Fingertip replantation: determinants of survival.

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Li, Jing; Guo, Zheng; Zhu, Qingsheng; Lei, Wei; Han, Yisheng; Li, Mingquan; Wang, Zhen

2008-09-01

The purpose of this study was to determine the risk factors for an unsuccessful replanted fingertip. Two hundred eleven complete fingertip amputations in 211 patients who underwent replantation surgery between August of 1990 and March of 2006 were included in this study. The patients' age, gender, smoking history, digit position, dominant hand, amputation level, injury mechanism, platelet count, ischemia time, preservation method of the amputated part, anesthesia, number of arteries repaired, venous drainage, use of vein grafting, neurorrhaphy, bone shortening, and smoking after operation were tested for their impact on fingertip survival. One hundred seventy-two of 211 patients (81.5 percent) had a successful replantation. Univariate analysis showed crush or avulsion injury, high platelet count, and inappropriate preservation of the amputated part in saline solution or ethanol to be associated with a high incidence of replantation failure. Twenty-two of 54 patients (41 percent) who had a crush or avulsion trauma had failed replantation. Logistic regression analysis identified injury mechanism, platelet count, smoking after operation, preservation method of the amputated part, and the use of vein grafting as statistically significant predictive factors for success or failure. Injury mechanism, platelet count, smoking after operation, preservation method of amputated part, and the use of vein grafting were found to be the main predictors for the survival of the replanted fingertip. Applying external bleeding in zone 1 and venous drainage through the medullary cavity in zone 2 or venous anastomosis combined with vein grafting rather than venous anastomosis alone were strongly recommended in the fingertip replantation of crush or avulsion injury.

Successful microsurgical replantation of an amputated penis

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Sanchit Garg

2016-01-01

Full Text Available Penile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

Dermal pocketing following distal finger replantation.

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Puhaindran, Mark E; Paavilainen, Pasi; Tan, David M K; Peng, Yeong Pin; Lim, Aymeric Y T

2010-08-01

Replantation is an ideal technique for reconstruction following fingertip amputation as it provides 'like for like' total reconstruction of the nail complex, bone pulp tissue and skin with no donor-site morbidity. However, fingertips are often not replanted because veins cannot be found or are thought to be too small to repair. Attempts at 'cap-plasty' or pocketing of replanted tips with and without microvascular anastomosis have been done in the past with varying degrees of success. We prospectively followed up a group of patients who underwent digital replantation and dermal pocketing in the palm to evaluate the outcome of this procedure. There were 10 patients with 14 amputated digits (two thumbs, five index, four middle, two ring and one little) who underwent dermal pocketing of the amputated digit following replantation. Among the 14 digits that were treated with dermal pocketing, 11 survived completely, one had partial atrophy and two were completely lost. Complications encountered included finger stiffness (two patients) and infection of the replanted fingertip with osteomyelitis of the distal phalanx (one patient). We believe that this technique can help increase the chance of survival for distal replantation with an acceptable salvage rate of 85% in our series. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Tetanus following replantation of an amputated finger: a case report.

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Hayashida, Kenji; Murakami, Chikako; Fujioka, Masaki

2012-10-08

Tetanus is an infectious disease caused by tetanus toxin produced by Clostridium tetani and induces severe neurological manifestations. We treated a patient who developed tetanus during hospitalization for replantation of an amputated finger. To the best of our knowledge, this is the first published case report of such an entity. A 49-year-old Japanese man had an amputation of his right middle finger at the distal interphalangeal joint region in an accident at work. His middle finger was successfully replanted, but his fingertip was partially necrotized because of crushing and so additional reconstruction with a reverse digital arterial flap was performed 15 days after the injury. Tetanus developed 21 days after replantation of the middle finger, but symptoms remitted via rapid diagnosis and treatment. In replantation after finger trauma with exposure of nerve and blood vessel bundles, concern over injuring nerves and blood vessels may prevent irrigation and debridement from being performed sufficiently; these treatments may have been insufficiently performed in this patient. It is likely that the replanted middle finger partially adhered, and Clostridium tetani colonized the partially necrotized region. Even when there is only limited soil contamination, administration of tetanus toxoid and anti-tetanus immunoglobulin is necessary when the fingers are injured outdoors and the finger nerves and blood vessels are exposed. The drugs should be administered just after replantation if the finger has been amputated. However, if clinicians pay attention to the possibility of tetanus development, treatment can be rapidly initiated.

Standardized protocol for artery-only fingertip replantation.

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Buntic, Rudolf F; Brooks, Darrell

2010-09-01

Artery-only fingertip replantation can be reliable if low-resistance flow through the replant is maintained until venous outflow is restored naturally. Injuring the tip of the replant to promote ongoing bleeding augmented with anticoagulation usually accomplishes this; however, such management results in prolonged hospitalization. In this study, we analyzed the outcomes of artery-only fingertip replantation using a standardized postoperative protocol consisting of dextran-40, heparin, and leech therapy. Between 2001 and 2008, we performed 19 artery-only fingertip replants for 17 patients. All patients had the replanted nail plate removed and received intravenous dextran-40, heparin, and aspirin to promote fingertip bleeding and vascular outflow. Anticoagulation was titrated to promote a controlled bleed until physiologic venous outflow was restored by neovascularization. We used medicinal leeches and mechanical heparin scrubbing for acute decongestion. By postoperative day 6, bleeding was no longer promoted. We initiated fluorescent dye perfusion studies to assess circulatory competence and direct further anticoagulant intervention if necessary. The absence of bleeding associated with an initial rise followed by an appropriate fall in fluorescent dye concentration would trigger a weaning of anticoagulation. All of the 19 replants survived. The average length of hospital stay was 9 days (range, 7-17 d). Eleven patients received blood transfusions. The average transfusion was 1.8 units (range, 0-9 units). All patients were happy with the decision to replant, and the cosmetic result. A protocol that promotes temporary, controlled bleeding from the fingertip is protective of artery-only replants distal to the distal interphalangeal joint until physiologic venous outflow is restored. The protocol described is both safe and reliable. The patient should be informed that such replant attempts may result in the need for transfusions and extended hospital stays, factors that

Challenges in fingertip replantation.

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Kim, Jin-Soo; Yang, Jae-Won; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young

2013-11-01

Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence. By addressing these anatomic challenges, fingertip replantation can be a routine reconstructive option for microvascular surgeons.

Challenges in Fingertip Replantation

OpenAIRE

Kim, Jin-Soo; Yang, Jae-Won; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young

2013-01-01

Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence. By addressing these anatomic challenges, fingertip replantation can be a routine reconstructive option for microvascular surgeons.

Tetanus following replantation of an amputated finger: a case report

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Hayashida Kenji

2012-10-01

Full Text Available Abstract Introduction Tetanus is an infectious disease caused by tetanus toxin produced by Clostridium tetani and induces severe neurological manifestations. We treated a patient who developed tetanus during hospitalization for replantation of an amputated finger. To the best of our knowledge, this is the first published case report of such an entity. Case presentation A 49-year-old Japanese man had an amputation of his right middle finger at the distal interphalangeal joint region in an accident at work. His middle finger was successfully replanted, but his fingertip was partially necrotized because of crushing and so additional reconstruction with a reverse digital arterial flap was performed 15 days after the injury. Tetanus developed 21 days after replantation of the middle finger, but symptoms remitted via rapid diagnosis and treatment. Conclusions In replantation after finger trauma with exposure of nerve and blood vessel bundles, concern over injuring nerves and blood vessels may prevent irrigation and debridement from being performed sufficiently; these treatments may have been insufficiently performed in this patient. It is likely that the replanted middle finger partially adhered, and Clostridium tetani colonized the partially necrotized region. Even when there is only limited soil contamination, administration of tetanus toxoid and anti-tetanus immunoglobulin is necessary when the fingers are injured outdoors and the finger nerves and blood vessels are exposed. The drugs should be administered just after replantation if the finger has been amputated. However, if clinicians pay attention to the possibility of tetanus development, treatment can be rapidly initiated.

Mini replants: fingertip replant distal to the IP or DIP joint.

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Dautel, G; Barbary, S

2007-01-01

Amputations through the distal interphalangeal joint or distal to this joint are frequent and they represent probably one of the best indications for replantation. Details on the vascular anatomy of the fingertip have to be perfectly known by the surgeon who will have to deal with these replantations. Factors such as age, mechanism of amputation and type of anastomosis will influence the overall success rate of the procedure. Return of a true static two points discrimination can be observed in children even in the absence of any neural repair.

Fingertip replantation: Technical considerations and outcome analysis of 24 consecutive fingertip replantations

OpenAIRE

Venkatramani, H.; Sabapathy, S. Raja

2011-01-01

Fingertip amputations are one of the most common injuries faced in an emergency department. Finger tip replantation though technically possible, are not regularly done due to the presumed complexity of the procedure and doubts about the outcome. This article deals with our experience of 24 fingertip replantations in 24 patients done over a period of 8 years since the year 2000. Twenty-one fingertips survived. The most common affected digit in the series was thumb followed by index, middle, an...

[Fingertip replantation after amputation: report of 32 fingers].

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Ren, Gao-hong; Pei, Guo-xian; Gu, Li-qiang; Guo, Gang

2004-08-01

To describe the surgical techniques and our experiences in fingertip replantation after amputation. On the basis of examination of the anatomic features and the degree of fingertip vascular injury, 32 amputated fingertips in 26 cases were replanted, and flexible revascularization procedures of both artery and vein anastomoses, artery-only anastomosis, arterialized vein and arteriovenous anastomosis were adopted. All the replanted fingertips were trained with comprehensive rehabilitation program. Twenty-nine replanted fingertips survived but 3 failed, and the overall survival rate was 90.06%. During the follow-up lasting from 4 months to 5 years, the 29 replanted fingertips survived with excellent blood supply, good sensory functions, satisfactory shape and functions according to the criteria by Society of Hand Surgery of Chinese Medical Association. Fingertip replantation after amputation can achieve not only high survival rate but also satisfactory appearance and functions as long as appropriate operative procedures are adopted with comprehensive rehabilitation therapy.

Intramedullary Venous Drainage System for Distal Fingertip Replantations.

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Purisa, Husrev; Ozturk, Muhammed Besir; Kabakas, Fatih; Mersa, Berkan; Ozcelik, Ismail Bulent; Sezer, Ilker

2017-08-01

The number of venous anastomoses performed during fingertip replantation is one of the most important factors affecting the success of replantation. However, because vessel diameters decrease in the zone 1 level, vessel anastomoses, especially vein anastomoses, are technically difficult and, thus, cannot be performed in most cases. Alternative venous drainage methods are crucial when any reliable vein repair is not possible. In the literature, so many artery-only replantation techniques have been defined, such as arteriovenous anastomoses, forming an arteriovenous or venocutaneous fistula, manual milking and massage, puncturing, and external bleeding via a fishmouth incision and using a medical leech. It has been shown that, in distal fingertip replantations, the medullary cavity may also be a good way for venous return. In this study, we introduce an alternative intramedullary venous drainage system we developed to facilitate venous drainage in artery-only fingertip replantations. The results of 24 fingertip replantations distal to the nail fold by using this system are presented with a literature review.

Retention and Healing Outcomes after Intentional Replantation.

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Cho, Sin-Yeon; Lee, Yoon; Shin, Su-Jung; Kim, Euiseong; Jung, Il-Young; Friedman, Shimon; Lee, Seung-Jong

2016-06-01

Intentional replantation is an alternative to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This study assessed tooth retention and healing after intentional replantation and explored predictors of these outcomes. Data of intentional replantation procedures performed between March 2000 and December 2010 were collected prospectively, excluding teeth with preoperative periodontal and root defects. A cohort of 159 teeth was followed up for 0.5-12 years. Retention and healed status without complications (periapical radiolucency, external root resorption, ankylosis, signs/symptoms, probing ≥6 mm) was recorded and analyzed with Kaplan-Meier survival analysis and Cox proportional hazard regression model (P regression identified extraoral time ≤15 minutes as predictor of complication-free healing (P < .04; hazard ratio, 2.767; 95% confidence interval, 1.053-7.272). This prospective cohort study of contemporary intentional replantation suggested a cumulative 12-year retention rate of 93% and healed rate of 77% after 3 years. Healing occurred 1.7 times more frequently in teeth replanted within 15 minutes. Although most complications occurred within 1 year after replantation, follow-up should extend for at least 3 years to capture late complications. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Unfavorable results in replantation

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Abraham G Thomas

2013-01-01

Full Text Available Reattachment of amputated parts of the body (Replantation has become a reality since the first arm replant was carried out six decades ago. Failures were not uncommon in the beginning, leading on to the analysis of the problem and refinements in technique. Improvements in sutures, instrumentation and better microscopes further helped the surgeons to do replantation with better finesse and functional results. Evaluation of results and particularly failure and long term results help the younger surgeons to learn from the difficulties faced earlier to do better in the future. An attempt is made to list various aspects of replantation experienced by the author during the past 30 years, particularly in reference to unfavorable results, which had been occasionally total failure, or a partial failure, with poor function and cosmesis due to infection. An insensate limb with poor function is the result of inadequate or improper nerve coaptation or infection destroying the whole repair. It is apt to mention that infection is mostly the result of poor vascularity due to devitalized tissue. Difficulties arise often in identifying the viable tissue, particularly while debriding in the distal amputated part since there is no bleeding. Experience counts in this, specifically to identify the viable muscle. The factors that may lead to complications are listed with remarks to avoid them.

Management of complications relating to finger amputation and replantation.

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Woo, Sang-Hyun; Kim, Young-Woo; Cheon, Ho-Jun; Nam, Hyun-Je; Kang, Dong-Ho; Kim, Jong-Min; Ahn, Hee-Chan

2015-05-01

There are many options in the management of fingertip or finger amputations. Injudicious revision amputation may cause complications. These complications can be prevented by tension-free closure of the amputation stump or primary coverage with appropriate flap. Replantation is the best way to keep the original length and maintain digital function. Patent vein repair or venous drainage with bleeding until neovascularization to the replanted part is the key to successful replantation. Prevention and management of complications in replantation and revision amputation increase patients' satisfaction and decrease costs. Research is needed to define new indications of replantation for digital amputation. Copyright © 2015 Elsevier Inc. All rights reserved.

[Partial replantation following proximal limb injury].

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Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

2000-11-01

Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

Fingertip Replantation Using Y-Shaped Vein Graft to Pulp Artery.

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Kim, Jun Hyuk; Lee, Young Man

2015-10-01

Re-establishing adequate venous outflow is the most important factor for success of fingertip replantation. However, in zone I level, replantation is very difficult, especially in repairing venous circulation. The authors have made an attempt to replantation using Y-shaped vein (YSV) graft to identify and repair veins easily in fingertip replantation. From January 2007 to December 2012, a total of 46 fingertip replantations in 44 consecutive patients with amputations in the Tamai zone I level were performed by using YSV graft. In all patients, arterial anastomosis was performed using YSV graft, and interpositional vein grafts were used for venous repair. The overall success rate of the YSV-grafted replantations was 91.3% (42/46). Postoperative vascular complications occurred in 6 YSV-grafted replantations (13%), and pulp atrophy in the YSV-grafted digits was 9.5% (4/42). Fingertip replantation in zone I level is a difficult territory to a microsurgeon, especially anastomosing veins. However, our YSV grafting technique has shown value in this setting, enabling better esthetic and functional results.

Nonsurgical factors of digital replantation and survival rate A metaanalysis

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Huawei Yu

2015-01-01

Full Text Available The aim of this metaanalysis was to evaluate the association between nonsurgical factors and survival rate of digital replantation. A computer search of MEDLINE, OVID, EMBASE and CNKI databases was conducted to identify literatures for digital replantation, with the keywords of "digit," "finger" and "replantation" from their inception to June 10, 2014. Based on the inclusion and exclusion criteria, data were extracted independently by two authors using piloted forms. Review Manager 5.2 software was used for data analysis. The effect of some nonsurgical factors (gender, age, amputated finger, injury mechanisms, ischemia time and the way of preservation on the survival rate of digital replantation was assessed. The metaanalysis result suggested that gender and ischemia time had no significant influence on the survival rate of amputation replantation. However, the survival rate of digital replantation of adults was significantly higher than that of children. The guillotine injury of a finger was easier to replant successfully than the crush and avulsion. The little finger was more difficult for replantation than thumb. Survival rate of fingers stored in low temperature was higher than that in common temperature. The present metaanalysis suggested that age, injury mechanism, amputated finger and the way of preservation were significantly associated with the survival rate of digital replantation.

Survival Rate of Limb Replantation in Different Age Groups.

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Tatebe, Masahiro; Urata, Shiro; Tanaka, Kenji; Kurahashi, Toshikazu; Takeda, Shinsuke; Hirata, Hitoshi

2017-08-01

Revascularization of damaged limbs/digits is technically feasible, but indications for surgical replantation remain controversial. The authors analyzed the survival rate of upper limb amputations and the associated factors in different age groups. They grouped 371 limb/digit amputees (average age, 44 years; range, 2-85 years) treated in their hospital during the past 10 years into three groups based on age (young, ≤ 15 years, n  = 12; adult, 16-64 years, n  = 302; elderly, ≥ 65 years, n  = 57) and analyzed their injury type (extent of injury and stump status), operation method, presence of medical complications (Charlson comorbidity index), and survival rate. There were 168 replantations, and the overall replantation survival rate was 93%. The Charlson comorbidity index of the replantation patients was 0 in 124 cases; 1 in 32; 2 in 9; and 3 in 3, but it did not show any significant difference in survival rate after replantation. Eight elderly patients (14%) did not opt for replantation. Younger patients tended to undergo replantation, but they had lower success rates due to their severe injury status. The results of this study show that the survival rate of replantation in elderly patients is equal to that in adults. Stump evaluation is important for survival, but the presence of medical complications is not associated with the overall survival rate.

The chicken foot digital replant training model.

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Athanassopoulos, Thanassi; Loh, Charles Yuen Yung

2015-01-01

A simple, readily available digital replantation model in the chicken foot is described. This high fidelity model will hopefully allow trainees in hand surgery to gain further experience in replant surgery prior to clinical application.

Successful replantation of a finger in an 8-month old child.

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Stewart, D A; Coombs, C J

2013-01-01

A successful replantation of an index fingertip in an 8-month old girl is reported. A literature review of replants in very young children suggests this is one of the youngest patients ever to undergo digital replantation and possibly the youngest finger replant performed.

Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

OpenAIRE

Kazufumi Tachi; Masanori Mori; Reiko Tsukuura; Rintaro Hirai

2018-01-01

Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the...

DSA in digital replantations

International Nuclear Information System (INIS)

Wang Liuhong; Chao Ming; Jiang Dingyao; Zhang Guangqiang; Wu Jianjun; Chen Xianyi; Li Bin; Sun Jihong

2008-01-01

Objective: To assess revascularization and vessel anastomosis in digital replantations with DSA. Methods: Twelve cases of digital replantations underwent digital subtract angiography during 2 to 4 days after fingers reattachment. The vessel anastomosis, hemodynamics, stenosis and discontinuation were investigated. The unobstructed and smooth anastomosis was suggested as early stage survival of the reattached fingers, the spasm and stenosis of the reattached vessels were considered as mild vascular crisis, and the discontinuation of hemodynamics were indicated as severe vascular crisis. Results: The total 27 vessels were clearly displayed on DSA. Of these vessels, 23 vessels were unobstructed and smooth, all digits were survived. Diagnosis coincidence of early stage survival was 100% (23/23). Two vessels were obstructed, which were testified having thrombus by operation research. The other 2 vessels were spasm, the digits were also survived ultimately by expectant treatment. All 4 abnormal vessel anatomosis were found by DSA. Conclusion: DSA is important modality in assessing revascularization and blood circulation for digital replantations, guiding in dealing with the vascular crisis, and in predicting early stage survival of the reattached digits. (authors)

Fingertip replantation at or beyond the nail base in children.

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Shi, Dehai; Qi, Jian; Li, Donghui; Zhu, Lei; Jin, Wentao; Cai, Daozhang

2010-07-01

Although success of digital replantations in children has been reported by many authors, the very distal fingertip replantation remains technically demanding. The aim of this article is to review our experience with fingertip replantations at or distal to the nail base in pediatric patients and evaluate the clinical outcomes. From October 2000 to May 2007, 12 pediatric fingertips amputated at or distal to the nail base were replanted. Only one artery was anastomosed for revascularization with or without nerve repair; vein drainage was provided by the controlled bleeding technique. Eleven of the 12 replants (91%) survived; one replant of crushed digit failed. An average of 26 month (range, 6 to 36 months) follow-up revealed excellent restoration of finger motion and appearance. The regained static 2-point discrimination (S2PD) sensation was from 3.2 to 5.0 mm (mean, 4.2 mm). Both the parents and the children were satisfied with the final results. In conclusion, fingertip replantation in children allows good functional and esthetical recovery and should be attempted if technically feasible. (c) 2010 Wiley-Liss, Inc.

[Results After Distal Digital Replantation - Is It Worth The Effort?

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Braig, David; Thiele, Jan R; Penna, Vincenzo; Stark, G Björn; Eisenhardt, Steffen U

2017-02-01

There are only relative indications for distal digital replantation in zones 1 and 2 according to Tamai. In contrast to primary closure for fingertip amputations, replantation is a complex procedure that requires skills in supermicrosurgical techniques, as vessels with diameters between 0.3-0.8 mm are connected. In addition the time spent in hospital and the time off from work are longer. Distal digital replantation is thus only indicated, if the expected functional and aesthetic benefits surmount those of primary closure. We retrospectively analysed all fingertip amputations in zone 1 and 2 according to Tamai between 9/2009 and 7/2014 where we attempted distal digital replantation. The success of replantation, wound healing and functional results were evaluated according to Yamano. We performed 11 distal digital replantations in the study period. There were 6 total amputations, 4 subtotal amputations and 1 avulsion of the digital pulp. Revascularisation with long-term reattachment of the amputated tissues was possible in 8 cases (73%). In 3 cases (27%) secondary amputation closure was necessary. The mean operating time was 3 h 56 min. 6 patients, which had a successful replantation, were available for follow-up examinations after a mean period of 19 months. 5 patients were satisfied with the result and would again prefer replantation over primary amputation closure. 4 patients reported a good function of the replanted digits and did not complain about any limitations in their use. 2 patients complained about restricted function. All patients could return to their previous places of employment and were free of pain. Of the 12 affected digital nerves 11 nerves had a 2-point discrimination (2-PD) of ≤15 mm, 3 of them had a 2-PD between 7 and 10 mm and 4 of them of replanted digits and nail deformities in 2 patients. Distal digital replantation is complex and technically challenging. It leads to high patient satisfaction with only minimal functional

Timing of pulp extirpation for replanted avulsed teeth.

LENUS (Irish Health Repository)

Stewart, Chris

2009-01-01

A search was performed (April 2004) across four databases, namely Ovid Medline, Cochrane Library, PubMed and Web of Science, relevant to the proposed PICO ( Patient or problem, Intervention, Comparison, Outcome) question: (P) for a replanted avulsed permanent tooth, (I) is early pulp extirpation within 10-14 days of replantation, (C) compared with delayed pulp extirpation, (O) associated an increased likelihood of successful periodontal healing after tooth replantation. Only articles published in the English language were considered.

Intravascular stenting (IVaS) method for fingertip replantation.

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Narushima, Mitsunaga; Mihara, Makoto; Koshima, Isao; Gonda, Koichi; Takuya, Iida; Kato, Harunosuke; Nakanishi, Kenji; Yamamoto, Yusuke; Araki, Jun; Abe, Hiroaki; Mundinger, Gerhard S; Kikuchi, Kazuki; Uehara, Eri

2009-01-01

Remarkable progress has been made in microsurgery. However, fingertip replantation following amputation has not gained much popularity because of its technical difficulty. We have developed the intravascular stenting (IVaS) method, in which a nylon monofilament is placed inside the vessel lumen to act as a temporary stent, facilitating anastomosis completion. This report describes 7 fingertip replantations using the IVaS method. Intravascular stent size varied from 4-0 to 6-0 (0.199-0.07 mm diameter). There were no cases in which the back wall of a vessel became inadvertently caught in the anastomosis. The overall survival rate for distal digital replants was 85% (6/7 replants). It is very difficult to evenly anastomose vessels of differing diameter, especially on a supermicrosurgical scale. In this respect, the IVaS method plays a role in stably anchoring the 2 vessel ends, allowing for the even spacing of suture knots, even in vessels of different caliber. Because of its ease of use and exactitude, many surgeons may be able to use the IVaS method to reliably complete small anastomoses in fingertip replantations.

Replantation of digits

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... the surgery area. Outlook (Prognosis) Children are better candidates for replantation surgery because of their greater ability ... www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. ...

Complete amputation of the palm and replantation: case report

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Yousef Shafaee

2017-03-01

Full Text Available Background: Even though replantation surgery has now become a routine procedure, it remains delicate and demanding surgery, requiring adequate training and expertise in microsurgical techniques. Functional outcomes following replantation vary with the level of injury. Replants of the fingers distal to the flexor superficial are insertion, the hand at the wrist, and the upper extremity at the distal forearm can achieve good function. With the advent of refined microscopes, sutures, and needles, along with specialized surgical training, replantation has become a routine part of hand-surgery practice in centers all over the world. Clearly, survival does not equate with function. Amputations constitute multisystem injury, with disruption of skeletal support (bone, motor function (muscle, sensibility (nerve, circulation (blood vessel, and soft-tissue coverage (skin. A lot of News work-related accidents published daily. Complete amputation of the palm with sharp objects electric disrupts quality of life and irreversible effects on their life. Replantation or repair the damaged organ can improve their quality of life, functional body. Case presentation: The case is a man with complete amputation of the palm while working with an electrical machine, at the same time as damage and severe crush was also the distal phalanx of the first finger of the right hand. Patient was admitted to the emergency unit at Fatemi Hospital of Ardabil city in January 2014, Iran, and underwent to surgery for replantation. Conclusion: Complete amputation of palm and its successful replantation are among rarely occurred and reportable cases. Complete amputation of palm and successful replantation and the 10-month follow-up indicated that the patient had a successful operation. No abnormalities were found in the blood circulation, and finger grasping was acceptable. Nerve development was acceptable.

Validity of exploration for suitable vessels for replantation in the distal fingertip amputation in early childhood: replantation or composite graft.

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Imaizumi, Atsushi; Ishida, Kunihiro; Arashiro, Ken; Nishizeki, Osamu

2013-09-01

Composite grafting, grafting without microvascular anastomoses, has been widely performed for distal fingertip amputation in children with variable results, whereas successful replantation of these amputations using microsurgical technique has been reported. However, most of these reports included a wide age-range and a mix of different amputation levels. This study reviewed our cases of paediatric digital amputation, in order to verify the value of distal fingertip replantation over composite grafting, especially in early childhood. Seventeen young children (aged 3 years and 8 months on average), with single-digit fingertip amputations in Tamai zone I were reviewed from 1993-2008. Each amputation was subdivided into three types: distal, middle, and proximal. There were three distal, 13 middle, and one proximal type zone I amputations. All were crush or avulsion injuries. All three distal-type cases were reattached as primary composite grafts with one success. For middle-type cases, the survival rate of primary composite graft without exploration for possible vessels for anastomosis was 57%. On exploration, suitable vessels for anastomosis were found 50% of the time, in which all replantations were succeeded. The remaining cases were reattached as secondary composite grafts, with one success using the pocket method. Consequently, the success rate after exploration was 67%. The only one proximal-type amputation was failed in replantation. For the middle-type zone I amputation in early childhood, replantation has a high success rate if suitable vessels can be found. Therefore, exploration is recommended for amputations at this level with a view to replantation, irrespective of the mechanism of injury.

Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

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Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

2017-11-01

Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

[Replantation of fingertip amputation in lack of availability of intravenous anastomosis].

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Wei, Jian-Min; Sun, Jun-Suo; Jiao, Xiao-Hu; Jing, Dou-Xing; He, Wei; Jin, Wen-Kuo; Chen, Shi-Gao

2012-08-01

To discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis. From November 2009 to November 2010, 86 patients (104 fingers) with fingertip amputation were treated with replantatioin, including 64 males and 22 females, with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h, time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases: (1) replantation with anastomosis of single or bilateral proper digital artery in 37 fingers; (2) replantation with arteriovenous bypass in 27 fingers; (3) replantation with exclusive anastomosis of digital artery in 24 fingers; (4) replantation with removing the palmar pocket method in 16 fingers. One hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases (92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 52 cases, good in 19, poor in 4. It benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope.

Replantation and revascularization vs. amputation in injured digits

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Mulders, Marjolein A. M.; Neuhaus, Valentin; Becker, Stéphanie J. E.; Lee, Sang-Gil; Ring, David C.

2013-01-01

The purpose of this study was to analyze factors associated with the decision to replant or revascularize rather than amputate an injured digit as well as factors associated with successful replantation or revascularization. We reviewed 315 complete and subtotal amputations at or proximal to the

Fingertip replantations: importance of venous anastomosis and the clinical results.

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Hasuo, Takaaki; Nishi, Genzaburo; Tsuchiya, Daiji; Otsuka, Takanobu

2009-01-01

Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

Fingertip replantation using the subdermal pocket procedure.

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Lin, Tsan-Shiun; Jeng, Seng-Feng; Chiang, Yuan-Cheng

2004-01-01

Restoration of finger length and function are the goals of replantation after fingertip amputation. Methods include microsurgical replantation and nonmicrosurgical replantation, such as composite graft techniques. To increase the survival rates for composite grafts, the subcutaneous pocket procedure has been used as a salvage procedure. The subdermal pocket procedure, which is a modification of the subcutaneous pocket procedure, was used for replantation of 17 fingertips in 16 consecutive patients. Eight fingertips experienced guillotine injuries and the other nine fingertips experienced crush injuries. Revascularization of one digital artery without available venous outflow was performed for six fingers, and composite graft techniques were used for the other 11 fingers. The success rate was 16 of 17 cases. The difference in success rates for guillotine versus crush injuries was statistically significant. Comparison of patients with arterial anastomoses and patients without arterial anastomoses also indicated a statistically significant difference. Thirteen fingertips survived completely. One finger, demonstrating complete loss and early termination of the pocketing procedure, was amputated on the eighth postoperative day. Two fingers were partially lost because of severe crushing injuries. One finger demonstrated partial loss of more than one quarter of the fingertip, which required secondary revision, because the patient was a heavy smoker. The pocketing period was 8 +/- 1 days (mean +/- SD, n = 6) for the fingers revascularized with one digital arterial anastomosis and 13.3 +/- 1.9 days (n = 10) for the fingers successfully replanted with composite graft techniques. The mean active range of motion of the interphalangeal joint of the three thumbs was 65 +/- 5 degrees, and that of the distal interphalangeal joint of the other 11 fingers was 51 +/- 11 degrees. The static two-point discrimination result was 6.4 +/- 1.0 mm (n = 14) after an average of 11 +/- 5 months

Fingertip Replantation With Palmar Venous Anastomoses in Children.

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Wen, Gen; Xu, Jia; Chai, Yi-Min

2017-06-01

Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

A new device expanding operability of fingertip replantation: subzone 1 fingertip replantation assisted by non-enhanced angiography in a 2-year-old boy.

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Yoshimatsu, Hidehiko; Yamamoto, Takumi; Seki, Yukio; Narushima, Mitsunaga; Iida, Takuya; Koshima, Isao

2012-11-01

Fingertip replantation in young children is difficult, especially in cases with amputation at subzone 1. Replantation is preferred whenever possible, but the identification of vessels of operative size can be very challenging. Non-enhanced angiography (NEA; Genial Viewer; Genial Light, Shizuoka, Japan) emits infrared light with the wavelength of 850 nm, which is exclusively absorbed by haemoglobin. The light penetrates the bones and other soft tissues, effectively visualising vessels containing blood, and the image is shown in real time on the screen of a laptop computer. We present a case in which preoperative NEA visualised vessels in the amputated fingertip, allowing a successful replantation in a 2-year-old boy. By taking the guesswork out of vessel localisation, NEA can be useful in expanding operability of replantation surgery in fingertip amputations. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Crossover replantation after bilateral traumatic lower limb amputations: a case report

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Fang Jun

2012-07-01

Full Text Available Abstract Introduction Replantation of a limb to the contralateral stump after bilateral traumatic amputations is rare. To the best of our knowledge, there are only a few reports of crossover lower limb replantation in the literature. Case presentation We treated a 37-year-old Chinese woman with bilateral lower limb crush injuries sustained in a traffic accident. Her lower limb injuries were at different anatomic levels. We performed emergency bilateral amputations followed by crossover replantation. Five years later, the woman had recovered well, and had perfect movement and stability in her replanted leg. After reviewing the literature, we thought that presentation of our patient’s case might provide useful information for clinicians. Conclusions Crossover replantation should be considered when evaluating a patient with bilateral lower limb injuries, thus allowing the patient to touch the ground and stand using their own foot.

Considerations for double-hand replantation in a resource-constrained healthcare facility

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Bibhuti Bhusan Nayak

2016-01-01

Full Text Available Bilateral-hand amputation is extremely rare and double-hand replantation is even rarer. Only one case of successful double replantation at arm level has been reported from India. We present a case of double-hand replantation at proximal palmar level in a young adult executed in a small nursing home. The patient presented 5 h after injury with limbs preserved well in ice. There were difficulties in executing such an unusual case in a small nursing home set-up. The patient is performing his activities of daily living and basic functions independently. We share our experience of this double-hand replantation with special emphasis on problems encountered.

Analysis of bacterial and fungal community structure in replant ...

African Journals Online (AJOL)

High quality DNA is the basis of analyzing bacterial and fungal community structure in replant strawberry rhizosphere soil with the method of denaturing gradient gel electrophoresis (DGGE). DNA of soil microorganisms was extracted from the rhizosphere soil of strawberries planted in different replanted years (0, two, ...

Finger Replantation in Sanglah General Hospital: Report of Five Cases and Literature Review

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Agus Roy Rusly Hariantana Hamid

2016-11-01

Full Text Available Background: Replantation is the prime treatment for amputated hands and fingers due to functional and aesthetic advantages. The absolute indications for replantation are amputations of the thumb, multiple fingers, trans metacarpal or hand, and any upper extremity in a child, regardless of the amputation level. A fingertip amputation distal to the insertion of the flexor digitorum superficialis (FDS is also a good indication. Indications have been expanded to include amputation at nail level, and when there is a request from the patient, replantation is attempted even for a single finger amputation regardless of the amputation level. Based on the mechanism of injury, a clean-cut sharp amputation is more likely replanted compare to a crush and avulsion injuries. With a proper management of the amputated finger, replantation can be attempted even after 24 hours. This report was written to provide examples of finger replantation cases and the measures that can be taken in a resource-limited hospital in order to conduct a replantation. Case Series: We reported five out of nine digital replantation cases in Sanglah General Hospital between January and July 2014. Two patients were a six and an eleven years old boys who accidentally cut their finger while playing, the rests were male labors between 20-30 years old whose amputations due to machine injuries. Result: A 100% replant survival was achieved. After a period of follow up with occupational therapy, all patients regain good functional and cosmetic results. 

Ultrastructural study of tissues surrounding replanted teeth and dental implants.

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Shioya, Kazuhiro; Sawada, Takashi; Miake, Yasuo; Inoue, Sadayuki; Yanagisawa, Takaaki

2009-03-01

The aim of this study was to describe the ultrastructure of the dentogingival border at replanted teeth and implants. Wistar rats (8 weeks old) were divided into groups for replantation and implantation experiments. In the former, the upper right first molars were extracted and then immediately replanted. In the latter, pure titanium implants were used. All tissues were fixed, demineralized and embedded in epoxy resin for ultrastructural observations. One week after replantation, the junctional epithelium was lost, and the oral sulcular epithelium covered the enamel surface. The amount of the epithelium increased in 2 weeks, and resembled the junctional epithelium, and the internal basal lamina and hemidesmosomes were formed in 4 weeks. One week after implantation, peri-implant epithelium was formed, and in 2 and 4 weeks, this epithelium with aggregated connective tissue cells were observed. In 8 weeks, the peri-implant epithelium receded, and aligned special cells with surrounding elongated fibroblasts and bundles of collagen fibers appeared to seal the implant interface. In replantation of the tooth, the internal basal lamina remained at the surface of the enamel of the replanted tooth, which is likely to be related to regeneration of the junctional epithelium and the attachment apparatus at the epithelium-tooth interface. Following implantation, a layer of cells with characteristics of connective tissue cells, but no junctional epithelium and attachment apparatus, was formed to seal the site of the implant.

Reconstruction of circulation in the fingertip without vein repair in zone I replantation.

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Zhang, Xu; Wen, Sumin; Wang, Baoshi; Wang, Qi; Li, Chenglin; Zhu, Hongwei

2008-11-01

In fingertip replantation, adequate venous drainage is important for success. As the level of amputation becomes more distal, anastomosis of veins becomes more technically difficult. External bleeding is a common solution to venous congestion, but the process is burdensome because of duration of bleeding for 3 or more days after surgery. We present a new technique for reconstructing circulation without vein anastomosis in zone I replantation and analyze the outcomes of this technique in terms of eliminating external bleeding and of a high survival rate of the replanted digits. Between 1997 and 2007, we performed 120 replantations in 112 patients (83 male and 29 female; mean age, 33 years; range, 3-54 years). All were zone I amputations, based on the Tamai classification. We surgically repaired both proper digital arteries, excluded the vein, and then ligated 1 of the arteries. Using this technique, circulation was restored. Included in the outcome evaluation were 91 digits in the 87 patients (mean age, 35 years; range, 14-54) who returned for outcome assessments 12 months after surgery. Of 120 digits replanted, 115 digits survived, corresponding to an overall success rate of 96%. No patients received alternative means to alleviate venous congestion, such as leeches or other means of external bleeding. Nearly all of the 87 patients (91 digits) were satisfied with the results of the replantations. Our technique reconstructs circulation without vein anastomosis in zone I replantation. This alternative to venous congestion involves a simple surgical procedure and straightforward postoperative care. Follow-up assessments of a series of 120 replantations show that the majority of zone I replantations led to satisfactory function. We therefore propose this technique as an effective method for zone I replantation. Therapeutic IV.

A novel technique for distal fingertip replantation: Polypropylene suture guided interpositional vein graft.

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Dadaci, Mehmet; Ince, Bilsev; Altuntas, Zeynep; Bitik, Ozan; Uzun, Hakan; Bilgen, Fatma

2015-05-04

Despite current advances in microsurgery, fingertip replantation is still controversial, mainly due to its difficulty and cost. The purpose of this study is to describe a new technique of interposition vein graft guided by polypropylene suture in distal fingertip replantation. A total of eight consecutive Tamai zone 1 fingertip replantations performed by the same author were included. All replantations were performed using interposition vein graft guided by polypropylene suture. This technique involved a vein graft of ∼ 2 cm, with appropriate calibration, obtained from the volar part of the forearm and a 2-0 polyprolene suture passed through the interposition vein graft. Then, a polypropylene suture guide carrying the vein graft was inserted into the artery. The anastomosis was easily performed with the aid of 10-0 or 11-0 nylon in a bloodless medium and without encountering the posterior wall problem. Average surgery time was 2.5 hours (range = 2-3 hours). Among eight Tamai zone 1 replantations, six were successful (75%). There were two replantations lost because of arterial failure. This technique may ease fingertip replantations and increase the success rate for Tamai zone 1 injuries.

Fingertip replantation in children.

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Dautel, G

2000-11-01

Despite common unfavorable mechanisms, fingertip replantation is a rewarding procedure in children. Cosmetic final results are usually better than those obtained by local or pedicled flaps. The success rate and the sensory reinnervation are also better than what can be expected in adult patients.

High-Grade Leiomyosarcoma Arising in a Previously Replanted Limb

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Tiffany J. Pan

2015-01-01

Full Text Available Sarcoma development has been associated with genetics, irradiation, viral infections, and immunodeficiency. Reports of sarcomas arising in the setting of prior trauma, as in burn scars or fracture sites, are rare. We report a case of a leiomyosarcoma arising in an arm that had previously been replanted at the level of the elbow joint following traumatic amputation when the patient was eight years old. He presented twenty-four years later with a 10.8 cm mass in the replanted arm located on the volar forearm. The tumor was completely resected and pathology examination showed a high-grade, subfascial spindle cell sarcoma diagnosed as a grade 3 leiomyosarcoma with stage pT2bNxMx. The patient underwent treatment with brachytherapy, reconstruction with a free flap, and subsequently chemotherapy. To the best of our knowledge, this is the first case report of leiomyosarcoma developing in a replanted extremity. Development of leiomyosarcoma in this case could be related to revascularization, scar formation, or chronic injury after replantation. The patient remains healthy without signs of recurrence at three-year follow-up.

Distal finger replantation.

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Scheker, Luis R; Becker, Giles W

2011-03-01

Reconstruction of the fingertip distal to the flexor tendon insertion by replantation remains controversial and technically challenging, but the anatomy of the fingertip has been well described and provides help in surgical planning. The open-book surgical technique is described with potential complications and is illustrated with clinical cases. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Sensory outcome of fingertip replantations without nerve repair.

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Ozcelik, Ismail Bulent; Tuncer, Serdar; Purisa, Husrev; Sezer, Ilker; Mersa, Berkan; Kabakas, Fatih; Celikdelen, Pinar

2008-01-01

The sensory recovery outcomes of fingertip replantations without nerve repair were retrospectively studied. Between 2000 and 2006, 112 fingertip replantations with only arterial repair were carried out in 98 patients. About 76 of the replants survived totally, with a success rate of 67.8%. Evaluation of sensory recovery was possible in 31 patients (38 replantations). Sensory evaluation was made with Semmes-Weinstein, static and dynamic two-point discrimination, and vibration sense tests. Fingertip atrophy, nail deformities, and return to work were also evaluated. According to the Semmes-Weinstein test, 29.0% (11/38) of the fingers had normal sense, 60.5% (23/38) had diminished light touch, 7.9% (3/38) had diminished protective sensation, and 2.6% (1/38) had loss of protective sensation. Mean static and dynamic two-point discriminations were 7.2 mm (3-11 mm), and 4.60 mm (3-6 mm), respectively. Vibratory testing revealed increased vibration in 42.1% of the fingers, decreased vibration in 36.8%, and equal vibration when compared with the non-injured fingers in 21.1%. Atrophy was present in 14 (36.8%) fingers and negatively affected the results. Nail deformities, cold intolerance, return to work, and the effect of sensory education were investigated. Comparison of crush and clean cut injuries did not yield any significant difference in any of the parameters. Patients who received sensory education had significantly better results in sensory testing. The results were classified as excellent, good, and poor based on results of two-point discrimination tests. The outcome was excellent in 18 fingers and good in 20 fingers. Overall, satisfactory sensory recovery was achieved in fingertip replantations without nerve repair. (c) 2008 Wiley-Liss, Inc.

Effects of non-surgical factors on digital replantation survival rate: a meta-analysis.

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Ma, Z; Guo, F; Qi, J; Xiang, W; Zhang, J

2016-02-01

This study aimed to evaluate the risk factors affecting survival rate of digital replantation by a meta-analysis. A computer retrieval of MEDLINE, OVID, EMBASE, and CNKI databases was conducted to identify citations for digital replantation with digit or finger or thumb or digital or fingertip and replantation as keywords. RevMan 5.2 software was used to calculate the pooled odds ratios. In total, there were 4678 amputated digits in 2641 patients. Gender and ischemia time had no significant influence on the survival rate of amputation replantation (P > 0.05). Age, injured hand, injury type, zone, and the method of preservation the amputated digit significantly influence the survival rate of digital replantation (P < 0.05). Children, right hand, crush, or avulsion and little finger are the risk factors that adversely affect the outcome. Level 5*. © The Author(s) 2015.

Evaluation of sensory function and recovery after replantation of fingertips at Zone I in children.

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Zhu, Zhao-Wei; Zou, Xiao-Yan; Huang, Yong-Jun; Liu, Jiang-Hui; Huang, Xi-Jun; He, Bo; Wang, Zeng-Tao

2017-11-01

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function after replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, repair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replantation of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation provides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

Evaluation of sensory function and recovery after replantation of fingertips at Zone I in children

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Zhao-wei Zhu

2017-01-01

Full Text Available Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function after replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, repair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replantation of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation provides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

Microsurgical replantation of a small segment of thumb volar skin.

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Akyürek, Mustafa; Safak, Tunç

2004-06-01

This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

Evaluation of sensory function and recovery after replantation of fingertips at Zone I in children

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Zhu, Zhao-wei; Zou, Xiao-yan; Huang, Yong-jun; Liu, Jiang-hui; Huang, Xi-jun; He, Bo; Wang, Zeng-tao

2017-01-01

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function after replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July ...

Allelochemicals and activities in a replanted Chinese fir (Cunninghamia lanceolata (Lamb.) Hook) tree ecosystem.

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Kong, C H; Chen, L C; Xu, X H; Wang, P; Wang, S L

2008-12-24

Autotoxicity is a major reason for replant problems in managed tree ecosystems. Studies have related phenolics-based allelochemicals to autotoxicity. We selected a 20-year-old replanted Chinese fir [Cunninghamia lancealata (Lamb.) Hook] tree ecosystem to isolate, identify, determine the biological activity of, and quantify soil phytotoxins. Eight common phenolics (coumarin, vanillin, isovanillin, and p-hydroxybenzoic, vanillic, benzoic, cinnamic, and ferulic acids), friedelin, and a novel cyclic dipeptide (6-hydroxy-1,3-dimethyl-8-nonadecyl-[1,4]-diazocane-2,5-diketone) were obtained by using the bioassay-guided isolation technique from toxic soil of the replanted Chinese fir tree ecosystem. Chemical structures were determined by spectroscopic means, including 2D-NMR (COSY, HMQC, HMBC, and NOESY) experiments. High concentrations of soil phenolics and friedelin were observed in the natural evergreen broadleaf forest (CK) rather than in the Chinese fir tree ecosystem. The phenolics and friedelin were not phytotoxic to Chinese fir trees. However, the cyclic dipeptide inhibited Chinese fir growth at soil concentrations determined in the replanted Chinese fir tree ecosystem. There was a significantly higher soil concentration of cyclic dipeptide in the replanted Chinese fir tree ecosystem than in a fresh Chinese fir tree ecosystem. The results suggest that phenolics and friedelin are not key allelochemicals since they are weakly phytotoxic and are detected in low concentrations in the replanted Chinese fir tree ecosystem, while cyclic dipeptide is a highly active allelochemical with a phytotoxic effect that limits offspring growth in the replanted Chinese fir tree ecosystem. The discovery of cyclic dipeptide, as well as a further understanding of its potential action mechanism in the replanted Chinese fir tree ecosystem, may contribute to solving the replant problems in managed tree ecosystems.

The use of arteriovenous anastomosis for venous drainage during Tamai zone I fingertip replantation.

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Wu, Fei; Shen, Xiaofang; Eberlin, Kyle R; Sun, Zhibo; Zhou, Xiao; Xue, Mingyu

2018-03-27

The purpose of this study was to evaluate outcomes for patients sustaining a distal fingertip amputation who underwent replantation witharteriovenous anastomosis for venous drainage over a one year period at our institution. This technique has been utilized when insufficient veins are identified in the amputated part for standard veno-venous anastomosis. A retrospective study was performed on patients presenting from 2013 to 2014. Guillotine, crush, and avulsion/degloving injuries were included if they underwent fingertip (Tamai Zone I) replantation with arterial anastomosis for vascular inflow and arteriovenous anastomosis for venous drainage. The cases were further classified as Ishikawa subzone I and subzone II. Arteriovenous anastomosis for venous drainage during replantation was used in 45 digits in 35 patients. 41 of the 45 digits underwent successful replantation using this technique (91%). The mean active ROM in the DIP joint of the fingers and in the IP joint of thumbs was 65° and 57°, respectively. Sensory evaluation demonstrated a mean of 6.9 mm s2PD in digits where the digital nerves could be repaired. 11 replanted digits without nerve repair regained some sensory recovery with a mean of 9.6 mm s2PD. 91% of patients were highly satisfied with the appearance of the replanted digits based on Tamai criteria. Arteriovenous anastomosis for venous outflow should be considered during zone I fingertip replantation if sufficient veins are not identified in the amputated part. This technique may allow for more routine and successful distal replantation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Illumina amplicon sequencing of 16S rRNA tag reveals bacterial community development in the rhizosphere of apple nurseries at a replant disease site and a new planting site.

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Jian Sun

Full Text Available We used a next-generation, Illumina-based sequencing approach to characterize the bacterial community development of apple rhizosphere soil in a replant site (RePlant and a new planting site (NewPlant in Beijing. Dwarfing apple nurseries of 'Fuji'/SH6/Pingyitiancha trees were planted in the spring of 2013. Before planting, soil from the apple rhizosphere of the replant site (ReSoil and from the new planting site (NewSoil was sampled for analysis on the Illumina MiSeq platform. In late September, the rhizosphere soil from both sites was resampled (RePlant and NewPlant. More than 16,000 valid reads were obtained for each replicate, and the community was composed of five dominant groups (Proteobacteria, Acidobacteria, Bacteroidetes, Gemmatimonadetes and Actinobacteria. The bacterial diversity decreased after apple planting. Principal component analyses revealed that the rhizosphere samples were significantly different among treatments. Apple nursery planting showed a large impact on the soil bacterial community, and the community development was significantly different between the replanted and newly planted soils. Verrucomicrobia were less abundant in RePlant soil, while Pseudomonas and Lysobacter were increased in RePlant compared with ReSoil and NewPlant. Both RePlant and ReSoil showed relatively higher invertase and cellulase activities than NewPlant and NewSoil, but only NewPlant soil showed higher urease activity, and this soil also had the higher plant growth. Our experimental results suggest that planting apple nurseries has a significant impact on soil bacterial community development at both replant and new planting sites, and planting on new site resulted in significantly higher soil urease activity and a different bacterial community composition.

Functional and cosmetic results of fingertip replantation: anastomosing only the digital artery.

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Matsuzaki, Hironori; Yoshizu, Takae; Maki, Yutaka; Tsubokawa, Naoto

2004-10-01

In fingertip amputations, conventional stump plasty provides an almost acceptable functional result. However, replanting fingertips can preserve the nail and minimize loss of function. We investigated the functional and cosmetic results of fingertip replantation at the terminal branch of the digital artery. Outcomes were nailbed width and distal-segment length; sensory recovery; and range of motion (ROM) of thumb-interphalangeal (IP) or finger-distal interphalangeal (DIP) joints, and total active motion (TAM) of the replanted finger. Of 15 fingertips replanted after only arterial anastomosis, 13 were successful, and 12 were studied. After a median of 1.3 years, mean nailbed widths and distal-segment lengths were 95.4% and 93.0%, respectively, of the contralateral finger. Average TAM and ROM of the thumb-IP or finger-DIP joints were 92.0% and 83.0% of normal, respectively. Semmes-Weinstein results were blue (3.22 to 3.61) in 4 fingers and purple (3.84 to 4.31) in 8; the mean result from the 2-point discrimination test was 5.9 mm (range, 3 to 11 mm). Thus, amputated fingertips should be aggressively replanted.

[Replantation of amputated penis in Chinese men: a meta-analysis].

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Li, Gui-Zhong; Man, Li-Bo; He, Feng; Huang, Guang-Lin

2013-08-01

To evaluate the methods for the replantation of the amputated penis in Chinese men. We performed a meta-analysis on the domestic literature relating replantation of the amputated penis, particularly its successful methods published from 1964 to January 2012. We identified 109 reports on 111 cases of replantation of the amputated penis that met the inclusion criteria, including 103 adults and 8 children. The mean age, warm ischemia time and total ischemia time were 29 +/- 11 years (range 2 - 56 years), 5.2 +/- 5.7 hours (range 0 - 38 hours) and 6.3 +/- 5.7 hours (range 1 - 38 hours). Fifty-three of the cases were treated by microsurgery and 44 by non-microsurgery. Complications occurred in 81 (73%) of the cases, including ED in 14 cases, urethral stricture in 16, urinary fistula in 8, skin necrosis in 58 and skin sensory abnormality in 31. The incidences of ED, urethral stricture and urinary fistula exhibited significant differences between the microsurgery and non-microsurgery groups of the partial amputation patients (P penis and reduction of complications, and therefore can be regarded as a "standard" method for penile replantation in China.

Correlation of volumetric flow rate and skin blood flow with cold intolerance in digital replantation.

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Zhao, Gang; Mi, Jingyi; Rui, Yongjun; Pan, Xiaoyun; Yao, Qun; Qiu, Yang

2017-12-01

Cold intolerance is a common complication of digital replantation. The exact etiology is unclear, but it is considered to be multifactorial, including nonsurgical characteristics, vascular, and neurologic conditions. Blood flow may play a significant role in cold intolerance. This study was designed to evaluate the correlation of digital blood flow, including volumetric flow rate (VFR) and skin blood flow (SkBF), with cold intolerance in replanted fingers.A retrospective study was conducted among patients who underwent digital replantation between 2010 and 2013. Patients were selected into study cohort based on the inclusion criteria. Surgical data was collected on each patient, including age, sex, injury mechanism, amputation level, ischemia time, number of arteries repaired, and whether or not vascular crisis occurred. Patients were included as study cohort with both nerves repaired and without chronic disease. Cold intolerance was defined as a Cold Intolerance Symptom Severity (CISS) score over 30. The arterial flow velocity and caliber were measured by Color Doppler Ultrasound and the digital VFR was calculated. The SkBF was measured by Laser Speckle Imager. Both VFR and SkBF were calculated as a percentage of the contralateral fingers. Comparative study of surgical data and blood flow was performed between the patient with and without cold intolerance. Correlation between VFR and SkBF was also analyzed.A total of 93 patients met inclusion criteria for the study. Approximately, 42 patients were identified as having cold intolerance. Fingers that survived vascular crisis had a higher incidence of cold intolerance with a lower VFR and SkBF. The VFR was higher in 2-artery replantation, but the SkBF and incidence of cold intolerance did not differ significantly. No differences were found in age, sex, injury mechanism, amputation level, or ischemia time. Furthermore, no correlation was found between VFR and SkBF.Cold intolerance of digital replantation is associated

Nonarterialized Venous Replantation of Part of Amputated Thumb—A Case Report and Review of the Literature

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Kalimuthu, Ramasamy

2006-01-01

Since the first successful replantation of a human thumb reported by Komatsu and Tamai in 1968, thousands of severed digits and body parts have been successfully salvaged. Restoration of anatomic form and function are the goals of replantation after traumatic tissue amputation. Regardless of anatomic location, methods include microsurgical replantation and nonmicrosurgical replantation, such as composite graft techniques. Numerous techniques to maximize tissue survival after revascularization have been described, including “pocket procedures” to salvage composite grafts, interposition vein grafts, and medicinal leeches to name a few. Artery-to-venous anastomoses have been performed with successful “arterialization” of the distal venous system in fingertip replantation. Although there is documented survival of free venous cutaneous flaps, to our knowledge this is the first report of a replanted composite body part (bone, tendon, soft tissues, and skin) utilizing exclusively multiple, microvascular, nonarterialized venous–venous anastomoses. We present a patient with an isolated band saw fillet amputation to the back of the thumb at the metacarpal–phalangeal joint region, resulting in a composite graft composed of bone, tendon, soft tissue, and skin. The hand wound provided no viable regional arterial inflow source, but there were multiple good caliber superficial veins present. The amputated tissues were replanted and revascularized by using only venous blood flow. The replanted part survival was 100% with excellent function of the digit. We conclude that a hand composite body part involving bone, tendon, soft tissues, and skin can survive replantation with a strict venous blood supply if sufficient good caliber, microvascular, venous–venous anastomoses are performed, granted that arterial inflow options are not available. This is an isolated case, yet introduces a new way of thinking regarding tissue replantation. PMID:18780032

Assessment of survival rates compared according to the Tamai and Yamano classifications in fingertip replantations.

