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Sample records for single-incision triangulated umbilical

  1. Initial experience with laparoscopic single-incision triangulated umbilical surgery (SITUS) in simple and radical nephrectomy.

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    Nagele, Udo; Walcher, Ute; Herrmann, Thomas R W

    2012-10-01

    New transumbilical laparoendoscopic procedures are an emerging field in urologic surgery. We introduced the concept of single-incision triangulated umbilical surgery (SITUS) in 2009. SITUS technique uses straight optics and instruments in a triangulated fashion via three trocars placed through an umbilical incision resulting in a familiar laparoscopic environment. Aim of the study was to demonstrate the feasibility of SITUS in simple and radical nephrectomy in daily routine. From October 2009 to July 2010, in 3 patients with cirrhotic kidneys a simple and in 12 patients a radical nephrectomy was performed in SITUS technique. The umbilical fold was incised at three-fourth of its circumference; in the patient with radical nephrectomy, additionally small "c"-shaped skin flaps were removed. After achieving a pneumoperitoneum by Verres technique, a 5-mm camera port and then a cranial 5 mm and a caudal 11 mm working trocar were placed with at a distance of 5-10 cm with the aid of two Langenbeck hooks, thus allowing triangulation except in the radical nephrectomy patients, where an 11-mm caudal trocar (Endopath, Ethicon, Hamburg, GER) was used. Using long conventional laparoscopic instruments, En-Seal pressure coagulator and dissector (Erbe, Tuebingen, Germany), Hem-O-Lock clips (Weck, Teleflex, USA), and a 30° 5-mm optic (Karl Storz, Tuttlingen, GER), the interventions were executed like conventional laparoscopic transperitoneal procedures. OR time was mean 127 min [120, 153] for cirrhotic kidney nephrectomy group and mean 137 min [91, 185] in the radical nephrectomy group. Mean hemoglobin drop was 1.5 g/dl [1.2, 1.7] in benign cases and 2.4 [1.1, 4.9] in radial nephrectomies. All except one diabetic patient with wound infection had an uneventful follow-up without postoperative complications. The patients were discharged at postoperative day 5 [3, 29]. SITUS technique for simple and radical nephrectomy is an attractive alternative to conventional laparoscopy and single

  2. A triangulating operating platform enhances bimanual performance and reduces surgical workload in single-incision laparoscopy.

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    Rieder, Erwin; Martinec, Danny V; Cassera, Maria A; Goers, Trudie A; Dunst, Christy M; Swanstrom, Lee L

    2011-03-01

    Single-site laparoscopy (SSL) attempts to further reduce the surgical impact of minimally invasive surgery. However, crossed instruments and the proximity of the endoscope to the operating instruments placed through one single site leads to inevitable instrument or trocar collision. We hypothesized that a novel, single-port, triangulating surgical platform (SPSP) might enhance performance by improving bimanual coordination and decreasing the surgeon's mental workload. Fourteen participants, proficient in basic laparoscopic skills, were tested on their ability to perform a validated intracorporeal suturing task by either an SSL approach with crossed articulated instruments or a novel SPSP, providing true-right and true-left manipulation. Standard laparoscopic (SL) access served as control. Sutures were evaluated using validated scoring methods and the National Aeronautics and Space Administration Task Load Index was used to rate mental workload. All participants proficiently performed intracorporeal knots by SL (mean score 99.0; 95% CI 97.0 to 100.9). Performance decreased significantly (more than 50%, p mental workload when using true-right and true-left manipulation. This study objectively assessed SSL performance and current attempts for instrumentation improvement in single-site access. While SSL significantly impairs basic laparoscopic skills, surgical platforms providing true-left and true-right maneuvering of instruments appear to be more intuitive and address some of the current challenges of SSL that may otherwise limit its widespread acceptance. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Single Incision Laparoscopic Splenectomy: Our First Experiences

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    Umut Barbaros

    2011-06-01

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

  4. Single-incision laparoscopic surgery for pyloric stenosis.

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    Kozlov, Yury; Novogilov, Vladimir; Podkamenev, Alexey; Rasputin, Andrey; Weber, Irina; Solovjev, Alexey; Yurkov, Pavel

    2012-04-01

    Laparoscopy is the most common procedure for correction of congenital pyloric stenosis. The standard laparoscopic approach is based on the three-port technique. In contrast to the standard laparoscopic technique, the single-incision laparoscopic surgery (SILS) requires only one incision. We report on our experience with this surgical approach. Between September 2009 and August 2010 a total of 24 children underwent a laparoscopic pyloromyotomy, 12 in SILS technique. The single incision was carried through the center of the umbilicus. The working instruments were introduced in a two-dimensional direction into the peritoneal cavity via the same umbilical incision. The two groups were compared for patients' demographics, operative report and early postoperative outcomes. All SILS procedures were performed successfully with no conversion rate. There were no differences in the preoperative parameters between the two groups regarding age before surgery and body weight at operation. Operative time and time of full enteral intake was similar to comparable procedures with usage of a standard laparoscopic approach. There were no operative or postoperative complications. The early experience described in this study confirms that SILS can be applied for treatment of pyloric stenosis with outcomes similar to the standard laparoscopic surgery.

  5. Single-incision total laparoscopic hysterectomy

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    Sinha Rakesh

    2011-01-01

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

  6. Single incision laparoscopic colorectal resection: Our experience

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    Chinnusamy Palanivelu

    2012-01-01

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

  7. Single incision pediatric endoscopic surgery: advantages of relatively large incision

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    Yilmaz, E.; Afsarlar, E.; Karaman, I.

    2015-01-01

    To describe Single Incision Pediatric Endoscopic Surgery (SIPES) performed on children with various diagnoses, emphasizing its advantages. Study Design: An observational case series. Place and Duration of Study: Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Child Health Hospital, Ankara, Turkey, from January 2011 to November 2014. Methodology: A review of patient charts was conducted in which SIPES was preferred as the surgical procedure. Patient demographics, operative details, operative time, clinical outcomes, postoperative pain and cosmesis were analyzed. Results: SIPES was performed on 45 patients (21 girls, 24 boys). Thirty-three appendectomies, 5 varicocelectomies, 3 oophorectomies, 2 ovarian and one paratubal cyst excision, and one fallopian tube excision were performed. All except one procedures were performed through our standard 2cm umbilical vertical or smile incision. In 18 cases, abdominal irrigation/aspiration was easily performed through the existing larger incision, as is done with open surgical technique. None of the patients had early postoperative shoulder/back pain since complete disinflation of CO/sub 2/ could be ensured. All of the patients/parents were satisfied with the cosmesis. Conclusion: SIPES has the advantages of limiting the surgical scar to within the umbilicus and providing easy disinflation of CO/sub 2/, allowing intraabdominal cleaning and extraction of large volume tissue samples through a single large umbilical incision. (author)

  8. Single incision laparoscopic pancreas resection for pancreatic metastasis of renal cell carcinoma.

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    Barbaros, Umut; Sümer, Aziz; Demirel, Tugrul; Karakullukçu, Nazlı; Batman, Burçin; Içscan, Yalın; Sarıçam, Gülay; Serin, Kürçsat; Loh, Wei-Liang; Dinççağ, Ahmet; Mercan, Selçuk

    2010-01-01

    Transumbilical single incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. Herein, we report the first transumbilical single incision laparoscopic pancreatectomy case in a patient who had renal cell cancer metastasis on her pancreatic corpus and tail. A 59-year-old female who had metastatic lesions on her pancreas underwent laparoscopic subtotal pancreatectomy through a 2-cm umbilical incision. Single incision pancreatectomy was performed with a special port (SILS port) and articulated equipment. The procedure lasted 330 minutes. Estimated blood loss was 100mL. No perioperative complications occurred. The patient was discharged on the seventh postoperative day with a low-volume (20mL/day) pancreatic fistula that ceased spontaneously. Pathology result of the specimen was renal cell cancer metastases. This is the first reported SILS pancreatectomy case, demonstrating that even advanced surgical procedures can be performed using the SILS technique in well-experienced centers. Transumbilical single incision laparoscopic pancreatectomy is feasible and can be performed safely in experienced centers. SILS may improve cosmetic results and allow accelerated recovery for patients even with malignancy requiring advanced laparoscopic interventions.

  9. Single-incision laparoscopic bariatric surgery

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    Huang Chih-Kun

    2011-01-01

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

  10. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus.

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    Palanivelu, Praveenraj; Patil, Kedar Pratap; Parthasarathi, Ramakrishnan; Viswambharan, Jaiganesh K; Senthilnathan, Palanisami; Palanivelu, Chinnusamy

    2015-01-01

    The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11) and with corrugated drain (2.09) needlescopic method (1.2), Umbilical tape sling (1.95), crural stitch method (2.5). Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.

  11. Current Status of Single-incision Laparoscopic Surgery

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    Ahmed, Irfan; Ciancio, Fabio; Ferrara, Vincenzo

    2012-01-01

    Recent advances in minimally invasive surgery have centered on reducing the number of incisions required, which has led to the development of the single-incision laparoscopic technique. A panel of European single-incision laparoscopy experts met to discuss the current status of, and the future ex...... to be published to confirm its value. An ideal training route for surgeons who are adopting the technique was agreed upon, as was the need for a single, large clinical registry of data....

  12. Single-incision sling operations for urinary incontinence in women.

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    Nambiar, Arjun; Cody, June D; Jeffery, Stephen T

    2014-06-01

    Urinary incontinence has been shown to affect up to 50% of women. Studies in the United States have shown that up to 80% of these women have an element of stress urinary incontinence. Colposuspension and now mid-urethral slings have been shown to be effective in treating patients with stress incontinence. However, associated adverse events include bladder and bowel injury, groin pain and haematoma formation. This has led to the development of third-generation single-incision slings, also referred to as mini-slings.It should be noted that TVT-Secur (Gynecare, Bridgewater, NJ, USA) is one type of single-incision sling; it has been withdrawn from the market because of poor results. However, it is one of the most widely studied single-incision slings and was used in several of the trials included in this review. Despite its withdrawal from clinical use, it was decided that data pertaining to this sling should be included in the first iteration of this review, so that level 1a data are available in the literature to confirm its lack of efficacy. To assess the effectiveness of mini-sling procedures in women with urodynamic clinical stress or mixed urinary incontinence in terms of improved continence status, quality of life or adverse events. We searched the Cochrane Incontinence Group Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE in process; we handsearched journals and conference proceedings (searched 6 February 2013) and searched ClinicalTrials.gov (searched 20 September 2012), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 20 September 2012) and the reference lists of relevant articles. Randomised or quasi-randomised controlled trials in women with urodynamic stress incontinence, symptoms of stress incontinence or stress-predominant mixed urinary incontinence, in which at least one trial arm involves one of the

  13. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus

    Directory of Open Access Journals (Sweden)

    Praveenraj Palanivelu

    2015-01-01

    Full Text Available Background: The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. Material and Methods: A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11 and with corrugated drain (2.09 needlescopic method (1.2, Umbilical tape sling (1.95, crural stitch method (2.5. Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. Conclusions: The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.

  14. Single-incision laparoscopic partial gastrectomy for gastric submucosal tumors without compromising transumbilical stapling.

