cases. Follicular-patterned lesions, colloid goiter and cancer were the most common histologic diagnosis.

  13. Estimated Numbers of Community Cases of Illness Due to Salmonella, Campylobacter and Verotoxigenic Escherichia Coli: Pathogen-Specific Community Rates

    Directory of Open Access Journals (Sweden)

    M Kate Thomas

    2006-01-01

    Full Text Available OBJECTIVE: To estimate the annual number of cases of illness due to verotoxigenic Escherichia coli (VTEC, Salmonella and Campylobacter in the Canadian population, using data from the National Notifiable Disease registry (NND, estimates of under-reporting derived from several National Studies on Acute Gastrointestinal Illness, and the literature.

  14. Numerical simulation of fatigue crack growth rate and crack retardation due to an overload using a cohesive zone model

    NARCIS (Netherlands)

    Silitonga, S.; Maljaars, J.; Soetens, F.; Snijder, H.H.

    2014-01-01

    In this work, a numerical method is pursued based on a cohesive zone model (CZM). The method is aimed at simulating fatigue crack growth as well as crack growth retardation due to an overload. In this cohesive zone model, the degradation of the material strength is represented by a variation of the

  15. Causes and strategies of reoperation in cervico-occipital diseases%枕颈部疾患再手术原因分析与对策

    Institute of Scientific and Technical Information of China (English)

    贺宝荣; 杨小彬; 闫亮; 郝定均; 郭华; 王晓东; 郑博隆

    2015-01-01

    of severe complications of cervico-occipital diseases were retrospectively analyzed.There were 14 males and 9 females with the age at primary surgery range from 18-52 years.The interval between reoperation to primary surgery was 3 h-11 years.The reasons of reoperation included pseudarthrosis in 15 cases,aggravated neurological deficit in 3 cases,internal fixation failure in 2 cases,cerebrospinal fluid leakage in 1 case and tumor recurrence in 2 cases.All patients presented with continuous neck pain,numbness of the limbs or pyramidal tract signs.11 patients suffered from neurological deficit,with the average JOA score of 7.8.All patients underwent excision of posterior arch or decompression of foramen magnum,iliac bone grafting,atlantoaxial or occipital-cervical fusion.JOA score and radiograph were used to evaluate the surgical outcome during follow-up.Results The operation was completed successfully in all cases.The average surgical time was 160 min (130-310 min),and the average blood loss of 800 ml (range 300 to 2000 ml).No intraoperative vascular,nerve and spinal cord injury.There were no postoperative neurological deterioration,pharyngeal wall and intraspinal infection.Two cases of postoperative wound infection,healing by dressing change and prolong the use of antibiotics.No severe complications were noted.All patients were followed up for an average of 21 months (6 months-3 years).At the final follow-up,the JOA score was significantly better as compared with preoperation,with an average of 13.2.Based on Macnab criteria,there were 11 excellence,8 good,4middle.Bone fusion was achieved in all patients without instrumentation failure at final follow-up.Conclusion The main reasons of reoperation in cervico-occipital diseases are pseudoarthrosis and remnant symptoms,effective fusion and decompression are the key points to reduce reoperation rate in cervicooccipital operation.

  16. Re-operation of residual ventricular septal defect in 12 cases%残余室间隔缺损的再手术治疗12例

    Institute of Scientific and Technical Information of China (English)

    胡晓峰; 周运乾; 曹庆亨; 邱兆崑

    2001-01-01

    Objective To analyze the causation, surgical indications and pivotal points in reoperation of residual ventricular septal defect (VSD). Methods Collecting the clinical data of 12 cases of reoperated residual VSD in this hospital from 1988 to 1998 and investigating into insight of their causation, surgical indications and keys elements of reoperation in residual VSD. Results This group consisted of 12 patients of whom 8 were operated in this hospital from 1977 to 1997, and 4 were operated in other hospital. The re-operative rate of VSD in our hospital was 0.18 %.The defects in the first operation were 8 cases of simple VSD and 3 tetralogy of Fallot. The mean interval between the two operations was 4.1 years (5 months-12 years). Residual shunting in 10 patients were adjacent to the base of anterior and septal leaflets of tricuspid valve. The mean longitudinal diameter of residual VSD was 1.2 cm(0.3~2.5 cm).Three patients died after reoperation. Causes of death included low cardiac output syndrome, cardiac arrhythmia and cardiac tamponade. Conclusion 1. The common location of residual VSD is around the base of anterior and septal leaflets of tricuspid valve, this area involves some important structures like aortic valve and AV bundle which are not easily exposed. 2. Adequate exposure of entire VSD margin is the key element to avoid leakage by laceration. 3. Early re-operation is required for all residual VSD with diameter above 0.5 cm. 4. The key points of reoperation are timely operation, atrial incisional approach, patch repairment and careful hemostasis.%目的分析残余室间隔缺损(VSD)的发生原因、防治措施、手术指征和手术要点。方法对12例施行残余VSD再手术治疗患者的发生原因、预防措施、手术指征和手术要点进行分析。结果 12例中8例首次手术于1977年至1997年在我院施行,4例在外院施行,我院VSD再手术率为0.18%。首次手术时单纯VSD 9例,法洛四联症(TOF)3

  17. Subsequent abdominal surgery after laparoscopic ventral and incisional hernia repair with an expanded polytetrafluoroethylene mesh: a single institution experience with 72 reoperations.

    Science.gov (United States)

    Wassenaar, E B; Schoenmaeckers, E J P; Raymakers, J T F J; Rakic, S

    2010-04-01

    Laparoscopic ventral and incisional hernia repair (LVIHR) carries a risk of adhesion formation and can influence subsequent abdominal operations (SAOs). We performed a retrospective study of findings during reoperations of patients who had previously had an LVIHR by using an expanded polytetrafluoroethylene mesh (DualMesh; WL Gore, Flagstaff, AZ, USA). The medical records of all 695 patients who had LVIHR at our hospital were reviewed. Patients who underwent SAO for various indications were identified (n = 72) and analyzed. Seven LVIHR patients (1%) had early SAO (within a few days). In six patients (86%), removal of the mesh was required. Intra-operatively, in all six of these patients with peritonitis, there were no adhesions against the implant identified. Late SAOs (after more than 1 month) were performed in 65 patients (9.4%). Only one patient required acute surgical intervention due to an LVIHR-related adhesion (0.15%). Laparoscopy was performed in 83% and laparotomy in 17% of patients. Adhesions against the implant were present in 83% of patients; in 65%, the adhesions involved omentum only, and in 18%, they involved the bowel. Adhesiolysis was always easy and caused no inadvertent enterotomies. SAOs were devoid of postoperative complications. In this largest series of reoperations after LVIHR, the majority of patients had mild or moderate adhesions against the implant. The specific observations that: (1) no relaparoscopies had to be converted, (2) no inadvertent enterotomies were made during adhesiolysis, and (3) SAOs have practically been devoid of peri- and postoperative complications indicate that SAOs can be safely performed after previous LVIHR with DualMesh.

  18. Analytical investigation of the decrease in the size of the habitable zone due to limited CO$_2$ outgassing rate

    CERN Document Server

    Abbot, Dorian S

    2016-01-01

    The habitable zone concept is important because it focuses the scientific search for extraterrestrial life and aids the planning of future telescopes. Recent work has shown that planets near the outer edge of the habitable zone might not actually be able to stay warm and habitable if CO$_2$ outgassing rates are not large enough to maintain high CO$_2$ partial pressures against removal by silicate weathering. In this paper I use simple equations for the climate and CO$_2$ budget of a planet in the habitable zone that can capture the qualitative behavior of the system. With these equations I derive an analytical formula for an effective outer edge of the habitable zone, including limitations imposed by the CO$_2$ outgassing rate. I then show that climate cycles between a Snowball state and a warm climate are only possible beyond this limit if the weathering rate in the Snowball climate is smaller than the CO$_2$ outgassing rate (otherwise stable Snowball states result). I derive an analytical solution for the c...

  19. Impurity microsegregation due to periodic changes in the temperature and pulling rate of crystal grown by the Stepanov method

    Energy Technology Data Exchange (ETDEWEB)

    Zhdanov, A.V.; Nikolaeva, L.P.; Red`kin, B.S. [Institute of Solid-State Physics, Chernogolovka (Russian Federation)

    1995-12-01

    A mathematical model is proposed to describe the behavior of a doping impurity concentration in a crystal grown by the Stepanov method from a melt and subjected to periodic changes in its pulling rate and temperature of the thermal node. Various modes of these effects are discussed. The results obtained are given by graphs that characterize their influence on concentration distribution.

  20. Analytical Investigation of the Decrease in the Size of the Habitable Zone Due to a Limited CO2 Outgassing Rate

    Science.gov (United States)

    Abbot, Dorian S.

    2016-08-01

    The habitable zone concept is important because it focuses the scientific search for extraterrestrial life and aids the planning of future telescopes. Recent work has shown that planets near the outer edge of the habitable zone might not actually be able to stay warm and habitable if CO2 outgassing rates are not large enough to maintain high CO2 partial pressures against removal by silicate weathering. In this paper, I use simple equations for the climate and CO2 budget of a planet in the habitable zone that can capture the qualitative behavior of the system. With these equations I derive an analytical formula for an effective outer edge of the habitable zone, including limitations imposed by the CO2 outgassing rate. I then show that climate cycles between a snowball state and a warm climate are only possible beyond this limit if the weathering rate in the snowball climate is smaller than the CO2 outgassing rate (otherwise stable snowball states result). I derive an analytical solution for the climate cycles including a formula for their period in this limit. This work allows us to explore the qualitative effects of weathering processes on the effective outer edge of the habitable zone, which is important because weathering parameterizations are uncertain.

  1. What factors predict improvements in outcomes scores and reoperations after the Bernese periacetabular osteotomy?

    Science.gov (United States)

    Beaulé, Paul E; Dowding, Chris; Parker, Gillian; Ryu, Jae-Jin

    2015-02-01

    The Bernese periacetabular osteotomy (PAO) has entered its fourth decade and is frequently used for corrective osteotomy in patients with acetabular dysplasia. Although our capacity to preserve the joint after corrective osteotomy is excellent, gaining a better understanding on how well patients function after this surgery is important as well. (1) What changes in patient-reported outcomes scores occur in patients treated with PAO for hip dysplasia in the setting of a single-surgeon practice? (2) What are the predictors of clinical function and survivorship? All 67 patients presenting to a single surgeon's clinic with hip dysplasia treated with PAO between October 2005 and January 2013 were prospectively followed. Baseline demographic data as well as pre- and postoperative radiographic and functional measurements were obtained with a minimum of 1-year followup. Radiographic criteria included Tönnis grade, Tönnis angle, minimum joint space width, center-edge angle, presence of crossover sign, medial translation of the hip center, and alpha angle. We also used validated outcome measures including the WOMAC, the UCLA Activity Scale, and the SF-12. Multiple regression analysis was used to determine predictors of functional outcome scores. There were increases in WOMAC, UCLA, and SF-12 Physical scores. Higher preoperative alpha angle was associated with a lower postoperative WOMAC score (β=-0.47; 95% confidence interval [CI], -0.92 to -0.02; R2=0.08; p=0.04). The 5-year Kaplan-Meier survivorship was 94.1% (95% CI, 90.7-97.5) with reoperation (ie, hip arthroscopy and/or total hip arthroplasty) used as the endpoint for failure. With the limited numbers available, we could not identify any demographic or radiographic factors associated with reoperation. Overall survivorship for the PAO at our center at 5 years is comparable to other clinical series with overall functional scores improving. A greater alpha angle preoperatively was associated with poorer patient

  2. An examination of heat rate improvements due to waste heat integration in an oxycombustion pulverized coal power plant

    Science.gov (United States)

    Charles, Joshua M.

    Oxyfuel, or oxycombustion, technology has been proposed as one carbon capture technology for coal-fired power plants. An oxycombustion plant would fire coal in an oxidizer consisting primarily of CO2, oxygen, and water vapor. Flue gas with high CO2 concentrations is produced and can be compressed for sequestration. Since this compression generates large amounts of heat, it was theorized that this heat could be utilized elsewhere in the plant. Process models of the oxycombustion boiler, steam cycle, and compressors were created in ASPEN Plus and Excel to test this hypothesis. Using these models, heat from compression stages was integrated to the flue gas recirculation heater, feedwater heaters, and to a fluidized bed coal dryer. All possible combinations of these heat sinks were examined, with improvements in coal flow rate, Qcoal, net power, and unit heat rate being noted. These improvements would help offset the large efficiency impacts inherent to oxycombustion technology.

  3. Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

    Science.gov (United States)

    Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

    2017-08-24

    In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database. All consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications. The relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%. The

  4. Oral antibody to interleukin-10 reduces growth rate depression due to Eimeria spp. infection in broiler chickens.

    Science.gov (United States)

    Sand, Jordan M; Arendt, Maria K; Repasy, Alec; Deniz, Gűlay; Cook, Mark E

    2016-02-01

    Eimeria spp. must be controlled in floor-reared poultry to prevent the onset of coccidiosis. Here we use an oral antibody to chicken IL-10 to prevent growth depression due to Eimeria spp. infection. Egg antibody directed against an antigenic peptide of IL-10 was produced in laying hens and measured using an ELISA. In the first experiment, egg yolk powder containing antibody to chicken IL-10 (vlpramqt conjugate) (anti-IL-10 yolk powder) was fed at 3.4 g/kg feed to determine growth response following mixed Eimeria spp. challenge. Chicks were fed either anti-IL-10 antibodies or control antibodies and challenged (d3) with either sterile saline or a 10× attenuated Eimeria spp. vaccine. Control-fed and Eimeria-challenged chicks grew 8.8% slower than those challenged with saline (P Eimeria challenged chicks were not different from untreated controls. In the second trial a dose response was performed with doses of either 0 (control antibody), 0.34-, or 3.4-g anti-IL-10 yolk powder/kg feed. Control-fed, Eimeria-challenged chicks grew 10.6% slower than control saline-challenged chicks (P Eimeria vaccine at d 3. After 14 d, antibody was removed from the diet. Chicks were either saline or 10× Eimeria challenged at d 17. We found that the anti-IL-10-fed chickens did not show a reduction in growth due to challenge; hence anti-IL-10 does not appear to affect adaptive immunity during the primary immunization. Overall, use of an antibody to IL-10 is a novel method in preventing adverse effects of Eimeria spp. infection in poultry.

  5. Variations in radiation and photolysis rates in the southern midlatitudes due to ozone depletion over the Antarctica

    Science.gov (United States)

    López Comí, Laura; Morgenstern, Olaf; Zeng, Guang; Masters, Sarah L.

    2013-04-01

    Lauder (45° S, 170° E), a research station located on the South Island of New Zealand, is a clean-air atmospheric observatory representative of southern mid-latitudes. Long-term records of various atmospheric chemical compounds have been measured here for up to three decades. We assess observations of selected atmospheric chemical species, including ozone, and their variability throughout the recording period. By utilizing these observational data and a photolysis scheme (FAST-JX) we will address how changes in the total ozone column and in aerosols at Lauder affect radiation and photolysis rates of different species. The results serve as a stepping stone towards constructing a single-column photolysis model for Lauder constrained with profiles of stable species (e.g. ozone, methane, CO, HCHO, halogen compounds, etc) measured at Lauder to derive variations and trends of shorter-lived species. One of our targets will be changes in the tropospheric oxidizing capacity in the Southern Hemisphere.

  6. Rate of deaths due to child abuse and neglect in children 0-3 years of age in Germany.

    Science.gov (United States)

    Banaschak, Sibylle; Janßen, Katharina; Schulte, Babette; Rothschild, Markus A

    2015-09-01

    In recent years, increasing attention has been paid to the issue of (fatal) child abuse and neglect, largely due to the media attention garnered by some headline-grabbing cases. If media statements are to be believed, such cases may be an increasing phenomenon. With these published accounts in mind, publicly available statistics should be analysed with respect to the question of whether reliable statements can be formulated based on these figures. It is hypothesised that certain data, e.g., the Innocenti report published by UNICEF in 2003, may be based on unreliable data sources. For this reason, the generation of such data, and the reliability of the data itself, should also be discussed. Our focus was on publicly available German mortality and police crime statistics (Polizeiliche Kriminalstatistik). These data were classified with respect to child age, data origin, and cause of death (murder, culpable homicide, etc.). In our opinion, the available data could not be considered in formulating reliable scientific statements about fatal child abuse and neglect, given the lack of detail and the flawed nature of the basic data. Increasing the number of autopsies of children 0-3 years of age should be considered as a means to ensure the capture of valid, practical, and reliable data. This could bring about some enlightenment and assist in the development of preemptive strategies to decrease the incidence of (fatal) child abuse and neglect.

  7. Low post-glacial rebound rates in the Weddell Sea due to Late Holocene ice-sheet readvance

    Science.gov (United States)

    Bradley, Sarah L.; Hindmarsh, Richard C. A.; Whitehouse, Pippa; Bentley, Michael J.; King, Matt

    2014-05-01

    The Holocene deglaciation of West Antarctica resulted in widespread ice surface lowering. While many ice-sheet reconstructions generally assume a monotone Holocene retreat for the West Antarctica Ice sheet (WAIS) [Ivins et al., 2013; Peltier, 2004; Whitehouse et al., 2012], an increasing number of glaciological observations infer it is readvancing, following retreat behind the present-day margin[Siegert et al., 2013]. We will show that a readvance in the Weddell Sea region can reconcile two outstanding problems: (i) the present-day widespread occurrence of seemingly stable ice-streams grounded on beds that deepen inland in apparent contradiction to theory [Schoof, 2007]; and (ii) the inability of models of Glacial Isostatic Adjustment (GIA) to match present-day uplift rates [Whitehouse et al., 2012]. Combining a suite of ice loading histories that include a readvance with a model of GIA provides significant improvements to predictions of present-day uplift rates, and we are able to reproduce previously unexplained observations of subsidence in the southern sector of the Weddell Sea. We hypothesize that retreat behind present grounding lines occurred when the bed was lower, and isostatic recovery led to shallowing, ice sheet re-grounding and readvance. We will conclude that some sections of the current WAIS grounding line that are theoretically unstable, may be advancing and that the volume change of the WAIS may have been more complex in the Late Holocene than previously posited. This revised Holocene ice-loading history would have important implications for the GIA correction applied to Gravity Recovery and Climate Experiment (GRACE) data, likely resulting in a reduction in the GIA correction and a smaller estimate of present-day ice mass loss within the Weddell Sea region of the WAIS. Ivins, E. R., T. S. James, J. Wahr, E. J. O. Schrama, F. W. Landerer, and K. M. Simon (2013), Antarctic contribution to sea level rise observed by GRACE with improved GIA correction

  8. Two-body orbit expansion due to time-dependent relative acceleration rate of the cosmological scale factor

    CERN Document Server

    Iorio, Lorenzo

    2013-01-01

    By phenomenologically assuming a slow temporal variation of the percent acceleration rate $\\ddot S S^{-1}$ of the cosmic scale factor $S(t)$, it is shown that the orbit of a local binary undergoes a secular expansion. To first order in the power expansion of $\\ddot S S^{-1}$ around the present epoch $t_0$, a non-vanishing shift per orbit $\\left\\langle\\Delta r\\right\\rangle$ of the two-body relative distance $r$ occurs for eccentric trajectories. A general relativistic expression, which turns out to be cubic in the Hubble parameter $H_0$ at the present epoch, is explicitly calculated for it in the case of matter-dominated epochs with Dark Energy. For a highly eccentric Oort comet orbit with period $P_{\\rm b}\\approx 31$ Myr, the general relativistic distance shift per orbit turns out to be of the order of $\\left\\langle\\Delta r\\right\\rangle\\approx 70$ km. For the Large Magellanic Cloud, assumed on a bound elliptic orbit around the Milky Way, the shift per orbit is of the order of $\\left\\langle\\Delta r\\right\\rangl...

  9. Two-Body Orbit Expansion Due to Time-Dependent Relative Acceleration Rate of the Cosmological Scale Factor

    Directory of Open Access Journals (Sweden)

    Lorenzo Iorio

    2014-01-01

    Full Text Available By phenomenologically assuming a slow temporal variation of the percent acceleration rate S̈S -1 of the cosmic scale factor S(t, it is shown that the orbit of a local binary undergoes a secular expansion. To first order in the power expansion of S̈S -1 around the present epoch t0, a non-vanishing shift per orbit (Δr of the two-body relative distance r occurs for eccentric trajectories. A general relativistic expression, which turns out to be cubic in the Hubble parameter H0 at the present epoch, is explicitly calculated for it in the case of matter-dominated epochs with Dark Energy. For a highly eccentric Oort comet orbit with period Pb ≈ 31 Myr, the general relativistic distance shift per orbit turns out to be of the order of (Δr ≈ 70 km. For the Large Magellanic Cloud, assumed on a bound elliptic orbit around the Milky Way, the shift per orbit is of the order of (Δr ≈ 2–4 pc. Our result has a general validity since it holds in any cosmological model admitting the Hubble law and a slowly varying S̈S-1(t. More generally, it is valid for an arbitrary Hooke-like extra-acceleration whose “elastic” parameter κ is slowly time-dependent, irrespectively of the physical mechanism which may lead to it. The coefficient κ1 of the first-order term of the power expansion of κ(t can be preliminarily constrained in a model-independent way down to a κ1 ≲ 2 x 10-13 year-3 level from latest Solar System’s planetary observations. The radial velocities of the double lined spectroscopic binary ALPHA Cen AB yield κ1 ≲ 10-8 year-3.

  10. Two-Body Orbit Expansion Due to Time-Dependent Relative Acceleration Rate of the Cosmological Scale Factor

    Science.gov (United States)

    Iorio, Lorenzo

    2014-01-01

    By phenomenologically assuming a slow temporal variation of the percent acceleration rate S̈S -1 of the cosmic scale factor S(t), it is shown that the orbit of a local binary undergoes a secular expansion. To first order in the power expansion of S̈S -1 around the present epoch t0, a non-vanishing shift per orbit (Δr) of the two-body relative distance r occurs for eccentric trajectories. A general relativistic expression, which turns out to be cubic in the Hubble parameter H0 at the present epoch, is explicitly calculated for it in the case of matter-dominated epochs with Dark Energy. For a highly eccentric Oort comet orbit with period Pb ≈ 31 Myr, the general relativistic distance shift per orbit turns out to be of the order of (Δr) ≈ 70 km. For the Large Magellanic Cloud, assumed on a bound elliptic orbit around the Milky Way, the shift per orbit is of the order of (Δr) ≈ 2-4 pc. Our result has a general validity since it holds in any cosmological model admitting the Hubble law and a slowly varying S̈S-1(t). More generally, it is valid for an arbitrary Hooke-like extra-acceleration whose "elastic" parameter κ is slowly time-dependent, irrespectively of the physical mechanism which may lead to it. The coefficient κ1 of the first-order term of the power expansion of κ(t) can be preliminarily constrained in a model-independent way down to a κ1 ≤ 2 x 10-13 year-3 level from latest Solar System's planetary observations. The radial velocities of the double lined spectroscopic binary ALPHA Cen AB yield κ1 ≤ 10-8 year-3.

  11. Temperature increase of Zircaloy-4 cladding tubes due to plastic heat dissipation during tensile tests at 0.1-10 s-1 strain rates

    Science.gov (United States)

    Hellouin de Menibus, Arthur; Auzoux, Quentin; Besson, Jacques; Crépin, Jérôme

    2014-11-01

    This study is focused on the impact of rapid Reactivity Initiated Accident (RIA) representative strain rates (about 1 s-1 NEA, 2010) on the behavior and fracture of unirradiated cold work stress relieved Zircaloy-4 cladding tubes. Uniaxial ring tests (HT) and plane strain ring tensile tests (PST) were performed in the 0.1-10 s-1 strain rate range, at 25 °C. The local temperature increase due to plastic dissipation was measured with a high-speed infrared camera. Limited temperature increases were measured at 0.1 s-1 strain rate. Limited but not strongly localized temperature increases were measured at 1 s-1. Large temperature increase were measured at 5 and 10 s-1 (142 °C at 5 s-1 strain rate in HT tests). The local temperature increase induced heterogeneous temperature fields, which enhanced strain localization and resulted in a reduction of the plastic elongation at fracture.

  12. Generalized peritonitis requiring re-operation after leakage of omental patch repair of perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Hemmat Maghsoudi

    2011-01-01

    Full Text Available Background/Aim: Peptic ulcer perforations are a common emergency, but available literature is silent on the exact definition, incidence, management, and complications of peritonitis due to omental patch leakage. Patients and Methods: Retrospective data were collected on 422 patients who underwent omental patch repair of perforated peptic ulcer between March 20, 1999 and March 20, 2006. The definitive diagnosis of perforated peptic ulcer and omental patch leakage was obtained at surgery. Results: Seventeen (4% patients experienced generalized peritonitis due to omental patch leakage. Mean age was 60.6 years. Mortality rate was 29.4%, and the mean hospital stay was 23.6 days. Delay in surgical approach, shock on admission, and age were all significantly associated with increased mortality. Conclusions: Peritonitis due to omental patch leakage can result in significant morbidity and mortality. The most common causes of omental patch leakage and operative procedures were unknown and reinsertion of omentum, respectively. Factors such as shock on admission or delayed surgery, have significantly contributed to fatal outcomes and need careful attention.

  13. Lower reoperation rate for cemented hemiarthroplasty than for uncemented hemiarthroplasty and internal fixation following femoral neck fracture

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Overgaard, Søren; Lauritsen, Jens;

    2013-01-01

    treated with either internal fixation (IF), cemented HA, or uncemented HA (with or without hydroxyapatite coating), after 12-19 years of follow-up. Methods 4 hospitals with clearly defined guidelines for the treatment of 75+ year-old patients with a displaced femoral neck fracture were included. Cohort 1...... an uncemented hydroxyapatite-coated Furlong HA. Data were retrieved from patient files, from the region-based patient administrative system, and from the National Registry of Patients at the end of 2010. We performed survival analysis with adjustment for comorbidity, age, and sex. Results Cemented HA had...

  14. Modification of erbium photoluminescence decay rate due to ITO layers on thin films of SiO{sub 2}:Er doped with Si-nanoclusters

    Energy Technology Data Exchange (ETDEWEB)

    Wojdak, M., E-mail: m.wojdak@ucl.ac.uk [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Jayatilleka, H. [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Department of Electrical and Computer Engineering, University of Toronto, 10 King' s College Road, Toronto, Ontario, Canada M5S 3G4 (Canada); Shah, M. [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Kenyon, A.J., E-mail: t.kenyon@ucl.ac.uk [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Gourbilleau, F.; Rizk, R. [Centre de Recherche sur les Ions, les Matériaux et la Photonique (CIMAP), ENSICAEN, CNRS, CEA/IRAMIS, Université de Caen, 14050 CAEN cedex (France)

    2013-04-15

    During the fabrication of MOS light emitting devices, the thin film of active material is usually characterized by photoluminescence measurements before electrical contacts are deposited. However, the presence of a conductive contact layer can alter the luminescent properties of the active material. The local optical density of states changes due to the proximity of luminescent species to the interface with the conductive medium (the top electrode), and this modifies the radiative rate of luminescent centers within the active layer. In this paper we report enhancement of the observed erbium photoluminescence rate after deposition of indium tin oxide contacts on thin films of SiO{sub 2}:Er containing silicon nanoclusters, and relate this to Purcell enhancement of the erbium radiative rate. -- Highlights: ► We studied photoluminescence of Er in SiO{sub 2} thin films doped with Si nanoclusters. ► Presence of ITO layer on the top enhances photoluminescence decay rate of Er. ► The effect depends on the thickness of active film. ► Radiative rate change in proximity of ITO layer was calculated theoretically. ► The calculation results are compared with the experiment and discussed.

  15. [Central hemodynamic changes in children reoperated on for congenital spinal cord hernia using balanced anesthesia based on midasolam and propofol].

    Science.gov (United States)

    Diordiev, A V; Kontakevich, M M; Il'in, A V; Kusakin, V V; Ostreĭkov, I F

    2005-01-01

    The central hemodynamics was studied and analyzed in 51 patients reoperated on for congenital spinal cord hernia under balanced anesthesia based on midasolam and proforol. The procedure for anesthesiological provision of replastic repair of operated spinal hernia, which is based on propofol of bolus administration of midasolam with a hypnotic appliance, was found to cause no negative hemodynamic effects. When the benzodiazepine antagonist flumazenyl is used, the interval between the end of surgery and tracheal extubation is virtually identical in the propofol and midasolam groups since the intravenous injection of flumazenyl induces a drastic awakening effect.

  16. rhBMP-2 protects against reoperation for pseudoarthrosis and/or instrumentation failure: A matched case-control study of 448 patients.

    Science.gov (United States)

    Macki, Mohamed; Syeda, Sbaa; Kerezoudis, Panagiotis; Bydon, Ali; Witham, Timothy F; Sciubba, Daniel M; Wolinsky, Jean-Paul; Bydon, Mohamad; Gokaslan, Ziya

    2016-10-01

    The objective of this independent study is to determine the impact of recombinant human bone morphogenetic protein 2 (rhBMP-2) on reoperation for pseudarthrosis and/or instrumentation failure. A nested case-control study of first-time posterolateral, instrumented fusion of the lumbar spine for degenerative spinal disease was undertaken. Cases of reoperation for pseudoarthrosis and/or instrumentation failure were assigned to controls, who did not experience the primary outcome measure at the time of reoperation. Cases and controls were matched on number of interspaces fused and inclusion of interbody. Predictors of reoperation for pseudoarthrosis and/or instrumentation failure were assessed with a conditional logistical regression controlling for rhBMP-2, age, obesity, and smoking. Of the 448 patients, 155 cases of reoperation for pseudoarthrosis and/or instrumentation were matched with 293 controls. Twenty-six percent of first-time surgeries included rhBMP-2, which was statistically more commonly used in the control cohort (33.11%) versus the case cohort (12.90%) (Unadjusted odds ratio [ORunadj]=0.28) (95% confidence interval [CI]: 0.16-0.49). Following a multivariate analysis controlling for age, obesity, and smoking, the rhBMP-2 recipients incurred a 73% lower odds of reoperation for pseudoarthrosis and/or instrumentation failure (95% CI, 0.15-0.48). Neither sarcomatous nor osseous neoplasm was detected in the study population. Mean follow up did not differ between the cases (81.57±standard deviation [SD] 4.98months) versus controls (74.75±2.49month) (ORunadj=1.01) (95% CI: 1.00-1.01). rhBMP-2 in lumbar fusion constructs protects against reoperation for pseudoarthrosis and/or instrumentation failure. However, the decision to include fusion supplements should be weighted between surgical determinants and clinical outcomes.

  17. Estimation of soil redistribution rates due to snow cover related processes in a mountainous area (Valle d'Aosta, NW Italy

    Directory of Open Access Journals (Sweden)

    E. Ceaglio

    2011-09-01

    Full Text Available Mountain areas are widely affected by soil erosion, which is commonly linked to runoff processes. Also winter processes, like snow gliding and full-depth avalanches, may be important factors that can enhance soil erosion, however the role and importance of snow movements as agents of soil redistribution are not well understood yet. The aim of this study is to provide information on the relative importance of snow related soil erosion processes in comparison to runoff processes. In the study area, which is an avalanche path characterized by intense snow movements and soil erosion, soil redistribution rates were quantified with two methods: (i by field measurements of sediment yield in an avalanche deposition area during 2009 and 2010 winter seasons; (ii by Caesium-137 method, which supplies the cumulative net soil loss/gain since 1986, including winter and summer soil erosion processes. The soil erosion rates estimated from the sediment yield at the avalanche deposit area (3.2 and 20.8 Mg ha−1 event−1 is comparable to the yearly erosion rates (averaged since 1986 estimated with the Cs-137 method (8.8–13.4 Mg ha−1 yr−1. The soil accumulation rate estimated with data from the avalanche deposition area (28.2 and 160.7 Mg ha−1 event−1 is even more intense than the yearly deposition rates estimated with Cs-137 (8.9–12.6 Mg ha−1 yr−1. This might be due to the high relevance of the two investigated avalanche events and/or to the discrepancy between the long-term (since 1986 signal of the Cs-137 method compared to rates of 2009 and 2010. Even though the comparability is limited by the different time scale of the applied methods, both methods yielded similar magnitudes of soil redistribution rates indicating that soil erosion due to snow movements is the main driving force of soil redistribution in the area. Therefore winter processes have to be

  18. Clinical Research of Reoperation Reasons for Hypertension Cerebral Hemorrhage%高血压性脑出血术后再手术原因的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋明浩; 李志祥; 马文斌

    2012-01-01

    目的 对高血压性脑出血术后再手术的原因进行临床研究,为以后的临床工作提供理论及实践依据. 方法 回顾性分析我院自2002年2月~2011年6月所有因高血压性脑出血行手术治疗213例,其中因各种原因再次手术治疗36例的临床资料. 结果 因颅内再出血再次行手术治疗29例,因大面积脑梗塞再次行手术治疗7例.再出血再手术组患者的GOS结果提示,Ⅰ~Ⅲ级者明显多于再出血未再手术组,差异有显著统计学意义(P<0.01);GOSⅣ者差异无统计学意义(P>0.05);GOSV级者明显少于未再手术组,差异有显著统计学意义(P<0.01).脑梗塞再手术组患者的GOS结果提示,Ⅰ~Ⅲ级明显多于脑梗塞未再手术组,差异有统计学意义(P<0.05);GOSⅣ级者,差异无统计学意义(P>0.05);GOSⅤ级者明显少于未再手术组,差异有显著统计学意义(P<0.05). 结论 术前认真评估患者的整体状况,手术切口的选择,手术的规范化操作,术中及术后规范化治疗以及避免医源性损伤都是防止因再出血和脑梗塞而再手术的关键.%Objective To explore the reoperation causes for hypertensive cerebral hemorrhage, so as to provide theoretical and practical basis for the future clinical work. Method The clinical data of 36 patients with reoperation out of 213 patients who received surgical operation for hypertension cerebral hemorrhage in our hospital from February 2002 to June 2011 were reviewed and analyzed. Results There were 29 cases of rebleeding and 7 cases with a large area of cerebral infarct received reoperation. In the reoperation group of rebleeding patients, the rate of I ~ III GOS stage was obviously higher than the non-reoperation group ( P 0. 05 ). And the rate of V stage was much lower ( P 0. 05). And the rate of V stage was much lower( P < 0. 05). Conclusion Careful evaluation of the overall condition, suitable surgical incision, standardized operation and

  19. Successful Localization of Abnormal Parathyroid Gland Using Ultrasound-Guided Methylene Blue Dye Injection in the Reoperative Neck.

    Science.gov (United States)

    Haciyanli, Mehmet; Koruyucu, Melike Bedel; Erdoğan, Nezahat Karaca; Dere, Ozcan; Sarı, Erdem; Kumkumoğlu, Yusuf; Tavusbay, Cengiz; Kamer, Erdinc

    2015-12-01

    Persistent or recurrent hyperparathyroidism is a challenging problem for endocrine surgeons. The aim of this study was to review our experience using ultrasound-guided (US-G) methylene blue dye injection for the localization and removal of abnormal parathyroid glands in patients having primary hyperparathyroidism and previous neck surgery. Between January 2012 and May 2013, six consecutive patients with primary hyperparathyroidism (PHPT) and previous neck surgery underwent focused parathyroidectomy with the use of US-G methylene blue dye injections to localize the presumed parathyroid adenoma were included in the study. We analyzed the data of six patients who underwent reoperative parathyroid surgery using US-G methylene blue dye injection retrospectively. The dye injection was performed just prior to surgery. All patients were successfully treated for their hyperparathyroidism which was confirmed by at least 50 % drop in intraoperative parathormone level 10 min after resection. There were no complications related with US-G dye injection or with surgery. US-G methylene blue dye injection is a cheap, safe, and effective method for localization of diseased parathyroid glands and guiding surgery in the reoperative neck.

  20. Preliminary Assessment of the Impact on Reactor Vessel dpa Rates Due to Installation of a Proposed Low Enriched Uranium (LEU) Core in the High Flux Isotope Reactor (HFIR)

    Energy Technology Data Exchange (ETDEWEB)

    Daily, Charles R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    An assessment of the impact on the High Flux Isotope Reactor (HFIR) reactor vessel (RV) displacements-per-atom (dpa) rates due to operations with the proposed low enriched uranium (LEU) core described by Ilas and Primm has been performed and is presented herein. The analyses documented herein support the conclusion that conversion of HFIR to low-enriched uranium (LEU) core operations using the LEU core design of Ilas and Primm will have no negative impact on HFIR RV dpa rates. Since its inception, HFIR has been operated with highly enriched uranium (HEU) cores. As part of an effort sponsored by the National Nuclear Security Administration (NNSA), conversion to LEU cores is being considered for future HFIR operations. The HFIR LEU configurations analyzed are consistent with the LEU core models used by Ilas and Primm and the HEU balance-of-plant models used by Risner and Blakeman in the latest analyses performed to support the HFIR materials surveillance program. The Risner and Blakeman analyses, as well as the studies documented herein, are the first to apply the hybrid transport methods available in the Automated Variance reduction Generator (ADVANTG) code to HFIR RV dpa rate calculations. These calculations have been performed on the Oak Ridge National Laboratory (ORNL) Institutional Cluster (OIC) with version 1.60 of the Monte Carlo N-Particle 5 (MCNP5) computer code.

  1. Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

    Science.gov (United States)

    Kaneko, Kenji; Shimazaki, Natsumi; Gotoh, Maya; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    Our photo thermal reaction heating architecture balloon realizes less than 10 s short term heating that can soften vessel wall collagen without damaging surrounding tissue thermally. New thermal balloon angioplasty, photo-thermo dynamic balloon angioplasty (PTDBA) has experimentally shown sufficient opening with 2 atm low pressure dilation and prevention of chronic phase restenosis and acute phase thrombus in vivo. Even though PTDBA has high therapeutic potential, the most efficient heating condition is still under study, because relationship of treatment and thermal dose to vessel wall is not clarified yet. To study and set the most efficient heating condition, we have been working on establishment of temperature history estimation method from our previous experimental results. Heating target of PTDBA, collagen, thermally denatures following rate process. Denaturation is able to be quantified with measured collagen birefringence value. To express the denaturation with equation of rate process, the following ex vivo experiments were performed. Porcine extracted carotid artery was soaked in two different temperature saline baths to enforce constant temperature heating. Higher temperature bath was set to 40 to 80 degree Celsius and soaking duration was 5 to 40 s. Samples were observed by a polarizing microscope and a scanning electron microscope. The birefringence was measured by polarizing microscopic system using Brace-Koehler compensator 1/30 wavelength. The measured birefringence showed temperature dependency and quite fit with the rate process equation. We think vessel wall temperature is able to be estimated using the birefringence changes due to thermal denaturation.

  2. Estimation of soil redistribution rates due to snow cover related processes in a mountainous area (Valle d'Aosta, NW Italy

    Directory of Open Access Journals (Sweden)

    E. Ceaglio

    2012-02-01

    Full Text Available Mountain areas are widely affected by soil erosion, which is generally linked to runoff processes occurring in the growing season and snowmelt period. Also processes like snow gliding and full-depth snow avalanches may be important factors that can enhance soil erosion, however the role and importance of snow movements as agents of soil redistribution are not well understood yet. The aim of this study was to provide information on the relative importance of snow related processes in comparison to runoff processes. In the study area, which is an avalanche path characterized by intense snow movements, soil redistribution rates were quantified with two methods: (i by field measurements of sediment yield in an avalanche deposition area during 2009 and 2010 winter seasons; (ii by caesium-137 method, which supplies the cumulative net soil loss/gain since 1986, including all the soil erosion processes. The snow related soil accumulation estimated with data from the deposit area (27.5 Mg ha−1 event−1 and 161.0 Mg ha−1 event−1 was not only higher than the yearly sediment amounts, reported in literature, due to runoff processes, but it was even more intense than the yearly total deposition rate assessed with 137Cs (12.6 Mg ha−1 yr−1. The snow related soil erosion rates estimated from the sediment yield at the avalanche deposit area (3.7 Mg ha−1 and 20.8 Mg ha−1 were greater than the erosion rates reported in literature and related to runoff processes; they were comparable to the yearly total erosion rates assessed with the 137Cs method (13.4 Mg ha−1 yr−1 and 8.8 Mg ha−1 yr−1. The 137Cs method also showed that, where the ground avalanche does not release, the erosion and deposition of soil particles from the upper part of the basin was considerable and likely related to

  3. Influence of cooling rate in planar thermally assisted magnetic random access memory: Improved writeability due to spin-transfer-torque influence

    Energy Technology Data Exchange (ETDEWEB)

    Chavent, A. [Univ. Grenoble Alpes, INAC-SPINTEC, F-38000 Grenoble (France); CNRS, INAC-SPINTEC, F-38000 Grenoble (France); CEA, INAC-SPINTEC, F-38000 Grenoble (France); Crocus Technology, 38000 Grenoble (France); Ducruet, C.; Portemont, C.; Creuzet, C.; Alvarez-Hérault, J. [Crocus Technology, 38000 Grenoble (France); Vila, L. [Univ. Grenoble Alpes, INAC-SP2M, F-38000 Grenoble, France and CEA, INAC-SP2M, F-38000 Grenoble (France); Sousa, R. C.; Prejbeanu, I. L.; Dieny, B. [Univ. Grenoble Alpes, INAC-SPINTEC, F-38000 Grenoble (France); CNRS, INAC-SPINTEC, F-38000 Grenoble (France); CEA, INAC-SPINTEC, F-38000 Grenoble (France)

    2015-09-14

    This paper investigates the effect of a controlled cooling rate on magnetic field reversal assisted by spin transfer torque (STT) in thermally assisted magnetic random access memory. By using a gradual linear decrease of the voltage at the end of the write pulse, the STT decays more slowly or at least at the same rate as the temperature. This condition is necessary to make sure that the storage layer magnetization remains in the desired written direction during cooling of the cell. The influence of the write current pulse decay rate was investigated on two exchange biased synthetic ferrimagnet (SyF) electrodes. For a NiFe based electrode, a significant improvement in writing reproducibility was observed using a gradual linear voltage transition. The write error rate decreases by a factor of 10 when increasing the write pulse fall-time from ∼3 ns to 70 ns. For comparison, a second CoFe/NiFe based electrode was also reversed by magnetic field assisted by STT. In this case, no difference between sharp and linear write pulse fall shape was observed. We attribute this observation to the higher thermal stability of the CoFe/NiFe electrode during cooling. In real-time measurements of the magnetization reversal, it was found that Ruderman-Kittel-Kasuya-Yosida (RKKY) coupling in the SyF electrode vanishes for the highest pulse voltages that were used due to the high temperature reached during write. As a result, during the cooling phase, the final state is reached through a spin-flop transition of the SyF storage layer.