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Dadaci, Mehmet; Ince, Bilsev; Altuntas, Zeynep; Bitik, Ozan; Kamburoglu, Haldun Onuralp; Uzun, Hakan

2016-01-01

The fingertip is the most frequently injured and amputated segment of the hand. There are controversies about defining clear indications for microsurgical replantation. Many classification systems have been proposed to solve this problem. No previous study has simultaneously correlated different classification systems with replant survival rate. The aim of the study is to compare the outcomes of fingertip replantations according to Tamai and Yamano classifications. 34 consecutive patients who underwent fingertip replantation between 2007 and 2014 were retrospectively reviewed with respect to the Tamai and Yamano classifications. The medical charts from record room were reviewed. The mean age of the patients was 36.2 years. There were 30 men and 4 women. All the injuries were complete amputations. Of the 34 fingertip amputations, 19 were in Tamai zone 2 and 15 were in Tamai zone 1. When all the amputations were grouped in reference to the Yamano classification, 6 were type 1 guillotine, 8 were type 2 crush and 20 were type 3 crush avulsions. Of the 34 fingertips, 26 (76.4%) survived. Ten (66.6%) of 15 digits replanted in Tamai zone 1 and 16 (84.2%) of 19 digits replanted in Tamai zone 2 survived. There were no replantation failures in Yamano type 1 injuries (100%) and only two failed in Yamano type 2 (75%). Replantation was successful in 14 of 20 Yamano type 3 injuries, but six failed (70%). The percentage of success rates was the least in the hybridized groups of Tamai zone 1-Yamano type 2 and Tamai zone 1-Yamano type 3. Although clinically distinct, the survival rates between the groups were not statistically significantly different. The level and mechanism of injury play a decisive role in the success of fingertip replantation. Success rate increases in proximal fingertip amputations without crush injury.

Assessment of survival rates compared according to the Tamai and Yamano classifications in fingertip replantations

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Mehmet Dadaci

2016-01-01

Full Text Available Background: The fingertip is the most frequently injured and amputated segment of the hand. There are controversies about defining clear indications for microsurgical replantation. Many classification systems have been proposed to solve this problem. No previous study has simultaneously correlated different classification systems with replant survival rate. The aim of the study is to compare the outcomes of fingertip replantations according to Tamai and Yamano classifications. Materials and Methods: 34 consecutive patients who underwent fingertip replantation between 2007 and 2014 were retrospectively reviewed with respect to the Tamai and Yamano classifications. The medical charts from record room were reviewed. The mean age of the patients was 36.2 years. There were 30 men and 4 women. All the injuries were complete amputations. Of the 34 fingertip amputations, 19 were in Tamai zone 2 and 15 were in Tamai zone 1. When all the amputations were grouped in reference to the Yamano classification, 6 were type 1 guillotine, 8 were type 2 crush and 20 were type 3 crush avulsions. Results: Of the 34 fingertips, 26 (76.4% survived. Ten (66.6% of 15 digits replanted in Tamai zone 1 and 16 (84.2% of 19 digits replanted in Tamai zone 2 survived. There were no replantation failures in Yamano type 1 injuries (100% and only two failed in Yamano type 2 (75%. Replantation was successful in 14 of 20 Yamano type 3 injuries, but six failed (70%. The percentage of success rates was the least in the hybridized groups of Tamai zone 1-Yamano type 2 and Tamai zone 1-Yamano type 3. Although clinically distinct, the survival rates between the groups were not statistically significantly different. Conclusions: The level and mechanism of injury play a decisive role in the success of fingertip replantation. Success rate increases in proximal fingertip amputations without crush injury.

Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis.

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Huan, An-Shi; Regmi, Subhash; Gu, Jia-Xiang; Liu, Hong-Jun; Zhang, Wen-Zhong

2016-01-01

The purpose of this study was to report our experience of fingertip replantation without venous anastomosis using alternate method to counter post-operative venous congestion. 30 Patients (18 men and 12 women) with 30 fingertip amputations (Tamai zone I) were treated with artery-only anastomosis fingertip replantation between March 2010 and July 2014. Postoperative venous outflow was maintained by allowing bleeding through wound gaps combined with topical (12500 u :250mlNS) and systemic (4000 IU SC once daily) heparin. The outcomes of replantation were evaluated using standard evaluating systems. The average duration of hospital stay was 10 days (range 7-14 days). Twenty-eight (93 %) replanted fingertips survived. Five replanted fingertip experienced postoperative vascular crisis. The estimated post-operative blood loss was about 200-450 ml (mean, 292 ml). Follow-up period ranged from 12 to 24 months (average, 18 months). At final follow-up examinations, the average value of static two point discrimination test was 5.6 mm (range 3-9 mm) and Semmes-Weinstein monofilament test was 3.35 g (range 2.83-4.56 g). The mean range of motion of distal interphalangeal joint was 65.2° (range 0-90°) and all patients returned to their work within 7-18 weeks (average, 11 weeks). Artery-only fingertip replantation can provide satisfactory cosmetic and functional results. Adequate venous outflow can be obtained by allowing minimal external bleeding through wound gaps combined with topical and systemic heparin.

Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

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Nima Moradi Majd

2014-01-01

Full Text Available Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

Intentional replantation: A viable alternative for management of palatogingival groove

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Vijay Kumar; Ajay Logani; Naseem Shah

2013-01-01

Radicular groove is an anatomical malformation that often leads to combined endodontic-periodontic lesions. Treatment of complex groove presents a clinical challenge to the operator. A case of type III palatogingival groove is successfully treated with intentional replantation. With the understanding of the procedure and strict adherence to guidelines improves, practitioners can use intentional replantation as an easy and cost-effective alternative for the management of radicular groove. The ...

A retrospective study of the intentionally replanted mandibular second molars with C-shaped root canal configurations

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Objectives

2011-01-01

Full Text Available Objectives The purpose of this retrospective study was to evaluate the success rate of intentionally replanted mandibular second molar with C-shaped canal configurations and to access the impact of preoperative periapical lesion on the success of intentional replantation procedure. Materials and Methods This retrospective chart review study evaluated 52 intentionally replanted mandibular second molar teeth treated at Seoul National University Dental Hospital Department of Conservative Dentistry from January 2005 to December 2007. Seventeen teeth were lost for the follow-up, and another 6 teeth did not meet inclusion criteria of C-shaped root canal configurations. Healing outcome such as success, uncertain healing, and failure after follow-up was evaluated by clinical criteria and radiographs. Results The overall success rate was 72.4% for the 29 intentionally replanted C-shaped mandibular second molars. The success rate of replanted teeth with preoperative periapical lesions was similar to that of replanted teeth which have no periapical lesions. Conclusions Therefore, root canal treatment failure on C-shaped mandibular second molar can be predictably treated by intentional replantation regardless of the presence of periapical lesion.

Vacuum assisted closure therapy for treatment of complex wounds in replanted extremities.

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Zhou, Min; Qi, Baiwen; Yu, Aixi; Pan, Zhenyu; Zhu, Shaobo; Deng, Kai; Tao, Shengxiang

2013-11-01

The object of this study was to compare the outcomes of the vacuum assisted closure (VAC) therapy and conventional wound care with dressing change for treatment of complex wounds in patients with replantation of amputated upper and lower extremities. Data of 43 patients with replantation of amputated extremities from May 2004 to December 2011 were reviewed. There were 18 wounds of 18 patients with replantation, which were treated by dressing change and 26 wounds of 25 patients by VAC therapy. The outcomes were evaluated by the survival rate of replanted extremities, growth of granulation tissue, interval between wound treatment and secondary procedure and eventual secondary wound coverage methods. Vascular thromboses were found in 3 patients with wound treatment by dressing change and 5 by VAC. All replants of two groups of patients survived after salvage procedures. The wound score was 3.6 ± 0.7 in the conventional dressing change group and 5.8 ± 0.7 in the VAC group at the sixth day after treatment, respectively. The intervals between wound treatment and secondary wound coverage procedure were 12.0 ± 1.7 days in the dressing change group and 6.1 ± 0.7 days in the VAC group. Flaps were applied for wound coverage in 9 out of 18 (50.0%) wounds in the dressing change group and 5 out of 26 (19.2%) in the VAC group (P VAC could promote the growth of granulation tissue of wound, decrease the need of flap for wound coverage, and did not change the survival of replantation. Copyright © 2013 Wiley Periodicals, Inc.

The Effect of Re-Planting Trees on Soil Microbial Communities in a Wildfire-Induced Subalpine Grassland

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Ed-Haun Chang

2017-10-01

Full Text Available Wildfire often causes tremendous changes in ecosystems, particularly in subalpine and alpine areas, which are vulnerable due to severe climate conditions such as cold temperature and strong wind. This study aimed to clarify the effect of tree re-planting on ecosystem services such as the soil microbial community after several decades. We compared the re-planted forest and grassland with the mature forest as a reference in terms of soil microbial biomass C and N (Cmic and Nmic, enzyme activities, phospholipid fatty acids (PLFA composition, and denaturing gradient gel electrophoresis (DGGE. The Cmic and Nmic did not differ among the grassland, re-planted forest and mature forest soil; however, ratios of Cmic/Corg and Nmic/Ntot decreased from the grassland to re-planted forest and mature forest soil. The total PLFAs and those attributed to bacteria and Gram-positive and Gram-negative bacteria did not differ between the re-planted forest and grassland soil. Principle component analysis of the PLFA content separated the grassland from re-planted forest and mature forest soil. Similarly, DGGE analysis revealed changes in both bacterial and fungal community structures with changes in vegetation. Our results suggest that the microbial community structure changes with the re-planting of trees after a fire event in this subalpine area. Recovery of the soil microbial community to the original state in a fire-damaged site in a subalpine area may require decades, even under a re-planted forest.

Penile Replantation After Five Hours of Warm Ischemia

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Fernando N. Facio Jr.

2015-05-01

Full Text Available Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

Nonmicrosurgical replantation using a subcutaneous pocket for salvage of the amputated fingertip.

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Muneuchi, Gan; Kurokawa, Masato; Igawa, Kazuhiko; Hamamoto, Yusuke; Igawa, Hiroharu H

2005-05-01

The pocket principle suggested by Brent in 1979 is an alternative method for use when microsurgical replantation is not feasible. The application and the amputation level for which the method is available, however, have not been well examined. Between 1999 and 2003 we treated 6 patients (7 fingers) by nonmicrosurgical replantation using a subcutaneous pocket (the Brent technique). All patients had sustained complete fingertip amputations across or proximal to the lunula in digits other than the thumb. In every case the amputation was a crush or avulsion-type injury and microsurgical replantation was not feasible; however, cosmetic symmetry was desired strongly by the patient. Of the 7 fingers only one survived completely but became atrophic after 4 months. One finger developed necrosis involving less than half of the replant but a hooked nail deformity developed. Two fingers developed partial necrosis involving more than half of the replant but both fingers were missing the fingernail and the cosmetic results were not acceptable. Three fingers developed total necrosis. In addition a slight flexion contracture not improved with therapy in the digits was noted in 4 patients. The Brent technique should be performed scrupulously for fingertip amputation across or proximal to the lunula because of the poor survival rate and the possibility of contracture in the digits or other proximal joints.

Saving Natural Teeth: Intentional Replantation-Protocol and Case Series.

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Grzanich, Derek; Rizzo, Gabriella; Silva, Renato Menezes

2017-12-01

Intentional replantation is a reliable and predictable treatment for cases in which nonsurgical endodontic retreatment failed or is impractical and endodontic surgery is hampered because of anatomic limitations. This article presents a protocol for intentional replantation illustrated with some interesting cases. The cases presented here are from patients (average age, 61 years) with no contributing medical history. The cases are molars with previous failed endodontic treatment/retreatment and diagnosed with apical periodontitis. Treatment procedures included atraumatic extractions with minimal manipulations of the periodontal ligament, followed by root-end resection, root-end preparation with ultrasonic tips, root-end fill with bioceramic cement, and rapid tooth replacement into the socket. Granulomatous tissue was gently curetted when applicable. All procedures were performed under the microscope. Intentional replantation with careful case selection may be considered as a last option for preserving hopeless teeth. Atraumatic extraction by using state-of-the-art equipment, instruments, and materials, minimal extra-alveolar time, and maintaining an aseptic technique are key factors for success. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Microvascular transplantation and replantation of the dog submandibular gland.

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Su, Wan Fu; Jen, Yee Min; Chen, Shyi Gen; Nieh, Shin; Wang, Chih-Hung

2006-05-01

Transplantation and replantation of the submandibular gland with microvascular techniques were demonstrated in a previous study, with good gland survival. The application of radiation on the neck bed was attempted to address an actual clinical scenario in this study. Five canine submandibular glands were transplanted using microvascular techniques to the ipsilateral femoral system. Radiotherapy at a dosage level of 3,600 cGy using 600 cGy q.d was delivered to the nasopharyngeal and neck regions 2 weeks after transplantation. The transferred glands were then reintroduced into the original but radiated neck bed. The glands were harvested for histological examination 8 weeks later. Four of five canine submandibular glands can withstand microvascular transplantation and then replantation into a radiated neck bed for at least 8 weeks. However, the salivary function was depleted. The canine submandibular gland can survive the transplantation and replantation for at least 8 weeks in spite of precipitating radiation insult on the neck bed for 3 weeks. Neurorraphy is, however, essential to maintaining the glandular function.

Assessment of survival rates compared according to the Tamai and Yamano classifications in fingertip replantations

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Mehmet Dadaci; Bilsev Ince; Zeynep Altuntas; Ozan Bitik; Haldun Onuralp Kamburoglu; Hakan Uzun

2016-01-01

Background: The fingertip is the most frequently injured and amputated segment of the hand. There are controversies about defining clear indications for microsurgical replantation. Many classification systems have been proposed to solve this problem. No previous study has simultaneously correlated different classification systems with replant survival rate. The aim of the study is to compare the outcomes of fingertip replantations according to Tamai and Yamano classifications. Materials a...

Treatment of fingertip amputation: comparison of results between microsurgical replantation and pocket principle.

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Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

2012-05-01

In this article, a comparison of replantation using microsurgical replantation (replantation) and the Brent method and its modification (pocket principle) in the treatment of fingertip amputation is reported. As a classification of amputation level, we used Ishikawa's subzone classification of fingertip amputation, and the cases of amputations only in subzone 2 were included in this study. Between these two groups, there was no statistical difference in survival rate, postoperative atrophy, or postoperative range of motion. In terms of sensory recovery, some records were lost and exact study was difficult. But there was no obvious difference between these cases. In our comparison of microsurgical replantation versus the pocket principle in treatment of subzone 2 fingertip amputation, there was no difference in postoperative results. Each method has pros and cons, and the surgeon should choose which technique to use based on his or her understanding of the characteristics of both methods. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

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Aksoy, Alper; Gungor, Melike; Sir, Emin

2017-01-01

The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

[Fingertip replantation with anastomosis of palm vein and retaining the nail].

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Wang, Xiang; Zhang, Wei-Kai; Yin, Shao-Meng; Wang, Hai-Bing; He, Tao; Gong, Yong-Qing; Zhu, Guo-Ming; Mao, Gen-Lian; Hu, Ming-Xing; Li, Jian

2013-08-01

To study the replantation methods and clinical results of amputated fingertip. From October 2007 to June 2011, 18 fingers of 13 cases were replanted with anastomosis of palm vein and retaining the nail, including 9 males and 4 females,with an average age of 26 years old ranging from 17 to 45 years old. The time from injury to therapy was from 30 min to 5 h, time of broken finger ischemia was from 1.5 to 7 h. All broken fingers were preservation under normal temperature. All fingers were survived, no vascular crisis happened. All cases were followed up from 3 to 24 months with an average of 14 months. The length and shape of replanted fingers were similar to that of the healthy side. The new nails were smooth, the function was perfect,the sense of pain and touched sensation had been recovered. Their two-piont discriminations ranged from 3 to 6 mm with an average of 5 mm. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 14 cases, good in 3 cases, poor in 1 case. Fingertip replantation with anastomosis of palm vein and retaining the nail is regained satisfactory appearance and function of the digits with a high survival rate.

ANALYSIS OF OIL PALM SUSTAINABLE REPLANTING MODELS, A CASE AT PT. AGROWIYANA , TUNGGUL ULU, TANJUNG JABUNG BARAT, JAMBI

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Solikhin Solikhin

2012-09-01

Full Text Available The oil palm replanting program is becoming of importance for the next decade as some of oil palm plantations are reaching the productivity peak. This research was aimed to select the priority of oil palm replanting strategy with respect to the related factors and impacts to the share holders of PIR Trans and KPPA plantation of PT. AGROWIYANA , and to identify key success indicators of replanting model. A discriptive research methodoligy was carried out using Analytical Hierarchy Process (AHP and Focus Group Discussion (FGD involving multi stakeholders of PT. AGROWIYANA . Results of this research indicated that financial is considered as the most important factor for replanting implemention with the total cutting using standard technology as chosen replanting strategy. The funding scheme through intensive fund rising IDAPERTABUN needs to be well prepared to involve more farmer groups.Keywords: PT. AGROWIYANA , Replanting Strategy

Successful replantation in ten-digit amputation.

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Kantarci, Umit; Cepel, Selim; Buldu, Halil

2010-01-01

Amputations involving ten digits are very rare because of different lengths of the digits. A 34-year-old man working in a printing house presented one hour after guillotine amputation involving all ten digits. Surgery was initiated 80 minutes after admission and took seven hours. Under axillary anesthesia, the operation was performed by two teams each consisting of two microsurgeons and two assistants. Replantation was completed without the use of any skin graft or flap. Fingertip examination showed poor arterial circulation in the second, third, and fourth digits of the left hand after 24 hours of replantation and surgical exploration was performed, during which anastomosis of the ulnar digital artery of the second digit was re-established and a Y-shaped vein graft was placed at the level of the third web to restore revascularization of the third and fourth digits. However, these interventions did not prevent the development of necrosis in the distal segment of the fourth digit which resulted in dry gangrene that required amputation. After 38 months of replantation, radiographic examination showed complete union in all fingers without malunion or damage to the joint surface and about 8 degrees of medial angulation in the proximal phalanx of the fourth digit of the right hand. The patient did not have difficulty in performing daily activities and had a considerably good pinching. Losses of active range of motion of the metacarpophalangeal and interphalangeal joints were within the rage of 10 to 30 degrees in both hands. In the assessment of sensation, static and dynamic two-point discrimination test results were 6.1 mm and 4.0 mm, respectively.

A retrospective study of functional outcomes after successful replantation versus amputation closure for single fingertip amputations.

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Hattori, Yasunori; Doi, Kazuteru; Ikeda, Keisuke; Estrella, Emmanuel P

2006-01-01

To compare the functional outcome of successful microsurgical replantation versus amputation closure for single fingertip amputations. Forty-six fingertip amputations in 46 patients (23 were replanted successfully, 23 had amputation closure) were included in this study. Thumb amputations were excluded. Grip strength and active range of motion of the proximal interphalangeal joint were evaluated. The patients were questioned about their symptoms of pain, paresthesia, and cold intolerance. The Disabilities of the Arm, Shoulder, and Hand questionnaire was given and the disability/symptom score was evaluated. Patients' satisfaction with the surgical result was assessed. Time spent in the hospital and time off from work were reviewed. Active range of motion of the proximal interphalangeal joint was greater in the successful replantation group. Although the existence of paresthesia and cold intolerance were not statistically different between the 2 groups, pain in the affected fingers was more frequent in the amputation closure group. The average Disabilities of the Arm, Shoulder, and Hand score of the successful replantation group was statistically better. All patients in the successful replantation group were highly or fairly satisfied with the surgical results, whereas 14 patients in the amputation closure group were highly or fairly satisfied. The time spent in the hospital and the time off from work for the successful replantation group were longer. Successful replantation of single fingertip amputations can result in minimal pain, better functional outcome, better appearance, and higher patient satisfaction. We recommend attempting fingertip replantation not only to obtain the best appearance but also to gain better functional outcome. If the patient requests the simple surgery and earlier return to work amputation closure is an accepted method despite the disadvantage of digital shortening and the risk for a painful stump. Therapeutic, Level III.

Intentional replantation: A viable alternative for management of palatogingival groove

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Vijay Kumar

2013-01-01

Full Text Available Radicular groove is an anatomical malformation that often leads to combined endodontic-periodontic lesions. Treatment of complex groove presents a clinical challenge to the operator. A case of type III palatogingival groove is successfully treated with intentional replantation. With the understanding of the procedure and strict adherence to guidelines improves, practitioners can use intentional replantation as an easy and cost-effective alternative for the management of radicular groove. The paper presents a brief review of palatogingival groove and highlights an easy and predictable alternative for its management.

Tooth replantation after use of Euro-Collins solution or bovine milk as storage medium: a histomorphometric analysis in dogs.

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Sottovia, André Dotto; Sottovia Filho, Dagoberto; Poi, Wilson Roberto; Panzarini, Sônia Regina; Luize, Danielle Shima; Sonoda, Celso Koogi

2010-01-01

Euro-Collins solution was developed for the preservation of organs for transplantation, whose characteristics have raised interest for its use as a storage medium for avulsed teeth before replantation. This study evaluated histologically and morphometrically the healing process of dog teeth replanted after storage in Euro-Collins solution or bovine milk. Eighty roots of 4 young adult mongrel dogs were randomly assigned to 4 groups (n = 20) and the root canals were instrumented and obturated with gutta-percha and a calcium hydroxide-based sealer. After 2 weeks, the teeth were extracted and subjected to the following protocols: GI (negative control), replantation immediately after extraction; GII (positive control), bench-drying for 2 hours before replantation; GIII and GIV, immersion in 10 mL of whole bovine milk and Euro-Collins solution at 4 degrees C, respectively, for 8 hours before replantation. The animals were sacrificed 90 days postoperatively. The pieces containing the replanted teeth were subjected to routine processing for histologic and histometric analyses under light microscopy and polarized light microscopy. Root resorption was observed in all groups. GII exhibited the greatest loss of dental structure (P < .01), and inflammatory resorption was predominant in this group. Storage in milk showed poorer results than immediate replantation and storage in Euro-Collins solution (P < .01). The teeth stored in Euro-Collins solution presented similar extension of root resorption and periodontal ligament reorganization to those of immediately replanted teeth. The findings of this study suggest that the Euro-Collins solution is an adequate storage medium for keeping avulsed teeth for up to 8 hours before replantation.

Artery-only fingertip replantations using a controlled nailbed bleeding protocol.

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Erken, H Yener; Takka, Semih; Akmaz, Ibrahim

2013-11-01

We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replantations treated using the artery-only technique without vein or nerve repair. We performed a retrospective review of 24 patients who had undergone fingertip replantation at the same center between 2005 and 2011. All patients in this study had complete fingertip amputation at or distal to the distal interphalangeal joint of the fingers or interphalangeal joint of the thumb. Patients with incomplete and complete amputations who had undergone vein and/or nerve repair along with artery repair were excluded. All patients received the same protocol including removal of the nail at the surgery and intravenous heparin 70 U/kg administered at the time of arterial anastomosis. After surgery, the nailbed was mechanically made to bleed with a sterile needle and mechanically scrubbed with a heparin-saline gauze. All patients received the same postoperative medical treatment protocol until physiological outflow was restored. Successful replantation was confirmed with clinical observation. Twenty-one of the 24 fingertip replantations (88%) were successful. The mean length of hospital stay was 7 days (range, 4-9 d). Fifteen of 22 patients required blood transfusion. The average amount of blood transfusion was 1.2 U (range, 0-3 U). This study shows that the described technique and protocol reconstructed circulation without vein anastomosis and with a high success rate. Furthermore, adequate sensory recovery without any nerve repair had occurred by the 2-year follow-up. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Classification of distal fingertip amputation based on the arterial system for replantation.

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Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

2013-06-01

During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no injury to the central pulp artery, injury only to the lateral pulp artery. From April 2010 to June 2011, 27 patients were evaluated. Successful replantation was observed in 21 patients. Skin necrosis occurred in six patients. For distal fingertip amputation classification based on the damaged arterial system is an easy method to find out the appropriate artery which should be anastomosed during replantation.

Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis

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Huan, An-shi; Regmi, Subhash; Gu, Jia-xiang; Liu, Hong-jun; Zhang, Wen-zhong

2016-01-01

Purpose The purpose of this study was to report our experience of fingertip replantation without venous anastomosis using alternate method to counter post-operative venous congestion. Methods 30 Patients (18 men and 12 women) with 30 fingertip amputations (Tamai zone I) were treated with artery-only anastomosis fingertip replantation between March 2010 and July 2014. Postoperative venous outflow was maintained by allowing bleeding through wound gaps combined with topical (12500u:250mlNS) and ...

[Face replantation using labial artery for revascularization. Case report].

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de la Parra-Márquez, Miguel; Mondragón-González, Sergio; López-Palazuelos, Jaime; Naal-Mendoza, Norberto; Rangel-Flores, Jesús María

2013-01-01

Restoration of the face function and cosmetic appearance after a traumatic complex wound is a challenge for the plastic surgeon. Worldwide, few cases have been reported about face replantation. To present the case of the first partial face replantation reported in the national bibliography, using the labial artery for revascularization. On June 19th 2011, a 7 years old male presented to the emergency room of the Mexican Institute of Social Security at Monterrey, Mexico, 4 hours after a partial face amputation secondary to a dog bite. The amputated segment was composed of 75% of the upper lip, 33% of the lower lip, oral commissure and 75% of the left cheek. The labial coronary artery and vein were anastomosed with 11-0 nylon sutures and the miorraphy of the orbicularis oris, the depressor anguli oris and the depressor labii inferioris with 4-0 vycril sutures. Six months after the surgery, the functional and aesthetic outcomes were excellent with reestablishment of total labial continence and total recovery of articulation of words. amputations of any facial component should be initially managed with replantation. The function and cosmetics are better than any other technique of reconstruction. The labial coronary artery is an excellent choice for revascularization up to 25% of the face (lips and cheek).

Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations

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Deok Hyeon Ryu

2018-01-01

Full Text Available Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1, a single vein (group 2, and 2 or more veins (group 3. Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143. Failures were due equally to venous complications (n=4, 50% and to arterial complications (n=4, 50%. Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689. However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017. Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations

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Ryu, Deok Hyeon; Roh, Si Young; Kim, Jin Soo; Lee, Dong Chul; Lee, Kyung Jin

2018-01-01

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy. PMID:29076329

Fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision.

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Yabe, T; Muraoka, M; Motomura, H; Ozawa, T

2001-11-01

Four cases of fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision are reported. Because of lack of suitable arteries for anastomosis in the amputated finger, in each case a volar radial vein was anastomosed to the proximal digital artery and external drainage was performed through a transverse tip incision. In 3 cases the replanted fingertip survived completely; partial necrosis occurred in 1 case. Because veins are more superficial and larger than arteries, they are more available for anastomosis. The results indicate that this method is a useful alternative in fingertip replantation.

Healing process of incisor teeth of diabetic rats replanted after storage in milk.

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Ricieri, Camila Benez; Sonoda, Celso Koogi; Aranega, Alessandra Marcondes; Panzarini, Sônia Regina; Poi, Wilson Roberto; Sundefeld, Maria Lúcia Marçal Mazza; Okamoto, Tetuo

2009-06-01

Several local factors that influence the healing process of replanted teeth have been investigated. However, it remains unclear how systemic alterations, such as diabetes mellitus, affect the prognosis of these cases. The purpose of this study was to evaluate the healing process of incisors of non-controlled diabetic rats replanted after storage in bovine long shelf-life (UHT) whole milk. Thirty-two rats were randomly assigned to receive an endovenous injection of either citrate buffer solution (group I - control; n = 16) or streptozotocin dissolved in citrate buffer solution to induce diabetes (group II; n = 16). After confirmation of the diabetic status by analysis of the glycemic levels, the maxillary right incisor of each animal was extracted and immersed in milk for 60 min. The root canals of teeth were then instrumented, and were filled with a calcium hydroxide-based dressing and replanted into their sockets. All animals received systemic antibiotic and were killed by anesthetic overdose 10 and 60 days after replantation. The specimens containing the replanted teeth were removed, fixed, decalcified, and embedded in paraffin. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histologic and histometric analyses. The results showed that the connective tissue adjacent to the root surface was less organized in the diabetic animals than in the control animals in both periods; the root dentin was less severely affected by root resorption in the diabetic rats; there were no significant differences between the control and diabetic groups regarding the occurrence of replacement resorption and inflammatory resorption.

Delayed replantation of rat teeth after use of reconstituted powdered milk as a storage medium.

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dos Santos, Cláudia Letícia Vendrame; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sundefeld, Maria Lúcia Marçal Mazza; Negri, Márcia Regina

2009-02-01

Minimal extraoral dry storage period and moist storage for the avulsed tooth are identified as key steps for the treatment protocol of tooth replantation. Among the possible moist storage media, bovine milk has stood out because of its capacity of preserving the integrity of the periodontal ligament (PDL) fibers. This condition has attracted the attention to investigate the use of powdered milk, which is one of the presentation forms of bovine milk, as a feasible storage medium in cases of delayed tooth replantation. The aim of this study was to evaluate the healing process after delayed replantation of rat teeth stored in reconstituted powdered milk and long shelf-life (ultra high temperature) whole milk. Forty maxillary right rat incisors were assigned to four groups (n = 10): group I--the teeth were extracted and immediately replanted into theirs sockets; group II--the teeth were stored for 60 min in 200 ml of freshly reconstituted powdered milk; group III--the teeth were stored for 60 min in 200 ml of long shelf-life whole milk; group IV--the teeth were kept dry for the same time. All procedures were performed at room temperature. Next, the root canals of teeth in groups II, III, and IV were instrumented, filled with a calcium hydroxide-based paste, and replanted into their sockets. All animals received systemic antibiotic therapy and were killed by anesthetic overdose 60 days after replantation. The pieces containing the replanted teeth were removed, fixed, decalcified, and paraffin-embedded. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histomorphological analysis. There was statistically significant difference (P < 0.05) between groups I and IV regarding the presence of replacement resorption and PDL remnants on root surface. The powdered milk and long shelf-life whole milk presented similar results to each other and may be indicated as storage media for avulsed teeth.

Delayed replantation of avulsed teeth

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Adil N

2007-05-01

Full Text Available Dental injuries are very common and their extent has been classified by Ellis. Avulsion of tooth is a grievous injury and ranges from 1-16% among the traumatic injuries, of which maxillary anterior are commonest. Reimplantation of avulsed teeth is a standard procedure. However, it has certain limitations. Most often their management is very challenging. In this case report we are presenting the management of maxillary incisors by replantation after 36 hrs in a 12 year old girl.

Finger Replantation in Sanglah General Hospital: Report of Five Cases and Literature Review

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Agus Roy Rusly Hariantana Hamid; Gatot Triwono

2016-01-01

Background: Replantation is the prime treatment for amputated hands and fingers due to functional and aesthetic advantages. The absolute indications for replantation are amputations of the thumb, multiple fingers, trans metacarpal or hand, and any upper extremity in a child, regardless of the amputation level. A fingertip amputation distal to the insertion of the flexor digitorum superficialis (FDS) is also a good indication. Indications have been expanded to include amputation at nail level,...

Contralateral Abdominal Pocketing in Salvation of Replanted Fingertips with Compromised Circulation

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Hyung-Sup Shim

2014-01-01

Full Text Available Abdominal pocketing is one of the most useful methods in salvation of compromised replanted fingertips. Abdominal pocketing has generally been performed in the ipsilateral lower abdominal quadrant, but we have also performed contralateral pocketing at our institute. To determine which approach is more beneficial, a total of 40 patients underwent an abdominal pocketing procedure in either the ipsilateral or contralateral lower abdominal quadrant after fingertip replantation. Dates of abdominal pocketing after initial replantation, detachment after abdominal pocketing, range of motion (ROM before abdominal pocketing, and sequential ROM after the detachment operation and date of full ROM recovery and Disabilities of Arm, Shoulder, and Hand questionnaire (DASH score were recorded through medical chart review. Mean detachment date, mean abduction of shoulder after the detachment operation, and mean days to return to full ROM were not significantly different between the ipsilateral and contralateral pocketing groups. However, the mean DASH score was significantly lower in the contralateral group than the ipsilateral group. There were also fewer postoperative wound complications in the contralateral group than in the ipsilateral group. We, therefore, recommend contralateral abdominal pocketing rather than ipsilateral abdominal pocketing to increase patient comfort and reduce pain and complications.

Contralateral Abdominal Pocketing in Salvation of Replanted Fingertips with Compromised Circulation

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Shim, Hyung-Sup; Kim, Dong-Hwi; Kwon, Ho; Jung, Sung-No

2014-01-01

Abdominal pocketing is one of the most useful methods in salvation of compromised replanted fingertips. Abdominal pocketing has generally been performed in the ipsilateral lower abdominal quadrant, but we have also performed contralateral pocketing at our institute. To determine which approach is more beneficial, a total of 40 patients underwent an abdominal pocketing procedure in either the ipsilateral or contralateral lower abdominal quadrant after fingertip replantation. Dates of abdominal pocketing after initial replantation, detachment after abdominal pocketing, range of motion (ROM) before abdominal pocketing, and sequential ROM after the detachment operation and date of full ROM recovery and Disabilities of Arm, Shoulder, and Hand questionnaire (DASH) score were recorded through medical chart review. Mean detachment date, mean abduction of shoulder after the detachment operation, and mean days to return to full ROM were not significantly different between the ipsilateral and contralateral pocketing groups. However, the mean DASH score was significantly lower in the contralateral group than the ipsilateral group. There were also fewer postoperative wound complications in the contralateral group than in the ipsilateral group. We, therefore, recommend contralateral abdominal pocketing rather than ipsilateral abdominal pocketing to increase patient comfort and reduce pain and complications. PMID:25379539

Simple replantation protocol to avoid ankylosis in teeth intended for orthodontic treatment

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Yuli Nugraeni

2009-03-01

Full Text Available Background: Dento-alveolar trauma resulted from accidents involving the oral regions mostly affect the upper central incisors. Overjet that is beyond 5 mm and incompetent lip also contribute to increase the risk. Several literatures had already discussed different methods of replantation of avulsed teeth. However, it was not meant for further orthodontic treatment. Purpose: The objective of this review is to propose a simple replantation protocol of avulsed teeth which also prevent from ankylosis. Reviews: Protruded teeth usually need orthodontic treatment; therefore, an appropriate management should be done to avoid the development of ankylosis. Ankylosis of the periodontal ligament (PDL becomes a problem in orthodontic tooth movement in repositioned or replanted teeth. In addition, ankylosed teeth also more susceptible to root resorption. Actually, it was caused by the endodontic treatment. In particular, severely protruded or unoccluded teeth are hypofunctional, therefore have narrow PDL, thus it may facilitate to ankylosis development. Ideal management protocol such as the use of root canal sealer i.e. mineral trioxide aggregate (MTA; the using of Emdogain, and resilient wiring or semi-rigid fixation with brackets has become a solution in avulsed teeth arranged for orthodontic treatment. Nevertheless, the presence of oral surgeon, endodontist and orthodontist in the same time, and also ideal preparations after an accident was difficult to achieve. Conclusion: Considering that reducing the ongoing PDL inflammation with intracanal medicaments and maintaining the functional force during mastication is possible; it is concluded that this simple replantation protocol is likely.

The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

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Streit, L; Dvořák, Z; Novák, O; Stiborová, S; Veselý, J

2014-01-01

Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion.

The effect of Emdogain and 24% EDTA root conditioning on periodontal healing of replanted dog's teeth.

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Guzmán-Martínez, Nayelli; Silva-Herzog, Flores Daniel; Méndez, González Verónica; Martín-Pérez, Silvia; Cerda-Cristerna, Bernardino Isaac; Cohenca, Nestor

2009-02-01

Controversies still exist as for the regenerative role of enamel matrix derivatives and the need for removal of the periodontal ligament in replanted teeth. The purpose of this study was to evaluate the effect of Emdogain and 24% ethylenediamine tetraacetic acid (EDTA) root conditioning on periodontal healing of replanted dog's teeth. Teeth were extracted, endodontically treated and preconditioned as follows: group 1, Emdogain; group 2, Emdogain + EDTA and group 3, EDTA. Teeth were replanted after 30 min extraoral time, splinted for 15 days and animals sacrificed after 8 weeks of observation. Histological evaluation was performed using hematoxylin/eosin and Masson trichrome and results scored based on previously reported criteria for histological evaluation. Replacement root resorption was histologically diagnosed in all groups except in the negative control. A parametric analysis showed no statistically significant differences between experimental groups. Root preconditioning with Emdogain alone or in combination with 24% EDTA showed no evidence of regeneration of collagen fibers and consequently did not prevent the development of replacement root resorption on replanted dog's teeth.

Long-term functional, subjective and psychological results after single digit replantation

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Jing Chen

2018-03-01

Full Text Available Objective: The aim of this study was to analyse the long-term functional, subjective, and psychological results after single-digit replantation. Methods: Thirty cases of digital replantation (14 thumbs, 12 index fingers, 2 middle fingers, 1 ring finger, and 1 little finger in 30 patients (7 females and 23 males with a mean age of 44.2 years (20–65 years were evaluated at the end of a mean follow-up time of 36 months (19–50 months. The active range of motion of joints, grip and pinch strength, cutaneous sensibility, upper-extremity functioning, and subjective satisfaction were determined using the Disability of Arm, Shoulder, and Hand (DASH questionnaire and the Michigan Hand Outcomes questionnaire (MHQ. Psychological sequelae, including depression, anxiety, and posttraumatic stress disorder (PTSD, were assessed. A correlation analysis among variables was also performed. Results: The mean score for the DASH questionnaire was 6.6 (range: 0–39.2. The symptom of cold intolerance occurred in 53% of the patients. Two patients were diagnosed with depression, and only one patient exhibited PTSD. The DASH score had a good statistical correlation with total grip strength, pinch grip strength, and static two-point discrimination (S-2PD (P < 0.05. Several aspects of the MHQ were also statistically relevant to some or all of the three objective results. Furthermore, the grip strength showed significant correlation with DASH and most aspects of the MHQ in multivariate logistic regression analysis (P < 0.05. Conclusion: Total grip strength is the most important factor positively related to subjective outcomes. The incidence rates of psychological symptoms after digit replantation are very low at long-term follow-up. Level of evidence: Level IV, therapeutic study. Keywords: Digit Replantation, DASH score, Posttraumatic stress disorder

Lateral Nail Fold Incision Technique for Venous Anastomosis in Fingertip Replantation.

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Jeon, Byung-Joon; Yang, Jae-Won; Roh, Si Young; Ki, Sae Hwi; Lee, Dong Chul; Kim, Jin Soo

2016-01-01

Successful venous anastomosis is one of the most important factors in fingertip replantation. Volar veins in the fingertip course proximally in a random pattern, which makes it difficult to find out the exact locations. Although dorsal veins in the lateral nail fold have constant location and adequate diameter for anastomosis, they have been known as hard to dissect from the immobile subcutaneous tissue. The authors present a new lateral nail fold incision technique for venous anastomosis in the fingertip amputations. From February 2010 to October 2010, 9 replantations using the new incision and venous anastomosis technique were performed in 9 patients. The levels of amputations were from the nail base to half of the nail bed. After repairing the proper digital arteries, a skin incision was made along the junction between the lateral nail fold and nail bed. Careful dissection was performed to isolate the veins in the lateral nail fold. After evaluation of the suitability of the vessel, venous anastomosis was performed. Seven male and 2 female patients were enrolled in this study. Appropriate dorsal veins for anastomosis could be found in 8 of 9 patients. All the replanted stumps survived without venous congestion and following additional procedures. A sizable volar or dorsal vein could not be found in 1 patient. The salvage technique was required in this patient. Dorsal veins in the lateral nail fold can be found easily because of the constant anatomical location. The new incision on the lateral nail fold provides not only sufficient operative field for anastomosis but also additional opportunity of successful venous anastomosis in the selected cases. The authors, therefore, propose this technique as an effective method for an alternative venous anastomosis in the zone I replantation.

Arterial and venous revascularization with bifurcation of a single central artery: a reliable strategy for Tamai Zone I replantation.

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Hsu, Chung-Chen; Lin, Yu-Te; Moran, Steven L; Lin, Cheng-Hung; Wei, Fu-Chan; Lin, Chih-Hung

2010-12-01

Replantation of the distal phalanx and pulp can be performed to improve finger function and finger aesthetics; however, establishing adequate venous drainage is a challenge. Slattery et al. reported microsurgical reattachment of a partial distal phalanx with the use of a bifurcated terminal digital artery. The bifurcation was divided into two pedicles, one of which was used for venous drainage. In this article, the authors report their experience with a similar technique and propose a new algorithm for distal finger replantation. From January of 2008 to February of 2009, five replantations were performed using a single central artery. The replanted levels were pulp, avulsed fingertip of the thumb, and distal phalanges. There was no volar vein, dorsal vein, or second artery available in the amputated part for standard venous drainage. Venous drainage in all cases was established by creating an anastomosis from a branch of the solitary terminal artery to a recipient vein. All digits were replanted successfully without evidence of arterial insufficiency or venous congestion. Partial necrosis was not identified postoperatively in any of the five fingers. There were no cases of wound infection. A branch of the central solitary artery may be used successfully to reestablish venous outflow in cases of distal finger tip replantation. This technique allowed for the salvage of all fingers in this study without the use of leeches or other techniques used in cases of venous insufficiency.

Long Term Follow-Up of a Successful Lower Limb Replantation in a 3-Year-Old Child

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Akbar Jaleel Zubairi

2015-01-01

Full Text Available Replantation of the lower extremity has controversial indications but nevertheless it may be considered in carefully selected patients who present early and are expected to show good functional recoveries. Here we present a successful replantation in a 3-year-old boy who has made excellent recovery with no functional deficit evident at 12 years of follow-up. He sustained a traumatic amputation at the level of distal tibia when he fell of a “Qing Qi” (motorcycle rickshaw. Replantation was attempted at 8 hours cold ischemia time with the tibia shortened 4 cm and all tendons, vessels, and nerves repaired. Patient required a second procedure during the same hospital stay for skin coverage. Patient made good recovery with ambulation without support at 6 months, less than 3 cm limb length discrepancy, plantar and dorsiflexion power 4/5, and recovery of sensation over the foot. Now at 12 years of follow-up patient has a normal gait and has integrated into society with no functional deficit. Considering the functional outcome of our case, replantation should be attempted whenever possible and feasible especially in children.

Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth.

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Panzarini, Sônia Regina; Gulinelli, Jéssica Lemos; Saito, Célia T M H; Poi, Wilson Roberto; Sonoda, Celso Koogi; Américo de Oliveira, José; Melo, Moriel Evangelista; de Souza Gomes, Weglis Dyanne

2012-06-01

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy. © 2011 John Wiley & Sons A/S.

Long-term functional, subjective and psychological results after single digit replantation.

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Chen, Jing; Zhang, Ai Xian; Chen, Qing Zhong; Mu, Shuai; Tan, Jun

2018-03-01

The aim of this study was to analyse the long-term functional, subjective, and psychological results after single-digit replantation. Thirty cases of digital replantation (14 thumbs, 12 index fingers, 2 middle fingers, 1 ring finger, and 1 little finger) in 30 patients (7 females and 23 males) with a mean age of 44.2 years (20-65 years) were evaluated at the end of a mean follow-up time of 36 months (19-50 months). The active range of motion of joints, grip and pinch strength, cutaneous sensibility, upper-extremity functioning, and subjective satisfaction were determined using the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and the Michigan Hand Outcomes questionnaire (MHQ). Psychological sequelae, including depression, anxiety, and posttraumatic stress disorder (PTSD), were assessed. A correlation analysis among variables was also performed. The mean score for the DASH questionnaire was 6.6 (range: 0-39.2). The symptom of cold intolerance occurred in 53% of the patients. Two patients were diagnosed with depression, and only one patient exhibited PTSD. The DASH score had a good statistical correlation with total grip strength, pinch grip strength, and static two-point discrimination (S-2PD) (P digit replantation are very low at long-term follow-up. Level IV, therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Les difficultés de la replantation. Quel avenir pour le cacao en Côte d’Ivoire ?

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Ruf François

2001-11-01

Full Text Available La conférence internationale sur le thème « Quel avenir pour les cultures pérennes ? » est née de deux préoccupations. La première recouvre le champ des difficultés de la replantation, difficultés techniques, économiques mais aussi environnementales, sociales et politiques : comment replanter 1 ? La seconde est la baisse des cours, probablement structurelle, de la plupart des matières premières agricoles, notamment de celles produites par des cultures pérennes. Si les prix restent aussi bas de façon aussi durable, pourquoi replanter ? De même qu’il est toujours de bon aloi d’acheter des actions quand la bourse s’écroule, les économistes recommandent de planter quand les cours des matières premières sont à leur plancher. Toutefois, si des centaines de milliers d’hectares sont plantés par des producteurs qui anticipent une remontée des cours, celle-ci peut alors être fort retardée. Cette capacité à anticiper un retour à des prix élevés est ainsi une des causes du prolongement de la phase des très bas prix du cacao jusqu’en 2001, ce qui semble bien relever d’un échec du marché 2. Le pourquoi et le comment de la replantation sont bien indissociables. Face aux enjeux, de nombreux pays détenteurs du patrimoine « cultures pérennes tropicales » ne manquent-ils pas d’une véritable politique de replantation prenant acte des changements nécessaires dans les conditions de production, se remettant en cause, tout en faisant face aux difficultés à interpréter les marchés ? Les problèmes de replantation ne peuvent se surmonter qu’à partir d’une compréhension des processus en œuvre, sur le terrain, en commençant par les décisions des producteurs. Les exemples, les études de cas, par village, par région, restent donc des fondamentaux pour une réflexion globale, pour une anticipation des problèmes, une action nationale, voire internationale, sur la replantation. En même temps, la question de

Replantation of fingertip amputation by using the pocket principle in adults.

Science.gov (United States)

Lee, P K; Ahn, S T; Lim, P

1999-04-01

There are several treatment modalities for zone 1 or zone 2 fingertip amputations that cannot be replanted by using microsurgical techniques, such as delayed secondary healing, stump revision, skin graft, local flaps, distant flaps, and composite graft. Among these, composite graft of the amputated digit tip is the only possible means of achieving a full-length digit with a normal nail complex. The pocket principle can provide an extra blood supply for survival of the composite graft of the amputated finger by enlarging the area of vascular contact. The surgery was performed in two stages. The amputated digit was debrided, deepithelialized, and reattached to the proximal stump. The reattached finger was inserted into the abdominal pocket. About 3 weeks later, the finger was removed from the pocket and covered with a skin graft. We have consecutively replanted 29 fingers in 25 adult patients with fingertip amputations by using the pocket principle. All were complete amputations with crushing or avulsion injuries. Average age was 33.64 years, and men were predominant. The right hand, the dominant one, was more frequently injured, with the middle finger being the most commonly injured. Of the 29 fingers, 16 (55.2 percent) survived completely and 10 (34.5 percent) had partial necrosis less than one-quarter of the length of the amputated part. The results of the above 26 fingers were satisfactory from both functional and cosmetic aspects. Twenty of the 29 fingers, which had been followed up for more than 6 months (an average of 16 months), were included in a sensory evaluation. Fifteen of these 20 fingers (75 percent) were classified as "good" (static two-point discrimination of less than 8 mm and normal use). From the overall results and our experience, we suggest that the pocket principle is a safe and valuable method in replantation of zone 1 or zone 2 fingertip amputation, an alternative to microvascular replantation, even in adults.

Management of complicated crown-root fracture in central incisors using intentional replantation with 180° rotation: A case report

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Reyhaneh Faghihian

2017-01-01

Full Text Available Introduction: Complicated crown-root fractures are rare and their treatment is complex. Numerous methods such as crown lengthening and orthodontic or surgical extrusion have been described for the treatment of crown-root fracture. The aim of this study was to report managing complicated crown-root fracture using intentional replantation with 180° rotation. Case report: This case report demonstrates successful management of complicated crown-root fracture in central incisor of a 10-year-old boy using intentional replantation with 180° rotation. Discussion: At 18-month follow-up, the replanted tooth revealed normal function with no obvious resorption.

Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

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Marília Pacífico Lucisano

2016-01-01

Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

Cross-finger dermal pocketing to augment venous outflow for distal fingertip replantation.

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Tan, Valerie H; Murugan, Arul; Foo, Tun-Lin; Puhaindran, Mark E

2014-09-01

Venous anastomosis in distal fingertip replantations is not always possible, and venous congestion is recognized as a potential cause of failure. Methods previously described to address this problem include amputate deepithelization and dermal pocketing postarterial anastomosis to augment venous outflow. However, attachment of the digit to the palm or abdomen resulted in finger stiffness. We describe a modification of the previous methods by utilizing dermal flaps raised from the adjacent digit in the form of a cross-finger flap. The key differences are the partial deepithelization of the replanted fingertip and subsequent replacement of the dermal flap to the donor digit to minimize donor site morbidity. During the period where the 2 digits are attached, interphalangeal joint mobilization is permitted to maintain joint mobility.

Use of the mechanical leech for successful zone I replantation.

Science.gov (United States)

Kim, Sang Wha; Han, Hyun Ho; Jung, Sung-No

2014-01-01

Replantation of zone I finger injuries remains a challenge, particularly if the fingertip was previously scarred or atrophied, which makes it difficult to secure a suitable vein at the amputation site. In cases of artery-only anastomosis, we propose using a mechanical leech technique to maintain sufficient venous outflow until the internal circulation regenerates. We applied this procedure to eight patients who had zone 1 amputations without veins that were suitable for anastomosis. Emergent surgery was performed and an artery-only anastomosis was created. As there were no veins available, we cut a branch of the central artery and anastomosed it with a 24-gauge angioneedle, which served as a conduit for venous drainage. The overall survival rate for zone I replantation using mechanical leech was 87.5% and the average time to maintain the mechanical leech was 5 days. The mechanical leech technique may serve as an alternative option for the management of venous congestion when no viable veins are available.

Use of the Mechanical Leech for Successful Zone I Replantation

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Sang Wha Kim

2014-01-01

Full Text Available Replantation of zone I finger injuries remains a challenge, particularly if the fingertip was previously scarred or atrophied, which makes it difficult to secure a suitable vein at the amputation site. In cases of artery-only anastomosis, we propose using a mechanical leech technique to maintain sufficient venous outflow until the internal circulation regenerates. We applied this procedure to eight patients who had zone 1 amputations without veins that were suitable for anastomosis. Emergent surgery was performed and an artery-only anastomosis was created. As there were no veins available, we cut a branch of the central artery and anastomosed it with a 24-gauge angioneedle, which served as a conduit for venous drainage. The overall survival rate for zone I replantation using mechanical leech was 87.5% and the average time to maintain the mechanical leech was 5 days. The mechanical leech technique may serve as an alternative option for the management of venous congestion when no viable veins are available.

Successful Replantation of Amputated Penile Shaft following Industrial Injury

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M Salehipour

2010-09-01

Full Text Available Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.

The timing of neovascularization in fingertip replantation by external bleeding.

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Han, Seung-Kyu; Chung, Heung-Soo; Kim, Woo-Kyung

2002-09-15

To overcome venous congestion in fingertip replantation with no venous anastomosis, the authors have used a salvage procedure that consists of continuous external bleeding through a stab incision on the paraungual area and dripping a heparinized saline solution at the incision site to maintain external bleeding. Because this method requires continuous bleeding for a certain period of time, it may be a great burden on the patient; therefore, it is most important to minimize the duration of bleeding. Many authors have studied the timing of the new venous channel formation of the flap. However, to our knowledge, a study on fingertip replantations has not yet been performed. From June of 1985 to November of 1999, the authors performed fingertip replantations on 144 fingers of 137 patients using our salvage procedure at Korea University Guro Hospital. Among the 144 fingers, 101 fingers of 96 patients were successfully transplanted, including those with partial necrosis. The authors reviewed the medical records of these 101 fingers retrospectively; they compared and analyzed the necessary duration of external bleeding according to sex, age, level of injury, cause of amputation, and the type of injury. The average period of the salvage procedure was 7.6 days. Regarding age, the shortest period (5.5 days) was required for patients younger than 10 years. On the basis of the types of injuries, the duration of bleeding was shortest for the guillotine injury group (5.9 days) compared with crush (8.2 days) or avulsion (8.0 days) injuries. Sex and level of injury did not make much difference in the duration of the procedure.

Distal fingertip replantation without skeletal fixation.