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    Takata, Akihiro; Nakajima, Kiyokazu; Kurokawa, Yukinori; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

    2014-01-01

    Although SILS has become an increasingly popular type of surgery, its application for gastric submucosal tumors (SMT) has been only sporadically reported. We herein describe 12 recent cases with gastric SMT located in the greater curvature or anterior wall. The aim is to validate technical feasibility and safety of single-incision laparoscopic partial gastrectomy. Thus far, this is one of the largest series of patients with gastric SMT who underwent SILS. From July 2009 to April 2013, single-incision laparoscopic partial gastrectomy was attempted in 12 consecutive patients with gastric SMT. Three trocars were assembled in the umbilical incision, and the lesion was mobilized and staple-resected with endoscopic stapling devices. SILS surgery was successfully completed without any additional trocars. The median operating time was 96.5 min, and median blood loss was 7.5 mL. The median tumor size was 30 mm, with histopathologic diagnosis of gastrointestinal stromal tumor (10) and schwannoma (2). There was no immediate postoperative morbidity. During a median follow-up of 12 months, all patients were on full regular diet without any gastrointestinal symptoms. SILS with transumbilical gastric stapling is a safe and practical alternative to conventional multiport laparoscopy in patients with gastric SMT, except for cases originating in the lesser curvature and close to the cardia/ pylorus. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  15. Single-incision laparoscopic cholecystectomy for cholecystitis requiring percutaneous transhepatic gallbladder drainage.

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    Igami, Tsuyoshi; Aoba, Taro; Ebata, Tomoki; Yokoyama, Yukihiro; Sugawara, Gen; Nagino, Masato

    2015-03-01

    Single-incision laparoscopic cholecystectomy (SILC) has been performed for patients with gallbladder stones but without acute cholecystitis. We report our experience of performing SILC for patients with cholecystitis requiring percutaneous transhepatic gallbladder drainage (PTGBD). We performed SILC via an SILS-Port with additional 5-mm forceps through an umbilical incision in ten patients with cholecystitis requiring PTGBD. All procedures were completed successfully. The mean operative time was 124 min (range 78-169 min) and there were no intraoperative or postoperative complications. The mean postoperative hospital stay was 2.7 days. All patients were satisfied with the cosmetic results. Our procedure may represent an alternative to conventional laparoscopic cholecystectomy (CLC) for patients who fervently demand the cosmetic advantages, despite cholecystitis requiring PTGBD. SILC should be performed carefully to avoid bile duct injury because the only advantage of SILC over CLC is cosmetic.

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

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    Tayar, Claude; Claude, Tayar; Subar, Daren; Daren, Subar; Salloum, Chady; Chady, Salloum; Malek, Alexandre; Alexandre, Malek; Laurent, Alexis; Alexis, Laurent; Azoulay, Daniel; Daniel, Azoulay

    2014-01-01

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

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

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    Tayar Claude

    2014-01-01

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

  18. [Preliminary clinical experience of single incision laparoscopic colorectal surgery].

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    Wu, S D; Han, J Y

    2016-06-01

    Objective: To discuss the preliminary experience of single incision laparoscopic colorectal surgery. Methods: The clinical data and surgical outcomes of 104 selected patients who underwent single incision laparoscopic colorectal surgery in the 2 nd Department of General Surgery, Shengjing Hospital of China Medical University from January 2010 to September 2015 were retrospectively analyzed. There were 62 male and 42 female patients, aging from 21 to 87 years with a mean of (61±12) years. Eighty-five patients were diagnosed with malignancy while the rest 19 cases were benign diseases. All the procedures were performed by the same surgeon using the rigid laparoscopic instruments. Surgical and oncological outcomes were analyzed in 4 kinds of procedures which are over 5 cases respectively, including low anterior resection, abdominoperineal resection, radical right colon resection and radical sigmoidectomy. Results: Single incision laparoscopic colorectal surgery was performed in 104 selected patients and was successfully managed in 99 cases with a total conversion rate of 4.8%. Radical procedures for malignancy in cases with the number of patients more than 5 were performed for 74 cases. For low anterior resection, 35 cases with an average surgical time of (191±57) minutes, average estimated blood loss of (117±72) ml and average number of harvested lymph nodes of 14.6±1.1. For abdominoperineal resection, 9 cases with an average surgical time of (226±54) minutes, average estimated blood loss of (194±95) ml and average number of harvested lymph nodes of 14.1±1.5. For radical right colon resection, 16 cases with an average surgical time of (222±62) minutes, average estimated blood loss of (142±68) ml and average number of harvested lymph nodes of 15.4±2.4. For radical sigmoidectomy, 14 cases with an average surgical time of (159±32) minutes, average estimated blood loss of (94±33) ml and average number of harvested lymph nodes of 13.9±1.5. The overall

  19. Early experience with single incision laparoscopic surgery: eliminating the scar from abdominal operations.

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    Dutta, Sanjeev

    2009-09-01

    Single incision laproscopic surgery (SILS) involves performing abdominal operations with laparoscopic instruments placed through a single, small umbilical incision. The primary goal is to avoid visible scarring. This is the first report of SILS cholecystectomy in children and the first report in the literature of SILS splenectomy. A retrospective chart review was performed in 20 consecutive inpatient SILS procedures (13 males, 7 females; ages 2-17 years) from May to December 2008. Outcome measures included need for conversion, operative time, time to oral analgesia, length of hospitalization, cosmetic outcome, and complications. There were 4 total splenectomies, 3 cholecystectomies, 2 combined splenectomy/cholecystectomies, and 11 appendectomies performed. All procedures were completed successfully without need for conversion to standard laparoscopy or open surgery. Mean operative time was 90 minutes for splenectomy, 68 minutes for cholecystectomy, 165 minutes for combined splenectomy/cholecystectomy, and 33 minutes for appendectomy. Mean hospital stay was 1 day for appendectomy, 1 day for cholecystectomy, and 2.5 days for splenectomy. One splenectomy patient received 1 U packed red blood cell transfusion. All appendectomy patients were converted to oral analgesia within 24 hours and splenectomy patients within 48 hours. All families were very pleased with the cosmetic outcome. Single incision laparoscopic surgery is feasible for a variety of pediatric general surgical conditions, allowing for scarless abdominal operations. This early experience suggests that outcomes are comparable to standard laparoscopic surgery but with improved cosmesis, however, a larger series is necessary to confirm these findings and to determine if there are any benefits in pain or recovery. Surgeons performing SILS should have a firm foundation of advanced minimal access surgical skills and a cautious, gradated approach to attempting the various procedures. Technological refinements will

  20. Single Incision Laparoscopic Cholecystectomy vs Conventional Cholecystectomy in Developing Country

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    P B Thapa

    2010-09-01

    Full Text Available INTRODUCTION: Use of laparoscopic surgery has demanded principles of less trauma of access hence less scar and so probably less complications. Hence conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES and then single incision laparoscopic surgery (SILS. With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all. METHODS: Comparative case control study between conventional laparoscopic cholecystectomy and SILS in public teaching hospital. RESULTS: Total 20 patients underwent SILS cholecystectomy and 20 underwent conventional cholecystectomy and found that no difference between both in terms of post operative pain score, hospital stay and post operative wound infection except significant difference in mean operative time and patient's level of satisfaction was less in patient with SILC if were subjected to pay for instruments in order to maintain cosmesis. CONCLUSIONS: Though SILS have gained rapid acceptance in surgical fraternity, large number of randomized controlled trials are necessary to show its benefit over conventional laparoscopic cholecystectomy. Keywords: cholecystectomy, conventional, laparoscopy, single incision, surgery

  1. Single-incision laparoscopic surgery for diverticulitis in overweight patients.

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    Rink, Andreas D; Vestweber, Boris; Hahn, Jasmina; Alfes, Angelika; Paul, Claudia; Vestweber, Karl-Heinz

    2015-10-01

    Single-incision laparoscopic surgery (SILS) has been introduced as a new technique for the treatment of various colorectal diseases. Recurrent or complicated diverticulitis of the sigmoid colon is a frequent indication for minimally invasive sigmoid colectomy. The aim of this study was to investigate the impact of obesity on the outcome of SILS sigmoid colectomy. From September 2009 to October 2014, data from 377 patients who had intended SILS sigmoid colectomy for diverticulitis at our institution were collected in a prospective database. The patients were categorized in the following subgroups: group 1 (normal weight, body mass index (BMI)  35 kg/m(2)). The groups were equivalent for sex, age, status of diverticulitis, the presence of acute inflammation in the specimen, and the percentage of teaching operations, but the percentage of patients with accompanying diseases was significantly more frequent in groups 2, 3, and 4 (p = 0.04, 0.008, and 0.018, respectively). As compared to group 1, the conversion rate was significantly increased in groups 2 and 4 (2.3 vs. 9.3% (p = 0.013) and 2.3 vs. 12.5% (p = 0.017), respectively). The duration of surgery, hospitalization, and morbidity did not differ between the four groups. Up to a body mass index of 35 kg/m(2), increased body weight does not significantly reduce the feasibility and outcome of single-incision laparoscopic surgery for diverticulitis.

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

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    Srikanth G

    2011-01-01

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

  3. Transumbilical single incision laparoscopic cholecystectomy with conventional instruments: A continuing study

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    Rajeev Sinha

    2014-01-01

    Full Text Available Introduction: The feasibility of the single incision, multiport transumbilical approach(SILC for the treatment of symptomatic gallbladder calculus disease has been established. Aims: The study examines both short and long term morbidity of the SILC approach. Materials and Methods: All the 1338 patients were operated by the same surgeon through a transversely placed umbilical incision in the upper third of the umbilicus.Three conventional ports,10,5 and 5 mm were introduced through the same skin incision but through separate transfascial punctures.The instruments were those used for standard laparoscopic cholecystectomy(SLC.Patients with acute cholecystitis and calculous pancreatitis were included,while those with choledocholithiasis were excluded.Results were compared with those of SLC. Results: Forty patients had difficult gall bladders, 214 had acute cholecystitis, and 16 had calculous pancreatitis.The mean operating time was 24.7 mins as compared to 18.4 mins in SLC. Intracorporeal knotting was required in four patients. Conversion to SLC was required in 12 patients.Morrisons pouch drain was left in 3 patients.Injectable analgesics were required in 85% vs 90% (SILC vs SLC on day 1 and 25% vs 45% on day 2 and infection was seen in 6(0. 45% patients.Port site hernia was seen in 2 patients. The data was compared with that of SLC and significance calculated by the student ′t′ test. A p value less than 0.05 was considered as significant. Conclusions: Trans umbilical SILC gives comparable results to SLC, and is a superior alternative when cosmesis and postoperative pain are considered, but the operative time is significantly more.

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

    Science.gov (United States)

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

    2015-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Benzing, Christian

    2015-12-01

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

  6. The transverse colon cancer with the reversed rotation of the midgut treated with single incision laparoscopic colectomy.