  4. Reoperation to the ossification of the posterior longitudinal ligament%颈椎后纵韧带骨化症再手术原因分析

    Institute of Scientific and Technical Information of China (English)

    潘胜发; 刘忠军; 孙宇; 张凤山; 王少波; 李迈; 张立

    2012-01-01

    Objective To discuss surgical approaches of ossification of the posterior longitudinal ligament(OPLL) of cervical spine.Methods Between June 2005 to July 2010,36 patients with OPLL of cervical spine were reoperated.There were 23 male,13 female,age from 39 to 72 years( mean 57 years).The time of the first operation to the reoperation were 4 months to 24 years,an average of 3.9 years.Among 20 patients underwent anterior corpectomy and fusion(ACD) at first operation,14 cases combined stenosis of cervical spinal canel,10 cases were insufficient decompression of OPLL,5 cases injuried of cervical spinal cord during the first operation,1 case was adjacent disc herniation.Among 14 cases underwent expensive open-door laminoplasty (ELAP)at first operation,6 cases were insufficient decompression of OPLL,4 cases were inadequate decompressed segment,2 cases were cervical segmental kyphosis,2 cases were progression of OPLL combined with disc herniation.Among 2 cases underwent combined approach at first operation,I case was insufficient decompression of OPLL,the other was adjacent disc herniation.Their pre- and post-operative X-ray,CT and MRI were analyzed.The complications of reoperation were recorded.Result There were 30 patients followed-up,with a period of 1.5-4.0 years,average 1.8 years.With 36 patients,none had deterioration,2 patients had no recovery post-reoperation,34 patients had 31.2% Japanese Orthopedic Association score improve rate.Among 22 cases underwent ELAP at second operation,3 cases had postoperative segmental palsy.Among 14 cases underwent ACD at second operation,3 cases had intraoperative dural defects.Conclusion Surgical strategy for OPLL of cervical spine should consider the type of OPLL and stenosis of cervical spinal canel.%目的 通过分析颈椎后纵韧带骨化症再手术的原因,探讨确定手术方式的影响因素.方法 对2005年6月至2010年7月收治的36例颈椎后纵韧带骨化症再手术患者资料进行回顾性分析,男性23

  5. Trends in Hospitalization and Mortality Rates Due to Acute Cardiovascular Disease in Castile and León, 2001 to 2015.

    Science.gov (United States)

    López-Messa, Juan B; Andrés-de Llano, Jesús M; López-Fernández, Laura; García-Cruces, Jesús; García-Crespo, Julio; Prieto González, Miryam

    2017-07-31

    To analyze hospitalization and mortality rates due to acute cardiovascular disease (ACVD). We conducted a cross-sectional study of the hospital discharge database of Castile and León from 2001 to 2015, selecting patients with a principal discharge diagnosis of acute myocardial infarction (AMI), unstable angina, heart failure, or acute ischemic stroke (AIS). Trends in the rates of hospitalization/100 000 inhabitants/y and hospital mortality/1000 hospitalizations/y, overall and by sex, were studied by joinpoint regression analysis. A total of 239 586 ACVD cases (AMI 55 004; unstable angina 15 406; heart failure 111 647; AIS 57 529) were studied. The following statistically significant trends were observed: hospitalization: ACVD, upward from 2001 to 2007 (5.14; 95%CI, 3.5-6.8; P < .005), downward from 2011 to 2015 (3.7; 95%CI, 1.0-6.4; P < .05); unstable angina, downward from 2001 to 2010 (-12.73; 95%CI, -14.8 to -10.6; P < .05); AMI, upward from 2001 to 2003 (15.6; 95%CI, 3.8-28.9; P < .05), downward from 2003 to 2015 (-1.20; 95%CI, -1.8 to -0.6; P < .05); heart failure, upward from 2001 to 2007 (10.70; 95%CI, 8.7-12.8; P < .05), upward from 2007 to 2015 (1.10; 95%CI, 0.1-2.1; P < .05); AIS, upward from 2001 to 2007 (4.44; 95%CI, 2.9-6.0; P < .05). Mortality rates: downward from 2001 to 2015 in ACVD (-1.16; 95%CI, -2.1 to -0.2; P < .05), AMI (-3.37, 95%CI, -4.4 to -2, 3, P < .05), heart failure (-1.25; 95%CI, -2.3 to -0.1; P < .05) and AIS (-1.78; 95%CI, -2.9 to -0.6; P < .05); unstable angina, upward from 2001 to 2007 (24.73; 95%CI, 14.2-36.2; P < .05). The ACVD analyzed showed a rising trend in hospitalization rates from 2001 to 2015, which was especially marked for heart failure, and a decreasing trend in hospital mortality rates, which were similar in men and women. These data point to a stabilization and a decline in hospital mortality, attributable to established prevention measures. Copyright © 2017 Sociedad Española de Cardiología. Published by

  6. Invasion of a semi-arid shrubland by annual grasses increases autotrophic and heterotrophic soil respiration rates due to altered soil moisture and temperature patterns

    Science.gov (United States)

    Mauritz, M.; Hale, I.; Lipson, D.

    2010-12-01

    Shrub grassland conversions are a globally occurring phenomenon altering habitat structure, quality and nutrient cycling. Grasses and shrubs differ in their above and belowground biomass allocation, root architecture, phenology, litter quality and quantity. Conversion affects soil microbial communities, soil moisture and temperature and carbon (C) allocation patterns. However, the effect of conversion on C storage is regionally variable and there is no consistent direction of change. In Southern California invasion by annual grasses is a major threat to native shrub communities and it has been proposed that grass invasion increases NPP and ecosystem C storage (Wolkovich et al, 2009). In order to better understand how this shrub grassland conversion changes ecosystem C storage it is important to understand the partitioning of soil respiration into autotrophic and heterotrophic components. Respiration was measured in plots under shrubs and grasses from February when it was cold and wet to July when it was hot and dry, capturing seasonal transitions in temperature and water availability. Roots were excluded under shrubs and grasses with root exclusion cores to quantify heterotrophic respiration. Using total soil respiration (Rt) = autotrophic respiration (root) (Ra)+ heterotrophic respiration (microbial) (Rh) the components contributing to total soil respiration can be evaluated. Respiration, soil moisture and temperature were measured daily at four hour intervals using Licor 8100 automated chamber measurements. Throughout the measurement period, Rt under grasses exceeded Rt under shrubs. Higher Rt levels under grasses were mainly due to higher Ra in grasses rather than changes in Rh. On average grass Ra was almost double shrub Ra. Higher grass respiration levels are partially explained by differences in soil moisture and temperature between shrubs and grasses. Respiration rates responded similarly to seasonal transitions regardless of treatment although Ra had a much

  7. Thirty-day readmission and reoperation after surgery for spinal tumors: a National Surgical Quality Improvement Program analysis.

    Science.gov (United States)

    Karhade, Aditya V; Vasudeva, Viren S; Dasenbrock, Hormuzdiyar H; Lu, Yi; Gormley, William B; Groff, Michael W; Chi, John H; Smith, Timothy R

    2016-08-01

    OBJECTIVE The goal of this study was to use a large national registry to evaluate the 30-day cumulative incidence and predictors of adverse events, readmissions, and reoperations after surgery for primary and secondary spinal tumors. METHODS Data from adult patients who underwent surgery for spinal tumors (2011-2014) were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry. Multivariable logistic regression was used to evaluate predictors of reoperation, readmission, and major complications (death, neurological, cardiopulmonary, venous thromboembolism [VTE], surgical site infection [SSI], and sepsis). Variables screened included patient age, sex, tumor location, American Society of Anesthesiologists (ASA) physical classification, preoperative functional status, comorbidities, preoperative laboratory values, case urgency, and operative time. Additional variables that were evaluated when analyzing readmission included complications during the surgical hospitalization, hospital length of stay (LOS), and discharge disposition. RESULTS Among the 2207 patients evaluated, 51.4% had extradural tumors, 36.4% had intradural extramedullary tumors, and 12.3% had intramedullary tumors. By spinal level, 20.7% were cervical lesions, 47.4% were thoracic lesions, 29.1% were lumbar lesions, and 2.8% were sacral lesions. Readmission occurred in 10.2% of patients at a median of 18 days (interquartile range [IQR] 12-23 days); the most common reasons for readmission were SSIs (23.7%), systemic infections (17.8%), VTE (12.7%), and CNS complications (11.9%). Predictors of readmission were comorbidities (dyspnea, hypertension, and anemia), disseminated cancer, preoperative steroid use, and an extended hospitalization. Reoperation occurred in 5.3% of patients at a median of 13 days (IQR 8-20 days) postoperatively and was associated with preoperative steroid use and ASA Class 4-5 designation. Major complications occurred in 14.4% of patients: the

  8. Clinical analysis of reoperation for differentiated thyroid carcinoma%分化型甲状腺癌再次手术的临床分析

    Institute of Scientific and Technical Information of China (English)

    郑绪才; 王圣应; 朱正志; 刘松; 陈公仆

    2015-01-01

    目的:分析行再次手术的104例分化型甲状腺癌( DTC)的手术方式、病理结果及疗效,探讨DTC再次手术策略。方法回顾性分析104例分化型甲状腺癌患者再次手术治疗的临床资料。结果经病理证实,甲状腺组织总残癌率66.35%,淋巴结残癌率77.89%。患者年龄<45岁、既往颈部淋巴结肿大、原发癌灶残留或复发、原发癌的多发与颈部淋巴结转移显著相关,差异有统计学意义(P<0.05)。术后暂时性喉返神经损伤发生率为2.88%,暂时性低钙血症发生率为5.77%,无永久性喉返神经损伤及甲状旁腺损伤。结论 DTC行再次手术时应保证肿瘤切除的彻底性,尤其对颈部淋巴结的处理;同时尽量防止喉返神经和甲状旁腺损伤等并发症的发生。%Objective To analyze the surgical methods, pathological results and therapeutic effect of 104 cases of differentiated thy-roid carcinoma ( DTC) , and to investigate the reoperation strategy. Methods The clinical data of 104 cases of differentiated thyroid carcino-ma treated by reoperation were retrospectively analyzed. Results The total residual cancer rate of thyroid tissues was 66. 35%, and the rate of lymph node residual cancer was 77. 89%. Univariate analysis showed that the patients were aged <45 years old, had a swollen past neck lymph nodes, residual or recurrence of primary cancer foci, and multiple cervical lymph node metastasis were significantly associated with the primary cancer (P<0. 05). Incidence of postoperative temporary larynx return nerve injury was 2. 88%, temporary hypocalcemia occur rate was 5. 77%, and there was no permanent laryngeal recurrent nerve injury and parathyroid injury. Conclusion DTC should guarantee the tumor resection thoroughly, especially for the treatment of cervical lymph nodes, and meanwhile complications such as recurrent laryngeal nerve and parathyroid injury should be prevented.

  9. Volumetric Growth Rate of Recurrent Pleomorphic Adenoma.

    Science.gov (United States)

    Naunheim, Molly; Wu, Xin; Ryan, William R; Wang, Steven J; Heaton, Chase M

    2017-07-01

    Surgery for recurrent pleomorphic adenoma (PA) can be challenging and may increase the risk of operative complications, particularly facial nerve weakness. As observation may be a viable alternative to surgery for slow-growing tumors, our objective was to assess the growth rate of recurrent PAs. This study is a case series of patients at our tertiary academic medical center with recurrent PA. Two magnetic resonance images (MRI) were compared; total volume (TV) of recurrent tumor on both studies was calculated to obtain our main outcomes of percent change in TV and tumor growth rate. Fourteen patients with recurrent PA had a median interval time between MRI of 12.8 months. Though growth rates were variable, the median continuous compound growth per year was 10.2%. Notably, 3 patients (21%) had no growth, and 2 patients (14%) had a reduction in TV. The median growth rate for enlarging tumors is estimated at 10.2% per year. Due to variability, tumor growth rate should be estimated on an individual patient basis. For slow-growing tumors, physicians may weigh the risk of this slow growth with the morbidity of reoperation.

  10. Theoretical predictions of source rates for exospheric CO 2 on icy satellites of the outer planets due to sublimation of deep subsurface CO 2 ice

    Science.gov (United States)

    Wood, Stephen E.

    2016-10-01

    The abundances of CO2 observed in the exospheres of Callisto and, more recently, Rhea and Dione are difficult to explain. The previously proposed sources for the CO2 either have production rates well below the expected rates of escape/destruction or should produce other species (e.g. CO) that are not observed.We consider a potential source that has not been previously investigated - CO2 vapor originating from crustal CO2 ice and driven upward by the endogenic heat flux - and have developed a model to make quantitative estimates of the corresponding global subsurface vapor flux.Our model is based on previous theoretical work by Clifford (1993) and Mellon et al. (1997) for equatorial ground ice on Mars, who showed that in times or places where subsurface pore ice is undergoing long-term sublimation and diffusive loss, the ice table (the shallowest depth where any pore ice exists) will not continue to recede indefinitely. Beyond a certain, predictable depth, the linear diffusive profile of vapor density between the ice table and the surface will become supersaturated with respect to the local temperature and recondense as pore ice. This is true for any planetary body with a non-negligible interior heat source (e.g. radiogenic, tidal, etc) and is due to the fact that, while the ice temperature increases ~linearly with depth, the corresponding equilibrium vapor density increases exponentially.Once this occurs, a steady-state profile of ice volume fraction, f_ice(z), develops, with net mass loss only occurring from the retreating pore-filling ice layer. The rate of vapor flux to the surface is then determined only by the vapor density and temperature gradient at the ice table depth. We use a 1-D thermal model coupled with an analytic physical model for regolith thermal conductivity (including its depth- and T-dependence), to calculate the zonally-integrated global CO2 vapor flux corresponding to the range of expected heat flow values. Our preliminary results show

  11. X-ray counterpart of gravitational waves due to binary neutron star mergers: light curves, luminosity functions, and event rate densities

    CERN Document Server

    Sun, Hui; Gao, He

    2016-01-01

    Zhang (2013) proposed a type of GRB-less X-ray transient associated with double neutron star (NS-NS) mergers under the conjecture of a rapidly-spinning magnetar merger product with the line of sight off the short GRB beam. We investigate possible light curves of these transients by considering different observer's viewing angles, including looking into a free zone where the emission due to direct dissipation of the magnetar wind is observable, and a trapped zone where X-rays are initially trapped by the ejecta launched during the merger, but later become transparent when the ejecta become optically thin. We perform Monte Carlo simulations to calculate the peak luminosity function (LF) and event rate density of these X-ray transients. By considering that a fraction of massive neutron stars may be supra-massive and collapse into black holes after a certain time, we investigate how the predicted luminosity functions depend on the equation of state (EoS) of the central object. In general, the luminosity functions...

  12. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy.

    Science.gov (United States)

    Goraya, Nimrit; Simoni, Jan; Jo, Chanhee; Wesson, Donald E

    2012-01-01

    The neutralization of dietary acid with sodium bicarbonate decreases kidney injury and slows the decline of the glomerular filtration rate (GFR) in animals and patients with chronic kidney disease. The sodium intake, however, could be problematic in patients with reduced GFR. As alkali-induced dietary protein decreased kidney injury in animals, we compared the efficacy of alkali-inducing fruits and vegetables with oral sodium bicarbonate to diminish kidney injury in patients with hypertensive nephropathy at stage 1 or 2 estimated GFR. All patients were evaluated 30 days after no intervention; daily oral sodium bicarbonate; or fruits and vegetables in amounts calculated to reduce dietary acid by half. All patients had 6 months of antihypertensive control by angiotensin-converting enzyme inhibition before and during these studies, and otherwise ate ad lib. Indices of kidney injury were not changed in the stage 1 group. By contrast, each treatment of stage 2 patients decreased urinary albumin, N-acetyl β-D-glucosaminidase, and transforming growth factor β from the controls to a similar extent. Thus, a reduction in dietary acid decreased kidney injury in patients with moderately reduced eGFR due to hypertensive nephropathy and that with fruits and vegetables was comparable to sodium bicarbonate. Fruits and vegetables appear to be an effective kidney protective adjunct to blood pressure reduction and angiotensin-converting enzyme inhibition in hypertensive and possibly other nephropathies.

  13. Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database.

    Science.gov (United States)

    Lim, Seokchun; Jordan, Sumanas W; Jain, Umang; Kim, John Y S

    2014-08-01

    Studies that evaluate the predictors and causes of unplanned re-operation in outpatient plastic surgery. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all plastic surgery outpatient cases performed in 2011. Multiple logistic regression analysis was utilised to identify independent risk factors and causes of unplanned reoperations. Of the 6749 outpatient plastic surgery cases identified, there were 125 (1.9%) unplanned re-operations (UR). Regression analysis demonstrated that body mass index (BMI, OR = 1.041, 95% CI = 1.019-1.065), preoperative open wound/wound infection (OR = 3.498, 95% CI = 1.593-7.678), American Society of Anesthesiologists (ASA) class 3 (OR = 2.235, 95% CI = 1.048-4.765), and total work relative value units (RVU, OR = 1.014, 95% CI = 1.005-1.024) were significantly predictive of UR. Additionally, the presence of any complication was significantly associated with UR (OR = 15.065, 95% CI = 5.705-39.781). In an era of outcomes-driven medicine, unplanned re-operation is a critical quality indicator for ambulatory plastic surgery facilities. The identified risk factors will aid in surgical planning and risk adjustment.

  14. Study on unplanned re-operation after radical gastrectomy for gastric cancer: Seven years' experience%胃癌根治术后非计划再手术35例

    Institute of Scientific and Technical Information of China (English)

    黄嫣妮; 钱雷敏; 黄建明; 戈军刚; 高林; 刘惠钧

    2013-01-01

    Objective To investigate the causes of unplanned re-operation following radical surgery for gastric cancer and to summarize clinical experience.Methods The clinical data of gastric cancer patients who underwent radical gastrectomy from Jan.2006 to Dec.2012 were retrospectively analyzed in the study,especially focusing on the preoperative,intraoperative and postoperative situations of unplanned re-operation cases at the same hospitalization.Results During seven years,radical gastrectomy for gastric cancer was implemented in 1707 cases,35 of which had unplanned re-operations.The rate of such re-operation was 2.05 %,following the mortality rate of 8.57%.Besides age,basic chronic illness and TNM stage,the primary operation way,which caused the higher incidence of unplanned re-operation,was radical total gastrectomy.Some complications after radical gastrectomy required unplanned re-operations,of which the most common was wound disruption and others,in turn,were pleural effusions/ascites,post-traumatic focal pancreatitis (PTFP),intestinal obstruction,intraperitoneal hemorrhage,while the most serious consequence was anastomotic leakage or stump fistula and partly led to death.Conclusion Unplanned re-operation after radical gastrectomy for gastric cancer can increase residential time,total treatment cost and the mortality rate.Comprehensive preoperative analysis,correct intraoperative and postoperative management,as well as timely treatment of complications are important measures to reduce the incidence of those unplanned re-operations.%目的 探讨胃癌根治术后非计划再手术的原因及总结临床治疗体会.方法 回顾性分析2006年1月—2012年12月间行胃癌根治术患者的临床资料,并重点分析同一住院期间非计划再手术病例的术前、手术及术后情况.结果 7年间共实施胃癌根治术1 707例,发生非计划再手术35例,再手术率2.05%,再手术死亡率8.57%.发生率较高者的初次手术方式为根治

  15. Numerical analysis of specific absorption rate in the human head due to a 13.56 MHz RFID-based intra-ocular pressure measurement system

    Science.gov (United States)

    Hirtl, Rene; Schmid, Gernot

    2013-09-01

    A modern wireless intra-ocular pressure monitoring system, based on 13.56 MHz inductively coupled data transmission, was dosimetrically analyzed with respect to the specific absorption rate (SAR) induced inside the head and the eye due to the electromagnetic field exposure caused by the reader antenna of the transmission system. The analysis was based on numerical finite difference time domain computations using a high resolution anatomical eye model integrated in a modern commercially available anatomical model of a male head. Three different reader antenna configurations, a 7-turn elliptic (30 mm × 50 mm) antenna at 12 mm distance from the eye, a flexible circular antenna (60 mm diameter, 8 turns on 2 mm substrate) directly attached to the skin, and a circular 7-turn antenna (30 mm diameter at 12 mm distance to the eye) were analyzed, respectively. Possible influences of the eye-lid status (closed or opened) and the transponder antenna contained in a contact lens directly attached to the eye were taken into account. The results clearly demonstrated that for typical reader antenna currents required for proper data transmission, the SAR values remain far below the limits for localized exposure of the head, as defined by the International Commission for Non-Ionizing Radiation Protection. Particularly the induced SAR inside the eye was found to be substantially (orders of magnitudes for typical reader antenna currents in the order of 1 A turn) below values which have been reported to be critical with respect to thermally induced adverse health effects in eye tissues.

  16. The role of 99mTc-MIBI SPECT-CT in reoperation therapy of persistent hyperparathyroidism patients

    Science.gov (United States)

    Yin, Lijie; Guo, Dandan; Liu, Jie; Yan, Jue

    2015-01-01

    To compare the role of 99mTc-MIBI SPECT-CT image and US in reoperation of persistent secondary hyperparathyroidism patients. A total of 8 persistent secondary hyperparathyroidism patients underwent parathyroidectomy. The sensitivity and accuracy of US and 99mTc-MIBI images before operation were determined. 9 of 14 surgical resection tissues from 8 persistent secondary hyperparathyroidism patients were confirmed to parathyroid hyperplasia. The results showed that the sensitivities were 77.8% and 100%, respectively, for US and 99mTc-MIBI SPECT-CT images. And the accuracies of US and 99mTc-MIBI dual time planar image and SPECT-CT were 50%, 78.6%, respectively. There was significantly difference between two procedures (P=0.021). The superior and inferior localization of glands were both detected by the ultrasound and scintigraphy. Two ectopic parathyroidism nodules were found by 99mTc-MIBI SPECT-CT imaging, while US provided no consistent findings. There was no significantly difference between two procedures (P=0.3). Although two cases of them were not confirmed by pathology, the iPTH of them (800 and 1429 respectively) were much higher than other four cases (<400) pg/ml. PTX is a safe and effective treatment for the patients with persistent SHPT. 99mTc-MIBI planar and SPECT-CT imaging may provide more helps for clinician’s localization the hyperparathyroidism glands accurately.

  17. Impact of reconstruction and reoperation on long-term patient-reported satisfaction after contralateral prophylactic mastectomy

    Science.gov (United States)

    Boughey, Judy C.; Hoskin, Tanya L.; Hartmann, Lynn C.; Johnson, Joanne L.; Jacobson, Steven R.; Degnim, Amy C.; Frost, Marlene H.

    2015-01-01

    Background Contralateral prophylactic mastectomy (CPM) is increasingly chosen by breast cancer patients and may be related to increased use of immediate reconstruction. This study examines long-term patient satisfaction with CPM and reconstruction in a historical cohort. Methods 621 unilateral breast cancer patients with a family history of breast cancer who underwent CPM between 1960–1993 were surveyed regarding QOL and satisfaction with CPM at two time points - approximately 10 years and 20 years after CPM. Results 583 women responded to the first follow-up questionnaire (median 10.7 years, mean 11.9 years) after CPM. 403 (69%) underwent reconstruction and 180 (31%) did not. Women electing reconstruction were younger (mean age 47 vs 53 years, p=0.01) and more likely to be married (85% vs 78%, p=0.048). Most women reported satisfaction with CPM (83%), that they would choose CPM again (84%) and make the same choice regarding reconstruction (73%). However, reconstruction patients demonstrated significantly lower satisfaction (p=0.0001) and were less likely to choose CPM again (pwomen responded to the second questionnaire (median 18.4 years, mean 20.2 years after CPM). Satisfaction with CPM remained high, with 92% of women stating they would choose CPM again. Conclusions Most women report stable long-term satisfaction with CPM. Women who had reconstruction and required reoperations in this historical cohort reported lower satisfaction. PMID:25192678

  18. Are Student Ratings of Communication Instructors Due to "Easy" Grading Practices? An Analysis of Teacher Credibility and Student-Reported Performance Levels.

    Science.gov (United States)

    Beatty, Michael J.; Zahn, Christopher J.

    1990-01-01

    Investigates the empirical relationships between student ratings of teachers and student-reported performance. Finds that students discriminate between sociability and qualification-related aspects of teacher performance and that student ratings were not the product of "easy" grading practices. (SR)

  19. [Successful outcome of a pregnancy with an extremely low fetal heart rate (34 bpm) due to isolated complete heart block--case report].

    Science.gov (United States)

    Hamela-Olkowska, Anita; Dangel, Joanna; Miszczak-Knecht, Maria

    2009-09-01

    Isolated complete congenital heart block (CHB) in the majority of cases is associated with the presence of autoantibodies to SSA (Ro) and SSB (La) antigens in the maternal serum. The prognosis is less favorable in fetuses with a ventricular rate bpm. We have reported a case of a fetus with an isolated non-autoimmune CHB with an extremely low ventricular rate (34bpm) in which the outcome was favorable. In the neonate the non-compaction of the myocardium was diagnosed.

  20. Reoperation on aortic disease in patients with previous aortic valve surgery%主动脉瓣置换术后患者再次主动脉外科干预47例

    Institute of Scientific and Technical Information of China (English)

    张良; 常谦; 孙晓刚; 于存涛; 钱向阳

    2013-01-01

    Objective Retrospectively analyze 47 cases received reoperation with aortic disease after aortic valve replacement to deepen the understanding of aortic valve disease.Methods From January 2003 to June 2012,47 patients with previous aortic valve replacement received aortic root or other aortic operation because of new aortic disease.38 male and 9 female,the interval (6.0 ± 3.8) years. All cases with new aortic disease were diagnosed by cardiac ultrasound and aortic computed tomography.Bentall's procedure were operated on 14 patients,total aortic arch replacement with elephant trunk procedure on 14 patients,aortic root and aortic arch with elephant trunk procedure on 7 patients,ascending aortic replacement on 10patients,total thoracic and abdominal aorta replacement on 2 cases.All patients were followed by clinic interview or telephone.Results Aortic dissection and aneurysmal dilatation were occurred on ascending aorta,each account for 50%,in patients with previous aortic valve replacement because of rheumatic valve disease and bicuspid aortic valve; 3 cases with Marfan syndrome occurred ascending aortic dilatation and 4 cases occurred aortic dissection.Diameter in ascending aorta increased (5.2 + 7.1)mm per year and aortic sinus (3.3 ± 3.1)mm per year.The value of ascending aortic dilatation per year in patients with rheumatic disease was higher than patients with Marfan syndrome(P < 0.05).47 patients were re-operated in fuwai hospital,1 patients died in operating room because aortic dissection seriously involved right coronary artery.7 patients have renal insufficiency after operation and all were cured by hemofiltration; neurological complication occurred in 14 patients including that 7 patients stroked and 7 patients had transient brain dysfunciotn.There were no postoperative spinal cord deficits occurred.All patients were followed up,the mean follow up time were(53.49 +33.79) months.8 cases were died during follow-up and threeyear survival rate was 83

  1. Causes and indications for reoperation in valve replacement and coronary artery bypass graft (CABG in 915 patients in cardiac surgery department in Imam Khomeini Hospital, 1374-77

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2001-08-01

    Full Text Available Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female. The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A Valvular complications (female/male=3/1, B Non valvular complications (female/male=1/3. The most common nonvalvular complication was bleeding (66.6 percent. The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915 the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.

  2. Does the cortical bone resorption rate change due to 90Sr-radiation exposure? Analysis of data from Techa Riverside residents

    Energy Technology Data Exchange (ETDEWEB)

    Tolstykh, E I; Shagina, N B; Degteva, M O; Anspaugh, L R; Napier, Bruce A

    2011-08-01

    The Mayak Production Association released large amounts of 90Sr into the Techa River (Southern Urals, Russia) with peak amounts in 1950-1951. Techa Riverside residents ingested an average of about 3,000 kBq of 90Sr. The 90Sr-body burden of approximately 15,000 individuals has been measured in the Urals Research Center for Radiation Medicine in 1974-1997 with use of a special whole-body counter (WBC). Strontium-90 had mainly deposited in the cortical part of the skeleton by 25 years following intake, and 90Sr elimination occurs as a result of cortical bone resorption. The effect of 90Sr-radiation exposure on the rate of cortical bone resorption was studied. Data on 2,022 WBC measurements were selected for 207 adult persons, who were measured three or more times before they were 50-55 years old. The individual-resorption rates were calculated with the rate of strontium recirculation evaluated as 0.0018 year-1. Individual absorbed doses in red bone marrow (RBM) and bone surface (BS) were also calculated. Statistically significant negative relationships of cortical bone resorption rate were discovered related to 90Sr-body burden and dose absorbed in the RBM or the BS. The response appears to have a threshold of about 1.5-Gy RBM dose. The radiation induced decrease in bone resorption rate may not be significant in terms of health. However, a decrease in bone remodeling rate can be among several causes of an increased level of degenerative dystrophic bone pathology in exposed persons.

  3. Energy-loss rate of hot electrons due to confined acoustic phonon modes in a semiconductor quantum wire under transverse electric field

    Science.gov (United States)

    Stepanyan, A.; Yeranosyan, M.; Vardanyan, L.; Asatryan, A.; Kirakosyan, A.; Vartanian, A.

    2017-08-01

    The hot-electron energy-loss rate via the acoustic-phonons in an embedded semiconductor quantum wire of circular cross section in the presence of external electric field has been investigated using deformation potential theory. Dimensional confinement effect on modifying acoustic-phonon modes are taken into account. The energy-loss rate as a function of electric field strength, electron density and electron temperature is obtained. Our calculations show that the electric field applied perpendicularly to the wire axis can be used as an important tool for the control of the energy-loss processes in nanowires.

  4. A practical approach to estimate emission rates of indoor air pollutants due to the use of personal combustible products based on small-chamber studies.

    Science.gov (United States)

    Szulejko, Jan E; Kim, Ki-Hyun

    2016-02-01

    As emission rates of airborne pollutants are commonly measured from combusting substances placed inside small chambers, those values need to be re-evaluated for the possible significance under practical conditions. Here, a simple numerical procedure is investigated to extrapolate the chamber-based emission rates of formaldehyde that can be released from various combustible sources including e-cigarettes, conventional cigarettes, or scented candles to their concentration levels in a small room with relatively poor ventilation. This simple procedure relies on a mass balance approach by considering the masses of pollutants emitted from source and lost through ventilation under the assumption that mixing occurs instantaneously in the room without chemical reactions or surface sorption. The results of our study provide valuable insights into re-evaluation procedure of chamber data to allow comparison between extrapolated and recommended values to judge the safe use of various combustible products in confined spaces. If two scented candles with a formaldehyde emission rate of 310 µg h(-1) each were lit for 4 h in a small 20 m(3) room with an air change rate of 0.5 h(-1), then the 4-h (candle lit) and 8-h (up to 8 h after candle lighting) TWA [FA] were determined to be 28.5 and 23.5 ppb, respectively. This is clearly above the 8-h NIOSH recommended exposure limit (REL) time weighted average of 16 ppb.

  5. Two challenges for U.S. irrigation due to climate change: increasing irrigated area in wet states and increasing irrigation rates in dry states.

    Directory of Open Access Journals (Sweden)

    Robert I McDonald

    Full Text Available Agricultural irrigation practices will likely be affected by climate change. In this paper, we use a statistical model relating observed water use by U.S. producers to the moisture deficit, and then use this statistical model to project climate changes impact on both the fraction of agricultural land irrigated and the irrigation rate (m³ ha⁻¹. Data on water withdrawals for US states (1985-2005 show that both quantities are highly positively correlated with moisture deficit (precipitation--PET. If current trends hold, climate change would increase agricultural demand for irrigation in 2090 by 4.5-21.9 million ha (B1 scenario demand: 4.5-8.7 million ha, A2 scenario demand: 9.1-21.9 million ha. Much of this new irrigated area would occur in states that currently have a wet climate and a small fraction of their agricultural land currently irrigated, posing a challenge to policymakers in states with less experience with strict regulation of agriculture water use. Moreover, most of this expansion will occur in states where current agricultural production has relatively low market value per hectare, which may make installation of irrigation uneconomical without significant changes in crops or practices by producers. Without significant increases in irrigation efficiency, climate change would also increase the average irrigation rate from 7,963 to 8,400-10,415 m³ ha⁻¹ (B1 rate: 8,400-9,145 m³ ha⁻¹, A2 rate: 9,380-10,415 m³ ha⁻¹. The irrigation rate will increase the most in states that already have dry climates and large irrigation rates, posing a challenge for water supply systems in these states. Accounting for both the increase in irrigated area and irrigation rate, total withdrawals might increase by 47.7-283.4 billion m³ (B1 withdrawal: 47.7-106.0 billion m³, A2 withdrawal: 117.4-283.4 billion m³. Increases in irrigation water-use efficiency, particularly by reducing the prevalence of surface irrigation, could eliminate the

  6. 浆细胞性乳腺炎再次手术原因分析及治疗研究%Analysis on Reason of Plasma Cell Mastitis Reoperation and Study on the Treatment

    Institute of Scientific and Technical Information of China (English)

    杨浩鑫

    2016-01-01

    目的:探讨浆细胞性乳腺炎需要再次手术的原因、手术时机的选择以及相应的手术方法。方法选择2010年12月至2012年12月北京市怀柔区中医医院收治的26例复发性浆细胞性乳腺炎患者作为研究对象,对其复发原因,治疗时机选择以及治疗方法进行分析。结果26例患者中有14例患者(53.84%)因乳房脓肿而需多次切开引流手术、6例患者(23.08%)因肿块切除后再次出现或不愈合、6例患者(23.08%)术后乳晕部炎症多次发作且面积相对较大而需再次实施手术治疗。对于处于炎症期的患者予以消炎治疗,对于乳房脓肿患者行脓肿切开引流,缩小炎症范围后再予手术治疗。手术治疗时需切除包括溃疡周围1 cm正常的皮肤组织以及病变乳管,术后随访9~50个月均无复发现象。结论浆细胞性乳腺炎再次复发的原因主要与临床医师对本病认识不够、处理方法不当等有关,再次手术治疗时应把握手术时机,完全切除病变组织,并对受累的乳管进行处理,以有效地降低再次手术的风险,防止再次复发。%Objective To investigate the reasons of plasma cell mastitis reoperation,operation timing selection and operation methods.Methods Total of 26 recurrent plasma cell mastitis patients in Huairou District Chinese Medicine Hospital of Beijing from Dec.2010 to Dec.2012 were selected,and the relapse rea-son,treatment timing and methods of treatment were analyzed.Results Among the 26 patients,14 patients (53.84%) were due to breast abscess requiring multiple incision and drainage,6 patients(23.08%) were due to lump reappearance or disunion,6 patients(23.08%) were due to multiple episodes of areola papil-laris inflammation with relatively large area involved needing surgery treatment .For the patients in inflamma-tory phase anti-inflammatory treatment was given first,galactapostema was given incision and drainage

  7. Wii, Kinect, and Move. Heart Rate, Oxygen Consumption, Energy Expenditure, and Ventilation due to Different Physically Active Video Game Systems in College Students.

    Science.gov (United States)

    Scheer, Krista S; Siebrant, Sarah M; Brown, Gregory A; Shaw, Brandon S; Shaw, Ina

    Nintendo Wii, Sony Playstation Move, and Microsoft XBOX Kinect are home video gaming systems that involve player movement to control on-screen game play. Numerous investigations have demonstrated that playing Wii is moderate physical activity at best, but Move and Kinect have not been as thoroughly investigated. The purpose of this study was to compare heart rate, oxygen consumption, and ventilation while playing the games Wii Boxing, Kinect Boxing, and Move Gladiatorial Combat. Heart rate, oxygen consumption, and ventilation were measured at rest and during a graded exercise test in 10 males and 9 females (19.8 ± 0.33 y, 175.4 ± 2.0 cm, 80.2 ± 7.7 kg,). On another day, in a randomized order, the participants played Wii Boxing, Kinect Boxing, and Move Gladiatorial Combat while heart rate, ventilation, and oxygen consumption were measured. There were no differences in heart rate (116.0 ± 18.3 vs. 119.3 ± 17.6 vs. 120.1 ± 17.6 beats/min), oxygen consumption (9.2 ± 3.0 vs. 10.6 ± 2.4 vs. 9.6 ± 2.4 ml/kg/min), or minute ventilation (18.9 ± 5.7 vs. 20.8 ± 8.0 vs. 19.7 ± 6.4 L/min) when playing Wii boxing, Kinect boxing, or Move Gladiatorial Combat (respectively). Playing Nintendo Wii Boxing, XBOX Kinect Boxing, and Sony PlayStation Move Gladiatorial Combat all increase heart rate, oxygen consumption, and ventilation above resting levels but there were no significant differences between gaming systems. Overall, playing a "physically active" home video game system does not meet the minimal threshold for moderate intensity physical activity, regardless of gaming system.

  8. The Reasons of Reoperation and Prevention in Congenital Choledochal Cyst%先天性胆总管囊肿再手术原因及预防

    Institute of Scientific and Technical Information of China (English)

    吴学东; 胡廷泽; 林春榕

    2001-01-01

    目的:分析先天性胆总管囊肿术后再手术原因及其预防措施。方法:对我院 1981年到 1999年收治的 112例先天性胆总管囊肿中再手术病例进行回顾性分析。结果: 112例中再手术 11例。早期再手术 4例,为胆总管囊肿切除、胆道重建术后 2~ 4d发生切口裂开、吻合口瘘、辅助外引流不畅等。远期因吻合口狭窄和盲袢综合征再手术各 1例,单纯囊肿引流术后返流性胆道感染再手术 5例 (其中 4例行胆总管囊肿切除、胆肠 Roux- Y吻合术,另 1例因胆总管穿孔引流术后腹腔广泛粘连作了囊肿空肠 Roux- Y式吻合术 ), 5例均于术中胆管空肠袢加做套叠瓣,全部获得治愈。结论:胆肠对等吻合、缝合严密和通畅引流可减少早期再手术;胆道返流、吻合口狭窄和盲袢存在是远期再手术的主要原因。囊肿切除、胆肠 Roux- Y吻合套叠瓣成形术可有效预防术后逆行性胆道感染。%Objective:Analyzed the reasons of reoperation in congenital choledochal cyst(CCC)and the ways of preventing.Method:11 reoperation cases were retrospective reviewed in 112 CCC patients in WCUMS from 1981 to 1999.Results:11 cases in 112 CCC patients underwent reoperation early and later after the first surgical procedure.4 children received reoperation 2- 4 days after cyst resection with a Roux- Y hepato je junostomy caused by the open of incition,anastomotic leakage and accessory drainage obstruction.7 cases underwent reoperation later after initiated operation (2 cases received anastomotic reconstruction and blindloop resection respectively after the cyst resection with a Roux- Y hepato je junostomy and 4 cases of another 5 underwent cyst resection with Roux- Y hepato je junostomy after cystoenterostomy;1 with Roux- Y cysto je junostomy after choledochostomy caused by choledoch perforation because of general adhering in abdomen)because of ascending cholangitis、 stoma

  9. Uncertainty propagation in a stratospheric model. I - Development of a concise stratospheric model. II - Monte Carlo analysis of imprecisions due to reaction rates. [for ozone depletion prediction

    Science.gov (United States)

    Rundel, R. D.; Butler, D. M.; Stolarski, R. S.

    1978-01-01

    The paper discusses the development of a concise stratospheric model which uses iteration to obtain coupling between interacting species. The one-dimensional, steady-state, diurnally-averaged model generates diffusion equations with appropriate sources and sinks for species odd oxygen, H2O, H2, CO, N2O, odd nitrogen, CH4, CH3Cl, CCl4, CF2Cl2, CFCl3, and odd chlorine. The model evaluates steady-state perturbations caused by injections of chlorine and NO(x) and may be used to predict ozone depletion. The model is used in a Monte Carlo study of the propagation of reaction-rate imprecisions by calculating an ozone perturbation caused by the addition of chlorine. Since the model is sensitive to only 10 of the more than 50 reaction rates considered, only about 1000 Monte Carlo cases are required to span the space of possible results.

  10. Shifts in the climate space of temperate cyprinid fishes due to climate change are coupled with altered body sizes and growth rates.

    Science.gov (United States)

    Ruiz-Navarro, Ana; Gillingham, Phillipa K; Britton, J Robert

    2016-09-01

    Predictions of species responses to climate change often focus on distribution shifts, although responses can also include shifts in body sizes and population demographics. Here, shifts in the distributional ranges ('climate space'), body sizes (as maximum theoretical body sizes, L∞) and growth rates (as rate at which L∞ is reached, K) were predicted for five fishes of the Cyprinidae family in a temperate region over eight climate change projections. Great Britain was the model area, and the model species were Rutilus rutilus, Leuciscus leuciscus, Squalius cephalus, Gobio gobio and Abramis brama. Ensemble models predicted that the species' climate spaces would shift in all modelled projections, with the most drastic changes occurring under high emissions; all range centroids shifted in a north-westerly direction. Predicted climate space expanded for R. rutilus and A. brama, contracted for S. cephalus, and for L. leuciscus and G. gobio, expanded under low-emission scenarios but contracted under high emissions, suggesting the presence of some climate-distribution thresholds. For R. rutilus, A. brama, S. cephalus and G. gobio, shifts in their climate space were coupled with predicted shifts to significantly smaller maximum body sizes and/or faster growth rates, aligning strongly to aspects of temperature-body size theory. These predicted shifts in L∞ and K had considerable consequences for size-at-age per species, suggesting substantial alterations in population age structures and abundances. Thus, when predicting climate change outcomes for species, outputs that couple shifts in climate space with altered body sizes and growth rates provide considerable insights into the population and community consequences, especially for species that cannot easily track their thermal niches.

  11. A novel index based on fractional calculus to assess the dynamics of heart rate variability: changes due to chi or yoga meditations

    OpenAIRE

    García González, Miguel Ángel; Ramos Castro, Juan José; Fernández Chimeno, Mireya

    2012-01-01

    The study aims to present and interpret a novel index based on fractional calculus ( αc) and to assess differences in RR time series dynamics in subjects during meditation. Fractional differintegration (FDI) of a RR time series provides a new time series.αc is defined as the order of the FDI operator that provides the time series with minimum variance. Analyzed time series were obtained from the Exaggerated Heart Rate Oscillations During Two Meditation Techniques database. This da...

  12. Blacks' Death Rate Due to Circulatory Diseases Is Positively Related to Whites' Explicit Racial Bias: A Nationwide Investigation Using Project Implicit

    OpenAIRE

    2016-01-01

    Perceptions of racial bias have been linked to poorer circulatory health among Blacks compared with Whites. However, little is known about whether Whites' actual racial bias contributes to this racial disparity in health. We compiled racial-bias data from 1,391,632 Whites and examined whether racial bias in a given county predicted Black-White disparities in circulatory-disease risk (access to health care, diagnosis of a circulatory disease; Study 1) and circulatory-disease-related death rate...

  13. Absorbed Dose Rate Due to Intake of Natural Radionuclides by Tilapia Fish (Tilapia nilotica,Linnaeus, 1758) Estimated Near Uranium Mining at Caetité, Bahia, Brazil

    Science.gov (United States)

    Pereira, Wagner de S.; Kelecom, Alphonse; Py Júnior, Delcy de Azevedo

    2008-08-01

    The uranium mining at Caetité (Uranium Concentrate Unit—URA) is in its operational phase. Aiming to estimate the radiological environmental impact of the URA, a monitoring program is underway. In order to preserve the biota of the deleterious effects from radiation and to act in a pro-active way as expected from a licensing body, the present work aims to use an environmental protection methodology based on the calculation of absorbed dose rate in biota. Thus, selected target organism was the Tilapia fish (Tilapia nilotica, Linnaeus, 1758) and the radionuclides were: uranium (U-238), thorium (Th-232), radium (Ra-226 and Ra-228) and lead (Pb-210). As, in Brazil there are no radiation exposure limits adopted for biota the value proposed by the Department of Energy (DOE) of the United States of 3.5×103 μGy y-1 has been used. The derived absorbed dose rate calculated for Tilapia was 2.51×100 μGy y-1, that is less than 0.1% of the dose limit established by DOE. The critical radionuclide was Ra-226, with 56% of the absorbed dose rate, followed by U-238 with 34% and Th-232 with 9%. This value of 0.1% of the limit allows to state that, in the operational conditions analyzed, natural radionuclides do not represent a radiological problem to biota.

  14. Absorbed dose rate due to intake of natural radionuclides by Tilapia fish (Tilapia nilotica, Linnaeus, 1758) estimated near uranium anomaly at Santa Quiteria, Ceara, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Wagner de [Industrias Nucleares do Brasil S.A. (INB), Pocos de Caldas, MG (Brazil). Coordenacao de Protecao Radiologica. Unidade de Tratamento de Minerios], E-mail: wspereira@inb.gov.br; Kelecom, Alphonse [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Programa de Pos-graduacao em Ciencia Ambiental; Py Junior, Delcy de Azevedo [Industrias Nucleares do Brasil S.A. (INB), Caetite, BA (Brazil). Coordenacao de Protecao Radiologica. Unidade de Concentrado de Uranio], E-mail: Delcy@inb.gov.br

    2007-07-01

    The uranium mining at Santa Quiteria (Santa Quiteria Unit - USQ) is in its environmental licensing phase. Aiming to estimate the radiological environmental impact of the USQ, a monitoring program is underway. However, radioprotection of biota is not explicitly mentioned in Brazilian norms. In order to preserve the biota of the deleterious effects from radiation and to behave in a pro-active way as expected by licensing organs, the present work aims to use an environmental protection methodology, based on the calculation of absorbed dose rate in biota. Thus, selected biomarker was the fish tilapia (Tilapia nilotica, Linnaeus, 1758) and the radionuclides were: uranium (U-238), thorium (Th-232), radium (Ra-226 and Ra-228) and lead (Pb-210). Since there are no exposition limits for biota, in Brazil, the value proposed by the Department of Energy (DOE) of the United States of 3.5 x 10{sup 3} {mu}Gy/y has been used. The derived absorbed dose rate calculated for tilapia was 2.76 x 10{sup 0} {mu}Gy/y, that is less than 0.1 % of the limit established by DOE. The critical radionuclide was U-238, with 99% of the absorbed dose rate. This value of 0.1% of the limit allows to state that in pre-operational conditions analyzed natural radionuclides do not represent a radiological problem to the biota. (author)

  15. Dizziness due to intravestibular protrusion of prosthesis after stapedectomy

    Directory of Open Access Journals (Sweden)

    Suheil Artul

    2014-10-01

    Full Text Available We present a case of 37 year-old female with severe dizziness for the past six months whose past medical history revealed stapedectomy due to otosclerosis two years prior to visiting our hospital. Coronal high resolution computed tomography reconstruction showed the protrusion of a metallic device “peosthesis”, which had been used to replace the stape bone, to the vestibule of inner ear. The patient was re-operated for revision and replacing the prosthesis with good clinical outcome. 