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Sabapathy, S Raja; Venkatramani, Hari; Bharathi, R Ravindra; Sebastin, Sandeep J

2005-01-01

The replantation of fingertip amputation (through the nail bed) requires repair of the artery and vein on the palmar side. These structures are present in different planes, with the artery being deeper and the veins superficial. The authors believe that vascular repair in such cases is facilitated by stabilization of the amputated part by nail-bed repair alone. This provides a certain degree of flexibility, which allows for easier placement of clamps in the limited space available. Although Kirschner wires were not used for bony fixation, bony union was achieved in all five cases in which this technique was used.

Effect of topical alendronate on root resorption of dried replanted dog teeth.

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Levin, L; Bryson, E C; Caplan, D; Trope, M

2001-06-01

Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-microm-thick cross-sections of the root and surrounding tissue taken every 70 microm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.

Replanting/underplanting strategy for old coconut plantations in Papua New Guinea

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Ollivier Jean

2001-11-01

Full Text Available In most producing countries, the population of coconut palms is growing old, and ways of replacing them are rarely implemented to ensure that production is maintained and the future of the industry and its profitability are safeguarded. Rehabilitating/replanting coconut plantations and adopting appropriate intercropping systems is one of the main challenges to be taken up for the future of coconut in the Asia-Pacific region. The example of Papua New Guinea (PNG reveals one of the lowest yields per hectare among the countries in the Asia-Pacific zone. Almost 106,000 ha were planted between 1910 and 1940, amounting to around 40% of the current coconut plantings, hence 80 to 100,000 ha can be expected to disappear in the next twenty years. Faced with this forecast, the PNG Cocoa and Coconut Research Institute (PNG CCRI launched several operations, beginning with the creation of a coconut research centre on the PNG mainland: examination of a replanting strategy for old coconut plantings, based on hybrid planting material, distribution of improved planting material through the creation of a seed garden, and development of a system for controlling pest populations in high-risk zones. The experiments set up at the station are designed to optimize the felling date for old coconut palms, by measuring the effects of competition with the underplanted hybrids, and to determine from an economic point of view the best strategy to be applied for implementing rehabilitation and/or replanting programmes in old coconut plantings. This paper describes the results of these operations.

An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

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Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

2009-04-01

Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

Rhizospheric microbial communities are driven by Panax ginseng at different growth stages and biocontrol bacteria alleviates replanting mortality

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Linlin Dong

2018-03-01

Full Text Available The cultivation of Panax plants is hindered by replanting problems, which may be caused by plant-driven changes in the soil microbial community. Inoculation with microbial antagonists may efficiently alleviate replanting issues. Through high-throughput sequencing, this study revealed that bacterial diversity decreased, whereas fungal diversity increased, in the rhizosphere soils of adult ginseng plants at the root growth stage under different ages. Few microbial community, such as Luteolibacter, Cytophagaceae, Luteibacter, Sphingomonas, Sphingomonadaceae, and Zygomycota, were observed; the relative abundance of microorganisms, namely, Brevundimonas, Enterobacteriaceae, Pandoraea, Cantharellales, Dendryphion, Fusarium, and Chytridiomycota, increased in the soils of adult ginseng plants compared with those in the soils of 2-year-old seedlings. Bacillus subtilis 50-1, a microbial antagonist against the pathogenic Fusarium oxysporum, was isolated through a dual culture technique. These bacteria acted with a biocontrol efficacy of 67.8%. The ginseng death rate and Fusarium abundance decreased by 63.3% and 46.1%, respectively, after inoculation with B. subtilis 50-1. Data revealed that microecological degradation could result from ginseng-driven changes in rhizospheric microbial communities; these changes are associated with the different ages and developmental stages of ginseng plants. Biocontrol using microbial antagonists alleviated the replanting problem. KEY WORDS: Panax ginseng, Microbial communities, Replanting problem, High-throughput sequencing, Different ages, Bioremediation

Microvascular replantation of avulsed tissue after a dog bite of the face

African Journals Online (AJOL)

Various authors have described successful microsurgical replantation of totally avulsed facial tissue. In a significant nwnber of cases difficulties were experienced with the venous anastomoses and/or venous drainage of the tissue. Many different methods were used to overcome the problem. Despite these difficulties, good ...

Effect of periodontal ligament removal with gauze prior to delayed replantation in rabbit incisors on rate of replacement resorption.

Science.gov (United States)

Maslamani, Manal; Joseph, Bobby; Gabato, Severino; Andersson, Lars

2018-03-23

Delayed (dry storage > 60 minutes) replantation results in ankylosis and replacement resorption. It has been suggested to remove the non-viable periodontal ligament before replantation to possibly reduce the rate of replacement resorption. However there has been no study on the rate of replacement resorption after such measures. The aim of this study was to investigate if there was any difference in the rate of replacement resorption by either removing the periodontal ligament (PDL) with gauze or not removing PDL in teeth subjected to delayed replantation followed by healing for 2 or 6 weeks. Maxillary central incisors were extracted in 8 rabbits. In the right central incisors, the necrotic PDL was removed by dry gauze over the root surface. In the left eight extracted teeth PDL was left on the root surface. All extracted teeth were left to dry for 60 minutes. Extra-oral root canal treatment was performed before replantation. The rabbits were sacrificed after 2 weeks and 6 weeks respectively. Histologic processing and evaluation was done. In the 2 weeks group, all teeth showed ankylosis. The cementum was intact, and fusion of the bone and root was generally seen without resorption of the root, whereas in the 6 weeks group regardless of whether PDL had been kept or not, ankylosis and osseous replacement of the dentin was seen. There was no evidence of inflammatory infiltrate in the sections examined. Removal of PDL prior to delayed replantation may result in some initial protection of the cementum during the first few weeks. However, over longer times there seems to be neither protection of the dentin from ankylosis and osseous replacement, nor any influence on the rate of replacement resorption. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Atypical arteriole anastomoses for fingertip replantations under digital block.

Science.gov (United States)

Koshima, Isao

2008-01-01

Reconstructive microsurgery is now in a new stage of supermicrosurgery. With this technique, very tiny (0.3mm) vascular anastomoses are possible. In this paper, we describe two cases of successful fingertip replantations employing arteriole (terminal branch of digital artery) anastomoses, the arteriole graft being obtained from the same fingertip defect, reverse arteriole flow to subdermal venule, and delayed venular drainage for venous congestion. These atypical tiny vascular anastomoses were successfully carried out under digital block.

Multidisciplinary approach in the immediate replantation of a maxillary central incisor - A six and a half year follow-up

OpenAIRE

Cristina Braga Xavier; Beatriz Farias Vogt; Giselle Daer Faria; Leandro Calcagno Reinhardt; Elaini Sickert Hosni; Josué Martos

2015-01-01

This report proposes a discussion of the various peculiarities of a tooth 21 replantation in a 9-year-old patient and describes different treatment facets and a 6-year follow-up of the case. The splint was maintained for a 3-month period. After a 1΍ year therapy with calcium hydroxide to control inflammatory resorption, the final canal obturation was performed 18 months after trauma with mineral trioxide aggregate. Two years after replantation, the orthodontic treatment had been initiated and...

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats.

Science.gov (United States)

Sottovia, André Dotto; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Lauris, José Roberto Pereira

2006-04-01

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

Six years follow-up of a penis replantation in a child.

Science.gov (United States)

de Lagausie, Pascal; Jehanno, Pascal

2008-03-01

Total amputation of the penis is very rare in a child. This article presents a case of a traumatic penile amputation at the base of the perineum, with scissors, in a 4-year-old child. Six hours after the aggression, the penis was replanted. Three weeks after the intervention, except for skin necrosis, the results were excellent. Six years afterward, this child has done very well from pediatric, psychological, urological, and plastic surgery points of view. Sensibility and erections are present and normal. Longer follow-ups particularly during puberty are necessary. Total amputation of the penis is a very rare accident in a child. Partial lesions are more common, particularly during circumcision. As in adult cases, replantation of the penis in a child needs a clean section by scissors or a knife, a correct conservation of the penis (in ice but without direct contact), and a short period between the lesion and the surgical procedure. All these conditions explain that very few cases are reported in the literature. We present a case of amputation of the penis in a 4-year-old child, with good results 6 years afterward.

[Clinico-electromyographic evaluation of the state of motor units of the hand muscles replanted after traumatic amputation].

Science.gov (United States)

Rezkov, G I

1991-01-01

Needle electromyography was used to study motor units of the muscles leading away the thumb and little finger, replanted after traumatic amputation of the large segment of the upper limb in 34 patients. A direct relationship was discovered between the time of the appearance of action potentials of motor units (PMU), recovery of the movements, and trauma level. The appearance of clear PMU associated with movement recovery was recorded not earlier than 6-7 months after trauma. Analysis of PMU is a reliable criterion for the recovery of the own movements of the muscles and function of the neuromotor apparatus in patients with the replanted upper limb segment.

Replantation of multi-level fingertip amputation using the pocket principle (palmar pocket method).

Science.gov (United States)

Arata, J; Ishikawa, K; Soeda, H; Kitayama, T

2003-07-01

Two cases of multi-level fingertip amputation are presented. In each case, replantation was achieved in a two-stage procedure, involving reattachment, de-epithelialisation and insertion into a palmar pocket in stage 1, followed by removal from the palmar pocket 16 days later. The cases are described and the technique is discussed.

Fingertip replantation at the eponychial level with venous anastomosis: an anatomic study and clinical application.

Science.gov (United States)

Cheng, L; Chen, K; Chai, Y-M; Wen, G; Wang, C-Y

2013-11-01

We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertip amputations at the eponychial level were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.

The replanting campaign has begun

CERN Multimedia

GS-SEM Group - General Infrastructure and Services Department

2010-01-01

The poplars on the border of CERN's Prévessin site were felled, according to plan, on Friday, 26 February. The work was essential as the trees were showing signs of serious ageing problems (broken and dead branches, weakened trunks and root systems, etc.) and needed to be felled to ensure the safety of drivers on the D35 The trees that have been cut will be transformed into renewable energy wood chips and used to heat local schools and crèches. They will be replaced by a hedge of hornbeams, a native fast-growing tree, which will be planted in the spring.     The felling operation was entrusted to the French national forestry authorities, with the support of the Bellegarde-Pays de Gex Agence Routière et Technique. It marks the start of a vast poplar-felling and replanting campaign, which will be extended to CERN's Meyrin site.  The work is part of CERN's general renovation and site planning scheme for the future.    

Fingertip replantation at or distal to the nail base: use of the technique of artery-only anastomosis.

Science.gov (United States)

Akyürek, M; Safak, T; Keçik, A

2001-06-01

The authors describe the functional and aesthetic results of microsurgical replantation of 21 fingertip amputations at or distal to the nail base-namely, zone I amputations. There were 15 male and 6 female patients, with an average age of 26 years (age range, 1-41 years). Replantations were performed using the anastomosis of the artery-only technique, with neither vein nor nerve repair. Venous drainage was provided by an external bleeding method with a fish-mouth incision in "distal" zone I amputations for approximately 7 days, and by the use of leeches in more "proximal" zone I amputations for 10 to 12 days. Results indicated that the overall survival rate was 76%, with 16 of 21 digits surviving. Sensory evaluation at an average follow-up of 12 months (range, 6-18 months) revealed an average static two-point discrimination of 6.1 mm (range, 2.0-8.0 mm). Considering the unfavorable results and the donor site morbidity of various fingertip reconstructions, a microsurgical fingertip replantation should always be considered except in extremely distal, clean-cut, pediatric cases, in which case a composite graft is a possibility. The results of this series indicate that an amputated fingertip in zone I can be salvaged successfully by microvascular anastomosis of the artery only, with a nonmicrosurgical method of venous drainage. Furthermore, acceptable sensory recovery can be expected without any nerve coaptation.

[Experiment study on ultrashort wave for treating vascular crisis after rat tail replantation].

Science.gov (United States)

Tan, Long; Gao, Wenshan; Xi, Ali; Wang, Cong; Chen, Shouying; Zhao, Yanyan; Di, Keqian; Yang, Xincai; Weng, Shengbin

2012-10-01

To explore the effect and mechanism of ultrashort wave (USW) for prevention and treatment of vascular crisis after rat tail replantation. Eighty 3-month old female Sprague Dawley rats (weighing 232.8-289.6 g) were randomly divided into 5 groups. In each group, based on the caudal vein and the coccyx was retained, the tail was cut off. The tail artery was ligated in group A; the tail artery was anastomosed in groups B, C, D, and E to establish the tail replantation model. After surgery, the rats of group B were given normal management; the rats of group C were immediately given intraperitoneal injection (3.125 mL/kg) of diluted papaverine hydrochloride injection (1 mg/mL); the rats of groups D and E were immediately given the local USW treatment (once a day) at anastomotic site for 5 days at the dosage of 3 files and 50 mA for 20 minutes (group D) and 2 files and 28 mA for 20 minutes (group E). The survival rate of the rat tails was observed for 10 days after the tail replantation. The tail skin temperature difference between proximal and distal anastomosis was measured at pre- and post-operation; the change between postoperative and preoperative temperature difference was calculated. The blood plasma specimens were collected from the inner canthus before operation and from the tip of the tail at 8 hours after operation to measure the content of nitric oxide (NO). The survival rates of the rat tails were 0 (0/14), 36.4% (8/22), 57.1% (8/14), 22.2% (4/18), and 75.0% (9/12) in groups A, B, C, D, and E, respectively, showing significant overall differences among 5 groups (chi2 = 19.935, P = 0.001); the survival rate of group E was significantly higher than that of group B at 7 days (P 0.05). At preoperation, there was no significant difference in tail skin temperature difference among 5 groups (P > 0.05); at 8 hours, 5 days, 6 days, and 7 days after operation, significant overall difference was found in the change of the skin temperature difference among groups (P

The use of CT for evaluate to healing of segmental replantation in rabbits' tibia

International Nuclear Information System (INIS)

Liu Yifan; Hong Tianlu

2000-01-01

Objective: To study the value of CT in the bone healing. Methods: The rabbit's tibia segments were resected and replanted X-ray and CT photograph were taken after operation at 2,4,8,12 week. Results: CT is more clear than X-ray. Conclusion: CT is superior to X-ray photography in observed bone healing

Foster replantation of fingertip using neighbouring digital artery in a young child.

Science.gov (United States)

Xu, Jing-Hong; Gao, Zheng-Jun; Yao, Jing-Ming; Tan, Wei-Qiang; Dawreeawo, Javed

2010-06-01

Reconstruction of an amputated fingertip in a young child demands special techniques for success. We report a 2.5-year-old female patient with an amputated left index fingertip with the vascular defect being too severe to perform the usual replantation. Comparing several methods, we used the neighbouring digital artery as the feeding artery to perform foster replantation. Finally, the patient was satisfied with the appearance and function of her fingers. The clinical case, techniques, results are described and discussed. We consider it a useful technique, especially for those with a rather severe vascular defect. A 2.5-year-old girl suffered a crush amputation of the left index fingertip. Only the flexor tendon of the amputated fingertip was connected to the proximal finger tissue and the blood supply was completely lost (Figure 1). The distal amputated fingertip was fixed using Kirschner wire under general anaesthesia. Then, microsurgery operation was carried out immediately to replant this amputated fingertip. Both ulnar and radial digital arteries were avulsed, while the dorsal vein was intact and the digital nerve was also surviving. The integrity of blood vessels was too traumatised to connect to the proximal part. In the case of the distal part of the ulnar artery of the injured index finger, the blood supply was established by anastomosing the distal end of the amputated tip and the radial artery of the middle finger, which was the feeding artery (Figure 2). A 11/0 nylon suture was used. The dorsal vein and digital nerve were repaired by means of microsurgical anastomosis. The wound was covered with the dorsal skin of the middle finger and the palmar skin of the index finger to form a skin pedicle, and then, immobility of the two fingers was maintained to prevent avulsion. The index tip obtained good blood supply and survived completely (Figure 3). Detachment of the index and middle finger was performed after 3 weeks, and both of the fingers showed good

Leech Therapy For The Treatment Of Venous Congestion In Flaps, Digital Re-Plants And Revascularizations - A Two-Year Review From A Regional Centre.

Science.gov (United States)

Butt, Ahsan Masood; Ismail, Amir; Lawson-Smith, Matthew; Shahid, Muhammad; Webb, Jill; Chester, Darren L

2016-01-01

Leeches are a well-recognized treatment for congested tissue. This study reviewed the efficacy of leech therapy for salvage of venous congested flaps and congested replanted or revascularized hand digits over a 2-year period. All patients treated with leeches between 1 Oct 2010 and 30 Sep 2012 (two years) at Queen Elizabeth Hospital, Birmingham, UK were included in the study. Details regarding mode of injury requiring reconstruction, surgical procedure, leech therapy duration, subsequent surgery requirement and tissue salvage rates were recorded. Twenty tissues in 18 patients required leeches for tissue congestion over 2 years: 13 men and 5 women. The mean patient age was 41 years (range 17-79). The defect requiring reconstruction was trauma in 16 cases, following tumour resection in two, and two miscellaneous causes. Thirteen cases had flap reconstruction and seven digits in six patients had hand digit replantations or revascularisation. Thirteen of 20 cases (65%) had successful tissue salvage following leech therapy for congestion (77% in 10 out of 13 flaps, and 43% in 3 of 7 digits). The rate of tissue salvage in pedicled flaps was good 6/6 (100%) and so was in digital revascularizations 2/3 (67%), but poor in digital re-plants 1/4 (25%) and free flaps 0/2 (0%). Leeches are a helpful tool for congested tissue salvage and in this study, showed a greater survival benefit for pedicled flaps than for free flaps or digital replantations.

Classification of Distal Fingertip Amputation Based on the Arterial System for Replantation

OpenAIRE

Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

2012-01-01

During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no inj...

Plasticity of Select Primary Afferent Projections to the Dorsal Horn after a Lumbosacral Ventral Root Avulsion Injury and Root Replantation in Rats

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Allison J. Bigbee

2017-07-01

Full Text Available Injuries to the conus medullaris and cauda equina portions of the spinal cord result in neurological impairments, including paralysis, autonomic dysfunction, and pain. In experimental studies, earlier investigations have shown that a lumbosacral ventral root avulsion (VRA injury results in allodynia, which may be ameliorated by surgical replantation of the avulsed ventral roots. Here, we investigated the long-term effects of an L6 + S1 VRA injury on the plasticity of three populations of afferent projections to the dorsal horn in rats. At 8 weeks after a unilateral L6 + S1 VRA injury, quantitative morphological studies of the adjacent L5 dorsal horn showed reduced immunoreactivity (IR for the vesicular glutamate transporter, VGLUT1 and isolectin B4 (IB4 binding, whereas IR for calcitonin gene-related peptide (CGRP was unchanged. The IR for VGLUT1 and CGRP as well as IB4 binding was at control levels in the L5 dorsal horn at 8 weeks following an acute surgical replantation of the avulsed L6 + S1 ventral roots. Quantitative morphological studies of the L5 dorsal root ganglia (DRGs showed unchanged neuronal numbers for both the VRA and replanted series compared to shams. The portions of L5 DRG neurons expressing IR for VGLUT1 and CGRP, and IB4 binding were also the same between the VRA, replanted, and sham-operated groups. We conclude that the L5 dorsal horn shows selective plasticity for VGLUT1 and IB4 primary afferent projections after an L6 + S1 VRA injury and surgical repair.

Use of a halo frame for optimum intra- and post-operative management after scalp replantation/revascularization.

Science.gov (United States)

Koul, Ashok R; Nahar, Sushil; Valandi, Beena; Praveen, Kumar H P

2012-09-01

We present a new technique for stabilizing an avulsed scalp during and after replantation/revascularization. We used an aluminium "halo" frame with 4 screws. This technique can rigidly stabilize an avulsed scalp and eliminate the possibility of shearing/pressure necrosis. This device can make perioperative management easier and more comfortable for the patient and caregivers.

Stress distribution in delayed replanted teeth splinted with different orthodontic wires: a three-dimensional finite element analysis.

Science.gov (United States)

de Souza, Fernando Isquierdo; Poi, Wilson Roberto; da Silva, Vanessa Ferreira; Martini, Ana Paula; Melo, Regis Alexandre da Cunha; Panzarini, Sonia Regina; Rocha, Eduardo Passos

2015-06-01

The aim was to evaluate the biomechanical behavior of the supporting bony structures of replanted teeth and the periodontal ligament (PDL) of adjacent teeth when orthodontic wires with different mechanical properties are applied, with three-dimensional finite element analysis. Based on tomographic and microtomographic data, a three-dimensional model of the anterior maxilla with the corresponding teeth (tooth 13-tooth 23) was generated to simulate avulsion and replantation of the tooth 21. The teeth were splinted with orthodontic wire (Ø 0.8 mm) and composite resin. The elastic modulus of the three orthodontic wires used, that is, steel wire (FA), titanium-molybdenum wire (FTM), and nitinol wire (FN) were 200 GPa, 84 GPa, and 52 GPa, respectively. An oblique load (100 N) was applied at an angle of 45° on the incisal edge of the replanted tooth and was analyzed using Ansys Workbench software. The maximum (σmax) and minimum (σmin) principal stresses generated in the PDL, cortical and alveolar bones, and the modified von Mises (σvM) values for the orthodontic wires were obtained. With regard to the cortical bone and PDL, the highest σmin and σmax values for FTM, FN, and FA were checked. With regard to the alveolar bone, σmax and σmin values were highest for FA, followed by FTM and FN. The σvM values of the orthodontic wires followed the order of rigidity of the alloys, that is, FA > FTM > FN. The biomechanical behavior of the analyzed structures with regard to all the three patterns of flexibility was similar. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Microsurgical replantation and postoperative leech treatment of a large severed nasal segment

DEFF Research Database (Denmark)

Stemann Andersen, Peter; Elberg, Jens Jørgen

2012-01-01

The survival of a microsurgically replanted segment of nose in a 41-year-old woman was facilitated by the assistance of the medicinal leech Hirudo medicinalis. An arterial microanastomosis was made to a severed partial segment of nose with no possibility of recreating a venous anastomosis. The re....... The resulting venous congestion was treated with nine days of treatment with a medical leech until venous neovascularisation had been achieved. At follow-up six months after discharge there was a well-heeled nasal segment and a satisfying functional - as well as cosmetic - result....

Déterminants sociaux et économiques de la replantation

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Ruf François

2000-03-01

Full Text Available Sur les bourses européennes, la notion de durabilité des investissements dans les valeurs est explicite « Développement durable rime avec investissement rentable » (La Tribune, 11 mars 2000. La maxime émerge avec le développement des fonds éthiques. Selon leurs promoteurs, plus une société commerciale aura le souci de son environnement, plus elle sera boursièrement performante. D’une certaine façon, ce raisonnement reprend des courants de l’écologie humaine et de l’économie rurale, s’appliquant fort bien aux cultures pérennes. En l’absence de pensions et de retraites, les planteurs voient dans les cultures pérennes un moyen efficace pour accumuler des richesses, épargner, et éventuellement pour les transmettre à la génération suivante [1, 2]. Les cultures pérennes représentent bien un patrimoine, et leur propriétaire est à la fois un entrepreneur qui investit et un épargnant soucieux de la valeur de son patrimoine, donc de l’environnement garantissant sa durabilité. Cette notion de durabilité peut signifier une stratégie de prolongement de vie économique de l’actif épargné, la plantation, mais peut aussi passer par des stratégies de vente, de rachat, de reconversion, replantation, diversification. Pour un planteur, tout à la fois chef de famille, entrepreneur, épargnant et consommateur, la notion de durabilité s’applique d’abord à celle des revenus disponibles pour la famille. Par rapport à un objectif de durabilité des revenus, comment, pourquoi et quand un planteur prend-il la décision de replanter ? Nous essayerons ici de répondre à cette question sous forme de réflexion et d’exemples pris dans différents pays pour diverses cultures pérennes.

Age and timing of pulp extirpation as major factors associated with inflammatory root resorption in replanted permanent teeth.

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Bastos, Juliana Vilela; Ilma de Souza Côrtes, Maria; Andrade Goulart, Eugenio Marcos; Colosimo, Enrico Antonio; Gomez, Ricardo Santiago; Dutra, Walderez Ornelas

2014-03-01

External root resorption (ERR) is a serious complication after replantation, and its progressive inflammatory and replacement forms are significant causes of tooth loss. This retrospective study aimed to evaluate the factors related to the occurrence of inflammatory ERR (IERR) and replacement ERR (RERR) shortly after permanent tooth replantation in patients treated at the Dental Trauma Clinic at the School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. Case records and radiographs of 165 patients were evaluated for the presence, type, and extension of ERR and its association with age and factors related to the management and acute treatment of the avulsed tooth by using the logistic regression model. The patient's age at the moment of trauma had a marked effect on the ERR prevalence and extension. The patients older than 16 years at the moment of trauma had less chance of developing IERR and RERR (77% and 87%, respectively) before the pulp extirpation, regardless of the extension of the resorption. The patients older than 11 years of age at the moment of trauma showed the lowest indices of IERR (P = .02). Each day that elapsed between the replantation and the pulp extirpation increased the risk of developing IERR and RERR by 1.2% and 1.1%, respectively, and also raised the risk of severe IERR by 0.5% per day. The risk of mature teeth developing severe IERR before the onset of endodontic therapy was directly affected by the timing of the pulpectomy and was inversely proportional to age. Systemic antibiotic therapy use had no effect on the occurrence and severity of IERR in mature teeth. The occurrence of RERR before the onset of endodontic treatment stimulates further investigations of the early human host response to trauma and subsequent infection. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Use of an Intra-Arterial Catheter as a Provisional Conduit for Regulated Outflow Management in the Setting of Artery-Only Digital Replantation.

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DeFazio, Michael V; Han, Kevin D; Paryavi, Ebrahim

2017-12-01

Successful replantation of distal digital segments necessitates the establishment of sufficient outflow to minimize congestion and progressive tissue necrosis. In cases where only arterial anastomosis is feasible, an artificial outlet must be provided to maintain physiological requirements until microvenous circulation regenerates. This can be accomplished using any number of "exsanguination techniques" designed to facilitate egress through ongoing passive blood loss. Although reportedly effective, these measures are imprecise and carry a substantial risk of infection, scarring, and/or uncontrolled hemorrhage. Herein, we describe a preemptive alternative for provisional venous drainage, whereby direct catheterization of a distal arterial branch is used to enhance the precision of outflow management following artery-only digital replantation. The establishment of intravascular access, using the technique described, permits remote manipulation of the microcirculatory environment through timed administration of heparinized saline and regulated removal of controlled volumes of blood.

Identification and characterization of a Bacillus subtilis strain TS06 ...

African Journals Online (AJOL)

Replant disease is a major limitation for strawberry production in greenhouse. Bio-control may be a good way to cope with the replant diseases. Here, we report identification and characterization of a bacterial strain TS06 that may be used as a bio-control agent against the replant diseases in strawberry. TS06 was identified ...

Surgical management with intentional replantation on a tooth with palato-radicular groove

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Jorge Forero-López

2015-05-01

Full Text Available A palato-radicular groove (PRG is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.

Sistemas de tutoramento e épocas de transplante de physalis Periods replanting and training systems of cape-gooseberry

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Cláudia Simone Madruga Lima

2010-12-01

Full Text Available A physalis (Physalis peruviana é uma pequena fruta com grandes potencialidades, que, associadas ao seu ciclo curto e às propriedades nutracêuticas, apresenta possibilidade de alto retorno econômico. O objetivo deste trabalho foi avaliar o sistema de tutoramento e a época de transplante mais adequados para o crescimento e a produção de frutos de P. peruviana nas condições edafoclimáticas do sul do Rio Grande do Sul. O trabalho foi desenvolvido em Pelotas, RS, na safra de 2007/2008. O transplante de mudas de physalis foi realizado em duas épocas (época 1, 21/11/2007 e época 2 15/01/2008, sendo as plantas tutoradas em quatro sistemas de condução (sistema "V" invertido, sistema triangular, sistema vertical com bambu e sistema vertical com fitilho, semelhantes aos utilizados na cultura do tomateiro. O delineamento experimental adotado foi de blocos casualizados, com três repetições, sendo cada um representado por dez plantas. Os tratamentos formaram um fatorial 2x4 (épocas de transplante x sistemas de tutoramento. As variáveis analisadas foram: incremento do comprimento e da área da seção do ramo principal, área da seção do ramo principal, produtividade e eficiência produtiva. Foi evidenciado que a primeira época de transplante associada aos sistemas de tutoramento "V" invertido e triangular proporciona melhor desempenho agronômico das plantas de physalis.The cape-gooseberry (Physalis peruviana is a small fruit with great potentialities that whether associated to its short cycle and nutraceutical properties it shows high economical return. The work aimed to evaluate the best training system and replant period to plant growth, production and fruit quality of P. peruviana under edaphoclimatic at conditions of southern Rio Grande do Sul. The trial was carried out in Pelotas, RS, in 2007/2008 crop. Transplanting seedlings cape-gooseberry was conducted in two seasons Plant replanting was done in two periods (period 1, 21

Composite grafting with pulp adipofascial advancement flaps for treating non-replantable fingertip amputations.

Science.gov (United States)

Lai, Hsin-Ti; Wu, Sheng-Hua; Lai, Ya-Wei; Hsieh, Tung-Ying; Lee, Su-Shin; David Wang, Hui-Min; Chang, Kao-Ping; Lin, Sin-Daw; Lai, Chung-Sheng; Huang, Shu-Hung

2016-11-01

Non-replantable fingertip amputation is still a clinical challenge. We performed modified composite grafting with pulp adipofascial advancement flap for Hirase IIA fingertip amputations. Results from a series of patients are presented and achieved better outcome than traditional composite grafting. From September 2012 to April 2014, fourteen patients with sixteen digits were included in our study. Mean age of patients was 43.9 years (20-71 years). All of our patients underwent this procedure under digital block anesthesia. We performed pulp adipofascial advancement flap for better soft tissue coverage of bone exposure stump first. The amputated parts were defatted, trimming, and reattached as composite graft. Age and gender of patients, injured finger, Hirase classification, mechanism of trauma, overall graft survival area, two-point discrimination (2PD) (mm) at six-month, length of shortening of digit, The average disabilities of the arm, shoulder, and hand (DASH) score and subjective self-evaluation questionnaire at 6 month were recorded. Average graft survival area was 89% (75-100%). Average length of shortening was 2.2 mm (1.8-3.5 mm). 2PD at six-month after surgery was 6.3 mm in average (5-8 mm). Average DASH score at 6 month was 1.45 (0.83-2.5). The self-evaluated aesthetic results showed twelve patients (85.7%) were very satisfied, and no patient was completely unsatisfied. In Hirase zone IIA traumatic fingertip amputation where replantation is difficult, our modified technique of composite grafting with pulp adipofascial advancement flap provided an alternative choice with high successful rate, acceptable functional and aesthetic outcomes. © 2016 Wiley Periodicals, Inc. Microsurgery, 2016. © 2015 Wiley Periodicals, Inc. Microsurgery 36:651-657, 2016. © 2016 Wiley Periodicals, Inc.

Soil pH in fruit trees in relation to specific replant disorder of apple. I. Introduction and review of literature

NARCIS (Netherlands)

Jonkers, H.; Hoestra, H.

1978-01-01

A low pH of the soil prevents the specific apple replant disorder (SARD). Not much is known about the effect of a low pH on the growth of fruit trees. Most authors accept a pH of between 5.5 and 6.5 as optimum for apples but this assumption is not based on experimental research. It is feasible that

A histological and micro-CT investigation in to the effect of NGF and EGF on the periodontal, alveolar bone, root and pulpal healing of replanted molars in a rat model - a pilot study.

Science.gov (United States)

Furfaro, Francesco; Ang, Estabelle S M; Lareu, Ricky R; Murray, Kevin; Goonewardene, Mithran

2014-01-06

This study aims to investigate, utilising micro-computed tomography (micro-CT) and histology, whether the topical application of nerve growth factor (NGF) and/or epidermal growth factor (EGF) can enhance periodontal, alveolar bone, root and pulpal tissue regeneration while minimising the risk of pulpal necrosis, root resorption and ankylosis of replanted molars in a rat model. Twelve four-week-old male Sprague-Dawley rats were divided into four groups: sham, collagen, EGF and NGF. The maxillary right first molar was elevated and replanted with or without a collagen membrane impregnated with either the growth factors EGF or NGF, or a saline solution. Four weeks after replantation, the animals were sacrificed and the posterior maxilla was assessed using histological and micro-CT analysis. The maxillary left first molar served as the control for the corresponding right first molar. Micro-CT analysis revealed a tendency for all replanted molars to have reduced root length, root volume, alveolar bone height and inter-radicular alveolar bone volume. It appears that the use of the collagen membrane had a negative effect while no positive effect was noted with the incorporation of EGF or NGF. Histologically, the incorporation of the collagen membrane was found to negatively affect pulpal, root, periodontal and alveolar bone healing with pulpal inflammation and hard tissue formation, extensive root resorption and alveolar bone fragmentation. The incorporation of EGF and NGF did not improve root, periodontal or alveolar bone healing. However, EGF was found to improve pulp vascularisation while NGF-improved pulpal architecture and cell organisation, although not to the level of the control group. Results indicate a possible benefit on pulpal vascularisation and pulpal cell organisation following the incorporation of EGF and NGF, respectively, into the alveolar socket of replanted molars in the rat model. No potential benefit of EGF and NGF was detected in periodontal or root

Ethanol and lactic acid production using sap squeezed from old oil palm trunks felled for replanting.

Science.gov (United States)

Kosugi, Akihiko; Tanaka, Ryohei; Magara, Kengo; Murata, Yoshinori; Arai, Takamitsu; Sulaiman, Othman; Hashim, Rokiah; Hamid, Zubaidah Aimi Abdul; Yahya, Mohd Khairul Azri; Yusof, Mohd Nor Mohd; Ibrahim, Wan Asma; Mori, Yutaka

2010-09-01

Old oil palm trunks that had been felled for replanting were found to contain large quantities of high glucose content sap. Notably, the sap in the inner part of the trunk accounted for more than 80% of the whole trunk weight. The glucose concentration of the sap from the inner part was 85.2g/L and decreased towards the outer part. Other sugars found in relatively low concentrations were sucrose, fructose, galactose, xylose, and rhamnose. In addition, oil palm sap was found to be rich in various kinds of amino acids, organic acids, minerals and vitamins. Based on these findings, we fermented the sap to produce ethanol using the sake brewing yeast strain, Saccharomyces cerevisiae Kyokai no.7. Ethanol was produced from the sap without the addition of nutrients, at a comparable rate and yield to the reference fermentation on YPD medium with glucose as a carbon source. Likewise, we produced lactic acid, a promising material for bio-plastics, poly-lactate, from the sap using the homolactic acid bacterium Lactobacillus lactis ATCC19435. We confirmed that sugars contained in the sap were readily converted to lactic acid with almost the same efficiency as the reference fermentation on MSR medium with glucose as a substrate. These results indicate that oil palm trunks felled for replanting are a significant resource for the production of fuel ethanol and lactic acid in palm oil-producing countries such as Malaysia and Indonesia. Copyright 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

Soil pH in fruit trees in relation to specific apple replant disorder (SARD). II. The first five years at Wageningen research plot

NARCIS (Netherlands)

Jonkers, H.; Hoestra, H.; Borsboom, O.; Pouwer, A.

1980-01-01

Field plots were established with 4 target pH values, viz. 4, 5, 6 and 7, to study the effect of pH on specific apple replant disorder (SARD). The target pH levels were not stable and frequently showed fluctuations. Although no significant differences have been found on tree performance, the

Cape Saint Paul Wilt Disease of coconut in Ghana: surveillance and management of disease spread

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Nkansah-Poku Joe

2009-03-01

Full Text Available The Cape Saint Paul Wilt Disease (CSPWD, a lethal-yellowing type disease of coconut has been in Ghana since 1932. Aerial and/or ground surveys were undertaken to assess the current status of the disease spread. The survey showed that the spread of the disease for the past 5 years has mainly been the expansion of existing foci. However, new outbreaks were identified at Glidzi in the Volta, Bawjiase and Efutu Breman in Central regions. After the resurgence in the Volta region in 1995, the Woe-Tegbi-Dzelukope corridor has remained endemic, but less aggressive. Pockets of healthy groves remain along all the coastline and inland of known disease zones. Eradication of diseased palms at Ampain focus lying just about 60 km to the Ivorian border, and disease situations on new replanting with MYD × VTT hybrid are discussed.

[Decoronation management of the replacement resorption after delayed replantation of avulsed teeth-case report with 4-year follow-up].

Science.gov (United States)

Ruizhen, Fang; Siyi, Li; Lei, Gao; Li'an, Wu

2017-12-01

Replacement resorption is the most frequent complication after delayed replantation of avulsed teeth. The resorption can interfere with the development of the alveolar ridge and lead to tilt of the adjacent teeth in growing patients. However, there is no means of arresting or reversing the process. Recently decoronation is recommended by International Assocaition of Dental Traumatology as the optimal choice to manage it. This paper demonstrates the procedure and effectiveness of the decoronation by literature review and a case report with 4-year follow-up.

Different bacterial communities in heat and gamma irradiation treated replant disease soils revealed by 16S rRNA gene analysis – contribution to improved aboveground apple plant growth?

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Bunlong eYim

2015-11-01

Full Text Available Replant disease (RD severely affects apple production in propagation tree nurseries and in fruit orchards worldwide. This study aimed to investigate the effects of soil disinfection treatments on plant growth and health in a biotest in two different RD soil types under greenhouse conditions and to link the plant growth status with the bacterial community composition at the time of plant sampling. In the biotest performed we observed that the aboveground growth of apple rootstock M26 plants after eight weeks was improved in the two RD soils either treated at 50 °C or with gamma irradiation compared to the untreated RD soils. Total community DNA was extracted from soil loosely adhering to the roots and quantitative real-time PCR revealed no pronounced differences in 16S rRNA gene copy numbers. 16S rRNA gene-based bacterial community analysis by denaturing gradient gel electrophoresis (DGGE and 454-pyrosequencing revealed significant differences in the bacterial community composition even after eight weeks of plant growth. In both soils, the treatments affected different phyla but only the relative abundance of Acidobacteria was reduced by both treatments. The genera Streptomyces, Bacillus, Paenibacillus and Sphingomonas had a higher relative abundance in both heat treated soils, whereas the relative abundance of Mucilaginibacter, Devosia and Rhodanobacter was increased in the gamma-irradiated soils and only the genus Phenylobacterium was increased in both treatments. The increased abundance of genera with potentially beneficial bacteria, i.e. potential degraders of phenolic compounds might have contributed to the improved plant growth in both treatments.

Classification and evaluation of the functional results of replanted parts of the hand at the Prince of Wales Hospital and the Prince of Wales Children's Hospital: 1984 to 1988.

Science.gov (United States)

Milroy, B C; Sackelariou, R P; Lendvay, P G; Baldwin, M R; McGlynn, M

1991-01-01

This paper describes a simple method of classification and evaluation of the functional results of replanted and revascularized parts in the hand. The results are presented in graphic form and have been analyzed to correlate various factors: injured part, cause, and zone (level) of injury. The type of injury, ischemic time and age have been studied in more detail to determine their influence of the final functional result. The series contains 187 amputated and devascularized parts of the hand in 119 patients who have undergone surgery at the Prince of Wales Hospital from 1984 through 1988. The length of cold or warm ischemic times, up to 16 hours in this series, while not affecting survival of the amputated part, does adversely affect the functional result. The survival rate of replanted parts in children was significantly less favorable than in adults, but the functional results were uniformly superior.

Ronald Malt or Chen Zhongwei: Who performed the first surgical replantation?

Science.gov (United States)

Fan, Ka-Wai

2018-01-01

This article discusses the contributions of the two pioneers of the surgical procedure of replantation-Ronald Malt in the US and Chen Zhongwei in China. Ronald Malt performed the reattachment surgery on a boy who had an accident in 1962, but he published his case report two years later in 1964. Chen Zhongwei performed a similar surgery on a worker who cut off his forearm in 1963, but he published his case report the same year. There is some debate about which one of these reputed surgeons should be given credit for being the first one to perform this breakthrough surgery, because although Malt was the first to perform the procedure, Zhongwei was the first to report it. To shed light on this controversy, criteria for scientific priority suggested by Ronald Vale and Anthony Hyman were applied. Although the criteria mainly favored Zhongwei as the pioneer of this procedure, he did not entirely fulfill one of the criteria. Therefore, the article could not present a definitive answer to the question, and it concludes by pointing out the highly commendable achievements and contributions of both Ronald Malt and Chen Zhongwei.

Electronic Integrated Disease Surveillance System and Pathogen Asset Control System

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Tom G. Wahl

2012-06-01

Full Text Available Electronic Integrated Disease Surveillance System (EIDSS has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS. Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP sponsored by the US Defense Threat Reduction Agency (DTRA.

Electronic integrated disease surveillance system and pathogen asset control system.

Science.gov (United States)

Wahl, Tom G; Burdakov, Aleksey V; Oukharov, Andrey O; Zhilokov, Azamat K

2012-06-20

Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO) data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS) has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP) sponsored by the US Defense Threat Reduction Agency (DTRA).

Bacterial Infection Potato Tuber Soft Rot Disease Detection Based on Electronic Nose

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Chang Zhiyong

2017-11-01

Full Text Available Soft rot is a severe bacterial disease of potatoes, and soft rot infection can cause significant economic losses during the storage period of potatoes. In this study, potato soft rot was selected as the research object, and a type of potato tuber soft rot disease early detection method based on the electronic nose technology was proposed. An optimized bionic electronic nose gas chamber and a scientific and reasonable sampling device were designed to detect a change in volatile substances of the infected soft rot disease of potato tuber. The infection of soft rot disease in potato tuber samples was detected and identified by using the RBF NN algorithm and SVM algorithm. The results revealed that the proposed bionic electronic nose system can be utilized for early detection of potato tuber soft rot disease. Through comparison and analysis, the recognition rate using the SVM algorithm reached up to 89.7%, and the results were superior to the RBF NN algorithm.

Search for alternate hosts of the coconut Cape Saint Paul Wilt Disease pathogen

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Yankey Egya Ndede

2009-03-01

Full Text Available Lethal Yellowing disease locally called Cape Saint Paul wilt disease (CSPWD is the bane of the coconut industry in Ghana and is caused by a phytoplasma. In Ghana, there are areas where the disease has re-infected re-plantings long after decimating all the palms in the area. This brings to the fore the possibility of alternate hosts in the spread of the disease because the pathogen is an obligate parasite. In this work, a number of plants were screened for their host status to the CSPWD pathogen. The presence of phytoplasmas in these plants was tested by polymerase chain reaction analysis using universal phytoplasma primers P1/P7 and CSPWD-specific primers G813/GAKSR. Although Desmodium adscendens tested positive to the CSPWD-specific primers, cloning and sequencing did not confirm it as an alternate host. The identification of alternate hosts will help us to evolve sound control strategies against the spread of the disease.

Potential Applications and Limitations of Electronic Nose Devices for Plant Disease Diagnosis

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Antonio Cellini

2017-11-01

Full Text Available Electronic nose technology has recently been applied to the detection of several plant diseases and pests, with promising results. However, in spite of its numerous advantages, including operational simplicity, non-destructivity, and bulk sampling, drawbacks include a low sensitivity and specificity in comparison with microbiological and molecular methods. A critical review of the use of an electronic nose for plant disease diagnosis and pest detection is presented, describing the instrumental and procedural advances of sensorial analysis, for the improvement of discrimination between healthy and infected or infested plants. In conclusion, the use of electronic nose technology is suggested to assist, direct, and optimise traditionally adopted diagnostic techniques.

[Progress in improvement of continuous monoculture cropping problem in Panax ginseng by controlling soil-borne disease management].

Science.gov (United States)

Wang, Rui; Dong, Lin-Lin; Xu, Jiang; Chen, Jun-Wen; Li, Xi-Wen; Chen, Shi-Lin

2016-11-01

The continuous monoculture cropping problem severely has hindered the land resource of Panax ginseng cultivation and threatened the sustainable development of ginseng industry. There are comprehensive factors causing the continuous monoculture cropping problem, such as deterioration of soil physical and chemical properties, accumulation of allelochemical, increase of pesticide residue and heavy metal, imbalance of rhizospheric micro-ecosystem, and increase of soil-borne diseases. Among soil-borne disease was one of the key factors. More than 40 soil-borne diseases have been reported in the ginseng cultivation, especially, the diseases were more serious in the ginseng replanting land. Here main soil-borne diseases and their prevention way have been summarized, and we try to provide the effective improvement strategy of continuous monoculture cropping problem focusing on the disease control and offer reference for overcoming the ginseng continuous monoculture cropping problem. Copyright© by the Chinese Pharmaceutical Association.

Capturing structured, pulmonary disease-specific data elements in electronic health records.

Science.gov (United States)

Gronkiewicz, Cynthia; Diamond, Edward J; French, Kim D; Christodouleas, John; Gabriel, Peter E

2015-04-01

Electronic health records (EHRs) have the potential to improve health-care quality by allowing providers to make better decisions at the point of care based on electronically aggregated data and by facilitating clinical research. These goals are easier to achieve when key, disease-specific clinical information is documented as structured data elements (SDEs) that computers can understand and process, rather than as free-text/natural-language narrative. This article reviews the benefits of capturing disease-specific SDEs. It highlights several design and implementation considerations, including the impact on efficiency and expressivity of clinical documentation and the importance of adhering to data standards when available. Pulmonary disease-specific examples of collection instruments are provided from two commonly used commercial EHRs. Future developments that can leverage SDEs to improve clinical quality and research are discussed.

Discovering disease associations by integrating electronic clinical data and medical literature.

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Antony B Holmes

Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

Contribution of Electronic Medical Records to the Management of Rare Diseases

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Dominique Bremond-Gignac

2015-01-01

Full Text Available Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients’ data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. Results. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. Discussion. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Conclusion. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

Contribution of Electronic Medical Records to the Management of Rare Diseases.

Science.gov (United States)

Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

2015-01-01

Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

Myofibroblasts in interstitial lung diseases show diverse electron microscopic and invasive features.

Science.gov (United States)

Karvonen, Henna M; Lehtonen, Siri T; Sormunen, Raija T; Harju, Terttu H; Lappi-Blanco, Elisa; Bloigu, Risto S; Kaarteenaho, Riitta L

2012-09-01

The characteristic features of myofibroblasts in various lung disorders are poorly understood. We have evaluated the ultrastructure and invasive capacities of myofibroblasts cultured from small volumes of diagnostic bronchoalveolar lavage (BAL) fluid samples from patients with different types of lung diseases. Cells were cultured from samples of BAL fluid collected from 51 patients that had undergone bronchoscopy and BAL for diagnostic purposes. The cells were visualized by transmission electron microscopy and immunoelectron microscopy to achieve ultrastructural localization of alpha-smooth muscle actin (α-SMA) and fibronectin. The levels of α-SMA protein and mRNA and fibronectin mRNA were measured by western blot and quantitative real-time reverse transcriptase polymerase chain reaction. The invasive capacities of the cells were evaluated. The cultured cells were either fibroblasts or myofibroblasts. The structure of the fibronexus, and the amounts of intracellular actin, extracellular fibronectin and cell junctions of myofibroblasts varied in different diseases. In electron and immunoelectron microscopy, cells cultured from interstitial lung diseases (ILDs) expressed more actin filaments and α-SMA than normal lung. The invasive capacity of the cells obtained from patients with idiopathic pulmonary fibrosis was higher than that from patients with other type of ILDs. Cells expressing more actin filaments had a higher invasion capacity. It is concluded that electron and immunoelectron microscopic studies of myofibroblasts can reveal differential features in various diseases. An analysis of myofibroblasts cultured from diagnostic BAL fluid samples may represent a new kind of tool for diagnostics and research into lung diseases.

Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy.

Science.gov (United States)

Pohl, Yango; Filippi, Andreas; Kirschner, Horst

2005-04-01

The status of the periodontal ligament (PDL) and of the pulp are decisive for the healing of avulsed and replanted teeth. A tooth rescue box was developed and distributed to offer optimal storage conditions for avulsed teeth. The therapy comprised extraoral endodontic treatment and applications of medicaments to enhance periodontal healing. In this long-term clinical study the healing results following avulsion and replantation were investigated. Twenty-eight permanent teeth in 24 patients were evaluated. The extraoral storage media and periods varied considerably. Soon after avulsion six teeth were stored in a cell culture medium (tooth rescue box Dentosafe) for 1-53 h; the PDL was defined as not compromised. Sixteen teeth were stored in a non-physiologic situation temporarily, the PDL was considered as compromised. Six teeth were stored in non-physiologic conditions for longer periods; the condition of the PDL was defined as hopeless. On 14 teeth antiresorptive-regenerative therapy (ART) with the local application of glucocorticoids and enamel matrix derivative and the systemic administration of doxycyclin was used. In all teeth extraoral endodontic treatment by retrograde insertion of posts was performed. The mean observation period was 31.2 months (+/-24.1; 5.1-100.2; median: 23.8). All six teeth rescued physiologically healed with a functional PDL (functional healing, FH) irrespective of the storage period. Of eight teeth with a compromised PDL on which ART was used, three teeth healed with a functional PDL. All other teeth showed replacement resorption, in three teeth additionally infection-related resorption was recorded. The predominant influence on the healing results was the immediate physiologic rescue of avulsed teeth (chi-square, P = 0.0001). The use of ART seemed to support FH (chi-square, P = 0.0547) in teeth with a compromised PDL. No other factors (maturity of roots, crown fractures, gender, age, antibiotics) were related to healing. In a linear

TECHNIQUE OF EXTRACORPOREAL PARTIAL NEPHRECTOMY IN TERMS OF PHARMACO-COLD ISCHEMIA WITHOUT CROSSING THE URETER WITH RENAL VESSELS ORTHOTOPIC REPLANTATION IN PATIENTS WITH RENAL CELL CARCINOMA

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Alexander Gritskevitch

2015-01-01

Full Text Available Background. The most difficult is to determine medical tactics in patients with renal cell carcinoma (RCC with intraparenchimal and central localization in the single, the only functioning kidney, as well as with a combination of tumor and other illnesses in contralateral kidney. Partial nephrectomy leading to renal replacement therapy results in life-threatening complications and poor prognosis. The priority is to develop organ-preserving treatment: from minimally invasive endoscopic surgery to ex vivo kidney resection. Aim: to develop a technique of extracorporeal partial nephrectomy in terms of pharmaco-cold ischemia without crossing the ureter with renal vessels orthotopic replantation in patients with RCC. Materials and methods. The study included 37 patients with pT1a-T3vN0M0-1G1-3 RCC with intraparenchymal and central tumor location. The average age of the patients was 55.32 ± 13.1 years. The ratio of men and women - 2.7:1. Bilateral renal tumors were observed in 3 (8.1% patients, and the RCC of the single functioning kidney in 6 (16.2% patients. One patient (2.7% was diagnosed RCC of a single kidney with intraluminal invasion (cava-renal form. Results. The mean operation time was 413.97 ± 89.14 minutes. The mean warm ischemia time – 8.39 ± 4.75 minutes. Cold ischemia lasted from 70 to 240 minutes, on the average 151.41 ± 41.29 min. The amount of blood loss made up 729.03 ± 481.4 ml. Perioperative complications were detected in 3 (8.1% patients. In two cases after starting the renal blood flow the kidney was found to be nonviable and had to be removed. And in one case the recurrent prosthetic thrombosis of the renal artery resulted in a renal scarring. Postoperative complications were observed in 18 (48.6% patients. According to Clavien-Dindo classification there were 8 low grade (I-II degree complications (44.4%, 8 other of III degree, and one IV degree complication, and there was one lethal case (V degree. Conclusion

Problèmes entomologiques en replantation des palmeraies et des cocoteraies

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Mariau Dominique

2000-03-01

Full Text Available C’est aux alentours de la vingt-cinquième année que l’on envisage de replanter une palmeraie. C’est en effet vers cet âge que commencent à se poser des problèmes de récolte en raison de la taille des palmiers. En un quart de siècle, l’amélioration génétique aura suffisamment fait de progrès pour escompter un gain de production de l’ordre de 20%. Enfin, dans certaines situations, plusieurs maladies ont pu affecter les vieilles palmeraies. Avec de 15 à 25% d’arbres manquants, principalement lorsque ceux-ci se présentent sous la forme de taches, une diminution de la production se fait nettement sentir. Cela peut, par exemple, être le cas avec les maladies de la fusariose en Afrique de l’Ouest, lorsque la palmeraie n’a pas été plantée avec du matériel végétal tolérant, ou du ganoderma en Malaisie. Le renouvellement des cocoteraies se fait avec un espace de temps beaucoup plus long. En effet, la récolte des noix peut se faire au sol et la hauteur des cocotiers n’est donc pas un facteur limitant. Par ailleurs, la majorité des cocoteraies étant sous la forme de petites plantations villageoises, les agriculteurs rechignent toujours à abattre leurs cocotiers, même si des semences potentiellement plus productives leurs sont proposées. Ce sont les raisons pour lesquelles les cocoteraies de 50 ans et plus représentent la règle. L’abattage d’une plantation de palmiers à huile ou de cocotiers constitue naturellement un changement brutal de l’environnement, ce qui a des conséquences importantes notamment sur l’entomofaune, parmi laquelle des ravageurs majeurs ainsi que leurs ennemis naturels.

Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings.

Science.gov (United States)

Rattanaumpawan, Pinyo; Boonyasiri, Adhiratha; Vong, Sirenda; Thamlikitkul, Visanu

2018-02-01

Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings. We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians. A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection. This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study.

Science.gov (United States)

Bellicha, Alice; Macé, Sandrine; Oppert, Jean-Michel

2017-09-23

The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited. Practitioners' requirements when prescribing electronic activity monitors have been poorly described. The aims of this qualitative study were (1) to explore how specialist physicians prescribe electronic activity monitors to patients presenting with cardiometabolic conditions, and (2) to better understand their motivation for and barriers to prescribing such monitors. We conducted qualitative semistructured interviews in March to May 2016 with 11 senior physicians from a public university hospital in France with expertise in management of cardiometabolic diseases (type 1 and type 2 diabetes, obesity, hypertension, and dyslipidemia). Interviews lasted 45 to 60 minutes and were audiotaped, transcribed verbatim, and analyzed using directed content analysis. We report our findings following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Most physicians we interviewed had never prescribed electronic activity monitors, whereas they frequently prescribed blood glucose or blood pressure self-monitoring devices. Reasons for nonprescription included lack of interest in the data collected, lack of evidence for data accuracy, concern about work overload possibly resulting from automatic data transfer, and risk of patients becoming addicted to data. Physicians expected future marketing of easy-to-use monitors that will accurately measure physical activity duration and intensity and provide understandable motivating feedback. Features of electronic activity monitors

Utilizing Dental Electronic Health Records Data to Predict Risk for Periodontal Disease.