    Science.gov (United States)

    Hirano, Yasumitsu; Hattori, Masakazu; Fujita, Manami; Nishida, Youji; Douden, Kenji; Hashizume, Yasuo

    2013-06-01

    Reversed rotation of the midgut is a rare type of intestinal malrotation. Moreover, synchronous colon cancer has rarely been reported. Preliminary experience with single-incision laparoscopic colectomy (SILC) for colon cancer with reversed rotation of the midgut is reported. An 82-year-old woman was admitted because of a fecal occult blood. A colonoscopy revealed transverse colon cancer. An air-barium contrast enema showed the right-sided sigmoid colon and the left-sided cecum. A computed tomography revealed that the duodenum and the transverse colon were situated at the ventral side of the superior mesenteric artery, and a preoperative diagnosis of suspicion of reversed rotation of the midgut was made. First, a lap protector was inserted through a 4.0 cm transumbilical incision. Four 5 mm ports were placed in the lap protector. On the observation of laparoscopy, the cecum and the ascending colon were not fixed with the retroperitoneum and situated on the left, and the sigmoid colon was situated on the right. We successfully mobilized the transverse colon using a single-incision laparoscopic approach. Resection was achieved following extracorporealization, and the anastomosis was performed extracorporeally using staplers. The patient was discharged on the thirteenth postoperative day. Postoperative follow-up did not reveal any umbilical wound complications. SILC for colon cancer associated with malrotation of the midgut is feasible and a promising alternative method because of its less invasiveness and its adaptability to the malrotation without extending the skin incision.

  7. Single-incision laparoscopic surgery in a survival animal model using a transabdominal magnetic anchoring system.

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    Cho, Yong Beom; Park, Chan Ho; Kim, Hee Cheol; Yun, Seong Hyeon; Lee, Woo Yong; Chun, Ho-Kyung

    2011-12-01

    Though single-incision laparoscopic surgery (SILS) can reduce operative scarring and facilitates postoperative recovery, it does have some limitations, such as reduction in instrument working, difficulty in triangulation, and collision of instruments. To overcome these limitations, development of new instruments is needed. The aim of this study is to evaluate the feasibility and safety of a magnetic anchoring system in performing SILS ileocecectomy. Experiments were performed in a living dog model. Five dogs (26.3-29.2 kg) underwent ileocecectomy using a multichannel single port (OCTO port; Darim, Seoul, Korea). The port was inserted at the umbilicus and maintained a CO(2) pneumoperitoneum. Two magnet-fixated vascular clips were attached to the colon using an endoclip applicator, and it was held together across the abdominal wall by using an external handheld magnet. The cecum was then retracted in an upward direction by moving the external handheld magnet, and the mesocolon was dissected with Ultracision(®). Extracorporeal functional end-to-end anastomosis was done using a linear stapler. All animals survived during the observational period of 2 weeks, and then re-exploration was performed under general anesthesia for evaluation of intra-abdominal healing and complications. Mean operation time was 70 min (range 55-100 min), with each subsequent case taking less time. The magnetic anchoring system was effective in achieving adequate exposure in all cases. All animals survived and convalesced normally without evidence of clinical complication during the observation period. At re-exploration, all anastomoses were completely healed and there were no complications such as abscess, bleeding or organ injury. SILS ileocecectomy using a magnetic anchoring system was safe and effective in a dog model. The development of magnetic anchoring systems may be beneficial for overcoming the limitations of SILS.

  8. Transumbilical single-incision laparoscopic subtotal gastrectomy and total intracorporeal reconstruction of the digestive tract in the treatment of benign peptic ulcers.

    Science.gov (United States)

    Chen, Yong-Sheng; Wu, Shuo-Dong; Kong, Jing

    2014-12-01

    Single-incision laparoscopic surgery is being applied increasingly in many surgical specialties. However, few reports are available regarding its use in the treatment of benign peptic ulcer disease. We report here on nine patients with gastric or duodenal ulcers who underwent transumbilical single-incision laparoscopic subtotal gastrectomy (SILSG) between November 2010 and June 2013. All procedures were performed with conventional laparoscopic instruments placed through a single operating portal of entry created within the umbilicus. Total intracorporeal gastrojejunostomy or gastroduodenostomy was then performed for reconstruction of the digestive tract. Only one case required conversion from single-incision to multiple-incision surgery. Among the eight patients who successfully underwent SILSG, total intracorporeal gastroduodenostomy was performed in two and gastrojejunostomy in six. The mean operation time was 290 ± 50 min (range 230-360 min), and blood loss was 200 ± 66 mL (range 100-300 mL). The patients recovered fully, and the single umbilical scars healed well. We believe this is the first report of SILSG with total intracorporeal gastrojejunostomy or gastroduodenostomy in the treatment of benign peptic ulcers. On the basis of this initial experience, SILSG for this indication in the hands of experienced surgeons appears to be feasible and safe. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience.

    Science.gov (United States)

    Spinoglio, Giuseppe; Lenti, Luca Matteo; Maglione, Valeria; Lucido, Francesco Saverio; Priora, Fabio; Bianchi, Paolo Pietro; Grosso, Federica; Quarati, Raul

    2012-06-01

    Single-incision laparoscopic surgery is an emerging procedure developed to decrease parietal trauma and improve cosmetic results. However, many technical constraints, such as lack of triangulation, instrument collisions, and cross-handing, hamper this approach. Using a robotic platform may overcome these problems and enable more precise surgical actions by increasing freedom of movement and by restoring intuitive instrument control. We retrospectively collected, under institutional review board approval, data on the first 25 patients who underwent single-site robotic cholecystectomies (SSRC) at our center. Patients enrolled in this study underwent SSRC for symptomatic biliary gallstones or polyposis. Exclusion criteria were: BMI > 33; acute cholecystitis; previous upper abdominal surgery; ASA > II; and age >80 and <18 years. All procedures were performed with the da Vinci Si Surgical System and a dedicated SSRC kit (Intuitive). After discharge, patients were followed for 2 months. These SSRC cases were compared to our first 25 single-incision laparoscopic cholecystectomies (SILC) and with the literature. There were no differences in patient characteristics between groups (gender, P = 0.4404; age, P = 0.7423; BMI, P = 0.5699), and there were no conversions or major complications in either cohort. Operative time was significantly longer for the SILC group compared with SSRC (83.2 vs. 62.7 min, P = 0.0006), and SSRC operative times did not change significantly along the series. The majority of patients in each group were discharged within 24 h, with an average length of hospital stay of 1.2 days for the SILC group and 1.1 days for the SSRC group (P = 0.2854). No wound complications (infection, incisional hernia) were observed in the SSRC group and in the SILC. Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC.

  10. Two hundred seventy-five single-incision laparoscopic gastric band insertions: what have we learnt?

    Science.gov (United States)

    Murgatroyd, Beth; Chakravartty, Saurav; Sarma, Diwakar R; Patel, Ameet G

    2014-07-01

    Single-incision surgery in the morbidly obese patient has not been widely adopted, but remains a popular choice amongst patients. In the bariatric patient, it presents its own surgical challenges with hepatomegaly and increased abdominal adiposity. Here, we present our experience of 275 single-incision laparoscopic gastric bands.Between June 2009 and April 2013, 275 obese patients underwent single-incision laparoscopic adjustable gastric banding through a single incision using a multichannel single port and via a pars flaccida approach. Prospective data collection was undertaken including operating time, additional ports and additional procedures undertaken.In this series, median operative time was 60 (range 34-170) min. An additional port was placed in 15 patients (5%), including two conversions to four-port technique (0.7%). Of these patients (n = 15), the majority were male (p rate of success for all BMIs. Following 275 single-incision band insertions additional port placements were more commonly required in male patients, BMI >45 and earlier in the learning curve.

  11. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy--a randomised pilot study.

    Science.gov (United States)

    Lakdawala, Muffazal A; Muda, Nor Hisham; Goel, Sunita; Bhasker, Aparna

    2011-11-01

    This is a prospective pilot study done to evaluate the feasibility and to assess the outcomes and complication rates of the single-incision sleeve gastrectomy versus the conventional five-port laparoscopic sleeve gastrectomy. A prospective comparative analysis was done of 50 patients in each arm who underwent laparoscopic sleeve gastrectomy and single-incision sleeve gastrectomy from September 2009 until April 2010. Both groups were matched for age, gender and BMI and were then randomly assigned to either group. Postoperative pain scoring was done using the visual analogue scale. Postoperative outcomes in terms of pain scores, excess weight loss, resolution of comorbidities and complication rates were compared in both groups, at the end of 6 months. Operating times in both groups were comparable with experience. Intraoperative blood loss was similar in both groups. VAS scoring revealed lesser postoperative pain after the first 8 h in the single-incision group as compared to the laparoscopy group-P < 0.0001. At 6 months, excess weight loss and resolution of comorbidities were comparable in both groups. There were no major complications or mortalities in either group. Single-incision laparoscopic sleeve gastrectomy is a feasible surgical procedure for morbid obesity in selected individuals. When compared to conventional laparoscopic sleeve gastrectomy, it has equally effective weight loss and resolution of comorbidities. It also has the added benefits of little or no visible scarring and reduced postoperative pain.

  12. Safety and feasibility of single-incision laparoscopic cholecystectomy in obese patients

    Directory of Open Access Journals (Sweden)

    Masaki Wakasugi

    2017-01-01

    Full Text Available Current literature frequently indicates that experienced laparoscopic surgeons can safely perform single-incision laparoscopic cholecystectomy, but there have been few reports evaluating the feasibility and safety of performing single-incision laparoscopic cholecystectomy for obese patients. Therefore, a large single-center database was retrospectively reviewed to evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy for obese patients by comparing the outcomes of normal-weight and obese patients undergoing single-incision laparoscopic cholecystectomy.A retrospective analysis of 608 patients undergoing SILC between May 2009 and May 2015 at Osaka Police Hospital was performed, and the outcomes of obese [body mass index (BMI ≥ 30 kg/m2] and normal-weight patients (18.5 ≤ BMI < 25 kg/m2 were compared.Thirty-eight obese patients (mean BMI 32.5 kg/m2 were compared to 362 normal-weight patients (mean BMI 22.0 kg/m2. The American Society of Anesthesiologists (ASA scores of the obese patients were significantly higher than those of normal-weight patients. The mean operative times in the normal-weight and the obese groups were 110 min vs. 127 min, respectively (p < 0.05. There were no significant differences in the bleeding volume and the conversion rate to a different operative procedure. Perioperative complications were seen in 6% (23/362 of the patients in the normal-weight group and 8% (3/38 of the patients in the obese group (p = 0.7. The mean postoperative hospital stay was 4.5 days for the normal-weight group and 4.4 days for the obese group (p = 0.8.Single-incision laparoscopic cholecystectomy, which offers good cosmetic outcomes, seems feasible and safe in obese patients.•Single-incision laparoscopic cholecystectomy offers good cosmetic outcomes.•Single-incision laparoscopic cholecystectomy seems feasible and safe in obese patients.

  13. Learning Curve for Laparoendoscopic Single-Incision Live Donor Nephrectomy: Implications for Laparoendoscopic Practice and Training.