  16. Circadian rhythm of heart rate in the rabbit: prolongation of action potential duration by sustained beta adrenoceptor blockade is not due to associated bradycardia.

    Science.gov (United States)

    Vaughan Williams, E M; Dennis, P D; Garnham, C

    1986-07-01

    Six litters of six young rabbits were injected intraperitoneally, two per litter, with saline, alinidine, or nadolol once or twice daily for two weeks. In four litters successful radiotransmissions of electrocardiograms were recorded once hourly for four days before and during treatment. Alinidine and nadolol produced an overall mean bradycardia in comparison with saline treated animals, the effect of alinidine exceeding that of nadolol. At 48-70 hours after the end of treatment the hearts were used for in vitro electrophysiological study. Nadolol, but not alinidine, induced a prolongation of action potential duration compared with that of saline treated littermates in both atrial and ventricular muscle. An incidental observation was that heart rate in the rabbit followed a circadian rhythm, heart rates being slower in the morning and faster in late afternoon and evening. The circadian rhythm was attenuated but not abolished by alinidine and nadolol. These results suggest that if prolongation of action potential duration by sustained beta blockade in patients after myocardial infarction contributes to protection against sudden death (by a class III antiarrhythmic action) then alinidine would not be expected to provide a comparable prophylaxis.

  17. Growth Rate of and Gene Expression in Bradyrhizobium diazoefficiens USDA110 due to a Mutation in blr7984, a TetR Family Transcriptional Regulator Gene.

    Science.gov (United States)

    Ohkama-Ohtsu, Naoko; Honma, Haruna; Nakagome, Mariko; Nagata, Maki; Yamaya-Ito, Hiroko; Sano, Yoshiaki; Hiraoka, Norina; Ikemi, Takaaki; Suzuki, Akihiro; Okazaki, Shin; Minamisawa, Kiwamu; Yokoyama, Tadashi

    2016-09-29

    Previous transcriptome analyses have suggested that a gene cluster including a transcriptional regulator (blr7984) of the tetracycline repressor family was markedly down-regulated in symbiosis. Since blr7984 is annotated to be the transcriptional repressor, we hypothesized that it is involved in the repression of genes in the genomic cluster including blr7984 in symbiotic bacteroids. In order to examine the function and involvement of the blr7984 gene in differentiation into bacteroids, we compared the free-living growth/symbiotic phenotype and gene expression between a blr7984-knockout mutant and the wild-type strain of Bradyrhizobium diazoefficiens USDA110. The mutant transiently increased the cell growth rate under free-living conditions and nodule numbers over those with the wild-type strain USDA110. The expression of three genes adjacent to the disrupted blr7984 gene was strongly up-regulated in the mutant in free-living and symbiotic cells. The mutant also induced the expression of genes for glutathione S-transferase, cytochrome c oxidases, ABC transporters, PTS sugar transport systems, and flagella synthesis under free-living conditions. bll7983 encoding glutathione S-transferase was up-regulated the most by the blr7984 disruption. Since redox regulation by glutathione is known to be involved in cell division in prokaryotes and eukaryotes, the strong expression of glutathione S-transferase encoded by the bll7983 gene may have caused redox changes in mutant cells, which resulted in higher rates of cell division.

  18. Dose rate measurement due to activation of the head of a linear accelerator used in radiotherapy; Medida de tasa de dosis debido a la activacion del cabezal de un acelerador lineal utilizado en radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Ruiz-Zorrilla, J.; Minambres Moro, A.; Fernandez Leton, P.; Martinez Gomez, L. C.; Gillaranz Moreno, R.; Castro Novais, J.; Zucca Aparicio, D.; Perez Moreno, J. M.

    2011-07-01

    Electron accelerators which produce photon energies greater than 8 MV dose rates can present after irradiation due to the emission of neutrons and consequent formation of products of activation, the aim of this study is to measure the variation in the rate of dose over time produced by an accelerator of 25 MV and try to locate any of the isotopes produced and conservatively estimate the dose received by workers.

  19. 二尖瓣再次手术患者临床特征分析%Clinical Analysis on the Characteristic Underwent Mitral Valve Reoperation

    Institute of Scientific and Technical Information of China (English)

    周维正; 颜涛; 邹良建

    2011-01-01

    Objective:To study the risk factors and treatment methods of the re-valve surgery after mitral valve operation.Methods: From January 2006 to December 2009, a total of 28 patients underwent the second mitral valve replacement after their first mitral valve repair or replacement surgery. Among the patients who received mitral valve replacement for the first time, 7 patients had perivalvular leakage,6 patients happened the degeneration of the artificial hiovalves, 5 patients were valve stenosis.Among these patients, 4 were complicate with artificial valve endocarditis, with 3 positive of the blood culture,and 1 negative.One patient have infravalve stenosis of the artificial valve was because of thrombogenesis. Ten patients received the mitral valve replacement operation because of the degeneration of mitra valve after valve repair surgery. Results:Two patients were dead after operation, and the fatality rate was 7.14%, both were complicated with artificial valve endocarditis. The follow up was 5 months to 5 years. Two patient had severe atrioventricular block, and both received permanent pacemaker implantation in our hospital. All patients received cardioultrasonogragh, and the results showed the artificial valves worked well, and their cardiac function had been from Ⅰ to Ⅱ degree of the New York Heart Association (NYHA) functional cbassification. Conclusions:The degeneration of mitra valve after valve repair surgery has been gradually become the major cause of reoperation of the mitral valve, to restrict the indication of repair surgery can decrease the risk of reoperation. Prosthetic valve endocarditis is a severe complication with high mortality, we should discover it earlier, treat it earlier, to save enough time for the operation.%目的:探讨二尖瓣手术后再次行瓣膜手术的病因和治疗方式.方法:分析2006年1月-2009年12月28例接受再次二尖瓣置换术患者的临床资料.再次手术的病因:二尖瓣成

  20. Dose variation due to change in planned position for patients with carcinoma of the cervix undergoing high-dose-rate brachytherapy- 2D dose analysis

    Directory of Open Access Journals (Sweden)

    Anil Talluri

    2015-03-01

    Full Text Available Purpose: To assess the dosimetry to organs at risk (OARs in lithotomy position with a planned time-dose pattern obtained from supine position. Methods: The sample consists of thirty patients with carcinoma of the uterine cervix, Stage II and III. Patients often feel discomfort in supine position (S position when compared to lithotomy position (M position due to relaxation of pelvic floor muscles after the insertion of applicator (tandem and ovoids or before delivery of the treatment. Each patient was imaged with orthogonal X- ray radiographs simultaneously in two positions, i.e. S position and M position. Dwell time and dwell position pattern obtained from the optimized plan in S position was used to generate plan in M position. Following dose reference points (point A, pelvic wall points, bladder points, rectal, anorectum (AR point and rectosigmoid (RS point points were identified for analysis in S and M positions. The dosimetric data for reference points generated by the Brachyvision TPS was analyzed.Results: Pelvic wall points registered lower doses in M position when compared to S position. Mean doses for right pelvic wall point (RPW and left pelvic wall point (LPW were reduced by -10.02 % and -11.5% in M position, respectively. International Commission on Radiation Units and Measurements (ICRU bladder point also registered lower doses in M position with a mean dose of -6.8%. Rectal point showed dose reduction by mean of -6.4%. AR and RS points showed an increased dose in M position by a mean of 16.5% and 10%, respectively. Conclusion: Current dosimetry procedure serves as a model with time-dose pattern planned for S position, but delivered in M position, without dose optimization. Prioritization of comfort and position can be considered in conjunction with optimization of dose. 

  1. SAROTA: application of specific absorption rate (SAR) and over-the-air (OTA) data for the characterization of the real-life exposure due to mobile phones

    Science.gov (United States)

    Monebhurrun, Vikass

    2013-04-01

    The RF exposure level of a mobile phone is quantified by the measurement of the specific absorption rate (SAR) under laboratory conditions. The SAR which is measured while the mobile phone is operated at maximum power level does not reflect the real-life exposure scenario since the mobile phone typically re-adjusts its power level and frequency depending on the quality of the communication link with the nearest base station. The choice of a low RF exposure device based on the comparison of the relative SAR values of mobile phones can be misleading. The real-life RF exposure also depends on the over-the-air (OTA) performance of the mobile phone. Taken independently, the two sets of data do not allow a straightforward comparison of the global RF performance amongst mobile phones. A unique and simple parameter denoted as the SAROTA index is proposed for the characterization of mobile phones with regard to both RF exposure and OTA performance. The SAROTA index provides the real-life exposure index of the mobile phone.

  2. 27.3-day and Average 13.6-day Periodic Oscillations in the Earth's Rotation Rate and Atmospheric Pressure Fields Due to Celestial Gravitation Forcing

    Institute of Scientific and Technical Information of China (English)

    LI Guoqing; ZONG Haifeng; ZHANG Qingyun

    2011-01-01

    Variation in length of day of the Earth (LOD equivalent to the Earth's rotation rate) versus change in atmospheric geopotential height fields and astronomical parameters were analyzed for the years 1962-2006.This revealed that there is a 27.3-day and an average 13.6-day periodic oscillation in LOD and atmospheric pressure fields following lunar revolution around the Earth. Accompanying the alternating change in celestial gravitation forcing on the Earth and its atmosphere, the Earth's LOD changes from minimum to maximum,then to minimum. and the atmospheric geopotential height fields in the tropics oscillate from low to high,then to low. The 27.3-day and average 13.6-day periodic atmospheric oscillation in the tropics is proposed to be a type of strong atmospheric tide, excited by celestial gravitation forcing. A formula for a Tidal Index was derived to estimate the strength of the celestial gravitation forcing, and a high degree of correlation was found between the Tidal Index determined by astronomical parameters, LOD, and atmospheric geopotential height. The reason for the atmospheric tide is periodic departure of the lunar orbit from the celestial equator during lunar revolution around the Earth. The alternating asymmetric change in celestial gravitation forcing on the Earth and its atmosphere produces a "modulation" to the change in the Earth's LOD and atmospheric pressure fields.

  3. Being on sick leave due to heart failure: self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work.

    Science.gov (United States)

    Nordgren, Lena; Söderlund, Anne

    2015-01-01

    Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR = 4.1, p work (OR = 3.3, p work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.

  4. Evaluation Of Factors Influencing On Causes Of Prosthetic Valve Re-operation And Early Postoperative Survival Tehran Emam hospital (1991-2001

    Directory of Open Access Journals (Sweden)

    Rahmani Reaza

    2003-06-01

    Full Text Available Prosthetic valve re-operation has greater mortality and morbidity than primary valve replacement. By recognition of factors influencing on causes of redo operation and preoperative survival, one can select appropriate prosthesis at primary valve replacement and when operation performed at appropriate time, surgical risk can be reduced."nMethods and Materials: Two hundred patients that underwent prosthetic valve re-operation from October 1991 through November 2001 were included in this study. There were 68 men and 132 women with the mean age of 42:tl 1.8 years. Structural failure was the commonest cause of bio-prosthesis replacement (93%. Valve thrombosis was the common cause of mechanical valve replacement (32%. Age younger Than 50 (P= 0.01 and interval after the first implantation more than 10 years (P= 0.01 affected bio-prosthesis degeneration."nResults: Atrial fibrillation (P<0.01, Older age especially more than 40 (P<0.05 and mitral position (P<0.01 affected mechanical valve thrombosis. Cross clamp time (P= 0.005, Tricuspid insufficiency (P = 0.001, NYHA IV (P = 0.005 and emergent operation (P= 0.001 were independent determinants of hospital mortality."nConclusion: In conclusion, in patients with more than 10-years life expectancy and age younger than 50, mechanical valve can be selected for primary valve replacement. If operation performed before patients reach deteriorated condition, preoperative survival would be excellent.

  5. 食管癌二次手术19例原因分析%Analysis of 19 cases undergoing reoperation for complications following esophagectomy

    Institute of Scientific and Technical Information of China (English)

    杨永波; 闫万璞; 熊宏超; 梁震; 戴亮; 康晓征; 杨合利; 陈克能

    2014-01-01

    Objective To investigate the cause and the management of treatment and prevention of reoperation following esophagectomy. Methods Clinical data of 946 cases with esophageal cancer undergoing esophagectomy from January 2000 to December 2012 by the same surgical team in the Beijing Cancer Hospital were retrospectively analyzed. Among them , 19 patients underwent reoperation after esophagectomy because of serious complications. Clinical features and treatment course of these 19 cases were summarized. Results The indications and procedures of reoperation included thoracotomy for hemorrhage (n=4), diaphragmatic hernia repair (n=4), thoracic duct ligation for chylothorax (n= 4), re-suturing for incision dehiscence (n=4), re-laparotomy and re-thoracotomy for drainage of traumatic pancreatitis (n=1), re-laparotomy for intestinal obstruction (n=1), and tracheotomy for bilateral recurrent laryngeal nerve paralysis(n=1). All the 19 patients were successfully cured without perioperative deaths and further complications. Conclusions The indications of reoperation following esophagectomy include postoperative bleeding, diaphragmatic hernia, chylothorax and abdominal incision dehiscence.%目的:探讨食管癌行二次手术的原因及防治措施。方法回顾性分析2000年1月至2012年12月间北京大学肿瘤医院单一手术组施行的946例食管癌手术患者的临床资料,其中19例因术后严重并发症需行二次手术,总结该19例患者的临床特点及治疗经过。结果19例二次手术的患者中因术后胸腔内出血行开胸止血术4例,因膈疝行膈疝还纳、膈肌修补术4例,因乳糜胸行胸导管结扎术4例,因腹部切口裂开行切口缝合术4例,因创伤性胰腺炎行胸腹腔探查、腹腔置管引流术1例,因肠梗阻行回盲部切除、回肠造瘘术1例,因双侧喉返神经麻痹行气管切开术1例。19例二次手术患者全部治愈,无围手术期死亡和再次并发症发生。结论

  6. Economic Effects of Reservoir Re-operation Policy in the Rio Grande/Bravo for Sustainable Human and Environmental Water Management

    Science.gov (United States)

    Ortiz Partida, J. P.; Sandoval Solis, S.; Lane, B.

    2015-12-01

    A central challenge of integrated water management is the design and implementation of policies to allocate water to both humans and the environment in a sustainable manner. This study uses the results from a reach-scale water-planning model to quantify and compare the economic benefits of two water management policies: (1) a business as usual (Baseline) policy and (2) a proposed reservoir re-operation policy to provide environmental flows (EFs). Results show that the EF policy would increase water supply profit, slightly decrease recreational activities profit, and reduce costs from flood damage and environmental restoration compared to the Baseline policy. In addition to supporting ecological objectives, the proposed EF policy would increase the economic benefits of water management objectives.

  7. Pre-treatment ferritin level and alveolar-arterial oxygen gradient can predict mortality rate due to acute/subacute interstitial pneumonia in dermatomyositis treated by cyclosporine a/glucocorticosteroid combination therapy: a case control study [corrected].

    Directory of Open Access Journals (Sweden)

    Kentaro Isoda

    Full Text Available BACKGROUND: Acute/subacute interstitial pneumonia in dermatomyositis (DM-A/SIP is a disease associated with a poor prognosis that resists treatment with glucocorticosteroids (GC and progresses rapidly in a period of weeks to months to death. We retrospectively studied outcomes, prognostic factors, and their relations with survival rate in patients with DM-A/SIP treated with early cyclosporine A (CSA/GC combination therapy and 2-hour postdose blood concentration monitoring. METHODS: This study comprised 32 DM-A/SIP patients who were simultaneously treated with CSA and prednisolone. Clinical and laboratory findings were compared between those who died due to DM-A/SIP and those surviving 24 weeks after beginning of therapy. Prognostic factors were extracted, and their relations with the survival rate were evaluated. RESULTS: Of the 32 DM-A/SIP patients, 25 survived, 5 died of DM-A/SIP, and 2 died of infections. In those who died due to DM-A/SIP, ferritin level and the alveolar-arterial oxygen gradient were significantly increased compared with the survivors (P<0.001 and P = 0.002, respectively. Multivariate analyses showed that ferritin and alveolar-arterial oxygen gradient were independent prognostic factors of poor outcome. The survival rate 24 weeks after beginning of treatment was significantly lower in those with a ferritin level of ≥ 600 ng/ml and alveolar-arterial oxygen gradient of ≥ 45 Torr (P<0.001 and P<0.001, respectively. All patients with both prognostic factors died, and the outcome was significantly poorer in these patients than in those with one or neither of the prognostic factors (P<0.001. CONCLUSIONS: We identified pre-treatment high serum ferritin level and high alveolar-arterial oxygen gradient as poor prognostic factors in DM-A/SIP patients undergoing early CSA/GC combination therapy and showed that the outcomes were poor in patients with both factors.

  8. Re-operation of tricuspid regurgitation after mitral valve replacement with rheumatic heart disease%风湿性心脏病二尖瓣置换术后三尖瓣返流的再手术治疗

    Institute of Scientific and Technical Information of China (English)

    罗又桥; 方海宁; 谭伟; 李树松; 曹辉庆; 赖纪昌

    2014-01-01

    Objective To analyze clinical manifestation and investigate therapy effect of re-operation of tricuspid regurgitation (TR) after mitral valve replacement with rheumatic heart disease.Methods Seventeen cases with rheumatic heart disease recurred TR after mitral valve replacement surgery,underwent tricuspid valve surgery again in the Third People's Hospital of Nanchang from January 2000 to December 2011.Of 17 cases,10cases underwent tricuspid valve annuloplasty including 1 case for pure De Vega plasty,9 cases for the valve leaflets forming + artificial valve ring forming.Another 7 cases underwent tricuspid valve replacement surgery including 4 cases for biological valve replacement and 3 cases for mechanical valve.Retrospective analyzed the clinical manifestations,treatment process and condition of prognosis.Results One case was with early postoperative deaths (5.88%,1717),and died of postoperative left ventricular failure.Three cases were postoperative low cardiac output syndrome,2 cases were renal insufficiency,and 2 cases were respiratory insufficiency,all those cases were successfully cured.Sixteen cases were followed up from 3 months to 9 years and 2 cases were lost.Of 14,2 cases were NYHA class Ⅰ,8 cases for grade Ⅱ,4 cases for grade Ⅲ.Conclusion After mitral valve replacement in patients with rheumatic heart disease,TR in patients with reoperation is a suitable choice.Reasonable surgical indications,timing of surgery and good perioperative management are the keys to improve the success rate of surgery.%目的 分析风湿性心脏病二尖瓣置换术后再发三尖瓣返流(TR)患者的临床特点、外科手术方法和疗效,总结围手术期处理经验.方法 2000年1月至2011年12月,17例风湿性心脏病二尖瓣置换术后再发三尖瓣返流的患者在我院接受单纯再次三尖瓣手术,行三尖瓣成形术10例,包括单纯DeVega成形术1例、瓣叶成形+人工瓣环成形9例;行三尖瓣置换术7例,其中置换生物瓣4

  9. Do perceived job insecurity and annoyance due to air and noise pollution predict incident self-rated poor health? A prospective analysis of independent and joint associations using a German national representative cohort study

    Science.gov (United States)

    Riedel, Natalie; Loerbroks, Adrian; Bolte, Gabriele; Li, Jian

    2017-01-01

    Background Current economic and social change has contributed to increasing job insecurity and traffic-related pollution in residential areas. Both job insecurity and exposure to noise and air pollution are known determinants of population health and can concur in peoples' lives. This may hold true particularly for socially disadvantaged subpopulations. Nevertheless, the potential independent and joint links of those exposures to health have been rarely examined so far. We aimed to contribute to the scarce body of evidence. Methods Information on perceived job insecurity and exposures to noise and air pollution as expressed by annoyance as well as on self-rated health were gathered from 2 waves of the population-based German Socio-Economic Panel (2009 and 2011, N=6544). We performed multivariable Poisson regression to examine the independent and joint risk of poor health in 2011 by perceived job insecurity and annoyance due to noise and air pollution in 2009. Results After the 2-year follow-up in 2011, 571 (8.7%) participants rated their health as poor. The risk of reporting incident poor health was increased by roughly 40% in employees reporting high versus low perceived job insecurity and annoyance due to noise and air pollution, respectively. This risk increased when both exposures were present at higher levels (risk ratio=1.95 (1.49 to 2.55)). Conclusions Work-related and environmental exposures may accumulate and have a joint health impact. Elaboration on the link between occupational and residential exposures is warranted in the light of their concurrence and their implications for health inequities. PMID:28115332

  10. Influence of heat transfer on walls due to aerosol decomposition rate in the containment building of nuclear power plants during heavy incidents; Einfluss des Waermeuebergangs an Waenden auf die Aerosolabbaurate im Sicherheitsbehaelter von Kernkraftwerken bei schweren Stoerfaellen

    Energy Technology Data Exchange (ETDEWEB)

    Braun, T.

    2004-07-01

    Today, German nuclear power plants are leading in safety standards worldwide. Increasing potentials arise continuously along with improvements in technology. One of these potentials is the best-estimate simulation of fission product transport in case of a severe accident. A main part of the fission products is allocated on aerosols. Therefore, the aerosol behavior before containment leakage is important for the radioactive source term to the environment. Having a good knowledge about the main aerosol phenomena, it is possible to simulate them numerically. This enables to develop and test safety measures to limit damages before accidents occur. Within this study, the main aerosol phenomena have been ascertained and accordingly classified into formation, transport and reduction. On this basis, simulations of one- and multi-component aerosol experiments of the KAEVER series have been performed with the COCOSYS code. Due to an overprediction of the computed volume condensation rate, the results showed an overestimation of the reduction rate of insoluble aerosols. The reason was found to be the underestimation of the wall condensation rate. Based on an additional plain thermal hydraulic multi compartment experiment, these uncertainties in the wall heat transfer correlations were investigated in detail. The results show a strong dependency between the wall condensation rate and the convective heat transfer, resp. the characteristic length. In case of mainly forced convection, correct values for the characteristic length led to an underestimation of the calculated heat transfer coefficients. The analysis of the heat transfer models show an inconsistency in the coupling of free and forced convection. Therefore, an improved and consistent convection model has been developed and implemented. Both models have been tested on different experiments. Although the new model shows only minor improvements, it could be proven that the influence for forced convection is significant

  11. Does Preputial Reconstruction Increase Complication Rate Of Hypospadias Repair? 20-Year Systematic Review And Meta-analysis

    Directory of Open Access Journals (Sweden)

    Marco eCastagnetti

    2016-04-01

    Full Text Available Introduction: We performed a systematic review of the literature on preputial reconstruction (PR during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely fistula formation and overall reoperation rate of the repair.Material and Methods: A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword hypospadias. Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected. A meta-analysis of studies comparing PR vs. circumcision was performed for the outcomes hypospadias fistula formation and reoperation rate.Results: Twenty studies were identified. Nineteen reported the outcome of PR in 2115 patients. Overall, 95% (2016/2115 of patients undergoing PR had distal hypospadias. The cumulative rate of PR complications was 7.7% (163/2115 patients, including 5.7% (121/2115 patients preputial dehiscences and 1.5% (35/2117 reported patients secondary phimoses needing circumcision. A meta-analysis of 7 studies comparing patients undergoing PR vs. circumcision, showed no increased risk of urethral fistula formation associated with PR, Odds Ratio (Mantel-Haenszel, Fixed effect, 95% CI, 1.25 (0.80-1.97. Likewise, two studies comparing the overall reoperation rate did not show an increased risk of reoperation associated with PR, Odds Ratio (Mantel-Haenszel, Random effect, 95% CI, 1.27 (0.45-3.58. Conclusions: Preputial reconstruction carries an 8% risk of specific complications (dehiscence of reconstructed prepuce or secondary phimosis needing circumcision, but does not seem to increase the risk of urethroplasty complications, and the overall reoperation rate of hypospadias repair.

  12. Violência e desigualdade social: mortalidade por homicídios e condições de vida em Salvador, Brasil Violence and social inequalities: mortality rates due to homicides and life conditions in Salvador, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana C Macedo

    2001-12-01

    used to define a four-category variable related to living conditions. Mortality rates due to homicide and the relative risk regarding the lowest living condition area were calculated for each social stratum. The 95% confidence intervals were calculated using the Confidence Interval Analysis software. RESULTS: The highest mortality rates due to homicide were seen in the poorest areas. The relative risk due to homicide for the lowest and the highest living condition areas was statistically significant at 5% level and ranged from 2.9 to 5.1. CONCLUSIONS: The data show a strong association between social inequalities and homicide in this urban area, emphasizing the importance of crime reduction programs.

  13. Can a Resonant Quantum-Well State be Used as the initial and/or Final State of a Golden-Rule Calculation for a Transition Rate due to Photon or Phonon Emission or Absorption?

    Science.gov (United States)

    Hu, Chia-Ren

    1997-03-01

    According to conventional wisdom, the answer would be `no'. A resonant quantum-well state is an eigen-state with a complex eigen-energy (imaginary part negative), due to tunneling through a potential barrier into a reservoir. Such a state is obtained by demanding that only an `out-going' wave (i.e., away from the tunneling barrier) exists in the reservoir. Its wave function cannot be normalized. Therefore, it cannot be used in the way stated in the title. We have investigated a way to change the answer to `yes', so far with partial success. (I.e., `yes', but with some undesirable features.) An idea to improve it is currently being explored, and will be reported at the meeting. Our main trick is to introduce a suitable optical potential in the reservoir, in order to make the resonant state normalizable, and yet with a complex energy very close to the original value. The Fermi golden rule is then generalized, in order to accommodate a non-hermitian Hamiltonian. Other non-resonant reservoir states should make negligible contributions to the transition rate, if this trick is to work.

  14. 复发性上颌窦内翻性乳头状瘤二次手术探讨%Reoperation for recurrent inverting papilloma in maxillary sinus

    Institute of Scientific and Technical Information of China (English)

    梁敏志; 杨东辉; 夏广生; 谭向杲

    2014-01-01

    目的:探讨复发性上颌窦内翻性乳头状瘤二次手术治疗策略。方法回顾性分析32例复发性上颌窦内翻性乳头状瘤的临床资料,包括复发并恶变7例。鼻内镜下手术28例,泪前隐窝入路9例,上颌窦内侧壁切除入路13例,扩大上颌窦内侧壁切除入路6例,上颌骨切除术4例。总结疗效,分析其手术治疗策略。结果术后随访13~39个月,治愈29例;复发3例,其中2例经再次手术治愈;死亡1例。结论对于本病,应根据病变侵犯范围合理选择二次手术的手术入路及手术范围,以彻底切除病灶。内镜下多种手术入路可达切除肿瘤目的,可以避免鼻外辅助切口。%Objective TTo explore the therapeutic strategy with reoperation on cases with recurrent inverting papilloma in maxillary sinus.Methods A retrospective study was carried out among 32 cases with recurrent inverting papilloma in maxillary sinus, including 7 of relapse accompanied simultaneously with the lesion malignantly transformed, with their clinical data carefully analyzed. All these cases were given surgical treatment again, with 28 cases operated on under nasal endoscope, 9 undergoing the approach via anterior lacrimal recess, 13 via the approach of paries medialis maxillaries resection, 6 via that of enlarged paries medialis maxillaries resection, and 4 via maxillectomy.Results By the end of following up period lasted for 13 to 39 months, 29 cases were cured, and 3 cases with lesion reoccurred once more, among whom 2 were cured via surgery again and 1 died.Conclusions It should be important that to carrying out reoperation for cases with recurrent inverting papilloma in maxillary sinus via a reasonable choice of surgical approach based on the invaded extension of lesion in order to achieve the aim of complete resection of involved tissues. A variety of surgical approach under nasal endoscope can achieve the purpose of tumor resection, with the advantage

  15. Significance of Size of Persistent/Recurrent Central Nodal Disease on Surgical Morbidity and Response to Therapy in Reoperative Neck Dissection for Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Lang, Brian Hung-Hin; Shek, Tony W H; Chan, Angel On-Kei; Lo, Chung-Yau; Wan, Koon Yat

    2017-01-01

    To balance the risk of disease progression, morbidity, and efficacy of reoperative central neck dissection (RCND) in papillary thyroid carcinoma, the latest clinical guidelines recommend early surgery over surveillance when the largest diseased node is >8 mm in its smallest dimension. However, the evidence remains scarce. To determine an appropriate size for first-time RCND, the relationship between size of largest diseased central node, morbidity, and response-to-therapy following RCND was examined. A total of 130 patients who underwent RCND following initial surgery for persistent/recurrent nodal disease were reviewed. Patients with largest diseased central node measured preoperatively by ultrasonography were included. Eligible patients were categorized into three groups: largest central node 15 mm (group III). Surgical morbidity and response to therapy at one year after RCND were compared between groups. To evaluate biochemical response, patients with structural incompleteness were excluded. Group III not only had significantly more high-risk tumors (by American Thyroid Association risk stratification) at initial therapy (64.5% vs. 44.4%, respectively; p = 0.038), but this group also a higher risk of extranodal extension (35.5% vs. 16.0%; p = 0.055), recurrent laryngeal nerve involvement (19.4% vs. 0.0%; p 15 mm in the largest disease central node was an independent risk factor for incomplete biochemical response, while nodal size 10-15 mm was not. These findings imply that the recommended threshold of 8 mm might be too stringent and could be raised to 15 mm without increasing the surgical morbidity from RCND.

  16. 北京市某医院79例非计划再手术原因与改进措施%Causes and improvement measures for 79 cases of unplanned reoperation in a hospital in Beijing City

    Institute of Scientific and Technical Information of China (English)

    于瑾; 王东; 宋景晨; 马谢民

    2016-01-01

    目的:对北京市某三级甲等综合性医院2015年79例非计划再手术病例进行回顾性分析,探讨非计划再手术发生的原因,并提出防范措施,以指导医疗流程的改进。方法对筛选出的非计划再手术病例采用根因分析法分析手术病历信息。结果患者管理失误、患者合并症,以及手术技术错误,如手术后出血、未达预期效果手术再调整、手术损伤、吻合口瘘、切口问题是导致非计划再手术发生的根本原因。结论通过完善管理制度、加强围手术期管理、提高医务人员临床技能水平,可持续改进医疗服务质量,减少非计划再手术的发生。%Objective The paper conducts retrospective analysis on the 79 cases of unplanned reoperation in a Grade-A Class-3 hospital in Beijing during 2015, discusses the causes of unplanned reoperation, and brings forward precautionary measures in order to guide the improvement of medical process.Method For the cases of unplanned reoperation screened out, root cause analysis is adopted to analyze the medical record of operation of these cases.ResultThe root causes of unplanned reoperation include errors in perioperative management of patients, patient’s comorbidity, and errors in surgical technique, such as postoperative hemorrhage, readjustment through operation in case of the failure to reach the expected effect, operation injury, anastomotic leakage, and incision problem.Conclusion The medical service quality can be continuously improved and the occurrence of unplanned reoperation reduced by completing management system, enhancing the management during perioperative period, and improving the clinical skills of medical personnel.

  17. 腹部术后早期肠梗阻再手术治疗21例分析%Reasons for Reoperation in 21 Cases of Early Postoperative Intestinal Obstruction

    Institute of Scientific and Technical Information of China (English)

    汪雷; 刘弋

    2011-01-01

    目的 探讨腹部术后早期肠梗阻的因为,总结再手术的经验.方法 回顾分析2005年1月2010年6月21例腹部术后早期肠梗阻再手术患者的临床资料.结果 21例术后早期肠梗阻出现时间为术后4~11 d,经再手术明确梗阻因为,术中证实粘连性肠梗阻12例,漏诊消化系统肿瘤3例,漏诊直肠癌1例,陈旧性粘连带致肠管卡压2例,遗漏多发肠石1例,合并急性阑尾炎、阑尾周围脓肿合并肠粘连梗阻2例,合并肠套叠1例.1例粘连性肠梗阻为术后17 d再次手术,由于无法找到明确的梗阻点,故行梗阻远近两端侧侧吻合术,术后25 d梗阻解除;其余20例经再手术后3~5d梗阻均解除,无手术死亡病例.结论 腹部术后早期肠梗阻多见为肠粘连.充分的术前准备,规范的手术操作,严密的术后观察,可减少粘连性肠梗阻的几率.选择适宜的手术方式,精确细致的手术操作是再手术成功的关键.%Objective To analyze the reasons for reoperation for early postoperative intestinal small obstruction, and summarize the experience of reoperation and treatment.Methods The reasons for reoperation in 21 patients with early postoperative intestinal small obstruction treated in our hospital from Jan 2005 to June 2010 were retrospectively analyzed.Results The 21 cases of early intestinal obstruction were occurred from 4 to 11 days after operation.By re-operating these 21 patients, the reasons for early postoperative intestinal small obstruction were clear.12 of 21 cases were adhesive intestinal obstruction,3 of 21 cases with digestive system cancer were missed diagnosed, 1 case with rectum cancer was missed diagnosed, 1 case with multiple intestinal stones was missed.And 2 cases with old intestinal adhesions and compression were diagnosed, 2 cases with acute appendicitis, the appendix abscess combined adhesive intestinal obstruction was diagnosed, and 1 case with intussusception was diagnosed.1 of 21 cases with adhesive

  18. Flow Rate Capacity Reduction Due to Temporal and Dynamic Processes in Large Pipelines. Study with Field Measurements; Efectos dinamicos y temporales en la reduccion de la capacidad de conduccion en grandes acueductos. Estudio con medidas en prototipo

    Energy Technology Data Exchange (ETDEWEB)

    Carmona Paredes, Rafael; Ortiz Nunez, Luis Alfonso; Sanchez Huerta, Alejandro [Universidad Nacional Autonoma de Mexico (Mexico)

    2002-06-01

    More than 15 years of operation have show that some water transport pressurized pipelines change their flow rate capacity faster than expected due to normal roughness increase. As explained by the tubular pinch effects, the radial migration of suspended particles in a flow can produce a high concentration close to the pipe wall. The non-uniform particle concentration leads to higher velocities at the center of the tube, equivalent to a reduced hydraulic section that increases the head losses. A model to explain field measurements at the Chapala-Guadalajara Aqueduct is proposed that suggests to hydraulic engineers to be more distrustful when using traditional head loss formulas to analyze water transport pipelines. [Spanish] La perdida de la capacidad de conduccion es un grave problema en la operacion de grandes acueductos. Mas de 15 anos de estudios y de inspeccion directa al interior de las tuberias de varios sistemas de abastecimiento de agua potable han mostrado el desarrollo de capas de material fino fuertemente adheridas a la pared de los tubos. En algunos casos, la variacion de la perdida de carga no ha podido ser explicada con los modelos tradicionales de crecimiento de la rugosidad interna, por lo que para explicar de forma adecuada las mediciones de campo realizadas en el acueducto Chapala-Guadalajara ha sido necesario incorporar de manera simultanea fenomenos dinamicos y temporales. Con base en el fecto de elongacion tubular (o tubular pinch effect), descrito por otros autores, mas observaciones directas al interior de las tuberias, en este trabajo se plantea como una posible de la disminucion de capacidad de conduccion en el acueducto Chapala-Guadalajara un cambio aparente en la seccion efectiva del flujo, originado por la migracion radial hacia la pared del tubo de las particulas suspendidas en el agua. El modelo que propone reproduce las medidas en campo con diferencias menores al 10% e invita a reflexionar sobre las practicas convencionales para

  19. No Difference in Reoperations at 2 Years Between Ceramic-on-metal and Metal-on-metal THA: A Randomized Trial.

    Science.gov (United States)

    Engh, C Anderson; Sritulanondha, Supatra; Korczak, Abigail; Whalen, Terrence David; Naudie, Douglas D R; McCalden, Richard W; MacDonald, Steven J

    2016-02-01

    Hard-on-hard bearings for total hip arthroplasty continue to warrant analysis even though crosslinked polyethylene is performing very well. Ceramic-on-metal (CoM) has low in vitro wear and did well in an early clinical trial. We report on a prospective, randomized, multicenter investigational device trial comparing CoM with metal-on-metal (MoM). (1) Is there a difference in the number or type of revisions comparing CoM with MoM? (2) Are cobalt and chromium metal levels different for CoM and MoM THA? Between August 2005 and October 2006, of 1015 patients screened, 390 patients were enrolled at 11 centers and randomized to 194 CoM and 196 MoM bearings. There was no difference in the preoperative patient demographics between the study groups. Mean followup was 50 months (range, 22-75 months). Seventy-two patients from two centers had metal level analysis. With the numbers available, there was no difference in the proportion of patients undergoing revisions between the MoM and the CoM cohorts (MOM: 3% [six of 196]; COM: 1.5% [three of 194]; p = 0.50). Four MoM revisions were unrelated to the bearing surface. Two had bearing surface-related reoperations, one for an aseptic lymphocyte-dominated vasculitis-associated lesion and one for elevated metal levels with acetabular malposition. None of the CoM revisions were related to the bearing surface. The metal level analysis revealed that in contrast to the CoM, the MoM bearing group had increasing values of erythrocyte and serum cobalt from 1 to 5 years (CoM erythrocyte 0.45-0.55 ppb, p = 0.11 and CoM serum 0.88-0.85, p = 0.55, and MoM erythrocyte 0.32-0.51 ppb, p ppb, p ppb and serum IQR, 0.42-0.80 to 0.64-2.20 ppb, p group had no wear-related revisions and maintained consistently low metal levels. The MoM cobalt elevations may be important considering recent reports of taper corrosion. This CoM bearing was approved by the FDA but withdrawn from the market because of low sales. If it were available, the authors would not

  20. Análise de 1071 reoperações para revascularização do miocárdio: resultados obtidos e conduta sugerida com base nessa experiência Evaluation of 1071 reoperations for myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Luís Alberto Dallan

    1992-06-01

    encontravam-se em CF I ou II, dos quais 7 (2,2% faleceram; 449 em CF III, com 34 (7,6% óbitos e 305 em CF IV, com 46 (15,1% óbitos; 3 comprometimento triarterial associado ou não a lesão de tronco: 788 apresentavam tal tipo de comprometimento arterial, dos quais 74 (9,4% faleceram. Dentre 283 com lesão uni ou biarterial, 13 (4,6% foram a óbito; 4 caráter de emergência da cirurgia: dentre 110 operações de emergência, foram observados 35 (31,8% óbitos. Dentre 961 cirurgias eletivas, houve 52 (5,4% óbitos. Nos últimos dois anos, entretanto, foram realizadas 379 re-revascularizações do miocárdio, tendo sido observados apenas 13 (3,4% óbitos. Esse decréscimo de mortalidade em relação aos anos anteriores foi atribuído, entre outros fatores, aos métodos de proteção miocárdica empregados, especialmente nos doentes com pior função ventricular. Nesses dois anos foi também dado especial destaque ao emprego de enxertos arteriais na re-revascularizaçáo do miocárdio. A média da utilização de ao menos um enxerto arterial na reoperação coronária elevou para 82,2% (259/315. Acreditamos que, através da abordagem cirúrgica adequada, da utilização crescente de enxertos arteriais e, especialmente, pela indicação cirúrgica precoce, permitindo a re-revascularização de forma eletiva e, ainda, com boa viabilidade miocárdica, os resultados futuros serão mais promissores.Between January 1979 and January 1992, 1071 coronary bypass graft reoperations were performed at the Heart Institute and Beneficencia Portuguesa Hospital. Of these, 1015 were reoperated upon once, 53 twice and 3 three times. The surgeries were due to spread of coronary atherosclerosis in 117 patients (10.9%, partial or total graft occlusion in 183 (17.1%, combination of the prior factors in 728 (67.9%, technical problems in 21 (1.9%, and others in 22 (2.1%. The patients ages varied from 34 to 84 years (mean 61.6, predominantly male (86.1% and Caucasian (96.5%. The period between the

  1. 胸内食管胃吻合口瘘再手术病人的护理%Nursing Care of Patients Undergoing Re-operation due to Intrathoracic Esophagogastroanastomosis Fistula

    Institute of Scientific and Technical Information of China (English)

    陈明松; 薛培青; 冯玉玲

    2003-01-01

    对19例食管贲门癌术后并发胸内食管胃吻合口瘘再手术病人,术前密切观察体温变化、胸痛及呼吸困难程度,及时实施手术及给予心理支持;术后做好呼吸管理及营养护理等.结果治愈15例,死亡4例.提示早期发现,尽早手术是再手术成功的关键;系统的护理措施是病人痊愈的保证.

  2. Experience of ipsilateral laparoseopic reoperations in urology%泌尿外科同侧二次腹腔镜手术体会

    Institute of Scientific and Technical Information of China (English)

    马亮; 余大敏; 张志根; 李新德; 芮雪芳; 李恭会; 丁国庆

    2008-01-01

    目的 探讨泌尿外科同侧二次腹腔镜手术可行性,总结经验和体会. 方法行同侧二次腹腔镜手术患者13例.第一次手术路径:经腹膜后4例,经腹9例.第一次手术原因:肾盂输尿管连接处梗阻3例、输尿管结石3例、肾盂结石2例、肾上腺肿瘤2例、肾囊肿2例、多囊肾1例.第二次手术原因:患侧肾脏无功能4例、结石复发3例、肾囊肿复发1例、肾盂输尿管吻合处狭窄1例、同侧肾脏发生肾癌I例、多囊肾再次进展1例、肾上腺肿瘤残留和复发各1例.2次手术间隔6~72个月,平均30个月.第二次手术均取经腹入路,直视下进腹建立气腹,松解肠道粘连后打开侧腹膜及肾周筋膜,先从解剖清晰、粘连轻处按解剖层次,逐步暴露手术部位完成手术,未切除肾脏病例术后缝合肾周筋膜及侧腹膜,恢复解剖关系. 结果 第一次手术平均手术时间93 min,平均出血量70ml,平均术后住院时问4.8 d.第二次手术均顺利完成,平均手术时间97 min,平均出血量62 ml,平均术后住院时间5.0 d.第二次手术中均发现不同程度粘连和解剖位置变化,手术难度增加.二次手术后13例随访2~24个月,未发生严重并发症. 结论 选择合适病例,在熟练掌握相关技巧后,二次腹腔镜手术可以应用于有同侧泌尿外科腹腔镜手术史患者.%Objective To evaluate the feasibility and clinical results of laparoseopic reoperation for patients with history of previous ipsilateral urology laparoscopic surgeries. Methods Thirteen patients that underwent second ipsilateral urology laparoscopic surgeries were retrospectively ana-lysed. The reasons for a second operation included nonfunctional kidney after pyeloplasty, ure-terolithotomy or pyelolithotomy in 4 cases, recurrence of urinary calculi in 3 cases, pelviureteric june-tional stenosis after pyeloplasty in 1 case, recurrence of renal cyst in 1 case, recurrence of adrenal tumor in 1 case, residual adrenal

  3. Discussion on valve re-operative cases after cardiac valve replacement%关于心脏瓣膜置换术后再次瓣膜手术的探讨

    Institute of Scientific and Technical Information of China (English)

    宣海洋; 石开虎; 张飞; 徐盛松; 吴君旭; 曹炜; 龚文辉; 赵旭东

    2011-01-01

    Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.%目的 分析心脏瓣膜置换术后再次瓣膜手术的原因,探讨手术时机的选择、手术方法及对结果的影响因素.方法 对2008年10月至2010年2月心脏瓣膜置换术后再次瓣膜手术的13例患者进行回顾性分析,术前NYHA心功能Ⅲ级4例,Ⅳ级9例.单纯二尖瓣置换术7例,单纯主动脉瓣置换术3例,二尖瓣并主动脉瓣置换术3例.结果 术后早期死亡1例,病死率7.7%(1/13),死亡原因为术后低心排血量综合征.术后因出血二次开胸止血和再次气管插管各1例,经抢救治疗后均好转,12例患者均于3~6周出院.随访6~15

  4. A Variety of Aftershock Decays in the Rate- and State-Friction Model Due to the Effect of Secondary Aftershocks: Implications Derived from an Analysis of Real Aftershock Sequences

    Science.gov (United States)

    Iwata, Takaki

    2016-01-01

    The model based on rate- and state-dependent friction law reproduces the temporal decay of an aftershock sequence with the p value of the Omori-Utsu law equal to 1, if we simply assume a constant stress rate over time. However, because p values vary in real aftershock sequences, this model requires some modification. This study examined the effect of secondary aftershocks on the variety of the p value. A large aftershock causes a stepwise stress increase in the aftershock area, and the expected seismicity rate derived from the friction law also increases abruptly. These multiple increases in the seismicity rate during its decay following a mainshock could cause variation in the apparent p value. In this study, a model incorporating this idea is applied to two aftershock sequences observed in Japan and is shown to substantially modify the modeling of aftershock activity.