Science.gov (United States)

Thyvalikakath, Thankam P; Padman, Rema; Vyawahare, Karnali; Darade, Pratiksha; Paranjape, Rhucha

2015-01-01

Periodontal disease is a major cause for tooth loss and adversely affects individuals' oral health and quality of life. Research shows its potential association with systemic diseases like diabetes and cardiovascular disease, and social habits such as smoking. This study explores mining potential risk factors from dental electronic health records to predict and display patients' contextualized risk for periodontal disease. We retrieved relevant risk factors from structured and unstructured data on 2,370 patients who underwent comprehensive oral examinations at the Indiana University School of Dentistry, Indianapolis, IN, USA. Predicting overall risk and displaying relationships between risk factors and their influence on the patient's oral and general health can be a powerful educational and disease management tool for patients and clinicians at the point of care.

Treatment of extra-mammary Paget's disease with high energy electron beam

International Nuclear Information System (INIS)

Ogawa, Yasuhiro; Kimura, Syuji; Kumano, Machiko; Tsuboi, Yoshitaka; Gose, Kyuhei.

1979-01-01

10 patients with extra-mammary Paget's disease were treated with high energy electron beam. 3 were treated surgically before irradiation. They were irradiated with the dose from, 6,000 rad in 40 fractions in 53 days to 9,900 rad in 66 fractions in 90 days. 3 recurred within 2 years and 1 recurred after 4.8 years and 1 recurred after 5 years. The early recurrence was observed around the irradiated field, while the late recurrence was seen in the irradiated field. A wider area should be irradiated to control this invasive disease. (author)

Overview of the Epidemiology of Coconut Lethal Yellowing Disease ...

African Journals Online (AJOL)

It was also to compare the level of LYD susceptibility in the local West African Tall (WAT) variety and the MYD x VTT hybrid, recommended for replanting under the Coconut Sec-tor Development Project (CSDP). Structured survey questionnaires were administered for 15 months to obtain information on every CSPD coconut ...

Constraints on Biological Mechanism from Disease Comorbidity Using Electronic Medical Records and Database of Genetic Variants.

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Steven C Bagley

2016-04-01

Full Text Available Patterns of disease co-occurrence that deviate from statistical independence may represent important constraints on biological mechanism, which sometimes can be explained by shared genetics. In this work we study the relationship between disease co-occurrence and commonly shared genetic architecture of disease. Records of pairs of diseases were combined from two different electronic medical systems (Columbia, Stanford, and compared to a large database of published disease-associated genetic variants (VARIMED; data on 35 disorders were available across all three sources, which include medical records for over 1.2 million patients and variants from over 17,000 publications. Based on the sources in which they appeared, disease pairs were categorized as having predominant clinical, genetic, or both kinds of manifestations. Confounding effects of age on disease incidence were controlled for by only comparing diseases when they fall in the same cluster of similarly shaped incidence patterns. We find that disease pairs that are overrepresented in both electronic medical record systems and in VARIMED come from two main disease classes, autoimmune and neuropsychiatric. We furthermore identify specific genes that are shared within these disease groups.

Automatic prediction of rheumatoid arthritis disease activity from the electronic medical records.

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Chen Lin

Full Text Available We aimed to mine the data in the Electronic Medical Record to automatically discover patients' Rheumatoid Arthritis disease activity at discrete rheumatology clinic visits. We cast the problem as a document classification task where the feature space includes concepts from the clinical narrative and lab values as stored in the Electronic Medical Record.The Training Set consisted of 2792 clinical notes and associated lab values. Test Set 1 included 1749 clinical notes and associated lab values. Test Set 2 included 344 clinical notes for which there were no associated lab values. The Apache clinical Text Analysis and Knowledge Extraction System was used to analyze the text and transform it into informative features to be combined with relevant lab values.Experiments over a range of machine learning algorithms and features were conducted. The best performing combination was linear kernel Support Vector Machines with Unified Medical Language System Concept Unique Identifier features with feature selection and lab values. The Area Under the Receiver Operating Characteristic Curve (AUC is 0.831 (σ = 0.0317, statistically significant as compared to two baselines (AUC = 0.758, σ = 0.0291. Algorithms demonstrated superior performance on cases clinically defined as extreme categories of disease activity (Remission and High compared to those defined as intermediate categories (Moderate and Low and included laboratory data on inflammatory markers.Automatic Rheumatoid Arthritis disease activity discovery from Electronic Medical Record data is a learnable task approximating human performance. As a result, this approach might have several research applications, such as the identification of patients for genome-wide pharmacogenetic studies that require large sample sizes with precise definitions of disease activity and response to therapies.

Monitoring emerging diseases of fish and shellfish using electronic sources.

Science.gov (United States)

Thrush, M A; Dunn, P L; Peeler, E J

2012-10-01

New and emerging fish and shellfish diseases represent an important constraint to the growth and sustainability of many aquaculture sectors and have also caused substantial economic and environmental impacts in wild stocks. This paper details the results of 8 years of a monitoring programme for emerging aquatic animal diseases reported around the world. The objectives were to track global occurrences and, more specifically, to identify and provide advanced warning of disease threats that may affect wild and farmed fish stocks in the UK. A range of electronic information sources, including Internet newsletters, alerting services and news agency releases, was systematically searched for reports of new diseases, new presentations of known pathogens and known diseases occurring in new geographic locations or new host species. A database was established to log the details of key findings, and 250 emerging disease events in 52 countries were recorded during the period of study. These included 14 new diseases and a further 16 known diseases in new species. Viruses and parasites accounted for the majority of reports (55% and 24%, respectively), and known diseases occurring in new locations were the most important emerging disease category (in which viruses were dominant). Emerging diseases were reported disproportionally in salmonid species (33%), in farmed populations (62%) and in Europe and North America (80%). The lack of reports from some regions with significant aquaculture or fishery production may indicate that emerging diseases are not being recognized in these areas owing to insufficient surveillance or testing or that these events are being under-reported. The results are discussed in relation to processes underpinning disease emergence in the aquatic environment. © 2011 Crown Copyright. Reproduced with the permission of the Controller of Her Majesty’s Stationery Office and Centre for Environment Fisheries & Aquaculture Science.

Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts

DEFF Research Database (Denmark)

Roque, Francisco S.; Jensen, Peter B.; Schmock, Henriette

2011-01-01

Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting...... phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International...

Using electronic patient records to discover disease correlations and stratify patient cohorts.

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Francisco S Roque

2011-08-01

Full Text Available Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International Classification of Disease ontology and is therefore in principle language independent. As a use case we show how records from a Danish psychiatric hospital lead to the identification of disease correlations, which subsequently can be mapped to systems biology frameworks.

Identification and Progression of Heart Disease Risk Factors in Diabetic Patients from Longitudinal Electronic Health Records

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Jitendra Jonnagaddala

2015-01-01

Full Text Available Heart disease is the leading cause of death worldwide. Therefore, assessing the risk of its occurrence is a crucial step in predicting serious cardiac events. Identifying heart disease risk factors and tracking their progression is a preliminary step in heart disease risk assessment. A large number of studies have reported the use of risk factor data collected prospectively. Electronic health record systems are a great resource of the required risk factor data. Unfortunately, most of the valuable information on risk factor data is buried in the form of unstructured clinical notes in electronic health records. In this study, we present an information extraction system to extract related information on heart disease risk factors from unstructured clinical notes using a hybrid approach. The hybrid approach employs both machine learning and rule-based clinical text mining techniques. The developed system achieved an overall microaveraged F-score of 0.8302.

Ear replanatation: a case report and literature review

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Krešimir Božikov

2013-10-01

Full Text Available Background: Total ear amputation is a rare accident. The most common causes are traffic accidents (33 %, followed by fights (28 %. In 1980, Pennington et al. reported the first successful microsurgical ear replantation in a 29-year old man.Methods: An English literature review of trauma cases of total ear amputation showed only 13 successful replantations with arterial and venous microanastomoses. We present a case report of successful total ear replantation with arterial and vein microanastomoses in a 17-year old boy.Results: Our ear replantation with both arterial and venous anastomoses performed was successful and we achieved an excellent aesthetic outcome.Conclusion: The reason for such a low number of successful ear replantations is technical challenge due to small vessel diameter, difficult vessel identification, vessel approach and concomitant avulsion injury. The best aesthetic result in ear reconstruction is achieved by microsurgical replantation. The surgical technique depends on the intraoperative findings. Since ear replantation is a very challenging procedure, a microsurgeon needs to discuss with the patient the risk of partial/total necrosis of the replanted ear and the possibilities of other reconstructive options.

Effects of long-term continuous cropping on soil nematode community and soil condition associated with replant problem in strawberry habitat

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Li, Xingyue; Lewis, Edwin E.; Liu, Qizhi; Li, Heqin; Bai, Chunqi; Wang, Yuzhu

2016-08-01

Continuous cropping changes soil physiochemical parameters, enzymes and microorganism communities, causing “replant problem” in strawberry cultivation. We hypothesized that soil nematode community would reflect the changes in soil conditions caused by long-term continuous cropping, in ways that are consistent and predictable. To test this hypothesis, we studied the soil nematode communities and several soil parameters, including the concentration of soil phenolic acids, organic matter and nitrogen levels, in strawberry greenhouse under continuous-cropping for five different durations. Soil pH significantly decreased, and four phenolic acids, i.e., p-hydroxybenzoic acid, ferulic acid, cinnamic acid and p-coumaric acid, accumulated with time under continuous cropping. The four phenolic acids were highly toxic to Acrobeloides spp., the eudominant genus in non-continuous cropping, causing it to reduce to a resident genus after seven-years of continuous cropping. Decreased nematode diversity indicated loss of ecosystem stability and sustainability because of continuous-cropping practice. Moreover, the dominant decomposition pathway was altered from bacterial to fungal under continuous cropping. Our results suggest that along with the continuous-cropping time in strawberry habitat, the soil food web is disturbed, and the available plant nutrition as well as the general health of the soil deteriorates; these changes can be indicated by soil nematode community.

Spatial Distribution of Coffee Wilt Disease Under Roguing and Replanting Conditions: A Case Study from Kaweri Estate in Uganda.

Science.gov (United States)

Pinard, F; Makune, S E; Campagne, P; Mwangi, J

2016-11-01

Based on time and spatial dynamic considerations, this study evaluates the potential role of short- and long-distance dispersal in the spread of coffee wilt disease (CWD) in a large commercial Robusta coffee estate in Uganda (Kaweri, 1,755 ha) over a 4-year period (2008 to 2012). In monthly surveys, total disease incidence, expansion of infection foci, and the occurrence of isolated infected trees were recorded and submitted to spatial analysis. Incidence was higher and disease progression faster in old coffee plantings compared with young plantings, indicating a lack of efficiency of roguing for reducing disease development in old plantings. At large spatial scale (approximately 1 km), Moran indices (both global and local) revealed the existence of clusters characterized by contrasting disease incidences. This suggested that local environmental conditions were heterogeneous or there were spatial interactions among blocks. At finer spatial scale (approximately 200 m), O-ring statistics revealed positive correlation between distant infection sites across distances as great as 60 m. Although these observations indicate the role of short-distance dispersal in foci expansion, dispersal at greater distances (>20 m) appeared to also contribute to both initiation of new foci and disease progression at coarser spatial scales. Therefore, our results suggested the role of aerial dispersal in CWD progression.

Electronic Transport in Single-Stranded DNA Molecule Related to Huntington's Disease

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Sarmento, R. G.; Silva, R. N. O.; Madeira, M. P.; Frazão, N. F.; Sousa, J. O.; Macedo-Filho, A.

2018-04-01

We report a numerical analysis of the electronic transport in single chain DNA molecule consisting of 182 nucleotides. The DNA chains studied were extracted from a segment of the human chromosome 4p16.3, which were modified by expansion of CAG (cytosine-adenine-guanine) triplet repeats to mimics Huntington's disease. The mutated DNA chains were connected between two platinum electrodes to analyze the relationship between charge propagation in the molecule and Huntington's disease. The computations were performed within a tight-binding model, together with a transfer matrix technique, to investigate the current-voltage (I-V) of 23 types of DNA sequence and compare them with the distributions of the related CAG repeat numbers with the disease. All DNA sequences studied have a characteristic behavior of a semiconductor. In addition, the results showed a direct correlation between the current-voltage curves and the distributions of the CAG repeat numbers, suggesting possible applications in the development of DNA-based biosensors for molecular diagnostics.

Involvement of Dactylonectria and Ilyonectria spp. in tree decline affecting multigeneration apple orchards

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This study examined the etiology of typical replant disease symptom development, including growth reduction and leaf chlorosis, that was limited to specific foci within three multi-generation apple orchards that overall demonstrated optimal growth and good quality standard production. In bioassays c...

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

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Weirong Yan

Full Text Available BACKGROUND: Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. OBJECTIVE: This study describes the design and pilot implementation of an electronic surveillance system (ISS for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. METHODS: ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP, combining with modern communication and GIS technology. ISS has four interconnected functions: 1 work group and communication group; 2 data source and collection; 3 data visualization; and 4 outbreak detection and alerting. RESULTS: As of Jan. 31(st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. CONCLUSIONS: The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

SAGES: a suite of freely-available software tools for electronic disease surveillance in resource-limited settings.

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Sheri L Lewis

Full Text Available Public health surveillance is undergoing a revolution driven by advances in the field of information technology. Many countries have experienced vast improvements in the collection, ingestion, analysis, visualization, and dissemination of public health data. Resource-limited countries have lagged behind due to challenges in information technology infrastructure, public health resources, and the costs of proprietary software. The Suite for Automated Global Electronic bioSurveillance (SAGES is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings. One or more SAGES tools may be used in concert with existing surveillance applications or the SAGES tools may be used en masse for an end-to-end biosurveillance capability. This flexibility allows for the development of an inexpensive, customized, and sustainable disease surveillance system. The ability to rapidly assess anomalous disease activity may lead to more efficient use of limited resources and better compliance with World Health Organization International Health Regulations.

Deciphering potential mechanisms of anaerobic soil disinfestation (ASD)-mediated control of Pratylenchus penetrans

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Pratylenchus penetrans is a component of the apple replant disease (ARD) causal pathogen complex. The potential role for biological mechanisms contributing to ASD-mediated suppression of P. penetrans was examined in greenhouse study using orchard soil with a history of ARD. Populations of P. penetra...

Leveraging electronic health records to support chronic disease management: the need for temporal data views.

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Samal, Lipika; Wright, Adam; Wong, Bang T; Linder, Jeffrey A; Bates, David W

2011-01-01

The ageing population worldwide is increasingly acquiring multiple chronic diseases. The complex management of chronic diseases could be improved with electronic health records (EHRs) tailored to chronic disease care, but most EHRs in use today do not adequately support longitudinal data management. A key aspect of chronic disease management is that it takes place over long periods, but the way that most EHRs display longitudinal data makes it difficult to trend changes over time and slows providers as they review each patient's unique course. We present five clinical scenarios illustrating longitudinal data needs in complex chronic disease management. These scenarios may function as example cases for software development. For each scenario, we describe and illustrate improvements in temporal data views. Two potential solutions are visualisation for numerical data and disease-oriented text summaries for non-numerical data. We believe that development and widespread implementation of improved temporal data views in EHRs will improve the efficiency and quality of chronic disease management in primary care.

Initial experience with hand replantation after traumatic amputation in a nonspecialized center Experiência inicial com reimplante de mão após amputação traumática em um centro não-especializado

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Cleinaldo de Almeida Costa

2006-12-01

Full Text Available Traumatic amputation of the hand is an incapacitating injury, requiring skilled surgical care. Achieving functional recovery in addition to salvage of the amputated extremity should be the goal of the patient care team, after the life of the patient is secured. This is a report of the first five cases of hand replantation after complete traumatic amputation in Manaus (Amazonas, Brazil, carried out at Hospital Pronto-Socorro Dr. João Lúcio Pereira Machado. The patients were all young males, mean age of 22.8 years, presenting at the emergency room with complete sharp amputation of the hand. After initial procedures according to the ATLS® protocol, the following surgical actions were taken: heparinization of the blood vessels of the amputated extremity, fixation of the bones, wide opening of the carpal tunnel, primary vascular anastomoses and repair of nerves and tendons. In four cases, viability and partial functional recovery of the replanted hands were achieved. The unsuccessful case was due to extensive venous thrombosis.Through this preliminary experience, we can state that hand replantation can be performed successfully in a nonspecialized hospital and that optimal results depend on adequate prehospital care, multidisciplinary surgical treatment and careful postoperative assistance.A amputação traumática de mão é uma lesão incapacitante, requerendo tratamento cirúrgico hábil. Alcançar recuperação funcional além de salvar a extremidade amputada deve ser o objetivo da equipe médica, depois de resguardada a vida do paciente. Este é o relato dos cinco primeiros casos de reimplante de mão após amputações traumáticas completas na cidade de Manaus (AM, realizados no Hospital Pronto-Socorro Dr. João Lúcio Pereira Machado. Todos os pacientes eram homens jovens, média das idades de 22,8 anos, sendo admitidos na sala de emergência com amputação completa da mão por trauma inciso. Após medidas iniciais de acordo com o

Effects of arbuscular mycorrhizae on microbial population and ...

African Journals Online (AJOL)

Arbuscular mycorrhizal (AM) fungi are ubiquitous fungi distributed widely in soil ecosystems. It has been showed that AM fungi play an important role in improving soil nutrition and enhancing crop disease resistance, which have great application potentials in overcoming crop replant problems. In order to evaluate the effects ...

Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.

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Newman, Eric D; Lerch, Virginia; Billet, Jon; Berger, Andrea; Kirchner, H Lester

2015-04-01

Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software. The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception. Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted. We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated. Copyright © 2015 by the American College of Rheumatology.

Electron/photon matched field technique for treatment of orbital disease

International Nuclear Information System (INIS)

Arthur, Douglas W.; Zwicker, Robert D.; Garmon, Pamela W.; Huang, David T.; Schmidt-Ullrich, Rupert K.

1997-01-01

Purpose: A number of approaches have been described in the literature for irradiation of malignant and benign diseases of the orbit. Techniques described to date do not deliver a homogeneous dose to the orbital contents while sparing the cornea and lens of excessive dose. This is a result of the geometry encountered in this region and the fact that the target volume, which includes the periorbital and retroorbital tissues but excludes the cornea, anterior chamber, and lens, cannot be readily accommodated by photon beams alone. To improve the dose distribution for these treatments, we have developed a technique that combines a low-energy electron field carefully matched with modified photon fields to achieve acceptable dose coverage and uniformity. Methods and Materials: An anterior electron field and a lateral photon field setup is used to encompass the target volume. Modification of these fields permits accurate matching as well as conformation of the dose distribution to the orbit. A flat-surfaced wax compensator assures uniform electron penetration across the field, and a sunken lead alloy eye block prevents excessive dose to the central structures of the anterior segment. The anterior edge of the photon field is modified by broadening the penumbra using a form of pseudodynamic collimation. Direct measurements using film and ion chamber dosimetry were used to study the characteristics of the fall-off region of the electron field and the penumbra of the photon fields. >From the data collected, the technique for accurate field matching and dose uniformity was generated. Results: The isodose curves produced with this treatment technique demonstrate homogeneous dose coverage of the orbit, including the paralenticular region, and sufficient dose sparing of the anterior segment. The posterior lens accumulates less than 40% of the prescribed dose, and the lateral aspect of the lens receives less than 30%. A dose variation in the match region of ±12% is confronted when

Technological Advances in Huanglongbing (HLB or Citrus Greening Disease Management

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Krishna Prasad Paudyal

2015-12-01

Full Text Available Huanglongbing (HLB, previously citrus greening disease, is the most destructive of citrus species causing major threat to the world citrus industry. The disease was reported from China in 1919 and now known to occur in more than 40 different countries of Asia, Africa, South and North America. Three species of gram negative bacterium namely Candidatus Liberibacter asiaticus, Candidatus Liberibacter africanus and Candidatus Liberibacter americanus are the casual organisms of HLB, respectively prevailing in the continent of Asia, Africa and South America. It is one of the most extensively researched subjects in citriculture world. HLB was detected in 2004 and 2005, respectively in San Paulo of Brazil and Florida of USA: the two leading citrus production hub of the world causing huge economic loss within 5 years of first detection. Since then research on HLB detection and management was further accelerated in American continents. This paper presents the scientific advancement made on detection, spread, economic losses caused by HLB in different parts of the world and controlling management strategies. Remarkable achievements have been made on HLB detection techniques including iodine test, qPCR and more recently in spectroscopy. While efforts are being made to develop resistance varieties using conventional and biotechnological tools management strategy which includes reduction of inoculums source, vector control and replant with disease-free planting materials still remains major option for HLB control. Citrus intercropping with guava have shown promising results for vector reduction.

Early and late scanning electron microscopy findings in diabetic kidney disease.

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Conti, Sara; Perico, Norberto; Novelli, Rubina; Carrara, Camillo; Benigni, Ariela; Remuzzi, Giuseppe

2018-03-20

Diabetic nephropathy (DN), the single strongest predictor of mortality in patients with type 2 diabetes, is characterized by initial glomerular hyperfiltration with subsequent progressive renal function loss with or without albuminuria, greatly accelerated with the onset of overt proteinuria. Experimental and clinical studies have convincingly shown that early interventions retard disease progression, while treatment if started late in the disease course seldom modifies the slope of GFR decline. Here we assessed whether the negligible renoprotection afforded by drugs in patients with proteinuric DN could be due to loss of glomerular structural integrity, explored by scanning electron microscopy (SEM). In diabetic patients with early renal disease, glomerular structural integrity was largely preserved. At variance SEM documented that in the late stage of proteinuric DN, glomerular structure was subverted with nearly complete loss of podocytes and lobular transformation of the glomerular basement membrane. In these circumstances one can reasonably imply that any form of treatment, albeit personalized, is unlikely to reach a given cellular or molecular target. These findings should persuade physicians to start the putative renoprotective therapy soon after the diagnosis of diabetes or in an early phase of the disease before structural integrity of the glomerular filter is irreversibly compromised.

Project and construction of energy degrading and scattering plates for electron beam radiotherapy for skin diseases

International Nuclear Information System (INIS)

Fonseca, Gabriel Paiva

2010-01-01

There are many radiosensitive epidermotropics diseases such as mycosis fungo-ids and the syndrome of Sezary, coetaneous neoplasics originated from type T lymphocytes. Several studies indicate the eradication of the disease when treated with linear accelerators emitting electron beams with energies between 4 to 10 MeV. However, this treatment technique presents innumerable technical challenges since the disease in general reaches all patient's body, becoming necessary not only a very large field size radiation beam, but also deliver superficial doses limited to the skin depth. To reach the uniformity in the dose distribution, many techniques had already been developed. Based on these previous studies and guided by the report no. 23 of the American Association of Physicists in Medi-cine (AAPM), the present study developed an energy scattering and degrading plates and made dosimetry (computational and experimental), supplying subsidies for a future installation of Total Skin Electron Therapy (TSET) at the Servico de Radioterapia do Hospital das Clinicas de Sao Paulo. As part of the plates design, first of all, the energy spectrum of the 6 MeV electron beam of the VARIAN 2100C accelerator was reconstructed through Monte Carlo simulations using the MCNP4C code and based on experimental data. Once the spectrum is built, several materials were analyzed for the plates design based on radial and axial dose distribution, production of rays-x and dose attenuation. The simulation results were validated by experimental measurements in order to obtain a large field of radiation with 200 cm x 80 cm that meets the specifications of the AAPM protocol. (author)

Electronic health records and disease registries to support integrated care in a health neighbourhood: an ontology-based methodology.

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Liaw, Siaw-Teng; Taggart, Jane; Yu, Hairong; Rahimi, Alireza

2014-01-01

Disease registries derived from Electronic Health Records (EHRs) are widely used for chronic disease management (CDM). However, unlike national registries which are specialised data collections, they are usually specific to an EHR or organization such as a medical home. We approached registries from the perspective of integrated care in a health neighbourhood, considering data quality issues such as semantic interoperability (consistency), accuracy, completeness and duplication. Our proposition is that a realist ontological approach is required to systematically and accurately identify patients in an EHR or data repository of EHRs, assess intrinsic data quality and fitness for use by members of the multidisciplinary integrated care team. We report on this approach as applied to routinely collected data in an electronic practice based research network in Australia.

Mixture models for undiagnosed prevalent disease and interval-censored incident disease: applications to a cohort assembled from electronic health records.

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Cheung, Li C; Pan, Qing; Hyun, Noorie; Schiffman, Mark; Fetterman, Barbara; Castle, Philip E; Lorey, Thomas; Katki, Hormuzd A

2017-09-30

For cost-effectiveness and efficiency, many large-scale general-purpose cohort studies are being assembled within large health-care providers who use electronic health records. Two key features of such data are that incident disease is interval-censored between irregular visits and there can be pre-existing (prevalent) disease. Because prevalent disease is not always immediately diagnosed, some disease diagnosed at later visits are actually undiagnosed prevalent disease. We consider prevalent disease as a point mass at time zero for clinical applications where there is no interest in time of prevalent disease onset. We demonstrate that the naive Kaplan-Meier cumulative risk estimator underestimates risks at early time points and overestimates later risks. We propose a general family of mixture models for undiagnosed prevalent disease and interval-censored incident disease that we call prevalence-incidence models. Parameters for parametric prevalence-incidence models, such as the logistic regression and Weibull survival (logistic-Weibull) model, are estimated by direct likelihood maximization or by EM algorithm. Non-parametric methods are proposed to calculate cumulative risks for cases without covariates. We compare naive Kaplan-Meier, logistic-Weibull, and non-parametric estimates of cumulative risk in the cervical cancer screening program at Kaiser Permanente Northern California. Kaplan-Meier provided poor estimates while the logistic-Weibull model was a close fit to the non-parametric. Our findings support our use of logistic-Weibull models to develop the risk estimates that underlie current US risk-based cervical cancer screening guidelines. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Experimental studies on the treatment of traumatic dental avulsion in dogs

International Nuclear Information System (INIS)

Borissov, I.; Lazarova, L.

2001-01-01

The experiments were performed on 7 dogs aged between 2 and 4 years weighing 12-16 kg in the period October 1998- January 2000. After anaesthesia, the following dental procedures were accomplished; performance of a dental avulsion, endodontic treatment, apical dentotomy, tooth replantation and fixation with an orthodontic splint, figure-of-eight wire ligature and photopolymer. The treatment was effective in 71.4% of experimental replantations of incisors and the replanted teeth persisted for more than 8-9 months. The radiological survey showed that the regeneration began as early as the first post replantation days. In the period between days 30-45, a bone bridging was observed and the regeneration was complete by the end of the second month

High-resolution analytical imaging and electron holography of magnetite particles in amyloid cores of Alzheimer’s disease

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Plascencia-Villa, Germán; Ponce, Arturo; Collingwood, Joanna F.; Arellano-Jiménez, M. Josefina; Zhu, Xiongwei; Rogers, Jack T.; Betancourt, Israel; José-Yacamán, Miguel; Perry, George

2016-01-01

Abnormal accumulation of brain metals is a key feature of Alzheimer’s disease (AD). Formation of amyloid-β plaque cores (APC) is related to interactions with biometals, especially Fe, Cu and Zn, but their particular structural associations and roles remain unclear. Using an integrative set of advanced transmission electron microscopy (TEM) techniques, including spherical aberration-corrected scanning transmission electron microscopy (Cs-STEM), nano-beam electron diffraction, electron holography and analytical spectroscopy techniques (EDX and EELS), we demonstrate that Fe in APC is present as iron oxide (Fe3O4) magnetite nanoparticles. Here we show that Fe was accumulated primarily as nanostructured particles within APC, whereas Cu and Zn were distributed through the amyloid fibers. Remarkably, these highly organized crystalline magnetite nanostructures directly bound into fibrillar Aβ showed characteristic superparamagnetic responses with saturated magnetization with circular contours, as observed for the first time by off-axis electron holography of nanometer scale particles. PMID:27121137

Role of Mitochondrial Reverse Electron Transport in ROS Signaling: Potential Roles in Health and Disease

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Filippo Scialò

2017-06-01

Full Text Available Reactive Oxygen Species (ROS can cause oxidative damage and have been proposed to be the main cause of aging and age-related diseases including cancer, diabetes and Parkinson's disease. Accordingly, mitochondria from old individuals have higher levels of ROS. However, ROS also participate in cellular signaling, are instrumental for several physiological processes and boosting ROS levels in model organisms extends lifespan. The current consensus is that low levels of ROS are beneficial, facilitating adaptation to stress via signaling, whereas high levels of ROS are deleterious because they trigger oxidative stress. Based on this model the amount of ROS should determine the physiological effect. However, recent data suggests that the site at which ROS are generated is also instrumental in determining effects on cellular homeostasis. The best example of site-specific ROS signaling is reverse electron transport (RET. RET is produced when electrons from ubiquinol are transferred back to respiratory complex I, reducing NAD+ to NADH. This process generates a significant amount of ROS. RET has been shown to be instrumental for the activation of macrophages in response to bacterial infection, re-organization of the electron transport chain in response to changes in energy supply and adaptation of the carotid body to changes in oxygen levels. In Drosophila melanogaster, stimulating RET extends lifespan. Here, we review what is known about RET, as an example of site-specific ROS signaling, and its implications for the field of redox biology.

Open source electronic health records and chronic disease management.

Science.gov (United States)

Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

2014-02-01

To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC.

Detection of coronary calcium with electron beam tomography in coronary artery disease

International Nuclear Information System (INIS)

Haberl, R.; Knez, A.; Becker, A.; Becker, C.; Bruening, R.; Reiser, M.; Maass, A.; Steinbeck, G.

1998-01-01

Purpose: Coronary calcium is a powerful indicator of arteriosclerosis and can be detected very precisely with electron beam tomography. The method can be applied in patients with known coronary artery disease or in asymptomatic patients at risk of arteriosclerotic disease. Results: At the University of Munich we performed an EBT scan of the heart in 1100 patients within the last year. In 567 patients coronary angiography was performed also (±3 days). Confirming previous reports in the literature, we found a correlation of the calcium score with the age and gender of the patients. Severe coronary artery disease (stenoses ≥ 75%) was associated with significantly more calcium than less severe CAD. The calcium score did not discriminate between one-, two- and three-vessel disease. The site of calcification does not correlate with the localization of stenoses. Thirty-three percent of the patients with significant coronary artery disease showed a normal age-adjusted calcium score; a total of 8.1% of patients with severe stenoses did not reveal any coronary calcification (score =0). With asymptomatic patients there are only a few studies available. Soft plaques cannot be detected with EBT, but in most patients soft plaques occur together with hard plaques. Our results show that spiral CT of the newest generation may also be used for calcium screening. There was an excellent correlation of the calcium scores of EBT and spiral CT at all levels of calcification. Discussion: Coronary calcium is a sensitive marker of coronary artery disease. In the clinical setting EBT is indicated in patients with known coronary artery disease (to evaluate prognosis), in patients who are unable to perform a stress test, and in patients with atypical chest pain. However, lack of calcification may be associated with severe stenoses in a minority of patients. The clinical value in asymptomatic patients needs to be defined: Randomized studies are necessary. We see a possible indication in

[THE CHARACTERISTICS OF MORPHOLOGY OF BIOFILM OF PERIODONTIUM UNDER INFLAMMATORY DISEASES OF GUMS (CHRONIC CATARRHAL GINGIVITIS, CHRONIC PERIODONTITIS, CANDIDA-ASSOCIATED PERIODONTITIS) ACCORDING RESULTS OF ELECTRONIC MICROSCOPY].

Science.gov (United States)

Ippolitov, E V; Didenko, L V; Tzarev, V N

2015-12-01

The study was carried out to analyze morphology of biofilm of periodontium and to develop electronic microscopic criteria of differentiated diagnostic of inflammatory diseases of gums. The scanning electronic microscopy was applied to analyze samples of bioflm of periodont from 70 patients. Including ten patients with every nosologic form of groups with chronic catarrhal periodontitis. of light, mean and severe degree, chronic catarrhal gingivitis, Candida-associated paroperiodontitis and 20 healthy persons with intact periodontium. The analysis was implemented using dual-beam scanning electronic microscope Quanta 200 3D (FEI company, USA) and walk-through electronic micJEM 100B (JEOL, Japan). To detect marker DNA of periodont pathogenic bacteria in analyzed samples the kit of reagentsfor polymerase chain reaction "MultiDent-5" ("GenLab", Russia). The scanning electronic microscopy in combination with transmission electronic microscopy and polymerase chain reaction permits analyzing structure, composition and degree of development of biofilm of periodontium and to apply differentiated diagnostic of different nosologic forms of inflammatory diseases of periodontium, including light form of chronic periodontitis and gingivitis. The electronic microscopical indications of diseases ofperiodontium of inflammatory character are established: catarrhal gingivitis, (coccal morphological alternate), chronic periodontitis (bacillary morphological alternate), Candida-associated periodontitis (Candida morphological alternate of biofilm ofperiodontium).

Coronary artery disease risk assessment from unstructured electronic health records using text mining.

Science.gov (United States)

Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

2015-12-01

Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD. Copyright © 2015 Elsevier Inc. All rights reserved.

Real-time monitoring of school absenteeism to enhance disease surveillance: a pilot study of a mobile electronic reporting system.

Science.gov (United States)

Lawpoolsri, Saranath; Khamsiriwatchara, Amnat; Liulark, Wongwat; Taweeseneepitch, Komchaluch; Sangvichean, Aumnuyphan; Thongprarong, Wiraporn; Kaewkungwal, Jaranit; Singhasivanon, Pratap

2014-05-12

School absenteeism is a common source of data used in syndromic surveillance, which can eventually be used for early outbreak detection. However, the absenteeism reporting system in most schools, especially in developing countries, relies on a paper-based method that limits its use for disease surveillance or outbreak detection. The objective of this study was to develop an electronic real-time reporting system on school absenteeism for syndromic surveillance. An electronic (Web-based) school absenteeism reporting system was developed to embed it within the normal routine process of absenteeism reporting. This electronic system allowed teachers to update students' attendance status via mobile tablets. The data from all classes and schools were then automatically sent to a centralized database for further analysis and presentation, and for monitoring temporal and spatial patterns of absent students. In addition, the system also had a disease investigation module, which provided a link between absenteeism data from schools and local health centers, to investigate causes of fever among sick students. The electronic school absenteeism reporting system was implemented in 7 primary schools in Bangkok, Thailand, with total participation of approximately 5000 students. During May-October 2012 (first semester), the percentage of absentees varied between 1% and 10%. The peak of school absenteeism (sick leave) was observed between July and September 2012, which coincided with the peak of dengue cases in children aged 6-12 years being reported to the disease surveillance system. The timeliness of a reporting system is a critical function in any surveillance system. Web-based application and mobile technology can potentially enhance the use of school absenteeism data for syndromic surveillance and outbreak detection. This study presents the factors that determine the implementation success of this reporting system.

Retrospective Review of Air Transportation Use for Upper Extremity Amputations at a Level-1 Trauma Center.

Science.gov (United States)

Grantham, W Jeffrey; To, Philip; Watson, Jeffry T; Brywczynski, Jeremy; Lee, Donald H

2016-08-01

Air transportation to tertiary care centers of patients with upper extremity amputations has been utilized in hopes of reducing the time to potential replantation; however, this mode of transportation is expensive and not all patients will undergo replantation. The purpose of this study is to review the appropriateness and cost of air transportation in upper extremity amputations. Consecutive patients transported by aircraft with upper extremity amputations in a 7-year period at a level-1 trauma center were retrospectively reviewed. The distance traveled was recorded, along with the times of the injury, referral, transportation duration, arrival, and start of the operation. The results of the transfer were defined as replantation or revision amputation. Overall, 47 patients were identified with 43 patients going to the operating room, but only 14 patients (30%) undergoing replantation. Patients arrived at the tertiary hand surgery center with a mean time of 182.3 minutes following the injury, which includes 105.2 minutes of transportation time. The average distance traveled was 105.4 miles (range, 22-353 miles). The time before surgery of those who underwent replantation was 154.6 minutes. The average cost of transportation was $20,482. Air transportation for isolated upper extremity amputations is costly and is not usually the determining factor for replantation. The type of injury and patients' expectations often dictate the outcome, and these may be better determined at the time of referral with use of telecommunication photos, discussion with a hand surgeon, and patient counseling. III.

A Baseline Measure of Tree and Gastropod Biodiversity in Replanted and Natural Mangrove Stands in Malaysia: Langkawi Island and Sungai Merbok

Science.gov (United States)

Hookham, Brenda; Shau-Hwai, Aileen Tan; Dayrat, Benoit; Hintz, William

2014-01-01

The diversities of mangrove trees and of their associated gastropods were assessed for two mangrove regions on the west coast of Peninsular Malaysia: Langkawi Island and Sungai Merbok. The mangrove area sampled on Langkawi Island was recently logged and replanted, whereas the area sampled in Sungai Merbok was part of a protected nature reserve. Mangrove and gastropod diversity were assessed in four 50 m2 (10 × 5 m) sites per region. The species richness (S), Shannon Index (H’) and Evenness Index (J’) were calculated for each site, and the mean S, H’ and J’ values were calculated for each region. We report low tree and gastropod S, H’ and J’ values in all sites from both regions. For Langkawi Island, the mean S, H’ and J’ values for mangrove trees were S = 2.00±0, H’ = 0.44±0.17 and J’ = 0.44±0.17; the mean S, H’ and J’ values for gastropods were S = 4.00±1.63, H’ = 0.96±0.41 and J’ = 0.49±0.06. In Sungai Merbok, the mean S, H’ and J’ values for mangrove trees were S = 1.33±0.58, H’ = 0.22±0.39 and J’ = 0.22 ±0.39; the mean S, H’ and J’ values for gastropods were S = 4.75±2.22, H’ = 1.23±0.63 and J’ = 0.55±0.12. This study emphasises the need for baseline biodiversity measures to be established in mangrove ecosystems to track the impacts of anthropogenic disturbances and to inform management and restoration efforts. PMID:25210584

Automated Text Markup for Information Retrieval from an Electronic Textbook of Infectious Disease

Science.gov (United States)

Berrios, Daniel C.; Kehler, Andrew; Kim, David K.; Yu, Victor L.; Fagan, Lawrence M.

1998-01-01

The information needs of practicing clinicians frequently require textbook or journal searches. Making these sources available in electronic form improves the speed of these searches, but precision (i.e., the fraction of relevant to total documents retrieved) remains low. Improving the traditional keyword search by transforming search terms into canonical concepts does not improve search precision greatly. Kim et al. have designed and built a prototype system (MYCIN II) for computer-based information retrieval from a forthcoming electronic textbook of infectious disease. The system requires manual indexing by experts in the form of complex text markup. However, this mark-up process is time consuming (about 3 person-hours to generate, review, and transcribe the index for each of 218 chapters). We have designed and implemented a system to semiautomate the markup process. The system, information extraction for semiautomated indexing of documents (ISAID), uses query models and existing information-extraction tools to provide support for any user, including the author of the source material, to mark up tertiary information sources quickly and accurately.

Healthy and diseased striated muscle studied by analytical scanning electron microscopy with special reference to fibre type

International Nuclear Information System (INIS)

Wroblewski, R.

1982-01-01

X-ray microanalytical investigations of striated muscles in the scanning electron microscope are reviewed. The main part of the studies was performed on cryosections cut with a conventional cryostat operating at -20 degrees C to -40 degrees C. The preparation procedure including different types of attachment of the sections to the specimen holder is described in detail. The elemental changes in muscle are related to the muscle fibre type as demonstrated by histochemical methods or to histochemically demonstrated inclusions in diseased muscles. This is of great importance, because muscle disorders are often characterised by selective involvement of different muscle fibre types. The preparation methods of muscle for analytical scanning electron microscopy and the obtained results are compared with studies performed on thin cryo and epoxy sections, analysed in the transmission and scanning-transmission electron microscope. It is evident that X-ray microanalysis performed on thick cryosections provide a quick survey of the elemental composition of whole cells, and should be followed in interesting cases by close examination on the organelle level studied in thin cryosections in the transmission and scanning-transmission electron microscope

Automated electronic reminders to facilitate primary cardiovascular disease prevention: randomised controlled trial

Science.gov (United States)

Holt, Tim A; Thorogood, Margaret; Griffiths, Frances; Munday, Stephen; Friede, Tim; Stables, David

2010-01-01

Background Primary care databases contain cardiovascular disease risk factor data, but practical tools are required to improve identification of at-risk patients. Aim To test the effects of a system of electronic reminders (the ‘e-Nudge’) on cardiovascular events and the adequacy of data for cardiovascular risk estimation. Design of study Randomised controlled trial. Setting Nineteen general practices in the West Midlands, UK. Method The e-Nudge identifies four groups of patients aged over 50 years on the basis of estimated cardiovascular risk and adequacy of risk factor data in general practice computers. Screen messages highlight individuals at raised risk and prompt users to complete risk profiles where necessary. The proportion of the study population in the four groups was measured, as well as the rate of cardiovascular events in each arm after 2 years. Results Over 38 000 patients' electronic records were randomised. The intervention led to an increase in the proportion of patients with sufficient data who were identifiably at risk, with a difference of 1.94% compared to the control group (95% confidence interval [CI] = 1.38 to 2.50, P<0.001). A corresponding reduction occurred in the proportion potentially at risk but requiring further data for a risk estimation (difference = –3.68%, 95% CI = –4.53 to –2.84, P<0.001). No significant difference was observed in the incidence of cardiovascular events (rate ratio = 0.96, 95% CI = 0.85 to 1.10, P = 0.59). Conclusion Automated electronic reminders using routinely collected primary care data can improve the adequacy of cardiovascular risk factor information during everyday practice and increase the visibility of the at-risk population. PMID:20353659

Electron microscopy of Chytridiomycosis and the need to re-examine the disease from the gene to the cell

International Nuclear Information System (INIS)

Hyatt, A.; Siddon, N.; Speare, R.

2003-01-01

Full text: Over the past three decades there has been a global decline of amphibian populations. A variety of causative factors, including increased ultra violet radiation, habitat destruction and chemical pollution have been proposed; these, however, have not been correlated with all amphibian declines in the protected areas of Australia or overseas. During the past five years a network of electron microscopists, veterinary pathologists, molecular biologists and ecologists have been working on identifying the etiological agent. Examination of skin from a large number of dead and moribund frogs revealed 'a fungus belonging to the phylum Chytridiomycota and order Chytridiales. The fungus has been demonstrated to cause the disease chytridiomycosis which is now recognised as a fatal disease of amphibians and is the most common disease of Australian frogs. The fungus (Batrachochytrium dendrobatidis) was originally identified by electron microscopy, and is the only member of the Chytridiomycota that causes disease in vertebrates. The fungus has a broad amphibian host range and occurs worldwide. A total of 94 amphibian species from 15 families have been found infected with B. dendrobatidis, from Australia, South America, Central America, North America, Europe, New Zealand and Africa. Electron microscopy (transmission, scanning, immuno and cryo) provided pivotal information on pathogen identification and understanding of the life cycle of the organism. However, what light and electron microscopy has not been able to elucidate is the cause of death within the infected animals. Many veterinary pathologists have examined the 'pathology' of the disease but are unable to agree on the probable causes (physiological processes) associated with the death of the infected animals. Two hypotheses exist the chytrid irreversibly affects the osmoregulatory ability of the amphibians and the chytrid releases a toxin that over time leads to the death of the animals. The cause of death

[Optimising care structures for severe hand trauma and replantation and chances of launching a national network].

Science.gov (United States)

Haas, E M; Volkmer, E; Holzbach, T; Wallmichrath, J; Engelhardt, T O; Giunta, R E

2013-12-01

Severe hand traumata have a significant impact on our health system and on insurance companies, respectively. It is estimated that 33% of all occupational injuries and 9% of all invalidity pensions are due to severe hand trauma. Unfortunately, these high numbers are not only due to the severity of the trauma but to organisational deficiencies. Usually, the patient is treated at the general surgical emergency in the first place and only then forwarded to a microsurgeon. This redirection increases the time that is required for the patient to finally arrive at an expert for hand surgery. On the one hand, this problem can be explained by the population's lack of awareness for distinguished experts for hand and microsurgery, on the other hand, the emergency network, or emergency doctors in particular are not well informed about where to take a patient with a severe hand trauma - clearly a problem of communication between the hospitals and the ambulance. It is possible to tackle this problem, but put participating hand trauma centres have to work hand in hand as a network and thus exploit synergy effects. The French system "FESUM" is a good example for such a network and even comprises centres in Belgium and Switzerland. To improve the treatment of severe hand trauma, a similar alliance was initiated in Germany just recently. The pilot project "Hand Trauma Alliance" (www.handverletzung.com) was started in April 2013 and currently comprises two hospitals within the region of upper Bavaria. The network provides hand trauma replantation service on a 24/7 basis and aims at shortening the way from the accident site to the fully qualified hand surgeon, to improve the therapy of severe hand injuries and to optimise acute patient care in general. In order to further increase the alliance's impact it is intended to extend the project's scope from regional to national coverage - nevertheless, such an endeavour can only be done in collaboration with the German Society for Hand

Distal phalanx amputation with delayed presentation and successful reconstruction with reposition and flap after 2 weeks

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Jefferson Braga-Silva

2016-01-01

Full Text Available Traumatic finger amputations are common, causing significant functional and cosmetic deficits. Microsurgical replantation techniques are the mainstay of treatment for most such injuries although they require adequate conservation of the amputated segment for a successful result. In distal finger amputations, replantation is the procedure of choice, as long as the amputated fragment is viable. If replantation is not an option, reposition + flap using a neurovascular flap can be an efficient option, as this offers improved skin coverage. To the best of our knowledge, this case illustrates the longest cold ischaemic time with a successful outcome.

Continuous Infraclavicular Block for Forearm Amputation After Being Bitten by a Saltwater Crocodile (Crocodylus Porosus: A Case Report

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Chin-Hsi Chiu

2009-08-01

Full Text Available Two important issues after a complete right forearm amputation are replantation and ongoing pain management. There are no reports of successful forearm replantation as a consequence of a crocodile bite. Here, we discuss our pain management in a case of complete forearm amputation after a bite from a saltwater crocodile (Crocodylus porosus, which necessitated six further operations to achieve successful replantation. Continuous infraclavicular brachial plexus block was effective for acute pain control in this case. We strongly recommend performing the block with an indwelling catheter under ultrasound guidance for higher accuracy and safety.

First-principles calculation of structural and electronic properties of memantine (Alzheimer's disease) and adamantane (anti-flu) drugs

Science.gov (United States)

Middleton, Kirsten; Zhang, Guoping; George, Thomas F.

2012-02-01

Memantine is currently used as a treatment for mild to severe Alzheimer's disease, although its functionality is complicated. Using various density functional theory calculations and basis sets, we first examine memantine alone and then add ions which are present in the human body. This provides clues as to how the compound may react in the calcium ion channel, where it is believed to treat the disease. In order to understand the difference between calcium and magnesium ions interacting with memantine, we compute the electron affinity of each complex. We find that memantine is more strongly attracted to magnesium ions than calcium ions within the channel. By observing the HOMO-LUMO gap within memantine in comparison to adamantane, we find that memantine is more excitable than the anti-flu drug. We believe these factors to affect the efficiency of memantine as a treatment of Alzheimer's disease.

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats Reimplante dentário tardio após o tratamento da superfície radicular com hipoclorito de sódio e fluoreto de sódio: análise histomorfométrica em ratos

Directory of Open Access Journals (Sweden)

André Dotto Sottovia

2006-04-01

Full Text Available In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8, had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (pEm reimplante dentário tardio, o ligamento periodontal desvitalizado tem sido removido empregando-se o hipoclorito de sódio, buscando o controle da reabsorção radicular. Relatos de efeito irritante no tecido conjuntivo alveolar após o seu uso, têm sido descritos. Isso justificou a realização deste trabalho buscando minimizar esse inconveniente. Para isso 24 ratos, divididos em 3 grupos de 8 animais, tiveram o incisivo superior direito extra

A case of dorsal oblique fingertip amputation.

Science.gov (United States)

Takeda, Shinsuke; Tatebe, Masahiro; Morita, Akimasa; Yoneda, Hidemasa; Iwatsuki, Katsuyuki; Hirata, Hitoshi

2017-01-01

This study reports successful finger replantation in a patient with a dorsal oblique fingertip amputation. When repairing this unique type of injury, an evaluation of the remaining vessels is more useful for successful replantation than the anatomical zone classification. We propose that Kasai's classification is appropriate for guiding treatment.

A case of dorsal oblique fingertip amputation

OpenAIRE

Takeda, Shinsuke; Tatebe, Masahiro; Morita, Akimasa; Yoneda, Hidemasa; Iwatsuki, Katsuyuki; Hirata, Hitoshi

2017-01-01

Abstract This study reports successful finger replantation in a patient with a dorsal oblique fingertip amputation. When repairing this unique type of injury, an evaluation of the remaining vessels is more useful for successful replantation than the anatomical zone classification. We propose that Kasai?s classification is appropriate for guiding treatment.

Elemental analysis of occupational and environmental lung diseases by electron probe microanalyzer with wavelength dispersive spectrometer.

Science.gov (United States)

Takada, Toshinori; Moriyama, Hiroshi; Suzuki, Eiichi

2014-01-01

Occupational and environmental lung diseases are a group of pulmonary disorders caused by inhalation of harmful particles, mists, vapors or gases. Mineralogical analysis is not generally required in the diagnosis of most cases of these diseases. Apart from minerals that are encountered rarely or only in specific occupations, small quantities of mineral dusts are present in the healthy lung. As such when mineralogical analysis is required, quantitative or semi-quantitative methods must be employed. An electron probe microanalyzer with wavelength dispersive spectrometer (EPMA-WDS) enables analysis of human lung tissue for deposits of elements by both qualitative and semi-quantitative methods. Since 1993, we have analyzed 162 cases of suspected occupational and environmental lung diseases using an EPMA-WDS. Our institute has been accepting online requests for elemental analysis of lung tissue samples by EPMA-WDS since January 2011. Hard metal lung disease is an occupational interstitial lung disease that primarily affects workers exposed to the dust of tungsten carbide. The characteristic pathological findings of the disease are giant cell interstitial pneumonia (GIP) with centrilobular fibrosis, surrounded by mild alveolitis with giant cells within the alveolar space. EPMA-WDS analysis of biopsied lung tissue from patients with GIP has demonstrated that tungsten and/or cobalt is distributed in the giant cells and centrilobular fibrosing lesion in GIP. Pneumoconiosis, caused by amorphous silica, and acute interstitial pneumonia, associated with the giant tsunami, were also elementally analyzed by EPMA-WDS. The results suggest that commonly found elements, such as silicon, aluminum, and iron, may cause occupational and environmental lung diseases. Copyright © 2013 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Electronic Nose Technology and its Applications

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Esmaeil MAHMOUDI

2009-08-01

Full Text Available In the past decade, Electronic Nose instrumentation has generated much interest internationally for its potential to solve a wide variety of problems in fragrance and cosmetics production, food and beverages manufacturing, chemical engineering, environmental monitoring and more recently medical diagnostic, bioprocesses and clinical diagnostic plant diseases. This instrument measure electrical resistance changes generated by adsorption of volatiles to the surface of electro active- polymer coated sensor- unique digital electronic fingerprint of aroma derived from multi-sensor- responses to distinct mixture of microbial volatiles. Major advances in information and gas sensor technology could enhance the diagnostic power of future bio-electronic nose and facilitate global surveillance mode of disease control and management. Several dozen companies are now designed and selling electronic nose units globally for a wide variety of expending markets. The present review includes principles of electronic nose technology, biosensor structure and applications of electronic nose in many fields.

7 CFR 457.140 - Dry pea crop insurance provisions.

Science.gov (United States)

2010-01-01

... of the Basic Provisions that limit the amount of a replant payment to the actual cost of replanting... present that are identified by the Food and Drug Administration or other public health organizations of... feasible. We may obtain prices from any buyer of our choice. If we obtain prices from one or more buyers...

Treatment of fingertip amputation in adults by palmar pocketing of the amputated part.

Science.gov (United States)

Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam

2012-07-01

First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

Management of avulsed permanent maxillary central incisors during endotracheal intubation

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Ritesh R Kalaskar

2016-01-01

Full Text Available Avulsion is serious injury that may encounter during endotracheal intubation and its management often presents a challenge. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. The present article describes the management of air-dried maxillary permanent incisors that have been avulsed due to direct laryngoscopy during the induction of general anesthesia for tonsillectomy procedure. The replanted maxillary central incisors had maintained its function and esthetic for 1 year after replantation. Children in a mixed dentition phase are high-risk group children for traumatic dental injury during laryngoscopy; therefore, Anesthetic Departments should have local protocols to refer patients for dental treatment postoperatively in the event of trauma.

Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records.

Science.gov (United States)

Ingram, Maia; Doubleday, Kevin; Bell, Melanie L; Lohr, Abby; Murrieta, Lucy; Velasco, Maria; Blackburn, John; Sabo, Samantha; Guernsey de Zapien, Jill; Carvajal, Scott C

2017-10-01

To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes. Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact. Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.

Correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium scan

International Nuclear Information System (INIS)

Lee, Sang Hoon; Hong, Yong Kook; Park, Sung Il; Lee, Hyang Mee; Choe, Kyu Ok

1998-01-01

To determine the correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium(EBT CAC) scan and to measure the difference in calcium score according to symptoms. Materials and Methods : Fifty-six patients underwent EBT CAC scanning and either coronary angiography or stress thallium 201 scanning or the treadmill test. When the results were positive, coronary artery obstructive disease(CAOD) was assumed to be present. The patients were divided into three groups : symptomatic CAOD,asymptomatic CAOD, and asymptomatic non- CAOD; those with a previous history of myocardial ischemia or who showed positive results in any of the three tests relating to typical symptoms of angina were assigned to the symptomatic group. Results : The number of cases assigned to group to group 1,2 and 3 was 19, 16 and 21, respectively; total CAC scores were 571 ± 751, 600 ± 726 293± 401, respectively. The difference in CAC score between asymptomatic CAOD and asymptomatic non- CAOD was not statistically significant(p=0.079) but in asymptomatic CAOD, the score tended to be higher. The CAC score was not different between symptomatic and asymptomatic CAOD(p>0.1). When the CAC threshold was 1, sensitivity was 89% and specificity was 14%;when the threshold was 200, sensitivity was 60% and specificity was 67%. Conclusion : When the EBT CAC score is high, further evaluation provides early evidence of coronary artery obstructive disease

Feasibility of electron beam tomography in diagnosis of congenital heart disease: comparison with echocardiography

International Nuclear Information System (INIS)

Lee, Jongmin J.; Kang, Duk-Sik

2001-01-01

Objective: To evaluate the feasibility of electron beam tomography (EBT) for morphological assessment of congenital heart disease. Materials and methods: Sixteen subjects were examined by EBT, transthoracic echocardiography, cardiac cine angiography and surgery. EBT scan was performed using single slice continuous volume mode to acquire high-resolution static image. Double dose contrast medium was injected by bolus technique after measuring scan delay time and calculation of proper injection rate. The results of EBT and echocardiography were compared based on the results of cardiac cine angiography and surgical findings. All anomalous components were evaluated in all subjects and grouped according to major cardiac structures. Statistical analysis was performed to compare two modalities' ability to evaluate the anomalies of major structures. Results: EBT was more sensitive to evaluate the anomalies of systemic vessels, pulmonary vessels and small systemic arteries such as coronary artery. EBT was less sensitive to identify the abnormality of cardiac valves such as valvular regurgitation. There was no difference of sensitivity in evaluation of cardiac chambers and septa between the two modalities. Conclusion: EBT assisted by transthoracic echocardiography is excellent noninvasive modality to diagnose congenital heart disease

Pengaruh Pemberian Mikoriza Vesikula Arbuskula (MVA Campuran terhadap Kemunculan Penyakit Layu Fusarium pada Tanaman Melon (Cucumis melo L.

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Najmah Farhati

2017-09-01

Full Text Available Melon (Cucumis melo L. has economic potential to be cultivated because the fruit contains protein, fat, carbohydrate, calcium, phosphor, fiber, iron, vitamin A, vitamin B1, vitamin B2, vitamin C, and niacin. Fusarium wilt caused by Fusarium oxysporum will decrease melon crop production. One of controlling method to Fusarium wilt diseases on melon plants which safe for environtmental by using biological control. One of microorganisms which can be biological control agent is Vesicular Arbuscular Mycorrhiza (VAM. This research use experimental method with a Completely Randomized Design (CRD. The experimental treatment consists of two types of treatment which combine 5 doses of VAM mixture ( 0 g/plant, 10 g/plant, 12,5 g/plant, 15 g/plant, 17,5 g/plant and two inoculation method VAM is inoculated when seeds are planted and inoculation when the seedlings are replanted. Each treatment was repeated 3 times and each unit consist of three plant, so there are 30 units of experiments or 90 plants. The main variabels are observed consist of the incubation periode of the disease and the intensity of fusarium wilt and the supporting variabels consist of pH, temperature, humidity, and the scale of infection. The mixed MVA 15 g/plant dosage inoculated when seeds are planted and 15 g/plant dosage inoculated when the seedlings are replanted is the most effective to suppress incubation period of Fusarium wilt disease.

Identification of Ganoderma Disease Resistance Loci Using Natural Field Infection of an Oil Palm Multiparental Population

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Sébastien Tisné

2017-06-01

Full Text Available Multi-parental populations are promising tools for identifying quantitative disease resistance loci. Stem rot caused by Ganoderma boninense is a major threat to palm oil production, with yield losses of up to 80% prompting premature replantation of palms. There is evidence of genetic resistance sources, but the genetic architecture of Ganoderma resistance has not yet been investigated. This study aimed to identify Ganoderma resistance loci using an oil palm multi-parental population derived from nine major founders of ongoing breeding programs. A total of 1200 palm trees of the multi-parental population was planted in plots naturally infected by Ganoderma, and their health status was assessed biannually over 25 yr. The data were treated as survival data, and modeled using the Cox regression model, including a spatial effect to take the spatial component in the spread of Ganoderma into account. Based on the genotypes of 757 palm trees out of the 1200 planted, and on pedigree information, resistance loci were identified using a random effect with identity-by-descent kinship matrices as covariance matrices in the Cox model. Four Ganoderma resistance loci were identified, two controlling the occurrence of the first Ganoderma symptoms, and two the death of palm trees, while favorable haplotypes were identified among a major gene pool for ongoing breeding programs. This study implemented an efficient and flexible QTL mapping approach, and generated unique valuable information for the selection of oil palm varieties resistant to Ganoderma disease.

Identification of Ganoderma Disease Resistance Loci Using Natural Field Infection of an Oil Palm Multiparental Population

Science.gov (United States)

Tisné, Sébastien; Pomiès, Virginie; Riou, Virginie; Syahputra, Indra; Cochard, Benoît; Denis, Marie

2017-01-01

Multi-parental populations are promising tools for identifying quantitative disease resistance loci. Stem rot caused by Ganoderma boninense is a major threat to palm oil production, with yield losses of up to 80% prompting premature replantation of palms. There is evidence of genetic resistance sources, but the genetic architecture of Ganoderma resistance has not yet been investigated. This study aimed to identify Ganoderma resistance loci using an oil palm multi-parental population derived from nine major founders of ongoing breeding programs. A total of 1200 palm trees of the multi-parental population was planted in plots naturally infected by Ganoderma, and their health status was assessed biannually over 25 yr. The data were treated as survival data, and modeled using the Cox regression model, including a spatial effect to take the spatial component in the spread of Ganoderma into account. Based on the genotypes of 757 palm trees out of the 1200 planted, and on pedigree information, resistance loci were identified using a random effect with identity-by-descent kinship matrices as covariance matrices in the Cox model. Four Ganoderma resistance loci were identified, two controlling the occurrence of the first Ganoderma symptoms, and two the death of palm trees, while favorable haplotypes were identified among a major gene pool for ongoing breeding programs. This study implemented an efficient and flexible QTL mapping approach, and generated unique valuable information for the selection of oil palm varieties resistant to Ganoderma disease. PMID:28592650

Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach.

Science.gov (United States)

Lemmon, Joshua A; Janis, Jeffrey E; Rohrich, Rod J

2008-09-01

After studying this article, the participant should be able to: 1. Understand the anatomy of the fingertip. 2. Describe the methods of evaluating fingertip injuries. 3. Discuss reconstructive options for various tip injuries. The fingertip is the most commonly injured part of the hand, and therefore fingertip injuries are among the most frequent injuries that plastic surgeons are asked to treat. Although microsurgical techniques have enabled replantation of even very distal tip amputations, it is relatively uncommon that a distal tip injury will be appropriate for replantation. In the event that replantation is not pursued, options for distal tip soft-tissue reconstruction must be considered. This review presents a straightforward method for evaluating fingertip injuries and provides an algorithm for fingertip reconstruction.

Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data.

Science.gov (United States)

Widdifield, Jessica; Bernatsky, Sasha; Thorne, J Carter; Bombardier, Claire; Jaakkimainen, R Liisa; Wing, Laura; Paterson, J Michael; Ivers, Noah; Butt, Debra; Lyddiatt, Anne; Hofstetter, Catherine; Ahluwalia, Vandana; Tu, Karen

2016-01-01

The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care.

Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

Directory of Open Access Journals (Sweden)

Mi Sun Jung

2012-07-01

Full Text Available BackgroundFirst suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults.MethodsBetween 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm.ResultsOf a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results.ConclusionsA composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

Sites of infection by pythium species in rice seedlings and effects of plant age and water depth on disease development.

Science.gov (United States)

Chun, S C; Schneider, R W

1998-12-01

ABSTRACT Seedling disease, caused primarily by several species of Pythium, is one of the major constraints to water-seeded rice production in Louisiana. The disease, also known as water-mold disease, seed rot, and seedling damping-off, causes stand reductions and growth abnormalities. In severe cases, fields must be replanted, which may result in delayed harvests and reduced yields. To develop more effective disease management tactics including biological control, this study was conducted primarily to determine sites of infection in seeds and seedlings; effect of plant age on susceptibility to P. arrhenomanes, P. myriotylum, and P. dissotocum; and minimum exposure times required for infection and seedling death. In addition, the effect of water depth on seedling disease was investigated. Infection rates of seed embryos were significantly higher than those of endosperms for all three Pythium spp. The development of roots from dry-seeded seedlings was significantly reduced by P. arrhenomanes and P. myriotylum at 5 days after planting compared with that of roots from noninoculated controls. Susceptibility of rice to all three species was sharply reduced within 2 to 6 days after planting, and seedlings were completely resistant at 8 days after planting. There was a steep reduction in emergence through the flood water, relative to the noninoculated control, following 2 to 3 days of exposure to inoculum of P. arrhenomanes and P. myriotylum. In contrast, P. dissotocum was much less virulent and required longer exposure times to cause irreversible seedling damage. Disease incidence was higher when seeds were planted into deeper water, implying that seedlings become resistant after they emerge through the flood water. These results suggest that disease control tactics including flood water management need to be employed for a very short period of time after planting. Also, given that the embryo is the primary site of infection and it is susceptible for only a few days, the

Ectopic banking of amputated great toe for delayed thumb reconstruction: case report.

Science.gov (United States)

Valerio, Ian L; Hui-Chou, Helen G; Zelken, Jonathan; Basile, Patrick L; Ipsen, Derek; Higgins, James P

2014-07-01

Ectopic banking of amputated parts is a recognized technique for delayed replantation of an amputated part when the amputation stump will not permit immediate replantation. This is conventionally performed with the intent of transferring the injured part back to its anatomic position when the amputation stump is more appropriate for replantation. Current warfare conditions have led to a commonly encountered military trauma injury pattern of multiple extremity amputations with protected trunk and core structures. This pattern poses many challenges, including the limit or absence of donor sites for immediate or delayed flap reconstructive procedures. We describe a case in which we ectopically banked the great toe of an amputated lower extremity for delayed thumb reconstruction. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Survey of Pediatric Infectious Diseases Society Members About Congenital Chagas Disease.

Science.gov (United States)

Edwards, Morven S; Abanyie, Francisca A; Montgomery, Susan P

2018-01-01

Participants in a survey about congenital Chagas disease, distributed electronically to Pediatric Infectious Diseases Society members, perceived having limited knowledge about congenital Trypanosoma cruzi infection. Most rarely or never consider the diagnosis in infants born to parents from Latin America. Improved awareness of congenital Chagas disease and assessment of at-risk infants is needed.

Electronic tongue response to chemicals in orange juice that change concentration in relation to harvest maturity and citrus greening or Huanglongbing (HLB) disease

Science.gov (United States)

In an earlier study, the electronic tongue system (etongue) was used to differentiate between orange juice made from healthy fruit and from fruit affected by the citrus greening or Huanglongbing (HLB) disease. This study investigated the reaction of an etongue system to the main chemicals in orange ...

Coconut lethal yellowing diseases: a phytoplasma threat to palms of global economic and social significance

Directory of Open Access Journals (Sweden)

Gurr M Geoff

2016-10-01

Full Text Available The recent discovery of Bogia Coconut Syndrome in Papua New Guinea is the first report of a lethal yellowing disease (LYD in Oceania. Numerous outbreaks of LYDs of coconut have been recorded in the Caribbean and Africa since the late 19th century and have caused the death of millions of palms across several continents during the 20th century. Despite the severity of economic losses, it was only in the 1970s that the causes of LYDs were identified as phytoplasmas, a group of insect-transmitted bacteria associated with diseases in many other economically important crop species. Since the development of polymerase chain reaction (PCR technology, knowledge of LYDs epidemiology, ecology and vectors has grown rapidly. There is no economically viable treatment for LYDs and vector-based management is hampered by the fact that vectors have been positively identified in very few cases despite many attempted transmission trials. Some varieties and hybrids of coconut palm are known to be less susceptible to LYD but none are completely resistant. Optimal and current management of LYD is through strict quarantine, prompt detection and destruction of symptomatic palms, and replanting with less susceptible varieties or crop species. Advances in technology such as loop mediated isothermal amplification (LAMP for detection and tracking of phytoplasma DNA in plants and insects, remote sensing for identifying symptomatic palms, and the advent of clustered regularly interspaced short palindromic repeats (CRISPR-based tools for gene editing and plant breeding are likely to allow rapid progress in taxonomy as well as understanding and managing LYD phytoplasma pathosystems.

Coconut Lethal Yellowing Diseases: A Phytoplasma Threat to Palms of Global Economic and Social Significance.

Science.gov (United States)

Gurr, Geoff M; Johnson, Anne C; Ash, Gavin J; Wilson, Bree A L; Ero, Mark M; Pilotti, Carmel A; Dewhurst, Charles F; You, Minsheng S

2016-01-01

The recent discovery of Bogia coconut syndrome in Papua New Guinea (PNG) is the first report of a lethal yellowing disease (LYD) in Oceania. Numerous outbreaks of LYDs of coconut have been recorded in the Caribbean and Africa since the late Nineteenth century and have caused the death of millions of palms across several continents during the Twentieth century. Despite the severity of economic losses, it was only in the 1970s that the causes of LYDs were identified as phytoplasmas, a group of insect-transmitted bacteria associated with diseases in many other economically important crop species. Since the development of polymerase chain reaction (PCR) technology, knowledge of LYDs epidemiology, ecology and vectors has grown rapidly. There is no economically viable treatment for LYDs and vector-based management is hampered by the fact that vectors have been positively identified in very few cases despite many attempted transmission trials. Some varieties and hybrids of coconut palm are known to be less susceptible to LYD but none are completely resistant. Optimal and current management of LYD is through strict quarantine, prompt detection and destruction of symptomatic palms, and replanting with less susceptible varieties or crop species. Advances in technology such as loop mediated isothermal amplification (LAMP) for detection and tracking of phytoplasma DNA in plants and insects, remote sensing for identifying symptomatic palms, and the advent of clustered regularly interspaced short palindromic repeats (CRISPR)-based tools for gene editing and plant breeding are likely to allow rapid progress in taxonomy as well as understanding and managing LYD phytoplasma pathosystems.

Coconut Lethal Yellowing Diseases: A Phytoplasma Threat to Palms of Global Economic and Social Significance

Science.gov (United States)

Gurr, Geoff M.; Johnson, Anne C.; Ash, Gavin J.; Wilson, Bree A. L.; Ero, Mark M.; Pilotti, Carmel A.; Dewhurst, Charles F.; You, Minsheng S.

2016-01-01

The recent discovery of Bogia coconut syndrome in Papua New Guinea (PNG) is the first report of a lethal yellowing disease (LYD) in Oceania. Numerous outbreaks of LYDs of coconut have been recorded in the Caribbean and Africa since the late Nineteenth century and have caused the death of millions of palms across several continents during the Twentieth century. Despite the severity of economic losses, it was only in the 1970s that the causes of LYDs were identified as phytoplasmas, a group of insect-transmitted bacteria associated with diseases in many other economically important crop species. Since the development of polymerase chain reaction (PCR) technology, knowledge of LYDs epidemiology, ecology and vectors has grown rapidly. There is no economically viable treatment for LYDs and vector-based management is hampered by the fact that vectors have been positively identified in very few cases despite many attempted transmission trials. Some varieties and hybrids of coconut palm are known to be less susceptible to LYD but none are completely resistant. Optimal and current management of LYD is through strict quarantine, prompt detection and destruction of symptomatic palms, and replanting with less susceptible varieties or crop species. Advances in technology such as loop mediated isothermal amplification (LAMP) for detection and tracking of phytoplasma DNA in plants and insects, remote sensing for identifying symptomatic palms, and the advent of clustered regularly interspaced short palindromic repeats (CRISPR)-based tools for gene editing and plant breeding are likely to allow rapid progress in taxonomy as well as understanding and managing LYD phytoplasma pathosystems. PMID:27833616

Management of penile defects: a review.

Science.gov (United States)

Guizhong, Li; Feng, He; Guangling, Huang; Libo, Man; Kun, Liu; Yuming, Shen

2012-06-01

Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Text mining applied to electronic cardiovascular procedure reports to identify patients with trileaflet aortic stenosis and coronary artery disease.

Science.gov (United States)

Small, Aeron M; Kiss, Daniel H; Zlatsin, Yevgeny; Birtwell, David L; Williams, Heather; Guerraty, Marie A; Han, Yuchi; Anwaruddin, Saif; Holmes, John H; Chirinos, Julio A; Wilensky, Robert L; Giri, Jay; Rader, Daniel J

2017-08-01

Interrogation of the electronic health record (EHR) using billing codes as a surrogate for diagnoses of interest has been widely used for clinical research. However, the accuracy of this methodology is variable, as it reflects billing codes rather than severity of disease, and depends on the disease and the accuracy of the coding practitioner. Systematic application of text mining to the EHR has had variable success for the detection of cardiovascular phenotypes. We hypothesize that the application of text mining algorithms to cardiovascular procedure reports may be a superior method to identify patients with cardiovascular conditions of interest. We adapted the Oracle product Endeca, which utilizes text mining to identify terms of interest from a NoSQL-like database, for purposes of searching cardiovascular procedure reports and termed the tool "PennSeek". We imported 282,569 echocardiography reports representing 81,164 individuals and 27,205 cardiac catheterization reports representing 14,567 individuals from non-searchable databases into PennSeek. We then applied clinical criteria to these reports in PennSeek to identify patients with trileaflet aortic stenosis (TAS) and coronary artery disease (CAD). Accuracy of patient identification by text mining through PennSeek was compared with ICD-9 billing codes. Text mining identified 7115 patients with TAS and 9247 patients with CAD. ICD-9 codes identified 8272 patients with TAS and 6913 patients with CAD. 4346 patients with AS and 6024 patients with CAD were identified by both approaches. A randomly selected sample of 200-250 patients uniquely identified by text mining was compared with 200-250 patients uniquely identified by billing codes for both diseases. We demonstrate that text mining was superior, with a positive predictive value (PPV) of 0.95 compared to 0.53 by ICD-9 for TAS, and a PPV of 0.97 compared to 0.86 for CAD. These results highlight the superiority of text mining algorithms applied to electronic

Review of electron beam therapy physics

International Nuclear Information System (INIS)

Hogstrom, Kenneth R; Almond, Peter R

2006-01-01

For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)

Disease surveillance among newly arriving refugees and immigrants--Electronic Disease Notification System, United States, 2009.

Science.gov (United States)

Lee, Deborah; Philen, Rossanne; Wang, Zanju; McSpadden, Pamela; Posey, Drew L; Ortega, Luis S; Weinberg, Michelle S; Brown, Clive; Zhou, Weigong; Painter, John A

2013-11-15

Approximately 450,000 legal permanent immigrants and 75,000 refugees enter the United States annually after receiving required medical examinations by overseas panel physicians (physicians who follow the CDC medical screening guidelines provided to the U.S. Department of State). CDC has the regulatory responsibility for preventing the introduction, transmission, and spread of communicable diseases into the United States as well as for developing the guidelines, known as technical instructions, for the overseas medical examinations. Other conditions that are not infectious might preclude an immigrant or refugee from entering the United States and also are reported as part of the medical examination. After arrival in the United States, all refugees are recommended to obtain a medical assessment by a health-care provider or a health department within 30 days. In addition, immigrants with certain medical conditions such as noninfectious tuberculosis at the time of the original medical examination are recommended to be evaluated after arrival to ensure that appropriate prevention or treatment measures are instituted. Health departments need timely and accurate notifications of newly arriving immigrants, refugees, and persons with other visa types to facilitate these evaluations. Notifications for all newly arriving refugees (with or without medical conditions) and immigrants with medical conditions are provided by CDC's Electronic Disease Notification (EDN) system. This is the first report describing EDN. This report summarizes notifications by the EDN system during January-December 2009. The EDN system is a centralized electronic reporting system that collects health information on newly arriving refugees and immigrants with Class A and Class B medical conditions. Class A conditions render applicants inadmissible and require a waiver for entry; Class B conditions are admissible but might require treatment or follow-up. Information in the EDN system is used to notify

Using nationwide ‘big data’ from linked electronic health records to help improve outcomes in cardiovascular diseases:33 studies using methods from epidemiology, informatics, economics and social science in the ClinicAl disease research using LInked Bespoke studies and Electronic health Records (CALIBER) programme

OpenAIRE

Hemingway, Harry; Feder, Gene; Fitzpatrick, Natalie; Denaxas, Spiros; Shah, Amit; Timmis, A D

2017-01-01

BACKGROUND:Electronic health records (EHRs), when linked across primary and secondary care and curated for research use, have the potential to improve our understanding of care quality and outcomes.OBJECTIVE:To evaluate new opportunities arising from linked EHRs for improving quality of care and outcomes for patients at risk of or with coronary disease across the patient journey.DESIGN:Epidemiological cohort, health informatics, health economics and ethnographic approaches were used.SETTING:2...

Implementation of Indigenous Electronic Medical Record System to Facilitate Care of Sickle Cell Disease Patients in Chhattisgarh.

Science.gov (United States)

Choubey, Mona; Mishra, Hrishikesh; Soni, Khushboo; Patra, Pradeep Kumar

2016-02-01

Sickle cell disease (SCD) is prevalent in central India including Chhattisgarh. Screening for SCD is being carried out by Government of Chhattisgarh. Electronic Medical Record (EMR) system was developed and implemented in two phases. Aim was to use informatics techniques and indigenously develop EMR system to improve the care of SCD patients in Chhattisgarh. EMR systems had to be developed to store and manage: i) huge data generated through state wide screening for SCD; ii) clinical data for SCD patients attending the outpatient department (OPD) of institute. 'State Wide Screening Data Interface' (SWSDI) was designed and implemented for storing and managing data generated through screening program. Further, 'Sickle Cell Patients Temporal Data Management System' (SCPTDMS) was developed and implemented for storing, managing and analysing sickle cell disease patients' data at OPD. Both systems were developed using VB.Net and MS SQL Server 2012. Till April 2015, SWSDI has data of 1294558 persons, out of which 121819 and 4087 persons are carriers and patients of sickle cell disease respectively. Similarly till June 2015, SCPTDMS has data of 3760 persons, of which 923 are sickle cell disease patients (SS) and 1355 are sickle cell carriers (AS). Both systems are proving to be useful in efficient storage, management and analysis of data for clinical and research purposes. The systems are an example of beneficial usage of medical informatics solutions for managing large data at community level.

AN APPLICATION OF ELECTRONIC AMPLIFIER STETHOSCOPE

Directory of Open Access Journals (Sweden)

Alper KAÇAR

2014-05-01

Full Text Available Electronic stethoscopes are one of the important medical devices which affects the self-diagnostic or remote diagnostic in medical area. Rather the general stethoscopes, electronic ones increases the sound amplitude and quality. By filtering ambient noise, they can be used for advance analysis of heart or lung related diseases.

Identification of Ganoderma Disease Resistance Loci Using Natural Field Infection of an Oil Palm Multiparental Population.

Science.gov (United States)

Tisné, Sébastien; Pomiès, Virginie; Riou, Virginie; Syahputra, Indra; Cochard, Benoît; Denis, Marie

2017-06-07

Multi-parental populations are promising tools for identifying quantitative disease resistance loci. Stem rot caused by Ganoderma boninense is a major threat to palm oil production, with yield losses of up to 80% prompting premature replantation of palms. There is evidence of genetic resistance sources, but the genetic architecture of Ganoderma resistance has not yet been investigated. This study aimed to identify Ganoderma resistance loci using an oil palm multi-parental population derived from nine major founders of ongoing breeding programs. A total of 1200 palm trees of the multi-parental population was planted in plots naturally infected by Ganoderma , and their health status was assessed biannually over 25 yr. The data were treated as survival data, and modeled using the Cox regression model, including a spatial effect to take the spatial component in the spread of Ganoderma into account. Based on the genotypes of 757 palm trees out of the 1200 planted, and on pedigree information, resistance loci were identified using a random effect with identity-by-descent kinship matrices as covariance matrices in the Cox model. Four Ganoderma resistance loci were identified, two controlling the occurrence of the first Ganoderma symptoms, and two the death of palm trees, while favorable haplotypes were identified among a major gene pool for ongoing breeding programs. This study implemented an efficient and flexible QTL mapping approach, and generated unique valuable information for the selection of oil palm varieties resistant to Ganoderma disease. Copyright © 2017 Tisné et al.

Predicting changes in hypertension control using electronic health records from a chronic disease management program.

Science.gov (United States)

Sun, Jimeng; McNaughton, Candace D; Zhang, Ping; Perer, Adam; Gkoulalas-Divanis, Aris; Denny, Joshua C; Kirby, Jacqueline; Lasko, Thomas; Saip, Alexander; Malin, Bradley A

2014-01-01

Common chronic diseases such as hypertension are costly and difficult to manage. Our ultimate goal is to use data from electronic health records to predict the risk and timing of deterioration in hypertension control. Towards this goal, this work predicts the transition points at which hypertension is brought into, as well as pushed out of, control. In a cohort of 1294 patients with hypertension enrolled in a chronic disease management program at the Vanderbilt University Medical Center, patients are modeled as an array of features derived from the clinical domain over time, which are distilled into a core set using an information gain criteria regarding their predictive performance. A model for transition point prediction was then computed using a random forest classifier. The most predictive features for transitions in hypertension control status included hypertension assessment patterns, comorbid diagnoses, procedures and medication history. The final random forest model achieved a c-statistic of 0.836 (95% CI 0.830 to 0.842) and an accuracy of 0.773 (95% CI 0.766 to 0.780). This study achieved accurate prediction of transition points of hypertension control status, an important first step in the long-term goal of developing personalized hypertension management plans.

Predicting changes in hypertension control using electronic health records from a chronic disease management program

Science.gov (United States)

Sun, Jimeng; McNaughton, Candace D; Zhang, Ping; Perer, Adam; Gkoulalas-Divanis, Aris; Denny, Joshua C; Kirby, Jacqueline; Lasko, Thomas; Saip, Alexander; Malin, Bradley A

2014-01-01

Objective Common chronic diseases such as hypertension are costly and difficult to manage. Our ultimate goal is to use data from electronic health records to predict the risk and timing of deterioration in hypertension control. Towards this goal, this work predicts the transition points at which hypertension is brought into, as well as pushed out of, control. Method In a cohort of 1294 patients with hypertension enrolled in a chronic disease management program at the Vanderbilt University Medical Center, patients are modeled as an array of features derived from the clinical domain over time, which are distilled into a core set using an information gain criteria regarding their predictive performance. A model for transition point prediction was then computed using a random forest classifier. Results The most predictive features for transitions in hypertension control status included hypertension assessment patterns, comorbid diagnoses, procedures and medication history. The final random forest model achieved a c-statistic of 0.836 (95% CI 0.830 to 0.842) and an accuracy of 0.773 (95% CI 0.766 to 0.780). Conclusions This study achieved accurate prediction of transition points of hypertension control status, an important first step in the long-term goal of developing personalized hypertension management plans. PMID:24045907

Electronic beam CT diagnosis of infant congenital heart disease with the comparison of echocardiogram and operation

International Nuclear Information System (INIS)

Li Xiangmin; Zhou Xuhui; Yang Youyou; Meng Quanfei; Peng Qian; Tan Zhiyu

2003-01-01

Objective: To explore the advantage and limitation in the diagnosis of infant congenital heart disease (CHD) by electron beam computed tomography (EBCT). Methods: Eighty patients suspected or diagnosed as infant CHD underwent dynamic contrast enhanced EBCT imaging. EBCT imaging was carried out in two steps: single slice mode scanning and multiple slice mode scanning. The EBCT results of 80 cases were correlated with echocardiogram and operation records. 39 cases were confirmed by surgery. Chi-Square test was used for statistical analysis. Results: Among 80 patients, there were 27 cases in non-cyanosis and 53 cases in cyanosis. In this group including 16 types of CHD, 206 malformations were revealed with EBCT while 159 abnormalities with echocardiogram. 101 lesions were proved by surgery, which demonstrated a diagnosis accuracy of 96% (97/101) with EBCT, and 87% (88/101) with echocardiogram. A statistical significant difference was observed between the two methods (χ 2 =6.231, P<0.01). Conclusion: EBCT scanning can demonstrate the pathological morphology of CHD, especially, EBCT is helpful in the sequential segmental analysis in complex CHD. It is better than echocardiogram in demonstrating the aortic congenital disease and pulmonary artery development and anomalous pulmonary venous drainage

Clinical implementation of total skin electron irradiation treatment with a 6 MeV electron beam in high-dose total skin electron mode

International Nuclear Information System (INIS)

Lucero, J. F.; Rojas, J. I.

2016-01-01

Total skin electron irradiation (TSEI) is a special treatment technique offered by modern radiation oncology facilities, given for the treatment of mycosis fungoides, a rare skin disease, which is type of cutaneous T-cell lymphoma [1]. During treatment the patient’s entire skin is irradiated with a uniform dose. The aim of this work is to present implementation of total skin electron irradiation treatment using IAEA TRS-398 code of practice for absolute dosimetry and taking advantage of the use of radiochromic films.

Clinical implementation of total skin electron irradiation treatment with a 6 MeV electron beam in high-dose total skin electron mode

Energy Technology Data Exchange (ETDEWEB)

Lucero, J. F., E-mail: fernando.lucero@hoperadiotherapy.com.gt [Universidad Nacional de Costa Rica, Heredia (Costa Rica); Hope International, Guatemala (Guatemala); Rojas, J. I., E-mail: isaac.rojas@siglo21.cr [Centro Médico Radioterapia Siglo XXI, San José (Costa Rica)

2016-07-07

Total skin electron irradiation (TSEI) is a special treatment technique offered by modern radiation oncology facilities, given for the treatment of mycosis fungoides, a rare skin disease, which is type of cutaneous T-cell lymphoma [1]. During treatment the patient’s entire skin is irradiated with a uniform dose. The aim of this work is to present implementation of total skin electron irradiation treatment using IAEA TRS-398 code of practice for absolute dosimetry and taking advantage of the use of radiochromic films.

Discussion: Reconstruction of Fingertip Amputation: Necrosis Is Expected

OpenAIRE

Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam; Ki, Sae Hwi

2012-01-01

Background First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation ...

La filière du cocotier au Ghana et au Nigéria

Directory of Open Access Journals (Sweden)

Bene Serge

2009-03-01

Full Text Available In last ten years (1998-2007, the area planted to coconut in the world (average 12 Mha has shown a decreasing trend (average 1%/year. World coconut oil production has remained at more or less the same level in the last ten years (average 3 MT/year. The study of the coconut commodity chain in Ghana show that this sector is confronted with many constraints: the inadequacy price of coconut oil and the competition with other oleaginous plants; an aging coconut plantation; the impacts of the coconut yellow lethal disease, an important demand in peeled nuts towards Nigeria market and the weak dynamism of its institutional organization. Four commodity chains are moving together: the commodity chains of the processing of traditional and semi-industrial coconut oil produce little added value. The commodity of fresh nuts produces a higher added value with limited urban market. Finally, the recent export of peeled nuts commodity chain towards Nigeria offers a large market and brings an important added value to the smallholders. Despite a replanting project in hybrid coconuts, the rehabilitation/ replanting of coconut plantation remains one of the challenges to deal with, in order to boost the coconut commodity chain in Ghana. The observation is that smallholders have not taken up the challenge after the public interventions have seized, in order to rehabilitate or replant their coconut trees. The strategy developed does not sufficiently lay on the market signal which today has evolved. The improved material available and the tested technologies should allow the boosting of the production sector and the reduction of the vulnerable conditions of household affected or threaten by the disease. The same way, the divergent strategies of stakeholders of the coconut commodity chain in Ghana slow down the dynamic of reorientation of this sector towards the export of peeled nuts. Producers in particular, should take advantage of this lucrative commodity chain. It is

Total scalp avulsion with microvascular reanastomosis: A case report and literature review.

Science.gov (United States)

Plant, Mathew A; Fialkov, Jeffrey

2010-01-01

Total scalp avulsion is a rare but potentially devastating injury that when treated (following a few basic principles) can have very good reconstructive results. The present article reviews the current literature and describes the steps involved in the successful replantation of a complete avulsed scalp of a 33-year-old woman. To the authors' knowledge, the present case regarding replantation of a complete avulsed scalp using only a single artery is the first to be described in the Canadian literature.

Histopathological and electron microscopic studies of lymphangiectasia of the small intestine in Behçet's disease

Science.gov (United States)

Asakura, Hitoshi; Morita, Akira; Morishita, Tetsuo; Tsuchiya, Masaharu; Watanabe, Yoonosuke; Enomoto, Yasuhiro

1973-01-01

The gastrointestinal involvement and immunological findings in 16 patients with Behçet's disease are described. Four of 15 biopsy specimens of jejunal mucosa showed marked lymphangiectasia in the lamina propria similar to the appearance which was thought to be a characteristic finding in protein-losing enteropathy. None of the patients had hypoproteinaemia. Increases in serum immunoglobulin IgA were proved in six of 15 cases; in IgM, five of 15; and in IgG, one of 15. Electron microscopic studies showed that there were thousands of precipitated lymph protein bodies in the extracellular spaces of the lamina propria. Ulcers and healed ulcers of the large intestine were studied by light microscopy. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 7Fig. 8Fig. 9 PMID:4700433

Treatment of a Vertical Root Fracture Using Dual-Curing Resin Cement: A Case Report

Directory of Open Access Journals (Sweden)

Nima Moradi Majd

2012-01-01

Full Text Available Introduction. Vertical root fracture (VRF is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options. However, bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction. Methods. A vertically fractured left maxillary incisor was carefully extracted, fracture line was treated with adhesive resin cement, a retrograde cavity was produced and filled with calcium-enriched mixture (CEM cement, and tooth was replanted. Results. After 12 months the tooth was asymptomatic. The size of periapical radiolucency was noticeably reduced and there was no clinical sign of ankylosis. Conclusion. Using adhesive resin cement to bond the fracture lines extraorally in roots with VRF and intentional replantation of the reconstructed teeth could be considered as an alternative to tooth extraction, especially for anterior teeth.

Two uncommon uses of Bio-Oss for GTR and ridge augmentation following extractions: two case reports.

Science.gov (United States)

Pripatnanont, Prisana; Nuntanaranont, Thongchai; Chungpanich, Supis

2002-06-01

Bio-Oss is natural bovine bone mineral, which has the property of bone conduction. It is recommended to be used in two- or three-walled bony defects with an ample supply of pleuripotential cells. Two cases are reported. The first was an intentional replantation, because of previous trauma, of a hopeless tooth affected with severe periodontitis. The tooth was replanted after complete elimination of granulation tissue. Bio-Oss, together with a guided tissue regeneration (GTR) membrane, was used to enhance periodontal regeneration. After 2 years of follow-up, the replanted tooth was quite stable. In the second case, Bio-Oss, together with bone taken from the retromolar area, was used in a sinus lift grafting procedure after the removal of two supernumerary teeth from the floor of the maxillary sinus. Four months after grafting, an orthodontic treatment was applied to move the two adjacent teeth through the grafted site and align them in the proper position. The clinical results of the two cases were satisfactory.

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

Science.gov (United States)

Kamadjeu, Raoul; Gathenji, Caroline

2017-01-01

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response.

Application of Electronic Noses for Disease Diagnosis and Food Spoilage Detection

OpenAIRE

Casalinuovo, Ida A.; Di Pierro, Donato; Coletta, Massimiliano; Di Francesco, Paolo

2006-01-01

Over the last twenty years, newly developed chemical sensor systems (so-called “electronic noses”) have odour analyses made possible. This paper describes the applications of these systems for microbial detection in different fields such as medicine and the food industry, where fast detection methods are essential for appropriate management of health care. Several groups have employed different electronic noses for classification and quantification of bacteria and fungi to obtain accurate med...

TEMPORAL ORDER OF DISEASE PAIRS AFFECTS SUBSEQUENT DISEASE TRAJECTORIES

DEFF Research Database (Denmark)

Beck, Mette K; Westergaard, David; Jensen, Anders Boeck

2016-01-01

order of appearance. We discuss these different types of disease co-occurrences, and use the two diseases "sleep apnea" and "diabetes" to showcase the approach which otherwise can be applied to any disease pair. We benefit from seven million electronic medical records covering the entire population...... of Denmark for more than 20 years. Sleep apnea is the most common sleep-related breathing disorder and it has previously been shown to be bidirectionally linked to diabetes, meaning that each disease increases the risk of acquiring the other. We confirm that there is no significant temporal relationship......, as approximately half of patients with both diseases are diagnosed with diabetes first. However, we also show that patients diagnosed with diabetes before sleep apnea have a higher disease burden compared to patients diagnosed with sleep apnea before diabetes. The study clearly demonstrates that it is not only...

Using an electronic self-management tool to support patients with chronic kidney disease (CKD): a CKD clinic self-care model.

Science.gov (United States)

Ong, Stephanie W; Jassal, Sarbjit V; Porter, Eveline; Logan, Alexander G; Miller, Judith A

2013-01-01

New healthcare delivery models are needed to enhance the patient experience and improve quality of care for individuals with chronic conditions such as kidney disease. One potential avenue is to implement self-management strategies. There is growing evidence that self-management interventions help optimize various aspects of chronic disease management. With the increasing use of information technology (IT) in health care, chronic disease management programs are incorporating IT solutions to support patient self-management practices. IT solutions have the ability to promote key principles of self-management, namely education, empowerment, and collaboration. Positive clinical outcomes have been demonstrated for a number of chronic conditions when IT solutions were incorporated into self-management programs. There is a paucity of evidence for self-management in chronic kidney disease (CKD) patients. Furthermore, IT strategies have not been tested in this patient population to the same extent as other chronic conditions (e.g., diabetes, hypertension). Therefore, it is currently unknown if IT strategies will promote self-management behaviors and lead to improvements in overall patient care. We designed and developed an IT solution called My KidneyCare Centre to support self-management strategies for patients with CKD. In this review, we discuss the rationale and vision of incorporating an electronic self-management tool to support the care of patients with CKD. © 2013 Wiley Periodicals, Inc.

A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service.

Science.gov (United States)

Mesquita, Gabriela Campos; Soares, Priscilla Barbosa Ferreira; Moura, Camilla Christian Gomes; Roscoe, Marina Guimarães; Paiva, Saul Martins; Soares, Carlos José

2017-01-01

This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accident's location; teeth's cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accident's site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

Interaction of Pseudostellaria heterophylla with Fusarium oxysporum f.sp. heterophylla mediated by its root exudates in a consecutive monoculture system.

Science.gov (United States)

Zhao, Yongpo; Wu, Linkun; Chu, Leixia; Yang, Yanqiu; Li, Zhenfang; Azeem, Saadia; Zhang, Zhixing; Fang, Changxun; Lin, Wenxiong

2015-02-03

In this study, quantitative real-time PCR (qPCR) was used to determine the amount of Fusarium oxysporum, an important replant disease pathogen in Pseudostellaria heterophylla rhizospheric soil. Moreover, HPLC was used to identify phenolic acids in root exudates then it was further to explore the effects of the phenolic acid allelochemicals on the growth of F. oxysporum f.sp. heterophylla. The amount of F. oxysporum increased significantly in P. heterophylla rhizosphere soil under a consecutive replant system as monitored through qPCR analysis. Furthermore, the growth of F. oxysporum f.sp. heterophylla mycelium was enhanced by root exudates with a maximum increase of 23.8%. In addition, the number of spores increased to a maximum of 12.5-fold. Some phenolic acids promoted the growth of F. oxysporum f.sp. heterophylla mycelium and spore production. Our study revealed that phenolic acids in the root secretion of P. heterophylla increased long with its development, which was closely related to changes in rhizospheric microorganisms. The population of pathogenic microorganisms such as F. oxysporum in the rhizosphere soil of P. heterophylla also sharply increased. Our results on plant-microbe communication will help to better clarify the cause of problems associated with P. heterophylla under consecutive monoculture treatment.

Benefits of interrelationships between climate change mitigation and adaptation

DEFF Research Database (Denmark)

Møller, Lea Ravnkilde; Jacobsen, Jette Bredahl

2014-01-01

and product 2: climate change adaptation. The production possibilities frontier (PPF) summarises the production benefits of the two products. The case study of the paper is the replanting of mangrove forests in the coastal wetland areas of Peam Krasaob Wildlife Sanctuary in Cambodia. The benefits of climate...... benefits of climate change mitigation and adaptation are tested under different climate change scenarios, seeing as the impact and frequency of storms can have a significant effect on coastal wetland areas and the replanting of the mangrove forests and therefore also on the joint benefits of climate change...

Electronic Referrals and Digital Imaging Systems in Ophthalmology: A Global Perspective.

Science.gov (United States)

Jeganathan, V Swetha E; Hall, H Nikki; Sanders, Roshini

2017-01-01

Ophthalmology departments face intensifying pressure to expedite sight-saving treatments and reduce the global burden of disease. The use of electronic communication systems, digital imaging, and redesigned service care models is imperative for addressing such demands. The recently developed Scottish Eyecare Integration Project involves an electronic referral system from community optometry to the hospital ophthalmology department using National Health Service (NHS) email with digital ophthalmic images attached, via a virtual private network connection. The benefits over the previous system include reduced waiting times, improved triage, e-diagnosis in 20% without the need for hospital attendance, and rapid electronic feedback to referrers. We draw on the experience of the Scottish Eyecare Integration Project and discuss the global applications of this and other advances in teleophthalmology. We focus particularly on the implications for management and screening of chronic disease, such as glaucoma and diabetic eye disease, and ophthalmic disease, such as retinopathy of prematurity where diagnosis is almost entirely and critically dependent on fundus appearance. Currently in Scotland, approximately 75% of all referrals are electronic from community to hospital. The Scottish Eyecare Integration Project is globally the first of its kind and unique in a national health service. Such speedy, safe, and efficient models of communication are geographically sensitive to service provision, especially in remote and rural regions. Along with advances in teleophthalmology, such systems promote the earlier detection of sight-threatening disease and safe follow-up of non-sight-threatening disease in the community. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

Directory of Open Access Journals (Sweden)

Mi Sun Jung

2012-07-01

Full Text Available Background First suggested by Brent in 1979, the pocket principle is an alternative methodfor patients for whom a microsurgical replantation is not feasible. We report the successfulresults of a modified palmar pocket method in adults.Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantationusing palmar pocketing. All patients were adults who sustained a complete fingertip amputationfrom the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crushor avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmarpocketing method following a composite graft in these patients and prepared the pocket in thesubcutaneous layer of the ipsilateral palm.Results Of a total of 10 cases, nine had complete survival of the replantation and one had20% partial necrosis. All of the cases were managed to conserve the fingernails, which led toacceptable cosmetic results.Conclusions A composite graft and palmar pocketing in adult cases of fingertip injuryconstitute a simple, reliable operation for digital amputation extending from the tip to thelunula. These methods had satisfactory results.

The role of nanotechnology and nano and micro-electronics in monitoring and control of cardiovascular diseases and neurological disorders

Science.gov (United States)

Varadan, Vijay K.

2007-04-01

Nanotechnology has been broadly defined as the one for not only the creation of functional materials and devices as well as systems through control of matter at the scale of 1-100 nm, but also the exploitation of novel properties and phenomena at the same scale. Growing needs in the point-of-care (POC) that is an increasing market for improving patient's quality of life, are driving the development of nanotechnologies for diagnosis and treatment of various life threatening diseases. This paper addresses the recent development of nanodiagnostic sensors and nanotherapeutic devices with functionalized carbon nanotube and/or nanowire on a flexible organic thin film electronics to monitor and control of the three leading diseases namely 1) neurodegenerative diseases, 2) cardiovascular diseases, and 3) diabetes and metabolic diseases. The sensors developed include implantable and biocompatible devices, light weight wearable devices in wrist-watches, hats, shoes and clothes. The nanotherapeutics devices include nanobased drug delivery system. Many of these sensors are integrated with the wireless systems for the remote physiological monitoring. The author's research team has also developed a wireless neural probe using nanowires and nanotubes for monitoring and control of Parkinson's disease. Light weight and compact EEG, EOG and EMG monitoring system in a hat developed is capable of monitoring real time epileptic patients and patients with neurological and movement disorders using the Internet and cellular network. Physicians could be able to monitor these signals in realtime using portable computers or cell phones and will give early warning signal if these signals cross a pre-determined threshold level. In addition the potential impact of nanotechnology for applications in medicine is that, the devices can be designed to interact with cells and tissues at the molecular level, which allows high degree of functionality. Devices engineered at nanometer scale imply a

The electronic stethoscope.

Science.gov (United States)

Leng, Shuang; Tan, Ru San; Chai, Kevin Tshun Chuan; Wang, Chao; Ghista, Dhanjoo; Zhong, Liang

2015-07-10

Most heart diseases are associated with and reflected by the sounds that the heart produces. Heart auscultation, defined as listening to the heart sound, has been a very important method for the early diagnosis of cardiac dysfunction. Traditional auscultation requires substantial clinical experience and good listening skills. The emergence of the electronic stethoscope has paved the way for a new field of computer-aided auscultation. This article provides an in-depth study of (1) the electronic stethoscope technology, and (2) the methodology for diagnosis of cardiac disorders based on computer-aided auscultation. The paper is based on a comprehensive review of (1) literature articles, (2) market (state-of-the-art) products, and (3) smartphone stethoscope apps. It covers in depth every key component of the computer-aided system with electronic stethoscope, from sensor design, front-end circuitry, denoising algorithm, heart sound segmentation, to the final machine learning techniques. Our intent is to provide an informative and illustrative presentation of the electronic stethoscope, which is valuable and beneficial to academics, researchers and engineers in the technical field, as well as to medical professionals to facilitate its use clinically. The paper provides the technological and medical basis for the development and commercialization of a real-time integrated heart sound detection, acquisition and quantification system.

Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

Science.gov (United States)

Yamashita, Shuji; Narushima, Mitsunaga; Koshima, Isao; Miyamoto, Shimpei

2017-01-01

Background: Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness. Methods: Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases. Results: In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases. Conclusions: Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery. PMID:29263952

A wearable “electronic patch” for wireless continuous monitoring of chronically diseased patients

DEFF Research Database (Denmark)

Haahr, Rasmus Grønbek; Duun, Sune; Thomsen, Erik Vilain

2008-01-01

We present a wearable health system (WHS) for non-invasive and wireless monitoring of physiological signals. The system is made as an electronic patch where sensors, low power electronics, and radio communication are integrated in an adhesive material of hydrocolloid polymer making it a sticking...

Advances in Electronic-Nose Technologies for the Detection of Volatile Biomarker Metabolites in the Human Breath

Directory of Open Access Journals (Sweden)

Alphus D. Wilson

2015-03-01

Full Text Available Recent advancements in the use of electronic-nose (e-nose devices to analyze human breath profiles for the presence of specific volatile metabolites, known as biomarkers or chemical bio-indicators of specific human diseases, metabolic disorders and the overall health status of individuals, are providing the potential for new noninvasive tools and techniques useful to point-of-care clinical disease diagnoses. This exciting new area of electronic disease detection and diagnosis promises to yield much faster and earlier detection of human diseases and disorders, allowing earlier, more effective treatments, resulting in more rapid patient recovery from various afflictions. E-nose devices are particularly suited for the field of disease diagnostics, because they are sensitive to a wide range of volatile organic compounds (VOCs and can effectively distinguish between different complex gaseous mixtures via analysis of electronic aroma sensor-array output profiles of volatile metabolites present in the human breath. This review provides a summary of some recent developments of electronic-nose technologies, particularly involving breath analysis, with the potential for providing many new diagnostic applications for the detection of specific human diseases associated with different organs in the body, detectable from e-nose analyses of aberrant disease-associated VOCs present in air expired from the lungs.

The MURDOCK Study: a long-term initiative for disease reclassification through advanced biomarker discovery and integration with electronic health records

Science.gov (United States)

Tenenbaum, Jessica D; Christian, Victoria; Cornish, Melissa A; Dolor, Rowena J; Dunham, Ashley A; Ginsburg, Geoffrey S; Kraus, Virginia B; McHutchison, John G; Nahm, Meredith L; Newby, L Kristin; Svetkey, Laura P; Udayakumar, Krishna; Califf, Robert M

2012-01-01

Background Facing critically low return per dollar invested on clinical research and clinical care, the American biomedical enterprise is in need of a significant transformation. A confluence of high-throughput “omic” technologies and increasing adoption of the electronic health record has fueled excitement for a new paradigm for biomedical research and practice. The ability to simultaneously measure thousands of molecular variables and assess their relationships with clinical data collected during the course of care could enable reclassification of disease not only by gross phenotypic observation but according to underlying molecular mechanism and influence of social determinants.In turn, this reclassification could enable development of targeted therapeutic interventions as well as disease prevention strategies at the individual and population levels. Methods/Design The MURDOCK Study consists of distinct project “horizons” or stages. Horizon 1 entailed the generation and analysis of molecular data for existing large,clinically well-annotated cohorts in four disease areas. Horizon 1.5 involves creating and maintaining a 50,000-person,community volunteer registry for biomarker signature validation and prospective studies, including integration of environmental and social data. Horizon 2 leverages and prospectively recruits Horizon 1.5 volunteers, and extends the study to additional disease areas of interest. Horizon 3 will expand the study through regional, national,and international partnerships. Discussion The MURDOCK Study embodies a new model of team science investigation and represents a significant resource for translational research. The study team invites inquiries to form new collaborations to exploit the rich resources provided by these biospecimens and associated study data. PMID:22937207

Electron arc irradiation of the postmastectomy chest wall: clinical results

Energy Technology Data Exchange (ETDEWEB)

Gaffney, David K; Prows, Janalyn; Leavitt, Dennis; Egger, Marlene J; Morgan, John G; Stewart, J Robert

1995-07-01

Purpose/Objective: Since 1980 electron arc irradiation of the postmastectomy chest wall has been the preferred technique for patients with advanced breast cancer at the our institution. Here we report the results of this technique in 150 consecutive patients from 1980 to 1994. Materials and Methods: Thoracic computerized tomography was used to determine internal mammary lymph node depth and chest wall thickness, and for computerized dosimetry calculations in all patients. Total doses of 45-50 Gy in 5 to 5 (1(2)) weeks were delivered to the chest wall and internal mammary lymph nodes via electron arc and, in most cases, supraclavicular and axillary nodes were treated with a matching photon field. Patients were assessed for acute and late radiation changes, local and distant control of disease, and survival. The 10 most recently treated patients were censored for disease progression, survival, and late effects calculations, thus giving a mean follow up of 49 months and a median of 33 months. All patients had advanced disease: T stages 1, 2, 3, and 4 represented 21%, 39%, 21% and 19% of the study population, with a mean number of positive axillary lymph nodes of 6.5 (0-29). Analysis was performed according to adjuvant status (no residual disease, n = 90), residual disease (positive margin, n = 15, and primary radiation, n = 2), or recurrent disease (n = 33). Results: Acute radiation reactions were generally mild and self limiting. 27% of patients developed moist desquamation, and 32% had brisk erythema. Actuarial 5 year local control, freedom from distant failure and overall survival was 91%, 64%, and 67% in the adjuvant group; 84%, 50%, and 53% in the residual disease group; and 63%, 34%, and 30% in the recurrent disease group, respectively. In univariate cox regressions, the number of positive lymph nodes was predictive for local failure in the adjuvant group (p<0.037). Chronic complications were minimal with 10% of patients having arm edema, 15% hyperpigmentation

Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes? Review on E-cigarette vapor versus tobacco smoke.

Science.gov (United States)

Oh, Anne Y; Kacker, Ashutosh

2014-12-01

Development and utilization of electronic cigarettes (ECs) resulted from the search for healthier alternatives to conventional tobacco cigarettes (TCs) and the search for alternative methods for quitting TCs. This review compares the potential disease burden presented by TC smoke to that of EC vapor. Potential disease burden of EC vapor versus TC smoke was assessed by reviewing clinical studies that measured inhaled components. Chemicals and carcinogens produced by vapor versus smoke were compared. Studies show that EC vapors contain far less carcinogenic particles than TC smoke. Whereas ECs have the ability to reach peak serum cotinine/nicotine levels comparable to that of TCs, ECs do not cause an increase in total white blood cell count; thus, ECs have the potential to lower the risk of atherosclerosis and systemic inflammation. Use of ECs has been shown to improve indoor air quality in a home exposed to TC smoke. This reduces secondhand smoke exposure, thus having the potential to decrease respiratory illness/asthma, middle-ear disease, sudden infant death syndrome, and more. However, some studies claim that propylene glycol (PG) vapor can induce respiratory irritation and increase chances for asthma. To minimize risks, EC manufacturers are replacing PG with distilled water and glycerin for vapor production. Based on the comparison of the chemical analysis of EC and TC carcinogenic profiles and association with health-indicating parameters, ECs impart a lower potential disease burden than conventional TCs. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

[Occupational health status of electronics manufacturing female employees in China].

Science.gov (United States)

Wei, T T; Mei, L Y

2018-02-06

Electronics industry is a typical labor-intensive industry in China. There are a lot of female workers and various occupational hazard factors in the workplace. This article reviewed the characteristics of employment of women in electronics industry, occupational hazards of exposure, protective measures, occupational disease situation, influence of reproductive health and mental health, and occupational health management. Electronics female emplyees have the priority in reproductive health and mental health. Besides, this group has poor protective measures, occupational health management and policy should be taken to enhance the level of women health in electronics industry.

Detecting Lyme disease using antibody-functionalized carbon nanotubes

Science.gov (United States)

Dailey, Jennifer; Lerner, Mitchell; Goldsmith, Brett; Brisson, Dustin; Johnson, A. T. Charlie

2011-03-01

We combine antibodies for Lyme flagellar protein with carbon nanotube transistors to create an electronic sensor capable of definitive detection of Lyme disease. Over 35,000 cases of Lyme disease are reported in the United States each year, of which more than 23 percent are originally misdiagnosed. Rational design of the coupling of the biological system to the electronic system gives us a flexible sensor platform which we can apply to several biological systems. By coupling these antibodies to carbon nanotubes in particular, we allow for fast, sensitive, highly selective, electronic detection. Unlike antibody or biomarker detection, bacterial protein detection leads to positive identification of both early and late stage bacterial infections, and is easily expandable to environmental monitoring.

national jalma institute for leprosy & other mycobacterial diseases

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. NATIONAL JALMA INSTITUTE FOR LEPROSY & OTHER MYCOBACTERIAL DISEASES : MAJOR THRUST AREAS. LEPROSY : Understanding the disease better using electrophysiological, immunological, molecular and electron-microscopic tools. Developing better ...