    Science.gov (United States)

    Troppmann, Christoph; Santhanakrishnan, Chandrasekar; Fananapazir, Ghaneh; Troppmann, Kathrin M; Perez, Richard V

    2017-05-01

    The learning curve for laparoendoscopic single-incision live donor nephrectomy, which is technically more complex than the multiport, conventional laparoendoscopic approach, is unknown. In a retrospective cohort study, we analyzed the learning curve of the initial 114 consecutive single-incision laparoendoscopic nephrectomies performed in nonselected live kidney donors. Median donor body mass index was 26 kg/m 2 (range 20-34). In all, 92% of the nephrectomies were performed on the left side; 18% of the recovered kidneys had multiple renal arteries. Cumulative sum (CUSUM) analysis of operating time (OT) demonstrated that the learning curve was achieved after case 61. For the learning curve phase (Group 1 [cases 1-61]) vs the postlearning phase (Group 2 [cases 62-114]), the difference of the mean OT was 20 minutes (p = 0.05). Mean warm ischemic time in the donors was significantly longer during the learning phase (Group 1, 6 minutes; Group 2, 5 minutes; p = 0.04). Rates of conversions to multiport procedures and of donor complications were not significantly different between Groups 1 and 2. For the recipients, we observed delayed graft function in 2 (2%) cases, no technical graft losses; and 1-year death-censored graft survival was 100% (p = n.s. for all comparisons of Group 1 vs 2). Single-incision laparoendoscopic donor nephrectomy had a long learning curve (>60 cases), but resulted in excellent donor and recipient outcomes. The long learning curve has significant implications for the programs and surgeons who contemplate transitioning from multiport to single-incision nephrectomy. Furthermore, our observations are highly relevant for informing the development of training requirements for fellows to be trained in single-incision laparoendoscopic nephrectomy.

  14. Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound.

    Science.gov (United States)

    Rubin, Jacob A; Shigemoto, Reynsen; Reese, David J; Case, J Brad

    2015-01-01

    A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

  15. A gross anatomic study of distal tibia and fibula for single-incision approach

    OpenAIRE

    Ma, Hui; Zhao, Jie; Yu, Baoqing; Ye, Bin

    2014-01-01

    Objective This study aimed to investigate the feasibility of single incision for plating for the treatment of distal tibia and fibula fractures by a gross anatomic study. Methods The anatomical structures of the anterolateral lower legs were identified. The lower leg length was measured from the top of fibular head to the tip of lateral malleolus. The distances between the extensor digitorum longus and anterior border of distal thirds of the tibia as well as the fibula were also measured. Add...

  16. Single-Incision Laparoscopic Splenectomy and Splenic Autotransplantation for an Enlarged Wandering Spleen with Torsion

    OpenAIRE

    Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu

    2013-01-01

    A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The t...

  17. No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia.

    Science.gov (United States)

    Khalil, Ashraf A; Ibrahim, Amr; Afifi, Ahmed M

    2017-04-01

    Several different methods have been proposed for treatment of gynecomastia, depending on the amount of breast enlargement and skin redundancy. The liposuction pull-through technique has been proposed as an efficacious treatment for many gynecomastia cases. This work aims to study the outcome of this technique when applied as an outpatient procedure, without the use of drains and through a single incision. Fifty-two patients with bilateral gynecomastia without significant skin excess were included in this study. The liposuction pull-through technique was performed through a single incision just above the inframammary fold and without the use of drains. Patients were followed up for 6 months. The proposed technique was able to treat the gynecomastia in all patients, with a revision rate of 1.9% to remove residual glandular tissues. There were no seromas, hematomas, nipple distortion, permanent affection of nipple sensation or wound healing problems. The liposuction pull-through technique is an effective treatment for gynecomastia without significant skin redundancy. It combines the benefits of the direct excision of glandular tissues, with the minimally invasive nature of liposuction. Performing the procedure through a single incision without the use of drains and without general anesthesia is a safe alternative. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

  18. Assessment of treatment options for rectosigmoid cancer: single-incision plus one port laparoscopic surgery, single-incision laparoscopic surgery, and conventional laparoscopic surgery.

    Science.gov (United States)

    Liu, Ruoyan; Wang, Yanan; Zhang, Ze; Li, Tingting; Liu, Hao; Zhao, Liying; Deng, Haijun; Li, Guoxin

    2017-06-01

    The advantages of reduced-port laparoscopic surgery (RPLS) for rectosigmoid cancer treatment have been disputed. This study evaluated the outcomes of RPLS compared to conventional laparoscopic surgery (CLS) for rectosigmoid cancer. Data from 211 patients who underwent a selective sigmoidectomy or anterior resection from August 2011 to June 2014 at a single institution were collected and analyzed via propensity score matching. Operative outcomes, inflammatory responses, pain intensity, oncologic outcomes, quality of life, and cosmetic results were compared between groups. After matching, 96 patients (48 CLS and 48 RPLS) were evaluated. Sixteen RPLS cases underwent single-incision laparoscopic surgery (SILS), and 32 underwent single-incision plus one port laparoscopic surgery (SILS + 1). Baseline clinical characteristics were comparable between the RPLS and the CLS groups. Morbidity, pathologic outcomes, and 3-year disease-free survival and overall survival rates were also comparable between the 2 groups. Compared with the CLS group, the RPLS group had a shorter total incision length (p time to liquid diet (p = 0.027), ambulation (p = 0.026), and discharge (p times, C-reactive protein levels at 24 h and 96 h, and interleukin-6 levels at 24 h postoperatively were significantly lower in the SILS + 1 group than those in the CLS and SILS groups (p cosmetic results, and both groups showed better results than the CLS group (p < 0.001). RPLS for rectosigmoid cancer is feasible, with short-term safety and long-term oncological safety comparable to that of CLS. Better cosmesis and accelerated recovery can be expected. SILS + 1 is a better choice than CLS or SILS for rectosigmoid cancer because it minimizes invasiveness and reduces technical difficulties.

  19. Analysis of single-incision versus dual-incision fasciotomy for tibial fractures with acute compartment syndrome.

    Science.gov (United States)

    Bible, Jesse E; McClure, D Jake; Mir, Hassan R

    2013-11-01

    To analyze the rate of postoperative infection and nonunion after tibial fractures in patients treated for acute compartment syndrome (ACS) using (1) single-incision versus (2) dual-incision fasciotomy technique. Retrospective. Level I trauma center. Review of all adult tibial fractures operatively treated (n = 2756) over a 12-year period identified 175 patients with concurrent ACS requiring fasciotomy. Of 60 patients treated with intramedullary nails, 36 patients had single-incision fasciotomy and 24 had dual-incision fasciotomy. Of 81 patients treated with plate fixation, 59 patients had single-incision fasciotomy and 22 had dual-incision fasciotomy. Tibial fixation with fasciotomy for ACS. Occurrence of postoperative infection and nonunion. Both fasciotomy groups were similar across recorded patient and treatment characteristics. Need for skin graft was similar between fasciotomy groups. For patients treated with intramedullary nail (n = 60), 1 infection (2.8%) occurred in single-incision group versus 2 (8.3%) in dual-incision group (P = 0.558). Seven nonunions (19.4%) occurred in single-incision group versus 3 (12.5%) in dual-incision group (P = 0.726). For plate fixation patients (n = 81), 15 infections (25.4%) occurred with single-incision fasciotomy versus 5 infections (22.7%) with dual-incision fasciotomy (P = 1.000). Seven nonunions (11.9%) occurred with single-incision group versus 4 nonunions (18.2%) with dual-incision group (P = 0.479). This is the first study to compare a single-incision fasciotomy technique to a dual-incision technique in the setting of tibial fractures with ACS, with similar infection and nonunion rates with either technique. The choice of fasciotomy technique can be based on surgeon experience or patient condition as opposed to a suspected elevated infection or nonunion risk with either technique. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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

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    Xin-Lei Xia

    2015-01-01

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

  1. The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

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    Noah J. Switzer

    2012-01-01

    Full Text Available Beginning with its initial description by Fitz in the 19th century, acute appendicitis has been a significant long-standing medical challenge; today it remains the most common gastrointestinal emergency in adults. Already in 1894, McBurney advocated for the surgical removal of the inflamed appendix and is credited with the initial description of an Open Appendectomy (OA. With the introduction of minimally invasive surgery, this classic approach evolved into a procedure with multiple, smaller incisions; a technique termed Laparoscopic Appendectomy (LA. There is much literature describing the advantages of this newer approach. To name a few, patients have significantly less wound infections, reduced pain, and a reduction in ileus compared with the OA. In the past few years, Single Incision Laparoscopic Appendectomy (SILA has gained popularity as the next major evolutionary advancement in the removal of the appendix. Described as a pioneer in the era of “scarless surgery,” it involves only one transumbilical incision. Patients are postulated to have reduced post-operative complications such as infection, hernias, and hematomas, as well as a quicker recovery time and less post-operative pain scores, in comparison to its predecessors. In this review, we explore the advancement of the appendectomy from open to laparoscopic to single incision.

  2. Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

    Science.gov (United States)

    Liang, Hung-Hua; Hung, Chin-Sheng; Wang, Weu; Tam, Ka-Wai; Chang, Chun-Chao; Liu, Hui-Hsiung; Yen, Ko-Li; Wei, Po-Li

    2014-01-01

    Background Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery. Methods We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site. Results Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications. PMID:24869622

  3. [Drainage of amoebic liver abscess by single incision laparoscopic surgery. Report of a case].

    Science.gov (United States)

    Telich-Tarriba, José Eduardo; Parrao-Alcántara, Iris Jocelyn; Montes-Hernández, Jesús Manuel; Vega-Pérez, Jesús

    2015-01-01

    Single incision laparoscopic surgery has increased recently due to successful results, achieved in several procedures. The aim of the present work is to present the first case in which single incision laparoscopy is used for the drainage of an amoebic liver abscess. A 44-year-old man presented with intense right upper quadrant pain, generalised jaundice, tachycardia, fever, hepatomegaly and a positive Murphy's sign. Laboratory results revealed an increased plasma bilirubin, elevated alkaline phosphatase and transaminases, leucocytosis, negative viral panel for hepatitis, and positive antibodies against Entamoeba histolytica. On an abdominal computed tomography a 15 × 12.1 cm hypodense lesion was observed in the patient's liver, identified as an amoebic liver abscess. Analgesics and antibiotics were started and subsequently the patient was submitted to laparoscopic drainage of the abscess using a single port approach. Drainage and irrigation of the abscess was performed. Four days later the patient was discharged without complications. Management of amoebic liver abscess is focused on the elimination of the infectious agent and obliteration of the abscess cavity in order to prevent its complications, especially rupture. Laparoscopic surgery has proved to be a safe and effective way to manage this entity. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  4. A novel locally operated master-slave robot system for single-incision laparoscopic surgery.