  5. Paraplegia due to missed thoracic meningioma after lumbar spinal decompression surgery: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Mehtap Bozkurt

    2014-03-01

    Full Text Available Spinal meningiomas are often localized to the thoracic level and symptoms from a spinal meningioma are determined by the location of the mass. We present a case of thoracic paraplegia due to a thoracic spinal cord tumor (meningioma that was not detected during lumbar spinal decompressive surgery. Thoracic mass was detected in level of T2-3 on magnetic resonance imaging (MRI. The patient was re-operated and the patient's neurologic symptoms were partially relieved. Surgeons should know that a thoracic silent meningioma can aggrevate neurological symptoms after lumbar spinal decompression surgery and should inform their patient before surgery.

  6. 结直肠癌术后复发模式的临床研究及再手术治疗的预后分析%Clinical study and prognosis analysis of reoperation treatment and recurrence model for postoperative recurrent colorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    陈宁波; 曾杰

    2016-01-01

    ObjectiveTo summarize the clinical character and the reason of postoperative recurrent colorectal carcinoma, investigate the methods, prognosis of reoperation for postoperative recurrent colorectal carcinoma.Methods 96 cases of postoperative recurrent colorectal carcinoma who were cured at the surgical department in the emergency center of Sichuan Province hospital from 2000 to 2012 were analyzed retrospectively. Patients were divided into two groups according to liver metastasis or not. To analyze the clinical character of postoperative recurrent colorectal carcinoma, investigate the methods and prognosis of reoperation respectively.ResultsNeoadjuvant chemotherapy was arranged in 13 cases, adjuvant chemotherapy was accepted for 41 cases. 45 cases were recurrent rectum carcinoma after operation and 51 cases were recurrent colon carcinoma after operation. 76 cases were liver metastasis after operation (29 cases were recurrent rectum carcinoma and 47 cases were recurrent colon carcinoma), 20 cases were non-liver metastasis after operation (16 cases were recurrent rectum carcinoma and 4 cases were recurrent colon carcinoma). 44 cases were simple isolated liver metastasis in the first group, 40 cases were treated with radical operation (22 cases were recurrent rectum carcinoma and 18 cases were recurrent colon carcinoma), 32 cases were multiple liver metastasis, 26 cases were treated with palliative surgery (3 cases were recurrent rectum carcinoma and 23 cases were recurrent colon carcinoma), 6 cases were abandon reoperation because of metastasis generally (3 cases were recurrent rectum carcinoma and 3 cases were recurrent colon carcinoma). 18 cases were treated with radical operation in the non-liver metastasis group (15 cases were recurrent rectum carcinoma and 3 cases were recurrent colon carcinoma). 64 cases were treated with radical operation in two groups, the rate of radical operation was 60.4%; 26 cases were treated with palliative surgery, the rate was 27

  7. Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996-2005

    DEFF Research Database (Denmark)

    Hannerz, Harald; Dalhoff, Kim; Burr, Hermann

    2014-01-01

    Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people...... or death due to IHD (SHR = 0.80, 95% CI: 0.71-0.91). CONCLUSION: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine...... data in addition to or instead of the use of death or hospital data in epidemiological studies on work-related IHD risk will bring about a tremendous increase in statistical power....

  8. Seismicity rate changes along the central California coast due to stress changes from the 2003 M 6.5 San Simeon and 2004 M 6.0 Parkfield earthquakes

    Science.gov (United States)

    Aron, A.; Hardebeck, J.L.

    2009-01-01

    We investigated the relationship between seismicity rate changes and modeled Coulomb static stress changes from the 2003 M 6.5 San Simeon and the 2004 M 6.0 Parkfield earthquakes in central California. Coulomb stress modeling indicates that the San Simeon mainshock loaded parts of the Rinconada, Hosgri, and San Andreas strike-slip faults, along with the reverse faults of the southern Los Osos domain. All of these loaded faults, except for the San Andreas, experienced a seismicity rate increase at the time of the San Simeon mainshock. The Parkfield earthquake occurred 9 months later on the loaded portion of the San Andreas fault. The Parkfield earthquake unloaded the Hosgri fault and the reverse faults of the southern Los Osos domain, which both experienced seismicity rate decreases at the time of the Parkfield event, although the decreases may be related to the decay of San Simeon-triggered seismicity. Coulomb stress unloading from the Parkfield earthquake appears to have altered the aftershock decay rate of the southern cluster of San Simeon after-shocks, which is deficient compared to the expected number of aftershocks from the Omori decay parameters based on the pre-Parkfield aftershocks. Dynamic stress changes cannot explain the deficiency of aftershocks, providing evidence that static stress changes affect earthquake occurrence. However, a burst of seismicity following the Parkfield earthquake at Ragged Point, where the static stress was decreased, provides evidence for dynamic stress triggering. It therefore appears that both Coulomb static stress changes and dynamic stress changes affect the seismicity rate.

  9. Histopathology of explanted AlphaCor due to keratoprosthesis extrusion.

    Science.gov (United States)

    Caporossi, Aldo; Mazzotta, Cosimo; Balestrazzi, Angelo; Occhini, Rossella; Toti, Paolo; Traversi, Claudio

    2006-07-01

    AlphaCor keratoprosthesis (KPro) is a new-concept poly (2-hydroxyethyl methacrylate) one-piece KPro that makes possible a two-step implantation technique easy to perform with a short learning curve. In literature an 18% incidence of AlphaCor removal due to melting complications is reported. The histopathology of corneal tissue removed during a re-operation while bearing an AlphaCor KPro has previously been described in the literature only in one report. Herein, the first histological features of an AlphaCor-corneal complex explanted because of KPro extrusion is described. The histopathology of the AlphaCor-corneal complex is characterized by mild inflammation in the corneal tissues, limited to the region surrounding the anteriorized and extruded part of the KPro. It is not possible to fully understand the mechanisms that trigger the device extrusion. One possible explanation could be a dislocation of the prosthesis in the corneal pocket due to the untied fixation stitch. Another explanation could be a foreign body reaction induced by KPro.

  10. 达芬奇机器人手术系统再手术入路的选择%Selection of surgical approach for patients with reoperation using Da Vinci surgical system

    Institute of Scientific and Technical Information of China (English)

    陈军周; 周宁新; 刘全达; 张效东; 刘军桂; 陈蒈; 张涛

    2010-01-01

    Objective To summarize the clinical experience of operations with Da Vinci surgical system in 27 patients with previous abdominal surgery.Methods The clinical data of 27 patients with previous abdominal surgery who had received reoperation using Da Vinci surgical system at General Hospital of Second Artillery of PLA from January to December 2009 were retrospectively analysed.The distribution of trocars was designed according to the surgical sites and previous surgical incision sites.The operation was divided into 2 steps:firstly,intraabdominal adhesion was dissected and the robotic arms were set up;secondly,the lesions were resected.Experience in trocars placement,surgical approach and management of complications were summarized.Results Six approaches were designed according to previous incision sites.Of all patients,22 were with severe intraabdominal and hepatic hilar band adhesion,and 5 with strip adhesion.One patient who underwent intraabdominal radiotherapy and chemotherapy abandoned robotic surgery because of the failure in trocar placement and pneumoperitoneum establishment.Twenty-six patients had successfully undergone robotic surgery and the success rate was 96%(26/27).Of the 26 patients,1 was complicated with enterorrhexis intraoperatively and received repairment.No postoperative complication was observed.Conclusions Previous abdominal surgery has little influence on robotic surgery with Da Vinci system. Pneumoperitoneum establishment,insertion point of the first trocar and dissection of the intraabdominal adhesions are key points for success of operation.%目的 总结达芬奇机器人手术系统在27例有腹部手术史患者中应用的临床经验.方法 回顾性分析2009年1月至12月解放军第二炮兵总医院应用达芬奇机器人手术系统对27例有腹部手术史患者进行手术的临床资料.根据手术部位以及原手术切口的位置设计Trocar排布,整个手术过程分为两步,第1步游离腹

  11. 食管闭锁术后食管气管瘘复发再手术的临床分析%Clinical analysis of reoperation for esophageal atresia with recurrent tracheoesophageal fistulas

    Institute of Scientific and Technical Information of China (English)

    朱海涛; 沈淳; 肖现民; 董岿然; 郑珊

    2014-01-01

    目的:分析食管闭锁(EA)术后食管气管瘘复发(RTEF)再手术的临床资料,总结RTEF的原因、诊断方法及再手术的经验。方法回顾性分析2005年1月至2013年12月我们收治的10例EA术后RTEF患儿的临床资料,其中男7例,女3例,再手术平均年龄为19个月,平均体重为8.3 kg,所有病例均为GrossⅢ型;10例中有9例曾接受经右胸食管气管瘘结扎+食管端端吻合术。结果在初次手术中有4例(4/10)瘘管并未切断。9例(9/10)复发瘘管的食管端开口于原食管吻合口狭窄处或近端食管。8例(8/10)术后存在不同程度吻合口狭窄,1例合并吻合口瘘。再手术前所有患儿行食管欧乃派克造影检查,确诊和疑似RTEF分别为5例(5/10,50%)、4例(4/10,40%)。所有RTEF通过胃镜及支气管镜确诊(10/10,100%)。患儿均接受再次进胸手术,平均手术时间3.2 h,平均术后住院时间为15.8 d。术后均获随访3~96个月,食管造影提示所有病例均治愈,未再发生RTEF。结论 EA术后RTEF与初次手术瘘管处理不当、食管吻合口局部炎症反应等因素有关,需再次手术治疗,再手术的疗效及患儿预后良好。%Objetive To summarize the reoperative experience for esophageal atresia (EA)with recur-rent tracheoesophageal fistulas (RTEF). Methods A retropective analysis was given to the 1 0 RTEF patients underwent reoperation in our center from Jan.2005 and Dec.2013.Male to female ratio was 4:1.The median age and average weight at reoperation were 19 months and 8.3 kilograms respectively.All cases were Gross type Ⅲ.9 cases underwent the primary repair of EA. Results During the primary repair,TEF were not cut in 4/1 0 cases.Esophageal orifices of the fistula in 9 of 1 0 cases were located around the anastomotic site or the proximal esophagus.8 cases had anastomotic stricture and 1 case had anastomotic leakage after the primary re

  12. Extremely fast increase in the organic loading rate during the co-digestion of rapeseed oil and sewage sludge in a CSTR--characterization of granules formed due to CaO addition to maintain process stability.

    Science.gov (United States)

    Kasina, M; Kleyböcker, A; Michalik, M; Würdemann, H

    2015-01-01

    In a co-digestion system running with rapeseed oil and sewage sludge, an extremely fast increase in the organic loading rate was studied to develop a procedure to allow for flexible and demand-driven energy production. The over-acidification of the digestate was successfully prevented by calcium oxide dosage, which resulted in granule formation. Mineralogical analyses revealed that the granules were composed of insoluble salts of long chain fatty acids and calcium and had a porous structure. Long chain fatty acids and calcium formed the outer cover of granules and offered interfaces on the inside thereby enhancing the growth of biofilms. With granule size and age, the pore size increased and indicated degradation of granular interfaces. A stable biogas production up to the organic loading rate of 10.4 kg volatile solids m(-3) d(-1) was achieved although the hydrogen concentration was not favorable for propionic acid degradation. However, at higher organic loading rates, unbalanced granule formation and degradation were observed. Obviously, the adaption time for biofilm growth was too short to maintain the balance, thereby resulting in a low methane yield.

  13. 颅底肿瘤术后再手术原因的分析(附14例报告)%Analysis the reasons of emergency reoperation after skull base surgery: report of 14 cases

    Institute of Scientific and Technical Information of China (English)

    郝淑煜; 薛湛; 李达; 肖新如; 汤劼; 王亮; 吴震; 张力伟; 张俊廷

    2015-01-01

    目的 探讨神经外科颅底肿瘤手术后急诊再次开颅手术病例的临床特征.方法 回顾性分析首都医科大学附属北京天坛医院神经外科2008年10月至2013年10月2 500例颅底手术病例中术后再次急诊开颅手术的14例患者,其中颅底脑膜瘤6例,神经鞘瘤3例,垂体腺瘤、颅咽管瘤、骨软骨瘤、血管平滑肌瘤、颈静脉球瘤各1例.第一次手术平均用时9.2h,术中平均出血2 750 ml.再手术的原因由术者和专家组分析得出,并由全科讨论确认.结果 再手术的14例患者中,9例表现为意识减弱,2例术后未能正常苏醒,2例术后常规CT检查发现异常,1例为突发性伤口出血.CT检查发现异常的平均时间为术后17 h,其中瘤腔内出血4例,脑内血肿伴脑挫裂伤4例,大面积脑梗死2例,脑内血肿合并硬膜下血肿l例,硬膜外血肿2例,椎动脉出血1例.再手术后恢复良好6例,中残2例,重残2例,植物生存1例,死亡3例.结论 对于行颅底肿瘤手术的患者,应加强围手术期管理,减少再次手术的发生.%Objective To report the clinical features of the patients who underwent emergent recraniotomy after skull base operation.Methods A serial of 14 cases of reoperation after elective surgery in the Department of Neurosurgery,Beijing Tiantan Hospital between October 2008 and October 2013 were reviewed.Six cases were skull basal meningioma,3 schwannoma,1 pituitary adenoma,1 craniopharyngioma,1 chondroma,1 angioleiomyoma,and 1 glomus jugular tumor.The mean length of first operation time was 9.2 h,and the mean amount of bleeding was 2 750 ml.The reason of reoperation was evaluated by the surgeons and experts,and then approved by all doctors.Results The clinical features of these reoperation patients included altered level of consciousness in 9 cases,unrecovered from anesthesia in two,abnormal CT scan in two and one sudden bleeding in wound.The mean time of abnormal CT scan was 17 h.As for the reason for

  14. Assessment and management of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension%胆道多次手术合并肝硬化门静脉高压症的评估及处理

    Institute of Scientific and Technical Information of China (English)

    柏立山; 柴新群; 胡志坚; 冯贤松

    2011-01-01

    Objective To probe the assessment and management of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension. Methods The clinical data of 18 patients of bile duct re operation accompanied with hepatocirrhosis and portal hypertension from January 2005 to December 2008 were retro spectively analyzed. Results Of the 18 patients. 4 were grouped to Child A according to Child-Pugh classificalion. 10 were child B, another 4 were Child C. As to the causes of hepatoeirrhosis: 14 patients (77.8%)resulted from biliary cirrhosis. 2 posthepatitic cirrhosis. 2 schistosomiasis cirrhosis. Sixteen patients received simply hiliary tract re-operation. 2 received biliary tract re-operation with devascularization; the bleeding amount during operation was up to 800~1 600 mL. Three of whom had post operative complications: 1 with biliary fistula, I with intestinal fistula and 1 with upper gastrointestinal bleeding. The other patient died of multi-organ dysfunction in preoperative period. Conclusion To the patients of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension, surgical operation will get good results if the assessment of relevant pre-operative issues are enhanced and the appropriate treatments are executed. Child-Pugh classification is not appropriate to assess the patients of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension.%目的 探讨胆道多次手术同时合并肝硬化门静脉高压症的评估及处理.方法 回顾性分析2005年1月至2008年12月我院收治的18例胆道多次手术同时合并肝硬化门静脉高压症患者的临床资料.结果 18例胆道多次手术同时合并肝硬化门静脉高压症患者中,按照Child-Pugh分级,A级4例,B级10例,C级4例.肝硬化原因:胆汁性肝硬化14例(77.8%),肝炎后肝硬化2例,血吸虫性肝硬化2例.单独行胆道多次手术16例,联合行胆道多次手术和断流术2例;术中出血量达800

  15. Reoperation factors and treatment strategies for posterior lumbar intervertebral disc herniation%腰椎椎间盘突出症再手术因素及治疗策略

    Institute of Scientific and Technical Information of China (English)

    吴伟平; 刘宝戈; 江建明

    2011-01-01

    Objective To discuss the reoperation factors, surgical treatment strategies, and the treatment outcomes of patients with posterior lumbar intervertebral disc herniation. Methods A total of 73 patients with posterior lumbar intervertebral disc herniation who underwent reoperation during January 2007 to June 2010 after primary lumbar discectomy with or without instrument fixation were retrospectively studied. Reoperation was performed by discectomy with unilateral laminactomy in 14 cases, hemilaminactomy decompression in 11 cases, discectomy with total laminactomy in 6 cases, posterior lumbar interbody fusion ( PLIF ) in 40 cases, and revision surgery with failed instrument in 2 cases. Results After a follow-up of 21 months ( ranging 6-44 months ), complications were found in 14 cases; the Oswestry disability index ( ODI )and visual analog scale ( VAS ) scores were both significantly improved after operation ( P<0.05 ). ODI was decreased from ( 63. 26 ±5. 36 )% before operation to ( 19. 68 ± 8. 42 ) % 3 months after operation. VAS score was decreased from 7. 26 ± 2.06 before operation to 3. 68 ± 1. 22 3 months after operation. Conclusion The major reoperation factors for posterior lumbar intervertebral disc surgery include intraoperative segment malpositioning, residual nucleus pulposus, sequestered intervertebral disc, adjacent segment degeneration, inadequate decompression, lumbar instability and instrumentation failure. Satisfactory effectiveness of reoperation can be obtained by proper operation time and surgery strategies.%目的 探讨腰椎椎间盘突出症再手术的因素,以及手术治疗的方法和疗效.方法 回顾分析2007年1月~2010年6月收治的腰椎椎间盘突出症再手术病例共计73例,再手术方式为单侧椎板开窗椎间盘切除术14例,半椎板切除减压椎间盘切除术11例,全椎板切除减压椎间盘切除术6例,后路腰椎椎间盘切除联合椎体间植骨融合术40例,内固定翻修2例.结果

  16. Experiment on damage in K9 glass due to repetition rate pulsed CO2 laser radiation%重频脉冲CO2激光损伤K9玻璃的实验

    Institute of Scientific and Technical Information of China (English)

    王玺; 卞进田; 李华; 聂劲松; 孙晓泉; 尹学忠; 雷鹏

    2013-01-01

      对脉冲CO2激光在不同重频模式下损伤K9玻璃进行了实验研究。采用输出能量为10 J,脉宽为90 ns,重复频率在100 Hz至300 Hz之间连续可调的脉冲CO2激光器,对K9玻璃样品进行了激光损伤实验,观察到两次不同重频条件下样品的损伤形貌。实验结果表明,重频越高,对样品的损伤程度就越严重;应力损伤成为K9玻璃激光损伤的最主要的原因,在重频强激光的辐照下,K9玻璃表面出现强烈的等离子体闪光,伴随明显的熔融气化破坏,并形成等离子体爆轰波。爆轰波对玻璃材料产生了严重的力学冲击作用,这种应力作用足以对K9玻璃造成毁灭性破坏。运用有限元分析对激光辐照K9玻璃的温度与应力分布进行仿真,其计算结果与实验基本吻合。%  In this paper, the experiment on damage in K9 glass induced by pulsed CO2 laser under different repetition rates was carried out, which had a pulse width of 90 ns. The laser pulse energy was 10 J and the repetition rate was kept within the range of 100 Hz to 300 Hz. The damage morphologies of two kind repetition rates after laser irradiation were characterized. The experimental results indicate that the effect of laser irradiation on samples can be affected considerably by the change of laser repetition rate, and the intensity of damage morphology on the sample increases with the laser repetition rate, and the damage in K9 glass induced by pulsed CO2 laser is dominated by stress. As a result, the plasma detonation wave induced by laser occured, the material was broken result from the melting and evaporation of K9 glass. It is shown that the plasma detonation wave affected stress damage considerably, and this mechanical effect almost destroyed K9 glass sample. A numerical simulation was performed to calculate temperature and stress distributions in K9 glass sample irradiated by pulsed CO2 laser using finite element method. The model

  17. Secular Changes in the Moon's Mean Motion and Earth Rotation Rate Due to Tidal Dissipation%月球平均运动和地球自转速率长期变化的潮汐耗散

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    利用1983~1994年(共11年)期间,全球人卫激光测距(SLR)观测网对Lageos-1卫星的观测资料,估算二阶重力场系数和潮汐参数。SLR和卫星测高的潮汐解被用来计算月球轨道根数相对黄道坐标系的长期变化和地球自转速率的长期变化。SLR确定的总的潮汐耗散引起的月球平均运动的长期变化为-24.78″/世纪2,与激光测月结果((-24.9±1.0)″/世纪2) 非常一致。日月潮汐引起的地球自转速率的长期变化为 -5.25×10-22rad /s2,顾及地球扁率变化(2)的非潮汐效应,对应的日长变化为1.49 ms/世纪,与1620年以来的天文月掩星结果(1.4 ms/世纪)十分相符。本文还联合卫星测高和人卫激光测距确定的潮汐解,在月球平均运动和地球自转速率的长期变化中,分离出固体地球和海洋的耗散效应。%Using 11 years (1983~1994) observation data of Satellite Laser Ranging (SLR) to the Lageos-1 satellite in the global tracking network,we estimate the second degree gravity field coefficient and tidal parameters.The tidal solutions obtained from SLR and satellite altimetry are used to compute the secular changes in the Moon's orbit elements and the Earth rotation rate in the ecliptic reference system.The SLR-derived secular change in the Moon's mean motion caused by the total tidal dissipation is -24.78 arc sec/century2,agreeing very well with the result ((-24.9±1.0) arc sec/century2) from the analysis of the lunar laser ranging data.The secular change in the Earth rotation rate caused by the solar and lunar tides is -5.25×10-22 rad/s2.Taking into account the non-tidal effect of the changes in the Earth rotation rate,the corresponding change in length of day is 1.49 ms/century.This value is consistent with recent astronomical result (1.4 ms/century) of eclipse records since 1620.We also combine the tidal solutions determined by altimetry and SLR to distinguish the dissipation effects of the solid

  18. Increased Release of Mercury from Dental Amalgam Fillings due to Maternal Exposure to Electromagnetic Fields as a Possible Mechanism for the High Rates of Autism in the Offspring: Introducing a Hypothesis.

    Science.gov (United States)

    Mortazavi, Gh; Haghani, M; Rastegarian, N; Zarei, S; Mortazavi, S M J

    2016-03-01

    According to the World Health Organization (WHO), factors such as growing electricity demand, ever-advancing technologies and changes in social behaviour have led to steadily increasing exposure to man-made electromagnetic fields.  Dental amalgam fillings are among the major sources of exposure to elemental mercury vapour in the general population. Although it was previously believed that low levels are mercury (i.g. release of mercury from dental amalgam) is not hazardous, now numerous data indicate that even very low doses of mercury cause toxicity. There are some evidence indicating that perinatal exposure to mercury is significantly associated with an increased risk of developmental disorders such as autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). Furthermore, mercury can decrease the levels of neurotransmitters dopamine, serotonin, noreprenephrine, and acetylcholine in the brain and cause neurological problems. On the other hand, a strong positive correlation between maternal and cord blood mercury levels is found in some studies. We have previously shown that exposure to MRI or microwave radiation emitted by common mobile phones can lead to increased release of mercury from dental amalgam fillings. Moreover, when we investigated the effects of MRI machines with stronger magnetic fields, our previous findings were confirmed. As a strong association between exposure to electromagnetic fields and mercury level has been found in our previous studies, our findings can lead us to this conclusion that maternal exposure to electromagnetic fields in mothers with dental amalgam fillings may cause elevated levels of mercury and trigger the increase in autism rates. Further studies are needed to have a better understanding of the possible role of the increased mercury level after exposure to electromagnetic fields and the rate of autism spectrum disorders in the offspring.

  19. Increased Release of Mercury from Dental Amalgam Fillings due to Maternal Exposure to Electromagnetic Fields as a Possible Mechanism for the High Rates of Autism in the Offspring: Introducing a Hypothesis

    Science.gov (United States)

    Mortazavi, Gh.; Haghani, M.; Rastegarian, N.; Zarei, S.; Mortazavi, S.M.J.

    2016-01-01

    According to the World Health Organization (WHO), factors such as growing electricity demand, ever-advancing technologies and changes in social behaviour have led to steadily increasing exposure to man-made electromagnetic fields.  Dental amalgam fillings are among the major sources of exposure to elemental mercury vapour in the general population. Although it was previously believed that low levels are mercury (i.g. release of mercury from dental amalgam) is not hazardous, now numerous data indicate that even very low doses of mercury cause toxicity. There are some evidence indicating that perinatal exposure to mercury is significantly associated with an increased risk of developmental disorders such as autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). Furthermore, mercury can decrease the levels of neurotransmitters dopamine, serotonin, noreprenephrine, and acetylcholine in the brain and cause neurological problems. On the other hand, a strong positive correlation between maternal and cord blood mercury levels is found in some studies. We have previously shown that exposure to MRI or microwave radiation emitted by common mobile phones can lead to increased release of mercury from dental amalgam fillings. Moreover, when we investigated the effects of MRI machines with stronger magnetic fields, our previous findings were confirmed. As a strong association between exposure to electromagnetic fields and mercury level has been found in our previous studies, our findings can lead us to this conclusion that maternal exposure to electromagnetic fields in mothers with dental amalgam fillings may cause elevated levels of mercury and trigger the increase in autism rates. Further studies are needed to have a better understanding of the possible role of the increased mercury level after exposure to electromagnetic fields and the rate of autism spectrum disorders in the offspring. PMID:27026954

  20. Diplopia due to Dacryops

    OpenAIRE

    Rahmi Duman; Reşat Duman; Mehmet Balcı

    2013-01-01

    Dacryops is a lacrimal ductal cyst. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Diplopia due to dacryops has not been reported previously. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops.

  1. Diplopia due to Dacryops

    Directory of Open Access Journals (Sweden)

    Rahmi Duman

    2013-01-01

    Full Text Available Dacryops is a lacrimal ductal cyst. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Diplopia due to dacryops has not been reported previously. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops.

  2. Wage differentials due to gender.

    Science.gov (United States)

    Smith, N; Westergard-nielsen, N

    1988-10-01

    "In this paper, a longitudinal data set covering 5% of all Danish wage earners over a 9-year period is used to shed light on the observed wage differentials due to gender. A human capital model is used to isolate the effects of changes in experience, schooling and unemployment, together with other factors.... Despite the observation from macro statistics that women have had the highest observed increases in wage rates, the models show that this increase is mainly due to an improvement in their background characteristics and that men still receive a higher return to their characteristics. The main difference between genders appears to be that female workers do not, in general, get any return to their experience. The estimates also show negative effects on the wage rate of previous spells of unemployment." excerpt

  3. Stroke due to Hematologic Aspects

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2004-01-01

    @@ Stroke due to ‘cerebral vein thrombosis' (CVT) is commonly used to refer to thrombosis of the cerebral venous system, including either dural venous sinuses, or deep and superficial (cortical) cerebral veins. CVT are frightening events due to the severity of their clinical manifestations and their high mortality rate (up to 30% in some casereports).The clinical signs and symptoms of CVT are relatively nonspecific: they include headache, papilledema, vomiting,seizures, focal neurological deficits (motor or sensory) and impaired consciousness. CVT has long been considered as rare and mostly infection-related event; moreover, due to its nonspecific clinical manifestations, the diagnosis has been difficult, delayed and could often be made only post mortem.

  4. O espectro da reoperação em cirurgia de coronária The spectrum os re-operation in coronary surgery

    Directory of Open Access Journals (Sweden)

    Jarbas J Dinkhuysen

    1989-04-01

    ção, angioplastia mal sucedida e presença de mamária prévia não causaram impacto decisivo na morbidade e na mortalidade desta série (P > 0,05.The authors present the results obtained in the first 30 day P.O. of 204 patients who underwent reoperations for coronary atherosclerosis. The interval between first and second operation varied from 1 month to 16.5 years. There was also two small groups of patients of third intervention and with associated cardiac lesions. The basic strategy consisted on anticoagulation, the aplication of the mammary arteries (one or two whenever possible, and revascularization as complete as possible. Most patients showed uneventfull evolution and a quarter of them presented some kind of non-fatal complication with good response to specific therapeutic measures. The overall mortality was about 9%. Patients with atherosclerotic lesions in native coronary circulation presented the greater morbidity, but in those with atherosclerotic lesions both in the grafts and coronary native circulation, the mortality was higher. Contrary to expectation, the younger group showed higher mortality, and the older group presented higher morbidity. The aplication of the IMA's on the reintervention does not add morbidity or mortality, but the concomitant correction of the associated cardiac pathologies represented a higher risk in the procedure. Recent myocardial infarction influenced also morbidity. The third intervention, failure transluminal angioplastic coronary dilatation and the presence of previous IMA does not exert deleterious impact on the morbidity or mortality.

  5. Late-onset chest wall abscess due to a biodegradable rib pin infection after lung transplantation.

    Science.gov (United States)

    Goda, Yasufumi; Chen-Yoshikawa, Toyofumi F; Kusunose, Masaaki; Hamaji, Masatsugu; Motoyama, Hideki; Hijiya, Kyoko; Aoyama, Akihiro; Date, Hiroshi

    2017-03-17

    A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space. Reoperative thoracotomy revealed abscesses mainly located around the fifth rib, where the pin was inserted. Both cultures of the abscess and the fifth rib were positive for methicillin-sensitive S. aureus, which suggested that the rib pin was the cause of the secondary infection. This case suggests the rib pins, even if they are biodegradable, could have a risk of infections side effect especially for the immunosuppressed patients.

  6. Due process traditionalism.

    Science.gov (United States)

    Sunstein, Cass R

    2008-06-01

    In important cases, the Supreme Court has limited the scope of "substantive due process" by reference to tradition, but it has yet to explain why it has done so. Due process traditionalism might be defended in several distinctive ways. The most ambitious defense draws on a set of ideas associated with Edmund Burke and Friedrich Hayek, who suggested that traditions have special credentials by virtue of their acceptance by many minds. But this defense runs into three problems. Those who have participated in a tradition may not have accepted any relevant proposition; they might suffer from a systematic bias; and they might have joined a cascade. An alternative defense sees due process traditionalism as a second-best substitute for two preferable alternatives: a purely procedural approach to the Due Process Clause, and an approach that gives legislatures the benefit of every reasonable doubt. But it is not clear that in these domains, the first-best approaches are especially attractive; and even if they are, the second-best may be an unacceptably crude substitute. The most plausible defense of due process traditionalism operates on rule-consequentialist grounds, with the suggestion that even if traditions are not great, they are often good, and judges do best if they defer to traditions rather than attempting to specify the content of "liberty" on their own. But the rule-consequentialist defense depends on controversial and probably false assumptions about the likely goodness of traditions and the institutional incapacities of judges.

  7. Onycholysis due to trauma

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-04-01

    Full Text Available Female patient, 35 years old who came to the private office due to discoloration of her left thumbnail and little pain since 1 month ago. Clinical examination shows nail disease on her left thumbnail with onycholysis and dyschromia, dermatoscopy showed white-yellowish discoloration (Fig. 1A, B. The rest of the clinical examination was normal. Patient use to using acrylic nails since 2 years ago and denied some trauma at the nail. The diagnosis of onycholysis due to trauma was done and recommended her not to use acrylic nail, maintain the nail short and avoid wetness.

  8. Technical Due Diligence

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Varano, Mattia

    2011-01-01

    Technical Due Diligence (TDD) as an evaluation of the performance of constructed facilities has become an important new field of practice for consultants. Before the financial crisis started in autumn 2008 it represented the fastest growing activity in some consulting companies. TDD is mostly car...

  9. Maternal mortality due to trauma.

    Science.gov (United States)

    Romero, Vivian Carolina; Pearlman, Mark

    2012-02-01

    Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.

  10. Acesso transeptal vertical ampliado em reoperações valvares mitrais com átrio esquerdo pequeno Extended vertical transseptal approach in mitral valve reoperation with a small left atrium

    Directory of Open Access Journals (Sweden)

    Walter Vosgrau Fagundes

    2004-03-01

    Full Text Available OBJETIVO: Avaliar a abordagem transeptal vertical ampliada em reoperações da valva mitral com átrio esquerdo pequeno. MÉTODO: De janeiro de 2001 a dezembro de 2002, 15 pacientes portadores de doença valvar mitral com indicação de reintervenção cirúrgica, átrio esquerdo pequeno (menor ou igual a 4,0 cm e fibrilação atrial crônica, foram submetidos à abordagem transeptal vertical ampliada da valva mitral. Nove pacientes (pt eram do sexo feminino. A idade variou de 22 a 48 anos. As indicações cirúrgicas foram: disfunção de prótese mitral (seis pt; insuficiência mitral (cinco pt e dupla lesão mitral (quatro pt. Três pacientes apresentavam insuficiência aórtica associada e um pt, insuficiência tricúspide. Nove (60% pacientes encontravam-se em ICC CF III da NYHA e seis (40%, em CF IV. RESULTADOS: A exposição do aparelho valvar mitral foi excelente. O tempo de circulação extracorpórea variou de 65 a 150 min (média = 95min. Foram implantadas próteses em todos os pacientes (15 mitrais, três aórticas e um tricúspide. A mortalidade hospitalar foi de 6,7%, com um óbito devido a baixo débito cardíaco e falência de múltiplos órgãos. Um (6,7% paciente apresentou broncopneumonia na fase hospitalar. Dez pacientes permaneceram com fibrilação atrial, três pt reverteram para ritmo sinusal e um evoluiu com ritmo juncional. A permanência hospitalar média foi de 8,2 dias. Doze (85,7% pacientes encontram-se em CF I e dois (14,3% em CF II. A curva atuarial de sobrevida é de 92,5 % em 22 meses de seguimento. CONCLUSÃO: A técnica cirúrgica empregada proporciona excelente visibilização do aparelho valvar mitral, com baixo índice de complicações.OBJECTIVE: To evaluate the efficacy of the extended vertical transseptal approach in mitral valve reoperation with a small left atrium. METHOD: From January 2001 to December 2002, 15 patients with previous mitral operations, small left atrium and atrial fibrillation

  11. Reoperation for recurrent cardiac valve disease%复发性心脏瓣膜病再次外科治疗效果及其相关因素

    Institute of Scientific and Technical Information of China (English)

    陈文生; 段维勋; 俞世强; 张金洲; 郑奇军; 王红兵; 易定华

    2011-01-01

    AIM: To retrospectively review the experience of valve replacement after closed mitral commissurotomy, valvuloplasty, perivalvular leakage, prosthetic valve obstruction and dysfunction of bioprosthetic valve in 331 patients.METHODS: Three hundred and thirty-one patients (143 males and 188 females) with ages ranging from 12 to 73 years (45.6 ± 12.2 years) with recurrent cardiac valve disease underwent valve replacement.Duration between reoperation and former surgery was 3 months to 25 years ( 17.3 ± 8.1 years).The reasons for reoperation included mitral valve restenosis after closed mitral commisurotomy (143 cases), valve restenosis and/or insufficiency after mitral or aortic valvuloplasty (53 cases), bioprosthetic valve decline (32 cases), perivaivular leakage (26 cases), other valve diseases after primary valve replacement (21 cases), infective endocarditis after valve replacement,valvuloplasty and repair of ventricular septal defect (24 cases), trieuspid insufficiency after repair of Ebstein's anomaly (15 cases), prosthetic valve obstruction (9 cases), mitral or tricuspid insufficiency after repair of congenital heart disease (6 cases), and mitral valve restenosis after percutaneous balloon mitral valvuloplasty (2 cases).Reoperations included mitral valve replacement, aortic valve replacement, aortic and mitral valve replacement, tricuspid valve replacement, repair of perivalvular leakage,and valvuloplasty.RESULTS: Four patients died during surgery and 23 patients died during the early postoperative stage.The main causes of early-stage deaths were low cardiac output syndrome, ventricular arrhythmia, multiple organ dysfunction failure, left ventricle rupture, infective endocarditis and renal failure.Three hundred and four patients recovered.Follow-up was performed in 259 patients and duration was from 6 months to 21 years (9.5 ±6.8 years).NYHA cardiac functional status Ⅰ to Ⅱ was found in 189 cases.CONCLUSION: Risk factors for reoperation for heart valve

  12. Credit where due.

    Science.gov (United States)

    Friedman, Steven G

    2016-08-01

    The history of medicine is filled with stories of tireless researchers who failed to get credit for their hard work. Examples of this include Rosalind Franklin, who helped to elucidate the structure of DNA; Frederick Banting, who helped to discover insulin; and Jay McLean, who discovered heparin. The founding of the field of vascular surgery provides one of the most vivid examples of uncredited work. Even though Alexis Carrel was an unpaid, untitled assistant in Charles Guthrie's laboratory, it was Carrel alone who received a Nobel Prize for their work. In an attempt to give credit where due, the reasons for this injustice are described. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  13. 神经外科开颅术后再次手术的临床疗效观察%Observation Clinical Curative Effect on Neurosurgery Craniotomy of Reoperation

    Institute of Scientific and Technical Information of China (English)

    刘宇

    2015-01-01

    Objective To explore the effectiveness of implementation of neurosurgical patients after craniotomy line reoperation. Methods Selected 40 cases with implemented postoperative craniotomy surgery again from January 2015 to January 2014 in our hospital neurosurgery, the effectiveness of the treatment of patients and their medical records were reviewed relevant Results 40 cases with the line craniotomy surgery again, according to the GOS score, which GOS 1 level, GOS 2 level, GOS 3 level, GOS 4 level , GOS 5 level number respectively was ifve cases, two cases, 7 cases, 20 cases and six cases Conclusion Neurosurgical diseases were higher probability of reoperation, and therefore must be under the premise of an accurate analysis of the cause of surgery, accurately grasp the timing of treatment, in order to upgrade and improve the survival and quality of life of patients.%目的:探讨神经外科患者实施开颅术后行再次手术治疗的成效。方法选取2014年1月~2015年1月于我院神经外科实施开颅术后行再次手术治疗的患者40例作为研究对象,对治疗成效及其相关病历资料进行回顾分析。结果40例开颅患者在行再次手术后,其中GOS 1级、GOS 2级、GOS 3级、GOS 4级、GOS 5级人数分别为5例、2例、7例、20例和6例。结论神经外科疾病行再次手术的几率较高,因此必须在准确分析手术病因的前提下,准确把握治疗时机,提升和改善患者的生存率和生活质量。

  14. Avaliação dos resultados das reoperações de pacientes com lesões do manguito rotador Evaluation of the results from reoperations on patients with rotator cuff lesions

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2011-01-01

    Full Text Available OBJETIVOS: Avaliar o resultado do tratamento cirúrgico, por via aberta ou artroscópica, dos pacientes com recidiva sintomática da lesão do manguito rotador. MÉTODOS: Foram avaliados 30 pacientes entre dezembro de 1990 e julho de 2007 submetidos a um novo procedimento cirúrgico pelo Grupo de Cirurgia de Ombro e Cotovelo do Departamento de Ortopedia e Traumatologia da Santa Casa de São Paulo - Pavilhão Fernandinho Simonsen devido à deiscência da sutura do manguito rotador. Foram incluídos pacientes com recidivas sintomáticas da lesão e com tempo de seguimento mínimo pós-operatório de 24 meses. RESULTADOS: Pelos critérios de avaliação da UCLA, 21 (70% pacientes tiveram resultados excelentes e bons; nove (30% pacientes tiveram resultados regulares e ruins. CONCLUSÃO: O tratamento cirúrgico, por via aberta e artroscópica, das recidivas da lesão do manguito rotador tende a apresentar resultados piores que o reparo primário. Neste estudo, obtivemos 70% de resultados excelentes e bons. A presença de lesões extensas na segunda operação tende a evoluir com um maior número de resultados insatisfatórios. No nosso estudo, obtivemos melhores resultados com a cirurgia realizada por via artroscópica em comparação com a via aberta.OBJECTIVES: To assess the results from open or arthroscopic surgical treatment on patients with symptomatic recurrence of rotator cuff injuries. METHODS: Between December 1990 and July 2007, 30 patients were assessed and underwent reoperation performed by the Shoulder and Elbow Surgery Group of the Department of Orthopedics and Traumatology, Fernandinho Simonsen Wing, Santa Casa de São Paulo, because of dehiscence of the rotator cuff suture. The study included patients with symptomatic recurrence of the injury and with at least 24 months of postoperative follow- up. RESULTS: According to the UCLA evaluation criteria, 21 patients (70% showed excellent or good outcomes; and nine patients (30% showed fair

  15. Repeat surgical interventions following "definitive" instrumentation and fusion for idiopathic scoliosis: five-year update on a previously published cohort.

    Science.gov (United States)

    Ramo, Brandon A; Richards, B Stephens

    2012-06-15

    A retrospective case series. To identify the overall reoperation rate and factors contributing to reoperation in a recent 5-year cohort of patients (2003-2007) undergoing spinal deformity surgery. These patients were compared with a previously published 15-year cohort of consecutive patients (1988-2002) from the same institution to assess for any significant differences in reoperation rates. In a previously published report from this institution, the reoperation rate for patients with idiopathic scoliosis treated during a 15-year period (1988-2002) was 12.9%. That group was predominantly treated with first-generation TSRH (Medtronic, Memphis, TN) implants and CD implants. Lower profile, more rigid implant systems are now used along with refined techniques for correction of scoliosis deformity. We hypothesized that these factors would lead to lower rates of reoperation. METHODS.: The medical records of 452 consecutive patients (older than 9 yr) surgically treated for idiopathic scoliosis at one institution during 5 years (2003-2007) were reviewed to identify those who required reoperation. The reoperation rate for this cohort was 7.5% (34 of 452 patients). Compared with the prior cohort, significant decreases were noted with regard to total reoperation rate as well as reoperation due to infection and pseudarthrosis. Trends were noted toward decreased rates of reoperation due to prominent implants, dislodged implants, and implant proximity to vital structures. Within the newer cohort, a trend toward decreased reoperation rate was also noted for lower profile implant systems compared with first-generation TSRH implants. With the evolution of newer lower profile segmental implant systems that provide more rigid fixation and with the advancements in techniques for deformity correction, the repeat surgical intervention rate for idiopathic scoliosis has decreased.

  16. Improved three-tubing approach for the reoperation of perforation suturing anastomotic fistula after radical radiotherapy of upper thoracic esophgeal squamous cell carcinoma.

    Science.gov (United States)

    Ke, Honggang; Zhao, Hui; Qiu, Xiaojun; Dong, Hanxuan; You, Qingsheng

    2013-12-01

    As we all know that traditional three tubes treatment for the anastomotic fistula after esophagectomy is easy and efficient, but there are still so many problems such as pain, intubation discomfort, psychological pressure and prognosis slowly. Our report would introduce a new method to cure the anastomotic fistula for the patient after radical radiotherapy. CT and DSA-guided percutaneous cervical gastric wall puncture were performed for the patient while the Flocare tube was introduced entering the mediastinum via the anastomotic fistula under the guidance of contrast medium followed by the procedure of persistent vacuum-suction for 24 hours. Meanwhile, the patient underwent the treatments such as fasting, gastrointestinal decompression, anti-inflammation and nutritional support. Four months later, the patient was discharged after the healing of gastroesophageal anastomotic fistula, significant shrink of tracheo-mediastinal fistula and no discomfort when taking semi-liquid diet. With the benefits of long-term tube retention, improved three-tubing will lead to positive and effective treatment, especially for the patient who has the healing capacity of the tissue decreases due to radical radiotherapy.

  17. Collisional Aggregation due to Turbulence

    CERN Document Server

    Pumir, Alain

    2015-01-01

    Collisions between particles suspended in a fluid play an important role in many physical processes. As an example, collisions of microscopic water droplets in clouds are a necessary step in the production of macroscopic raindrops. Collisions of dust grains are also conjectured to be important for planet formation in the gas surrounding young stars, and also to play a role in the dynamics of sand storms. In these processes, collisions are favoured by fast turbulent motions. Here we review recent advances in the understanding of collisional aggregation due to turbulence. We discuss the role of fractal clustering of particles, and caustic singularities of their velocities. We also discuss limitations of the Smoluchowski equation for modelling these processes. These advances lead to a semi-quantitative understanding on the influence of turbulence on collision rates, and point to deficiencies in the current understanding of rainfall and planet formation.