DISEASE MANAGEMENT INFORMATION SYSTEM

OpenAIRE

Bens Pardamean; Anindito; Anjela Djoeang; Nana Tobing

2013-01-01

The study designed an information system model for Disease Management (DisMan) that met the specifications and needs of a consumer electronics manufacturer. The diseases monitored by this study were diabetes, hypertension and tuberculosis. Data were collected through interviews with the companyâs human resources department and occupational health provider. As for the model, literature and online research were conducted to collect health standards and information system standards on existing D...

INCORRECT PRESERVATION OF AMPUTATED DIGITS

Directory of Open Access Journals (Sweden)

Uroš Ahčan

2004-09-01

Full Text Available Background. A decision to replant is critically dependent on the condition of the amputated digit and the way it was preserved during transport. The most common error is exposing the amputated digit to very low temperatures. Preservation directly on ice, on cooling devices in portable refrigerators, or on top of packets of frozen meat often result in a frozen and therefore unusable body digit.Methods. An inquiry questionnaire on correct methods of preservation of amputated digits was conducted on a sample of 30 lay persons, 30 medical students, and 15 physicians.Three simulations of most frequently used methods of preservation of amputated digit were conducted (the correct method; directly on ice; on cooling devices of portable refrigerators. Environment temperature of the (simulated amputated digits stored was measured.In a retrospective study, hospital records of patients treated at the Clinical department of plastic surgery and burns in Ljubljana between 1998 and 2002 were examined. We determined the number of replantations performed, gender of the patients, their age, the mechanism of the injury, the success rate of the replantation, and the duration of hospitalisation. In five case described in detail, we present an inadequate treatment of the amputated digits.Results. The results of the questionnaire survey show that no less than 86.7% of lay person respondents would have treated the injuries in an incorrect way; same holds for 43.4% students of medicine, and 33.3% of practicing physicians.The temperature of the simulated amputated digit remained above 5°C throughout the simulated correct treatment. When preserved directly on ice on or coolant bodies, the temperature dropped below the freezing point and never climbed above 0°C throughout the duration of the simulation (150 minutes.Between years 1998 and 2002, Clinical department of plastic surgery and burns at the University clinical centre Ljubljana admitted 124 injured persons with

Titanium pigmentation. An electron probe microanalysis study

International Nuclear Information System (INIS)

Dupre, A.; Touron, P.; Daste, J.; Lassere, J.; Bonafe, J.L.; Viraben, R.

1985-01-01

A patient had an unusual pigmentary disease induced by titanium dioxide. The use of a topical cream containing titanium dioxide caused a xanthomalike appearance on the patient's penis. Electron probe microanalysis was valuable in establishing the cause of this balanitis

The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth: An Animal Study

Science.gov (United States)

Heydari, Azar; Tahmasbi, Soodeh; Badiee, Mohammadreza; Izadi, SeyedSadra; Mashhadi Abbas, Fatemeh; Mokhtari, Sepideh

2016-01-01

Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption. PMID:27790261

Fingertip amputation salvage on arterial anastomosis alone: an investigation of its limitations.

Science.gov (United States)

Ito, Hiroshi; Sasaki, Kenji; Morioka, Kousuke; Nozaki, Motohiro

2010-09-01

We have previously reported the importance of adequate and precise arterial anastomosis and the hypothesis that, up to subzone III, fingertip amputation salvage can be achieved on arterial anastomosis alone. These findings were reported during the meeting of the Japanese Society of Reconstructive Microsurgery. This is our follow-up report with insight and opinion on the limitations of complete fingertip amputation salvage on arterial anastomosis alone. We examined 67 fingers (59 patients) with fingertip amputations presenting to our hospital between January 2005 and December 2008. Amputation levels and whether these injuries received only arterial or both arterial and venous anastomoses were noted. Fisher exact test was used to examine statistical differences between the groups. Amputation levels were 11 in subzone I, 20 in subzone II, 17 in subzone III, and 19 in subzone IV. Successful replantation was achieved in 87% (58 of 67) of fingers. There was no statistically significant difference between fingers receiving arterial alone versus both anastomoses in amputations of subzones I, II, and III. We found that with proper postoperative congestion care, no statistically significant difference in replantation success of fingers receiving arterial anastomosis alone versus both arterial and venous were noted up to subzone III. However, in subzone IV, regardless of the postoperative congestion, compete necrosis rates are high; thus, it is speculated that a venous anastomosis is necessary for successful replantation. It is preferable to perform as many anastomoses as possible, but we believe that it is also desirable for the procedure to be fast and less invasive. In cases that have no adequate vein, fingertip replantation can be achieved on arterial anastomosis alone up to subzone III.

Distribution Pattern of Shrimps and Fish Among Avicenniaand RhizophoraMicrohabitats in the Pagbilao Mangroves, Philippines

Science.gov (United States)

Rönnbäck, P.; Troell, M.; Kautsky, N.; Primavera, J. H.

1999-02-01

For sustainable management of mangrove ecosystems, there is a pressing need to increase our knowledge of fish and invertebrates associated with this system. This study sampled microhabitats (89-258 m 2) inside the mangrove forest at Pagbilao, the Philippines, on two consecutive spring tides using stake nets. Distribution patterns of shrimps and fish were compared among four microhabitats that differed in dominant mangrove species ( Avicennia marina, A. officinalisor Rhizophora apiculata), structural complexity of the root system, and proximity to open water habitat. A 5 to 6-year-old replanted Rhizophoramicrohabitat was also sampled to study faunal recolonization following replantation. The mean (±SE) density of the shrimp community was 1·5±0·2 shrimps m -2, dominated by Palaemonidae, followed by Acetessp., Penaeus merguiensisand Metapenaeus ensis. The highest shrimp density was observed in the replanted Rhizophorahabitat, which also had the highest structural complexity. The mean (±SE) density and biomass of the fish community was 5·1±2·0 fish m -2and 10·4±3·3 g m -2, respectively, dominated by Ambassis kopsi, A. urotaeniaand Atherinomorus balabacensis. The fish community preferred the pneumatophore ( Avicennia) microhabitats to the prop root ( Rhizophora) habitats. Highest fish abundance and biomass were observed in the most inland habitat, which also lacked larger (total length >100 mm) carnivorous fish. The results demonstrate the extensive use of intertidal mangrove forests by vagile fauna, as well as the successful recolonization by shrimps and fish of replanted Rhizophorahabitat. The role of mangroves as predation refuges, based on the distribution pattern of shrimps and fish, is discussed. Sampling strategies in mangrove intertidal habitat are also outlined.

Self-powered implantable electronic-skin for in situ analysis of urea/uric-acid in body fluids and the potential applications in real-time kidney-disease diagnosis.

Science.gov (United States)

Yang, Wenyan; Han, Wuxiao; Gao, Huiling; Zhang, Linlin; Wang, Shuai; Xing, Lili; Zhang, Yan; Xue, Xinyu

2018-01-25

As the concentration of different biomarkers in human body fluids are an important parameter of chronic disease, wearable biosensors for in situ analysis of body fluids with high sensitivity, real-time detection, flexibility and biocompatibility have significant potential therapeutic applications. In this paper, a flexible self-powered implantable electronic-skin (e-skin) for in situ body fluids analysis (urea/uric-acid) as a real-time kidney-disease diagnoser has been proposed based on the piezo-enzymatic-reaction coupling process of ZnO nanowire arrays. It can convert the mechanical energy of body movements into a piezoelectric impulse, and the outputting piezoelectric signal contains the urea/uric-acid concentration information in body fluids. This piezoelectric-biosensing process does not need an external electricity supply or battery. The e-skin was implanted under the abdominal skin of a mouse and provided in situ analysis of the kidney-disease parameters. These results provide a new approach for developing a self-powered in situ body fluids-analysis technique for chronic-disease diagnosis.

Rhizobial characterization in revegetated areas after bauxite mining

Directory of Open Access Journals (Sweden)

Wardsson Lustrino Borges

2016-06-01

Full Text Available Abstract Little is known regarding how the increased diversity of nitrogen-fixing bacteria contributes to the productivity and diversity of plants in complex communities. However, some authors have shown that the presence of a diverse group of nodulating bacteria is required for different plant species to coexist. A better understanding of the plant symbiotic organism diversity role in natural ecosystems can be extremely useful to define recovery strategies of environments that were degraded by human activities. This study used ARDRA, BOX-PCR fingerprinting and sequencing of the 16S rDNA gene to assess the diversity of root nodule nitrogen-fixing bacteria in former bauxite mining areas that were replanted in 1981, 1985, 1993, 1998, 2004 and 2006 and in a native forest. Among the 12 isolates for which the 16S rDNA gene was partially sequenced, eight, three and one isolate(s presented similarity with sequences of the genera Bradyrhizobium, Rhizobium and Mesorhizobium, respectively. The richness, Shannon and evenness indices were the highest in the area that was replanted the earliest (1981 and the lowest in the area that was replanted most recently (2006.

Comparison of electron beam computed tomography and exercise electrocardiography in detecting coronary artery disease in the elderly

International Nuclear Information System (INIS)

Inoue, Shinji; Mitsunami, Kenichi; Kinoshita, Masahiko

1998-01-01

Although exercise electrocardiography (ECG) is a useful noninvasive screening test for coronary artery disease (CAD), one prerequisite for ECG screening is that patient be able to exercise enough to evoke myocardial ischemia. Thus, exercise ECG may not be suitable for, some elderly people with CAD who cannot exercise enough. We compared electron beam Computed Tomography (EBCT) with exercise ECG for detecting CAD in 196 patients (mean age, 58.4±12.5 (standard deviation)) who had undergone coronary angiography. Using the angiographic findings as the ''gold standard'', we found that the sensitivity, specificity, positive predictive value, and negative predictive value were 88%, 77%, 89%, and 77%, respectively, for EBCT, and 66%, 72%, 83%, and 52%, respectively, for exercise ECG. Although the results were similar when the subjects were divided into different age groups, the negative predictive value for exercise ECG, among older patients was very low. These findings suggest that EBCT is superior to exercise ECG in detecting CAD in the elderly. (author)

Merging Electronic Health Record Data and Genomics for Cardiovascular Research: A Science Advisory From the American Heart Association.

Science.gov (United States)

Hall, Jennifer L; Ryan, John J; Bray, Bruce E; Brown, Candice; Lanfear, David; Newby, L Kristin; Relling, Mary V; Risch, Neil J; Roden, Dan M; Shaw, Stanley Y; Tcheng, James E; Tenenbaum, Jessica; Wang, Thomas N; Weintraub, William S

2016-04-01

The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. © 2016 American Heart Association, Inc.

Maxillary first molar with an O-shaped root morphology:report of a case

Institute of Scientific and Technical Information of China (English)

Yooseok Shin; Yemi Kim; Byoung-Duck Roh

2013-01-01

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

Maxillary first molar with an O-shaped root morphology: report of a case.

Science.gov (United States)

Shin, Yooseok; Kim, Yemi; Roh, Byoung-Duck

2013-12-01

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

Pleomorphism and Viability of the Lyme Disease Pathogen Borrelia burgdorferi Exposed to Physiological Stress Conditions: A Correlative Cryo-Fluorescence and Cryo-Scanning Electron Microscopy Study

Czech Academy of Sciences Publication Activity Database

Vancová, Marie; Rudenko, Natalia; Vaněček, Jiří; Golovchenko, Maryna; Strnad, Martin; Rego, Ryan O. M.; Tichá, Lucie; Grubhoffer, Libor; Nebesářová, Jana

2017-01-01

Roč. 8, 11 April (2017), č. článku 596. ISSN 1664-302X R&D Projects: GA TA ČR(CZ) TE01020118; GA MŠk(CZ) LM2015062 EU Projects: European Commission(XE) 278976 - ANTIGONE Institutional support: RVO:60077344 Keywords : cryo-fluorescence * cryo-scanning electron microscopy * Borrelia burgdorferi * Lyme disease * round body * pleomorphism * viability staining Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: 2.11 Other engineering and technologies Impact factor: 4.076, year: 2016

Electronic applications for the CFQ-R scoring

DEFF Research Database (Denmark)

Ronit, Andreas; Gelpi, Marco; Argentiero, Jonathan

2017-01-01

Patient reported outcomes (PROs) have become widely accepted outcome measures in cystic fibrosis (CF) and other respiratory diseases. The Cystic Fibrosis-Questionnaire-Revised (CFQ-R) is the best validated and most widely used PRO for CF. Data collection can be time-intensive, and electronic plat......, score and save CFQ-R data for all versions. All codes are open access, which will enable other PRO users to design similar applications for other respiratory diseases, such as primary ciliary dyskinesia and non-CF bronchiectasis....

Electron/electron acoustic instability

International Nuclear Information System (INIS)

Gary, S.P.

1987-01-01

The electron acoustic wave becomes a normal mode of an unmagnetized collisionless plasma in the presence of two electron components with similar densities, but strongly disparate temperatures. The characteristic frequency of this mode is the plasma frequency of the cooler electron component. If these two electron components have a relative drift speed several times the thermal speed of the cooler component, the electron/electron acoustic instability may arise. This paper describes the parametric dependences of the threshold drift speed and maximum growth rate of this instability, and compares these with the same properties of the electron/ion acoustic instability. Under the condition of zero current, the electron/ion acoustic instability typically has the lower threshold drift speed, so that observation of the electron/electron acoustic instability is a strong indication of the presence of an electrical current in the plasma

SU-E-I-78: Neuromelanin in the Subthalamic Nucleus of Patients with Parkinson's Disease: An Electron Spin Resonance Spectroscopy Study.

Science.gov (United States)

Gomez, J; Salmon, C Garrido; Filho, O Baffa; Santos, J Peixoto; Pitella, J

2012-06-01

Parkinson disease and related syndromes are associated directly with the concentrations of neuromelanin, iron and other heavy metals, and nowadays it is discussed the possible protective role of neuromelanin by the sequester redox active iron ions, reducing the formation of free hydroxyl radicals and therefore inactivating the iron ions that induce oxidative stress. The aim of this work is to study the concentration ratios between iron ions and neuromelanin in subthalamic nucleus of patients with Parkinson's disease (PD) using Electron Spin Resonance (ESR). Necropsy samples of subthalamic nucleus from eight human brains were studied: three non-affected by any neurodegenerative disease and five with Parkinson's disease. The samples were stored in formaldehyde and washed with a solution of 0.01 molar of ethylenediaminetetraacetic acid. ESR experiments were development in a JEOL FA-200 X-Band spectrometer at different temperatures between -170° C to room temperature. The relative concentrations of each species were estimated from the double integral values of the fitted spectra. For all samples, ESR spectra showed to be composed of three different signals following the Curie's law. One signal was attributed to high-spin ferric ions (g∼ 4.3) in rhomboedric symmetry, Cu(II) ions (close to g=2.0) and neuromelanin (g∼ 2.01). The ferric ions concentration ratio between patients and controls was 3.0±0.2. The same ratio for neuromelanine was 0.24±0.06. Our preliminary results indicated a significant increment of iron concentration in PD samples which agrees with previous histochemical and biochemical reports. This finding and the clear reduction of neuromelanin concentration in PD samples suggest the possible role of neuromelanin as iron ions storage. © 2012 American Association of Physicists in Medicine.

Electronics and electronic systems

CERN Document Server

Olsen, George H

1987-01-01

Electronics and Electronic Systems explores the significant developments in the field of electronics and electronic devices. This book is organized into three parts encompassing 11 chapters that discuss the fundamental circuit theory and the principles of analog and digital electronics. This book deals first with the passive components of electronic systems, such as resistors, capacitors, and inductors. These topics are followed by a discussion on the analysis of electronic circuits, which involves three ways, namely, the actual circuit, graphical techniques, and rule of thumb. The remaining p

Electrons, Electronic Publishing, and Electronic Display.

Science.gov (United States)

Brownrigg, Edwin B.; Lynch, Clifford A.

1985-01-01

Provides a perspective on electronic publishing by distinguishing between "Newtonian" publishing and "quantum-mechanical" publishing. Highlights include media and publishing, works delivered through electronic media, electronic publishing and the printed word, management of intellectual property, and recent copyright-law issues…

[Computer-aided Diagnosis and New Electronic Stethoscope].

Science.gov (United States)

Huang, Mei; Liu, Hongying; Pi, Xitian; Ao, Yilu; Wang, Zi

2017-05-30

Auscultation is an important method in early-diagnosis of cardiovascular disease and respiratory system disease. This paper presents a computer-aided diagnosis of new electronic auscultation system. It has developed an electronic stethoscope based on condenser microphone and the relevant intelligent analysis software. It has implemented many functions that combined with Bluetooth, OLED, SD card storage technologies, such as real-time heart and lung sounds auscultation in three modes, recording and playback, auscultation volume control, wireless transmission. The intelligent analysis software based on PC computer utilizes C# programming language and adopts SQL Server as the background database. It has realized play and waveform display of the auscultation sound. By calculating the heart rate, extracting the characteristic parameters of T1, T2, T12, T11, it can analyze whether the heart sound is normal, and then generate diagnosis report. Finally the auscultation sound and diagnosis report can be sent to mailbox of other doctors, which can carry out remote diagnosis. The whole system has features of fully function, high portability, good user experience, and it is beneficial to promote the use of electronic stethoscope in the hospital, at the same time, the system can also be applied to auscultate teaching and other occasions.

Electron-electron Bremsstrahlung for bound target electrons

International Nuclear Information System (INIS)

Haug, E.

2008-01-01

For the process of electron-electron (e-e) Bremsstrahlung the momentum and energy distributions of the recoiling electrons are calculated in the laboratory frame. In order to get the differential cross section and the photon spectrum for target electrons which are bound to an atom, these formulae are multiplied by the incoherent scattering function and numerically integrated over the recoil energy. The effect of atomic binding is most pronounced at low energies of the incident electrons and for target atoms of high atomic numbers. The results are compared to those of previous calculations. (authors)

Network biology concepts in complex disease comorbidities

DEFF Research Database (Denmark)

Hu, Jessica Xin; Thomas, Cecilia Engel; Brunak, Søren

2016-01-01

collected electronically, disease co-occurrences are starting to be quantitatively characterized. Linking network dynamics to the real-life, non-ideal patient in whom diseases co-occur and interact provides a valuable basis for generating hypotheses on molecular disease mechanisms, and provides knowledge......The co-occurrence of diseases can inform the underlying network biology of shared and multifunctional genes and pathways. In addition, comorbidities help to elucidate the effects of external exposures, such as diet, lifestyle and patient care. With worldwide health transaction data now often being...

Involvement of an autotoxic compound in asparagus decline.

Science.gov (United States)

Kato-Noguchi, Hisashi; Nakamura, Keisuke; Okuda, Nobuyuki

2018-03-19

Asparagus (Asparagus officinalis L.) is a widely cultivated perennial veritable and can be harvested more than ten years. However, the crop quality and yield decline after a few year's cultivation, which is called "asparagus decline". Even though those asparagus plants were replaced with new young asparagus plants, the productivity and quality of the crop remain relatively low, which is known as a "asparagus replant problem". One of the possible reasons for "asparagus decline" and "asparagus replant problem" is thought to be autotoxicity of asparagus. However, the compounds involved in the autotoxicity is not clear. The objective of this study was therefore to determine the potential role of autotoxicity in the "asparagus decline" and "asparagus replant problem". An aqueous methanol extract of 10-year-asparagus-cultivated soils inhibited the growth of asparagus seedlings and other two test plants with concentration dependent manner. The result confirmed that the asparagus soils have autotoxic activity. The extract was then purified by several chromatographies with monitoring the inhibitory activity and a potent growth inhibitory substance causing the autotoxic effect was isolated. The chemical structures of the compound was determined by spectral data to be trans-cinnamic acid. trans-Cinnamic acid inhibited the growth of asparagus seedlings at concentrations greater than 10 μM. The concentrations required for 50% growth inhibition of asparagus (IC 50 ) were 24.1-41.6 μM. trans-Cinnamic acid accumulated 174 μM in the 10-year-asparagus-cultivated soils, which may be enough levels to cause the growth inhibition on asparagus considering its IC 50 value. Therefore, trans-cinnamic acid may contribute to the autotoxic effect of asparagus soils, and may be in part responsible for "asparagus decline" and "asparagus replant problem". Copyright © 2018 Elsevier GmbH. All rights reserved.

Studying Disease Occurrence and Drug Effects in Children: A global approach

NARCIS (Netherlands)

O.U. Osokogu (Osemeke)

2017-01-01

markdownabstractChildhood diseases result from different causes and exhibit different characteristics. The occurrence of such diseases can be estimated from electronic healthcare records but the characteristics of both the diseases and the databases should be considered. Licensed drugs have limited

Glycogen storage disease type II (Pompe disease in children

Directory of Open Access Journals (Sweden)

A. N. Semyachkina

2014-01-01

Full Text Available The paper gives the data available in the literature, which reflect the manifestations, diagnosis, and current treatments of the rare (orphan inherited disease glycogen storage disease type II or Pomp disease in children, as well as its classification. The infant form is shown to be most severe, resulting in death from cardiovascular or pulmonary failure generally within the first year of a child’s life. Emphasis is laid on major difficulties in the differential and true diagnosis of this severe disease. Much attention is given to the new pathogenetic treatment — genetically engineered enzyme replacement drug Myozyme®. The authors describe their clinical case of a child with the juvenile form of glycogen storage disease type II (late-onset Pompe disease. Particular emphasis is laid on the clinical symptoms of the disease and its diagnostic methods, among which the morphological analysis of a muscle biopsy specimen by light and electron microscopies, and enzyme and DNA diagnoses are of most importance. The proband was found to have significant lysosomal glycogen accumulation in the muscle biopsy specimen, reduced lymphocyte acid α-1,4-glucosidase activity to 4,2 nM/mg/h (normal value, 13,0—53,6 nM/mg/h, described in the HGMD missense mutation database from 1000 G>A p.Gly334er of the GAA in homozygous state, which verified the diagnosis of Pompe disease. 

Interplay between electron-phonon and electron-electron interactions

International Nuclear Information System (INIS)

Roesch, O.; Gunnarsson, O.; Han, J.E.; Crespi, V.H.

2005-01-01

We discuss the interplay between electron-electron and electron-phonon interactions for alkali-doped fullerides and high temperature superconductors. Due to the similarity of the electron and phonon energy scales, retardation effects are small for fullerides. This raises questions about the origin of superconductivity, since retardation effects are believed to be crucial for reducing effects of the Coulomb repulsion in conventional superconductors. We demonstrate that by treating the electron-electron and electron-phonon interactions on an equal footing, superconductivity can be understood in terms of a local pairing. The Jahn-Teller character of the important phonons in fullerides plays a crucial role for this result. To describe effects of phonons in cuprates, we derive a t-J model with phonons from the three-band model. Using exact diagonalization for small clusters, we find that the anomalous softening of the half-breathing phonon as well as its doping dependence can be explained. By comparing the solution of the t-J model with the Hartree-Fock approximation for the three-band model, we address results obtained in the local-density approximation for cuprates. We find that genuine many-body results, due to the interplay between the electron-electron and electron-phonon interactions, play an important role for the the results in the t-J model. (copyright 2005 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

Rhizobial characterization in revegetated areas after bauxite mining.

Science.gov (United States)

Borges, Wardsson Lustrino; Prin, Yves; Ducousso, Marc; Le Roux, Christine; de Faria, Sergio Miana

2016-01-01

Little is known regarding how the increased diversity of nitrogen-fixing bacteria contributes to the productivity and diversity of plants in complex communities. However, some authors have shown that the presence of a diverse group of nodulating bacteria is required for different plant species to coexist. A better understanding of the plant symbiotic organism diversity role in natural ecosystems can be extremely useful to define recovery strategies of environments that were degraded by human activities. This study used ARDRA, BOX-PCR fingerprinting and sequencing of the 16S rDNA gene to assess the diversity of root nodule nitrogen-fixing bacteria in former bauxite mining areas that were replanted in 1981, 1985, 1993, 1998, 2004 and 2006 and in a native forest. Among the 12 isolates for which the 16S rDNA gene was partially sequenced, eight, three and one isolate(s) presented similarity with sequences of the genera Bradyrhizobium, Rhizobium and Mesorhizobium, respectively. The richness, Shannon and evenness indices were the highest in the area that was replanted the earliest (1981) and the lowest in the area that was replanted most recently (2006). Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

DNA comet assay for rice seeds treated with low energy electrons ('soft-electrons')

International Nuclear Information System (INIS)

Todoriki, Setsuko; Hayashi, Toru

1999-01-01

As rice seeds are sometimes contaminated with phytopathogenic organisms such as blast disease fungi and nematodes, a novel non-chemical disinfection method for rice seeds is highly required. In order to develop a disinfection method, the effect of low energy electron ('soft-electrons') on seed DNA was examined by using the neutral comet assay. Rice seeds (whole grain) were treated with electrons of different acceleration voltages (180 kV to 1 MV) at a dose of 5 kGy. Nucleus suspensions were prepared from whole brown rice and subjected to electrophoresis. DNA from un-irradiated (control) seeds relaxed and produced comets with a short tail, most of the comets distributed within the range of comet length between 30 μm to 70 μm. In the case of seeds treated with electrons at acceleration voltages up to 190 kV, cells without seed coats were not damaged and the frequency histograms of comet length showed almost the same pattern as that for control. At acceleration voltages higher than 200 kV, the cells were distributed into two categories; DNA comets with a short tail (with little DNA damages, less than 70 μm in the comet length) and DNA comets with long tails (with sever strand breaks, more than 130 μm in the comet length). The ratios of damaged cells increased with increasing acceleration voltage. The growths of rice seedlings were not affected by the treatment with electrons at up to 200 kV. On the contrary, the cells of gamma-irradiated seed showed small variations in the comet length, and which were depending on radiation dose. The individual cells of gamma-irradiated seeds at 1 kGy showed shorter comet than the damaged cells with soft electron, seed treated with gamma rays (1-5 kGy) did not shoot nor root. (author)

Relationship between spending on electronic cigarettes, 30-day use, and disease symptoms among current adult cigarette smokers in the U.S.

Directory of Open Access Journals (Sweden)

Tingting Yao

Full Text Available To examine the relationship between spending on electronic cigarettes (e-cigarettes and disease symptoms compared with the relationship between 30-day e-cigarette use and disease symptoms among adult cigarette smokers in the U.S.We analyzed data from the Tobacco and Attitudes Beliefs Survey which included 533 respondents aged 24+ who were current cigarette smokers and e-cigarette ever users. Fifteen self-reported disease symptoms were included as outcome variables. Separate multivariable logistic regression models were estimated for each disease symptom with total spending on e-cigarettes in the past 30 days and with reported 30-day e-cigarette use. All models controlled for cigarettes smoked per day (CPD and sociodemographic characteristics.We found that those who spent more on e-cigarettes were more likely to report chest pain (AOR = 1.25, 95% CI 1.02-1.52, to notice blood when brushing their teeth (AOR = 1.23, 95% CI 1.02-1.49, to have sores or ulcers in their mouth (AOR = 1.36, 95% CI 1.08-1.72, and to have more than one cold (AOR = 1.36, 95% CI 1.05-1.78 than those with no spending on e-cigarettes in the past 30 days in an adjusted analysis. After controlling for CPD and other covariates, there were no significant relationships between 30-day e-cigarette use and symptoms. Even after controlling for CPD, e-cigarette expenditures or use was associated with greater odds of wheezing and shortness of breath.E-cigarette expenditures might be a more useful measure of intensity of e-cigarette use. The additional health effect of e-cigarette use or expenditures among smokers independent of the effect of CPD suggests that e-cigarette use adds adverse health effects even among cigarette smokers.

Relationship between spending on electronic cigarettes, 30-day use, and disease symptoms among current adult cigarette smokers in the U.S.

Science.gov (United States)

Yao, Tingting; Max, Wendy; Sung, Hai-Yen; Glantz, Stanton A; Goldberg, Rachel L; Wang, Julie B; Wang, Yingning; Lightwood, James; Cataldo, Janine

2017-01-01

To examine the relationship between spending on electronic cigarettes (e-cigarettes) and disease symptoms compared with the relationship between 30-day e-cigarette use and disease symptoms among adult cigarette smokers in the U.S. We analyzed data from the Tobacco and Attitudes Beliefs Survey which included 533 respondents aged 24+ who were current cigarette smokers and e-cigarette ever users. Fifteen self-reported disease symptoms were included as outcome variables. Separate multivariable logistic regression models were estimated for each disease symptom with total spending on e-cigarettes in the past 30 days and with reported 30-day e-cigarette use. All models controlled for cigarettes smoked per day (CPD) and sociodemographic characteristics. We found that those who spent more on e-cigarettes were more likely to report chest pain (AOR = 1.25, 95% CI 1.02-1.52), to notice blood when brushing their teeth (AOR = 1.23, 95% CI 1.02-1.49), to have sores or ulcers in their mouth (AOR = 1.36, 95% CI 1.08-1.72), and to have more than one cold (AOR = 1.36, 95% CI 1.05-1.78) than those with no spending on e-cigarettes in the past 30 days in an adjusted analysis. After controlling for CPD and other covariates, there were no significant relationships between 30-day e-cigarette use and symptoms. Even after controlling for CPD, e-cigarette expenditures or use was associated with greater odds of wheezing and shortness of breath. E-cigarette expenditures might be a more useful measure of intensity of e-cigarette use. The additional health effect of e-cigarette use or expenditures among smokers independent of the effect of CPD suggests that e-cigarette use adds adverse health effects even among cigarette smokers.

[Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis].

Science.gov (United States)

Li, Xiaodong; Wang, Pei; Yu, Changyu; Yan, Xiaowei; Yin, Jing

2017-10-01

To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases. The arterial crisis happened at 2.5-18 hours (mean, 7.5 hours) after limb replantation surgery. Color doppler ultrasonography was used to diagnose the arterial thrombosis, finally the anastomotic thrombosis were found in 16 cases, non-anastomotic thrombosis in 7 cases, and combined thrombosis in 4 cases. All the thrombosis were deteced in the arteries with the length of 0.8-3.9 cm. No complication such as vascular perforation, rupture, air embolism, thromboembolism, wound infection, or sepsis happened after operation. Arterial crisis occurred again in 3 cases at 1.5-13.5 hours after limb replantation and treated by arterial exploration, 1 case was treated successfully; 2 cases had arterial occlusion and partial necrosis of limb, and got amputation treatment at last. The rest 24 cases survived with the incision healing by first stage. In the 24 cases, 1 case suffered from acute myonephropathic metabolic syndrome and corrected after hemodialysis; 1 case suffered from acute liver functional damage and corrected by comprehensive treatment of internal medicine. The 24 patients were followed up 7-38 months (mean, 11 months). At last follow-up, blood supply of the limb was good with normal skin temperature and improved sense of feeling, activity, and swelling. According to Chinese Medical Association of hand surgery to the upper extremity function assessment standard, the results were

Improving Care for Patients With or at Risk for Chronic Kidney Disease Using Electronic Medical Record Interventions: A Pragmatic Cluster-Randomized Trial Protocol

Science.gov (United States)

Nash, Danielle M.; Ivers, Noah M.; Young, Jacqueline; Jaakkimainen, R. Liisa; Garg, Amit X.; Tu, Karen

2017-01-01

Background: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. Objective: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. Design: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted. Setting: The study population comes from the Electronic Medical Record Administrative data Linked Database®, which includes clinical data for more than 140 000 rostered adults cared for by 194 family physicians in 34 clinics across Ontario, Canada. The 34 primary care clinics will be randomized to the intervention or control group. Intervention: The intervention group will receive resources from the “CKD toolkit” to help improve care including practice audit and feedback, printed educational materials for physicians and patients, electronic decision support and reminders, and implementation support. Measurements: Patients with or at risk for CKD within participating clinics will be identified using laboratory data in the electronic medical records. Outcomes will be assessed after dissemination of the CKD tools and after 2 rounds of feedback on performance on quality indicators have been sent to the physicians using information from the electronic medical records. The primary outcome is the proportion of patients aged 50 to 80 years with nondialysis-dependent CKD who are on a statin. Secondary outcomes include process of care measures such as screening tests, CKD recognition, monitoring tests, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker prescriptions, blood pressure targets met, and nephrologist referral. Hierarchical analytic modeling will be performed to account for clustering. Semistructured interviews will be conducted with a random purposeful sample of physicians in the

76 FR 65139 - Protection of Stratospheric Ozone: The 2012 Critical Use Exemption From the Phaseout of Methyl...

Science.gov (United States)

2011-10-20

... use exemption including farmers of vegetable crops, fruits and nursery stock and owners of stored food.... Nursery stock--fruits, nuts, flowers. Orchard replants. Ornamentals. Peppers--field. Strawberry--field...

Electronic growth charts: watching our patients grow.

Science.gov (United States)

Murphy, Cynthia A; Carstens, Kimberly; Villamayor, Precy

2005-01-01

Pediatric Growth Charts have been used in the pediatric community since 1977. The first growth charts were developed by the National Center for Health Statistics as a clinical tool for health care professionals. The growth charts, revised in 2000, by the Center for Disease Control consists of a series of percentile curves for selected body measurements in children [1]. Capitalizing on the benefits of our Electronic Medical Record (EMR), and as a byproduct of nursing electronic documentation of routine heights, weights, and frontal occipital circumferences, our system plots the routine measurements without additional intervention by the staff. Clinicians can view the graphs online or generate printed reports as needed during routine examination for outpatient or hospitalized care. This abstract outlines the background, design process, programming rules utilized to plot growth curves, and the evaluation of the electronic CDC growth charts in our organization.

Electronic emission and electron guns

International Nuclear Information System (INIS)

Roy, Amitava

2010-01-01

This paper reviews the process of electron emission from metal surface. Although electrons move freely in conductors like metals, they normally do not leave the metal without some manipulation. In fact, heating and bombardment are the two primary ways in which electrons are emitted through the use of a heating element behind the cathode (termed thermionic emission) or as a result of bombardment with a beam of electrons, ions, or metastable atoms (termed secondary emission). Another important emission mechanism called Explosive Electron Emission (EEE) is also often used in various High Voltage Pulse Power Systems to generate very high current (few hundreds of kA) pulsed electron beams. The electron gun is the device in that it shoots off a continuous (or pulsed) stream of electrons. A brief idea about the evolution of the electron gun components and their basis of functioning are also discussed. (author)

35 years of electron microscopy in Costa Rica

International Nuclear Information System (INIS)

Hernandez Chavarria, Francisco

2011-01-01

orbital more external, has jumped to fill the vacancy and the remaining energy is emitted as an X-ray photon. Because of this energy is characterized for each item depending on the orbital involved, has been possible to measure and determine the element that produced it, thus can make an elemental chemical analysis of the sample. The main contributions of electron microscopy in Costa Rica have been in the biomedical area, as much as in histopathological diagnosis of diseases such as the identification of microbial agents that cause uncommon symptoms, especially those of viral etiology, as for example, studies of etiology and epidemiology of childhood diarrhea, that have led to the first diagnostic in the country on viruses associated with this disease. Also, the contributions of electron microscopy have been relevant in other fields, such as animal and plant health, biology and non-biological areas, such as physics, chemistry, geology, archaeology and others [es

Treatment of basal cell epithelioma with high energy electron beam

Energy Technology Data Exchange (ETDEWEB)

Ogawa, Y. (Hyogo-ken Cancer Center, Kobe (Japan)); Kumano, M.; Kumano, K.

1981-11-01

Thirty patients with basal cell epithelioma received high energy electron beam therapy. They were irradiated with a dose ranging from 4,800 rad (24 fractions, 35 days) to 12,000 rad (40 fractions, 57 days). Tumors disappeared in all cases. These were no disease-related deaths; in one patient there was recurrence after 2 years. We conclude that radiotherapy with high energy electron beam is very effective in the treatment of basal cell epithelioma.

Advanced methods for teaching electronic-nose technologies to diagnosticians and clinical laboratory technicians

Science.gov (United States)

Alphus D. Wilson

2012-01-01

Electronic-detection technologies and instruments increasingly are being utilized in the biomedical field to perform a wide variety of clinical operations and laboratory analyses to facilitate the delivery of health care to patients. The introduction of improved electronic instruments for diagnosing diseases and for administering treatments has required new training of...

Replantation (Finger, Hand, or Arm)

Science.gov (United States)

... part in recovery. For the missing part, a prosthesis may be worn (a device that substitutes for ... does not look like it did before. These feelings are common. Talking about these feelings with your ...

CNNs for electron microscopy segmentation

OpenAIRE

García-Amorena García, Pablo

2013-01-01

In the framework of Biomedicine, mitochondria are known to play an important role in neural function. Recent studies show mitochondrial morphology to be crucial to cellular physiology and synaptic function, and a link between mitochondrial defects and neuro-degenerative diseases is strongly suspected. Electron microscopy (EM), with its very high resolution in all three directions, is one of the key tools to look more closely into these tissues, but the huge amounts of data it produces m...

Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

Science.gov (United States)

Ben-Assuli, Ofir; Leshno, Moshe

2016-09-01

In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

Challenges in the implementation of an electronic surveillance system in a resource-limited setting: Alerta, in Peru

Directory of Open Access Journals (Sweden)

Soto Giselle

2008-11-01

Full Text Available Abstract Background Infectious disease surveillance is a primary public health function in resource-limited settings. In 2003, an electronic disease surveillance system (Alerta was established in the Peruvian Navy with support from the U.S. Naval Medical Research Center Detachment (NMRCD. Many challenges arose during the implementation process, and a variety of solutions were applied. The purpose of this paper is to identify and discuss these issues. Methods This is a retrospective description of the Alerta implementation. After a thoughtful evaluation according to the Centers for Disease Control and Prevention (CDC guidelines, the main challenges to implementation were identified and solutions were devised in the context of a resource-limited setting, Peru. Results After four years of operation, we have identified a number of challenges in implementing and operating this electronic disease surveillance system. These can be divided into the following categories: (1 issues with personnel and stakeholders; (2 issues with resources in a developing setting; (3 issues with processes involved in the collection of data and operation of the system; and (4 issues with organization at the central hub. Some of the challenges are unique to resource-limited settings, but many are applicable for any surveillance system. For each of these challenges, we developed feasible solutions that are discussed. Conclusion There are many challenges to overcome when implementing an electronic disease surveillance system, not only related to technology issues. A comprehensive approach is required for success, including: technical support, personnel management, effective training, and cultural sensitivity in order to assure the effective deployment of an electronic disease surveillance system.

Influence of Skin Diseases on Fingerprint Recognition

Science.gov (United States)

Drahansky, Martin; Dolezel, Michal; Urbanek, Jaroslav; Brezinova, Eva; Kim, Tai-hoon

2012-01-01

There are many people who suffer from some of the skin diseases. These diseases have a strong influence on the process of fingerprint recognition. People with fingerprint diseases are unable to use fingerprint scanners, which is discriminating for them, since they are not allowed to use their fingerprints for the authentication purposes. First in this paper the various diseases, which might influence functionality of the fingerprint-based systems, are introduced, mainly from the medical point of view. This overview is followed by some examples of diseased finger fingerprints, acquired both from dactyloscopic card and electronic sensors. At the end of this paper the proposed fingerprint image enhancement algorithm is described. PMID:22654483

Influence of Skin Diseases on Fingerprint Recognition

Directory of Open Access Journals (Sweden)

Martin Drahansky

2012-01-01

Full Text Available There are many people who suffer from some of the skin diseases. These diseases have a strong influence on the process of fingerprint recognition. People with fingerprint diseases are unable to use fingerprint scanners, which is discriminating for them, since they are not allowed to use their fingerprints for the authentication purposes. First in this paper the various diseases, which might influence functionality of the fingerprint-based systems, are introduced, mainly from the medical point of view. This overview is followed by some examples of diseased finger fingerprints, acquired both from dactyloscopic card and electronic sensors. At the end of this paper the proposed fingerprint image enhancement algorithm is described.

Common Principles of Molecular Electronics and Nanoscale Electrochemistry.

Science.gov (United States)

Bueno, Paulo Roberto

2018-05-24

The merging of nanoscale electronics and electrochemistry can potentially modernize the way electronic devices are currently engineered or constructed. It is well known that the greatest challenges will involve not only miniaturizing and improving the performance of mobile devices, but also manufacturing reliable electrical vehicles, and engineering more efficient solar panels and energy storage systems. These are just a few examples of how technological innovation is dependent on both electrochemical and electronic elements. This paper offers a conceptual discussion of this central topic, with particular focus on the impact that uniting physical and chemical concepts at a nanoscale could have on the future development of electroanalytical devices. The specific example to which this article refers pertains to molecular diagnostics, i.e., devices that employ physical and electrochemical concepts to diagnose diseases.

Born-Oppenheimer Dynamics, Electronic Friction, and the Inclusion of Electron-Electron Interactions

Science.gov (United States)

Dou, Wenjie; Miao, Gaohan; Subotnik, Joseph E.

2017-07-01

We present a universal expression for the electronic friction as felt by a set of classical nuclear degrees of freedom (DOFs) coupled to a manifold of quantum electronic DOFs; no assumptions are made regarding the nature of the electronic Hamiltonian and electron-electron repulsions are allowed. Our derivation is based on a quantum-classical Liouville equation for the coupled electronic-nuclear motion, followed by an adiabatic approximation whereby electronic transitions are assumed to equilibrate faster than nuclear movement. The resulting form of friction is completely general, but does reduce to previously published expressions for the quadratic Hamiltonian (i.e., Hamiltonians without electronic correlation). At equilibrium, the second fluctuation-dissipation theorem is satisfied and the frictional matrix is symmetric. To demonstrate the importance of electron-electron correlation, we study electronic friction within the Anderson-Holstein model, where a proper treatment of electron-electron interactions shows signatures of a Kondo resonance and a mean-field treatment is completely inadequate.

Evaluation of an Electronic Smart-Card Based School Absenteeism Surveillance System

OpenAIRE

So, HC; Lam, CK; Tam, YH; Cowling, BJ; Leung, GM; Lau, EHY; Ip, DKM

2014-01-01

We evaluated the performance of an electronic smart-card based school absenteeism surveillance system which was initiated in 2008 in Hong Kong. The result demonstrated the feasibility and potential benefit of employing electronic school absenteeism data as captured automatically by a smart card system as an alternative data stream for monitoring influenza activities, and flexibility in establishing surveillance for emerging diseases. The increasing popularity of usage of smart card technology...

Synergistic electron transfer effect-based signal amplification strategy for the ultrasensitive detection of dopamine.

Science.gov (United States)

Lu, Qiujun; Chen, Xiaogen; Liu, Dan; Wu, Cuiyan; Liu, Meiling; Li, Haitao; Zhang, Youyu; Yao, Shouzhuo

2018-05-15

The selective and sensitive detection of dopamine (DA) is of great significance for the identification of schizophrenia, Huntington's disease, and Parkinson's disease from the perspective of molecular diagnostics. So far, most of DA fluorescence sensors are based on the electron transfer from the fluorescence nanomaterials to DA-quinone. However, the limited electron transfer ability of the DA-quinone affects the level of detection sensitivity of these sensors. In this work, based on the DA can reduce Ag + into AgNPs followed by oxidized to DA-quinone, we developed a novel silicon nanoparticles-based electron transfer fluorescent sensor for the detection of DA. As electron transfer acceptor, the AgNPs and DA-quinone can quench the fluorescence of silicon nanoparticles effectively through the synergistic electron transfer effect. Compared with traditional fluorescence DA sensors, the proposed synergistic electron transfer-based sensor improves the detection sensitivity to a great extent (at least 10-fold improvement). The proposed sensor shows a low detection limit of DA, which is as low as 0.1 nM under the optimal conditions. This sensor has potential applicability for the detection of DA in practical sample. This work has been demonstrated to contribute to a substantial improvement in the sensitivity of the sensors. It also gives new insight into design electron transfer-based sensors. Copyright © 2018. Published by Elsevier B.V.

7 CFR 783.6 - Benefits.

Science.gov (United States)

2010-01-01

... costs for the qualifying loss (that loss over and above the calculated 15% mortality). The payment shall... replanting; (2) Site preparation and debris handling within normal cultural practices for the type of...

A rule-based electronic phenotyping algorithm for detecting clinically relevant cardiovascular disease cases.

Science.gov (United States)

Esteban, Santiago; Rodríguez Tablado, Manuel; Ricci, Ricardo Ignacio; Terrasa, Sergio; Kopitowski, Karin

2017-07-14

The implementation of electronic medical records (EMR) is becoming increasingly common. Error and data loss reduction, patient-care efficiency increase, decision-making assistance and facilitation of event surveillance, are some of the many processes that EMRs help improve. In addition, they show a lot of promise in terms of data collection to facilitate observational epidemiological studies and their use for this purpose has increased significantly over the recent years. Even though the quantity and availability of the data are clearly improved thanks to EMRs, still, the problem of the quality of the data remains. This is especially important when attempting to determine if an event has actually occurred or not. We sought to assess the sensitivity, specificity, and agreement level of a codes-based algorithm for the detection of clinically relevant cardiovascular (CaVD) and cerebrovascular (CeVD) disease cases, using data from EMRs. Three family physicians from the research group selected clinically relevant CaVD and CeVD terms from the international classification of primary care, Second Edition (ICPC-2), the ICD 10 version 2015 and SNOMED-CT 2015 Edition. These terms included both signs, symptoms, diagnoses and procedures associated with CaVD and CeVD. Terms not related to symptoms, signs, diagnoses or procedures of CaVD or CeVD and also those describing incidental findings without clinical relevance were excluded. The algorithm yielded a positive result if the patient had at least one of the selected terms in their medical records, as long as it was not recorded as an error. Else, if no terms were found, the patient was classified as negative. This algorithm was applied to a randomly selected sample of the active patients within the hospital's HMO by 1/1/2005 that were 40-79 years old, had at least one year of seniority in the HMO and at least one clinical encounter. Thus, patients were classified into four groups: (1) Negative patients (2) Patients with Ca

New Directions in Chronic Disease Management

Directory of Open Access Journals (Sweden)

Hun-Sung Kim

2015-06-01

Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

The Effect of Long-Term Continuous Cropping of Black Pepper on Soil Bacterial Communities as Determined by 454 Pyrosequencing

Science.gov (United States)

Xiong, Wu; Li, Zhigang; Liu, Hongjun; Xue, Chao; Zhang, Ruifu; Wu, Huasong; Li, Rong; Shen, Qirong

2015-01-01

In the present study, 3 replanted black pepper orchards with continuously cropping histories for 10, 21, and 55 years in tropical China, were selected for investigating the effect of monoculture on soil physiochemical properties, enzyme activities, bacterial abundance, and bacterial community structures. Results showed long-term continuous cropping led to a significant decline in soil pH, organic matter contents, enzymatic activities, and resulted in a decrease in soil bacterial abundance. 454 pyrosequencing analysis of 16S rRNA genes revealed that the Acidobacteria and Proteobacteria were the main phyla in the replanted black pepper orchard soils, comprising up to 73.82% of the total sequences; the relative abundances of Bacteroidetes and Firmicutes phyla decreased with long-term continuous cropping; and at genus level, the Pseudomonas abundance significantly depleted after 21 years continuous cropping. In addition, bacterial diversity significantly decreased after 55 years black pepper continuous cropping; obvious variations for community structures across the 3 time-scale replanted black pepper orchards were observed, suggesting monoculture duration was the major determinant for bacterial community structure. Overall, continuous cropping during black pepper cultivation led to a significant decline in soil pH, organic matter contents, enzymatic activities, resulted a decrease in soil bacterial abundance, and altered soil microbial community membership and structure, which in turn resulted in black pepper poor growth in the continuous cropping system. PMID:26317364

Retention of seed trees fails to lifeboat ectomycorrhizal fungal diversity in harvested Scots pine forests.

Science.gov (United States)

Varenius, Kerstin; Lindahl, Björn D; Dahlberg, Anders

2017-09-01

Fennoscandian forestry has in the past decades changed from natural regeneration of forests towards replantation of clear-cuts, which negatively impacts ectomycorrhizal fungal (EMF) diversity. Retention of trees during harvesting enables EMF survival, and we therefore expected EMF communities to be more similar to those in old natural stands after forest regeneration using seed trees compared to full clear-cutting and replanting. We sequenced fungal internal transcribed spacer 2 (ITS2) amplicons to assess EMF communities in 10- to 60-year-old Scots pine stands regenerated either using seed trees or through replanting of clear-cuts with old natural stands as reference. We also investigated local EMF communities around retained old trees. We found that retention of seed trees failed to mitigate the impact of harvesting on EMF community composition and diversity. With increasing stand age, EMF communities became increasingly similar to those in old natural stands and permanently retained trees maintained EMF locally. From our observations, we conclude that EMF communities, at least common species, post-harvest are more influenced by environmental filtering, resulting from environmental changes induced by harvest, than by the continuity of trees. These results suggest that retention of intact forest patches is a more efficient way to conserve EMF diversity than retaining dispersed single trees. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Web-based infectious disease reporting using XML forms.

Science.gov (United States)

Liu, Danhong; Wang, Xia; Pan, Feng; Xu, Yongyong; Yang, Peng; Rao, Keqin

2008-09-01

Exploring solutions for infectious disease information sharing among hospital and public health information systems is imperative to the improvement of disease surveillance and emergent response. This paper aimed at developing a method to directly transmit real-time data of notifiable infectious diseases from hospital information systems to public health information systems on the Internet by using a standard eXtensible Markup Language (XML) format. The mechanism and work flow by which notifiable infectious disease data are created, reported and used at health agencies in China was evaluated. The capacity of all participating providers to use electronic data interchange to submit transactions of data required for the notifiable infectious disease reporting was assessed. The minimum data set at national level that is required for reporting for national notifiable infectious disease surveillance was determined. The standards and techniques available worldwide for electronic health data interchange, such as XML, HL7 messaging, CDA and ATSM CCR, etc. were reviewed and compared, and an XML implementation format needed for this purpose was defined for hospitals that are able to access the Internet to provide a complete infectious disease reporting. There are 18,703 county or city hospitals in China. All of them have access to basic information infrastructures including computers, e-mail and the Internet. Nearly 10,000 hospitals possess hospital information systems used for electronically recording, retrieving and manipulating patients' information. These systems collect 23 data items required in the minimum data set for national notifiable infectious disease reporting. In order to transmit these data items to the disease surveillance system and local health information systems instantly and without duplication of data input, an XML schema and a set of standard data elements were developed to define the content, structure and semantics of the data set. These standards

Integrating phenotypic data from electronic patient records with molecular level systems biology

DEFF Research Database (Denmark)

Brunak, Søren

2011-01-01

Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracti...... Classification of Disease ontology and is therefore in principle language independent. As a use case we show how records from a Danish psychiatric hospital lead to the identification of disease correlations, which subsequently are mapped to systems biology frameworks....

A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft.

Science.gov (United States)

Kim, K S; Eo, S R; Kim, D Y; Lee, S Y; Cho, B H

2001-01-01

Many methods have been used to reattach amputated fingertips. Of these methods, microsurgery has been accepted as the procedure of choice because the defining characteristic of a microsurgically replanted finger is that its surival in the recipient bed is predicated on functioning intravascular circulation. Although considerable progress has been made in the techniques for microvascular replantation of amputated fingers, the replantation of an amputated fingertip is difficult because digital arteries branch into small arteries. This is in addition to digital veins that run from both sides of the nail bed to the median dorsal sides, which are difficult to separate from the immobile soft tissue. Furthermore, even with the most technically skilled microsurgeon, replantation failure often occurs, especially in severe injury cases. Therefore, the technique is not the only protection against failure, and a new strategy of fingertip reattachment is needed. From March of 1997 to December of 1999, 12 fingers of 11 patients with zone 1 or zone 2 fingertip amputations that were reattached microsurgically but were compromised were deepithelialized, reattached, and then inserted into the abdominal pocket. All had been complete amputations with crushing injuries. Approximately 3 weeks later, the fingers were depocketed and covered with a skin graft. Of the 12 fingers, 7 survived completely and 3 had partial necrosis on less than one-third the volume of the amputated part. The complete survival rate was approximately 58 percent. The results of the above 10 fingers were satisfactory from both functional and cosmetic aspects. The authors believe that this high success rate was achieved because the deepithelialized finger pulp was placed in direct contact with the deep abdominal fascia, which was equipped with plentiful vascularity, not subcutaneous fat. In addition, the pocketing was performed promptly before necrosis of the compromised fingertip occurred. From the results of this

Progress in increasing electronic reporting of laboratory results to public health agencies--United States, 2013.

Science.gov (United States)

2013-09-27

Electronic reporting of laboratory results to public health agencies can improve public health surveillance for reportable diseases and conditions by making reporting more timely and complete. Since 2010, CDC has provided funding to 57 state, local, and territorial health departments through the Epidemiology and Laboratory Capacity for Infectious Diseases cooperative agreement to assist with improving electronic laboratory reporting (ELR) from clinical and public health laboratories to public health agencies. As part of this agreement, CDC and state and large local health departments are collaborating to monitor ELR implementation in the United States by developing data from each jurisdiction regarding total reporting laboratories, laboratories sending ELR by disease category and message format, and the number of ELR laboratory reports compared with the total number of laboratory reports. At the end of July 2013, 54 of the 57 jurisdictions were receiving at least some laboratory reports through ELR, and approximately 62% of 20 million laboratory reports were being received electronically, compared with 54% in 2012. Continued progress will require collaboration between clinical laboratories, laboratory information management system (LIMS) vendors, and public health agencies.

Effective electron-electron and electron-phonon interactions in the Hubbard-Holstein model

International Nuclear Information System (INIS)

Aprea, G.; Di Castro, C.; Grilli, M. . E-mail marco.grilli@roma1.infn.it; Lorenzana, J.