    Science.gov (United States)

    Horise, Yuki; Matsumoto, Toshinobu; Ikeda, Hiroki; Nakamura, Yuta; Yamasaki, Makoto; Sawada, Genta; Tsukao, Yukiko; Nakahara, Yujiro; Yamamoto, Masaaki; Takiguchi, Shuji; Doki, Yuichiro; Mori, Masaki; Miyazaki, Fumio; Sekimoto, Mitsugu; Kawai, Toshikazu; Nishikawa, Atsushi

    2014-12-01

    Single-incision laparoscopic surgery (SILS) provides more cosmetic benefits than conventional laparoscopic surgery but presents operational difficulties. To overcome this technical problem, we have developed a locally operated master-slave robot system that provides operability and a visual field similar to conventional laparoscopic surgery. A surgeon grasps the master device with the left hand, which is placed above the abdominal wall, and holds a normal instrument with the right hand. A laparoscope, a slave robot, and the right-sided instrument are inserted through one incision. The slave robot is bent in the body cavity and its length, pose, and tip angle are changed by manipulating the master device; thus the surgeon has almost the same operability as with normal laparoscopic surgery. To evaluate our proposed system, we conducted a basic task and an ex vivo experiment. In basic task experiments, the average object-passing task time was 9.50 sec (SILS cross), 22.25 sec (SILS parallel), and 7.23 sec (proposed SILS). The average number of instrument collisions was 3.67 (SILS cross), 14 (SILS parallel), and 0.33 (proposed SILS). In the ex vivo experiment, we confirmed the applicability of our system for single-port laparoscopic cholecystectomy. We demonstrated that our proposed robot system is useful for single-incision laparoscopic surgery.

  5. Task performance in standard laparoscopy in comparison with single-incision laparoscopy in a modified skills trainer.

    Science.gov (United States)

    Wright, Andrew S; Khandelwal, Saurabh

    2016-08-01

    Single-incision laparoscopy (SIL) is similar to conventional laparoscopic surgery (LAP), but carries specific technical challenges due to lack of triangulation, reduced dexterity, conflicts due to inline instrumentation, and impaired visualization. This study was designed to evaluate technical skill performance of SIL versus LAP surgery in a simulated environment. We developed a modified laparoscopic skills trainer for SIL based upon the fundamentals of laparoscopic surgery (FLS) model. This includes a standard laparoscopic tower for visualization, allowing replication of the conflicts between scope and instruments. It also has a modified trainer box allowing use of different access devices and instruments for SIL. Sixteen subjects at different levels of training (novice through expert) completed four FLS tasks with standard LAP techniques. They then practiced the same tasks using SIL technique until they reached a steady state of performance. The first and last SIL trials were recorded. Baseline SIL peg transfer was worse than FLS (254 ± 157 s vs 99 ± 27, p < 0.0002). Final SIL time was still significantly worse than FLS (173 ± 130, p < 0.02). FLS, baseline SIL, and final SIL circle cutting were not significantly different (p = 0.058). Final SIL loop ligation was significantly faster than FLS (48 ± 19 vs 70 ± 42, p < 0.05). FLS suturing was faster than SIL suturing (281 ± 188 vs. 526 ± 105, p < 0.01). There was substantial dropout due to frustration with SIL, and only two surgeons were able to successfully complete SIL suturing. There are technical challenges with SIL that vary depending on task. Peg transfer and suturing were significantly impaired in SIL, while circle cutting was not significantly affected, and ligating loop was faster with SIL than LAP. These challenges may impact clinical outcomes of SIL and should influence training in SIL as well as future product development.

  6. Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

    Directory of Open Access Journals (Sweden)

    Kamil Gulpinar

    2011-01-01

    Full Text Available Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

  7. Single-incision Laparoscopic Surgery (SILS) in general surgery: a review of current practice.

    Science.gov (United States)

    Froghi, Farid; Sodergren, Mikael Hans; Darzi, Ara; Paraskeva, Paraskevas

    2010-08-01

    Single-incision laparoscopic surgery (SILS) aims to eliminate multiple port incisions. Although general operative principles of SILS are similar to conventional laparoscopic surgery, operative techniques are not standardized. This review aims to evaluate the current use of SILS published in the literature by examining the types of operations performed, techniques employed, and relevant complications and morbidity. This review considered a total of 94 studies reporting 1889 patients evaluating 17 different general surgical operations. There were 8 different access techniques reported using conventional laparoscopic instruments and specifically designed SILS ports. There is extensive heterogeneity associated with operating methods and in particular ways of overcoming problems with retraction and instrumentation. Published complications, morbidity, and hospital length of stay are comparable to conventional laparoscopy. Although SILS provides excellent cosmetic results and morbidity seems similar to conventional laparoscopy, larger randomized controlled trials are needed to assess the safety and efficacy of this novel technique.

  8. Single-incision laparoscopic splenectomy and splenic autotransplantation for an enlarged wandering spleen with torsion.

    Science.gov (United States)

    Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu

    2014-06-01

    A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The transplanted splenic tissues could be identified on a spleen scintigram obtained 3 months after the surgery. Howell-Jolly bodies were not observed in blood specimens. This procedure is able to prevent an overwhelming postsplenectomy infection, and leads to satisfactory cosmetic results.

  9. Transobturator Midurethral Slings versus Single-Incision Slings for Stress Incontinence in Overweight Patients

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    Omer Bayrak

    2015-08-01

    Full Text Available ABSTRACTPurpose:To compare transobturator midurethral sling (TOS and single-incision sling procedures in terms of their effects on urinary incontinence and the quality of life in overweight (BMI ≥25-29.9 kg/m2 female patients using the International Consultation on Incontinence Questionnaire scoring form (ICIQ-SF and Quality of Life of Persons with Urinary Incontinence scoring form (I-QOL.Materials and Methods:In this prospective trial, the patients were divided into two groups consecutively; first 20 overweight female patients underwent the TOS (Unitape T®,Promedon, Cordoba, Argentina procedure and the subsequent 20 consecutive overweight female patients underwent the single-incision sling [TVT-secur (Ethicon Inc., Sommerville, USA] procedure. Age, urinary incontinence period, parity and daily pads usage were recorded. No usage of pads was defined as subjective cure rate postoperatively. Before the operation and 6. month after the surgery, the patients completed the ICIQ-SF and I-QOL.Results:There was no significant difference between the two groups in terms of mean age, duration of incontinence, parity, and BMI (p>0.05. ICIQ-SF and I-QOL revealed that the patients in the TOS group showed significantly better improvement (76.20% versus 64.10%, p=0.001, 81.31% versus 69.28%, p=0.001, respectively. In addition, subjective cure rates were found higher in TOS group (75% versus 55%, p=0.190.Conclusions:The existing data is showed that incontinence symptoms and the quality of life have higher improvement in overweight female patients who underwent the TOS procedure. It is likely that the TOS procedure may provide stronger urethral support and better contributes to continence in this group of patients.

  10. Hybrid Single-Incision Laparoscopic Colon Cancer Surgery Using One Additional 5 mm Trocar.

    Science.gov (United States)

    Kim, Hyung Ook; Choi, Dae Jin; Lee, Donghyoun; Lee, Sung Ryol; Jung, Kyung Uk; Kim, Hungdai; Chun, Ho-Kyung

    2018-02-01

    Single-incision laparoscopic surgery (SILS) is a feasible and safe procedure for colorectal cancer. However, SILS has some technical limitations such as collision between instruments and inadequate countertraction. We present a hybrid single-incision laparoscopic surgery (hybrid SILS) technique for colon cancer that involves use of one additional 5 mm trocar. Hybrid SILS for colon cancer was attempted in 70 consecutive patients by a single surgeon between August 2014 and July 2016 at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine. Using prospectively collected data, an observational study was performed on an intention-to-treat basis. Hybrid SILS was technically completed in 66 patients, with a failure rate of 5.7% (4/70). One patient was converted to open surgery for para-aortic lymph node dissection. Another was converted to open surgery due to severe peritoneal adhesion. An additional trocar was inserted for adhesiolysis in the other two cases. Median lengths of proximal and distal margins were 12.8 cm (interquartile range [IQR], 10.0-18.6), and 8.2 cm (IQR, 5.5-18.3), respectively. Median total number of lymph nodes harvested was 24 (IQR, 18-33). Overall rate of postoperative morbidity was 12.9%, but there were no Clavien-Dindo grade III or IV complications. There was no postoperative mortality or reoperation. Median postoperative hospital stay was 6 days (IQR, 5-7). Hybrid SILS using one additional 5 mm trocar is a safe and effective minimally invasive surgical technique for colon cancer. Experienced laparoscopic surgeons can perform hybrid SILS without a learning curve based on the formulaic surgical techniques presented in this article.

  11. Single incision multi-trocar hepatic cyst excision with partial splenectomy

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    Palanivelu Chinnusamy

    2013-01-01

    Full Text Available Introduction: Surgery has the potential to remove the entire hydatid cyst and can lead to complete cure. Presence of hydatid cysts in multiple abdominal organs imposes special challenges for laparoscopic management. The patient position and port placement for one organ may not be adequate for other and proper exposure in hydatid cyst is of paramount importance to prevent spillage and complete removal of the cyst. Single incision multi-trocar technique has a unique advantage of allowing surgeon to work in different quadrants of abdomen using the same incision and ports. We report in this paper the first Laparo-endoscopic single-site hepatic cyst excision with partial splenectomy for hydatid cyst in liver and spleen using conventional laparoscopic instruments. Patient and Technique: The procedure was performed on a 64 year old female diagnosed to have Hydatid cyst in segment VIII of liver and another cyst in lower pole of spleen a transverse 3 cm incision was made 6 cm above umbilicus and was deepened up to fascia. Two 10mm and one 5mm ports were inserted. Procedure was completed in 160 minutes without any intra-operative complication. There were no post-operative complication and patient was discharged on day 5. Conclusion: Single incision multi-trocar surgery has cosmetic advantage over standard laparoscopic approach. It is even more marked when two procedures are combined in different quadrants of abdomen. As this is a rare combination procedure so it remains to be determined if this technique offers additional advantages of decreased analgesia, decreased hospital stay or cost effectiveness.

  12. Single incision multi-trocar hepatic cyst excision with partial splenectomy

    Science.gov (United States)

    Chinnusamy, Palanivelu; Ahluwalia, Jasmeet Singh; Palanisamy, Senthilnathan; Seshiyer, Rajan Pidigu

    2013-01-01

    INTRODUCTION: Surgery has the potential to remove the entire hydatid cyst and can lead to complete cure. Presence of hydatid cysts in multiple abdominal organs imposes special challenges for laparoscopic management. The patient position and port placement for one organ may not be adequate for other and proper exposure in hydatid cyst is of paramount importance to prevent spillage and complete removal of the cyst. Single incision multi-trocar technique has a unique advantage of allowing surgeon to work in different quadrants of abdomen using the same incision and ports. We report in this paper the first Laparo-endoscopic single-site hepatic cyst excision with partial splenectomy for hydatid cyst in liver and spleen using conventional laparoscopic instruments. PATIENT AND TECHNIQUE: The procedure was performed on a 64 year old female diagnosed to have Hydatid cyst in segment VIII of liver and another cyst in lower pole of spleen a transverse 3 cm incision was made 6 cm above umbilicus and was deepened up to fascia. Two 10mm and one 5mm ports were inserted. Procedure was completed in 160 minutes without any intra-operative complication. There were no post-operative complication and patient was discharged on day 5. CONCLUSION: Single incision multi-trocar surgery has cosmetic advantage over standard laparoscopic approach. It is even more marked when two procedures are combined in different quadrants of abdomen. As this is a rare combination procedure so it remains to be determined if this technique offers additional advantages of decreased analgesia, decreased hospital stay or cost effectiveness. PMID:23741118

  13. Feasibility of single-incision laparoscopic surgery for appendicitis in abnormal anatomical locations: A single surgeon′s initial experience

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    Sanoop K Zachariah

    2013-01-01

    Full Text Available Background: Single-incision laparoscopic surgery is considered as a more technically demanding procedure than the standard laparoscopic surgery. Based on an initial and early experience, single-incision laparoscopic appendectomy (LA was found to be technically advantageous for dealing with appendicitis in unusual anatomical locations. This study aims to highlight the technical advantages of single-incision laparoscopic surgery in dealing with the abnormally located appendixes and furthermore report a case of acute appendicitis occurring in a sub-gastric position, which is probably the first such case to be reported in English literature. Materials and Methods: A retrospective analysis of the first 10 cases of single-incision LA which were performed by a single surgeon is presented here. Results: There were seven females and three males. The mean age of the patients was 30.6 (range 18-52 years, mean BMI was 22.7 (range 17-28 kg/m 2 and the mean operative time was 85.5 (range 45-150 min. The mean postoperative stay was 3.6 (range 1-7 days. The commonest position of the appendix was retro-caecal (50% followed by pelvic (30%. In three cases the appendix was found to be in abnormal locations namely sub-hepatic, sub-gastric and deep pelvic or para-vesical or para-rectal. All these cases could be managed with this technique without any conversions Conclusion: Single-incision laparoscopic surgery appears to be a feasible and safe technique for dealing with appendicitis in rare anatomical locations. Appendectomy may be a suitable procedure for the initial training in single-incision laparoscopic surgery.