  18. Automation of the monitoring in real time of the absorbed dose rate in air due to the environmental gamma radiation in Cuba; Automatizacion del monitoreo en tiempo real de la tasa de dosis absorbida en aire debido a la radiacion gamma ambiental en Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez L, O.; Capote F, E.; Carrazana G, J.A.; Manzano de Armas, J.F.; Alonso A, D.; Prendes A, M.; Zerquera, J.T.; Caveda R, C.A. [CPHR, Calle 20, No. 4113 e/41 y 47, Playa, La Habana, 11300, A.P. 6195 C.P. 10600 (Cuba); Kalberg, O. [Swedish Radiation Protection Institute (SSI) (Sweden); Fabelo B, O.; Montalvan E, A. [CIAC, Camaguey (Cuba); Cartas A, H. [CEAC, Cienfuegos (Cuba); Leyva F, J.C. [CISAT (Cuba)]. e-mail: orlando@cphr.edu.cu

    2006-07-01

    The Center of Protection and Hygiene of the Radiations (CPHR) like center rector of the National Net of Environmental Radiological Surveillance (RNVRA), it has strengthened their detection capacity and of answer before a situation of radiological emergency. The measurements of the absorbed dose rate in air due to the environmental gamma radiation in the main stations of the Net are obtained in real time and the CPHR receives the data coming from these posts at one time relatively short. To improve the operability of the RNVRA it was necessary to complete the facilities of existent monitoring using 4 automatic measurement stations with probes of gamma detection, implementing in this way a measurement system on real time. On the other hand the software were developed: GenironProbeFech, to obtain the data of the probes, DataMail for the shipment of the same ones by electronic mail and GammaRed that receives and processes the data in the rector center. (Author)

  19. Aortic rupture during reoperative bariatric surgery

    Directory of Open Access Journals (Sweden)

    Sorin Hostiuc

    2015-08-01

    Full Text Available Abstract Morbid obesity has become a very common problem worldwide, causing severe health-related consequences including cardiovascular or metabolic diseases, arthritis, sleep apnea, or an increased risk of cancer. Bariatric surgery was shown to be the only way to achieve sustainable weight loss and to decrease the frequency and severity of metabolic and cardiovascular comorbidities. The purpose of this article is to present a case of bariatric surgery complicated with lesion of the aorta with a lethal outcome.

  20. 76 FR 8946 - Security Ratings

    Science.gov (United States)

    2011-02-16

    ... that support the contract has declined due to rising interest rates, insurers sometime impose an MVA... purchased on the basis of interest rates and security ratings.\\29\\ \\25\\ See Reproposal of Comprehensive... very small number of registrants. The Commission believed the lack of usage was due in part to interest...

  1. Safety of greenlight photoselective vaporisation of prostate in lower urinary tract symptoms due to benign prostatic hyperplasia in patients using anticoagulants due to cardiovascular comorbidities

    Directory of Open Access Journals (Sweden)

    Basri Cakiroglu

    2015-07-01

    Full Text Available Lasers have been used in the management of benign prostatic hyperplasia for the last two decades. To be comparable, they should reduce or avoid the immediate and long-term complications of transurethral resection of the prostate (TURP or open prostatectomy (OP, especially bleeding and need for blood transfusion. Although Holmium laser treatment of the prostate was compared frequently in terms of cardiovascular safety with TURP or OP, photoselective vaporisation of the prostate (PVP was not largely evaluated. In this article we analyzed the current literature to see if there is convincing data to support the observation of some authors that use of PVP is associated with increased safety in patients on anticoagulants with cardiovascular comorbidities. With this purpose a Medline search between January 2004 to March 2013 was performed using evidence obtained from randomised trials, well-designed controlled studies without randomisation, individual cohort studies, individual case control studies and case reports Results: In the last 10 years, several case-control and cohort studies have demonstrated the efficacy of PVP as well as its safety in patients with cardiovascular comorbidities using anticoagulants. The results confirmed the overall lower perioperative and postoperative morbidity of PVP, whereas the efficacy was comparable to TURP in the short term, despite a higher reoperation rate. Conclusion: Although it is still developing, PVP with KTP or LBO seems to be a promising alternative to both TURP and OP in terms of cardiovascular safety and in patients using anticoagulants.

  2. Surgical skill and complication rates after bariatric surgery.

    Science.gov (United States)

    Birkmeyer, John D; Finks, Jonathan F; O'Reilly, Amanda; Oerline, Mary; Carlin, Arthur M; Nunn, Andre R; Dimick, Justin; Banerjee, Mousumi; Birkmeyer, Nancy J O

    2013-10-10

    Clinical outcomes after many complex surgical procedures vary widely across hospitals and surgeons. Although it has been assumed that the proficiency of the operating surgeon is an important factor underlying such variation, empirical data are lacking on the relationships between technical skill and postoperative outcomes. We conducted a study involving 20 bariatric surgeons in Michigan who participated in a statewide collaborative improvement program. Each surgeon submitted a single representative videotape of himself or herself performing a laparoscopic gastric bypass. Each videotape was rated in various domains of technical skill on a scale of 1 to 5 (with higher scores indicating more advanced skill) by at least 10 peer surgeons who were unaware of the identity of the operating surgeon. We then assessed relationships between these skill ratings and risk-adjusted complication rates, using data from a prospective, externally audited, clinical-outcomes registry involving 10,343 patients. Mean summary ratings of technical skill ranged from 2.6 to 4.8 across the 20 surgeons. The bottom quartile of surgical skill, as compared with the top quartile, was associated with higher complication rates (14.5% vs. 5.2%, Pbariatric surgeons varied widely, and greater skill was associated with fewer postoperative complications and lower rates of reoperation, readmission, and visits to the emergency department. Although these findings are preliminary, they suggest that peer rating of operative skill may be an effective strategy for assessing a surgeon's proficiency.

  3. Pulmonary Complications due to Esophagectomy

    Directory of Open Access Journals (Sweden)

    Yashar Talebi

    2011-08-01

    Full Text Available Introduction: Esophageal carcinoma is the scourge of human beings. Pulmonary compli-cations in patients who have undergone operation are common (20-30% of cases and there are no suitable tools and ways to predict these complications. Methods: During a period of 10 years, from March 1998 to February 2007, 200 patients (150 male and 50 female underwent Esophagectomy due to esophageal carcinoma in thoracic surgery ward retrospectively. Complications include the length of hospitalization, mechanical ventilation, morbidity and mortality. Patients’ risk factors include age, preoperative chemo-radiotherapy, stage of the disease and preoperative spirometry condition. Results: We grouped our patients into three categories: Normal (FEV1 ≥ 80% predicted, mildly impaired (FEV1 65% to 79% predicted, more severely impaired (FEV1 < 65% predicted.Although almost all patients had radiographic pulmonary abnormalities, significant pulmonary complications occurred in 40 patients (20% which underwent Esophagectomy. Pleural effusion and atelectasia in 160 patients (80%. 24 patients needed chest-tube insertion. 20 patients (10% developed ARDS. 14 patients (7% developed chylothorax. 20 patients (10% of patients died during their postoperative hospital stay. 30 patients (15% required mechanical ventilation for greater than 48 hours. Conclusion: We reviewed a number of preoperative clinical variables to determine whether they contributed to postoperative pulmonary complications as well as other outcomes. In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS. In fact pulmonary complications rate after Esophagectomy are high and there was associated mortality and morbidity.

  4. Mortality due to lung cancer in Mexico.

    Science.gov (United States)

    Ruíz-Godoy, L; Rizo Rios, P; Sánchez Cervantes, F; Osornio-Vargas, A; García-Cuellar, C; Meneses García, A

    2007-11-01

    The highest mortality due to cancer worldwide for both genders corresponds to lung cancer (1,179,000 deaths). In Mexico, the crude mortality rate due to lung cancer was of 5.01 per 10(5) inhabitants in 1979. The most important risk factor is smoking. The present study was aimed at analyzing the mortality due to lung cancer in Mexico, assessing data from each of the states constituting the Mexican Republic during the 1998-2004 period. Data were obtained from the National Institute of Statistics, Geography and Informatics (INEGI, for its initials in Spanish) corresponding to deaths due to lung cancer (1998-2004). We estimated the mean annual mortality rate (MAMR) for each of the 32 states of Mexico. We used the "World Population Standard". The MAMR was standardized according to age (ARS) direct method, and the standard error was determined by Poisson's approximation at a 95% confidence interval. To know the excess risk due to mortality, we calculated the standardized mortality ratios (SMRs) of ARS for each federal state, using the national rate as reference. In this period, 397,400 deaths due to malignant neoplasms were recorded, corresponding 45,578 (11.5%) to lung cancer; for men, 31,025 (68.1%) with MAMR of 8.9 and the respective ARS of 13.2 both x10(5) inhabitants. For women, results were 4553 (31.9%) deaths with MAMR of 4.1 and ARS of 5.4 both x10(5) inhabitants. The highest mortality rates due to lung cancer in both genders were observed in the north of Mexico, whereas for women this was observed in the central states. Although smoking is the main risk for lung cancer, there are other factors such as environmental pollution or exposure to toxicants that could be associated to this cancer. The years potentially lost due to lung cancer were 258,550 for men and 133,315 for women, with a total of 391,865 according to histopathology registry neoplasm malignant RHNM (1985-1995). Studies focused on the characterization and measurement of polluting agents would be a

  5. Interest Rate Transmission to Commercial Credit Rates in Austria

    OpenAIRE

    Burgstaller, Johann

    2003-01-01

    The transmission process from policy-controlled interest rates to bank lending rates deserves reconsideration owing to the implementation of the European Monetary Union (EMU) in 1999. Additional attention to the subject in Austria is due to several large banks which, in 2002, have been charged for not passing on interest rate decreases to their customers. I examine dynamic responses of commercial credit rates to changes in key policy rates and money market rates. Using Austrian data from 1995...

  6. 38 CFR 4.58 - Arthritis due to strain.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Arthritis due to strain... FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.58 Arthritis due to strain. With service incurred lower extremity amputation or shortening, a disabling arthritis, developing in...

  7. Conducting Due Diligence in China

    Institute of Scientific and Technical Information of China (English)

    CHRIS; DEVONSHIRE-ELLIS

    2008-01-01

    Ninety percent of problems when set- ting up business in China can be avoided by the deployment of due diligence at the front end of the investment planning.Here we point out some of the areas that can hinder a sensible approach to due diligence,the hidden risks and basic checks.The process does not have to be expensive. Land use rights These relate to the status of the land on which your Chinese partner has his prem-

  8. Ratings Revisited

    DEFF Research Database (Denmark)

    Lai, Signe Sophus

    2015-01-01

    tværs af medier og platforme, forskudt i tid og on-demand. This article focuses on audience ratings, which have functioned as the central ‘currency’ informing the media trade. It discusses changes to the production and accuracy of audience ratings at a time when established standards are being...... consumption. It argues that current tracking systems cannot capture increasingly cross-media, time-shifted, mobile, and on-demand audience behavior....

  9. Due Process Hearing Case Study

    Science.gov (United States)

    Bateman, David F.

    2009-01-01

    William is 9 years of age, residing with his parent within the boundaries of an unnamed district ("the District"). As a student with autism he is eligible for special education programming and services. There was one issue presented for this due process hearing: What was the appropriate program and placement for him for the 2008-2009 school year?…

  10. Elephantine nose due to rhinoentomophthoromycosis.

    Science.gov (United States)

    Ghorpade, Ashok; Sarma, Podila S A; Iqbal, Syed Md

    2006-01-01

    Rhinoentomophthoromycosis in an immunocompetent Indian male due to Basidiobolus species resulting in a huge (elephantine) nasal deformity, is reported. The diagnosis was done by demonstration of hyphae in direct tissue smear examination in potassium hydroxide, histopathological examination and by cultural characteristics. He showed an excellent response to oral potassium iodide solution.

  11. Endocarditis Due to Citrobacter Freundii

    OpenAIRE

    Reyes, Cesar V.; Folwarkiw, Oksana

    1984-01-01

    The etiologic association of acute bacterial endocarditis with the Citrobacter species has been rare, although it is one of the opportunistic organisms that afflicts the elderly, neonates, the debilitated and immunocompromised. We report a case of endocarditis due to Citrobacter freundii.

  12. Visual Impairment Due to Lissencephaly

    OpenAIRE

    Marqués-Fernández, V. E.; Sánchez-Tocino, H.; Escudero-Caro, M.T.; Cancho-Candela, R.; García-Zamora, M.

    2016-01-01

    Lissencephaly is a rare disorder due to abnormal neural migration, causing neurological impairment and clinically characterised by mental retardation and epilepsy. Any disturbance of the visual pathway can cause loss of vision. The authors describe a case of a 6-year-old boy referred to the ophthalmologist presenting poor bilateral vision. This child had no other known medical conditions, and neurological examination was completely normal. Only when a magnetic resonance imaging was made that ...

  13. Autoerotic death due to electrocution

    Directory of Open Access Journals (Sweden)

    Piotr Arkuszewski

    2014-08-01

    Full Text Available Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

  14. Pseudoaneurysm of gastroduodenal artery due to duodenal ulcer causing jaundice and interstitial pancreatitis but not gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Jovanović Miodrag

    2004-01-01

    Full Text Available Aneurysms and pseudoaneurysms of the gastroduodenal artery are rare with less then 50 cases reported. Most frequently they are one of the consequences of pancreatitis much rarer duodenal ulcer or operative trauma during gastrectomy for duodenal ulcer or choledochotomy. We report on a 47 year-old man, chronic heavy alcohol consumer in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum, eroded gastroduodenal artery causing pseudo-aneurysm but without noticeable gastrointestinal bleeding. The patient had jaundice of obstructive type and elevated amilase. After Billroth II gastrectomy, suture of the gastroduodenal artery, cholecystectomy and T tube drainage of the common bile duct the patient developed intestinal obstruction caused by two interintestinal abscesses so that he had to be reoperated. After that he had a successful recovery, his general health greatly improved, he gained 15 kg in weight but two years after surgery he again started with heavy drinking and soon died due to serious brain damage. The case is rare and unusual at least for few reasons: First, the pseudoaneurysm was caused by duodenal ulcer. Second, a serious gastrointestinal bleeding did not take place. Third, the pseudoaneurysm was diagnosed by Doppler ultrasonography while angiography failed to opacity it due to thrombosis of the artery.

  15. Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy.

    Science.gov (United States)

    Canelas, Caroline M; Shih, Richard D; Clayton, Lisa M; Giroski, Laura J; Alter, Scott M; Feinstein, Stacey; Learman, Lee A

    2017-06-01

    A leading cause of maternal mortality in the first trimester is hemorrhage due to a ruptured ectopic pregnancy. With the advent of tube salvage surgery, ectopic pregnancies can be removed while ensuring hemostasis and preserving the integrity of the fallopian tube. A major drawback of tube salvage surgery is the significant risk of persistent trophoblastic tissue being left behind. We report a case of a 30year old female who presented to the ED with acute abdomen and hemoperitoneum due to a ruptured ectopic pregnancy. She was treated with salpingostomy and the pathologic report confirmed removal of the ectopic pregnancy. After an initially uneventful post-operative recovery, she presented to the ED 27days later with signs of acute abdomen and hemoperitoneum. Surgical intervention confirmed a ruptured ectopic pregnancy in the same site as previous, and salpingectomy was performed, after which the patient recovered without complications. The increased risk of persistent trophoblastic tissue associated with tube salvage surgery can lead to subsequent reoperation for tubal rupture. Patients undergoing these procedures should be closely monitored in the following weeks and undergo serial β-hCG testing in order to confirm successful removal of the ectopic. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Anaphylaxis Due to Head Injury

    Directory of Open Access Journals (Sweden)

    Bruner, Heather C.

    2015-05-01

    Full Text Available Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. [West J Emerg Med. 2015;16(3:435–437.

  17. Endocarditis due to Kingella kingae.

    Science.gov (United States)

    Odum, L; Jensen, K T; Slotsbjerg, T D

    1984-06-01

    Four cases of endocarditis due to Kingella kingae are described in compromised patients. All had primary heart disease, and two had systemic lupus erythematosis and congenital heart defect respectively, in addition. Confirmation of Kingella kingae was made in one case at autopsy. The literature on 11 cases of endocarditis, 2 bacteremia, 4 osteomyelitis, 5 septic arthritis and 1 intervertebral disc infection, all caused by Kingella kingae, is reviewed. Our findings confirm that the organism is of low pathogenicity. Children may be predisposed to infection with Kingella kingae.

  18. Interference due to coherence swapping

    Indian Academy of Sciences (India)

    Arun Kumar Pati; Marek Zukowski

    2001-02-01

    We propose a method called ‘coherence swapping’ which enables us to create superposition of a particle in two distinct paths, which is fed with initially incoherent, independent radiation. This phenomenon is also present for the charged particles, and can be used to swap the effect of flux line due to the Aharonov–Bohm effect. We propose an optical version of experimental set-up to test the coherence swapping. The phenomenon, which is simpler than entanglement swapping or teleportation, raises some fundamental questions about the true nature of wave-particle duality, and also opens up the possibility of studying the quantum erasure from a new angle.

  19. Tardive akathisia due to sulpiride.

    Science.gov (United States)

    López de Munain, A; Poza, J J; Gorospe, A; Arce, A; Martí Massó, J F

    1994-10-01

    A 56 year-old woman who suffered from parkinsonism, oro-lingual dyskinesia (OLD) and tardive akathisia (TA) due to sulpiride is reported. OLD and TA appeared after sulpiride withdrawal. The patient was successfully treated with tetrabenazine even a mild parkinsonism was present. TA seems to be related with an apparent dopaminergic hyperactivity and it has to be differentiated of other neuroleptic-induced movement disorders such as restless legs syndrome in order of an appropriate treatment. Sulpiride has the same possible side effects than classic neuroleptics.

  20. Maculopathy due to drug inhalation.

    Science.gov (United States)

    Asensio-Sánchez, V M; Gonzalez-Buendia, L; Marcos-Fernández, M

    2014-08-01

    A case of maculopathy due to "poppers" is described. Poppers is a drug composed of various forms of alkyl nitrite. A 39 year-old man, who had been using poppers for years, was seen in the clinic with phosphenes, reduced visual acuity and central scotoma. The SD-OCT in the right eye showed disruption at the level of the IS/OS junction line. The SD-OCT scan in the left eye showed an outer rectangular retinal hole and an outer retinal cyst. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  1. Attenuation of 3CM Microwaves Due to Artificial Rain

    Directory of Open Access Journals (Sweden)

    J. K. Singh

    1966-04-01

    Full Text Available Observations to study the variation of attenuation of 3cm waves due to falling of water or artificial rain are confined to the high rates of precipitation and short distance between the transmitter and receiver, due to low power of the microwave generator. A comparison of these observations and those recorded by others shows that the attenuation increases nonlinearly with the intensity of artificial rainfall which is generally assumed to be linear for the observations at lower rates of precipitation.

  2. Aspectos práticos na indicação de revisão de hemostasia no pós-operatório imediato de cirurgia cardíaca Practical aspects in the recommendation for reoperation in immediate postoperative phase of cardiac surgery

    Directory of Open Access Journals (Sweden)

    Luís Alberto Dallan

    1989-12-01

    Full Text Available Foram estudados restrospectivamente os coagulogramas de 65 pacientes submetidos a revisão de hemostasia no pós-operatório imediato de cirurgia cardíaca. Os coagulogramas foram considerados compatíveis ou não com distúrbio da coagulação sangüínea, por hematologista que desconhecia o achado cirúrgico. Dentre 51 pacientes cujos valores do coagulograma foram considerados normais, 46 (90,2% apresentavam sangramento ativo localizado, passível de correção cirúrgica. Os 5 (9,8% demais pacientes apresentavam sangramento difuso. Dentre os 14 pacientes restantes, cujo coagulograma encontrava-se alterado, 8 (57,2% apresentavam sangramento difuso e 6 (42,8%, localizado. Os autores concluem que, na persistência de sangramento excessivo pós-operatório e coagulograma normal, a revisão de hemostasia deverá ser prontamente indicada. Entretanto, se houver alteração do coagulograma, dever-se-à empregar, inicialmente, o tratamento clínico, desde que o ritmo do sangramento o permita. Caso o sangramento persista, mesmo com melhora do coagulograma, deverá ser pesquisada a presença de coágulos retidos no mediastino. Se positiva, deve-se programar nova toracotomia, visando à remoção de coágulos do mediastino.Blood coagulation of 65 patients that needed reoperation to control excessive bleeding after cardiopulmonary bypass surgery was evaluated by hematologist that didn't know the reoperation findings. Forty-six (90.2% of 51 patients with normal tests before the reintervention had localizated bleeding, and five (9.8% had difuse hemorrhage. From 14 patients with abnormal coagulation tests, eight (57.2% had difuse bleeding and six (42.8% had a localizated bleeding. The authors concluded that with normal coagulation tests and excessive bleeding after cardiopulmonary bypass surgery a new reoperation is indicated. Otherwise, patients with abnormal coagulation tests can receive initial clinical treatment.

  3. Recurrence of sickness absence due to common mental disorders

    NARCIS (Netherlands)

    Koopmans, P.C.; Bultmann, U.; Roelen, C.A.; Hoedeman, R.; van der Klink, J.J.; Groothoff, J.W.

    2011-01-01

    PURPOSE: Common mental disorders (CMDs) are an important cause of work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. This study examines the recurrence risk of sickness absence due to CMDs. METHODS: A cohort o

  4. Modelling Australia's Retail Mortgage Rate

    OpenAIRE

    Abbas Valadkhani; Sajid Anwar

    2012-01-01

    There is an ongoing controversy over whether banks’ mortgage rates rise more readily than they fall due to their asymmetric responses to changes in the cash rate. This paper examines the dynamic interplay between the cash rate and the variable mortgage rate using monthly data in the post-1989 era. Unlike previous studies for Australia, our proposed threshold and asymmetric error-correction models account for both the amount and adjustment asymmetries. We found thatrate rises have much larger ...

  5. Occupational injuries due to violence.

    Science.gov (United States)

    Hales, T; Seligman, P J; Newman, S C; Timbrook, C L

    1988-06-01

    Each year in the United States, an estimated 800 to 1,400 people are murdered at work, and an unknown number of nonfatal injuries due to workplace violence occur. Based on Ohio's workers' compensation claims from 1983 through 1985, police officers, gasoline service station employees, employees of the real estate industry, and hotel/motel employees were found to be at the highest risk for occupational violent crime (OVC) injury and death. Grocery store employees, specifically those working in convenience food stores, and employees of the real estate industry had the most reported rapes. Four previously unidentified industries at increased risk of employee victimization were described. Identification of industries and occupations at high risk for crime victimization provides the opportunity to focus preventive strategies to promote employee safety and security in the workplace.

  6. Recurrence rate after absorbable tack fixation of mesh in laparoscopic incisional hernia repair

    DEFF Research Database (Denmark)

    Christoffersen, Mette W; Brandt, E; Helgstrand, F;

    2015-01-01

    absorbable or non-absorbable tacks for mesh fixation. METHODS: This was a nationwide consecutive cohort study based on data collected prospectively concerning perioperative information and clinical follow-up. Patients undergoing primary, elective, laparoscopic incisional hernia repair with absorbable or non......-absorbable tack fixation during a 4-year interval were included. Follow-up was by a structured questionnaire regarding recurrence and chronic pain, supplemented by clinical examination, and CT when indicated. Recurrence was defined as either reoperation for recurrence or clinical/radiological recurrence. RESULTS......: Of 1037 eligible patients, 84·9 per cent responded to the questionnaire, and 816 were included for analysis. The median observation time for the cohort was 40 (range 0-72) months. The cumulative recurrence-free survival rate was 71·5 and 82·0 per cent after absorbable and non-absorbable tack fixation...

  7. Secondary amyloidosis due to FMF.

    Science.gov (United States)

    Yonem, Ozlem; Bayraktar, Yusuf

    2007-06-01

    Familial Mediterranean fever (FMF) is an ethnically restricted disease with an autosomal recessive inheritance characterized by recurrent attacks of fever, painful manifestations in the abdomen, chest and joints. The disease affects mainly non-Ashkenazi Jews, Armenians, Turks Arabs and other people of Mediterranean origin. The disease may present at any age, more than 80% of patients being symptomatic by the age of 20. Although the inflammatory attacks that characterize the disease may sometimes be debilitating, secondary (AA) amyloidosis remains the most serious manifestation of FMF causing considerable morbidity due mostly to nephropathic amyloidosis. The largest series of secondary amyloidosis in FMF have been reported from Turkey. The pathophysiological steps in progressing a patient from FMF to amyloidosis are not definitely known. Daily treatment with colchicine can prevent both the attacks and amyloid deposition but no effective alternative treatment exists for colchicine resistant cases. Meanwhile more population based epidemiological and genetic data should be gathered by worldwide collaborative studies to elucidate the link between FMF and amyloidosis and to develop alternative therapies.

  8. Galactorrhea due to psychotropic drugs.

    Science.gov (United States)

    Kropp, S; Ziegenbein, M; Grohmann, R; Engel, R R; Degner, D

    2004-03-01

    Within the drug safety program in psychiatry AMSP ( Arzneimittelsicherheit in der Psychiatrie), severe adverse drug reactions (ADRs) are assessed. Currently 35 psychiatric hospitals and departments are participating in detecting severe ADRs. This paper focuses on prolactin-dependent ADRs such as gynecomastia and galactorrhea due to psychotropic medications. Related to the number of patients surveyed (122,562 from 1993 to 2000), these are rare events (0.03 % or 35 cases). Imputed drugs were mostly antipsychotics, but antidepressants were also imputed in single cases. In the group of antipsychotics, relative frequencies of galactorrhea were highest for amisulpride and risperidone and corresponded to the degree of D2 binding. Galactorrhea assessed as "severe" was accompanied by distressing symptoms such as pain, tension, enlargement of breasts, or soaked clothing. The AMSP data contribute to the knowledge on endocrine ADRs by the large number of patients examined and help clinicians select the appropriate drug if their patients have been prone to for these ADRs in the past.

  9. Otomycosis due to filamentous fungi.

    Science.gov (United States)

    García-Agudo, Lidia; Aznar-Marín, Pilar; Galán-Sánchez, Fátima; García-Martos, Pedro; Marín-Casanova, Pilar; Rodríguez-Iglesias, Manuel

    2011-10-01

    Otomycosis is common throughout the world but barely studied in Spain. Our objective was to determine the microbiological and epidemiological characteristics of this pathology in Cadiz (Spain) between 2005 and 2010. Samples from patients with suspicion of otomycosis underwent a direct microscopic examination and culture on different media for fungi and bacteria. Mycological cultures were incubated at 30°C for at least seven days. Identification of fungi was based on colonial morphology and microscopic examination of fungal structure. From a total of 2,633 samples, microbial growth was present in 1,375 (52.2%) and fungal isolation in 390 (28.4%). We identified 228 yeasts and 184 filamentous fungi (13.4% of positive cultures and 47.2% of otomycosis), associated with yeasts in 22 cases (5.6%). The most frequent species were Aspergillus flavus (42.4%), A. niger (35.9%), A. fumigatus (12.5%), A. candidus (7.1%), A. terreus (1.6%), and Paecilomyces variotii (0.5%). Infection was predominant in men (54.9%) and patients beyond 55 years old (46.8%). The most common clinical symptoms were itching (98.9%), otalgia (59.3%), and hypoacusis (56.0%). Fall season reported the lowest number of cases (20.1%). Incidence of otomycosis and fungi producing otomycosis vary within the distinct geographical areas. In Cadiz, this infection is endemic due to warm temperatures, high humidity, sea bathing, and wind, which contributes to disseminate the conidia. Despite Aspergillus niger has been reported as the main causative agent, A. flavus is predominant in Cadiz. Although infection is usually detected in warm months, we observed a homogeneous occurrence of otomycosis in almost all the seasons.

  10. Telomere attrition due to infection.

    Directory of Open Access Journals (Sweden)

    Petteri Ilmonen

    Full Text Available BACKGROUND: Telomeres--the terminal caps of chromosomes--become shorter as individuals age, and there is much interest in determining what causes telomere attrition since this process may play a role in biological aging. The leading hypothesis is that telomere attrition is due to inflammation, exposure to infectious agents, and other types of oxidative stress, which damage telomeres and impair their repair mechanisms. Several lines of evidence support this hypothesis, including observational findings that people exposed to infectious diseases have shorter telomeres. Experimental tests are still needed, however, to distinguish whether infectious diseases actually cause telomere attrition or whether telomere attrition increases susceptibility to infection. Experiments are also needed to determine whether telomere erosion reduces longevity. METHODOLOGY/PRINCIPAL FINDINGS: We experimentally tested whether repeated exposure to an infectious agent, Salmonella enterica, causes telomere attrition in wild-derived house mice (Mus musculus musculus. We repeatedly infected mice with a genetically diverse cocktail of five different S. enterica strains over seven months, and compared changes in telomere length with sham-infected sibling controls. We measured changes in telomere length of white blood cells (WBC after five infections using a real-time PCR method. Our results show that repeated Salmonella infections cause telomere attrition in WBCs, and particularly for males, which appeared less disease resistant than females. Interestingly, we also found that individuals having long WBC telomeres at early age were relatively disease resistant during later life. Finally, we found evidence that more rapid telomere attrition increases mortality risk, although this trend was not significant. CONCLUSIONS/SIGNIFICANCE: Our results indicate that infectious diseases can cause telomere attrition, and support the idea that telomere length could provide a molecular

  11. Cellulitis Due to Salmonella infantis.

    Directory of Open Access Journals (Sweden)

    Satish R Patil

    2013-01-01

    Full Text Available Bacteria of the genus Salmonella are highly adapted for the growth in both humans and animals and cause a wide spectrum of disease. The growth of Serotypes S. typhi and S. paratyphi is restricted to human hosts, in whom these organisms cause enteric (typhoid fever. The remaining Serotypes (non typhoidal Salmonella or NTS can colonize the gastrointestinal tracts of the broad range of animals, including mammals, reptiles, birds and insects. The usual clinical presentation of non-typhoidal salmonellae (NTS infection is self limited gastroenteritis; however bacteremia and focal extra intestinal infection may occur. However salmonella localization to the skin presenting as cutaneous ulceration is regarded as a rare event. Rates of morbidity and mortality associated with NTS are highest among the elderly, infants, and immunocompromised individuals, including those with hemoglobinopathies, HIV infection, or infections that cause blockade of the reticuloendothelial system. We isolated S.infantis in 50 years old man with left leg cellulitis. The serotype was confirmed at Central Research Institute, Kasauli.

  12. Laparoscopic treatment of colovesical fistulas due to complicated colonic diverticular disease: a systematic review.

    Science.gov (United States)

    Cirocchi, R; Cochetti, G; Randolph, J; Listorti, C; Castellani, E; Renzi, C; Mearini, E; Fingerhut, A

    2014-10-01

    Colovesical fistulas originating from complicated sigmoid diverticular disease are rare. The primary aim of this review was to evaluate the role of laparoscopic surgery in the treatment of this complication. The secondary aim was to determine the best surgical treatment for this disease. A systematic search was conducted for studies published between 1992 and 2012 in PubMed, the Cochrane Register of Controlled Clinical Trials, Scopus, and Publish or Perish. Studies enrolling adults undergoing fully laparoscopic, laparoscopic-assisted, or hand-assisted laparoscopic surgery for colovesical fistula secondary to complicated sigmoid diverticular disease were considered. Data extracted concerned the surgical technique, intraoperative outcomes, and postoperative outcomes based on the Cochrane Consumers and Communication Review Group's template. Descriptive statistics were reported according to the PRISMA statement. In all, 202 patients from 25 studies were included in this review. The standard treatment was laparoscopic colonic resection and primary anastomosis or temporary colostomy with or without resection of the bladder wall. Operative time ranged from 150 to 321 min. It was not possible to evaluate the conversion rate to open surgery because colovesical fistulas were not distinguished from other types of enteric fistulas in most of the studies. One anastomotic leak after bowel anastomosis was reported. There was zero mortality. Few studies conducted follow-up longer than 12 months. One patient required two reoperations. Laparoscopic treatment of colovesical fistulas secondary to sigmoid diverticular disease appears to be a feasible and safe approach. However, further studies are needed to establish whether laparoscopy is preferable to other surgical approaches.

  13. Rates of Gravel Dispersion

    Science.gov (United States)

    Haschenburger, J. K.

    2010-12-01

    Sediment transfers in gravel-bed rivers involve the three-dimensional dispersion of mixed size sediment. From a kinematics standpoint, few studies are available to inform on the streamwise and vertical rates of sediment dispersion in natural channels. This research uses a gravel tracing program to quantify dispersion rates over 19 flood seasons. Empirical observations come from Carnation Creek, a small gravel-bed river with large woody debris located on the west coast of Vancouver Island, Canada. Frequent floods and the relatively limited armor layer facilitate streambed activity and relatively high bedload transport rates, typically under partial sediment transport conditions. Over 2500 magnetically tagged stones, ranging in size from 16 to 180 mm, were deployed on the bed surface between 1989 and 1992 in four generations. To quantify gravel dispersion over distances up to 2.6 km, observations are taken from 11 recoveries. Over 280 floods capable of moving bedload occurred during this period, with five exceeding the estimated bankfull discharge. Streamwise dispersion is quantified by virtual velocity, while dispersion into the streambed is quantified by a vertical burial rate. The temporal trend in streamwise dispersion rates is described by a power function. Initial virtual velocities decline rapidly from around 1.4 m/hr to approach an asymptote value of about 0.2 m/hr. The rapid change corresponds to a significant increase in the proportion of buried tracers due to vertical mixing. Initial burial rates reflect the magnitude of the first flood after tracer deployment and range from 0.07 to 0.46 cm/hr depending on tracer generation. Burial rates converge to about 0.06 cm/hr after the fourth flood season and then gradually decline to about 0.01 cm/hr. Thus, the rate of streamwise dispersion exceeds that of vertical dispersion by three orders of magnitude when the movement of sediment routinely activated by floods is considered.

  14. What to Expect After Your Due Date

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG What to Expect After Your Due Date Home For ... Your Due Date FAQ069, August 2011 PDF Format What to Expect After Your Due Date Pregnancy What ...

  15. Heart rate turbulence.

    Science.gov (United States)

    Cygankiewicz, Iwona

    2013-01-01

    Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death. © 2013.

  16. Clinical characteristics and reoperation of symptomatic adjacent segment degeneration post-operation of lumbar fusion%腰椎融合术后症状性邻近节段退变的临床特点和再手术治疗

    Institute of Scientific and Technical Information of China (English)

    孙浩林; 李淳德; 刘宪义; 邑晓东; 刘洪; 卢海霖; 李宏; 于峥嵘; 赵硕

    2012-01-01

    Objective:To evaluate the clinical characteristics and reoperation of symptomatic adjacent segment degeneration post-operation of lumbar fusion. Methods;In the study, 28 cases of symptomatic adjacent segment degeneration post-operation of lumbar fusion from May 2007 to April 2012 were retrospectively reviewed,with an average age of (64. 3±8. 7) years. The mean period between reoperation and primary fusion surgery was (47. 5 ±30. 8) months. Symptomatic adjacent segment degeneration located in cephalic segments in 12 cases, in caudal segments in 14 cases and in both segments in 2 cases. Of all the 28 patients, 12 suffered from lumbar stenosis, other 13 from lumbar disc herniation and still other 3 from both lumbar stenosis and disc herniation, of whom 11 were together with segment instability. Localization diagnoses of 19 cases were clear and other 9 received diagnostic nerve root block. The cases were divided into two groups by the type of reoperation, of which 8 cases were in adjacent degenerative segment nonfusion group and the other 20 cases in adjacent degenerative segment fusion group. The clinical results were assessed by lumbar pain visual analog score (VAS) and lower limber pain VAS, lumbar Japanese Orthopedic Association (JOA) score and Prolo functional score before operation and in the final follow-up. Results; In adjacent degenerative segment nonfusion group, the average operation time was (86. 3±17. 1) min and average blood volume was (125. 0±37. 8 ) mL of reoperation and 1 case with dural injury; and in adjacent degenerative segment fusion group, the average operation time was (201.6± 71. 0) min and average blood volume was (313. 6±18. 9) mL of revision surgery and 4 cases with dural injury. The average follow-up period was 25. 5 months. In the final follow-up,lumbar pain VAS,lower limber pain VAS, lumbar JOA score and Prolo functional score of adjacent degenerative segment nonfusion group were 2.4± 1. 2, 2. 8±1.4,23. 5±4. 2 and 8. 2±1

  17. Calculus of radiolytic products generation in water due to alpha radiation. Determination of the spent nuclear fuels matrix alteration rate Determination of velocity of spent fuel matrix; Calculo de la generacion de productos radioliticos en agua por radiacion {alpha}. Determinacion de la velocidad de alteracion de la matriz del combustible nuclear gastado

    Energy Technology Data Exchange (ETDEWEB)

    Quinones, J.; Serrano, J.; Diaz Arocas, P.; Rodriguez Almazan, J. L. [Ciemat. Madrid (Spain); Bruno, J.; Cera, E.; Merino, J.; Esteban, J. A.; Martinez-Esparza, A. [Enresa. Madrid (Spain)

    2000-07-01

    The generation of radiolytic products as a result of alpha radiation in the surface of the spent fuel is a key process in order to understand how the it becomes degraded in repository conditions. The present work has established a radiolytic model based on a set of reactions involving fuel oxidation-dissolution and radiolytic products recombination. It also includes the decrease of the dose rates as the main alpha emitters decay away. Four cases, with varying parameters of the system, have been assessed. The results show a decrease in both the concentration of the radiolytic products in the gap water and the degradation of the fuel matrix. It has been estimated that in the period of the evaluation (10''6 years) up to 52% of the pellet is altered in the conservative cases, whereas only 11% is altered in the realistic cases. No significant differences were observed when the carbonates reactions were included in the system. (Author)

  18. 5 CFR 732.301 - Due process.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Due process. 732.301 Section 732.301...) NATIONAL SECURITY POSITIONS Due Process and Reporting § 732.301 Due process. When an agency makes an... any determination. (b) Comply with all applicable administrative due process requirements, as...

  19. 38 CFR 3.273 - Rate computation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Rate computation. 3.273 Section 3.273 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension... of rates due to changes in the maximum annual pension rate or rate of income following the...

  20. Negative Policy Rates, Banking Flows and Exchange Rates

    OpenAIRE

    Khayat, Anwar

    2015-01-01

    Setting negative nominal rates is one of the unconventional policies implemented after the Great Recession to overcome the Zero Lower Bound. Using data from the euro area and Denmark, I assess the impact of introducing a negative interest rate on reserves. I find that it did put a depreciation pressure on the currency due to a reversal in banking flows. This effect is not only caused by policy differentials, but also by a distinct impact of going into negative territory from lowering interest...

  1. Heart rate variability and heart rate recovery as prognostic factors

    OpenAIRE

    GRAD, COSMIN

    2015-01-01

    Background and aim Heart rate (HR) can appear static and regular at rest, during exercise or recovery after exercise. However, HR is constantly adjusted due to factors such as breathing, blood pressure control, thermoregulation and the renin-angiotensin system, leading to a more dynamic response that can be quantified using HRV (heart rate variability). HRV is defined as the deviation in time between successive normal heart beat and is a noninvasive method to measure the total variation in a ...

  2. 2007 Wholesale Power Rate Schedules : 2007 General Rate Schedule Provisions.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    2006-11-01

    This schedule is available for the contract purchase of Firm Power to be used within the Pacific Northwest (PNW). Priority Firm (PF) Power may be purchased by public bodies, cooperatives, and Federal agencies for resale to ultimate consumers, for direct consumption, and for Construction, Test and Start-Up, and Station Service. Rates in this schedule are in effect beginning October 1, 2006, and apply to purchases under requirements Firm Power sales contracts for a three-year period. The Slice Product is only available for public bodies and cooperatives who have signed Slice contracts for the FY 2002-2011 period. Utilities participating in the Residential Exchange Program (REP) under Section 5(c) of the Northwest Power Act may purchase Priority Firm Power pursuant to the Residential Exchange Program. Rates under contracts that contain charges that escalate based on BPA's Priority Firm Power rates shall be based on the three-year rates listed in this rate schedule in addition to applicable transmission charges. This rate schedule supersedes the PF-02 rate schedule, which went into effect October 1, 2001. Sales under the PF-07 rate schedule are subject to BPA's 2007 General Rate Schedule Provisions (2007 GRSPs). Products available under this rate schedule are defined in the 2007 GRSPs. For sales under this rate schedule, bills shall be rendered and payments due pursuant to BPA's 2007 GRSPs and billing process.

  3. Predator and prey perception in copepods due to hydromechanical signals

    DEFF Research Database (Denmark)

    Kiørboe, Thomas; Visser, Andre

    1999-01-01

    (deformation rate, vorticity, acceleration) generated by the predator. On the assumption that hydrodynamic disturbances are perceived through the mechanical bending of sensory setae, we estimate the magnitude of the signal strength due to each of the fluid disturbance components. We then derive equations...

  4. Economic evaluation of water loss saving due to the biological ...

    African Journals Online (AJOL)

    Economic evaluation of water loss saving due to the biological control of water hyacinth at New ... Log in or Register to get access to full text downloads. ... The benefit/cost ratio at the low evapotranspiration rate was less than one, implying that ...

  5. When you pass your due date

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000515.htm When you pass your due date To use the sharing features ... link between you and your baby. As you pass your due date, the placenta may not work ...

  6. 34 CFR 602.25 - Due process.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Due process. 602.25 Section 602.25 Education... Required Operating Policies and Procedures § 602.25 Due process. The agency must demonstrate that the procedures it uses throughout the accrediting process satisfy due process. The agency meets this...

  7. Mortalidade por doenças do aparelho circulatório no município de Ribeirão Preto - SP, de 1980 a 2004 Mortalidad por enfermedades del aparato circulatorio en el municipio de Ribeirão Preto-SP, del 1980 a 2004 Mortality rates due to diseases of the circulatory system (DCS in Ribeirão Preto - SP, from 1980 to 2004

    Directory of Open Access Journals (Sweden)

    Suzana Alves de Moraes

    2009-12-01

    subsidies for health management hypotheses. OBJECTIVE: Identify mortality rate pattern for diseases of the circulatory system (DCS in Ribeirão Preto, SP (RP-SP, in the period between 1980 and 2004. METHODS: The number of deaths due to DCS were obtained from the Mortality Information System (SIM. Populational estimates for RP-SP - taking gender, age group, and calendar years into account - were obtained from the Brazilian Institute of Geography and Statistics (IBGE. Specific mortality rates were calculated on yearly basis according to gender and age group in 10-year intervals starting at 30 years of age. The trend analysis was conducted through polynomial regression models for time series. Significance level was < 0.05. RESULTS: Specific mortality rates due to DCS increased with age both among males and females, being higher among males in the 40 to 49-year-old range. After that, figures were comparable, although at 80-year-old age groups data for females showed to be higher than that for males in some years of the series. Along the study period, significant reduction was observed for mortality rates among both males and females, and for all age ranges from those causes (p<0.001. CONCLUSIONS: Mortality rate pattern due to DCS in RP-SP was similar to that found in developed areas, which helped formulate hypotheses on the likely protection factors that may explain the observed decline.

  8. Clinical reasearch of re-operation for postoperative recurrence of chronic dacryocystitis%慢性泪囊炎术后复发再手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    周昆; 刘玥; 周明辉

    2016-01-01

    目的:对比改良型外径路和鼻内镜下泪囊鼻腔吻合术对慢性泪囊炎术后复发患者的疗效。方法术后复发的慢性泪囊炎18例(18眼)随机分成两组;A组行外径路泪囊鼻腔吻合术,B组行鼻内镜下泪囊鼻腔吻合术。术后随访6个月。结果 A组8眼中治愈6眼、好转1眼,无效1眼。总体有效率87.50%;B组10眼中治愈9眼、好转1眼,总体有效率100%。两组差异具有统计学意义(χ2=7.8030,P=0.0019)。结论慢性泪囊炎术后复发患者,鼻内镜下泪囊鼻腔吻合术为更适合的手术方式,术前术后需要眼科及耳鼻喉科医师的跨学科合作。%Objective To compare the effect of improved exterior route dacryocystorhinostomy and nasal endoscopic dacryocystorhinostomy for postoperatively recurrent chronic dacryocystitis .Methods Eighteen eyes of 18 cases with postoperative recurrence of chronic dacryocystitis were randomly divided into two groups.8 eyes of group A was treated with improved dacryocystorhinostomy , and 10 eyes of group B was treated with improved nasal endoscopic dacryocystorhinostomy .All patients were followed up for 6 months. Results In group A, 6 eyes were cured, 1 eyes was improved and 1 eye was noneffective; the total therapeutic effective rate was 87.5%.In group B, 9 eyes were cured, 1 eyes was improved and none was noneffective;the total treatment effective rate was 100%.The difference between two groups was statistically significant(χ2 =7.8030,P=0.0019).Conclusion Nasal endoscopic dacryocystorhinostomy is suitable for postoperative recurrence chronic dacryocystitis .Interdisciplinary cooperation between ophthalmologist and rhinologist is required .