2006-01-01

We investigate the interplay between the electron-electron and the electron-phonon interaction in the Hubbard-Holstein model. We implement the flow-equation method to investigate within this model the effect of correlation on the electron-phonon effective coupling and, conversely, the effect of phonons in the effective electron-electron interaction. Using this technique we obtain analytical momentum-dependent expressions for the effective couplings and we study their behavior for different physical regimes. In agreement with other works on this subject, we find that the electron-electron attraction mediated by phonons in the presence of Hubbard repulsion is peaked at low transferred momenta. The role of the characteristic energies involved is also analyzed

Amyloid Structure and Assembly: Insights from Scanning Transmission Electron Microscopy

Energy Technology Data Exchange (ETDEWEB)

Goldsbury, C.; Wall, J.; Baxa, U.; Simon, M. N.; Steven, A. C.; Engel, A.; Aebi, U.; Muller, S. A.

2011-01-01

Amyloid fibrils are filamentous protein aggregates implicated in several common diseases such as Alzheimer's disease and type II diabetes. Similar structures are also the molecular principle of the infectious spongiform encephalopathies such as Creutzfeldt-Jakob disease in humans, scrapie in sheep, and of the so-called yeast prions, inherited non-chromosomal elements found in yeast and fungi. Scanning transmission electron microscopy (STEM) is often used to delineate the assembly mechanism and structural properties of amyloid aggregates. In this review we consider specifically contributions and limitations of STEM for the investigation of amyloid assembly pathways, fibril polymorphisms and structural models of amyloid fibrils. This type of microscopy provides the only method to directly measure the mass-per-length (MPL) of individual filaments. Made on both in vitro assembled and ex vivo samples, STEM mass measurements have illuminated the hierarchical relationships between amyloid fibrils and revealed that polymorphic fibrils and various globular oligomers can assemble simultaneously from a single polypeptide. The MPLs also impose strong constraints on possible packing schemes, assisting in molecular model building when combined with high-resolution methods like solid-state nuclear magnetic resonance (NMR) and electron paramagnetic resonance (EPR).

An electron microscopic study of clinical Paget's disease of the nipple

DEFF Research Database (Denmark)

Jahn, H; Osther, P J; Nielsen, E H

1995-01-01

An ultrastructural study of the epidermis from eight patients with clinical Paget's disease of the nipple supports the epidermotropic theory. There was no evidence that the Paget's cells originated from keratinocytes. We propose the hypothesis that Paget's cells represent transformed ductal cells...

"Ormilo disease" a disorder of zebu cattle in Tanzania: bovine cerebral theileriosis or new protozoan disease?

Science.gov (United States)

Catalano, Deborah; Biasibetti, Elena; Lynen, Godelieve; Di Giulio, Giuseppe; De Meneghi, Daniele; Tomassone, Laura; Valenza, Federico; Capucchio, Maria Teresa

2015-06-01

"Ormilo" disease is a neurological disorder of cattle described by Maasai herders in Tanzania. It is attributed to infection by Theileria species, although no detailed data are available in the literature. The authors describe the macroscopical and histological changes observed in 30 brains of indigenous short-horn zebu cattle from Northern Tanzania, aged 2-9 years, with the characteristic neurological signs of "Ormilo". Moreover, the ultrastructural details observed in 14 selected brain samples were reported. Areas of congestion and hemorrhages, associated with the obstruction of the cerebral vessels with large numbers of parasitized lymphoid cells, were observed. Electron microscopy showed the presence of intralymphocytic parasites morphologically comparable to flagellated protozoa, not previously described in the lymphoid cells of cattle, but only reported during the sexual stages within the vector. Theileria taurotragi was detected by polymerase chain reaction (PCR) and reverse line blot (RLB) in nine samples. The authors hypothesize that the parasite detected by electron microscopy could be a strain of a Theileria endemic to this region till now not investigated, having an intralymphocytic phase and being associated with other Theileria spp. infestation. Further studies are needed to better understand the etiology of "Ormilo" disease and to characterize the morphology of the observed parasite, clarifying its role in the disease in Tanzania.

Electron-electron coincidence spectroscopies at surfaces

International Nuclear Information System (INIS)

Stefani, G.; Iacobucci, S.; Ruocco, A.; Gotter, R.

2002-01-01

In the past 20 years, a steadily increasing number of electron-electron coincidence experiments on atoms and molecules have contributed to a deeper understanding of electron-electron correlation effects. In more recent years this technique has been extended to the study of solid surfaces. This class of one photon IN two electrons OUT experiments will be discussed with an emphasis on grazing incidence geometry, that is expected to be particularly suited for studying surfaces. The crucial question of which is the dominant mechanism that leads to ejection of pairs of electron from the surface will be addressed. It will be shown that, depending on the kinematics chosen, the correlated behaviour of the pairs of electrons detected might be singled out from independent particle one

An electronic nose in the discrimination of patients with non-small cell lung cancer and COPD

NARCIS (Netherlands)

Dragonieri, Silvano; Annema, Jouke T.; Schot, Robert; van der Schee, Marc P. C.; Spanevello, Antonio; Carratú, Pierluigi; Resta, Onofrio; Rabe, Klaus F.; Sterk, Peter J.

2009-01-01

Background: Exhaled breath contains thousands of gaseous volatile organic compounds (VOCs) that may be used as non-invasive markers of lung disease. The electronic nose analyzes VOCs by composite nano-sensor arrays with learning algorithms. It has been shown that an electronic nose can distinguish

Clinical uses of the medicinal leech: A practical review

Directory of Open Access Journals (Sweden)

B S Porshinsky

2011-01-01

Full Text Available The medicinal leech, Hirudo medicinalis, is an excellent example of the use of invertebrates in the treatment of human disease. Utilized for various medical indications since the ancient times, the medicinal leech is currently being used in a narrow range of well-defined and scientifically-grounded clinical applications. Hirudotherapy is most commonly used in the setting of venous congestion associated with soft tissue replantations and free flap-based reconstructive surgery. This is a comprehensive review of current clinical applications of hirudotherapy, featuring a comprehensive search of all major medical search engines (i.e. PubMed, Google Scholar, ScientificCommons and other cross-referenced sources. The authors focus on indications, contraindications, practical application/handling of the leech, and therapy-related complications.

The Influence of Independent and Intervening Variables on Adoption ...

African Journals Online (AJOL)

=80. Table 2: Distribution of respondents according to sex and adoption of maize varieties. Sex. Adoption. Replanted hybrid Local varieties Recommended hybrid. Total n. % n. % n. % n ... other sources of technology. Better-educated farmers ...

Benefits from cover crops based on plant-microbial interaction

OpenAIRE

Manici , L.M.; Kelderer, M.; Caputo, F.; De Luca Picione , F.; Topp, A.

2014-01-01

This study was performed on the impact of two different cover crops (cereal and legume) on composition of root fungal endophytes and rhizospheric bacterial communities as a function of crop health in replanted apple orchards.

Electron distribution function in electron-beam-excited plasmas

International Nuclear Information System (INIS)

Brau, C.A.

1976-01-01

In monatomic plasmas excited by high-intensity relativistic electron beams, the electron secondary distribution function is dominated by elastic electron-electron collisions at low electron energies and by inelastic electron-atom collisions at high electron energies (above the excitation threshold). Under these conditions, the total rate of excitation by inelastic collisions is limited by the rate at which electron-electron collisions relax the distribution function in the neighborhood of the excitation threshold. To describe this effect quantitatively, an approximate analytic solution of the electron Boltzmann equation is obtained, including both electron-electron and inelastic collisions. The result provides a simple formula for the total rate of excitation

The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health.

Science.gov (United States)

Pillai, Satish K; Beekmann, Susan E; Santibanez, Scott; Polgreen, Philip M

2014-04-01

In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN.

Classification of human pathogen bacteria for early screening using electronic nose

Science.gov (United States)

Zulkifli, Syahida Amani; Mohamad, Che Wan Syarifah Robiah; Abdullah, Abu Hassan

2017-10-01

This paper present human pathogen bacteria for early screening using electronic nose. Electronic nose (E-nose) known as gas sensor array is a device that analyze the odor measurement give the fast response and less time consuming for clinical diagnosis. Many bacterial pathogens could lead to life threatening infections. Accurate and rapid diagnosis is crucial for the successful management of these infections disease. The conventional method need more time to detect the growth of bacterial. Alternatively, the bacteria are Pseudomonas aeruginosa and Shigella cultured on different media agar can be detected and classifies according to the volatile compound in shorter time using electronic nose (E-nose). Then, the data from electronic nose (E-nose) is processed using statistical method which is principal component analysis (PCA). The study shows the capability of electronic nose (E-nose) for early screening for bacterial infection in human stomach.

Skin-Inspired Electronics: An Emerging Paradigm.

Science.gov (United States)

Wang, Sihong; Oh, Jin Young; Xu, Jie; Tran, Helen; Bao, Zhenan

2018-05-15

Future electronics will take on more important roles in people's lives. They need to allow more intimate contact with human beings to enable advanced health monitoring, disease detection, medical therapies, and human-machine interfacing. However, current electronics are rigid, nondegradable and cannot self-repair, while the human body is soft, dynamic, stretchable, biodegradable, and self-healing. Therefore, it is critical to develop a new class of electronic materials that incorporate skinlike properties, including stretchability for conformable integration, minimal discomfort and suppressed invasive reactions; self-healing for long-term durability under harsh mechanical conditions; and biodegradability for reducing environmental impact and obviating the need for secondary device removal for medical implants. These demands have fueled the development of a new generation of electronic materials, primarily composed of polymers and polymer composites with both high electrical performance and skinlike properties, and consequently led to a new paradigm of electronics, termed "skin-inspired electronics". This Account covers recent important advances in skin-inspired electronics, from basic material developments to device components and proof-of-concept demonstrations for integrated bioelectronics applications. To date, stretchability has been the most prominent focus in this field. In contrast to strain-engineering approaches that extrinsically impart stretchability into inorganic electronics, intrinsically stretchable materials provide a direct route to achieve higher mechanical robustness, higher device density, and scalable fabrication. The key is the introduction of strain-dissipation mechanisms into the material design, which has been realized through molecular engineering (e.g., soft molecular segments, dynamic bonds) and physical engineering (e.g., nanoconfinement effect, geometric design). The material design concepts have led to the successful demonstrations of

Hard electronics; Hard electronics

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

Hard material technologies were surveyed to establish the hard electronic technology which offers superior characteristics under hard operational or environmental conditions as compared with conventional Si devices. The following technologies were separately surveyed: (1) The device and integration technologies of wide gap hard semiconductors such as SiC, diamond and nitride, (2) The technology of hard semiconductor devices for vacuum micro- electronics technology, and (3) The technology of hard new material devices for oxides. The formation technology of oxide thin films made remarkable progress after discovery of oxide superconductor materials, resulting in development of an atomic layer growth method and mist deposition method. This leading research is expected to solve such issues difficult to be easily realized by current Si technology as high-power, high-frequency and low-loss devices in power electronics, high temperature-proof and radiation-proof devices in ultimate electronics, and high-speed and dense- integrated devices in information electronics. 432 refs., 136 figs., 15 tabs.

A case developing minimal change disease during the course of IgG4-related disease.

Science.gov (United States)

Yamada, Kazunori; Zoshima, Takeshi; Ito, Kiyoaki; Mizushima, Ichiro; Hara, Satoshi; Horita, Shigeto; Nuka, Hiromi; Hamano, Ryoko; Fujii, Hiroshi; Yamagishi, Masakazu; Kawano, Mitsuhiro

2017-07-01

We describe a 66-year-old male with immunoglobulin G4-related disease (IgG4-RD) presenting with minimal change disease (MCD). Three years prior to this admission, the patient had been diagnosed with IgG4-RD. The development of sudden massive proteinuria (4+; 16.7 g/gCr) with a weight gain of 8 kg within a two-week period was noted, and nephrotic syndrome was suspected. The patient's serum IgG4 level did not increase and hypocomplementemia was not found. A renal biopsy showed no cellular infiltration in the renal interstitium, and no spiking or bubbling was found on periodic acid methenamine silver staining. On electron microscopy, foot process effacement was seen, but no subepithelial electron-dense deposits were found. The patient was diagnosed with MCD. Ten days after starting prednisolone (60 mg/day), proteinuria was negative. Since IgG4-RD and MCD share a T-helper 2-dominant immunoreaction, the development of MCD in IgG4-RD patients may reflect more than a mere coincidence.

An analytical approach to characterize morbidity profile dissimilarity between distinct cohorts using electronic medical records.

Science.gov (United States)

Schildcrout, Jonathan S; Basford, Melissa A; Pulley, Jill M; Masys, Daniel R; Roden, Dan M; Wang, Deede; Chute, Christopher G; Kullo, Iftikhar J; Carrell, David; Peissig, Peggy; Kho, Abel; Denny, Joshua C

2010-12-01

We describe a two-stage analytical approach for characterizing morbidity profile dissimilarity among patient cohorts using electronic medical records. We capture morbidities using the International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes. In the first stage of the approach separate logistic regression analyses for ICD-9 sections (e.g., "hypertensive disease" or "appendicitis") are conducted, and the odds ratios that describe adjusted differences in prevalence between two cohorts are displayed graphically. In the second stage, the results from ICD-9 section analyses are combined into a general morbidity dissimilarity index (MDI). For illustration, we examine nine cohorts of patients representing six phenotypes (or controls) derived from five institutions, each a participant in the electronic MEdical REcords and GEnomics (eMERGE) network. The phenotypes studied include type II diabetes and type II diabetes controls, peripheral arterial disease and peripheral arterial disease controls, normal cardiac conduction as measured by electrocardiography, and senile cataracts. Copyright © 2010 Elsevier Inc. All rights reserved.

Usefulness of data from primary care for real-time surveillance of diseases.

NARCIS (Netherlands)

Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

2006-01-01

Background: The increased threat of bioterrorism and the outbreaks of new infectious diseases require rapid identification of clusters of illness. The increased availability of electronic data in health care makes real-time surveillance of diseases possible. Therefore, we investigated the

A survey of occupational health hazards among 7,610 female workers in China's electronics industry.

Science.gov (United States)

Yu, Wenlan; Lao, Xiang Qian; Pang, Shulan; Zhou, Jianjiao; Zhou, Anshou; Zou, Jianfang; Mei, Liangying; Yu, Ignatius Tak-sun

2013-01-01

To investigate the occupational hazards among Chinese female workers in the electronics industry, the authors systematically sampled a total of 8,300 female workers at random across 4 provinces in a variety of electronics factories. A detailed questionnaire was used to collect information on occupational hazards and the occurrence of occupation-related diseases. The results show that 4,283 female workers (51.9%) were exposed to 1 or more occupational hazards. The most common chemical hazard was organic solvent, and the second most common was heavy metals. The ergonomic hazards included repetitive movements, poor standing posture, and the lifting of heavy goods. More than 60% of the female workers self-reported occupation-related diseases. These results showed that occupational health hazards were common in the electronics industry in China and that they caused serious occupation-related health problems for the female workers therein.

Electron radiography

Science.gov (United States)

Merrill, Frank E.; Morris, Christopher

2005-05-17

A system capable of performing radiography using a beam of electrons. Diffuser means receive a beam of electrons and diffuse the electrons before they enter first matching quadrupoles where the diffused electrons are focused prior to the diffused electrons entering an object. First imaging quadrupoles receive the focused diffused electrons after the focused diffused electrons have been scattered by the object for focusing the scattered electrons. Collimator means receive the scattered electrons and remove scattered electrons that have scattered to large angles. Second imaging quadrupoles receive the collimated scattered electrons and refocus the collimated scattered electrons and map the focused collimated scattered electrons to transverse locations on an image plane representative of the electrons' positions in the object.

Re-plant problems in long-term no-tillage cropping systems : causal analysis and mitigation strategies

OpenAIRE

Afzal

2016-01-01

No-tillage is considered as a promising alternative for tillage-based conventional farming, by saving energy-input and time, reducing groundwater pollution and counteracting soil erosion and losses of the soil-organic matter. However, in the recent past, no-tillage farmers in Southwest Germany repeatedly reported problems particularly in winter wheat production, characterized by stunted plant growth in early spring, chlorosis, impaired fine root development and increased disease susceptibilit...

Comparative analyses of population-scale phenomic data in electronic medical records reveal race-specific disease networks

Science.gov (United States)

Glicksberg, Benjamin S.; Li, Li; Badgeley, Marcus A.; Shameer, Khader; Kosoy, Roman; Beckmann, Noam D.; Pho, Nam; Hakenberg, Jörg; Ma, Meng; Ayers, Kristin L.; Hoffman, Gabriel E.; Dan Li, Shuyu; Schadt, Eric E.; Patel, Chirag J.; Chen, Rong; Dudley, Joel T.

2016-01-01

Motivation: Underrepresentation of racial groups represents an important challenge and major gap in phenomics research. Most of the current human phenomics research is based primarily on European populations; hence it is an important challenge to expand it to consider other population groups. One approach is to utilize data from EMR databases that contain patient data from diverse demographics and ancestries. The implications of this racial underrepresentation of data can be profound regarding effects on the healthcare delivery and actionability. To the best of our knowledge, our work is the first attempt to perform comparative, population-scale analyses of disease networks across three different populations, namely Caucasian (EA), African American (AA) and Hispanic/Latino (HL). Results: We compared susceptibility profiles and temporal connectivity patterns for 1988 diseases and 37 282 disease pairs represented in a clinical population of 1 025 573 patients. Accordingly, we revealed appreciable differences in disease susceptibility, temporal patterns, network structure and underlying disease connections between EA, AA and HL populations. We found 2158 significantly comorbid diseases for the EA cohort, 3265 for AA and 672 for HL. We further outlined key disease pair associations unique to each population as well as categorical enrichments of these pairs. Finally, we identified 51 key ‘hub’ diseases that are the focal points in the race-centric networks and of particular clinical importance. Incorporating race-specific disease comorbidity patterns will produce a more accurate and complete picture of the disease landscape overall and could support more precise understanding of disease relationships and patient management towards improved clinical outcomes. Contacts: rong.chen@mssm.edu or joel.dudley@mssm.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27307606

Electron transfer from electronic excited states to sub-vacuum electron traps in amorphous ice

International Nuclear Information System (INIS)

Vichnevetski, E.; Bass, A.D.; Sanche, L.

2000-01-01

We investigate the electron stimulated yield of electronically excited argon atoms (Ar * ) from monolayer quantities of Ar deposited onto thin films of amorphous ice. Two peaks of narrow width ( - electron-exciton complex into exciton states, by the transfer of an electron into a sub-vacuum electron state within the ice film. However, the 10.7 eV feature is shifted to lower energy since electron attachment to Ar occurs within small pores of amorphous ice. In this case, the excess electron is transferred into an electron trap below the conduction band of the ice layer

Comparative analyses of population-scale phenomic data in electronic medical records reveal race-specific disease networks.

Science.gov (United States)

Glicksberg, Benjamin S; Li, Li; Badgeley, Marcus A; Shameer, Khader; Kosoy, Roman; Beckmann, Noam D; Pho, Nam; Hakenberg, Jörg; Ma, Meng; Ayers, Kristin L; Hoffman, Gabriel E; Dan Li, Shuyu; Schadt, Eric E; Patel, Chirag J; Chen, Rong; Dudley, Joel T

2016-06-15

Underrepresentation of racial groups represents an important challenge and major gap in phenomics research. Most of the current human phenomics research is based primarily on European populations; hence it is an important challenge to expand it to consider other population groups. One approach is to utilize data from EMR databases that contain patient data from diverse demographics and ancestries. The implications of this racial underrepresentation of data can be profound regarding effects on the healthcare delivery and actionability. To the best of our knowledge, our work is the first attempt to perform comparative, population-scale analyses of disease networks across three different populations, namely Caucasian (EA), African American (AA) and Hispanic/Latino (HL). We compared susceptibility profiles and temporal connectivity patterns for 1988 diseases and 37 282 disease pairs represented in a clinical population of 1 025 573 patients. Accordingly, we revealed appreciable differences in disease susceptibility, temporal patterns, network structure and underlying disease connections between EA, AA and HL populations. We found 2158 significantly comorbid diseases for the EA cohort, 3265 for AA and 672 for HL. We further outlined key disease pair associations unique to each population as well as categorical enrichments of these pairs. Finally, we identified 51 key 'hub' diseases that are the focal points in the race-centric networks and of particular clinical importance. Incorporating race-specific disease comorbidity patterns will produce a more accurate and complete picture of the disease landscape overall and could support more precise understanding of disease relationships and patient management towards improved clinical outcomes. rong.chen@mssm.edu or joel.dudley@mssm.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

Monte Carlo study of electron relaxation in graphene with spin polarized, degenerate electron gas in presence of electron-electron scattering

Science.gov (United States)

Borowik, Piotr; Thobel, Jean-Luc; Adamowicz, Leszek

2017-12-01

The Monte Carlo simulation method is applied to study the relaxation of excited electrons in monolayer graphene. The presence of spin polarized background electrons population, with density corresponding to highly degenerate conditions is assumed. Formulas of electron-electron scattering rates, which properly account for electrons presence in two energetically degenerate, inequivalent valleys in this material are presented. The electron relaxation process can be divided into two phases: thermalization and cooling, which can be clearly distinguished when examining the standard deviation of electron energy distribution. The influence of the exchange effect in interactions between electrons with parallel spins is shown to be important only in transient conditions, especially during the thermalization phase.

Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients.

Directory of Open Access Journals (Sweden)

Julie George

Full Text Available While the association of ethnic group with individual cardiovascular diseases has been studied, little is known about ethnic differences in the initial lifetime presentation of clinical cardiovascular disease in contemporary populations.We studied 1,068,318 people, aged ≥30 years and free from diagnosed CVD at baseline (90.9% White, 3.6% South Asian and 2.9% Black, using English linked electronic health records covering primary care, hospital admissions, acute coronary syndrome registry and mortality registry (CALIBER platform. During 5.7 years median follow-up between 1997-2010, 95,224 people experienced an incident cardiovascular diagnosis. 69.9% (67.2%-72.4% of initial presentation in South Asian <60 yrs were coronary heart disease presentations compared to 47.8% (47.3%-48.3% in White and 40.1% (36.3%-43.9% in Black patients. Compared to White patients, Black patients had significantly lower age-sex adjusted hazard ratios (HRs for initial lifetime presentation of all the coronary disease diagnoses (stable angina HR 0.80 (95% CI 0.68-0.93; unstable angina- 0.75 (0.59-0.97; myocardial infarction 0.49 (0.40-0.62 while South Asian patients had significantly higher HRs (stable angina- 1.67 (1.52-1.84; unstable angina 1.82 (1.56-2.13; myocardial infarction- 1.67 (1.49-1.87. We found no ethnic differences in initial presentation with heart failure (Black 0.97 (0.79-1.20; S Asian 1.04(0.87-1.26. Compared to White patients, Black patients were more likely to present with ischaemic stroke (1.24 (0.97-1.58 and intracerebral haemorrhage (1.44 (0.97-2.12. Presentation with peripheral arterial disease was less likely for Black (0.63 (0.50-0.80 and South Asian patients (0.70 (0.57-0.86 compared with White patients.While we found the anticipated substantial predominance of coronary heart disease presentations in South Asian and predominance of stroke presentations in Black patients, we found no ethnic differences in presentation with heart failure. We

Yellow fever vaccine-associated viscerotropic disease: current perspectives

OpenAIRE

Thomas, Roger E

2016-01-01

Roger E Thomas Department of Family Medicine, Faculty of Medicine, University of Calgary, Research Office, G012, Health Sciences Centre, Calgary, AB, Canada Purpose: To assess those published cases of yellow fever (YF) vaccine-associated viscerotropic disease that meet the Brighton Collaboration criteria and to assess the safety of YF vaccine with respect to viscerotropic disease. Literature search: Ten electronic databases were searched with no restriction of date or language and r...

Big Data for Infectious Disease Surveillance and Modeling

OpenAIRE

Bansal, Shweta; Chowell, Gerardo; Simonsen, Lone; Vespignani, Alessandro; Viboud, Cécile

2016-01-01

We devote a special issue of the Journal of Infectious Diseases to review the recent advances of big data in strengthening disease surveillance, monitoring medical adverse events, informing transmission models, and tracking patient sentiments and mobility. We consider a broad definition of big data for public health, one encompassing patient information gathered from high-volume electronic health records and participatory surveillance systems, as well as mining of digital traces such as socia...

Correlative Light and Electron Microscopy (CLEM) and its applications in infectious disease

Science.gov (United States)

2016-05-20

has been shown to handle OsO4 fixation by withstanding standard EM processing concentrations of 1% [29]. A great utility of FPs is the endogenous...Development of imaging techniques to study the pathogenesis of biosafety level 2/3 infectious agents. Pathog Dis, 2014. 72(3): p. 167-73. 3. Sridhar...3): p. 397-406. 32. Johnson, E., et al., Correlative in-resin super-resolution and electron microscopy using standard fluorescent proteins. Sci Rep

Fingertip injuries: an update on management.

Science.gov (United States)

Lee, Donald H; Mignemi, Megan E; Crosby, Samuel N

2013-12-01

Injuries to the fingertip are common. The goal of treatment is restoration of a painless, functional digit with protective sensation. The amount of soft-tissue loss, the integrity of the nail bed, and the age and physical demands of the patient should be considered when selecting a treatment method. Some new products are effective for management of injuries to the fingertip. The use of 2-octylcyanoacrylate for nail bed repair is faster than suture repair, with equivalent results reported. Dermal regeneration template is effective for coverage of digital injuries with exposed tendons or bones that lack peritenon or periosteum. Although fingertip replantation offers better functional results than does revision amputation, replantation is more technically demanding and requires longer recovery time. Complications associated with management of injuries to the fingertip include nail deformities, insensate digits, and painful neuromas.

Revascularization of an impacted, immature dilacerated permanent maxillary central incisor associated with odontoma and a supernumerary tooth

Directory of Open Access Journals (Sweden)

Priya Subramaniam

2013-01-01

Full Text Available To intentionally replant an impacted immature permanent maxillary central incisor in the mixed dentition period followed by revascularization in order to achieve apical root closure. A 9-year-old boy presented with retained maxillary left primary incisors. Radiographic evaluation revealed the presence of a supernumerary tooth and an odontoma associated with an impacted permanent maxillary left central incisor, having root dilaceration. Treatment included surgical removal of mesiodens and odontoma. The impacted dilacerated permanent central incisor was removed and intentionally replanted, followed by revascularization of pulp. During the follow-up, root end closure with narrowing of canal space was observed, patient has been asymptomatic and the tooth remains vital. Revascularization of the immature reimplanted tooth showed continued root development and thickening of the lateral dentinal walls through deposition of new hard tissue and narrowing of the canal space.

78 FR 43797 - Protection of Stratospheric Ozone: The 2013 Critical Use Exemption From the Phaseout of Methyl...

Science.gov (United States)

2013-07-22

... replants Ornamentals Peppers--field Strawberry--field Strawberry runners Tomatoes--field EPA sought comment... Southeastern Pepper Consortium; members of the Southeastern Strawberry Consortium and Florida strawberry..., curcurbits, strawberries, ornamentals and forest nursery seedlings, and onions. The CUN considered only a...

Ciliary body toxicities of systemic oxcarbazepine and valproic acid treatments: electron microscopic study.

Science.gov (United States)

Göktaş, Güleser; Aktaş, Zeynep; Erdoğan, Deniz; Seymen, Cemile Merve; Karaca, Emine Esra; Cansu, Ali; Serdaroğlu, Ayşe; Kaplanoğlu, Gülnur Take

2015-01-01

Ciliary body is responsible for humour aqueous production in posterior chamber. Valproic acid (VPA) has been widely used for the treatment of epilepsy and other neuropsychiatric diseases such as bipolar disease and major depression. Oxcarbazepine (OXC) is a new anti-epileptic agent that has been used recently for childhood epilepsies such as VPA. In this study, we aimed to investigate the effects of VPA and OXC treatments used as antiepileptic in ciliary body by electron microscopy. In our study, 40 Wistar rats (21 days old) were divided equally into four groups which were applied saline (group 1), VPA (group 2), OXC (group 3) and VPA + OXC (group 4). The as-prepared ocular tissues were characterized by transmission electron microscopy (TEM) technique in scanning and transmission electron microscopy (SEM-TEM) (Carl Zeiss EVO LS10). The results confirmed that VPA caused dense ciliary body degeneration. Additionally, ciliary body degeneration in group 4 was supposed to be due to VPA treatment. Ciliary body damage and secondary outcomes should be considered in patients with long-term VPA therapy.

Multiprofissional electronic protocol in ophtalmology with enfasis in strabismus

Directory of Open Access Journals (Sweden)

CHRISTIE GRAF RIBEIRO

Full Text Available ABSTRACT Objective: to create and validate an electronic database in ophthalmology focused on strabismus, to computerize this database in the form of a systematic data collection software named Electronic Protocol, and to incorporate this protocol into the Integrated System of Electronic Protocols (SINPE(c. Methods: this is a descriptive study, with the methodology divided into three phases: (1 development of a theoretical ophthalmologic database with emphasis on strabismus; (2 computerization of this theoretical ophthalmologic database using SINPE(c and (3 interpretation of the information with demonstration of results to validate the protocol. We inputed data from the charts of fifty patients with known strabismus through the Electronic Protocol for testing and validation. Results: the new electronic protocol was able to store information regarding patient history, physical examination, laboratory exams, imaging results, diagnosis and treatment of patients with ophthalmologic diseases, with emphasis on strabismus. We included 2,141 items in this master protocol and created 20 new specific electronic protocols for strabismus, each with its own specifics. Validation was achieved through correlation and corroboration of the symptoms and confirmed diagnoses of the fifty included patients with the diagnostic criteria for the twenty new strabismus protocols. Conclusion: a new, validated electronic database focusing on ophthalmology, with emphasis on strabismus, was successfully created through the standardized collection of information, and computerization of the database using proprietary software. This protocol is ready for deployment to facilitate data collection, sorting and application for practitioners and researchers in numerous specialties.

Electron attachment cross sections obtained from electron attachment spectroscopy

International Nuclear Information System (INIS)

Popp, P.; Baumbach, J.I.; Leonhardt, J.W.; Mothes, S.

1988-01-01

Electron capture detectors have a high sensitivity for substances with high thermal electron attachment cross sections. The electron attachment spectroscopy makes it possible to change the mean electron energy in such a way that the maximum for dissociative electron attachment is reached. Thus, best operation modes of the detection system as well as significant dependencies of electron attachment coefficients are available. Cross sections for electron attachment as a function of the electron energy are obtained with the knowledge of electron energy distribution functions from Boltzmann equation analysis by a special computer code. A disadvantage of this electron attachment spectroscopy is the superposition of space charge effects due to the decrease of the electron drift velocity with increasing mean electron energy. These influences are discussed. (author)

Electron beam effects in auger electron spectroscopy and scanning electron microscopy

International Nuclear Information System (INIS)

Fontaine, J.M.; Duraud, J.P.; Le Gressus, C.

1979-01-01

Electron beam effects on Si(100) and 5% Fe/Cr alloy samples have been studied by measurements of the secondary electron yield delta, determination of the surface composition by Auger electron spectroscopy and imaging with scanning electron microscopy. Variations of delta as a function of the accelerating voltage Esub(p) (0.5 -9 Torr has no effect on technological samples covered with their reaction layers; the sensitivities to the beam depend rather on the earlier mechanical, thermal and chemical treatment of the surfaces. (author)

The effect of electron-electron interaction induced dephasing on electronic transport in graphene nanoribbons

Energy Technology Data Exchange (ETDEWEB)

Kahnoj, Sina Soleimani; Touski, Shoeib Babaee [School of Electrical and Computer Engineering, University of Tehran, P.O. Box 14395-515, Tehran (Iran, Islamic Republic of); Pourfath, Mahdi, E-mail: pourfath@ut.ac.ir, E-mail: pourfath@iue.tuwien.ac.at [School of Electrical and Computer Engineering, University of Tehran, P.O. Box 14395-515, Tehran (Iran, Islamic Republic of); Institute for Microelectronics, TU Wien, Gusshausstrasse 27–29/E360, 1040 Vienna (Austria)

2014-09-08

The effect of dephasing induced by electron-electron interaction on electronic transport in graphene nanoribbons is theoretically investigated. In the presence of disorder in graphene nanoribbons, wavefunction of electrons can set up standing waves along the channel and the conductance exponentially decreases with the ribbon's length. Employing the non-equilibrium Green's function formalism along with an accurate model for describing the dephasing induced by electron-electron interaction, we show that this kind of interaction prevents localization and transport of electrons remains in the diffusive regime where the conductance is inversely proportional to the ribbon's length.

Electron Beam Generation in Tevatron Electron Lenses

International Nuclear Information System (INIS)

Kamerdzhiev, V.; Kuznetsov, G.; Shiltsev, V.; Solyak, N.; Tiunov, M.

2006-01-01

New type of high perveance electron guns with convex cathode has been developed. Three guns described in this article are built to provide transverse electron current density distributions needed for Electron Lenses for beam-beam compensation in the Tevatron collider. The current distribution can be controlled either by the gun geometry or by voltage on a special control electrode located near cathode. We present the designs of the guns and report results of beam measurements on the test bench. Because of their high current density and low transverse temperature of electrons, electron guns of this type can be used in electron cooling and beam-beam compensation devices

Electron beam generation in Tevatron electron lenses

International Nuclear Information System (INIS)

Kamerdzhiev, V.; Kuznetsov, G.; Shiltsev, V.; Solyak, N.; Tiunov, M.

2006-01-01

New type of high perveance electron guns with convex cathode has been developed. Three guns described in this article are built to provide transverse electron current density distributions needed for Electron Lenses for beam-beam compensation in the Tevatron collider. The current distribution can be controlled either by the gun geometry or by voltage on a special control electrode located near cathode. We present the designs of the guns and report results of beam measurements on the test bench. Because of their high current density and low transverse temperature of electrons, electron guns of this type can be used in electron cooling and beam-beam compensation devices

Respiratory bronchiolitis-associated interstitial lung disease secondary to electronic nicotine delivery system use confirmed with open lung biopsy.

Science.gov (United States)

Flower, Mark; Nandakumar, Lakshmy; Singh, Mahendra; Wyld, David; Windsor, Morgan; Fielding, David

2017-05-01

As a modern phenomenon, there is currently limited understanding of the possible toxic effects and broader implications of electronic nicotine delivery systems (ENDS). Large volumes of aerosolized particles are inhaled during "vaping" and there are now an increasing number of case reports demonstrating toxic effects of ENDS, as well as human studies demonstrating impaired lung function in users. This article presents a case of respiratory bronchiolitis interstitial lung disease (RB-ILD) precipitated by vaping in a 33-year-old male with 10 pack years of traditional cigarette and prior treatment for mixed germ cell tumour. The patient had started vaping 10-15 times per day while continuing to smoke 10 traditional cigarettes per day. After 3 months of exposure to e-cigarette vapour, chest computed tomography demonstrated multiple new poorly defined pulmonary nodules with fluffy parenchyma opacification centred along the terminal bronchovascular units. Video-assisted thoracoscopy with lung biopsy of the right upper and right middle lobes was undertaken. The microscopic findings were overall consistent with RB-ILD. This case demonstrates toxicity with use of ENDS on open lung biopsy with resolution of radiographic findings on cessation. We believe that this is the first case where open lung biopsy has demonstrated this and our findings are consistent with RB-ILD.

Electronic technology

International Nuclear Information System (INIS)

Kim, Jin Su

2010-07-01

This book is composed of five chapters, which introduces electronic technology about understanding of electronic, electronic component, radio, electronic application, communication technology, semiconductor on its basic, free electron and hole, intrinsic semiconductor and semiconductor element, Diode such as PN junction diode, characteristic of junction diode, rectifier circuit and smoothing circuit, transistor on structure of transistor, characteristic of transistor and common emitter circuit, electronic application about electronic equipment, communication technology and education, robot technology and high electronic technology.

Electronic Cigarette Prevalence and Patterns of Use in Adults with a History of Cardiovascular Disease in the United States.

Science.gov (United States)

Stokes, Andrew; Collins, Jason M; Berry, Kaitlyn M; Reynolds, Lindsay M; Fetterman, Jessica L; Rodriguez, Carlos J; Siegel, Michael B; Benjamin, Emelia J

2018-04-26

Characterizing electronic cigarette (e-cigarette) use patterns is important for guiding tobacco regulatory policy and projecting the future burden of tobacco-related diseases. Few studies have examined patterns of e-cigarette use in individuals with cardiovascular disease (CVD). We examined e-cigarette use in adults aged 18 to 89 years with a history of CVD, using data from the 2014 National Health Interview Survey. We investigated associations between ever and current e-cigarette use and smoking with multivariable logistic regression. In a secondary analysis, we modeled the association between e-cigarette use and a quit attempt over the past year. Former smokers with CVD who quit smoking within the past year showed 1.85 (95% confidence interval, 1.03, 3.33) times the odds of having ever used e-cigarettes as compared with those who reported being "some days" current smokers. Current smokers who attempted to quit smoking within the past year showed significantly increased odds of ever having used e-cigarettes (odds ratio, 1.70; 95% confidence interval, 1.25, 2.30) and currently using e-cigarettes (odds ratio, 1.97; 95% confidence interval, 1.32, 2.95) as compared with smokers who had not attempted to quit over the past year. Individuals with CVD who recently quit smoking or reported a recent quit attempt were significantly more likely to use e-cigarettes than current smokers and those who did not report a quit attempt. Our findings may indicate that this population is using e-cigarettes as an aid to smoking cessation. Characterizing emerging e-cigarette use behaviors in adults with CVD may help to inform outreach activities aimed at this high-risk population. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

The Electron

Energy Technology Data Exchange (ETDEWEB)

Thomson, George

1972-01-01

Electrons are elementary particles of atoms that revolve around and outside the nucleus and have a negative charge. This booklet discusses how electrons relate to electricity, some applications of electrons, electrons as waves, electrons in atoms and solids, the electron microscope, among other things.

Determination of the electron-electron collisional frequency by means of plasma electron spectroscopy

International Nuclear Information System (INIS)

Kolokolov, N.B.; Kudryavtsev, A.A.; Romanenko, V.A.

1989-01-01

Methods of controlling fast part of electron distribution function (DF) in nonlocal regime of current-free plasma are suggested and realized. Artificially created step in DF fast part has a simple link with frequencies of electron-electron and elastic electron-atom collisions that may be defined in the corresponding experiments

Electron beam-plasma interaction and electron-acoustic solitary waves in a plasma with suprathermal electrons

Science.gov (United States)

Danehkar, A.

2018-06-01

Suprathermal electrons and inertial drifting electrons, so called electron beam, are crucial to the nonlinear dynamics of electrostatic solitary waves observed in several astrophysical plasmas. In this paper, the propagation of electron-acoustic solitary waves (EAWs) is investigated in a collisionless, unmagnetized plasma consisting of cool inertial background electrons, hot suprathermal electrons (modeled by a κ-type distribution), and stationary ions. The plasma is penetrated by a cool electron beam component. A linear dispersion relation is derived to describe small-amplitude wave structures that shows a weak dependence of the phase speed on the electron beam velocity and density. A (Sagdeev-type) pseudopotential approach is employed to obtain the existence domain of large-amplitude solitary waves, and investigate how their nonlinear structures depend on the kinematic and physical properties of the electron beam and the suprathermality (described by κ) of the hot electrons. The results indicate that the electron beam can largely alter the EAWs, but can only produce negative polarity solitary waves in this model. While the electron beam co-propagates with the solitary waves, the soliton existence domain (Mach number range) becomes narrower (nearly down to nil) with increasing the beam speed and the beam-to-hot electron temperature ratio, and decreasing the beam-to-cool electron density ratio in high suprathermality (low κ). It is found that the electric potential amplitude largely declines with increasing the beam speed and the beam-to-cool electron density ratio for co-propagating solitary waves, but is slightly decreased by raising the beam-to-hot electron temperature ratio.

Advances in electronic-nose technologies developed for biomedical applications.

Science.gov (United States)

Wilson, Alphus D; Baietto, Manuela

2011-01-01

The research and development of new electronic-nose applications in the biomedical field has accelerated at a phenomenal rate over the past 25 years. Many innovative e-nose technologies have provided solutions and applications to a wide variety of complex biomedical and healthcare problems. The purposes of this review are to present a comprehensive analysis of past and recent biomedical research findings and developments of electronic-nose sensor technologies, and to identify current and future potential e-nose applications that will continue to advance the effectiveness and efficiency of biomedical treatments and healthcare services for many years. An abundance of electronic-nose applications has been developed for a variety of healthcare sectors including diagnostics, immunology, pathology, patient recovery, pharmacology, physical therapy, physiology, preventative medicine, remote healthcare, and wound and graft healing. Specific biomedical e-nose applications range from uses in biochemical testing, blood-compatibility evaluations, disease diagnoses, and drug delivery to monitoring of metabolic levels, organ dysfunctions, and patient conditions through telemedicine. This paper summarizes the major electronic-nose technologies developed for healthcare and biomedical applications since the late 1980s when electronic aroma detection technologies were first recognized to be potentially useful in providing effective solutions to problems in the healthcare industry.

Advances in Electronic-Nose Technologies Developed for Biomedical Applications

Directory of Open Access Journals (Sweden)

Alphus D. Wilson

2011-01-01

Full Text Available The research and development of new electronic-nose applications in the biomedical field has accelerated at a phenomenal rate over the past 25 years. Many innovative e-nose technologies have provided solutions and applications to a wide variety of complex biomedical and healthcare problems. The purposes of this review are to present a comprehensive analysis of past and recent biomedical research findings and developments of electronic-nose sensor technologies, and to identify current and future potential e-nose applications that will continue to advance the effectiveness and efficiency of biomedical treatments and healthcare services for many years. An abundance of electronic-nose applications has been developed for a variety of healthcare sectors including diagnostics, immunology, pathology, patient recovery, pharmacology, physical therapy, physiology, preventative medicine, remote healthcare, and wound and graft healing. Specific biomedical e-nose applications range from uses in biochemical testing, blood-compatibility evaluations, disease diagnoses, and drug delivery to monitoring of metabolic levels, organ dysfunctions, and patient conditions through telemedicine. This paper summarizes the major electronic-nose technologies developed for healthcare and biomedical applications since the late 1980s when electronic aroma detection technologies were first recognized to be potentially useful in providing effective solutions to problems in the healthcare industry.

Smart Technology in Lung Disease Clinical Trials.

Science.gov (United States)

Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

2016-01-01

This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research. Published by Elsevier Inc.

Exploring the use of tablet computer-based electronic data capture system to assess patient reported measures among patients with chronic kidney disease: a pilot study.

Science.gov (United States)

Wong, Dorothy; Cao, Shen; Ford, Heather; Richardson, Candice; Belenko, Dmitri; Tang, Evan; Ugenti, Luca; Warsmann, Eleanor; Sissons, Amanda; Kulandaivelu, Yalinie; Edwards, Nathaniel; Novak, Marta; Li, Madeline; Mucsi, Istvan

2017-12-06

Collecting patient reported outcome measures (PROMs) via computer-based electronic data capture system may improve feasibility and facilitate implementation in clinical care. We report our initial experience about the acceptability of touch-screen tablet computer-based, self-administered questionnaires among patients with chronic kidney disease (CKD), including stage 5 CKD treated with renal replacement therapies (RRT) (either dialysis or transplant). We enrolled a convenience sample of patients with stage 4 and 5 CKD (including patients on dialysis or after kidney transplant) in a single-centre, cross-sectional pilot study. Participants completed validated questionnaires programmed on an electronic data capture system (DADOS, Techna Inc., Toronto) on tablet computers. The primary objective was to evaluate the acceptability and feasibility of using tablet-based electronic data capture in patients with CKD. Descriptive statistics, Fischer's exact test and multivariable logistic regression models were used for data analysis. One hundred and twenty one patients (55% male, mean age (± SD) of 58 (±14) years, 49% Caucasian) participated in the study. Ninety-two percent of the respondents indicated that the computer tablet was acceptable and 79% of the participants required no or minimal help for completing the questionnaires. Acceptance of tablets was lower among patients 70 years or older (75% vs. 95%; p = 0.011) and with little previous computer experience (81% vs. 96%; p = 0.05). Furthermore, a greater level of assistance was more frequently required by patients who were older (45% vs. 15%; p = 0.009), had lower level of education (33% vs. 14%; p = 0.027), low health literacy (79% vs. 12%; p = 0.027), and little previous experience with computers (52% vs. 10%; p = 0.027). Tablet computer-based electronic data capture to administer PROMs was acceptable and feasible for most respondents and could therefore be used to systematically assess PROMs

Identifying primary care patients at risk for future diabetes and cardiovascular disease using electronic health records

Directory of Open Access Journals (Sweden)

Shrader Peter

2009-09-01

Full Text Available Abstract Background Prevention of diabetes and coronary heart disease (CHD is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. Methods We analyzed electronic health record (EHR data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic syndrome (MetS characteristics defined by NCEP-ATPIII criteria; if missing, we used surrogate characteristics, and validated this approach by directly measuring risk factors in a subset of 154 patients. For subjects with at least 3 of 5 MetS criteria measured at baseline (2003-2004, we defined 3 categories: No MetS (0 criteria; At-risk-for MetS (1-2 criteria; and MetS (≥ 3 criteria. We examined new diabetes and CHD incidence, and resource utilization over the subsequent 3-year period (2005-2007 using age-sex-adjusted regression models to compare outcomes by MetS category. Results After excluding patients with diabetes/CHD at baseline, 78,293 patients were eligible for analysis. EHR-defined MetS had 73% sensitivity and 91% specificity for directly measured MetS. Diabetes incidence was 1.4% in No MetS; 4.0% in At-risk-for MetS; and 11.0% in MetS (p MetS vs No MetS = 6.86 [6.06-7.76]; CHD incidence was 3.2%, 5.3%, and 6.4% respectively (p Conclusion Risk factor clustering in EHR data identifies primary care patients at increased risk for new diabetes, CHD and higher resource utilization.

Personal health records as portal to the electronic medical record.

Science.gov (United States)

Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

2014-03-01

This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients.

Identifying patterns of non-communicable diseases in developed eastern coastal China: a longitudinal study of electronic health records from 12 public hospitals.

Science.gov (United States)

Yu, Dehua; Shi, Jianwei; Zhang, Hanzhi; Wang, Zhaoxin; Lu, Yuan; Zhang, Bin; Pan, Ying; Wang, Bo; Sun, Pengfei

2017-10-05

Few studies have examined the spectrum and trends of non-communicable diseases (NCDs) in inpatients in eastern coastal China, which is transforming from an industrial economy to a service-oriented economy and is the most economically developed region in the country. This study aimed to dynamically elucidate the spectrum and characteristics of severe NCDs in eastern coastal China by analysing patients' longitudinal electronic health records (EHRs). To monitor the spectrum of NCDs dynamically, we extracted the EHR data from 12 general tertiary hospitals in eastern coastal China from 2003 to 2014. The rankings of and trends in the proportions of different NCDs presented by inpatients in different gender and age groups were calculated and analysed. We obtained a total sample of 1 907 484 inpatients with NCDs from 2003 to 2014, 50.05% of whom were men and 81.53% were aged 50 years or older. There was an increase in the number of total NCD inpatients in eastern coastal China from 2003 to 2014. However, the proportion of chronic respiratory diseases and cancer inpatients decreased over the 12-year period. Compared with men, women displayed a significant increase in the proportion of mental and behavioural disorders (pdeveloping prevention guides for regions experiencing transition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

FCDD: A Database for Fruit Crops Diseases.

Science.gov (United States)

Chauhan, Rupal; Jasrai, Yogesh; Pandya, Himanshu; Chaudhari, Suman; Samota, Chand Mal

2014-01-01

Fruit Crops Diseases Database (FCDD) requires a number of biotechnology and bioinformatics tools. The FCDD is a unique bioinformatics resource that compiles information about 162 details on fruit crops diseases, diseases type, its causal organism, images, symptoms and their control. The FCDD contains 171 phytochemicals from 25 fruits, their 2D images and their 20 possible sequences. This information has been manually extracted and manually verified from numerous sources, including other electronic databases, textbooks and scientific journals. FCDD is fully searchable and supports extensive text search. The main focus of the FCDD is on providing possible information of fruit crops diseases, which will help in discovery of potential drugs from one of the common bioresource-fruits. The database was developed using MySQL. The database interface is developed in PHP, HTML and JAVA. FCDD is freely available. http://www.fruitcropsdd.com/

Cardiovascular Disease, Mitochondria, and Traditional Chinese Medicine

Directory of Open Access Journals (Sweden)

Jie Wang

2015-01-01

Full Text Available Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we show that cardiovascular disease is negatively affected by mutations in mitochondrial DNA and that TCM can be used to treat cardiovascular disease by regulating the structure and function of mitochondria via increases in mitochondrial electron transport and oxidative phosphorylation, modulation of mitochondrial-mediated apoptosis, and decreases in mitochondrial ROS. However further research is still required to identify the mechanism by which TCM affects CVD and modifies mitochondrial DNA.

Development of single locus DNA microsatellite markers in Oryctes ...

Indian Academy of Sciences (India)

Oryctes rhinoceros, commonly known as rhinoceros bee- tle, is an important pest in oil palm plantations. The pres- ence of this pest in replanting sites as early as six months ..... rhinoceros: breeding and damage on oil palm in an oil palm to oil.

Mwebaze et al ACSJ 121-127 vol 14 (2).pmd

African Journals Online (AJOL)

Administrator

Viable pathogen cells survived for slightly a longer period in soil in the field than non-sterile soil under ... plants. Bananas are the most important food crop in Uganda according to annual production, ... guide farmers on when it is safe to replant.

Maize (Zea

African Journals Online (AJOL)

essary to replant two to three times to establish a ited rainwater as runoff. .... Table 1: Amount of rainwater (mm) lost from runoff plots under different inanagement systems during long rains (March'- May;l99-' .... E10 Irrigatio'tl and Drainage pa-.

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease

Directory of Open Access Journals (Sweden)

Moldovan Laura

2010-10-01

Full Text Available Abstract Background Computer-based teaching (CBT is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II. Aim To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. Implementation and Results The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca, was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. Conclusions The

Hunter disease eClinic: interactive, computer-assisted, problem-based approach to independent learning about a rare genetic disease.

Science.gov (United States)

Al-Jasmi, Fatma; Moldovan, Laura; Clarke, Joe T R

2010-10-25

Computer-based teaching (CBT) is a well-known educational device, but it has never been applied systematically to the teaching of a complex, rare, genetic disease, such as Hunter disease (MPS II). To develop interactive teaching software functioning as a virtual clinic for the management of MPS II. The Hunter disease eClinic, a self-training, user-friendly educational software program, available at the Lysosomal Storage Research Group (http://www.lysosomalstorageresearch.ca), was developed using the Adobe Flash multimedia platform. It was designed to function both to provide a realistic, interactive virtual clinic and instantaneous access to supporting literature on Hunter disease. The Hunter disease eClinic consists of an eBook and an eClinic. The eClinic is the interactive virtual clinic component of the software. Within an environment resembling a real clinic, the trainee is instructed to perform a medical history, to examine the patient, and to order appropriate investigation. The program provides clinical data derived from the management of actual patients with Hunter disease. The eBook provides instantaneous, electronic access to a vast collection of reference information to provide detailed background clinical and basic science, including relevant biochemistry, physiology, and genetics. In the eClinic, the trainee is presented with quizzes designed to provide immediate feedback on both trainee effectiveness and efficiency. User feedback on the merits of the program was collected at several seminars and formal clinical rounds at several medical centres, primarily in Canada. In addition, online usage statistics were documented for a 2-year period. Feedback was consistently positive and confirmed the practical benefit of the program. The online English-language version is accessed daily by users from all over the world; a Japanese translation of the program is also available. The Hunter disease eClinic employs a CBT model providing the trainee with realistic

A national facility for biological cryo-electron microscopy

International Nuclear Information System (INIS)

Saibil, Helen R.; Grünewald, Kay; Stuart, David I.

2015-01-01

This review provides a brief update on the use of cryo-electron microscopy for integrated structural biology, along with an overview of the plans for the UK national facility for electron microscopy being built at the Diamond synchrotron. Three-dimensional electron microscopy is an enormously powerful tool for structural biologists. It is now able to provide an understanding of the molecular machinery of cells, disease processes and the actions of pathogenic organisms from atomic detail through to the cellular context. However, cutting-edge research in this field requires very substantial resources for equipment, infrastructure and expertise. Here, a brief overview is provided of the plans for a UK national three-dimensional electron-microscopy facility for integrated structural biology to enable internationally leading research on the machinery of life. State-of-the-art equipment operated with expert support will be provided, optimized for both atomic-level single-particle analysis of purified macromolecules and complexes and for tomography of cell sections. The access to and organization of the facility will be modelled on the highly successful macromolecular crystallography (MX) synchrotron beamlines, and will be embedded at the Diamond Light Source, facilitating the development of user-friendly workflows providing near-real-time experimental feedback

Repairing the vibratory vocal fold.

Science.gov (United States)

Long, Jennifer L

2018-01-01

A vibratory vocal fold replacement would introduce a new treatment paradigm for structural vocal fold diseases such as scarring and lamina propria loss. This work implants a tissue-engineered replacement for vocal fold lamina propria and epithelium in rabbits and compares histology and function to injured controls and orthotopic transplants. Hypotheses were that the cell-based implant would engraft and control the wound response, reducing fibrosis and restoring vibration. Translational research. Rabbit adipose-derived mesenchymal stem cells (ASC) were embedded within a three-dimensional fibrin gel, forming the cell-based outer vocal fold replacement (COVR). Sixteen rabbits underwent unilateral resection of vocal fold epithelium and lamina propria, as well as reconstruction with one of three treatments: fibrin glue alone with healing by secondary intention, replantation of autologous resected vocal fold cover, or COVR implantation. After 4 weeks, larynges were examined histologically and with phonation. Fifteen rabbits survived. All tissues incorporated well after implantation. After 1 month, both graft types improved histology and vibration relative to injured controls. Extracellular matrix (ECM) of the replanted mucosa was disrupted, and ECM of the COVR implants remained immature. Immune reaction was evident when male cells were implanted into female rabbits. Best histologic and short-term vibratory outcomes were achieved with COVR implants containing male cells implanted into male rabbits. Vocal fold cover replacement with a stem cell-based tissue-engineered construct is feasible and beneficial in acute rabbit implantation. Wound-modifying behavior of the COVR implant is judged to be an important factor in preventing fibrosis. NA. Laryngoscope, 128:153-159, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Predicting and explaining inflammation in Crohn's disease patients using predictive analytics methods and electronic medical record data.