  14. Plane Delaunay triangulation

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    Števančec, Tadej

    2016-01-01

    Delaunay triangulation is one of the fundamental data structures in computational geometry. In the thesis we present the planar Delaunay triangulation and describe its construction. Several types of algorithms for building a two-dimensional Delaunay triangulation exist, the most popular are randomized incremental algorithms. We implemented the Bowyer-Watson algorithm in the programming language Java and tested it on a number of samples of randomly generated point sets. The expected degree of ...

  15. Single-incision laparoscopic distal gastrectomy for early gastric cancer through a homemade single port access device.

    Science.gov (United States)

    Jiang, Zhi-Wei; Zhang, Shu; Wang, Gang; Zhao, Kun; Liu, Jiang; Ning, Li; Li, Jieshou

    2015-01-01

    We presented a series of single-incision laparoscopic distal gastrectomies for early gastric cancer patients through a type of homemade single port access device and some other conventional laparoscopic instruments. A single-incision laparoscopic distal gastrectomy with D1 + α lymph node dissection was performed on a 46 years old male patient who had an early gastric cancer. This single port access device has facilitated the conventional laparoscopic instruments to accomplish the surgery and we made in only 6 minutes. Total operating time for this surgery was 240 minutes. During the operation, there were about 100 milliliters of blood loss, and 17 lymph-nodes were retrieved. This homemade single port access device shows its superiority in economy and convenience for complex single-incision surgeries. Single-incision laparoscopic distal gastrectomy for early gastric cancer can be conducted by experienced laparoscopic surgeons. Fully take advantage of both SILS and fast track surgery plan can bring to successful surgeries with minimal postoperative pain, quicker mobilization, early recovery of intestinal function, and better cosmesis effect for the patients.

  16. Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8).

    Science.gov (United States)

    Galvez, Carlos; Lirio, Francisco; Sesma, Julio; Baschwitz, Benno; Bolufer, Sergio

    2017-01-01

    Unusual anatomical segmentectomies are technically demanding procedures that require a deep knowledge of intralobar anatomy and surgical skill. In the other hand, these procedures preserve more normal lung parenchyma for lesions located in specific anatomical segments, and are indicated for benign lesions, metastasis and also early stage adenocarcinomas without nodal involvement. A 32-year-old woman was diagnosed of a benign pneumocytoma in the anterior segment of the left-lower lobe (S8, LLL), so we performed a single-incision video-assisted thoracoscopic surgery (SI-VATS) anatomical S8 segmentectomy in 140 minutes under intercostal block. There were no intraoperative neither postoperative complications, the chest tube was removed at 24 hours and the patient discharged at 5 th postoperative day with low pain on the visual analogue scale (VAS). Final pathologic exam reported a benign sclerosant pneumocytoma with free margins. The patient has recovered her normal activities at 3 months completely with radiological normal controls at 1 and 3 months.

  17. Single-Incision Laparoscopic Colectomy for Cancer: Short-Term Outcomes and Comparative Analysis

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    Rodrigo Pedraza

    2013-01-01

    Full Text Available Introduction. Single-incision laparoscopic colectomy (SILC is a viable and safe technique; however, there are no single-institution studies comparing outcomes of SILC for colon cancer with well-established minimally invasive techniques. We evaluated the short-term outcomes following SILC for cancer compared to a group of well-established minimally invasive techniques. Methods. Fifty consecutive patients who underwent SILC for colon cancer were compared to a control group composed of 50 cases of minimally invasive colectomies performed with either conventional multiport or hand-assisted laparoscopic technique. The groups were paired based on the type of procedure. Demographics, intraoperative, and postoperative outcomes were assessed. Results. With the exception of BMI, demographics were similar between both groups. Most of the procedures were right colectomies ( and anterior resections (. There were no significant differences in operative time (127.9 versus 126.7 min, conversions (0 versus 1, complications (14% versus 8%, length of stay (4.5 versus 4.0 days, readmissions (2% versus 2%, and reoperations (2% versus 2%. Oncological outcomes were also similar between groups. Conclusions. SILC is an oncologically sound alternative for the management of colon cancer and results in similar short-term outcomes as compared with well-established minimally invasive techniques.

  18. Multipurpose internal retractor for Single-incision surgery (SIS): single-institution case series.

    Science.gov (United States)

    Galvani, Carlos A; Garza, Ulises; Echeverria, Angela; Kaul, Amit; Samamé, Julia

    2014-04-01

    Single-incision laparoscopic surgery (SIS) is less invasive than standard laparoscopic surgery; however, it is more difficult due to restriction of motion and the impossibility to use assistants. To overcome these obstacles, we developed a self-sustaining multipurpose internal retractor by attaching a Lone Star retractor hook to a laparoscopic bulldog clamp. Herein, we report our SIS experience using our novel retractor. Between October 2008 and April 2011, 104 patients underwent SIS using the internal retractor: 67 bandings (43% simultaneous hiatal hernia repair), 8 sleeve gastrectomies, 27 cholecystectomies, and 2 Nissen fundoplication. Mean age was 40 (range, 21 to 85) and mean body mass index was 40 kg/m (range, 20 to 64 kg/m). No intraoperative complications were observed from the use of the retractor but 2 cases required additional retraction due to liver size. This retractor has been successfully used for different SIS procedures showing to be safe, adaptable, and easy to use, lessening some challenges of SIS.

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Physical and mental workload in single-incision laparoscopic surgery and conventional laparoscopy.

    Science.gov (United States)

    Koca, Dilek; Yıldız, Sedat; Soyupek, Feray; Günyeli, İlker; Erdemoglu, Ebru; Soyupek, Sedat; Erdemoglu, Evrim

    2015-06-01

    The aim of the present study is to evaluate mental workload and fatigue in fingers, hand, arm, shoulder in single-incision laparoscopic surgery (SILS) and multiport laparoscopy. Volunteers performed chosen tasks by standard laparoscopy and SILS. Time to complete tasks and finger and hand strength were evaluated. Lateral, tripod, and pulp pinch strengths were measured. Hand dexterity was determined by pegboard. Electromyography recordings were taken from biceps and deltoid muscles of both extremities. The main outcome measurement was median frequency (MF) slope. NASA-TLX was used for mental workload. Time to complete laparoscopic tasks were longer in the SILS group (P laparoscopy. Pegboard time was increased in both hands after SILS (P laparoscopy was close to reference slope, indicating there was more fatigue in biceps and deltoid muscles of both upper extremities in SILS group. NASA-TLX score was 73 ± 13.3 and 42 ± 19.5 in SILS and multiport laparoscopy, respectively (P laparoscopy (P < .01). SILS is mentally and physically demanding, particularly on arms and shoulders. Fatigue of big muscles, effort, and frustration were major challenges of SILS. Ergonomic intervention of instruments are needed to decrease mental and physical workload. © The Author(s) 2014.

  1. Randomized Trial of Immediate Postoperative Pain Following Single-incision Versus Traditional Laparoscopic Cholecystectomy

    Science.gov (United States)

    Guo, Wei; Liu, Yang; Han, Wei; Liu, Jun; Jin, Lan; Li, Jian-She; Zhang, Zhong-Tao

    2015-01-01

    Background: We undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy (SILC) was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy (TLC). Moreover, the influencing factors of SILC were analyzed. Methods: A total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC (n = 138) or TLC (n = 414). Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle. Results: Among SILC group, 4 (2.9%) cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC (58.97 ± 21.56 vs. 43.38 ± 19.02 min, P 5 (≥100 min: 5/7 patients vs. <40 min, 3/16 patients, P = 0.015). Conclusions: The primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery. PMID:26668145

  2. Randomized Trial of Immediate Postoperative Pain Following Single-incision Versus Traditional Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Wei Guo

    2015-01-01

    Full Text Available Background: We undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy (SILC was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy (TLC. Moreover, the influencing factors of SILC were analyzed. Methods: A total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC (n = 138 or TLC (n = 414. Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle. Results: Among SILC group, 4 (2.9% cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC (58.97 ± 21.56 vs. 43.38 ± 19.02 min, P 5 (≥100 min: 5/7 patients vs. <40 min, 3/16 patients, P = 0.015. Conclusions: The primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery.

  3. SILC for SILC: Single Institution Learning Curve for Single-Incision Laparoscopic Cholecystectomy

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    Chee Wei Tay

    2013-01-01

    Full Text Available Objectives. We report the single-incision laparoscopic cholecystectomy (SILC learning experience of 2 hepatobiliary surgeons and the factors that could influence the learning curve of SILC. Methods. Patients who underwent SILC by Surgeons A and B were studied retrospectively. Operating time, conversion rate, reason for conversion, identity of first assistants, and their experience with previous laparoscopic cholecystectomy (LC were analysed. CUSUM analysis is used to identify learning curve. Results. Hundred and nineteen SILC cases were performed by Surgeons A and B, respectively. Eight cases required additional port. In CUSUM analysis, most conversion occurred during the first 19 cases. Operating time was significantly lower (62.5 versus 90.6 min, P = 0.04 after the learning curve has been overcome. Operating time decreases as the experience increases, especially Surgeon B. Most conversions are due to adhesion at Calot’s triangle. Acute cholecystitis, patients’ BMI, and previous surgery do not seem to influence conversion rate. Mean operating times of cases assisted by first assistant with and without LC experience were 48 and 74 minutes, respectively (P = 0.004. Conclusion. Nineteen cases are needed to overcome the learning curve of SILC. Team work, assistant with CLC experience, and appropriate equipment and technique are the important factors in performing SILC.