  9. THE ANALYSIS OF POPULATION MORBIDITY RATE DUE TO INCREASED ENERGY DEMAND

    Directory of Open Access Journals (Sweden)

    Perticas Diana

    2012-07-01

    Full Text Available Sustainable development as general acceptance is that form of ensuring the bio-socio-economic needs of the present generation without affecting the existence and development opportunities for the generations to come. Secondary, the concept refers to the protection of the environment that is at present greatly affected by externalities of the socio-economic activity of previous and present generations. As it is shown in this paper the negative effects of the environmental pollution records higher and higher values in a short period of time of which we analyze their impact on population health, focusing on the situation of Romania. I started the analysis from the assumptions that the health of an organism is a normal physical and physiological state, being the opposite of the concept disease. The most common diseases are: hereditary, infectious, internal, infantile, autoimmune, allergic, socio-professional, tumorous, degenerative diseases etc. Of these infant, allergic, tumorous and autoimmune diseases are mainly generated by environmental pollution. Extremely special, regarding the incidence of harmful environmental factors, are the socio-professional diseases or of civilization that are represented by those diseases that are more common in industrialized countries than in the so called third world. In respect to air pollution-generated illnesses with products resulting from burning fossil fuels are highlighted respiratory diseases, immunological diseases, benign and malignant neoplasm of the airways and also dermatitis. Most activities follow sooner or later to increase welfare. Economic growth, environmental protection as well as fulfilling social needs of individuals are only a few elements that lead to the increase of population welfare. If we accept the above mentioned things, then it means that promoting the realisation of sustainable development based on clean and renewable resources and the rationally using the conventional ones is an objective to be supported and of course achieved.

  10. Measuring the dayside reconnection rate during an interval of due northward interplanetary magnetic field

    Directory of Open Access Journals (Sweden)

    G. Chisham

    2004-12-01

    Full Text Available This study presents, for the first time, detailed spatiotemporal measurements of the reconnection electric field in the Northern Hemisphere ionosphere during an extended interval of northward interplanetary magnetic field. Global convection mapping using the SuperDARN HF radar network provides global estimates of the convection electric field in the northern polar ionosphere. These are combined with measurements of the ionospheric footprint of the reconnection X-line to determine the spatiotemporal variation of the reconnection electric field along the whole X-line. The shape of the spatial variation is stable throughout the interval, although its magnitude does change with time. Consequently, the total reconnection potential along the X-line is temporally variable but its typical magnitude is consistent with the cross-polar cap potential measured by low-altitude satellite overpasses. The reconnection measurements are mapped out from the ionosphere along Tsyganenko model magnetic field lines to determine the most likely reconnection location on the lobe magnetopause. The X-line length on the lobe magnetopause is estimated to be ~6–11 RE in extent, depending on the assumptions made when determining the length of the ionospheric X-line. The reconnection electric field on the lobe magnetopause is estimated to be ~0.2mV/m in the peak reconnection region.

    Key words. Space plasma physics (Magnetic reconnection – Magnetospheric physics (Magnetopause, cusp and boundary layers – Ionosphere (Plasma convection

  11. Emergency thyroidectomy: Due to acute respiratory failure

    Directory of Open Access Journals (Sweden)

    Zulfu Bayhan

    2014-01-01

    CONCLUSION: Respiratory failure due to giant nodular goiter is a life-threatening situation and should be treated immediately by performing awake endotracheal intubation following emergency total thyroidectomy.

  12. Moisture Risk in Unvented Attics Due to Air Leakage Paths

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, D. [IBACOS, Inc., Pittsburgh, PA (United States); Shaffer, M. [IBACOS, Inc., Pittsburgh, PA (United States)

    2014-11-01

    IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Wärme und Feuchte instationär Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated with this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.

  13. Moisture Risk in Unvented Attics Due to Air Leakage Paths

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, D.; Shaffer, M.

    2014-11-01

    IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Warme und Feuchte instationar Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated with this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.

  14. Unwanted effects due to cosmetics - a review

    NARCIS (Netherlands)

    Schnuch, A.

    2007-01-01

    Cosmetics are a heterogeneous group of products, consisting of products abundantly used as shampoos or cleansing agents on the one hand, and of products not so frequently used as those applied for decorative purposes such as nail cosmetics. Due to a differing frequency of use and due to differing (c

  15. Procedural Due Process Rights in Student Discipline.

    Science.gov (United States)

    Pressman, Robert; Weinstein, Susan

    To assist administrators in understanding procedural due process rights in student discipline, this manual draws together hundreds of citations and case summaries of federal and state court decisions and provides detailed commentary as well. Chapter 1 outlines the general principles of procedural due process rights in student discipline, such as…

  16. Unwanted effects due to cosmetics - a review

    NARCIS (Netherlands)

    Schnuch, A.

    2007-01-01

    Cosmetics are a heterogeneous group of products, consisting of products abundantly used as shampoos or cleansing agents on the one hand, and of products not so frequently used as those applied for decorative purposes such as nail cosmetics. Due to a differing frequency of use and due to differing (c

  17. Peritoneal tuberculosis due to Mycobacterium caprae

    Directory of Open Access Journals (Sweden)

    T. Nebreda

    2016-01-01

    Full Text Available The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made.

  18. Unwanted effects due to cosmetics - a review

    NARCIS (Netherlands)

    Schnuch, A.

    2007-01-01

    Cosmetics are a heterogeneous group of products, consisting of products abundantly used as shampoos or cleansing agents on the one hand, and of products not so frequently used as those applied for decorative purposes such as nail cosmetics. Due to a differing frequency of use and due to differing

  19. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental disorders due to... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.129 Mental disorders due to traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  20. Rating Movies and Rating the Raters Who Rate Them

    OpenAIRE

    Zhou, Hua; Lange, Kenneth

    2009-01-01

    The movie distribution company Netflix has generated considerable buzz in the statistics community by offering a million dollar prize for improvements to its movie rating system. Among the statisticians and computer scientists who have disclosed their techniques, the emphasis has been on machine learning approaches. This article has the modest goal of discussing a simple model for movie rating and other forms of democratic rating. Because the model involves a large number of parameters, it is...

  1. Study Of Gear Teeth Distortions Due To Heat Treatment

    Directory of Open Access Journals (Sweden)

    V. Khade

    2015-02-01

    Full Text Available Abstract The work aims to study the distortion occurred due to heat treatment on the Gear teeth. The paper studies various causes of distortion control techniques to eliminate distortion which includes changes in design selection of material heat treatment process mainly due to quenching that includes cooling rates quenching mediums fixtures. An experimental study and results conducted for the effects of the distortion on the Gear teeth and to reduce the distortion with certain changes design modification resulting in shape amp size changes phase changes changes in hardness microstructure and residual stresses. It is observed that adequate velocity of quench oil around the component to be heat treated ensures uniform amp desired cooling rate as per heat treatment cycle. Modification in design of baffles achieved the adequate velocity and minimization of distortion. Also Fixtures for holding finished parts or assemblies during heat treatment may be either support or restraint type to control dimensional relations during aging.

  2. Moderate patient-prosthesis mismatch predicts cardiac events and advanced functional class in young and middle-aged patients undergoing surgery due to severe aortic stenosis.

    Science.gov (United States)

    Hernandez-Vaquero, Daniel; Garcia, Jose M; Diaz, Rocio; Calvo, David; Khalpey, Zain; Hernández, Ernesto; Rodriguez, Víctor; Morís, César; Llosa, Juan C

    2014-03-01

    The clinical impact of patient-prosthesis mismatch (PPM) on outcomes in young and middle-aged patients undergoing surgery for aortic valve replacement (AVR) remains unknown. Our objective was to examine the mid-term impact of PPM on overall mortality, quality of life, and cardiac events in this population. All patients younger than 70 years of age undergoing isolated AVR from October 2005 to October 2011 were analyzed. PPM was defined as the indexed effective orifice area ≤ 0.85 cm(2) /m(2) . We studied the impact of PPM on mid-term overall mortality, cardiac events, and New York Heart Association functional class using an analysis stratified for propensity score. Cardiac events were defined as cardiac death, sudden death, hospital readmission due to angina, syncope or heart failure or reoperation on aortic prosthesis. Two hundred and ninety-three patients were included in the study, of whom 81 (27.61%) had some degree of PPM. PPM had no impact on mid-term overall mortality (HR=1.45; 95% CI=0.65-3.22; p=0.36), although it had a negative impact on cardiac events (HR=11.52; 95% CI=5.25-25.24; pclass (RR=7.55; 95% CI=2.59-22.03; pclass in young and middle-aged patients undergoing AVR for severe stenosis. However, it is possible that it has no impact on overall mortality. © 2013 Wiley Periodicals, Inc.

  3. Prosthetic Joint Infections Due to Coagulase-Negative Staphylococci

    Directory of Open Access Journals (Sweden)

    Mohamad

    2015-12-01

    Full Text Available Context Staphylococcus aureus and coagulase-negative staphylococci (CoNS are the most frequently isolated pathogens and are responsible for approximately two-thirds of joint replacement infections. Evidence Acquisition Although both belong to the staphylococci genus, there are several epidemiological and therapeutic differences between S. aureus and the heterogenous group of CoNS. In general, however, preventive and therapeutic recommendations for Prosthetic Joint Infection PJI due to CoNS do not differ from PJI caused by other pathogens. Results The main differences between the pathogens lie in the clinical presentation of PJI, the presumed origin of infection, and the presence of a higher proportion of methicillin-resistant strains leading to a limited choice of antibiotic agents. Conclusions Fortunately, due to its lower virulence as compared to its cousin S. aureus, PJI due to CoNS may display higher remission rates than S. aureus-caused PJI after combined surgical and medical management.

  4. Complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital.

    Science.gov (United States)

    Haripriya, Aravind; Chang, David F; Reena, Mascarenhas; Shekhar, Madhu

    2012-08-01

    To analyze the rate of intraoperative complications, reoperations, and endophthalmitis with phacoemulsification, manual small-incision cataract surgery (SICS), and large-incision extracapsular cataract extraction (ECCE). Aravind Eye Hospital, Madurai, India. Retrospective cohort study. This study comprised consecutive cataract surgeries performed during a 12-month period. All surgical complications and endophthalmitis cases were tabulated and analyzed for each of 4 surgeon groups (staff, fellows, residents, visiting trainees). Within each surgeon group, complication rates with phacoemulsification, manual SICS, and ECCE were compared. The surgical distribution was 20,438 (26%) phacoemulsification, 53,603 (67%) manual SICS, and 5736 (7%) ECCE. The overall intraoperative complication rate was 0.79% for staff, 1.19% for fellows, 2.06% for residents, and 5% for visiting trainees. Extracapsular cataract extraction had the highest overall rate of surgical complications (2.6%). The overall complication rate was 1.01% for manual SICS and 1.11% for phacoemulsification. However, the combined complication rate for trainees was significantly higher with phacoemulsification (4.8%) than with manual SICS (1.46%) (P<.001). The corrected distance visual acuity was better than 6/12 in 96% after phacoemulsification complications and 89% after manual SICS complications (P<.001). There were 27 cases (0.04%) of endophthalmitis but no statistical differences between surgical methods or surgeon groups. For staff surgeons experienced with both phacoemulsification and manual SICS, intraoperative complication rates were comparably low. However, for trainee surgeons, the complication rate was significantly higher with phacoemulsification, suggesting that manual SICS may be a safer initial procedure to learn for inexperienced cataract surgeons in the developing world. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS

  5. Sudden death due to swimming in elderly women.

    Science.gov (United States)

    Škavić, Petar; Duraković, Din

    2015-03-01

    The aim was to analyze the rate of sudden death in elderly Croatian women in comparison to elderly Croatian men, who died suddenly due to swimming. In the period from 2002 to 2011 one elderly Croatian woman and five elderly men died suddenly during swimming. In the same time, the same number of elderly foreigners died due to swimming at the Croatian Adriatic coast. One Croatian woman aged 66, who suffered of arterial hypertension with left ventricular hyper- trophy of 15 mm, diabetes mellitus and alcoholic liver cirrhosis, drowned in the sea during swimming. She was intoxi- cated with alcohol and had alcohol level in urine of 3.03 per thousand. One foreign woman, aged 82, who suffered coronary heart disease with left ventricular scar after myocardial infarction, arterial hypertension with excessive left ventricular hypertrophy of 22 mm and nephroangiosclerosis, suddenly lost conscionsness during swimming. The death rate in elderly Croatian women due to swimming reached 0.25, and the death rate in men is eight times higher: 1.97 (p = 0.0701), but the difference is not significant probably because of a small observational number.

  6. Eumycotic mycetoma due to Madurella grisea

    Directory of Open Access Journals (Sweden)

    Walter Belda Júnior

    1989-06-01

    Full Text Available The authors reported one case of eumycotic mycetoma due to Madurella grisea (black grains occurred on the right foot of the patient studied. The structure, microscopic morphology and therapeutic evolution are also studied and reported.

  7. REVIEW ON LOCAL SCOUR DUE TO JETS

    Institute of Scientific and Technical Information of China (English)

    Arindam SARKAR; Subhasish DEY

    2004-01-01

    The safety of an apron of the energy dissipator is threatened by the large-scale scour in the downstream of the apron due to the erosive action of a horizontal jet issuing from a sluice opening. Also, large-scale deposition of the scoured sediments due to an impinging jet in a plunging pool type energy dissipator affects the passage of flow adversely in the downstream channels. Owing to the significant practical importance, the problem of local scour due to jets has been studied by many investigators. In this paper, a comprehensive review of the up-to-date investigations on local scour due to horizontal and impinging jets is presented including all possible aspects, such as scouring process, parameters affecting scour, time variation of scour,velocity distribution on the apron and within the scour hole, development of boundary layer thickness, bed shear stress, scour estimation formulas and protection works.

  8. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  9. Severe spruelike enteropathy due to olmesartan

    Directory of Open Access Journals (Sweden)

    Gioia Fiorucci

    2014-02-01

    Full Text Available Villous atrophy and negative serologic testing is a diagnostic challenge, and the rarer possibility of drug-induced enteritis should be considered. We report a rare case of severe spruelike enteritis due to olmesartan that completely resolved after withdrawal of the drug. The possibility that patient labeled as "refractory" celiac disease may actually be due to drug treatment should always be taken into consideration, to avoid unnecessary investigations.

  10. Onychomadesis Secondary Erythroderma Exfoliative due to Ciprofloxacin

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-01-01

    Full Text Available Female patient 63 years old who was hospitalized due to erythroderma exfoliative (Fig. 1 after taking ciprofloxacin by urinary tract infection, 4 weeks later we began to observe the detachment of the finger and toenails from the proximal nail fold predominantly on the thumbs (Fig. 2, and the diagnosis of onychomadesis was done. Nail diseases are common but no all people and doctors know about nail changes due to drug reaction or systemic diseases.

  11. Dysphagia due to Multiple Esophageal Rings

    Directory of Open Access Journals (Sweden)

    Stephen N Sullivan

    1995-01-01

    Full Text Available A 27-year-old Saudi man with dysphagia due to multiple esophageal rings is reported and the literature reviewed. Dysphagia due to multiple esophageal rings is very rare. Only 15 cases have been reported. The patient is usually male and has had dysphagia for many years when presenting. The cause of the rings is unknown. Theories to explain dysphagia are that the rings are either congenital or an unusual manifestation of gastroesophageal reflux.

  12. Greenhouse effect due to atmospheric nitrous oxide

    Science.gov (United States)

    Yung, Y. L.; Wang, W. C.; Lacis, A. A.

    1976-01-01

    The greenhouse effect due to nitrous oxide in the present atmosphere is about 0.8 K. Increase in atmospheric N2O due to perturbation of the nitrogen cycle by man may lead to an increase in surface temperature as large as 0.5 K by 2025, or 1.0 K by 2100. Other climatic effects of N2O are briefly discussed.

  13. Fatal necrotizing fasciitis due to Vibrio damsela.

    Science.gov (United States)

    Yuen, K Y; Ma, L; Wong, S S; Ng, W F

    1993-01-01

    A patient who succumbed to fulminant necrotizing fasciitis due to Vibrio damsela after injury by a rabbitfish is described. Despite the absence of any known underlying illness, he did not respond to appropriate antibiotic therapy and radical surgical intervention. This represents the first documented case of necrotizing fasciitis due to this organism, and is also the first reported case in Southeast Asia inflicted by rabbitfish.

  14. Colonic urticaria pattern due to early ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, H.M.; Goldberg, H.I.; Axel, L.

    1981-05-15

    The unusual radiographic pattern of bleb-like mounds on the surface of the colon mucosa, previously described as colonic urticaria, was seen in 3 patients in whom no allergic state was present. This urticaria-like pattern was due to colonic distention in all 3, and represented only submucosal edema on the gross and microscopic specimens. We hypothesize that this pattern is due to early changes of ischemia caused by colon distention.

  15. [Reoperations in surgical oncology: recurrence of colon carcinoma after surgery].

    Science.gov (United States)

    Grassi, G B; Drago, S; Mancini, S; Remedi, M; Manfroni, S; Ferrante, D; Antonellis, D

    1997-01-01

    Colon cancer is the second leading cause of death for cancer disease, after lung cancer, with nearly 18,000 deaths per year in Italy. In spite of the progress that have taken place over the past 30 years, little improvement has been gained in this dismal outcome, and the 5-year survival remains around 50%. Over one half of the patients will suffer from recurrence after a potentially curative resection. A major challenge lies in better detection of recurrences in order to diagnose those patients still amenable to curative resection. Locoregional recurrence is of particular interest and its frequency, diagnostic limitations and surgical treatment are herein discussed.

  16. [Deep neck abscess. Factors related to reoperation and mortality].

    Science.gov (United States)

    Obregón-Guerrero, Gabriela; Martínez-Ordaz, José Luis; Moreno-Aguilera, Eduardo; Ramírez-Martinez, Martha; Peña-García, Juan Francisco; Pérez-Álvarez, Claudia

    2013-01-01

    Antecedentes: los abscesos profundos de cuello son complicaciones de infecciones, principalmente de origen odontogénico y de vías aéreas superiores, que afectan con mayor frecuencia a pacientes con morbilidades que favorecen la diseminación de la infección. Muchos requieren tratamiento quirúrgico, evaluación y drenaje apropiado para obtener los mejores resultados. Objetivo: identificar los factores relacionados con la reoperación y la mortalidad en pacientes con drenaje quirúrgico por absceso profundo de cuello. Material y métodos: estudio longitudinal, retrospectivo, observacional y comparativo efectuado con base en la revisión de todos los pacientes con absceso profundo de cuello que se operaron en un servicio de cabeza y cuello de un hospital de tercer nivel. Resultados: se estudiaron 87 pacientes, 44 de ellos eran mujeres. La mediana de edad fue de 49 años. El 40% tenían comorbilidades (35 pacientes) y la diabetes melltitus fue la más frecuente en 30 pacientes (34%). Se reoperaron 21 pacientes (24%), la mayoría por drenaje incompleto. Los factores de riesgo identificados fueron: comorbilidades (principalmente diabetes mellitus) (pabscesos profundos de cuello la evaluación preoperatoria y el drenaje quirúrgico completo de todos los espacios afectados son primordiales para evitar la reoperación y mejorar la supervivencia.

  17. High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis

    DEFF Research Database (Denmark)

    Laursen, Jens Ole

    2017-01-01

    PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant...... than 4 cm(2). Patients were followed for 2 years with American Knee Society Subjective outcome Scores (AKSS), pain scores and radiographic evaluations and for up to 6 years with complications and reoperations. RESULTS: At the 1- and 2-year follow-up mean AKSS clinical score, the mean AKSS function...... pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients...

  18. Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate.

    Science.gov (United States)

    Grosso, Matthew J; Danoff, Jonathan R; Murtaugh, Taylor S; Trofa, David P; Sawires, Andrew N; Macaulay, William B

    2017-01-01

    Hemiarthroplasty (HA) has been a mainstay treatment for displaced femoral neck fractures for many years. The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures and compare outcomes between implant constructs (bipolar vs unipolar), fixation options (cemented vs cementless stems), and age groups (fractures at our institution between 1999 and 2013 with a minimum of 2-year follow-up. The overall component revision rate, including conversion to THA, revision HA, revision with open reduction internal fixation, and Girdlestone procedure, was 5.6% (39/686). Seventeen patients (2.5%) were converted from HA to THA at an average of 1.9 years after index procedure. A significantly lower conversion rate of 1.4% (7/499 patients) was found in the older patient cohort (≥75 years old) compared to 5.3% (11/187) in the younger cohort. The most common causes for conversion surgery to THA were acetabular wear (5 patients), aseptic loosening (4 patients), and periprosthetic fracture (3 patients). There was a significantly lower rate of periprosthetic fracture (0.4% vs 2.5%, P value .025) in the cemented implant group compared to the cementless group. We observed a higher rate of dislocations in the bipolar vs unipolar group (3.8% vs 1%, P value .02) and no other significant differences between these groups. We observed a low reoperation rate for this cohort of patients, relatively higher conversion rates for the younger population, fewer periprosthetic fractures with the use of cemented stems, and no advantage of bipolar over unipolar prostheses. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Physiological growth hormone replacement and rate of recurrence of craniopharyngioma: the Genentech National Cooperative Growth Study.

    Science.gov (United States)

    Smith, Timothy R; Cote, David J; Jane, John A; Laws, Edward R

    2016-10-01

    OBJECTIVE The object of this study was to establish recurrence rates in patients with craniopharyngioma postoperatively treated with recombinant human growth hormone (rhGH) as a basis for determining the risk of rhGH therapy in the development of recurrent tumor. METHODS The study included 739 pediatric patients with craniopharyngioma who were naïve to GH upon entering the Genentech National Cooperative Growth Study (NCGS) for treatment. Reoperation for tumor recurrence was documented as an adverse event. Cox proportional-hazards regression models were developed for time to recurrence, using age as the outcome and enrollment date as the predictor. Patients without recurrence were treated as censored. Multivariate logistic regression was used to examine the incidence of recurrence with adjustment for the amount of time at risk. RESULTS Fifty recurrences in these 739 surgically treated patients were recorded. The overall craniopharyngioma recurrence rate in the NCGS was 6.8%, with a median follow-up time of 4.3 years (range 0.7-6.4 years.). Age at the time of study enrollment was statistically significant according to both Cox (p = 0.0032) and logistic (p treatment era.

  20. Clinical Outcome and Fusion Rates after the First 30 Extreme Lateral Interbody Fusions

    Directory of Open Access Journals (Sweden)

    Gregory M. Malham

    2012-01-01

    Full Text Available Introduction. The lateral transpsoas approach for lumbar interbody fusion (XLIF is gaining popularity. Studies examining a surgeon's early experience are rare. We aim to report treatment, complication, clinical, and radiographic outcomes in an early series of patients. Methods. Prospective data from the first thirty patients treated with XLIF by a single surgeon was reviewed. Outcome measures included pain, disability, and quality of life assessment. Radiographic assessment of fusion was performed by computed tomography. Results. Average follow-up was 11.5 months, operative time was 60 minutes per level and blood loss was 50 mL. Complications were observed: clinical subsidence, cage breakage upon insertion, new postoperative motor deficit and bowel injury. Approach side-effects were radiographic subsidence and anterior thigh sensory changes. Two patients required reoperation; microforaminotomy and pedicle screw fixation respectively. VAS back and leg pain decreased 63% and 56%, respectively. ODI improved 41.2% with 51.3% and 8.1% improvements in PCS and MCS. Complete fusion (last follow-up was observed in 85%. Conclusion. The XLIF approach provides superior treatment, clinical outcomes and fusion rates compared to conventional surgical approaches with lowered complication rates. Mentor supervision for early cases and strict adherence to the surgical technique including neuromonitoring is essential.

  1. Raters & Rating Scales.

    Science.gov (United States)

    Lopez, Winifred A.; Stone, Mark H.

    1998-01-01

    The first article in this section, "Rating Scales and Shared Meaning," by Winifred A. Lopez, discusses the analysis of rating scale data. The second article, "Rating Scale Categories: Dichotomy, Double Dichotomy, and the Number Two," by Mark H. Stone, argues that dichotomies in rating scales are more useful than multiple ratings. (SLD)

  2. Production lost due to cervical cancer in Poland in 2012.

    Science.gov (United States)

    Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Seweryn, Michał; Koperny, Magdalena

    Poland has one of the highest cervical cancer mortality rates in Europe. It is related to the problem of late diagnosis and low attendance rate in screening programs. The objective of the study has been to assess the annual production loss due to the cervical cancer morbidity and mortality in Poland in 2012. The outcomes have been to provide comprehensive information on cervical cancer's influence on population's ability to work and its overall economic burden for the society. The study has also provided the methodological framework for disease-related production losses in Polish settings. The human capital method was used. The production losses were calculated in both monetary and quantitative terms (working days lost) due to 4 following reasons: 1) temporary disability to work, 2) permanent disability, 3) informal care, and 4) mortality. Cervical cancer resulted in approx. 702 964 working days lost in 2012 due to absence at work for both patients and care givers and a total number of 957 678 working days lost due to patients' mortality. The total value of production lost was assessed at 111.4 million euros. More than 66% of this value was attributed to women's mortality. The calculation of production lost due to cervical cancer burden provides strong evidence to support adequate health promotion and disease prevention actions. Actions promoting cervical cancer screening should be intensified including workplace health promotion activities. Med Pr 2016;67(3):289-299. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  3. Paraneoplastic Cushing Syndrome Due To Wilm's Tumor.

    Science.gov (United States)

    Faizan, Mahwish; Manzoor, Jaida; Saleem, Muhammad; Anwar, Saadia; Mehmood, Qaiser; Hameed, Ambreen; Ali, Agha Shabbir

    2017-05-01

    Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity. Few case reports are available in the literature exploring the option of preoperative chemotherapy as well as upfront nephrectomy. We report a rare case of paraneoplastic Cushing syndrome due to a Wilm's tumor. Based on gradual decrease of postoperative weight, blood pressure, serum adrenocorticotropic hormone, and plasma cortisol levels, along with histological confirmation of Wilm's tumor, paraneoplastic Cushing syndrome due to Wilm's tumor was confirmed.

  4. Gynecomastia: An ADR due to drug interaction

    Directory of Open Access Journals (Sweden)

    Aiman Umme

    2009-01-01

    Full Text Available Gynecomastia results from conditions that cause an imbalance of estrogenic and androgenic effects on the breast, resulting in an increased or unopposed estrogen action on breast tissue. Approximately 4 to 10% cases of gynecomastia are due to drugs. Both Digoxin and Furosemide are also reported to cause the same condition. Although, chances of gynecomastia could be more if these two drugs are coadministered, but no case report of this adverse effect is ever reported when both are prescribed concurrently. Here we report a case of gynecomastia suspected to have resulted from the coadministation of both the drugs. Probability of the adverse effect due to drug interaction was evaluated by DIPS, which suggests that the adverse drug reaction (ADR due to DI is "Possible."

  5. Angioedema-Urticaria Due to Acitretin.

    Science.gov (United States)

    Solak, Berna; Metin, Nurcan; Erdem, Mustafa Teoman

    2016-01-01

    Acitretin is a synthetic oral retinoid that has been used for a number of dermatological diseases. Several side effects of acitretin have been reported such as teratogenicity, cheilitis, xerosis, dyslipidemia, and photosensitivity. Many drugs, mainly antibiotics and nonsteroidal anti-inflammatory drugs, can cause angioedema-urticaria. We present the case of angioedema-urticaria due to acitretin, confirmed by oral provocation test, in a 61-year-old man with psoriasis. To the best of our knowledge, only 1 case of angioedema due to oral acitretin has been reported in the literature so far. We report this case to draw attention that acitretin may cause angioedema-urticaria and to inform patients about this risk besides other side effects due to acitretin.

  6. [Conjunctivitis due to Achromobacter xylosoxidans: case report].

    Science.gov (United States)

    Lucatelli, Juliana Faggion; Cantarelli, Vlademir Vicente; Picoli, Simone Ulrich

    2009-01-01

    We report here a case of conjunctivitis in an immunocompetent patient due to Achromobacter xylosoxidans, which was associated with the use of rigid contact lenses. The bacteria were isolated from the scraped conjunctival swab as well as from the lens cleaning fluid. A. xylosoxidans is an opportunistic pathogen, especially in immunocompromised patients; however, in isolates of ocular infections, from immunocompetent patients, it may be confused with other gram-negative organisms, particularly Pseudomonas aeruginosa. Due to an increased resistance against different antimicrobial agents, A. xylosoxidans must be fully identified and differentiated from other gram-negative isolates from ocular infections.

  7. Enterolith ileus due to jejunal diverticulosis.

    Science.gov (United States)

    Monchal, Tristan; Hornez, Emmanuel; Bourgouin, Stéphane; Sbardella, Fabrice; Baudoin, Yoann; Butin, Christophe; Salle, Etienne; Thouard, Hervé

    2010-04-01

    Jejunal diverticulosis is a rare malformation that is often asymptomatic. Complications might be similar to those occurring in large-bowel diverticula but also include a much more particular event: intestinal obstruction due to migration and impaction of enterolith formed inside diverticula. This is a very uncommon entity; diagnosis and management are thus often delayed. Mostly surgical exploration is necessary because obstruction symptoms are unresponsive to medical treatment. The authors report a new case of enterolith ileus in a 74-year-old man, due to jejunal diverticulosis, and its successful surgical management in emergency. Only 39 similar cases have ever been reported in the literature.

  8. Vulvar myiasis due to Wohlfahrtia magnifica.

    Science.gov (United States)

    Delir, S; Handjani, F; Emad, M; Ardehali, S

    1999-07-01

    Myiasis is a condition resulting from the invasion of tissues or organs of man or animals by the larvae of dipterous flies. The distribution of myiasis is worldwide, with more cases being reported from tropical, subtropical, and warm temperate areas. The various forms of myiasis may be classified from an entomological or a clinical point of view. This report describes a rare case of vulvar myiasis due to Wohlfahrtia magnifica in an otherwise healthy 20-year-old Iranian female. To our knowledge, this is the first report of cutaneous myiasis of the vulva due to W. magnifica from Iran and the Middle East region.

  9. Perianal abscesses due to ingested foreign bodies

    Directory of Open Access Journals (Sweden)

    Doublali Mbarek

    2010-01-01

    Full Text Available The clinical presentation of perianal abscesses due to foreign bodies (FBs impacted in the anal canal mimics common causes of acute anal pain. The diagnosis can be established by digital rectal examination and/or proctoscopy, but may miss the presence of an FB. Incision and drainage of the abscess, along with removal of the FB, results in immediate pain relief and cure. Impacted FB must not be overlooked as an unusual cause of perianal abscess. One case of perianal abscesses due to FB impacted in the anal canal is reported.

  10. Due toponimi costieri istriani, Barbariga e Barabiga

    Directory of Open Access Journals (Sweden)

    Mario Doria

    1992-12-01

    Full Text Available Avranno pazienza i lettori se ancora una volta in questa Rivista - e con ciò ritengo anche di far cosa gradita al valoroso collega e amico Pavao Tekavčić - mi soffermo sull'analisi di due toponimi costieri istriani, precisamente Barbariga e Ba­ rabiga, toponimi i quali, sebbene designino due oggetti geografici distinti e lontani l'un l'altro, abbiano quindi storia e tradizione fra loro indipendenti, risalgono senz'al­ tro - a mio modesto parere - ad uno stesso etimo. Ma vediamo un po', per ordine, come stiamo con la documentazione.

  11. Chest wall abscess due to Prevotella bivia

    Institute of Scientific and Technical Information of China (English)

    Gwo-jong HSU; Cheng-ren CHEN; Mei-chu LAI; Shi-ping LUH

    2009-01-01

    Prevotella bivia is associated with pelvic inflammatory disease. A 77-year-old man developed a rapidly growing chest wall abscess due to P. Bivia within days. He underwent surgical resection of the infected area; his postoperative course was un-eventful. This is the first case of chest wall abscess due to P. Bivia infection. Its correct diagnosis cannot be underestimated be-cause fulminam infections can occur in aged or immunocompromised patients if treated incorrectly. Prompt, appropriate surgical management, and antibiotic therapy affect treatment outcome.

  12. Real Property Tax Rates

    Data.gov (United States)

    Montgomery County of Maryland — The Levy Year 2012 real property tax rate dataset reflects all the rates per $100 set each year by the County Council. These rates are applied to the assessed value...

  13. Total elbow arthroplasty in the United States: evaluation of cost, patient demographics, and complication rates

    Directory of Open Access Journals (Sweden)

    Hanbing Zhou

    2016-03-01

    Full Text Available Total elbow arthroplasty (TEA is utilized in the treatment of rheumatoid and post-traumatic elbow arthritis. TEA is a relatively low volume surgery in comparison to other types of arthroplasty and therefore little is known about current surgical utilization, patient demographics and complication rates in the United States. The purpose of our study is to evaluate the current practice trends and associated inpatient complications of TEA at academic centers in the United States. We queried the University Health Systems Consortium administrative database from 2007 to 2011 for patients who underwent an elective TEA. A descriptive analysis of demographics was performed which included patient age, sex, race, and insurance status. We also evaluated the following patient clinical benchmarks: hospital length of stay (LOS, hospital direct cost, inhospital mortality, complications, and 30-day readmission rates. Our cohort consisted of 3146 adult patients (36.5% male and 63.5% female with an average age of 58 years who underwent a total elbow arthroplasty (159 academic medical centers in the United States. The racial demographics included 2334 (74% Caucasian, 285 (9% black, 236 (7.5% Hispanic, 16 (0.5% Asian, and 283 (9% other patients. The mean LOS was 4.2±5 days and the mean total direct cost for the hospital was 16,300±4000 US Dollars per case. The overall inpatient complication rate was 3.1% and included mortality <1%, DVT (0.8%, re-operation (0.5%, and infection (0.4%. The 30-day readmission rate was 4.4%. TEA is a relatively uncommon surgery in comparison to other forms of arthroplasty but is associated with low in-patient and 30-day perioperative complication rate. Additionally, the 30-day readmission rate and overall hospital costs are comparable to the traditional total hip and knee arthroplasty surgeries.

  14. Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors*

    Science.gov (United States)

    Lara, Fernanda; Santamaría, Jesus Rodriguez; Garbers, Luiz Eduardo Fabricio de Melo

    2017-01-01

    BACKGROUND The best way to approach surgically removed basal cell carcinoma with positive histopathological margins is a controversial issue. Some authors believe that the more appropriate treatment is an immediate reoperation while others prefer a periodic follow up. The rates of recurrence are variable in literature, between 10% and 67%. OBJECTIVE To define the recurrence rate of basal cell carcinoma with positive margins after surgery. Secondarily, identify morphological aspects that can suggest a more frequent tumoral recurrence. METHODS This was a retrospective and observational study made by analysis of medical records of 487 patients between January 2003 and December 2009 in Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). From 402 basal cell carcinomas surgically treated, 41 fulfilled inclusion criteria and were evaluated for five years or more. Recurrence rate of these tumors was analyzed in all patients and clinical characteristics such as sex, age, tumor size, tumor site, ulceration, and histological type were evaluated in order to find if they were related to more common tumoral recurrence. RESULTS The rate of positive margins after surgery was 12.18%. There were five cases of tumoral recurrence in the observation group and three cases in the re-excision group. Tumor size, site, histological type, ulceration and type of positive margin did not differ statistically between groups. It was not possible to consider if these factors were important in recurrence rates. STUDY LIMITATIONS Ideally, a prospective study with a larger sample would be more accurate. CONCLUSION The treatment of choice in basal cell carcinoma with positive margins must be individualized to reduce recurrence rates. PMID:28225958

  15. Academic Due Process in Clinical Pharmacy Education.

    Science.gov (United States)

    Abood, Richard R.; Iovacchini, Eric V.

    1979-01-01

    The historical evolution of academic due process, its current concept as revealed in the Supreme Court ruling in Horowitz vs Board of Curators of the University of Missouri, and the application of that judicial opinion to clinical clerkship programs in pharmacy are discussed. Guidelines to protect faculty and administration are offered. (JMD)

  16. Supraventricular Tachycardia Atackt Due to Losewieght Drug

    Directory of Open Access Journals (Sweden)

    Murat Yalcin

    2016-01-01

    Full Text Available Obesity is an important health problem. Treatment of obesity includes diet, exercise and drugs. Some of these drugs are out of prescription. Advers effects of these drugs have not been known. In this report; we present a case with supraventricular tachycardia attack due to loseweight drug containing mangostana (mango, hibiscus, citrus mate, L-karnitin, guarana.

  17. Duodenocolic fistula due to safety pin ingestion.

    Science.gov (United States)

    Cay, Ali; Imamoğlu, Mustafa; Sarihan, Haluk; Sayil, Ozgür

    2004-01-01

    The authors describe the case of a 16-month-old boy with benign duodenocolic fistula due to safety pin ingestion who presented with abdominal pain, diarrhea and weight loss. Etiology, symptomatology, diagnosis and management are discussed and the literature is reviewed. Early diagnosis and surgical management are necessary to avoid serious morbidity.

  18. Sickness absence due to depressive symptoms

    NARCIS (Netherlands)

    Koopmans, P. C.; Roelen, C. A. M.; Groothoff, J. W.

    Objective There is no information on the duration of absence of depressed Dutch workers. The aim of this study was to determine the duration of sickness absence due to depressive symptoms in the working population. Methods In this observational study of 15% of the Dutch working population, all

  19. Is Hubble's Expansion due to Dark Energy

    CERN Document Server

    Gupta, R C

    2010-01-01

    {\\it The universe is expanding} is known (through Galaxy observations) since 1929 through Hubble's discovery ($V = H D$). Recently in 1999, it is found (through Supernovae observations) that the universe is not simply expanding but is accelerating too. We, however, hardly know only $4\\%$ of the universe. The Wilkinson Microwave Anisotropy Probe (WMAP) satellite observational data suggest $73\\%$ content of the universe in the form of dark-energy, $23\\%$ in the form of non-baryonic dark-matter and the rest $4\\%$ in the form of the usual baryonic matter. The acceleration of the universe is ascribed to this dark-energy with bizarre properties (repulsive-gravity). The question is that whether Hubble's expansion is just due to the shock of big-bang & inflation or it is due to the repulsive-gravity of dark-energy? Now, it is believed to be due to dark-energy, say, by re-introducing the once-discarded cosmological-constant $\\Lambda$. In the present paper, it is shown that `the formula for acceleration due to dark...

  20. Ratchet due to broken friction symmetry

    DEFF Research Database (Denmark)

    Norden, Bengt; Zolotaryuk, Yaroslav; Christiansen, Peter Leth

    2002-01-01

    A ratchet mechanism that occurs due to asymmetric dependence of the friction of a moving system on its velocity or a driving force is reported. For this kind of ratchet, instead of a particle moving in a periodic potential, the dynamics of which have broken space-time symmetry, the system must...

  1. Constructing the uncertainty of due dates.

    Science.gov (United States)

    Vos, Sarah C; Anthony, Kathryn E; O'Hair, H Dan

    2014-01-01

    By its nature, the date that a baby is predicted to be born, or the due date, is uncertain. How women construct the uncertainty of their due dates may have implications for when and how women give birth. In the United States as many as 15% of births occur before 39 weeks because of elective inductions or cesarean sections, putting these babies at risk for increased medical problems after birth and later in life. This qualitative study employs a grounded theory approach to understand the decisions women make on how and when to give birth. Thirty-three women who were pregnant or had given birth within the past 2 years participated in key informant or small-group interviews. The results suggest that women interpret the uncertainty of their due dates as a reason to wait for birth and as a reason to start the process early; however, information about a baby's brain development in the final weeks of pregnancy may persuade women to remain pregnant longer. The uncertainties of due dates are analyzed using Babrow's problematic integration, which distinguishes between epistemological and ontological uncertainty. The results point to a third type of uncertainty, axiological uncertainty. Axiological uncertainty is rooted in the values and ethics of outcomes.

  2. Contact dermatitis due to Alstroemeria (Peruvian lily).

    Science.gov (United States)

    Apted, J H

    1990-01-01

    Two cases of hand dermatitis due to contact with the plant Alstroemeria (Peruvian Lily) are recorded. This plant has been increasingly used for making floral decorations during the last decade. As it is available throughout the year in Victoria more cases are likely to be discovered in the community.

  3. Bacterial endocarditis due to Kingella kingae.

    Science.gov (United States)

    Sage, M J; Maslowski, A H; MacCulloch, D

    1983-10-26

    A case of infective bacterial endocarditis due to Kingella kingae in a 26 year old male involving a prosthetic mitral valve is described. Microbiological features of this organism are outlined, and the treatment of this endocarditis is discussed with reference to the four previously reported cases.

  4. Consort contact dermatitis due to oak moss.

    Science.gov (United States)

    Held, J L; Ruszkowski, A M; Deleo, V A

    1988-02-01

    An allergic contact dermatitis in a woman was found to be due to oak moss in her husband's after-shave lotion. When routine patch testing reveals a positive reaction, the dermatologist should consider exposure to the antigen not only in the patient but also through contact with the patient's consort.

  5. [Scalp burns due to hair bleach].

    Science.gov (United States)

    Wagenblast, Lene

    2011-02-28

    We present two cases of scalp burn or possible chemical reaction due to use of hair highlight products. One case was treated with serial excision of the scarred bald area after the burn, and the other case was treated with implantation of expanders and subsequent excision of the bald area.

  6. [Delayed asthma bronchiale due to epoxy resin].

    Science.gov (United States)

    Authried, Georg; Al-Asadi, Haifaa; Møller, Ulla; Sherson, David Lee

    2013-10-28

    Epoxy resin is a low molecular weight agent, which can cause both acute and delayed allergic reactions. However, it is known causing skin reactions with direct or airborne contact. Rarely it can cause airway reactions like asthma bronchiale. We describe a case of a windmill worker who developed delayed asthma bronchiale due to airborne contact with epoxy resin.

  7. Hair transplantation in alopecia due to radiation

    Energy Technology Data Exchange (ETDEWEB)

    Nordstroem, R.E.; Holsti, L.R.

    1983-10-01

    Two cases of alopecia due to radiation of the scalp are presented in which it has been possible to achieve a technically and cosmetically satisfactory reconstruction by punch hair grafting. This does not mean that every case is suitable, but it does mean that those without contraindications should at least be given a try.

  8. Aggradation in rivers due to overloading

    NARCIS (Netherlands)

    Ribberink, J.S.; Van der Sande, J.T.M.

    1984-01-01

    The problem of aggradation in a river due to overloading is tackled with a mathematical model consisting of a set of one-dimensional (in space) basic equations in which the water motion is assumed to be quasi-steady and the sediment transport is determined by local conditions. Analytical solutions a

  9. Inherited peripheral neuropathies due to mitochondrial disorders.

    Science.gov (United States)

    Cassereau, J; Codron, P; Funalot, B

    2014-05-01

    Mitochondrial disorders (MIDs) are frequently responsible for neuropathies with variable severity. Mitochondrial diseases causing peripheral neuropathies (PNP) may be due to mutations of mitochondrial DNA (mtDNA), as is the case in MERRF and MELAS syndromes, or to mutations of nuclear genes. Secondary abnormalities of mtDNA (such as multiple deletions of muscle mtDNA) may result from mitochondrial disorders due to mutations in nuclear genes involved in mtDNA maintenance. This is the case in several syndromes caused by impaired mtDNA maintenance, such as Sensory Ataxic Neuropathy, Dysarthria and Ophthalmoplegia (SANDO) due to recessive mutations in the POLG gene, which encodes the catalytic subunit of mtDNA polymerase (DNA polymerase gamma), or Mitochondrial Neuro-Gastro-Intestinal Encephalomyopathy (MNGIE), due to recessive mutations in the TYMP gene, which encodes thymidine phosphorylase. The last years have seen a growing list of evidence demonstrating that mitochondrial bioenergetics and dynamics might be dysfunctional in axonal Charcot-Marie-Tooth disease (CMT2), and these mechanisms might present a common link between dissimilar CMT2-causing genes. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Cytology of Pericardial Effusion due to Malignancy

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-09-01

    Full Text Available Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare.

  11. Plagiarism Due to Misunderstanding: Online Instructor Perceptions

    Science.gov (United States)

    Greenberger, Scott; Holbeck, Rick; Steele, John; Dyer, Thomas

    2016-01-01

    Plagiarism is an ongoing problem in higher education. This problem exists in both online and face-to-face modalities. The literature indicates that there are three ways higher education institutions define plagiarism, which includes theft, deception, and misunderstanding. Plagiarism due to misunderstanding has received less attention in the…

  12. Warming can boost denitrification disproportionately due to altered oxygen dynamics.

    Directory of Open Access Journals (Sweden)

    Annelies J Veraart

    Full Text Available BACKGROUND: Global warming and the alteration of the global nitrogen cycle are major anthropogenic threats to the environment. Denitrification, the biological conversion of nitrate to gaseous nitrogen, removes a substantial fraction of the nitrogen from aquatic ecosystems, and can therefore help to reduce eutrophication effects. However, potential responses of denitrification to warming are poorly understood. Although several studies have reported increased denitrification rates with rising temperature, the impact of temperature on denitrification seems to vary widely between systems. METHODOLOGY/PRINCIPAL FINDINGS: We explored the effects of warming on denitrification rates using microcosm experiments, field measurements and a simple model approach. Our results suggest that a three degree temperature rise will double denitrification rates. By performing experiments at fixed oxygen concentrations as well as with oxygen concentrations varying freely with temperature, we demonstrate that this strong temperature dependence of denitrification can be explained by a systematic decrease of oxygen concentrations with rising temperature. Warming decreases oxygen concentrations due to reduced solubility, and more importantly, because respiration rates rise more steeply with temperature than photosynthesis. CONCLUSIONS/SIGNIFICANCE: Our results show that denitrification rates in aquatic ecosystems are strongly temperature dependent, and that this is amplified by the temperature dependencies of photosynthesis and respiration. Our results illustrate the broader phenomenon that coupling of temperature dependent reactions may in some situations strongly alter overall effects of temperature on ecological processes.