Science.gov (United States)

Reddy, Bhargava K; Delen, Dursun; Agrawal, Rupesh K

2018-01-01

Crohn's disease is among the chronic inflammatory bowel diseases that impact the gastrointestinal tract. Understanding and predicting the severity of inflammation in real-time settings is critical to disease management. Extant literature has primarily focused on studies that are conducted in clinical trial settings to investigate the impact of a drug treatment on the remission status of the disease. This research proposes an analytics methodology where three different types of prediction models are developed to predict and to explain the severity of inflammation in patients diagnosed with Crohn's disease. The results show that machine-learning-based analytic methods such as gradient boosting machines can predict the inflammation severity with a very high accuracy (area under the curve = 92.82%), followed by regularized regression and logistic regression. According to the findings, a combination of baseline laboratory parameters, patient demographic characteristics, and disease location are among the strongest predictors of inflammation severity in Crohn's disease patients.

The Effects of a Single Electronic Music Improvisation Session on the Pain of Adults with Sickle Cell Disease: A Mixed Methods Pilot Study.

Science.gov (United States)

Rodgers-Melnick, Samuel N; Matthie, Nadine; Jenerette, Coretta; Griest Pell, Tara J; Lane, Deforia; Fu, Pingfu; Margevicius, Seunghee; Little, Jane A

2018-06-07

Adults with sickle cell disease (SCD) experience acute pain that is multidimensional. Despite recent improvements in treatment, pain management remains a significant challenge for these individuals. Music therapy interventions have the potential to address several dimensions of SCD pain, but they require systematic investigation. This study investigated feasibility and preliminary efficacy of a single-session electronic music improvisation with a music therapist to diminish pain intensity and improve pain relief and mood in adults with SCD. Using a three-group mixed methods intervention design, we randomized 60 adults with SCD to standard care plus one of three 20-minute study conditions: 1) electronic music improvisation with a music therapist (MT); 2) recorded music listening (ML); or 3) no intervention (control). Measures of pain intensity (VASPI), pain relief (VASPR), and mood (VASMOOD) were assessed before and after the study conditions, with a subset of MT and ML participants interviewed after measure completion. Compared to control, MT produced significant improvements in VASPI (odds ratio (OR) = 5.12, P = 0.035) and VASMOOD (OR = 11.60, P = 0.005). ML produced significant improvements in VASMOOD compared to control (OR = 5.76, P = 0.040). Qualitatively, there were two prominent themes directly related to music: 1) ML and MT offered many positive and few negative effects; and 2) music therapists provided comfort beyond the music. Preliminary findings were promising and support the need for additional studies evaluating improvisational music therapy interventions for acute pain management in adults with SCD.

Characterization and distribution of a Potyvirus associated with passion fruit woodiness disease in Uganda

Science.gov (United States)

This paper describes the incidence and etiology of viral infection on passion fruit in Uganda. Viral disease symptoms, including those characteristic of Passion fruit woodiness disease (PWD), were observed in producing areas with an overall mean infection level of 27%. Electron microscopic observati...

Leveraging Collaborative Filtering to Accelerate Rare Disease Diagnosis.

Science.gov (United States)

Shen, Feichen; Liu, Sijia; Wang, Yanshan; Wang, Liwei; Afzal, Naveed; Liu, Hongfang

2017-01-01

In the USA, rare diseases are defined as those affecting fewer than 200,000 patients at any given time. Patients with rare diseases are frequently misdiagnosed or undiagnosed which may due to the lack of knowledge and experience of care providers. We hypothesize that patients' phenotypic information available in electronic medical records (EMR) can be leveraged to accelerate disease diagnosis based on the intuition that providers need to document associated phenotypic information to support the diagnosis decision, especially for rare diseases. In this study, we proposed a collaborative filtering system enriched with natural language processing and semantic techniques to assist rare disease diagnosis based on phenotypic characterization. Specifically, we leveraged four similarity measurements with two neighborhood algorithms on 2010-2015 Mayo Clinic unstructured large patient cohort and evaluated different approaches. Preliminary results demonstrated that the use of collaborative filtering with phenotypic information is able to stratify patients with relatively similar rare diseases.

Electronic Government and Electronic Participation

NARCIS (Netherlands)

Tambouris, E; Scholl, H.J.; Janssen, M.F.W.H.A.; Wimmer, M.A.; Tarabanis, K; Gascó, M; Klievink, A.J.; Lindgren, I; Milano, M; Panagiotopoulos, P; Pardo, T.A.; Parycek, P; Sæbø, Ø

2016-01-01

Electronic government and electronic participation continue to transform the public sector and society worldwide and are constantly being transformed themselves by emerging information and communication technologies.This book presents papers from the 14th International Federation for Information

Electronic Government and Electronic Participation

NARCIS (Netherlands)

Tambouris, E.; Scholl, H.J.; Janssen, M.F.W.H.A.; Wimmer, M.A.; Tarabanis, K.; Gascó, M.; Klievink, A.J.; Lindgren, I.; Milano, M.; Panagiotopoulos, P.; Pardo, T.A.; Parycek, P.; Sæbø, O.

2015-01-01

Electronic government and electronic participation continue to transform the public sector and society worldwide and are constantly being transformed themselves by emerging information and communication technologies. This book presents papers from the 14th International Federation for Information

Electron detector

International Nuclear Information System (INIS)

Hashimoto, H.; Mogami, A.

1975-01-01

A device for measuring electron densities at a given energy level in an electron beam or the like having strong background noise, for example, in the detection of Auger electric energy spectrums is described. An electron analyzer passes electrons at the given energy level and at the same time electrons of at least one adjacent energy level. Detecting means associated therewith produce signals indicative of the densities of the electrons at each energy level and combine these signals to produce a signal indicative of the density of the electrons of the given energy level absent background noise

Electron-electron interactions in artificial graphene

Science.gov (United States)

Rasanen, Esa

2013-03-01

Recent advances in the creation and modulation of graphenelike systems are introducing a science of ``designer Dirac materials.'' In its original definition, artificial graphene is a man-made nanostructure that consists of identical potential wells (quantum dots) arranged in an adjustable honeycomb lattice in the two-dimensional electron gas. As our ability to control the quality of artificial graphene samples improves, so grows the need for an accurate theory of its electronic properties, including the effects of electron-electron interactions. Here we determine those effects on the band structure and on the emergence of Dirac points, and discuss future investigations and challenges in this field.

Decal electronics for printed high performance cmos electronic systems

KAUST Repository

Hussain, Muhammad Mustafa

2017-11-23

High performance complementary metal oxide semiconductor (CMOS) electronics are critical for any full-fledged electronic system. However, state-of-the-art CMOS electronics are rigid and bulky making them unusable for flexible electronic applications. While there exist bulk material reduction methods to flex them, such thinned CMOS electronics are fragile and vulnerable to handling for high throughput manufacturing. Here, we show a fusion of a CMOS technology compatible fabrication process for flexible CMOS electronics, with inkjet and conductive cellulose based interconnects, followed by additive manufacturing (i.e. 3D printing based packaging) and finally roll-to-roll printing of packaged decal electronics (thin film transistors based circuit components and sensors) focusing on printed high performance flexible electronic systems. This work provides the most pragmatic route for packaged flexible electronic systems for wide ranging applications.

Electron-beam-induced-current and active secondary-electron voltage-contrast with aberration-corrected electron probes

Energy Technology Data Exchange (ETDEWEB)

Han, Myung-Geun, E-mail: mghan@bnl.gov [Condensed Matter Physics & Materials Science, Brookhaven National Laboratory, Upton, NY 11973 (United States); Garlow, Joseph A. [Condensed Matter Physics & Materials Science, Brookhaven National Laboratory, Upton, NY 11973 (United States); Materials Science and Engineering Department, Stony Brook University, Stony Brook, NY 11794 (United States); Marshall, Matthew S.J.; Tiano, Amanda L. [Department of Chemistry, Stony Brook University, Stony Brook, NY 11974 (United States); Wong, Stanislaus S. [Condensed Matter Physics & Materials Science, Brookhaven National Laboratory, Upton, NY 11973 (United States); Department of Chemistry, Stony Brook University, Stony Brook, NY 11974 (United States); Cheong, Sang-Wook [Department of Physics and Astronomy, Rutgers Center for Emergent Materials, Rutgers University, Piscataway, NJ 08854 (United States); Walker, Frederick J.; Ahn, Charles H. [Department of Applied Physics and Center for Research on Interface Structures and Phenomena, Yale University, New Haven, CT 06520 (United States); Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT 06520 (United States); Zhu, Yimei [Condensed Matter Physics & Materials Science, Brookhaven National Laboratory, Upton, NY 11973 (United States)

2017-05-15

Highlights: • Electron-beam-induced-current (EBIC) and active secondary-electron voltage-contrast (SE-VC) are demonstrated in STEM mode combined with in situ electrical biasing in a TEM. • Electrostatic potential maps in ferroelectric thin films, multiferroic nanowires, and single crystals obtained by off-axis electron holography were compared with EBIC and SE-VC data. • Simultaneous EBIC and active SE-VC performed with atomic resolution STEM are demonstrated. - Abstract: The ability to map out electrostatic potentials in materials is critical for the development and the design of nanoscale electronic and spintronic devices in modern industry. Electron holography has been an important tool for revealing electric and magnetic field distributions in microelectronics and magnetic-based memory devices, however, its utility is hindered by several practical constraints, such as charging artifacts and limitations in sensitivity and in field of view. In this article, we report electron-beam-induced-current (EBIC) and secondary-electron voltage-contrast (SE-VC) with an aberration-corrected electron probe in a transmission electron microscope (TEM), as complementary techniques to electron holography, to measure electric fields and surface potentials, respectively. These two techniques were applied to ferroelectric thin films, multiferroic nanowires, and single crystals. Electrostatic potential maps obtained by off-axis electron holography were compared with EBIC and SE-VC to show that these techniques can be used as a complementary approach to validate quantitative results obtained from electron holography analysis.

Electronic Commerce and Electronic Business

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

This special issue is motivated by the recent upsurge of research activity in the areas of electronic commerce and electronic business both in India and all over the world. The current ... Monte Carlo methods for pricing financial options are then.

Big biomedical data and cardiovascular disease research: opportunities and challenges.

Science.gov (United States)

Denaxas, Spiros C; Morley, Katherine I

2015-07-01

Electronic health records (EHRs), data generated and collected during normal clinical care, are increasingly being linked and used for translational cardiovascular disease research. Electronic health record data can be structured (e.g. coded diagnoses) or unstructured (e.g. clinical notes) and increasingly encapsulate medical imaging, genomic and patient-generated information. Large-scale EHR linkages enable researchers to conduct high-resolution observational and interventional clinical research at an unprecedented scale. A significant amount of preparatory work and research, however, is required to identify, obtain, and transform raw EHR data into research-ready variables that can be statistically analysed. This study critically reviews the opportunities and challenges that EHR data present in the field of cardiovascular disease clinical research and provides a series of recommendations for advancing and facilitating EHR research.

Iron as a risk factor in neurological diseases

Science.gov (United States)

Galazka-Friedman, Jolanta

2008-02-01

In this review the properties of iron in various human brain structures (e.g. Substantia nigra, globus pallidus, hippocampus) were analyzed to assess the possibility of initiation of oxidative stress leading to such diseases as Parkinson’s and Alzheimer’s disease, and progressive supranuclear palsy. Our own studies with the use of Mössbauer spectroscopy, electron microscopy and enzyme-linked immuno-absorbent assay (ELISA) were confronted with other methods used in other laboratories. Our results suggest that hippocampus is the most fragile for oxidative stress structure in human brain (the death of nervous cells in hippocampus leads to Alzheimer’s disease). Changes in iron metabolism were also found in substantia nigra (the death of nervous cells of this structure produces Parkinson’s disease) and in globus pallidus (neurodegeneration of this structure causes progressive supranuclear palsy).

Iron as a risk factor in neurological diseases

International Nuclear Information System (INIS)

Galazka-Friedman, Jolanta

2008-01-01

In this review the properties of iron in various human brain structures (e.g. Substantia nigra, globus pallidus, hippocampus) were analyzed to assess the possibility of initiation of oxidative stress leading to such diseases as Parkinson's and Alzheimer's disease, and progressive supranuclear palsy. Our own studies with the use of Moessbauer spectroscopy, electron microscopy and enzyme-linked immuno-absorbent assay (ELISA) were confronted with other methods used in other laboratories. Our results suggest that hippocampus is the most fragile for oxidative stress structure in human brain (the death of nervous cells in hippocampus leads to Alzheimer's disease). Changes in iron metabolism were also found in substantia nigra (the death of nervous cells of this structure produces Parkinson's disease) and in globus pallidus (neurodegeneration of this structure causes progressive supranuclear palsy).

Chronic fluorosis: The disease and its anaesthetic implications

Directory of Open Access Journals (Sweden)

Madhuri S Kurdi

2016-01-01

Full Text Available Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifestations, some of which may impact anaesthetic management are relatively unknown. Keeping this in mind, the topic of chronic fluorosis was hand searched from textbooks, scientific journals and electronically through Google, PubMed and other scientific databases. This article concentrates on the effect of chronic fluorosis on various organ systems, its clinical features, diagnosis and the anaesthetic implications of the disease.

[An adult form of type-I. Gaucher's disease].

Science.gov (United States)

Múzes, G; Pitlik, E; Gohér, A; Somogyi, A; Tulassay, Z

2000-03-26

A young woman with no previous history of any diseases was admitted for further evaluation of a mild thrombocytopenia she has had for some months. No signs of bleeding have so far occurred. Physical examination was normal except for a moderately enlarged spleen. Routine investigations showed lower platelet count. There was no laboratory evidence of disease conditions with autoimmune/inflammatory or hematologic origin. Bone marrow aspirate indicated Gaucher's-like cells raising the suspicion of Gaucher's disease. This was further supported by electron microscopic demonstration of Gaucher's bodies (with the characteristic tubular structures) in crista biopsy specimens. However, definitive diagnosis was obtained by verifying deficient lysosomal glucosylceramide-beta-D-glucosidase activity in peripheral blood leukocytes. Upon the absence of neurologic involvement the patient was typical for the adult form or type-1 Gaucher's disease.

Proposed Electronic Medical Record with Emphasis on Hepatitis Diagnosis

Directory of Open Access Journals (Sweden)

Georgios Skapetis

2013-01-01

Full Text Available Introduction Medical domain is characterized, like many other domains, by an exponential evolution of the knowledge. There are a lot of tools which try to reduce the risk of error apparition in medical life. Medical decision becomes a very hard activity because the human experts, who have to make decisions, can hardly process the huge amounts of data. Diagnosis has a very important role here. It is the first step from a set of therapeutic actions, an error at this level can have dramatic consequences.The aim of this paper is to present a new electronic medical system for using it on patients with hepatitis virusinfection.Results: Hepatitis is a very complicated disease with numerous different types many of them can lead to serious diseases like cirrhosis and liver cancer. An early correct diagnosis and an adequate treatment could reduce the risks of liver cancer apparition or other severe diseases. The main goal of the system is to use artificial intelligence in order to offer predictions about patients infected with hepatitis virus and also to follow the healthcondition of the patient reevaluating at every time the initial diagnosis and suggesting tests and treatment. Our effort is to present a new electronic medical record that will “borrow” data from the standard health record of the patient and other resources where information is saved and will process it and give suggestions for the diagnosis and treatment of the patient and at the same time will use a simple operating environment, such as the internet, thus making it easy to use.Conclusions The medical record is a big step in improving health services in public hospitals. The proposed EMR with the use of artificial intelligence is the next logical step that will help in the diagnosis and early treatment of disease.

Electronic nose breathprints are independent of acute changes in airway caliber in asthma

NARCIS (Netherlands)

Lazar, Zsofia; Fens, Niki; Van der Maten, Jan; van der Schee, Marc P.; Wagener, Ariane H.; de Nijs, Selma B.; Dijkers, Erica; Sterk, Peter J.

2010-01-01

Molecular profiling of exhaled volatile organic compounds (VOC) by electronic nose technology provides breathprints that discriminate between patients with different inflammatory airway diseases, such as asthma and COPD. However, it is unknown whether this is determined by differences in airway

Electronic Nose Breathprints Are Independent of Acute Changes in Airway Caliber in Asthma

NARCIS (Netherlands)

Lazar, Z.; Fens, N.; Van der Maten, J.; van der Schee, M.P.; Wagener, A.H.; de Nijs, S.B.; Dijkers, E.; Sterk, P.J.

2010-01-01

Molecular profiling of exhaled volatile organic compounds (VOC) by electronic nose technology provides breathprints that discriminate between patients with different inflammatory airway diseases, such as asthma and COPD. However, it is unknown whether this is determined by differences in airway

Electron optical characteristics of a concave electrostatic electron mirror for a scanning electron microscope

International Nuclear Information System (INIS)

Hamarat, R.T.; Witzani, J.; Hoerl, E.M.

1984-08-01

Numerical computer calculations are used to explore the design characteristics of a concave electrostatic electron mirror for a mirror attachment for a conventional scanning electron microscope or an instrument designed totally as a scanning electron mirror microscope. The electron paths of a number of set-ups are calculated and drawn graphically in order to find the optimum shape and dimensions of the mirror geometry. This optimum configuration turns out to be the transition configuration between two cases of electron path deflection, towards the optical axis of the system and away from it. (Author)

Development of an integrated e-health tool for people with, or at high risk of, cardiovascular disease: The Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) web application.

Science.gov (United States)

Neubeck, Lis; Coorey, Genevieve; Peiris, David; Mulley, John; Heeley, Emma; Hersch, Fred; Redfern, Julie

2016-12-01

Cardiovascular disease is the leading killer globally and secondary prevention substantially reduces risk. Uptake of, and adherence to, face-to-face preventive programs is often low. Alternative models of care are exploiting the prominence of technology in daily life to facilitate lifestyle behavior change. To inform the development of a web-based application integrated with the primary care electronic health record, we undertook a collaborative user-centered design process to develop a consumer-focused e-health tool for cardiovascular disease risk reduction. A four-phase iterative process involved ten multidisciplinary clinicians and academics (primary care physician, nurses and allied health professionals), two design consultants, one graphic designer, three software developers and fourteen proposed end-users. This 18-month process involved, (1) defining the target audience and needs, (2) pilot testing and refinement, (3) software development including validation and testing the algorithm, (4) user acceptance testing and beta testing. From this process, researchers were able to better understand end-user needs and preferences, thereby improving and enriching the increasingly detailed system designs and prototypes for a mobile responsive web application. We reviewed 14 relevant applications/websites and sixteen observational and interventional studies to derive a set of core components and ideal features for the system. These included the need for interactivity, visual appeal, credible health information, virtual rewards, and emotional and physical support. The features identified as essential were: (i) both mobile and web-enabled 'apps', (ii) an emphasis on medication management, (iii) a strong psychosocial support component. Subsequent workshops (n=6; 2×1.5h) informed the development of functionality and lo-fidelity sketches of application interfaces. These ideas were next tested in consumer focus groups (n=9; 3×1.5h). Specifications for the application were

Electronic processes in organic electronics bridging nanostructure, electronic states and device properties

CERN Document Server

Kudo, Kazuhiro; Nakayama, Takashi; Ueno, Nobuo

2015-01-01

The book covers a variety of studies of organic semiconductors, from fundamental electronic states to device applications, including theoretical studies. Furthermore, innovative experimental techniques, e.g., ultrahigh sensitivity photoelectron spectroscopy, photoelectron yield spectroscopy, spin-resolved scanning tunneling microscopy (STM), and a material processing method with optical-vortex and polarization-vortex lasers, are introduced. As this book is intended to serve as a textbook for a graduate level course or as reference material for researchers in organic electronics and nanoscience from electronic states, fundamental science that is necessary to understand the research is described. It does not duplicate the books already written on organic electronics, but focuses mainly on electronic properties that arise from the nature of organic semiconductors (molecular solids). The new experimental methods introduced in this book are applicable to various materials (e.g., metals, inorganic and organic mater...

7 CFR 400.705 - Contents required for a new submission or changes to a previously approved submission.

Science.gov (United States)

2010-01-01

... expansion plans; (10) Identification, including names, addresses, telephone numbers, and e-mail addresses...., replanting, tree replacement or rehabilitation, prevented planting, etc.), as applicable; and (viii) A... policy not authorized under the Act and identification of the portion of the rate of premium due to these...

Mikrokirurgi ved reanimation, lymfødem og håndkirurgi

DEFF Research Database (Denmark)

Bonde, Christian T; Jensen, Lisa Toft; Tos, Tina

2016-01-01

Microsurgery is defined as surgery performed with the aid of ocular magnification. In Denmark, this is undertaken by four units. This review describes the history of microsurgery which evolved during the 1960s. Microsurgery in hand surgery is primarily replantation and revascularisation but also ...

75 FR 23167 - Protection of Stratospheric Ozone: The 2010 Critical Use Exemption From the Phaseout of Methyl...

Science.gov (United States)

2010-05-03

... seedlings. Nursery stock--fruit, nut, flower. Orchard replant. Ornamentals. Peppers--field. Strawberries--field. Strawberry runners. Tomatoes--field. Sweet potato slips. The agreed U.S. critical use levels for... Table A of Decision XXI/11 for southeast strawberry nurseries. Both Decisions noted that these amounts...

Advances in apple culture worldwide

Directory of Open Access Journals (Sweden)

Terence Robinson

2011-10-01

Full Text Available Over the last 60 years, planting densities for apple have increased as improved management systems have been developed. Dwarfing rootstocks have been the key to the dramatic changes in tree size, spacing and early production. The Malling series of dwarfing rootstocks (M.9 and M.26 have been the most important dwarfing rootstocks in the world but are poorly adapted in some areas of the world and they are susceptible to the bacterial disease fire blight and the soil disease complex, apple replant disease which limits their uses in some areas. Rootstock breeding programs in several parts of the world are developing improved rootstocks with resistance to fire blight, and replant disease, and improved cold hardiness and yield efficiency. A second important trend has been the increasing importance of new cultivars. New cultivars have provided opportunities for higher prices until they are over-produced. A new trend is the "variety club" in which variety owners manage the production and marketing of a new unique cultivar to bring higher prices to the growers and variety owners. This has led to many fruit growers being unable to plant or grow some new cultivars. Important rootstock and cultivar genes have been mapped and can be used in marker assisted selection of future rootstock and cultivar selections. Other important improvements in apple culture include the development of pre-formed trees, the development of minimal pruning strategies and limb angle bending which have also contributed to the dramatic changes in early production in the 2nd-5th years after planting. Studies on light interception and distribution have led to improved tree forms with better fruit quality. Simple pruning strategies and labor positioning platform machines have resulted in partial mechanization of pruning which has reduced management costs. Improved plant growth regulators for thinning and the development of a thinning prediction model based on tree carbohydrate balance

Decal electronics for printed high performance cmos electronic systems

KAUST Repository

Hussain, Muhammad Mustafa; Sevilla, Galo Torres; Cordero, Marlon Diaz; Kutbee, Arwa T.

2017-01-01

High performance complementary metal oxide semiconductor (CMOS) electronics are critical for any full-fledged electronic system. However, state-of-the-art CMOS electronics are rigid and bulky making them unusable for flexible electronic applications

Influenza vaccines for preventing cardiovascular disease

OpenAIRE

Clar,Christine; Oseni,Zainab; Flowers,Nadine; Keshtkar-Jahromi,Maryam; Rees,Karen

2015-01-01

ABSTRACTBACKGROUND: This is an update of the original review published in 2008. The risk of adverse cardiovascular outcomes is increased with influenza-like infection, and vaccination against influenza may improve cardiovascular outcomes.OBJECTIVES: To assess the potential benefits of influenza vaccination for primary and secondary prevention of cardiovascular disease.METHODS:Search methods:We searched the following electronic databases on 18 October 2013: The Cochrane Library (including Coch...

Design of electron beam bending magnet system using three sector magnets for electron and photon therapy: a simulation approach

International Nuclear Information System (INIS)

Shahzad, A.A.; Bhoraskar, V.N.; Dhole, S.D.

2013-01-01

The 270 degree doubly achromatic beam bending magnet system using three sector magnets has been designed mainly for treating cancer and skin diseases. The main requirements of the design of three magnet system is to focus an electron beam having a spot size less than 3mm x 3mm, energy spread within 3% and divergence angle ≤ 3 mrad at the target. To achieve these parameters the simulation was carried out using Lorentz-3EM software. The beam spot, divergence angle and energy spread were observed with respect to the variation in angles of sector magnets and drift distances. From the simulated results, it has been optimized that all the three sector magnets has an angle of 62 degree and the drift distance 68 mm. It is also observed that at the 1637, 2425, 3278, 4165 and 5690 Amp-turn, the optimized design produces 3851, 5754, 7434, 9356 and 11425 Gauss of magnetic field at median plane require to bend 6, 9, 12, 15 and 18 MeV energy of electron respectively for electron therapy. The output parameters of the optimized design are energy spread 3%, divergence angle ∼ 3 mrad and spot size 2.8 mm. Moreover, for 6 MV and 15 MV photon therapy application, an electron beam of energy 6.5 MeV and 15.5 MeV extracted from magnet system and focussed on the Bremsstrahlung target. For the photon therapy the 1780, and 4456 amp-turn, an optimized design produces 4148 and 9682 Gauss of magnetic field at median plane require to bend 6.5 and 15.5 MeV energy of electron respectively, which further produces Bremsstrahlung in Tungsten target. (author)

Impacto do manejo de resíduos orgânicos durante a reforma de plantios de eucalipto sobre indicadores de qualidade do solo Impact of organic residue management on soil quality indicators during replanting of eucalypt stands

Directory of Open Access Journals (Sweden)

Guilherme Montandon Chaer

2007-12-01

priorizaram a conservação dos resíduos orgânicos por ocasião da reforma do povoamento. Contrariamente, as áreas onde ocorreu a remoção ou a queima do material orgânico da superfície do solo foram as que mais se distanciaram da área de referência. Esses resultados demonstram que o sistema de manejo adotado na reforma dos povoamentos de eucalipto analisados influencia, em médio prazo, o potencial dos solos de estocar e ciclar nutrientes por meio da biomassa microbiana e das atividades bioquímicas ligadas a ela. A maior aproximação entre a área com vegetação nativa e a de eucalipto com 11 anos leva a supor que ciclos mais longos nas florestas de eucalipto, contrastando com o padrão atualmente em uso no Brasil (cerca de sete anos, pode ser relevante para se manter a sustentabilidade da atividade florestal em longo prazo, a despeito de uma menor produtividade média anual. Nesse caso, a opção pela produtividade de curto ou médio prazo, ou pela sustentabilidade do uso do solo, com a conseqüente manutenção da sua qualidade para as gerações futuras, poderá ser repensada a partir dos dados aqui apresentados.Agricultural soil use induces changes in soil physical, chemical, and microbiological characteristics. These changes can eventually lead to a loss of soil quality and a consequent reduction in plant growth and productivity. The analysis of biochemical and microbiological soil quality indicators is relevant to monitor changes in soil quality and in the performance of key soil functions, such as the capacity of nutrient cycling and storage. This study reports on physical, chemical, and biochemical/microbiological quality indicators of soil under eucalyptus plantation, evaluated 5.5 years after the site had undergone different management practices during stand replanting. Evaluations were based on the determination of 18 physical or chemical besides 12 biochemical or microbiological attributes that are considered soil quality indicators. The

Precession mechanism of spin relaxation at frequent electron-electron collisions

CERN Document Server

Glazov, M M

2002-01-01

It is shown that the spin relaxation mechanism in the two-dimensional electron gas, is controlled not only through the electron pulse relaxation processes, determining the mobility, but through the electron-electron collisions as well. It is decided to use the kinetic equation, describing the electron spin mixing in the k-space, for determining the spin relaxation time tau sub s at frequent electron-electron collisions. The tau sub s time is calculated for the nondegenerated electron gas both with an account and with no account of the exchange interaction

Characterization and evolution of dermal filaments from patients with Morgellons disease.

Science.gov (United States)

Middelveen, Marianne J; Mayne, Peter J; Kahn, Douglas G; Stricker, Raphael B

2013-01-01

Morgellons disease is an emerging skin disease characterized by formation of dermal filaments associated with multisystemic symptoms and tick-borne illness. Some clinicians hypothesize that these often colorful dermal filaments are textile fibers, either self-implanted by patients or accidentally adhering to lesions, and conclude that patients with this disease have delusions of infestation. We present histological observations and electron microscopic imaging from representative Morgellons disease samples revealing that dermal filaments in these cases are keratin and collagen in composition and result from proliferation and activation of keratinocytes and fibroblasts in the epidermis. Spirochetes were detected in the dermatological specimens from our study patients, providing evidence that Morgellons disease is associated with an infectious process.

Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System's Electronic Medical Record.

Science.gov (United States)

Reeves, Kelly W; Taylor, Yhenneko; Tapp, Hazel; Ludden, Thomas; Shade, Lindsay E; Burton, Beth; Courtlandt, Cheryl; Dulin, Michael

2016-10-19

Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation. The implementation process and the potential impact of the communication with providers on the reoccurrence of asthma exacerbations with the linked patients were evaluated. By engaging stakeholders from the school system and the healthcare system, we were able to collaboratively design a communication process and implement a pilot which demonstrated the feasibility of electronic communication between school nurses and primary care providers. Outcomes data was collected from the electronic medical record to examine the frequency of asthma exacerbations among patients with a message from their school nurse. The percent of exacerbations in the 12 months before and after electronic communication was compared using McNemar's test. The pilot system successfully established communication between the school nurse and primary care provider for 33 students who had been hospitalized for asthma and a decrease in hospital admissions was observed with students whose school nurse communicated through the EMR with the primary care provider. Findings suggest a collaborative model of care that is enhanced through electronic communication via the EMR could positively impact the health of children with asthma or other chronic illnesses.

Practical electronics handbook

CERN Document Server

Sinclair, Ian R

2013-01-01

Practical Electronics Handbook, Third Edition provides the frequently used and highly applicable principles of electronics and electronic circuits.The book contains relevant information in electronics. The topics discussed in the text include passive and active discrete components; linear and digital I.C.s; microprocessors and microprocessor systems; digital-analogue conversions; computer aids in electronics design; and electronic hardware components.Electronic circuit constructors, service engineers, electronic design engineers, and anyone with an interest in electronics will find the book ve

Composition quantification of electron-transparent samples by backscattered electron imaging in scanning electron microscopy

Energy Technology Data Exchange (ETDEWEB)

Müller, E., E-mail: erich.mueller@kit.edu; Gerthsen, D.

2017-02-15

The contrast of backscattered electron (BSE) images in scanning electron microscopy (SEM) depends on material parameters which can be exploited for composition quantification if some information on the material system is available. As an example, the In-concentration in thin In{sub x}Ga{sub 1−x}As layers embedded in a GaAs matrix is analyzed in this work. The spatial resolution of the technique is improved by using thin electron-transparent specimens instead of bulk samples. Although the BSEs are detected in a comparably small angular range by an annular semiconductor detector, the image intensity can be evaluated to determine the composition and local thickness of the specimen. The measured intensities are calibrated within one single image to eliminate the influence of the detection and amplification system. Quantification is performed by comparison of experimental and calculated data. Instead of using time-consuming Monte-Carlo simulations, an analytical model is applied for BSE-intensity calculations which considers single electron scattering and electron diffusion. - Highlights: • Sample thickness and composition are quantified by backscattered electron imaging. • A thin sample is used to achieve spatial resolution of few nanometers. • Calculations are carried out with a time-saving electron diffusion model. • Small differences in atomic number and density detected at low electron energies.

Light and scanning electron microscopic examination of hair in Garlic's syndrome

International Nuclear Information System (INIS)

Celik, Hakan H.; Tunali, S.; Tatar, I.; Aldur, Muhammad M.; Tore, H.

2007-01-01

Grisceli syndrome is a rare disease is a rare disease characterized by pigment dilution, partial albinism, variable cellular immunodeficiency and an acute phase of uncontrolled T-lymphocyte macrophage activation. Griscelli et al described this syndrome in 1978. Since then, only approximately, 60 cases have been reported, most from Turkish and Mediterranean population. In microscopic examination, silvery grey hair with large clumped melanosomes on the hair shaft is the diagnostic finding. Here, we present scanning electron microscopic study of hair in 2 cases of Griscelli syndrome where the hair showed normal cuticular pattern but nodular structures were present as an abnormal finding. (author)

Nonlinear electron-acoustic rogue waves in electron-beam plasma system with non-thermal hot electrons

Science.gov (United States)

Elwakil, S. A.; El-hanbaly, A. M.; Elgarayh, A.; El-Shewy, E. K.; Kassem, A. I.

2014-11-01

The properties of nonlinear electron-acoustic rogue waves have been investigated in an unmagnetized collisionless four-component plasma system consisting of a cold electron fluid, non-thermal hot electrons obeying a non-thermal distribution, an electron beam and stationary ions. It is found that the basic set of fluid equations is reduced to a nonlinear Schrodinger equation. The dependence of rogue wave profiles on the electron beam and energetic population parameter are discussed. The results of the present investigation may be applicable in auroral zone plasma.

Electron-cyclotron-resonant-heated electron distribution functions

International Nuclear Information System (INIS)

Matsuda, Y.; Nevins, W.M.; Cohen, R.H.

1981-01-01

Recent studies at Lawrence Livermore National Laboratory (LLNL) with a bounce-averaged Fokker-Planck code indicate that the energetic electron tail formed by electron-cyclotron resonant heating (ECRH) at the second harmonic is not Maxwellian. We present the results of our bounce-averaged Fokker-Planck code along with some simple analytic models of hot-electron distribution functions

Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

Science.gov (United States)

Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

2018-04-20

Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

Attainment of Electron Beam Suitable for Medium Energy Electron Cooling

International Nuclear Information System (INIS)

Seletskiy, Sergey M.; Rochester U.

2005-01-01

Electron cooling of charged particle beams is a well-established technique at electron energies of up to 300 keV. However, up to the present time the advance of electron cooling to the MeV-range energies has remained a purely theoretical possibility. The electron cooling project at Fermilab has recently demonstrated the first cooling of 8.9 GeV/c antiprotons in the Recycler ring, and therefore, has proved the validity of the idea of relativistic electron cooling. The Recycler Electron Cooler (REC) is the key component of the Tevatron Run II luminosity upgrade project. Its performance depends critically on the quality of electron beam. A stable electron beam of 4.3 MeV carrying 0.5 A of DC current is required. The beam suitable for the Recycler Electron Cooler must have an angular spread not exceeding 200 (micro)rad. The full-scale prototype of the REC was designed, built and tested at Fermilab in the Wideband laboratory to study the feasibility of attaining the high-quality electron beam. In this thesis I describe various aspects of development of the Fermilab electron cooling system, and the techniques used to obtain the electron beam suitable for the cooling process. In particular I emphasize those aspects of the work for which I was principally responsible. Chapter 1 is an introduction where I describe briefly the theory and the history of electron cooling, and derive the requirements to the quality of electron beam and requirements to the basic parameters of the Recycler Electron Cooler. Chapter 2 is devoted to the theoretical consideration of the motion of electrons in the cooling section, description of the cooling section and of the measurement of the magnetic fields. In Chapter 3 I consider different factors that increase the effective electron angle in the cooling section and suggest certain algorithms for the suppression of parasitic angles. Chapter 4 is devoted to the measurements of the energy of the electron beam. In the concluding Chapter 5 I review

Double differential distributions of electron emission in ion-atom and electron-atom collisions using an electron spectrometer

International Nuclear Information System (INIS)

Misra, Deepankar; Thulasiram, K.V.; Fernandes, W.; Kelkar, Aditya H.; Kadhane, U.; Kumar, Ajay; Singh, Yeshpal; Gulyas, L.; Tribedi, Lokesh C.

2009-01-01

We study electron emission from atoms and molecules in collisions with fast electrons and heavy ions (C 6+ ). The soft collision electrons (SE), two center electron emission (TCEE), the binary encounter (BE) events and the KLL Auger lines along with the elastically scattered peaks (in electron collisions) are studied using a hemispherical electrostatic electron analyzer. The details of the measurements along with description of the spectrometer and data acquisition system are given. The angular distributions of the low energy (few eV) electrons in soft collisions and the binary encounter electrons at keV energies are compared with quantum mechanical models based on the first Born (B1) and the continuum distorted wave-Eikonal initial state approximation (CDW-EIS).

VIRTUAL ELECTRONIC COMPONENTS OF THE ELECTRONIC EQUIPMENT

Directory of Open Access Journals (Sweden)

E. Lazarevich

2013-01-01

Full Text Available The article is present new idea of the creation, developments and improvements of the electronic equipment of complex systems by means of the virtual electronic components. The idea of the virtual electronic components is a presentation and perception of the creation and developments of the equipment on two forming: real – in the manner of standard marketed block of the intellectual property and image – in the manner of virtual component. The real component in most cases slows the development of the electronic equipment. The imaginary component is the «locomotive» of development of the electronic equipment. The Imaginary component contains the scientific has brushed against developer. The scientific has brushed against developer reveals of itself in the manner of virtual component on the modern level of the design rates of microelectronics.

A new stage of nuclear electronics-particle electronics

International Nuclear Information System (INIS)

Xi Deming

1987-01-01

The rapid development of high energy physics experiments has pushed the nuclear electronics to a new stage, i.e. the particle electronics. In this paper the background, main features and recent trends of the particle electronics are expounded

Electron transport effects in ion induced electron emission

Energy Technology Data Exchange (ETDEWEB)

Dubus, A. [Universite Libre de Bruxelles, Service de Metrologie Nucleaire (CP 165/84), 50 av. FD Roosevelt, B-1050 Brussels (Belgium)]. E-mail: adubus@ulb.ac.be; Pauly, N. [Universite Libre de Bruxelles, Service de Metrologie Nucleaire (CP 165/84), 50 av. FD Roosevelt, B-1050 Brussels (Belgium); Roesler, M. [Karl-Pokern-Str. 12, D-12587 Berlin (Germany)

2007-03-15

Ion induced electron emission (IIEE) is usually described as a three-step process, i.e. electron excitation by the incident projectile, electron transport (and multiplication) and electron escape through the potential barrier at the surface. In many cases, the first step of the process has been carefully described. The second step of the process, i.e. electron transport and multiplication, has often been treated in a very rough way, a simple decreasing exponential law being sometimes used. It is precisely the aim of the present work to show the importance of a correct description of electron transport and multiplication in a theoretical calculation of IIEE. A short overview of the electron transport models developed for IIEE is given in this work. The so-called 'Infinite medium slowing-down model' often used in recent works is evaluated by means of Monte Carlo simulations. In particular, the importance of considering correctly the semi-infinite character of the medium and the boundary condition at the vacuum-medium interface is discussed. Quantities like the electron escape depth are also briefly discussed. This evaluation has been performed in the particular case of protons (25keV

Studying electron-PAG interactions using electron-induced fluorescence

Science.gov (United States)

Narasimhan, Amrit; Grzeskowiak, Steven; Ostrander, Jonathan; Schad, Jonathon; Rebeyev, Eliran; Neisser, Mark; Ocola, Leonidas E.; Denbeaux, Gregory; Brainard, Robert L.

2016-03-01

In extreme ultraviolet (EUV) lithography, 92 eV photons are used to expose photoresists. Typical EUV resists are organic-based and chemically amplified using photoacid generators (PAGs). Upon exposure, PAGs produce acids which catalyze reactions that result in changes in solubility. In EUV lithography, photo- and secondary electrons (energies of 10- 80 eV) play a large role in PAG acid-production. Several mechanisms for electron-PAG interactions (e.g. electron trapping, and hole-initiated chemistry) have been proposed. The aim of this study is to explore another mechanism - internal excitation - in which a bound PAG electron can be excited by receiving energy from another energetic electron, causing a reaction that produces acid. This paper explores the mechanism of internal excitation through the analogous process of electron-induced fluorescence, in which an electron loses energy by transferring that energy to a molecule and that molecule emits a photon rather than decomposing. We will show and quantify electron-induced fluorescence of several fluorophores in polymer films to mimic resist materials, and use this information to refine our proposed mechanism. Relationships between the molecular structure of fluorophores and fluorescent quantum yield may aid in the development of novel PAGs for EUV lithography.

Electron-electron Thomas peak in fast transfer ionization

International Nuclear Information System (INIS)

Tolmanov, S. G.; McGuire, J. H.

2000-01-01

''Thomas process'' is a name used for a family of singular two-step processes that can lead to electron transfer. The Thomas process of the ''second kind,'' occurring in reactions with both transfer and ionization, utilizes the e-e scattering in the second step, so this Thomas process requires the dynamics of the electron-electron interaction. We calculate numerically the second order element of an S matrix and corresponding cross sections for the transfer ionization process. We find that the position and shape of the Thomas peak depend on both electron-electron and the electron-nucleus interaction. Also the direct and exchange amplitudes are equal at the peak position. We test the peaking approximation used for transfer ionization. Our results can be compared to experimental results for p + +He→H+He 2+ +e - . (c) 2000 The American Physical Society

Electron Tree

DEFF Research Database (Denmark)

Appelt, Ane L; Rønde, Heidi S

2013-01-01

The photo shows a close-up of a Lichtenberg figure – popularly called an “electron tree” – produced in a cylinder of polymethyl methacrylate (PMMA). Electron trees are created by irradiating a suitable insulating material, in this case PMMA, with an intense high energy electron beam. Upon discharge......, during dielectric breakdown in the material, the electrons generate branching chains of fractures on leaving the PMMA, producing the tree pattern seen. To be able to create electron trees with a clinical linear accelerator, one needs to access the primary electron beam used for photon treatments. We...... appropriated a linac that was being decommissioned in our department and dismantled the head to circumvent the target and ion chambers. This is one of 24 electron trees produced before we had to stop the fun and allow the rest of the accelerator to be disassembled....

Electronic Raman response in electron-doped cuprate superconductors

International Nuclear Information System (INIS)

Geng Zhihao; Feng Shiping

2012-01-01

The electronic Raman response in the electron-doped cuprate superconductors is studied based on the t-t'-J model. It is shown that although the domelike shape of the doping dependent peak energy in the B 2g symmetry is a common feature for both electron-doped and hole-doped cuprate superconductors, there are pronounced deviations from a cubic response in the B 2g channel and a linear response in the B 2g channel for the electron-doped case in the low energy limit. It is also shown that these pronounced deviations are mainly caused by a nonmonotonic d-wave gap in the electron-doped cuprate superconductors.

Effect of electron beam radiations on anxiety in experimental animal models

International Nuclear Information System (INIS)

Deepa, B; Suchetha Kumari; Sanjeev, Ganesh; Rao, Satheesh

2013-01-01

Exposures to ionizing radiation have been an inevitable part of the environment. This type of radiation can disrupt atoms, creating positive and negative charged particles, and cause biological harm. Ionizing radiation includes X-rays, gamma rays, alpha particles, beta particles and neutrons. They have the potential to cause both beneficial and harmful effects. There are concerns about these radiations as they are widely used in hospitals for treatment and diagnosis of various diseases. The present work was designed to test the effect of whole body electron beam radiation on anxiety in mice using the Elevated plus maze and Light dark arena, the commonly used models for assessing anxiety in rodents. Mice were irradiated with three different doses (2 Gy, 4 Gy and 6 Gy) of electron beam radiations. Statistical analysis revealed that whole body irradiation of the moderate dose range (2-6 Gy) of electron beam leads to a significant (p<0.001) anxiogenic activity in irradiated mice. Electron beam induced anxiety can be due to radiation induced reactive oxygen species in brain. (author)

Spectroscopy of electron irradiated polymers in electron microscope

International Nuclear Information System (INIS)

Faraj, S.H.; Salih, S.M.

1981-01-01

The damage induced by energetic electrons in the course of irradiation of polymers in a transmission electron microscope was investigated spectroscopically. Damage on the molecular level has been detected at very low exposure doses. These effects have been induced by electron doses less than that received by the specimen when it is situated at its usual place of the specimen stage in the electron microscope by a factor of 1,000. (author)

Oligometastatic Disease in Upper Gastrointestinal Cancer - How to Proceed?

Science.gov (United States)

Chiapponi, Costanza; Berlth, Felix; Plum, Patrick S; Betzler, Christopher; Stippel, Dirk L; Popp, Felix; Bruns, Christiane J

2017-03-01

In the present study we review and discuss the current evidence and suggest how to proceed in the management of oligometastatic disease in upper gastrointestinal cancer. An electronic search of the PubMed database for relevant articles was performed. Both the search for 'oligometastasis', 'oligometastases', 'oligometastatic', 'oligometastatic disease' as well as 'esophageal' and 'esophageal cancer' and the search for 'oligometastasis', 'oligometastases', 'oligometastatic', 'oligometastatic disease' as well as 'gastric', 'gastric cancer', 'stomach', and 'stomach cancer' yielded very few studies. Most data need to be extrapolated in general studies on oligometastatic diseases of different origins. No randomized controlled trial could be found. In the absence of data to formulate recommendations on how to proceed in the treatment of oligometastatic disease in upper gastrointestinal cancer, a more aggressive treatment of oligometastatic disease can be considered in patients whose tumors show a more favorable neoplastic behavior after the 'test of time'. The RENAISSANCE study will certainly deliver important data regarding this aspect.

Electron spectroscopy in the fundamental process of electron-nucleus bremsstrahlung

International Nuclear Information System (INIS)

Hillenbrand, Pierre-Michel

2013-07-01

Within the scope of this thesis the fundamental process of electron-nucleus bremsstrahlung was studied in inverse kinematics at the Experimental Storage Ring ESR at GSI. For the system U 88+ + N 2 at 90 MeV/u it was shown, that by using inverse kinematics coincidence measurements between the scattered electron and the emitted photon can be performed for the case, in which the incoming electron transfers almost all of its kinetic energy onto the emitted photon. The sensitivity to the fundamental process could be achieved by measuring triple differential cross sections as a function of the emission angle of the photon and the scattered electron as well as the energy of the scattered electron. The optics of the magnetic electron spectrometer used were thoroughly revised and optimized to the experimental requirements. Analyzing different coincidences in this collision system, it was possible to determine the contributions to the electron distribution arising from radiative electron capture to the projectile continuum, nonradiative electron capture to the projectile continuum, and electron loss to the projectile continuum. The experimental results of each of these processes were compared to theoretical calculations. The electron spectra for the radiative and the nonradiative electron capture to continuum clearly reproduce the opposite asymmetry predicted by theory. Furthermore electron spectra for collisions of U 28+ with different gases were measured.

Mixed Phenolic Acids Mediated Proliferation of Pathogens Talaromyces helicus and Kosakonia sacchari in Continuously Monocultured Radix pseudostellariae Rhizosphere Soil

Science.gov (United States)

Wu, Hongmiao; Wu, Linkun; Wang, Juanying; Zhu, Quan; Lin, Sheng; Xu, Jiahui; Zheng, Cailiang; Chen, Jun; Qin, Xianjin; Fang, Changxun; Zhang, Zhixing; Azeem, Saadia; Lin, Wenxiong

2016-01-01

Radix pseudostellariae L. is a common and popular Chinese medication. However, continuous monoculture has increased its susceptibility to severe diseases. We identified two pathogenic microorganisms, Talaromyces helicus M. (KU355274) and Kosakonia sacchari W. (KU324465), and their antagonistic bacterium, Bacillus pumilus Z. in rhizosphere soil of continuously monocultured R. pseudostellariae. Nine types of phenolic acids were identified both in the rhizosphere soil and in culture medium under sterile conditions. A syringic acid and phenolic acid mixture significantly promoted the growth of T. helicus and K. sacchari. T. helicus could utilize eight types of phenolic acids, whereas K. sacchari could only use four phenolic acids. K. sacchari produced protocatechuic acid when consuming vanillin. Protocatechuic acid negatively affected the growth of B. pumilus. The 3A-DON toxin produced by T. helicus promoted the growth of K. sacchari and inhibited growth of B. pumilus at low concentrations. These data help explain why phenolic exudates mediate a microflora shift and structure disorder in the rhizosphere soil of continuously monocultured R. pseudostellariae and lead to increased replanting disease incidence. PMID:27014250

Alzheimer\\'s Disease: Yesterday, Today, Tomorrow

Directory of Open Access Journals (Sweden)

Farid Fadaei

2007-04-01

Full Text Available Alzheimer's disease is the most common and well - known cause of dementia, as a progressive, irreversible brain disorder that affects cognitive function, personality, thought, perception and behaviour. Alzheimer's disease is the fourth leading cause of death in western countries. Interesting to know that this disease was unknown in medical community till 100 years ago and had no name. Dr. Alois Alzheimer, a German psychiatrist was the person who suspected the presence of this new illness and by succinct clinical, neuroanatomic, and neuropathologic examination of some cases; including the first known case of this disease- a woman named Auguste Deter- documented it. In further Emil Kraepe1inby knowing about the cases that Dr. Alzheimer reported, and another reports of this disease that were published in the first decade of the twentieth century, set the name of Alzbeimer on this new disease. Descriptions of Dr. Alzheimer and Kraepelin are the same as the present day descriptions of this disease. Electron microscopy, quantitative morphology and modem biochemistry emerging in the second half of the twentieth century opened a new era in dementia research with description of the ultra structure and biochemistry of senileplaques and neuronfibrillary tangles, the major disease markers of Alzheimer's disease. Basic research gave insight into the molecular genetics and pathophysiology of Alzheimers disease and based on the biochemical findings, new pharmacological treatment options were opened. The future attempts will probably be concentrated on the prevention of this disease. Oxidative stress, excessive transition metal ions, and misfolded / aggregated proteins and inflammation are among the probable causes of Alzheimer's disease and the future research will focus on their better understanding and prevention of their occurrence. As the last word, stem cells grafts that in animals have led to remarkable improvement of brain function may also be a

Oxidation of the FAD cofactor to the 8-formyl-derivative in human electron-transferring flavoprotein

Science.gov (United States)

Augustin, Peter; Toplak, Marina; Fuchs, Katharina; Gerstmann, Eva Christine; Prassl, Ruth; Winkler, Andreas; Macheroux, Peter

2018-01-01

The heterodimeric human (h) electron-transferring flavoprotein (ETF) transfers electrons from at least 13 different flavin dehydrogenases to the mitochondrial respiratory chain through a non-covalently bound FAD cofactor. Here, we describe the discovery of an irreversible and pH-dependent oxidation of the 8α-methyl group to 8-formyl-FAD (8f-FAD), which represents a unique chemical modification of a flavin cofactor in the human flavoproteome. Furthermore, a set of hETF variants revealed that several conserved amino acid residues in the FAD-binding pocket of electron-transferring flavoproteins are required for the conversion to the formyl group. Two of the variants generated in our study, namely αR249C and αT266M, cause glutaric aciduria type II, a severe inherited disease. Both of the variants showed impaired formation of 8f-FAD shedding new light on the potential molecular cause of disease development. Interestingly, the conversion of FAD to 8f-FAD yields a very stable flavin semiquinone that exhibited slightly lower rates of electron transfer in an artificial assay system than hETF containing FAD. In contrast, the formation of 8f-FAD enhanced the affinity to human dimethylglycine dehydrogenase 5-fold, indicating that formation of 8f-FAD modulates the interaction of hETF with client enzymes in the mitochondrial matrix. Thus, we hypothesize that the FAD cofactor bound to hETF is subject to oxidation in the alkaline (pH 8) environment of the mitochondrial matrix, which may modulate electron transport between client dehydrogenases and the respiratory chain. This discovery challenges the current concepts of electron transfer processes in mitochondria. PMID:29301933

`Twisted' electrons

Science.gov (United States)

Larocque, Hugo; Kaminer, Ido; Grillo, Vincenzo; Leuchs, Gerd; Padgett, Miles J.; Boyd, Robert W.; Segev, Mordechai; Karimi, Ebrahim

2018-04-01

Electrons have played a significant role in the development of many fields of physics during the last century. The interest surrounding them mostly involved their wave-like features prescribed by the quantum theory. In particular, these features correctly predict the behaviour of electrons in various physical systems including atoms, molecules, solid-state materials, and even in free space. Ten years ago, new breakthroughs were made, arising from the new ability to bestow orbital angular momentum (OAM) to the wave function of electrons. This quantity, in conjunction with the electron's charge, results in an additional magnetic property. Owing to these features, OAM-carrying, or twisted, electrons can effectively interact with magnetic fields in unprecedented ways and have motivated materials scientists to find new methods for generating twisted electrons and measuring their OAM content. Here, we provide an overview of such techniques along with an introduction to the exciting dynamics of twisted electrons.

The electron

International Nuclear Information System (INIS)

Hestenes, David; Weingartshofer, Antonio

1991-01-01

The stupendous successes of the Dirac equation and quantum electro-dynamics have established the electron as the best understood of the fundamental constituents of matter. Nevertheless, physicists agree that the electron still has secrets to reveal. Moreover, powerful new theoretical and experimental tools for probing those secrets have been sharpened during the last decade. This workshop was organized to bring theorists and experimentalists together to discuss their common goal of knowing the electron. Present state and future prospects for progress toward that goal are here described. The theoretical papers encompass a wide range of views on the electron. Several argue that the 'Zitter-bewegung' is more than a mathematical peculiarity of the Dirac equation, that it may well be a real physical phenomenon and worthy of serious study, theoretically and experimentally. Besides generating the electron spin and magnetic moment, the 'Zitterbewegung' may be a vital clue to electron structure and self-interaction. Some of the papers employ a radical new formulation of the Dirac theory which reveals a hidden geo-metric structure in the theory that supports a 'Zitterbewegung' inter-pretation. For the last half century the properties of electrons have been probed primarily by scattering experiments at ever higher energies. Recently, however, two powerful new experimental techniques have emerged capable of giving alternative experimental views of the electron. First, techniques for confining single electrons for long term study have led to the most accurate measurements of the electron magnetic moment. Second, the interaction of high intensity laser fields with atoms and electrons have revealed striking new phenomena such as multiphoton ionization. refs.; figs.; tabs

Basic electronics

CERN Document Server

Holbrook, Harold D

1971-01-01

Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t