  4. Single incision laparoscopic-assisted intestinal surgery (SILAIS) in 7 dogs and 1 cat.

    Science.gov (United States)

    Case, J Brad; Ellison, Gary

    2013-06-01

    To describe the clinical findings and short-term outcome in 7 dogs and 1 cat undergoing single-incision laparoscopic-assisted intestinal surgery (SILAIS) using an SILS™ or EndoCone™ port. Prospective case series. Dogs (n = 7) and cat (n = 1). An SILS™ port using three 5-mm instrument cannulas or EndoCone™ port was used to perform an initial limited laparoscopic abdominal exploration. The stomach and descending duodenum were explored intracorporeally and the jejunum through orad descending colon was explored extracorporeally. All intestinal procedures (enterotomy, biopsy, resection, and anastomosis) were performed extracorporeally. Omentalization of affected bowel was accomplished either intracorporeally or extracorporeally. Short-term outcome was determined. SILAIS was completed successfully in all but 1 dog and all animals had a good short-term outcome. Most (n = 5) animals were discharged the day after surgery. SILAIS was performed in a median of 120 minutes (interquartile range; 82-148 minutes) and was associated with a moderate level of difficulty. No major complications occurred but conversion to celiotomy (n = 1) and enlargement of the incision (n = 3) was required because of inability to exteriorize the affected bowel. SILAIS using an SILS™ or EndoCone™ port in dogs and cats is feasible and appears effective in selected cases. Single portal laparoscopic-assisted intestinal surgery might be an effective method of minimizing morbidity in dogs and cats with uncomplicated intestinal disease. © Copyright 2013 by The American College of Veterinary Surgeons.

  5. Single incision laparoscopic surgery (SILS) in gynaecology: feasibility and operative outcomes.

    Science.gov (United States)

    Behnia-Willison, Fariba; Foroughinia, Leila; Sina, Maryam; McChesney, Phil

    2012-08-01

    Single incision laparoscopic surgery (SILS) represents the latest advancement in minimally invasive surgery, combining the benefits of conventional laparoscopic surgery, such as less pain and faster recovery, with improved cosmesis. Although the successful use of this technique is well reported in general surgery and urology, there is a lack of studies on SILS in gynaecology. To evaluate the feasibility, safety, cosmesis and outcome of SILS in gynaecology. A prospective case series analysis of 105 women scheduled to undergo surgery by SILS from August 2010 to November 2011. Intra-operative data such as operative time, estimated blood loss, complications, additional ports and hospital stay were collected. Post-operative pain and cosmetic outcomes (scar size) were also recorded. Out of 105 women, SILS was performed for 84 (60 excisions of endometriosis, 13 divisions of adhesions, five hysterectomies, two mesh sacrohysteropexies and four ovarian cystectomies). SILS was not undertaken for 21 women because of a number of factors, including the lack of required equipment (eg bariatric scope, SILS port, roticulating instruments and diathermy leads). Four women required insertion of additional ports because of surgical difficulties. One intra-operative (uterine perforation) and seven post-operative complications (six wound infections and one vault haematoma) occurred. Mean operation times were as follows: mesh sacrohysteropexy - 60 min, excision of endometriosis - 55 min, hysterectomy - 150 min, laparoscopic division of adhesions - 62 min and ovarian cystectomy - 40 min. Our experience shows that SILS is a feasible and safe technique for the surgical management of various gynaecological conditions. Satisfaction is high because of improved cosmesis and reduced analgesic requirements post-operatively. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. Single Incision Distal Biceps Repair With Hemi-Krackow Suture Technique

    Science.gov (United States)

    Goljan, Peter; Patel, Nimit; Stull, Justin D.; Donnelly, Brandon P.; Culp, Randall W.

    2016-01-01

    Background: Many surgical methods exist for distal biceps repair. We present the technique and early outcomes of a series of distal biceps repairs completed with a novel suturing technique utilizing a hemi-Krackow locking stitch at the tendon-bone interface. Methods: A retrospective review was performed of patients who underwent primary distal biceps repair using a single anterior incision with 2 suture anchors utilizing a hemi-Krackow stitch. With both anchors, a locking stitch along the tendon edge was complimented by the other strand passing through the central aspect of the distal tendon and advanced to pull the tendon edge down to the bone with appropriate tension. Patients with revision surgery and the use of allograft were excluded. Clinical outcomes included elbow range of motion and grip strength. All patients completed a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and reported satisfaction level, pain level, and any postoperative complications. Results: Fourteen patients with an average age of 51.3 years (range, 27.8-66.4 years) were included in the study. The dominant arm was injured in 9 cases. At an average of 16.4 months’ follow-up (range, 6.8-34.3 months), all patients had elbow range of motion of 0° to >130°, and grip strength was 101.5% of the uninjured arm (range, 70.6%-121.4%). The Average QuickDASH score was 6.5 (range, 0-36.5). Conclusion: Single incision biceps repair with suture anchor fixation using our hemi-Krackow stitch provided a strong repair allowing easy tensioning of the biceps tendon to bone and showed satisfactory functional outcomes at early follow-up. No patients required revision surgery, and there was only 1 case of transient nerve complaints. PMID:27390570

  7. A Comparative Study of Single Incision versus Conventional Four Ports Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Hajong, Ranendra; Hajong, Debobratta; Natung, Tanie; Anand, Madhur; Sharma, Girish

    2016-10-01

    Cholelithiasis is one of the most common disorders of the digestive tract encountered by general surgeons worldwide. Conventional or open cholecystectomy was the mainstay of treatment for a long time for this disease. In the 1980s laparoscopic surgery revolutionized the management of biliary tract diseases. It brought about a revolutionary change in the basic concepts of surgical principles and minimal access surgery gradually started to be acknowledged as a safe means of carrying out surgeries. To investigate the technical feasibility, safety and benefit of Single Incision Laparoscopic Cholecystectomy (SILC) versus Conventional Four Port Laparoscopic Cholecystectomy (C4PLC). This prospective randomized control trial was conducted to compare the advantages if any between the SILC and C4PLC. Thirty two patients underwent SILC procedure and C4PLC, each. The age of the patients ranged from 16-60years. Other demographic data and indications for cholecystectomy were comparable in both the groups. Simple comparative statistical analysis was carried out in the present study. Results on continuous variables are shown in Mean ± SD; whereas results on categorical variables are shown in percentage (%) by keeping the level of significance at 5%. Intergroup analysis of the various study parameters was done by using Fisher exact test. SPSS version 22 was used for statistical analysis. The mean operating time was higher in the SILC group (69 ± 4.00 mins vs. 38.53 ± 4.00 mins) which was of statistical significance (p=post-operative pain, with lesser analgesic requirements (p=operating time was longer otherwise it has almost similar clinical outcomes to those of C4PLC.

  8. Video. Chopstick surgery: a novel technique enables use of the Da Vinci Robot to perform single-incision laparoscopic surgery.

    Science.gov (United States)

    Joseph, R A; Salas, N A; Johnson, C; Goh, A; Cuevas, S P; Donovan, M A; Kaufman, M G; Miles, B; Reardon, P R; Bass, B L; Dunkin, B J

    2010-12-01

    Single-incision laparoscopic surgery (SILS) is limited by the coaxial arrangement of the instruments. A surgical robot with "wristed" instruments could overcome this limitation but the "arms" collide when working coaxially. This video demonstrates a new technique of "chopstick surgery," which enables use of the robotic arms through a single incision without collision. Experiments were conducted utilizing the da Vinci S® robot (Sunnyvale, CA) in a porcine model with three laparoscopic ports (12 mm, 2-5 mm) introduced through a single "incision." Pilot work conducted while performing Fundamentals of Laparoscopic Surgery (FLS) tasks determined the optimal setup for SILS to be a triangular port arrangement with 2-cm trocar distance and remote center at the abdominal wall. Using this setup, an experienced robotic surgeon performed a cholecystectomy and nephrectomy in a porcine model utilizing the "chopstick" technique. The chopstick arrangement crosses the instruments at the abdominal wall so that the right instrument is on the left side of the target and the left instrument on the right. This arrangement prevents collision of the external robotic arms. To correct for the change in handedness, the robotic console is instructed to drive the "left" instrument with the right hand effector and the "right" instrument with the left. Both procedures were satisfactorily completed with no external collision of the robotic arms, in acceptable times and with no technical complications. This is consistent with results obtained in the box trainer where the chopstick configuration enabled significantly improved times in all tasks and decreased number of errors and eliminated instrument collisions. Chopstick surgery significantly enhances the functionality of the surgical robot when working through a small single incision. This technique will enable surgeons to utilize the robot for SILS and possibly for intraluminal or transluminal surgery.

  9. "Chopstick" surgery: a novel technique improves surgeon performance and eliminates arm collision in robotic single-incision laparoscopic surgery.

    Science.gov (United States)

    Joseph, Rohan A; Goh, Alvin C; Cuevas, Sebastian P; Donovan, Michael A; Kauffman, Matthew G; Salas, Nilson A; Miles, Brian; Bass, Barbara L; Dunkin, Brian J

    2010-06-01

    Single-incision laparoscopic surgery (SILS) is limited by the coaxial arrangement of the instruments. A surgical robot with wristed instruments could overcome this limitation, but the arms often collide when working coaxially. This study tests a new technique of "chopstick" surgery to enable use of the robotic arms through a single incision without collision. Experiments were conducted utilizing the da Vinci S robot (Intuitive Surgical, Inc., Sunnyvale, CA) in a Fundamentals of Laparoscopic Surgery (FLS) box trainer with three laparoscopic ports (1 x 12 mm, 2 x 5 mm) introduced through a single "incision." Pilot work determined the optimal setup for SILS to be a triangular port arrangement with 2-cm trocar distance and remote center at the abdominal wall. Using this setup, five experienced robotic surgeons performed three FLS tasks utilizing either a standard robotic arm setup or the chopstick technique. The chopstick arrangement crosses the instruments at the abdominal wall so that the right instrument is on the left side of the target and the left instrument on the right. This results in separation of the robotic arms outside the box. To correct for the change in handedness, the robotic console is instructed to drive the "left" instrument with the right-hand effector and the "right" instrument with the left. Performances were compared while measuring time, errors, number of clutching maneuvers, and degree of instrument collision (Likert scale 1-4). Compared with the standard setup, the chopstick configuration increased surgeon dexterity and global performance through significantly improved performance times, eliminating instrument collision, and decreasing number of camera manipulations, clutching maneuvers, and errors during all tasks. Chopstick surgery significantly enhances the functionality of the surgical robot when working through a small single incision. This technique will enable surgeons to utilize the robot for SILS and possibly for intraluminal or

  10. Single-Incision Versus Three-Port Laparoscopic Appendectomy: Short- and Long-Term Outcomes.

    Science.gov (United States)

    Vellei, Samatha; Borri, Alessandro

    2017-08-01

    To compare the outcome of patients who had undergone single-incision laparoscopic appendectomy (SILA) with others who had undergone three-port laparoscopic appendectomy (3-PORT). Data from all adults with uncomplicated appendicitis treated by laparoscopic appendectomy between June 2012 and December 2015 were prospectively collected. Patients with chronic pain, appendix malignancy, at least two previous laparotomies, and those undergoing concomitant surgery for different condition were excluded from analysis. Postoperative pain was assessed by a visual analog scale (VAS). Patients were reviewed postoperatively at 7 days and 1 month in the outpatient clinic. Late complications were assessed with a telephonic interview. A total of 91 patients were included (46 SILA; 45 3-PORT). There were 16 males and 30 females in the SILA group (mean age = 26.76 ± 10.58 years) and 18 males and 27 females in the 3-PORT group (mean age = 26.84 ± 10.79 years). The mean operative time for SILA was 48.54 ± 12.80 min, for the 3-PORT group the mean operative time was 46.33 ± 15.54 min (P = 0.46). No case required conversion. Mean postoperative hospital length of stay was 1.87 ± 0.69 days for SILA and 2.38 ± 1.11 days for 3-PORT (P = 0.01). VAS value of 3.91 ± 1.96 and mean ketorolac usage of 0.38 ± 0.65 in 3-PORT group and SILA patients reported 3.70 ± 1.58 and 0.39 ± 0.58, respectively (P = 0.91). Our mean follow-up in SILA group was 25.75 ± 10.82 months, for 3-PORT group the mean follow-up was 26.9 ± 11.8 months. Eleven patients missed long-term follow-up. No incisional hernia was found. There is a statistically significant difference in cosmetic evaluation in favor of SILA (P PORT laparoscopic appendectomy, but after SILA procedure discharge was quicker and long-term cosmetic satisfaction was superior.