  13. Reconciling Groundwater Storage Depletion Due to Pumping with Sustainability

    Directory of Open Access Journals (Sweden)

    Annukka Lipponen

    2010-11-01

    Full Text Available Groundwater pumping causes depletion of groundwater storage. The rate of depletion incurred by any new well is gradually decreasing and eventually becomes zero in the long run, after induced recharge and reduction of natural discharge of groundwater combined (capture have become large enough to balance the pumping rate completely. If aquifer-wide aggregated pumping rates are comparatively large, then such a new dynamic equilibrium may not be reached and groundwater storage may become exhausted. Decisions to pump groundwater are motivated by people’s need for domestic water and by expected benefits of using water for a variety of activities. But how much finally is abstracted from an aquifer (or is considered to be an optimal aggregate abstraction rate depends on a wide range of other factors as well. Among these, the constraint imposed by the groundwater balance (preventing aquifer exhaustion has received ample attention in the professional literature. However, other constraints or considerations related to changes in groundwater level due to pumping are observed as well and in many cases they even may dominate the decisions on pumping. This paper reviews such constraints or considerations, examines how they are or may be incorporated in the decision-making process, and evaluates to what extent the resulting pumping rates and patterns create conditions that comply with principles of sustainability.

  14. Timing shifts due to NIF beam repointing

    Energy Technology Data Exchange (ETDEWEB)

    Koch, J

    2007-08-15

    Repointing a NIF beam to hit a target position off target chamber center (TCC) will introduce a timing shift due to changes in the light pathlength. This shift could be important for target experiment requirements even for targets placed at TCC, since beam timing test shots will place beams up to 15 mm off TCC in order to spatially separate them on foil targets. In particular, timing errors due to beam repointing need to be considered against the 30 ps RMS timing requirement. Since the repointing process will keep the beam passing through a fixed point in the final optics assembly (the conversion crystal) by tip/tilt adjustments of two turning mirrors (LM5 and LM7), the problem naturally divides into two parts: Timing offsets past the conversion crystal due to target positioning changes, and timing offsets behind the fixed point on the conversion crystal due to turning mirror adjustments. Timing offsets past the conversion crystal can be significant, but are trivial to calculate exactly; however, an exact calculation of timing offsets behind the fixed point on the conversion crystal would require a three-dimensional optomechanical raytrace model to be developed for every beamline, and this would be difficult and expensive. In this memo, I estimate the magnitude of timing offsets due to pathlength changes behind the conversion crystal by analysis of a worst-case model. I conclude that these timing offsets are insignificant compared with the current allocation in the 30 ps RMS timing requirement, and that more detailed raytrace modeling of individual beams is not necessary.

  15. Brittle dynamic damage due to earthquake rupture

    Science.gov (United States)

    Bhat, Harsha; Thomas, Marion

    2016-04-01

    The micromechanical damage mechanics formulated by Ashby and Sammis, 1990, and generalized by Deshpande and Evans 2008 has been extended to allow for a more generalized stress state and to incorporate an experimentally motivated new crack growth (damage evolution) law that is valid over a wide range of loading rates. This law is sensitive to both the crack tip stress field and its time derivative. Incorporating this feature produces additional strain-rate sensitivity in the constitutive response. The model is also experimentally verified by predicting the failure strength of Dionysus-Pentelicon marble over wide range of strain rates. We then implement this constitutive response to understand the role of dynamic brittle off-fault damage on earthquake ruptures. We show that off-fault damage plays an important role in asymmetry of rupture propagation and is a source of high-frequency ground motion in the near source region.

  16. Rating Movies and Rating the Raters Who Rate Them.

    Science.gov (United States)

    Zhou, Hua; Lange, Kenneth

    2009-11-01

    The movie distribution company Netflix has generated considerable buzz in the statistics community by offering a million dollar prize for improvements to its movie rating system. Among the statisticians and computer scientists who have disclosed their techniques, the emphasis has been on machine learning approaches. This article has the modest goal of discussing a simple model for movie rating and other forms of democratic rating. Because the model involves a large number of parameters, it is nontrivial to carry out maximum likelihood estimation. Here we derive a straightforward EM algorithm from the perspective of the more general MM algorithm. The algorithm is capable of finding the global maximum on a likelihood landscape littered with inferior modes. We apply two variants of the model to a dataset from the MovieLens archive and compare their results. Our model identifies quirky raters, redefines the raw rankings, and permits imputation of missing ratings. The model is intended to stimulate discussion and development of better theory rather than to win the prize. It has the added benefit of introducing readers to some of the issues connected with analyzing high-dimensional data.

  17. Clozapine underutilization and discontinuation in African Americans due to leucopenia.

    Science.gov (United States)

    Kelly, Deanna L; Kreyenbuhl, Julie; Dixon, Lisa; Love, Raymond C; Medoff, Deborah; Conley, Robert R

    2007-09-01

    Clozapine use has been notably lower in African American patients than in Caucasians. It has been suggested that lower normal ranges for white blood cell (WBC) counts in African Americans, known as benign ethnic neutropenia, may account partially for the disparity. We examined the rates of leucopenia and agranulocytosis as reasons for discontinuation of clozapine in a sample of 1875 patients with schizophrenia treated in the State of Maryland. Between 1989 and 1999, 5.3% (31/588) of African Americans and 2.4% (31/1287) of Caucasians discontinued clozapine treatment due to leucopenia (chi square = 10.35, df = 1, P = 0.001). No African American patients developed agranulocytosis while 8 Caucasian patients (0.62%) developed this blood dyscrasia. Discontinuations due to leucopenia occurred throughout treatment. Discontinuations due to agranulocytosis occurred primarily in the first 18 weeks (7/8; 87.5% patients with agranulocytosis). It is likely that African Americans had clozapine discontinued unnecessarily due to benign ethnic neutropenia. We concur with recent recommendations to acknowledge differences in WBC values in African Americans and to modify prescribing guidelines or formally acknowledge benign ethnic leucopenia like in other countries in order to facilitate greater use of clozapine in these patients.

  18. Measurement of 2 characteristics of metastable helium important for laser cooling: loss rates due to collisions in presence of quasi-resonant laser radiation and transition rates for 2 forbidden transitions: 2{sup 3}P{sub 1} {yields} 1{sup 1}S{sub 0} and 2{sup 3}P{sub 2} {yields} 1{sup 1}S{sub 0}; Mesure de deux caracteristiques de l'helium metastable importantes pour le refroidissement radiatif: taux de pertes par collisions en presence de lumiere quasi-resonante et taux de transition des raies interdites 2{sup 3}P{sub 1} {yields} 1{sup 1}S{sub 0} et 2{sup 3}P{sub 2} {yields} 1{sup 1}S{sub 0}

    Energy Technology Data Exchange (ETDEWEB)

    Poupard, J

    2000-11-15

    This thesis presents the study of 2 characteristics of metastable helium that are important for laser cooling. First, we measure two-body losses in a magneto-optical trap. The losses, enhanced by nearly resonant laser radiation, are mainly due to ionizing collisions. We measure the loss rate by observing the decay of the number of trapped atoms using either atomic fluorescence or ion production. We study the loss rate as a function of the trapping laser parameters. The second part of the thesis concerns experiments to measure the transition rates of the intercombination lines: 2{sup 3}P{sub 1} to 1{sup 1}S{sub 0} and 2{sup 3}P{sub 2} to 1{sup 1}S{sub 0}. The first of these rates is measured by exciting a small fraction of the atoms in a magneto-optical trap to the 2{sup 3}P{sub 1} state and observing the decrease in the trap lifetime. We then measure the ratio of the transition rates for 2{sup 3}P{sub 1} and 2{sup 3}P{sub 2} towards the 1{sup 1}S{sub 0} ground state by monitoring the flux of UV photons associated with the transition. (author)

  19. [Neurologic complications of subarachnoid hemorrhage due to intracranial aneurysm rupture].

    Science.gov (United States)

    Rama-Maceiras, P; Fàbregas Julià, N; Ingelmo Ingelmo, I; Hernández-Palazón, J

    2010-12-01

    The high rates of morbidity and mortality after subarachnoid hemorrhage due to spontaneous rupture of an intracranial aneurysm are mainly the result of neurologic complications. Sixty years after cerebral vasospasm was first described, this problem remains unsolved in spite of its highly adverse effect on prognosis after aneurysmatic rupture. Treatment is somewhat empirical, given that uncertainties remain in our understanding of the pathophysiology of this vascular complication, which involves structural and biochemical changes in the endothelium and smooth muscle of vessels. Vasospasm that is refractory to treatment leads to cerebral infarction. Prophylaxis, early diagnosis, and adequate treatment of neurologic complications are key elements in the management of vasospasm if neurologic damage, lengthy hospital stays, and increased use of health care resources are to be avoided. New approaches to early treatment of cerebral lesions and cortical ischemia in cases of subarachnoid hemorrhage due to aneurysm rupture should lead to more effective, specific management.

  20. [Death by electric shock due to blatantly faulty repair].

    Science.gov (United States)

    Hartwig, Sven; Schmeling, Andreas; Wirth, Ingo

    2008-01-01

    Due to technical innovations and strict safety regulations the rate and mortality of accidents caused by electric current has been considerably reduced. Nevertheless there are still deaths caused by electric shock, which are mostly due to carelessness and ignorance. The described death by electric shock of a 39-year-old man was the consequence of an electrotechnical curiosity. When repairing a cut extender cable, he installed a second socket on the one part and a second plug on the other. On the day of the accident, he first plugged the part of the cable with the two plugs into a wall socket. Then, as he tried to connect it with the other part, he was electrocuted.

  1. Interest rate derivatives

    DEFF Research Database (Denmark)

    Svenstrup, Mikkel

    This Ph.D. thesis consists of four self-contained essays on valuation of interest rate derivatives. In particular derivatives related to management of interest rate risk care are considered.......This Ph.D. thesis consists of four self-contained essays on valuation of interest rate derivatives. In particular derivatives related to management of interest rate risk care are considered....

  2. Fixed drug eruption due to levocetirizine

    Directory of Open Access Journals (Sweden)

    Ratinder Jhaj

    2016-01-01

    Full Text Available A fixed drug eruption (FDE is a cutaneous adverse drug reaction due to Type IV or delayed cell-mediated hypersensitivity. Antihistamines, which antagonize the action of histamine during an allergic reaction by blocking the H 1 histamine receptors, are used routinely for the treatment of various allergic disorders such as urticaria, eczemas, and also in itchy lesions of skin like scabies.Levocetirizine, an active (R-enantiomer of cetirizine, is a newer or second generation antihistamine, with more specific actions and fewer side effects, including cutaneous reactions. FDE due to levocetirizine as well as with cetirizine are rare. We report a case of levocetirizine induced FDE in a 49-year-old male patient with scabies. The patient had a history of cetirizine induced FDE in the past.

  3. Sciatica due to pelvic hematoma: case report

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-12-01

    Full Text Available Sciatica is defined as pain in the sciatic nerve distribution. The most common reason of sciatica is radiculopathy due to lumbar disc hernia. Other causes can be congenital, acquired, infectious, neoplastic, or inflammatory. The piriformis syndrome is another cause. The pain starts in an insidious manner when the cause of sciatica is an extraspinal tumor. It is intermittent at first but a constant and progressive pain that does not decrease with position or rest gradually develops in all patients. The possibility of an intraabdominal or pelvic mass should always be considered and the relevant tests requested when the cause of the sciatica cannot be explained. We present an 83-year-old male who presented with non-traumatic and non-vascular lumbosacral plexopathy due to a large hematoma in the left adductor muscle following the use of warfarin sodium.

  4. Cardiogenic shock due to acute tramadol intoxication.

    Science.gov (United States)

    Perdreau, Elodie; Iriart, Xavier; Mouton, Jean-Baptiste; Jalal, Zakaria; Thambo, Jean-Benoît

    2015-01-01

    Tramadol is a common analgesic, widely prescribed because of its efficiency and safety. We report the case of a 7-year-old child admitted in cardiac intensive care unit for cardiogenic shock due to tramadol intoxication. Without any past history, the child was admitted at emergency room for generalised convulsion, followed by respiratory distress. Cardiogenic shock was suspected after clinical examination and chest X-ray and confirmed by transthoracic echocardiography showing low left ventricular ejection fraction (1 mg/L) and O-desmethyltramadol (>1.5 mg/L). Hemodynamic support by inotropic drug infusion and diuretics was necessary. Left ventricular function normalised after 2 days of treatment allowing drug infusion weaning. Cardiac magnetic resonance imaging performed 3 days after admission confirmed normal left ventricular ejection fraction and volumes without evidence of late gadolinium enhancement. Cardiogenic shock due to tramadol intoxication is rare but exists. Negative inotropic effect of high doses of tramadol has been suspected. Quick recovery is possible.

  5. ON DAMPING COEFFICIENT DUE TO PHASE TRANSFORMATION

    Institute of Scientific and Technical Information of China (English)

    Din-YuHSIEH

    2003-01-01

    The damping coefficient of capillary waves due to the evaporation-condensation process at the interface of the two phases of a fluid is evaluated. To highlight the mechanism of the effect of heat and mass transfer across the interface between regions of liquid and vapor, potential flow of incompressible fluids are assumed. Thus other mechanisms of damping are neglected. To fascilitate the analysis, the method of multiple-scale is employed in the analysis, even though the problem is linear.

  6. Dose due to {sup 40}K

    Energy Technology Data Exchange (ETDEWEB)

    Escareno J, E.; Vega C, H. R., E-mail: edmundoej@hotmail.com [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico)

    2011-10-15

    The dose due to {sup 40}K has been estimated. Potassium is one of the most abundant elements in nature, being approximately 2% of the Earth's crust. Potassium has three isotopes {sup 39}K, {sup 40}K and {sup 41}K, two are stable while {sup 40}K is radioactive with a half life of 1.2x10{sup 9} years; there is 0.0117% {sup 40}K-to-K ratio. Potassium plays an important role in plants, animals and humans growth and reproduction. Due to the fact that K is an essential element for humans, {sup 40}K is the most abundant radioisotope in human body. In order to keep good health conditions K must be intake at daily basis trough food and beverages, however when K in ingested above the requirements produce adverse health effects in persons with renal, cardiac and hypertension problems or suffering diabetes. In 89.3% {sup 40}K decays to {sup 40}C through {beta}-decay, in 10.3% decays through electronic capture and emitting 1.46 MeV {gamma}-ray. K is abundant in soil, construction materials, sand thus {gamma}-rays produced during {sup 40}K decay contribute to external dose. For K in the body practically all {sup 40}K decaying energy is absorbed by the body; thus {sup 40}K contributes to total dose in humans and it is important to evaluate its contribution. In this work a set of {sup 40}K sources were prepared using different amounts of KCl salt, a {gamma}-ray spectrometer with a NaI(Tl) was characterized to standardized the sources in order to evaluate the dose due to {sup 40}K. Using thermoluminescent dosemeters the dose due to {sup 40}K was measured and related to the amount of {sup 40}K {gamma}-ray activity. (Author)

  7. Acute flaccid paralysis due to rabies

    Directory of Open Access Journals (Sweden)

    J B Ghosh

    2009-01-01

    Full Text Available Two clinical forms of rabies are recognize: i a furious form associated with classical signs of excitation or phobic symptoms, ii Dumb rabies (paralytic rabies characterized by progressive paralysis without an initial furious phase wherein distinction from Guillain-Barrι Syndrome may be difficult. Paralytic rabies is more common in persons who have received postexposure vaccination. We report here the diagnostic dilemma of two cases of acute flaccid paralysis due to rabies.

  8. Deaths due to Unknown Foodborne Agents

    OpenAIRE

    2004-01-01

    This study reviews the available evidence on unknown pathogenic agents transmitted in food and examines the methods that have been used to estimate that such agents cause 3,400 deaths per year in the United States. The estimate of deaths was derived from hospital discharge and death certificate data on deaths attributed to gastroenteritis of unknown cause. Fatal illnesses due to unknown foodborne agents do not always involve gastroenteritis, and gastroenteritis may not be accurately diagnosed...

  9. Mesenteric tumor due to chronic anisakiasis

    Directory of Open Access Journals (Sweden)

    Pablo Menéndez

    2015-09-01

    Full Text Available Intestinal anisakiasis is a rare parasitic disease and difficult to diagnose due to symptoms are not specific, so it is considered an underdiagnosed disease. The clinical suspicion with a correct diagnosis of anisakiasis allows the establishment of a correct treatment; in most cases, the resolution is possible with conservative treatment, avoiding unnecessary surgery to the preoperative differential diagnosis of acute abdomen. We report the case of a patient who required urgent surgery secondary to an exacerbation of chronic anisakiasis.

  10. Cervical myelopathy due to degenerative spondylolisthesis

    OpenAIRE

    Koakutsu, Tomoaki; Nakajo, Junko; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin

    2011-01-01

    Objective To investigate clinical-radiological features of cervical myelopathy due to degenerative spondylolisthesis (DSL). Methods A total of 448 patients were operated for cervical myelopathy at Nishitaga National Hospital between 2000 and 2003. Of these patients, DSL at the symptomatic disc level was observed in 22 (4.9%) patients. Clinical features were investigated by medical records, and radiological features were investigated by radiographs. Results Disc levels of DSL were C3/4 in 6 ca...

  11. Pseudo skin factor due to partial penetration

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, A.C.; Chen, J.C.; Raghavan, R.

    1983-10-01

    In this study the authors examine the pseudo skin factor due to partial penetration in a two-layer reservoir when only one layer is open to flow. They show that the pseudo skin factor can be correlated as a unique function of three reservoir parameters and in some cases can be accurately correlated as a function of two reservoir parameters. They also present graphs and procedures for estimating the pseudo skin factor.

  12. Pseudo skin factor due to partial penetration

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, A.C.; Chen, J.C.; Raghavan, R.

    1983-01-01

    This study examines the pseudo skin factor due to partial penetration in a 2-layer reservoir when only one layer is open to flow. The pseudo skin factor can be correlated as a unique function of 3 reservoir parameters and in some cases can be correlated accurately as a function of 2 reservoir parameters. Graphs and procedures for estimating the pseudo skin factor are presented. 17 references.

  13. Pure Sensory Stroke due to Lenticulocapsular Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    杨益阶; 王国瑾; 潘松青

    2003-01-01

    @@ Pure sensory stroke (PSS) caused by lenticulo-capsular hemorrhage is rare. In this article, we re-ported 4 patients with PSS due to lenticulocapsularhemorrhage, including 3 men and 1 woman (mean age,58 years; range, 54 to 65 years), whose lesions couldbe identified by head computed tomographic (CT)scan and clinical findings correlated with the radio-logical lesions. All patients except 1 had hyperten-sion.

  14. Sprue-like enteropathy due to olmesartan.

    Science.gov (United States)

    Muñoz-Muñoz, Cándido; López-Vivancos, Josefa; Huaman, Walter; García-Cors, Montserrat

    2015-10-01

    A case of spue-like enteropathy due to olmesartan is reported to draw attention to this disease, given the high frequency of use of this drug and the difficulty of diagnosis if the entity if it is not known. In his journal one case was published as Clinical Note in 2014 and we wish to emphasize the importance of knowledge about this relatively new entity.

  15. The Drone Court And Due Process

    Science.gov (United States)

    2016-12-01

    independent military judge or some other neutral decision maker, and the accused shall be presumed innocent unless and until the prosecution proves his...drone targeting of U.S. citizens seeks to exact the death penalty without providing the due process procedures required by the Constitution. The scene ... neutral decision maker.”211 In the majority opinion, Justice O’Connor, joined by the Chief Justice, Justice Kennedy, and Justice Breyer, concluded

  16. Acute chylous peritonitis due to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  17. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide.

  18. Subcutaneous phaeohyphomycosis due to Pyrenochaeta romeroi mimicking a synovial cyst

    Directory of Open Access Journals (Sweden)

    Aurelien Dinh

    2016-08-01

    Full Text Available Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  19. Radiation by solitons due to higher-order dispersion

    DEFF Research Database (Denmark)

    Karpman, V.I.

    1993-01-01

    We consider the Korteweg-de Vries (KdV) and nonlinear Schrodinger (NS) equations with higher-order derivative terms describing dispersive corrections. Conditions of existence of stationary and radiating solitons of the fifth-order KdV equation are obtained. An asymptotic time-dependent solution...... to the latter equation, describing the soliton radiation, is found. The radiation train may be in front as well as behind the soliton, depending on the sign of dispersion. The change rate of the soliton due to the radiation is calculated. A modification of the WKB method, that permits one to describe...

  20. Numerical Simulation of Sediment Transport due to Plunging Breaking Waves

    DEFF Research Database (Denmark)

    Pedersen, Claus

    A numerical model simulating the sediment transport due to plunging breaking waves has been developed. The model is two-dimensional, assuming conditions in the long-shore direction invariable. A plunging breaker is simulated by superimposing a non-breaking wave with a jet. Based on the description...... of the sediment transport rates, a simple model describing the morphological changes has been applied to simulate the evolution of a plunge point generated vorticity included, the bottom topography from the experiments by Dette & Uliczka was not in equilibrium according to the model....

  1. Dynamic Model of Signal Fading due to Swaying Vegetation

    OpenAIRE

    2009-01-01

    In this contribution, we use fading measurements at 2.45, 5.25, 29, and 60 GHz, and wind speed data, to study the dynamic effects of vegetation on propagating radiowaves. A new simulation model for generating signal fading due to a swaying tree has been developed by utilizing a multiple mass-spring system to represent a tree and a turbulent wind model. The model is validated in terms of the cumulative distribution function (CDF), autocorrelation function (ACF), level crossing rate (LCR...

  2. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation

    Directory of Open Access Journals (Sweden)

    Claudia Patricia Zuluaga

    2016-01-01

    Full Text Available Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history of esophageal perforation due to foreign body (fishbone with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation.

  3. Infected abdominal aortic aneurysm due to Morganella morganii: CT findings.

    Science.gov (United States)

    Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan

    2011-02-01

    An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.

  4. Ethical Principles for Physician Rating Sites

    OpenAIRE

    Strech, Daniel

    2011-01-01

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites’ effects on physicians’ performance, patient outcomes, or the public’s trust in health care, most contributions refer to normative arguments, hypothetical ...

  5. Heart rate index

    DEFF Research Database (Denmark)

    Haedersdal, C; Pedersen, F H; Svendsen, J H

    1992-01-01

    The present study compares the variables assessed by standard exercise test with the left ventricular ejection fraction (LVEF) measured by multigated radionuclide angiocardiography (MUGA) in 77 patients early after myocardial infarction. The exercise test and MUGA were performed within two weeks...... after the myocardial infarction. A significant correlation (Spearman's correlation coefficient rs, p less than 0.05) was found between LVEF at rest and the following variables assessed at exercise test: 1) the heart rate at rest, 2) rise in heart rate, 3) ratio between maximal heart rate and heart rate...... at rest, 4) rise in systolic blood pressure, 5) rate pressure product at rest, 6) rise in rate pressure product, 7) ratio (rHR) between maximal rate pressure product and rate pressure product at rest, 8) total exercise time. The heart rate was corrected for effects caused by age (heart index (HR...

  6. Echocardiographic Follow-up of Robotic Mitral Valve Repair for Mitral Regurgitation due to Degenerative Disease

    Directory of Open Access Journals (Sweden)

    Yao Wang

    2016-01-01

    Conclusion: Robotic MV repair for MR due to degenerative disease is associated with a low rate of recurrent MR, and a significant improvement in MR grade, LAD, and LVEDD, but a significant decrease in LVEF at echocardiographic follow-up.

  7. Enhanced droplet spreading due to thermal fluctuations

    Energy Technology Data Exchange (ETDEWEB)

    Willis, A M; Freund, J B, E-mail: jbfreund@illinois.ed [Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, 1206 West Green Street, Urbana, IL 61801 (United States)

    2009-11-18

    The lubrication equation that governs the dynamics of thin liquid films can be augmented to account for stochastic stresses associated with the thermal fluctuations of the fluid. It has been suggested that under certain conditions the spreading rate of a liquid drop on a surface will be increased by these stochastic stresses. Here, an atomistic simulation of a spreading drop is designed to examine such a regime and provide a quantitative assessment of the stochastic lubrication equation for spreading. It is found that the atomistic drop does indeed spread faster than the standard lubrication equations would suggest and that the stochastic lubrication equation of Gruen et al (2006 J. Stat. Phys. 122 1261-91) predicts the spread rate.

  8. High Data Rate Quantum Cryptography

    Science.gov (United States)

    Kwiat, Paul; Christensen, Bradley; McCusker, Kevin; Kumor, Daniel; Gauthier, Daniel

    2015-05-01

    While quantum key distribution (QKD) systems are now commercially available, the data rate is a limiting factor for some desired applications (e.g., secure video transmission). Most QKD systems receive at most a single random bit per detection event, causing the data rate to be limited by the saturation of the single-photon detectors. Recent experiments have begun to explore using larger degree of freedoms, i.e., temporal or spatial qubits, to optimize the data rate. Here, we continue this exploration using entanglement in multiple degrees of freedom. That is, we use simultaneous temporal and polarization entanglement to reach up to 8.3 bits of randomness per coincident detection. Due to current technology, we are unable to fully secure the temporal degree of freedom against all possible future attacks; however, by assuming a technologically-limited eavesdropper, we are able to obtain 23.4 MB/s secure key rate across an optical table, after error reconciliation and privacy amplification. In this talk, we will describe our high-rate QKD experiment, with a short discussion on our work towards extending this system to ship-to-ship and ship-to-shore communication, aiming to secure the temporal degree of freedom and to implement a 30-km free-space link over a marine environment.

  9. Large leg ulcers due to autoimmune diseases

    Science.gov (United States)

    Rozin, Alexander P.; Egozi, Dana; Ramon, Yehuda; Toledano, Kohava; Braun-Moscovici, Yolanda; Markovits, Doron; Schapira, Daniel; Bergman, Reuven; Melamed, Yehuda; Ullman, Yehuda; Balbir-Gurman, Alexandra

    2011-01-01

    Summary Background Large leg ulcers (LLU) may complicate autoimmune diseases. They pose a therapeutic challenge and are often resistant to treatment. To report three cases of autoimmune diseases complicated with LLU. Case Report Case 1. A 55-year old woman presented with long-standing painful LLU due to mixed connective tissue disease (MCTD). Biopsy from the ulcer edge showed small vessel vasculitis. IV methylprednisolone (MethP) 1 G/day, prednisolone (PR) 1mg/kg, monthly IV cyclophosphamide (CYC), cyclosporine (CyA) 100mg/day, IVIG 125G, ciprofloxacin+IV Iloprost+enoxaparin+aspirin (AAVAA), hyperbaric oxygen therapy (HO), maggot debridement and autologous skin transplantation were performed and the LLU healed. Case 2. A 45-year old women with MCTD developed multiple LLU’s with non-specific inflammation by biopsy. MethP, PR, hydroxychloroquine (HCQ), azathioprine (AZA), CYC, IVIG, AAVAA failed. Treatment for underlying the LLU tibial osteomyelitis and addition of CyA was followed by the LLU healing. Case 3. A 20-year-old man with history of polyarteritis nodosa (PAN) developed painful LLU’s due to small vessel vasculitis (biopsy). MethP, PR 1 mg/kg, CYC, CyA 100 mg/d, AAVAA failed. MRSA sepsis and relapse of systemic PAN developed. IV vancomycin, followed by ciprofloxacin, monthly IVIG (150 g/for 5 days) and infliximab (5 mg/kg) were instituted and the LLU’s healed. Conclusions LLU are extremely resistant to therapy. Combined use of multiple medications and services are needed for healing of LLU due to autoimmune diseases. PMID:21169912

  10. Periungual Lesion due to Secondary Syphilis.

    Science.gov (United States)

    Noriega, Leandro; Gioia Di Chiacchio, Nilton; Cury Rezende, Flávia; Di Chiacchio, Nilton

    2017-01-01

    Several countries experience a new epidemic of syphilis, mainly due to the changes in risk behaviors. Dermatologists play an important role in the diagnosis, since cutaneous manifestations are frequent during disease progression. We report a rare case of secondary syphilis with periungual involvement. Syphilis, especially in the secondary form, may present with different clinical features, affecting different organs, and mimicking many diseases. Although nail apparatus lesions are more common in the primary form of the disease, they may also be present in the secondary and tertiary forms. Therefore, a comprehensive knowledge of the diverse forms of syphilis presentation is important for an early diagnosis and timely treatment.

  11. Obstructive hydrocephalus due to CNS toxocariasis.

    Science.gov (United States)

    Choi, Jae-Hwan; Cho, Jae-Wook; Lee, Jae-Hyeok; Lee, Sang Weon; Kim, Hak-Jin; Choi, Kwang-Dong

    2013-06-15

    A 46-year-old man developed intermittent headache, diplopia, and visual obscuration for two months. Funduscopic examination showed optic disk swelling in both eyes. Brain MRI exhibited hydrocephalus and leptomeningeal enhancement at the prepontine cistern, left cerebellopontine angle cistern and bilateral cerebral hemisphere, and hemosiderin deposition along the cerebellar folia. CSF analysis revealed an elevated opening pressure with xanthochromic appearance and small amount of red blood cells. Antibody titer against Toxocariasis using ELISA was elevated both in blood and CSF. Obstructive hydrocephalus and hemosiderin deposition in this case may result from the active inflammatory process due to CNS toxocariasis within the subarachnoid space.

  12. Broadband Clutter due to Aggregations of Fish

    Science.gov (United States)

    2015-01-15

    Fish     Richard  H.  Love   BayouAcoustics   Abita  Springs,  LA  70420   Phone:    (985...Long  Term  Goals     Develop  an  understanding  of  physical  parameters  of  aggregations   of   fish  that  control...Acoustic  Uncertainty  due  to   Marine  Mammals  and   Fish ,”  which  was  informally  known  as

  13. Orbital effects due to gravitational induction

    CERN Document Server

    Bini, Donato; Giordano, Domenico

    2015-01-01

    We study the motion of test particles in the metric of a localized and slowly rotating astronomical source, within the framework of linear gravitoelectromagnetism, grounded on a Post-Minkowskian approximation of general relativity. Special attention is paid to gravitational inductive effects due to time-varying gravitomagnetic fields. We show that, within the limits of the approximation mentioned above, there are cumulative effects on the orbit of the particles either for planetary sources or for binary systems. They turn out to be negligible.

  14. Segmental Renal Infarction due to Blunt Trauma.

    Science.gov (United States)

    Alevizopoulos, Aristeidis; Hamilton, Lauren; Stratu, Natalia; Rix, Gerald

    2016-05-01

    Segmental renal infarction is a rare situation which has been reported so far in the form of case reports. It's caused usually by cardiac conditions, such as atrial fibrillation, and systemic diseases (e.g. systemic lupus erythematous). We are presenting a case of a 31 year old healthy male, who sustained a left segmental renal infarction, following a motorbike accident. We report his presentation, management and outcome. We also review the literature in search of the optimal diagnostic and treatment pathway. To our knowledge, this is the first report of segmental renal infarction due to blunt trauma.

  15. Constrained inflaton due to a complex scalar

    Energy Technology Data Exchange (ETDEWEB)

    Budhi, Romy H. S. [Physics Department, Gadjah Mada University,Yogyakarta 55281 (Indonesia); Institute for Theoretical Physics, Kanazawa University,Kanazawa 920-1192 (Japan); Kashiwase, Shoichi; Suematsu, Daijiro [Institute for Theoretical Physics, Kanazawa University,Kanazawa 920-1192 (Japan)

    2015-09-14

    We reexamine inflation due to a constrained inflaton in the model of a complex scalar. Inflaton evolves along a spiral-like valley of special scalar potential in the scalar field space just like single field inflation. Sub-Planckian inflaton can induce sufficient e-foldings because of a long slow-roll path. In a special limit, the scalar spectral index and the tensor-to-scalar ratio has equivalent expressions to the inflation with monomial potential φ{sup n}. The favorable values for them could be obtained by varying parameters in the potential. This model could be embedded in a certain radiative neutrino mass model.

  16. Hyperekplexia and trismus due to brainstem encephalopathy

    Science.gov (United States)

    Kellett, M.; Humphrey, P.; Tedman, B.; Steiger, M.

    1998-01-01

    The brainstem is said to be the generator of pathological startle responses due to reticular reflex myoclonus or hyperekplexia. A patient with facial weakness, nystagmus, and pyramidal tract signs had generalised reflex spasms in response to auditory, visual and tactile stimuli which clinically and neurophysiologically resembled hyperekplexia. The case is unusual because as well as hyperekplexia, the patient's initial presentation was with an equally rare manifestation of brainstem pathology—brainstem mediated trismus. The causes of brainstem trismus and exaggerated startle responses are discussed with respect to their underlying mechanisms. 

 PMID:9667574

  17. Pure dysarthria due to an insular infarction.

    Science.gov (United States)

    Hiraga, Akiyuki; Tanaka, Saiko; Kamitsukasa, Ikuo

    2010-06-01

    Cortical infarction presenting with pure dysarthria is rarely reported. Previous studies have reported pure dysarthria due to cortical stroke at the precentral gyrus or middle frontal gyrus. We report a 72-year-old man who developed pure dysarthria caused by an acute cortical infarction in the insular cortex. The role of the insula in language has been difficult to assess clinically because of the rarity of pure insular strokes. Our patient showed pure dysarthria without aphasia, indicating that pure dysarthria can be the sole manifestation of insular infarctions.

  18. Stretch due to Penile Prosthesis Reservoir Migration

    Directory of Open Access Journals (Sweden)

    E. Baten

    2016-03-01

    Full Text Available A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

  19. Pneumonia due to Enterobacter cancerogenus infection.

    Science.gov (United States)

    Demir, Tülin; Baran, Gamze; Buyukguclu, Tuncay; Sezgin, Fikriye Milletli; Kaymaz, Haci

    2014-11-01

    Enterobacter cancerogenus (formerly known as CDC Enteric Group 19; synonym with Enterobacter taylorae) has rarely been associated with human infections, and little is known regarding the epidemiology and clinical significance of this organism. We describe a community-acquired pneumonia case in a 44-year-old female due to E. cancerogenus. Identification and antimicrobial susceptibility of the microorganism was performed by the automatized VITEK 2 Compact system (bioMerieux, France). The clinical case suggests that E. cancerogenus is a potentially pathogenic microorganism in determined circumstances; underlying diseases such as bronchial asthma, empiric antibiotic treatment, wounds, diagnostic, or therapeutic instruments.

  20. Erythema ab igne (Unilateral due to "Chulla"

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2014-01-01

    Full Text Available Erythema ab igne (EAI is characterized by localized areas of reticulated erythema and hyperpigmentation due to chronic and repeated exposure to infrared radiation. Taking a good history plays an important role in coming to the diagnosis of the disease condition; and at the same time, the particular cultural practices of a place determine its occurrence in the local masses. Herein we report the case of a young lady in her early thirties who presented to us with a dusky hyperpigmentation over her right arm and leg. Her detailed history and cutaneous examination led to the diagnosis of erythema ab igne.

  1. The rating reliability calculator

    Directory of Open Access Journals (Sweden)

    Solomon David J

    2004-04-01

    Full Text Available Abstract Background Rating scales form an important means of gathering evaluation data. Since important decisions are often based on these evaluations, determining the reliability of rating data can be critical. Most commonly used methods of estimating reliability require a complete set of ratings i.e. every subject being rated must be rated by each judge. Over fifty years ago Ebel described an algorithm for estimating the reliability of ratings based on incomplete data. While his article has been widely cited over the years, software based on the algorithm is not readily available. This paper describes an easy-to-use Web-based utility for estimating the reliability of ratings based on incomplete data using Ebel's algorithm. Methods The program is available public use on our server and the source code is freely available under GNU General Public License. The utility is written in PHP, a common open source imbedded scripting language. The rating data can be entered in a convenient format on the user's personal computer that the program will upload to the server for calculating the reliability and other statistics describing the ratings. Results When the program is run it displays the reliability, number of subject rated, harmonic mean number of judges rating each subject, the mean and standard deviation of the averaged ratings per subject. The program also displays the mean, standard deviation and number of ratings for each subject rated. Additionally the program will estimate the reliability of an average of a number of ratings for each subject via the Spearman-Brown prophecy formula. Conclusion This simple web-based program provides a convenient means of estimating the reliability of rating data without the need to conduct special studies in order to provide complete rating data. I would welcome other researchers revising and enhancing the program.

  2. Orbital dystopia due to orbital roof defect.

    Science.gov (United States)

    Rha, Eun Young; Joo, Hong Sil; Byeon, Jun Hee

    2013-01-01

    We performed a retrospective review of patients who presented with delayed dystopia as a consequence of an orbital roof defect due to fractures and nontraumatic causes to search for a correlation between orbital roof defect size and surgical indications for the treatment thereof. Retrospective analyses were performed in 7 patients, all of whom presented with delayed dystopia due to orbital roof defects, between January 2001 and June 2011. The causes of orbital roof defects were displaced orbital roof fractures (5 cases), tumor (1 case), and congenital sphenoid dysplasia (1 case). All 7 patients had initially been treated conservatively and later presented with significant dystopia. The sizes of the defects were calculated on computed tomographic scans. Among the 7 patients, aspiration of cerebrospinal fluid, which caused ocular symptoms, in 1 patient with minimal displaced orbital roof and reconstruction with calvarial bone, titanium micromesh, or Medpor in 6 other patients were performed. The minimal size of the orbital roof in patients who underwent orbital roof reconstruction was 1.2 cm (defect height) x 1.0 cm (defect length), 0.94 cm(2). For all patients with orbital dystopia, displacement of the globe was corrected without any complications, regardless of whether the patient was evaluated grossly or by radiology. In this retrospective study, continuous monitoring of clinical signs and active surgical management should be considered for cases in which an orbital roof defect is detected, even if no definite symptoms are noted, to prevent delayed sequelae.

  3. Allergic contact cheilitis due to lipstick

    Directory of Open Access Journals (Sweden)

    Yatty Ravitasari

    2015-12-01

    Full Text Available Background: Cheilitis is a common problem of unknown etiology. A possible cause of cheilitis is contact allergy. Drugs, lipsticks, sunblock and toothpaste are the most common implicated allergens. Allergic contact cheilitis is a chronic superficial inflammatory disorder of the vermilion borders characterized by desquamation due to delayed-type hypersensitivity reaction. Purpose: We report a management of Allergic contact cheilitis due to lipsticks. Case: A 21-year-old woman had a history of atopic allergy to eggs, milk, and chicken presented with sore, dry, fissured, scaled and sometimes bleeding lip, over a 3-month period after application of a lipstick. Her symptoms persisted despite treatments with hydrocortisone cream. The patient provided a detailed history and underwent physical examination and patch tests to cosmetic components and patch test to her own lipstick. The patient had strongly-positive result to the tested lipstick. A diagnosis of allergic contact cheilitis was made based on the history and clinical findings. Case management: Patient was advised to avoid wearing lipstick. To relieve symptoms, treatment was initiated with combined topical corticosteroid, antibiotic, and moisturizer. Conclusion: Contact allergy patients should be tested for both cosmetic component series and their own lipsticks to exclude exfolliative cheilitis, infection, or light actinic cheilitis as causal agents.

  4. Rate Review Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — As of September 1, 2011, the Affordable Care Act and rate review regulation require review of rate increases of 10 percent or more. A non-grandfathered health plan...

  5. Rating mutual funds

    DEFF Research Database (Denmark)

    Bechmann, Ken L.; Rangvid, Jesper

    obtained an annual risk-adjusted excess return that is approximately 3-4 percentage points higher per annum than if the funds with the highest costs had been invested in. We compare the atpRating with the Morningstar Rating. We show that one reason why the atpRating and the Morningstar Rating contain...... different information is that the returns Morningstar uses as inputs when rating funds are highly volatile whereas the costs the atpRating uses as inputs when rating funds are highly persistent. In other words, a fund that has low costs one year will most likely also have low costs the following year......, whereas the return of a fund in a certain year generally contains only little information about the future return that the fund will generate. Finally, we have information on the investments in different mutual funds made by a small subgroup of investors known to have been exposed to both the atpRating...

  6. Rating mutual funds

    DEFF Research Database (Denmark)

    Bechmann, Ken L.; Rangvid, Jesper

    2007-01-01

    obtained a risk-adjusted excess return that is approximately 3-4 percentage points higher per annum than if the funds with the highest costs had been invested in. We compare the atpRating with the Morningstar Rating. We show that one reason why the atpRating and the Morningstar Rating contain different...... information is that the returns Morningstar uses as inputs when rating funds are highly volatile whereas the costs the atpRating uses as inputs when rating funds are highly persistent. In other words, a fund that has low costs one year will most likely also have low costs the following year, whereas...... the return of a fund in a certain year generally contains only little information about the future return that the fund will generate. Finally, we have information on the investments in different mutual funds made by a small subgroup of investors known to have been exposed to both the atpRating...

  7. Glomerular filtration rate

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007305.htm Glomerular filtration rate To use the sharing features on this page, please enable JavaScript. Glomerular filtration rate (GFR) is a test used to check ...

  8. Labor Force Participation Rate

    Data.gov (United States)

    City and County of Durham, North Carolina — This thematic map presents the labor force participation rate of working-age people in the United States in 2010. The 2010 Labor Force Participation Rate shows the...

  9. Fertility Clinic Success Rates

    Science.gov (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  10. Driving performance impairments due to hypovigilance on monotonous roads.

    Science.gov (United States)

    Larue, Grégoire S; Rakotonirainy, Andry; Pettitt, Anthony N

    2011-11-01

    Drivers' ability to react to unpredictable events deteriorates when exposed to highly predictable and uneventful driving tasks. Highway design reduces the driving task mainly to a lane-keeping manoeuvre. Such a task is monotonous, providing little stimulation and this contributes to crashes due to inattention. Research has shown that driver's hypovigilance can be assessed with EEG measurements and that driving performance is impaired during prolonged monotonous driving tasks. This paper aims to show that two dimensions of monotony - namely road design and road side variability - decrease vigilance and impair driving performance. This is the first study correlating hypovigilance and driver performance in varied monotonous conditions, particularly on a short time scale (a few seconds). We induced vigilance decrement as assessed with an EEG during a monotonous driving simulator experiment. Road monotony was varied through both road design and road side variability. The driver's decrease in vigilance occurred due to both road design and road scenery monotony and almost independently of the driver's sensation seeking level. Such impairment was also correlated to observable measurements from the driver, the car and the environment. During periods of hypovigilance, the driving performance impairment affected lane positioning, time to lane crossing, blink frequency, heart rate variability and non-specific electrodermal response rates. This work lays the foundation for the development of an in-vehicle device preventing hypovigilance crashes on monotonous roads.

  11. An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal department

    NARCIS (Netherlands)

    Fleer, A.; Gerards, L.J.; Hennekam, R.C.M.; Dijk, W.C.V.; Roord, J.J.

    1984-01-01

    An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal ward is described. The epidemic affected 16 of 24 infants (infection-rate 66 per cent), of whom one died due to necrotizing enterocolitis. Administration of antibiotics was of limited value in treatment or in eradicating E.

  12. An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal department

    NARCIS (Netherlands)

    Fleer, A.; Gerards, L.J.; Hennekam, R.C.M.; Dijk, W.C.V.; Roord, J.J.

    1984-01-01

    An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal ward is described. The epidemic affected 16 of 24 infants (infection-rate 66 per cent), of whom one died due to necrotizing enterocolitis. Administration of antibiotics was of limited value in treatment or in eradicating E.

  13. A hedonic analysis of big game hunting club dues in Georgia, USA

    Science.gov (United States)

    James C. Mingie; Neelam C. Poudyal; J. M.  Bowker; Michael T.  Mengak; Jacek P.  Siry

    2017-01-01

    Hunting lease revenue can be a reliable supplemental income for forest landowners. Although studies have examined factors influencing per acre lease rates, little is known about how various characteristics are capitalized in hunting club dues. The objective of this study was to conduct a hedonic analysis of big game hunting club dues in Georgia, USA using a variety of...

  14. Heat Loss Due To Thermal Bridges In Buildings

    Science.gov (United States)

    Fang, J. B.; tarot, R. A.; Childs, K. W.; Courville, G. E.

    1984-03-01

    Building envelopes often contain numerous highly conductive heat flow paths, called thermal bridges, which are major sources of heat loss and deterioration of building materials due to moisture condensation. Some examples of thermal bridges occurring in office buildings are presented. Infrared thermography was used to identify the locations and magnitudes of thermally defective areas resulting from inadequate construction, design, or substandard workmanship in existing buildings. Due to the large thermal inertia of building components and transient conditions caused by fluctuating outdoor and indoor temperatures, long measurement periods are required. This makes thermography impractical for quantifying the heat loss. In order to estimate the heat loss rate from thermal bridges and to obtain a better understanding of the physical processes involved, a two-dimensional heat flow model has been developed for transient heat conduction within the exterior wall/intermediate floor systems. The calculated results from the mathematical model are compared with available experimental data. An in-situ measurement technique, which is currently under development at NBS for quantifying the energy loss due to thermal bridges, is described.

  15. Earth system commitments due to delayed mitigation

    Science.gov (United States)

    Pfister, Patrik L.; Stocker, Thomas F.

    2016-01-01

    As long as global CO2 emissions continue to increase annually, long-term committed Earth system changes grow much faster than current observations. A novel metric linking this future growth to policy decisions today is the mitigation delay sensitivity (MDS), but MDS estimates for Earth system variables other than peak temperature (ΔT max) are missing. Using an Earth System Model of Intermediate Complexity, we show that the current emission increase rate causes a ΔT max increase roughly 3-7.5 times as fast as observed warming, and a millenial steric sea level rise (SSLR) 7-25 times as fast as observed SSLR, depending on the achievable rate of emission reductions after the peak of emissions. These ranges are only slightly affected by the uncertainty range in equilibrium climate sensitivity, which is included in the above values. The extent of ocean acidification at the end of the century is also strongly dependent on the starting time and rate of emission reductions. The preservable surface ocean area with sufficient aragonite supersaturation for coral reef growth is diminished globally at an MDS of roughly 25%-80% per decade. A near-complete loss of this area becomes unavoidable if mitigation is delayed for a few years to decades. Also with respect to aragonite, 12%-18% of the Southern Ocean surface become undersaturated per decade, if emission reductions are delayed beyond 2015-2040. We conclude that the consequences of delaying global emission reductions are much better captured if the MDS of relevant Earth system variables is communicated in addition to current trends and total projected future changes.

  16. Meningitis due to Haemophilus influenzae type f.

    Science.gov (United States)

    Cardoso, Marta Pessoa; Pasternak, Jacyr; Giglio, Alfredo Elias; Casagrande, Rejane Rimazza Dalberto; Troster, Eduardo Juan

    2013-12-01

    With the decline in the rate of infections caused by Haemophilus influenzae serotype b since the widespread vaccination, non-b serotypes should be considered as potential pathogenic agents in children with invasive disease younger than 5 years old. We report the case of an immunocompetent 1-year-old boy with Haemophilus influenzae type f meningitis. The agent was identified in cerebrospinal fluid and blood cultures. Serotyping was performed by tests using polyclonal sera and confirmed by polymerase chain reaction. All Haemophilus influenzae isolates associated with invasive disease should be serotyped and notified as a way to evaluate the changes and trends in serotype distribution of this disease.

  17. Patterns of residual stresses due to welding

    Science.gov (United States)

    Botros, B. M.

    1983-01-01

    Residual stresses caused by welding result from the nonuniform rate of cooling and the restrained thermal contraction or non-uniform plastic deformation. From the zone of extremely high temperature at the weld, heat flows into both the adjoining cool body and the surrounding atmosphere. The weld metal solidifies under very rapid cooling. The plasticity of the hot metal allows adjustment initially, but as the structure cools the rigidity of the surrounding cold metal inhibits further contraction. The zone is compressed and the weld is put under tensile stresses of high magnitude. The danger of cracking in these structural elements is great. Change in specific volume is caused by the change in temperature.

  18. [Pleural trichomoniasis due to trichomonas tenax].

    Science.gov (United States)

    Porcheret, H; Maisonneuve, L; Estève, V; Jagot, J L; Le Pennec, M P

    2002-02-01

    Thoracic infections due to Trichomonas species often go unrecognised as they are seldom described in the literature. We describe a case that, to our knowledge, is the first reported case of empyema caused by this organism. A 59 year old man with metastatic adenocarcinoma of the lung developed a right pyopneumothorax following treatment with corticosteroids and radiotherapy. The pleural fluid was purulent and fetid, and contained large numbers of Trichomonas tenax amongst a mixed bacterial flora. Pleural drainage and antibiotic therapy with metronidazole, ciprofloxacin and gentalline were instituted immediately, but the patient died 4 days later. Trichomonas tenax is part of the normal oral floral and may on occasions colonize the airways. It can thus become involved during aspiration pneumonia or cause pleural infection following the rupture of a pulmonary abscess. Such infection tends to be associated with concurrent respiratory pathology or with immunodepression. The significance Trichomonas tenax when found in the airways is unclear and their pathogenic role is discussed.

  19. Plasma Braking Due to External Magnetic Perturbations

    Science.gov (United States)

    Frassinetti, L.; Olofsson, Kejo; Brunsell, P. R.; Khan, M. W. M.; Drake, J. R.

    2010-11-01

    The RFP EXTRAP T2R is equipped with a comprehensive active feedback system (128 active saddle coils in the full-coverage array) and active control of both resonant and non-resonant MHD modes has been demonstrated. The feedback algorithms, based on modern control methodology such as reference mode tracking (both amplitude and phase), are a useful tool to improve the ``state of the art'' of the MHD mode control. But this tool can be used also to improve the understanding and the characterization of other phenomena such as the ELM mitigation with a resonant magnetic perturbation or the plasma viscosity. The present work studies plasma and mode braking due to static RMPs. Results show that a static RMP produces a global braking of the flow profile. The study of the effect of RMPs characterized by different helicities will also give information on the plasma viscosity profile. Experimental results are finally compared to theoretical models.

  20. Acute renal failure due to rhabdomyolyisis

    Directory of Open Access Journals (Sweden)

    Nieto-Ríos, John Fredy

    2016-04-01

    Full Text Available Acute renal failure is a frequent cause of morbidity and mortality in emergency, hospitalization and critical care services. In 15 % of cases it is due to rhabdomyolysis, in which there is breakdown of skeletal muscle with massive necrosis and leakage of muscle cell contents into the circulation. It has many different etiologies. The rhabdomyolysis-induced acute kidney injury results from the combination of several mechanisms, including tubular obstruction, vasoconstriction and oxidative stress. The most important therapeutic measures are: Aggressive repletion of fluids, forced diuresis and avoidance of exposure to nephrotoxic substances. In cases of severe uremia, metabolic acidosis, hiperkalemia or fluid overload it is necessary to start renal replacement therapy. As a rule, kidney function is completely recovered, but these patients have higher risk of future chronic kidney disease.

  1. Nasal infection due to Mycobacterium fortuitum.

    Science.gov (United States)

    Nguyen, D-Q; Righini, C; Darouassi, Y; Schmerber, S

    2011-09-01

    Mycobacterium fortuitum, a rapidly growing non-tuberculous atypical mycobacterium, is commonly found in soil and water. This organism generally causes skin, bone, and soft tissue infections following local trauma or surgical procedures, and in immunodeficient patients. The case reported here is, to our knowledge, the first published report of M. fortuitum nasal infection. The authors report the case of a 3-year-old girl with intranasal tumour-like swelling associated with cervical lymph nodes due to M. fortuitum infection. A combination of radical surgical debridement and prolonged therapy with several antimicrobial agents was required to completely eradicate the infection. This case report indicates that non-tuberculous mycobacterial infections should be considered after failure of conventional antibiotic therapy or when classical microbiological tests fail to identify the pathogen responsible for sinonasal and cervical infections. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  2. [Child maltreatment due to alcohol abuse].

    Science.gov (United States)

    Abuná Salcedo, Lucia Julieta; Carvalho, Ana Maria Pimenta

    2005-01-01

    The purpose of this paper was to investigate the occurrence of maltreatment in children abused by alcohol users. Authors looked at the records of children hospitalized from 2000 to 2003 at the Children Hospital "Dr. Ovidio Aliga Uria". Findings showed that among the total of hospitalizations, 0.62% were due to maltreatment. Considering them, 57.9% involved alcohol users. Approximately 12.9% of them died as a consequence of brain trauma. The characterization of the aggressors showed that they are abusive drinkers with no dependence; with age varying from 20 to 30 years, are members of the children's family; finished primary school, do not have a job and are drug users. Although the low percentage of cases, there is a need to take care of this situation aiming at protecting the children and respecting their rights as well as at providing care to the adult that also experiences stressing conditions.

  3. Fixed drug eruption due to paracetamol

    Directory of Open Access Journals (Sweden)

    Anjali Kushwah

    2013-12-01

    Full Text Available Fixed drug eruption is a common type of drug eruption seen in dermatology OPD’s. Usually it is seen with sulphonamides, salicylates, tetracyclines, oxyphenbutazones, dapsone, barbiturates, phenolphthalein, morphine, codeine, quinine, phenacetin, erythromycin, griseofulvin, mebendazole etc. We hereby report a case of fixed drug eruption due to single dose of oral paracetamol in an otherwise healthy male after one hour of consuming it. A provisional diagnosis of Paracetamol induced fixed drug eruption was made. Paracetamol was stopped and patient advised never to take Paracetamol in future. Patient was managed with prednisolone 10mg /day, cetirizine 10 mg/day, and amoxicillin 500 mg twice a day and mometasone + fusidic acid cream to be applied over the lesions. [Int J Basic Clin Pharmacol 2013; 2(6.000: 833-835

  4. Small Bowel Obstruction due to Intestinal Xanthomatosis

    Directory of Open Access Journals (Sweden)

    L. E. Barrera-Herrera

    2015-01-01

    Full Text Available Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders.

  5. Hypomyelinating Leukodystrophy due to HSPD1 Mutations

    DEFF Research Database (Denmark)

    Schioldan Kusk, Maria; Damgaard, Bodil; Risom, Lotte

    2016-01-01

    The hypomyelinating leukodystrophies (HMLs) encompass the X-linked Pelizaeus-Merzbacher disease (PMD) caused by PLP1 mutations and known as the classical form of HML as well as Pelizaeus-Merzbacher-like disease (PMLD) (Online Mendelian Inheritance in Man [OMIM] 608804 and OMIM 260600) due to GJC2...... mutations. In addition, mutations in at least 10 other genes are known to cause HMLs. In 2008, an Israeli family with clinical and neuroimaging findings similar to those found in PMD was reported. The patients were found to have a homozygous missense mutation in HSPD1, encoding the mitochondrial heat......-shock protein 60 (Hsp60), and the disorder was defined as the autosomal recessive mitochondrial Hsp60 chaperonopathy (MitCHAP-60) disease. We here report the first case of this severe neurodegenerative disease since it was first described. Given the fact that the families carried the same mutation our patient...

  6. Lichenoid drug eruption due to imatinib mesylate.

    Science.gov (United States)

    Bhatia, Anuradha; Kanish, Bimal; Chaudhary, Paulina

    2015-01-01

    Imatinib mesylate is a selective tyrosinase kinase inhibitor which has revolutionized the treatment of chronic myeloid leukemia. It is also used in gastrointestinal stromal tumors and dermatofibrosarcoma protruberans. Cutaneous adverse reactions are the most common nonhematological side effects secondary to imatinib. Nonlichenoid reactions are common, while lichenoid reactions are rare. We report a case of lichenoid drug eruption due to imatinib. As the indications and use of imatinib are increasing, the incidences of adverse effects, including cutaneous ones, are likely to increase. Some of the reactions may be severe enough to warrant discontinuation of the drug. The physicians should be aware of this morphological entity, which is usually benign and does not warrant withdrawal of the drug.

  7. Seismoelectric effects due to mesoscopic heterogeneities

    CERN Document Server

    Jougnot, D; Carbajal, M Rosas; Linde, N; Holliger, K

    2014-01-01

    While the seismic effects of wave-induced fluid flow due to mesoscopic heterogeneities have been studied for several decades, the role played by these types of heterogeneities on seismoelectric phenomena is largely unexplored. To address this issue, we have developed a novel methodological framework which allows for the coupling of wave-induced fluid flow, as inferred through numerical oscillatory compressibility tests, with the pertinent seismoelectric conversion mechanisms. Simulating the corresponding response of a water-saturated sandstone sample containing mesoscopic fractures, we demonstrate for the first time that these kinds of heterogeneities can produce measurable seismoelectric signals under typical laboratory conditions. Given that this phenomenon is sensitive to key hydraulic and mechanical properties, we expect that the results of this pilot study will stimulate further exploration on this topic in several domains of the Earth, environmental, and engineering sciences.

  8. Understanding Interest Rate Volatility

    DEFF Research Database (Denmark)

    Volker, Desi

    This thesis is the result of my Ph.D. studies at the Department of Finance of the Copenhagen Business School. It consists of three essays covering topics related to the term structure of interest rates, monetary policy and interest rate volatility. The rst essay, \\Monetary Policy Uncertainty...... and Interest Rates", examines the role of monetary policy uncertainty on the term structure of interest rates. The second essay, \\A Regime-Switching A ne Term Structure Model with Stochastic Volatility" (co-authored with Sebastian Fux), investigates the ability of the class of regime switching models...... with and without stochastic volatility to capture the main stylized features of U.S. interest rates. The third essay, \\Variance Risk Premia in the Interest Rate Swap Market", investigates the time-series and cross-sectional properties of the compensation demanded for holding interest rate variance risk. The essays...

  9. Clinical study on the causes of recurrence of inguinal hernia after tension-free hernioplasty and methods of reoperation: a report of 108 cases%腹股沟疝无张力修补术后复发原因及再手术方法探讨(附108例报告)

    Institute of Scientific and Technical Information of China (English)

    郑启昌; 翟东升

    2008-01-01

    Objective To investigate the causes of recurrence of inguinal hernia after tension-free hernioplasty and study the reoperative methods.Mothods The 108 cases between 2003 and 2008 of recurrent inguinal hernia after tension-free hemioplasty were studied and analyzed retrospectively.Results 73 cases recurred in primary operative position,including 34 cases of justominor mesh,19 cases of displaced patch or mesh,14 cases of deformation or curling mesh and 6 cases Patch or mesh at the wrong position.35 cases (miss hernia)recurred outside primary operative position,including 16 cases of missing direct hernia, 11 cases of femoral hernia, 8 cases of indirect hernia. Kugel and Prolene-polypropylene hernia system(PHS)was conducted for 108 cases. No postoperative recurrence was found after 1 month to 5 years followed-up.Conclusions Many factors can cause inguinal hernia to recur after tension-free hernioplasty,such as miss hernia, displaced patch or mesh, inappropriate choice of size of mesh and operation method et al. Stoppa operation is an effective way for the treatment of recurrence of inguinal hernia after tension -free hernioplasty.%目的 讨论无张力疝修补术后腹股沟疝复发原因及再次手术方法.方法 对2003年4月至2008年3月间收治的108例无张力疝修补术后腹股沟复发疝患者的资料进行回顾性分析.结果 原修补部位复发73例,其中平片过小34例,网塞或补片移位19例,平片变形、卷曲14例,补片位置放置错误6例.在修补部位以外(术中遗漏疝 miss hernia)复发35例,其中遗漏直疝16例,股疝11例,斜疝8例.再次手术均应用腹膜前间隙修补,采用PHS及Kugel补片,术后随访1个月~5年均未复发.结论 无张力修补术后腹股沟疝复发与患者术中遗留疝、补片移位、补片大小及手术方式选择不当等因素相关;选择腹膜前间隙修补是治疗无张力疝修补术后腹股沟疝复发的有效方式.

  10. Injury due to leg bands in willow flycatchers

    Science.gov (United States)

    Sedgwick, J.A.; Klus, R.J.

    1997-01-01

    We report an apparently unusually high incidence of leg injury in Willow Flycatchers (Empidonax traillii) as a result of banding and color banding. Color bands and U.S. Fish and Wildlife Service (USFWS) bands applied to Willow Flycatchers from 1988-1995 resulted in an overall leg injury rate of 9.6% to birds returning to our study areas in subsequent years. Most injuries occurred on legs with only color band(s) (58.3%) or on legs with both a USFWS band and a color band (35%); only 6.7% of injuries (4/60) were due to USFWS bands alone, yielding an overall USFWS band injury rate of only 0.6%. Injuries ranged from severe (swollen, bleeding legs; a missing foot) to relatively minor (irritations on the tarsus). Amputation of the foot occurred in 33.9% of the cases. Return rates of adult injured birds in the year(s) following injury were significantly lower than for the population at large.

  11. Photoionization rates for helium: update

    CERN Document Server

    Sokół, Justyna M

    2014-01-01

    The NIS He gas has been observed at a few AU to the Sun almost from the beginning of the space age. To model its flow an estimate of the loss rates due to ionization by solar extreme-ultraviolet (EUV) flux is needed. The EUV irradiance has been measured directly from mid 1990-ties, but with high temporal and spectral resolution only from 2002. Beforehand only EUV proxies are available. A new method of reconstruction of the Carrington rotation averaged photoionization rates for neutral interstellar helium (NIS He) in the ecliptic at 1 AU to the Sun before 2002 is presented. We investigate the relation between the solar rotation averaged time series of the ionization rates for NIS He at 1 AU derived from TIMED measurements of EUV irradiance and the solar 10.7 cm flux (F10.7) only. We perform a weighted iterative fit of a nonlinear model to data split into sectors. The obtained formula allows to reconstruct the solar rotation averages of photoionization rates for He between ~1947 and 2002 with an uncertainty ran...

  12. Measuring zebrafish turning rate.

    Science.gov (United States)

    Mwaffo, Violet; Butail, Sachit; di Bernardo, Mario; Porfiri, Maurizio

    2015-06-01

    Zebrafish is becoming a popular animal model in preclinical research, and zebrafish turning rate has been proposed for the analysis of activity in several domains. The turning rate is often estimated from the trajectory of the fish centroid that is output by commercial or custom-made target tracking software run on overhead videos of fish swimming. However, the accuracy of such indirect methods with respect to the turning rate associated with changes in heading during zebrafish locomotion is largely untested. Here, we compare two indirect methods for the turning rate estimation using the centroid velocity or position data, with full shape tracking for three different video sampling rates. We use tracking data from the overhead video recorded at 60, 30, and 15 frames per second of zebrafish swimming in a shallow water tank. Statistical comparisons of absolute turning rate across methods and sampling rates indicate that, while indirect methods are indistinguishable from full shape tracking, the video sampling rate significantly influences the turning rate measurement. The results of this study can aid in the selection of the video capture frame rate, an experimental design parameter in zebrafish behavioral experiments where activity is an important measure.

  13. Comparison of complication rates of minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion: a systematic review of the literature.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; La Marca, Frank; Park, Paul

    2015-10-01

    OBJECT Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and lateral lumbar interbody fusion (LLIF) are 2 currently popular techniques for lumbar arthrodesis. The authors compare the total risk of each procedure, along with other important complication outcomes. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies (up to May 2015) that reported complications of either MI-TLIF or LLIF were identified from a search in the PubMed database. The primary outcome was overall risk of complication per patient. Secondary outcomes included risks of sensory deficits, temporary neurological deficit, permanent neurological deficit, intraoperative complications, medical complications, wound complications, hardware failure, subsidence, and reoperation. RESULTS Fifty-four studies were included for analysis of MI-TLIF, and 42 studies were included for analysis of LLIF. Overall, there were 9714 patients (5454 in the MI-TLIF group and 4260 in the LLIF group) with 13,230 levels fused (6040 in the MI-TLIF group and 7190 in the LLIF group). A total of 1045 complications in the MI-TLIF group and 1339 complications in the LLIF group were reported. The total complication rate per patient was 19.2% in the MI-TLIF group and 31.4% in the LLIF group (p < 0.0001). The rate of sensory deficits and temporary neurological deficits, and permanent neurological deficits was 20.16%, 2.22%, and 1.01% for MI-TLIF versus 27.08%, 9.40%, and 2.46% for LLIF, respectively (p < 0.0001, p < 0.0001, p = 0.002, respectively). Rates of intraoperative and wound complications were 3.57% and 1.63% for MI-TLIF compared with 1.93% and 0.80% for LLIF, respectively (p = 0.0003 and p = 0.034, respectively). No significant differences were noted for medical complications or reoperation. CONCLUSIONS While there was a higher overall complication rate with LLIF, MI-TLIF and LLIF both have

  14. QT Prolongation due to Graves’ Disease

    Directory of Open Access Journals (Sweden)

    Zain Kulairi

    2017-01-01

    Full Text Available Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status.

  15. QT Prolongation due to Graves' Disease

    Science.gov (United States)

    Deol, Nisha; Tolly, Renee; Manocha, Rohan; Naseer, Maliha

    2017-01-01

    Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status. PMID:28154763

  16. Tearing mode instability due to anomalous resistivity

    Energy Technology Data Exchange (ETDEWEB)

    Furuya, Atsushi [Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga, Fukuoka (Japan); Itoh, Sanae I.; Yagi, Masatoshi [Kyushu Univ., Fukuoka (Japan). Research Inst. for Applied Mechanics

    2000-09-01

    Tearing mode instability in the presence of microscopic truculence is investigates. The effects of microscopic turbulence on tearing mode are taken as drags which are calculated by one-point renormalization method and mean-field approximation. These effects are reduced to effective diffusivities in reduced MHD equations. Using these equations, the stability analyses of the tearing mode are performed. It is shown that a finite amplitude of fluctuation enhances the growth rate of tearing mode. For very high values of turbulent diffusivities, marginally stable state exists. The effects of each turbulent diffusivity on mode stability are examined near marginal stability boundary. Parameter dependence of the resistive ballooning mode turbulence on tearing mode is analyzed as an example. (author)

  17. Observations on brucellosis due to Brucella melitensis.

    Science.gov (United States)

    SPINK, W W

    1953-01-01

    A special study was made of the problem of brucellosis due to Brucella melitensis in visits to Mexico City in 1948, to the FAO/WHO Brucellosis Centres at Montpellier (France), Florence (Italy), and Rijeka (Yugoslavia) in 1951, and to Spain in 1952. Br. melitensis infection in human beings causes more severe illness than Br. abortus infection. It develops primarily in rural communities living in close contact with goats and sheep; cattle and swine may also harbour the infection.In diagnosis, the agglutination test has proved the most satisfactory procedure; testing would be more uniformly reliable if a single antigen were used. Lack of funds and technical assistance have in many instances limited the bacteriological studies upon which a more definitive diagnosis of brucellosis depends.Antibiotics, Brucella vaccines, and colloidal preparations of gold and silver-used separately and in combination-have proved of varying therapeutic value, although response to antibiotics is less favourable than in cases of Br. abortus infection.While the drastic measures-involving the slaughter of about 10,000 sheep-taken in Slovenia, Yugoslavia, in the late 1940's, against an outbreak of brucellosis, is an inspiring example of how the disease can be eradicated, the removal of all diseased animals is rarely feasible economically. It is hoped that future research will reveal a practicable alternative in the immunization of sheep and goats against the disease.

  18. Homocystinuria due to cystathionine beta synthase deficiency

    Directory of Open Access Journals (Sweden)

    Rao T

    2008-01-01

    Full Text Available A two year-old male child presented with cutis marmorata congenita universalis, brittle hair, mild mental retardation, and finger spasms. Biochemical findings include increased levels of homocysteine in the blood-106.62 µmol/L (normal levels: 5.90-16µmol/L. Biochemical tests such as the silver nitroprusside and nitroprusside tests were positive suggesting homocystinuria. The patient was treated with oral pyridoxine therapy for three months. The child responded well to this therapy and the muscle spasms as well as skin manifestations such as cutis marmorata subsided. The treatment is being continued; the case is reported here because of its rarity. Homocysteinuria arising due to cystathionine beta-synthase (CBS deficiency is an autosomal recessive disorder of methionine metabolism that produces increased levels of urinary homocysteine and methionine It manifests itself in vascular, central nervous system, cutaneous, and connective tissue disturbances and phenotypically resembles Marfan′s syndrome. Skin manifestations include malar flush, thin hair, and cutis reticulata / marmorata.

  19. Sleep disturbance due to aircraft noise exposure

    Directory of Open Access Journals (Sweden)

    Lawrence S Finegold

    2010-01-01

    Full Text Available Research on nighttime sleep disturbance due to community noise sources, particularly from exposure to aircraft noise, has been conducted for over a half decade. However, there are still no national environmental noise policies (i.e., laws and regulations promulgated which prescribe a specific criterion for an exposure limit which is regulatory in nature. In the U.S., the new American National Standards Institute (ANSI Noise Standard, ANSI S12.9-2008/Part 6, Quantities and Procedures for Description and Measurement of Environmental Sound - Part 6: Methods for Estimation of Awakenings Associated with Outdoor Noise Events Heard in Homes, does provide the currently recommended exposure-response relationship used in the U.S. In Europe, there has also been significant laboratory and field research on sleep disturbance, although the U.S. and European research publications often use different research methodologies, different noise metrics and different meta-analysis techniques. The current article will provide a brief overview of sleep disturbance research internationally to document the similarities and differences between the various research approaches and research results.

  20. Haemoptysis due to pulmonary venous stenosis

    Directory of Open Access Journals (Sweden)

    Silke Braun

    2014-06-01

    Full Text Available Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10–20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe. A review of the literature was performed using the Medline/PubMed database with the terms: “pulmonary venous stenosis”, “pulmonary venous infarction” and “haemoptysis”. Further references from the case reports were considered. 58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis. Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrast-enhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis.

  1. Health risks due to coffee dust.

    Science.gov (United States)

    Oldenburg, Marcus; Bittner, Cordula; Baur, Xaver

    2009-08-01

    This study assessed current health risks due to occupational exposure to coffee dust. We performed a cross-sectional study in a coffee haulage company (n = 24), a coffee silo (n = 19), and a decaffeinating company (n = 17). Cross-shift and cross-week case histories of these employees as well as lung function values were recorded. During the handling of green coffee, measurements of airborne dust were conducted. The employees in these workplaces were mainly affected by erythematous and rhinoconjunctival symptoms. They occurred especially in subjects exposed to a high dust load (> 10 mg of inhalable dust per cubic meter of air; n = 28) [Pearson chi(2) test, p = 0.020 and p = 0.023]. IgE antibodies to green coffee and castor beans were detected in 3 workers and 10 workers, respectively. The majority of them (two employees and six employees, respectively) had shown respiratory symptoms during the past 12 months. The preshift lung function values were below average but were not dependent on the level of the inhalable coffee dust exposure. Employees with a coffee dust load > 10 mg/m(3) of air showed higher unspecific bronchial responsiveness more frequently than those with lower exposures. During the transshipment (especially during unloading) of green coffee, a high and clinically relevant exposure to irritative and sensitizing dust occurs. Therefore, efforts to reduce these dust exposures are generally recommended.

  2. Acute hepatitis due to brucellosis: case report

    Directory of Open Access Journals (Sweden)

    Nevil AYKIN

    2009-06-01

    Full Text Available Brucella infection is a systemic disease. It rarely causes local infections like hepatitis in gastrointestinal system. In this article we would like to present an acute hepatitis case related to brucella infection that followed up in our clinic. A male, 30 year-old patient hospitalized due to common muscle pain, high fever and vomiting. During the physical examination the patient’s skin, scleras and mucosal membranes were icteric, the liver was 2-3 cm palpable and tender. Laboratory findings were as follows: AST:1190 U/L; ALT:715 U/L; GGT:961 U/L; ALP:369 U/L; total bilirubin:4.6 mg/dL; direct bilirubin:2.1 mg/dL. Viral markers were found to be negative. We started treatment with streptomicine and doxicycline since, the patient’s standard brucella tube agglutination test was positive (1/60 and brucella spp produced in his blood culture. From the second day of the treatment, we started to get clinical response. On the 17th day of the treatment, he discharged from the hospital because ALT, AST and bilirubine level were found normal and his treatment was completed to the 8 weeks. Brucella is continuing to be an important health problem especially who live in surrounding countryside and have to keep in mind in the differential diagnosis of the acute hepatitis.

  3. Subsidence due to geothermal fluid withdrawal

    Energy Technology Data Exchange (ETDEWEB)

    Narasimhan, T. N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Earth Sciences Division; Univ. of California, Berkeley, CA (United States); Goyal, K. P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Earth Sciences Division; Univ. of California, Berkeley, CA (United States)

    1984-12-01

    Single-phase and two-phase geothermal reservoirs are currently being exploited for power production in Italy, Mexico, New Zealand, the United States, and elsewhere. Vertical ground displacements of up to 4.5 m and horizontal ground displacements of up to 0.5 m have been observed at Wairakei, New Zealand, that are clearly attributable to the resource exploitation. Similarly, vertical displacements of about 0.13 m have been recorded at The Geysers, California. No significant ground displacements that are attributable to large-scale fluid production have been observed at Larderello, Italy, and Cerro Prieto, Mexico. In this paper, observations show that subsidence due to geothermal fluid production is characterized by such features as an offset of the subsidence bowl from the main area of production, time-lag between production and subsidence, and nonlinear stress-strain relationships. Several plausible conceptual models, of varying degrees of sophistication, have been proposed to explain the observed features. At present, relatively more is known about the physical mechanisms that govern subsidence than the relevant thermal mechanisms. Finally, although attempts have been made to simulate observed geothermal subsidence, the modeling efforts have been seriously limited by a lack of relevant field data needed to sufficiently characterize the complex field system.

  4. Dermatoses due to Indian cultural practices.

    Science.gov (United States)

    Gupta, Divya; Thappa, Devinder Mohan

    2015-01-01

    A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. 'Henna' use causes IgE-mediated hypersensitivity reactions and contact dermatitis. 'Kumkum' application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker 'bindis' and 'alta' induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with 'Holi' colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. 'Mudichood' represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device "kangri" is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.

  5. Jejunal Diverticular Perforation due to Enterolith

    Directory of Open Access Journals (Sweden)

    Ronaldo Nonose

    2011-08-01

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

  6. Horner syndrome due to vertebral artery stenosis.

    Science.gov (United States)

    Kim, Chul Han

    2013-11-01

    The author reports a rare case of Horner syndrome in a patient who resulted from stenosis of the vertebral artery after blunt trauma. A 31-year-old man was transferred to our department for evaluation of left medial orbital wall and nasal bone fractures. Five days ago, he was hospitalized due to multiple second to fourth rib fractures of the right chest following blunt trauma of the face, neck, and chest. Surgery was performed. Ten days later, he complained of drooping of the right eyelid. Physical examination revealed a discrete miosis and ptosis with normal levator function in the right eye. A workup for Horner syndrome was performed. Magnetic resonance angiography of the head and neck revealed a stenosis of the distal part of the right vertebral artery without the abnormality of carotid artery. He wore a cervical collar and underwent anticoagulation. However, Horner syndrome was not resolved over the next 12 months. Acute traumatic Horner syndrome may be associated with vertebral artery dissection in which the possibility of life-threatening injury can be masked.

  7. Decreased pain sensitivity due to trimethylbenzene exposure ...

    Science.gov (United States)

    Traditionally, human health risk assessments have relied on qualitative approaches for hazard identification, often using the Hill criteria and weight of evidence determinations to integrate data from multiple studies. Recently, the National Research Council has recommended the development of quantitative approaches for evidence integration, including the application of meta-analyses. The following hazard identification case study applies qualitative as well as meta-analytic approaches to trimethylbenzene (TMB) isomers exposure and the potential neurotoxic effects on pain sensitivity. In the meta-analytic approach, a pooled effect size is calculated, after consideration of multiple confounding factors, in order to determine whether the entire database under consideration indicates that TMBs are likely to be a neurotoxic hazard. The pain sensitivity studies included in the present analyses initially seem discordant in their results: effects on pain sensitivity are seen immediately after termination of exposure, appear to resolve 24 hours after exposure, and then reappear 50 days later following foot-shock. Qualitative consideration of toxicological and toxicokinetic characteristics of the TMB isomers suggests that the observed differences between studies are due to testing time and can be explained through a complete consideration of the underlying biology of the effect and the nervous system as a whole. Meta-analyses and –regressions support this conclus

  8. Subarachnoid hemorrhage due to retained lumbar drain.

    Science.gov (United States)

    Guppy, Kern H; Silverthorn, James W; Akins, Paul T

    2011-12-01

    Intrathecal spinal catheters (lumbar drains) are indicated for several medical and surgical conditions. In neurosurgical procedures, they are used to reduce intracranial and intrathecal pressures by diverting CSF. They have also been placed for therapeutic access to administer drugs, and more recently, vascular surgeons have used them to improve spinal cord perfusion during the treatment of thoracic aortic aneurysms. Insertion of these lumbar drains is not without attendant complications. One complication is the shearing of the distal end of the catheter with a resultant retained fragment. The authors report the case of a 65-year-old man who presented with a subarachnoid hemorrhage due to the migration of a retained lumbar drain that sheared off during its removal. To the best of the authors' knowledge, this is the first case of rostral migration of a retained intrathecal catheter causing subarachnoid hemorrhage. The authors review the literature on retained intrathecal spinal catheters, and their findings support either early removal of easily accessible catheters or close monitoring with serial imaging.

  9. Hospitalisations due to falls in older persons.

    LENUS (Irish Health Repository)

    Carey, D

    2005-06-01

    This paper describes hospitalisations due to falls among people aged 65 years and over resident in the Eastern Region of Ireland. Of the 2,029 hospitalisations recorded for 2002, 78% were female and 68% were aged 75 years and over. Fractures accounted for 1,697 or 84% of cases with nearly half of them (841) sustained to the hip. Females were more likely to have a limb fracture whereas males were more likely to have a head injury. The total inpatient costs of the 2,029 hospitalisations were estimated at 10.6 million euros. Hip fractures were the costliest injuries as they accounted for 7.4 million euros (70%) of inpatient costs. There are also substantial additional costs implications for hip fractures as they constituted the majority (56%) of cases transferred to nursing\\/convalescent homes or long-stay health facilities. In keeping with an ageing population, the problem of injuries in older people is likely to increase over time and as falls are the dominant cause of those injuries, all acute and long-stay health facilities need to develop and implement fall prevention strategies for older people.

  10. Recurrent Pneumonia due to Double Aortic Arch

    Directory of Open Access Journals (Sweden)

    I. Sedighi

    2012-04-01

    Full Text Available Introduction: Pneumonia is one of the most common infections during childhood. In children with recurrent bacterial pneumonia complete evaluation for underlying factors is necessary. The most common underlying diseases include: antibody deficiencies , cystic fibrosis , tracheoesophageal fistula and increased pulmonary blood flow. Vascular ring and its pressure effect is a less common cause of stridor and recurrent pneumonia. Congenital abnormalities in aortic arch and main branches which form vascular ring around esophagus and trachea with variable pressure effect cause respiratory symptoms such as stridor , wheezing and recurrent pneumoniaCase Report: A 2 year old boy was admitted in our hospital with respiratory distress and cough . Chest x-Ray demonstrated right lobar pneumonia. He had history of stridor and wheezing from neonatal period and hospitalization due to pneumonia for four times. The patient received appropriate antibiotics. Despite fever and respiratory distress improvement, wheezing continued. Review of his medical documents showed fixed pressure effect on posterior aspect of esophagus in barium swallow. In CT angiography we confirmed double aortic arch.Conclusion: Double aortic arch is one of the causes of persistant respiratory symptom and recurrent pneumonia in children for which fluoroscopic barium swallow is the first non-invasive diagnostic method.(Sci J Hamadan Univ Med Sci 2012;19(1:70-74

  11. Pediatric ischemic stroke due to dengue vasculitis.

    Science.gov (United States)

    Nanda, Subrat Kumar; Jayalakshmi, Sita; Mohandas, Surath

    2014-10-01

    Dengue infection is an important arboviral infection in southeast Asia, especially in India. Neurological manifestations of dengue are increasingly recognized. We report an ischemic stroke due to dengue vasculitis in an 8-year-old child. We present a girl with a short febrile illness followed by episodic severe headache, with gradually progressive hemiparesis and visual impairment. Her brain magnetic resonance imaging revealed multiple infarctions in the anterior and posterior circulation. The magnetic resonance angiogram revealed irregular narrowing of bilateral middle cerebral arteries, right anterior cerebral artery, left posterior cerebral, and bilateral vertebral arteries suggestive of vasculitis. Her dengue serology was strongly positive for immunoglobulin M with 68.9 panbio units. The rest of the evaluation for pediatric stroke was unremarkable. She was treated with intravenous followed by oral corticosteroids and recovered totally with resolution of vasculitis on magnetic resonance angiogram over the next 3 months. This child illustrates possible immune-mediated vasculitis caused by dengue infection which is rather a rare presentation in a child who subsequently recovered well. One should consider dengue in childhood strokes in endemic regions. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Pulmonary hypertension due to left heart diseases.

    Science.gov (United States)

    Vachiéry, Jean-Luc; Adir, Yochai; Barberà, Joan Albert; Champion, Hunter; Coghlan, John Gerard; Cottin, Vincent; De Marco, Teresa; Galiè, Nazzareno; Ghio, Stefano; Gibbs, J Simon R; Martinez, Fernando; Semigran, Marc; Simonneau, Gerald; Wells, Athol; Seeger, Werner

    2013-12-24

    Pulmonary hypertension (PH), a common complication of left heart diseases (LHD), negatively impacts symptoms, exercise capacity, and outcome. Although the true prevalence of PH-LHD is unknown, a subset of patients might present significant PH that cannot be explained by a passive increase in left-sided filling pressures. The term "out-of-proportion" PH has been used to identify that population without a clear definition, which has been found less than ideal and created confusion. We propose a change in terminology and a new definition of PH due to LHD. We suggest to abandon "out-of-proportion" PH and to distinguish "isolated post-capillary PH" from "post-capillary PH with a pre-capillary component" on the basis of the pressure difference between diastolic pulmonary artery pressure and pulmonary artery wedge pressure. Although there is no validated treatment for PH-LHD, we provide insights into management and discuss completed and randomized trials in this condition. Finally, we provide recommendations for future clinical trials to establish safety and efficacy of novel compounds to target this area of unmet medical need. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Catatonia due to systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Francisco de Assis Pinto Cabral Júnior Rabello

    2014-07-01

    Full Text Available Objectives Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE in a pediatric patient. Methods Single case report. Result A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. Conclusion Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration.

  14. Alpha particles diffusion due to charge changes

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, C. F., E-mail: cesar.clauser@ib.edu.ar; Farengo, R. [Centro Atómico Bariloche and Instituto Balseiro, Comisión Nacional de Energía Atómica and Universidad Nacional de Cuyo, Av. Bustillo 9500, 8400 Bariloche (Argentina)

    2015-12-15

    Alpha particles diffusion due to charge changes in a magnetized plasma is studied. Analytical calculations and numerical simulations are employed to show that this process can be very important in the pedestal-edge-SOL regions. This is the first study that presents clear evidence of the importance of atomic processes on the diffusion of alpha particles. A simple 1D model that includes inelastic collisions with plasma species, “cold” neutrals, and partially ionized species was employed. The code, which follows the exact particle orbits and includes the effect of inelastic collisions via a Monte Carlo type random process, runs on a graphic processor unit (GPU). The analytical and numerical results show excellent agreement when a uniform background (plasma and cold species) is assumed. The simulations also show that the gradients in the density of the plasma and cold species, which are large and opposite in the edge region, produce an inward flux of alpha particles. Calculations of the alpha particles flux reaching the walls or divertor plates should include these processes.

  15. Dermatoses Due to Indian Cultural Practices

    Science.gov (United States)

    Gupta, Divya; Thappa, Devinder Mohan

    2015-01-01

    A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ‘Henna’ use causes IgE-mediated hypersensitivity reactions and contact dermatitis. ‘Kumkum’ application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ‘bindis’ and ‘alta’ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ‘Holi’ colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ‘Mudichood’ represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device “kangri” is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause. PMID:25657390

  16. Sepsis due to clostridium septicum: case report

    Energy Technology Data Exchange (ETDEWEB)

    Foga, M.M.; McGinn, G.J.; Kroeker, M.A. [Univ. of Manitoba Teaching Hospitals, St. Boniface General Hospital, Dept. of Radiology, Winnipeg, Manitoba (Canada); Guzman, R. [Univ. of Manitoba Teaching Hospitals, St. Boniface General Hospital, Dept. of Surgery, Winnipeg, Manitoba (Canada)

    2000-04-15

    Clostridium septicum is an unusual anaerobic, gram-positive, gas-producing bacillus, which has been identified as a cause of fulminant rapidly fatal infection in humans. Infection with C. septicum usually occurs in patients with cancer, patients receiving immunosuppressive chemotherapy, or patients with a nonmalignant hematological disorder such as hemolytic uremic syndrome. C. septicum infection most commonly involves the abdomen, and a recent review article has identified 164 cases in the medical literature describing the abdominal findings in this disease. Intracranial manifestation of C. septicum infection are less common and include meningitis, cerebritis, abscess formation and pneumocephalus. There have been only 12 documented cases in the English literature describing central nervous system lesions associated with C. septicum. We present a case report of a 56-year-old man in whom septicemia due to C. septicum developed as a complication of Crohn's disease. To our knowledge, there has never been a previous report of C. septicum sepsis related to underlying Crohn's disease. Our case is also remarkable in that an intracerebral gas collection developed at the site of a mycotic infarct related to C. septicum bacteremia, Intracranial, intraparenchymal gas formation related to anaerobic infection is extremely rare; to our knowledge, this radiological finding related to C. septicum sepsis has been described in only 1 previous case report in the medical literature. We also describe the intra-abdominal manifestations of C. septicum sepsis that occurred in this patient as well as the associated radiographic and pathologic findings. (author)

  17. Cutaneous reactions due to antihypertensive drugs

    Directory of Open Access Journals (Sweden)

    Upadhayai J

    2006-01-01

    Full Text Available Out of a total of 1147 patients on antihypertensive drugs, 23 (2.04% developed adverse cutaneous drug reactions (ACDR. The commonest antihypertensive drug group causing ACDR was beta-blockers of which atenolol was the commonest culprit. The second most common group was calcium channel blockers with amlodipine as the commonest offender. The most common patterns of ACDR observed included urticaria followed by lichenoid drug eruption (LDE. We noted 2 new patterns of reactions; (i one patient developed brownish blue pigmentation of nails while on atenolol for 3 years, which resolved in 4 months after withdrawal and (ii another patient on amlodipine for 8 years developed Schamberg′s like purpuric pigmentation, which resolved on withdrawal of drug within 3 months. These findings have not been reported in the literature earlier. This study is presented for paucity of Indian data on ACDR due to antihypertensive drugs, and remarkable advancement in area of cardiovascular and antihypertensive pharmacology and a large number of population taking antihypertensive drugs.

  18. Subsidence due to geothermal fluid withdrawal

    Energy Technology Data Exchange (ETDEWEB)

    Narasimhan, T.N.; Goyal, K.P.

    1982-10-01

    Single-phase and two-phase geothermal reservoirs are currently being exploited for power production in Italy, Mexico, New Zealand, the U.S. and elsewhere. Vertical ground displacements of upto 4.5 m and horizontal ground displacements of up t o 0.5 m have been observed at Wairakei, New Zealand that are clearly attributable to the resource exploitation. Similarly, vertical displacements of about 0.13 m have been recorded at The Geysers, California. No significant ground displacements that are attributable to large-scale fluid production have been observed at Larderello, Italy and Cerro Prieto, Mexico. Observations show that subsidence due to geothermal fluid production is characterized by such features as an offset of the subsidence bowl from the main area of production, time-lag between production and subsidence and nonlinear stress-strain relationships. Several plausible conceptual models, of varying degrees of sophistication, have been proposed to explain the observed features. At present, relatively more is known about the physical mechanisms that govern subsidence than the relevant therma mechanisms. Although attempts have been made to simulate observed geothermal subsidence, the modeling efforts have been seriously limited by a lack of relevant field data needed to sufficiently characterize the complex field system.

  19. Dermatoses due to indian cultural practices

    Directory of Open Access Journals (Sweden)

    Divya Gupta

    2015-01-01

    Full Text Available A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ′Henna′ use causes IgE-mediated hypersensitivity reactions and contact dermatitis. ′Kumkum′ application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ′bindis′ and ′alta′ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ′Holi′ colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ′Mudichood′ represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device "kangri" is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.

  20. Supernova electron capture rates

    CERN Document Server

    Martínez-Pinedo, G

    1999-01-01

    We have calculated the Gamow-Teller strength distributions for the ground states and low lying states of several nuclei that play an important role in the precollapse evolution of supernova. The calculations reproduce the experimental GT distributions nicely. The GT distribution are used to calculate electron capture rates for typical presupernova conditions. The computed rates are noticeably smaller than the presently adopted rates. The possible implications for the supernova evolution are discussed.