  11. Single-incision trocar-less endoscopic management of giant liver hydatid cyst in children

    Science.gov (United States)

    Acharya, Himanshu; Agrawal, Vikesh; Tiwari, Abhishek; Sharma, Dhananjaya

    2018-01-01

    Introduction: Laparoscopic management of giant hydatid cyst has limitations such as spillage, poor control, difficulties in suctioning the contents through special ports which are not easily available, difficulty in the obliteration of residual cavity and recurrence. We describe single-incision trocar-less endoscopic (SITE) technique which simplifies enucleation and management of residual cavity. Method: Inclusion criteria for these cases were patients having single uncomplicated giant hydatid cyst >5 cm present at the surface of the liver and palpable on clinical examination. The cysts which were <5 cm, multiple, deep-seated and impalpable were excluded from the study. Technique: An incision of 1 cm is marked over the site of the maximum bulge and deepened to open peritoneum, cyst is held with two stay sutures, injection of scolicidal agent and aspiration is done and suction of the cyst content is done. After suction of the contents, 5 mm telescope is inserted, and the cyst cavity is inspected, clearance and cyst procedure is done. Results: In 6 years, 62 cases of giant hydatid cyst fulfilling the inclusion criteria and were taken for SITE technique. SITE was successful in all patients and none needed a conversion. Twenty-nine (46.77%) underwent omentopexy and three (4.83%) underwent SITE capitonnage. There was post-operative biliary leak in one (0.016%) patient who underwent capitonnage, which was managed by prolonged drainage which resolved in 10 days. Mean operative duration was 52 min (30 min to 85 min). Mean follow-up was for 18 months (12–36 months). One (0.016%) patient had cyst recurrence. Discussion: SITE has advantages of endoscopic clearance and does not require special ports which are expensive, technically difficult to use and often unavailable. It allows controlled handling, effective suction and easier management of bile communication. SITE can be a preferred procedure for endoscopic management of giant liver hydatid cysts. Conclusion: SITE

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

    Directory of Open Access Journals (Sweden)

    S. C. Blackburn

    2012-01-01

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

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

    Science.gov (United States)

    Blackburn, S C; Adams, S D; Mahomed, A A

    2012-01-01

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

  14. Coxeter triangulations have good quality

    OpenAIRE

    Choudhary, Aruni; Kachanovich, Siargey; Wintraecken, Mathijs

    2017-01-01

    Coxeter triangulations are triangulations of Euclidean space based on a simple simplex. By this we mean that given an individual simplex we can recover the entire triangulation of Euclidean space by inductively reflecting in the faces of the simplex. In this paper we establish that the quality of the simplices in all Coxeter triangulations is $O(1/ √ d)$ of the quality of regular simplex. We further investigate the Delaunay property (and an extension thereof) for these triangulations. In part...

  15. Transvaginal Excision of an Eroded Sacrocolpopexy Mesh by Using Single-Incision Laparoscopic Surgery Equipment.

    Science.gov (United States)

    Mohr, Stefan; Siegenthaler, Franziska; Imboden, Sara; Kuhn, Annette; Mueller, Michael D

    To show a new technique of using single-incision laparoscopic surgery (SILS) equipment in vaginal surgery to create a "pneumovagina." Explanatory video demonstrating the technique and intraoperative findings. University hospital. The 68-year-old patient was referred with a vaginal mesh erosion that resulted in abscess formation at the vaginal apex. The patient was symptomatic with an increasingly foul-smelling vaginal discharge for about 1 year. She had a laparoscopic sacrocolpopexy in a remote hospital 22 months before the current operation and had a total abdominal hysterectomy 15 years ago. The, patient's history was uneventful without dyspareunia, incontinence or voiding difficulties, and she was otherwise content with the sacrocolpopexy result. The local institutional review board granted exemption for this publication. Frequently, pelvic organ prolapse can only be effectively treated if the surgical procedure comprises support of the central compartment. Laparoscopic sacrocolpopexy shows superior outcomes for this indication, with success rates of up to 96%. However, a rare side effect of laparoscopic sacrocolpopexy is mesh erosion, occurring in up to 2.4% [1]. These erosions are usually treated laparoscopically [2]. In this video we show an alternative route for excision of a symptomatic exposed mesh by using a transvaginal approach: The SILS trocar is used vaginally for abscess irrigation and mesh excision with minimally invasive instruments. For treatment of the abscess and removal of the exposed mesh, the SILS trocar was placed vaginally, and laparoscopic instruments were used. The abscess was incised, cleansed and irrigated, debrided, and the mesh excised. Because no mesh material was exposed after excision, the vagina was not closed to avoid creating a cavity with the risk of promoting reabscess formation, and secondary wound healing was anticipated. Laparoscopy was used to confirm that no intra-abdominal lesion coexisted or occurred. There were

  16. Single-incision laparoscopic surgery: outcomes from 224 colonic resections performed at a single center using SILS.

    Science.gov (United States)

    Vestweber, Boris; Galetin, Thomas; Lammerting, Kathrin; Paul, Claudia; Giehl, Jeanette; Straub, Eberhard; Kaldowski, Bodo; Alfes, Angelika; Vestweber, Karl-Heinz

    2013-02-01

    Compared with single-incision laparoscopy, multiport laparoscopy is associated with greater risk of postoperative wound pain, infection, incisional hernias, and suboptimal cosmetic outcomes. The feasibility of minimally invasive single-incision laparoscopic surgery (SILS) for colorectal procedures is well-established, but outcome data remain limited. Patients with benign diverticular disease, Crohn's disease, or ulcerative colitis admitted to Klinikum Leverkusen, Germany, for colonic resection between July 2009 and March 2011 (n = 224) underwent single-incision laparoscopic surgery using the SILS port system. Surgeons had ≥7 years' experience in laparoscopic colon surgery but no SILS experience. Patient demographic and clinical data were collected prospectively. Pain was evaluated by using a visual analog scale (0-10). Data were analyzed by using the SPSS PASW Statistics 18 database. The majority of patients underwent sigmoid colectomy with high anterior resection (AR) or left hemicolectomy (n = 150) for diverticulitis. Our conversion rate to open surgery was 6.3 %, half in patients undergoing sigmoid colectomy with high AR or left hemicolectomy, 95 % of whom had diverticulitis. Mean operating time was 166 ± 74 (range, 40-441) min in the overall population, with shorter times for single-port transanal tumor resection (SPTTR; 89 ± 51 min; range, 40-153 min) and longer times for proctocolectomy (325 min; range, 110-441 min). Mean hospital stay was approximately 10 days, longer after abdominoperineal rectal resection or proctocolectomy (12-16 days). Most complications occurred following sigmoid colectomy with high AR or left hemicolectomy [19/25 (76 %) of early and 4/5 (80 %) of late complications, respectively]. Pain was surgery, conducted by experienced laparoscopic surgeons without specific training in use of the SILS port.

  17. Elective gastropexy with a reusable single-incision laparoscopic surgery port in dogs: 14 cases (2012-2013).

    Science.gov (United States)

    Stiles, Mandy; Case, J Brad; Coisman, James

    2016-08-01

    OBJECTIVE To describe the technique, clinical findings, and short-term outcome in dogs undergoing laparoscopic-assisted incisional gastropexy with a reusable single-incision surgery port. DESIGN Retrospective case series. ANIMALS 14 client-owned dogs. PROCEDURES Medical records of dogs referred for elective laparoscopic gastropexy between June 2012 and August 2013 were reviewed. History, signalment, results of physical examination and preoperative laboratory testing, surgical procedure, duration of surgery, postoperative complications, duration of hospital stay, and short-term outcome were recorded. All patients underwent general anesthesia and were positioned in dorsal recumbency. After an initial limited laparoscopic exploration, single-incision laparoscopic-assisted gastropexy was performed extracorporeally in all dogs via a conical port placed in a right paramedian location. Concurrent procedures included laparoscopic ovariectomy (n = 4), gastric biopsy (2), and castration (7). Short-term outcome was evaluated. RESULTS Median duration of surgery was 76 minutes (range, 40 to 90 minutes). Intraoperative complications were minor and consisted of loss of pneumoperitoneum in 2 of 14 dogs. A postoperative surgical site infection occurred in 1 dog and resolved with standard treatment. Median duration of follow-up was 371 days (range, 2 weeks to 1.5 years). No dogs developed gastric dilation-volvulus during the follow-up period, and all owners were satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that single-incision laparoscopic-assisted gastropexy with a reusable conical port was feasible and effective in appropriately selected cases. Investigation of the potential benefits of this reusable port versus single-use devices for elective gastropexy in dogs is warranted.

  18. Triangulation positioning system network

    Directory of Open Access Journals (Sweden)

    Sfendourakis Marios

    2017-01-01

    Full Text Available This paper presents ongoing work on localization and positioning through triangulation procedure for a Fixed Sensors Network - FSN.The FSN has to work as a system.As the triangulation problem becomes high complicated in a case with large numbers of sensors and transmitters, an adequate grid topology is needed in order to tackle the detection complexity.For that reason a Network grid topology is presented and areas that are problematic and need further analysis are analyzed.The Network System in order to deal with problems of saturation and False Triangulations - FTRNs will have to find adequate methods in every sub-area of the Area Of Interest - AOI.Also, concepts like Sensor blindness and overall Network blindness, are presented. All these concepts affect the Network detection rate and its performance and ought to be considered in a way that the network overall performance won’t be degraded.Network performance should be monitored contentiously, with right algorithms and methods.It is also shown that as the number of TRNs and FTRNs is increased Detection Complexity - DC is increased.It is hoped that with further research all the characteristics of a triangulation system network for positioning will be gained and the system will be able to perform autonomously with a high detection rate.

  19. Vaginal mesh repair SYSTEMS for pelvic organ prolapse: Anatomical study comparing transobturator/trangluteal versus single incision techniques.

    Science.gov (United States)

    Campagna, Giuseppe; Panico, Giovanni; Morciano, Andrea; Gadonneix, Pierre; Delmas, Vincent; Cervigni, Mauro; Ercoli, Alfredo; Scambia, Giovanni

    2017-09-18

    The present study aim to compare the anatomic landmarks of two pelvic floor repair systems, in order to identify the potential neurovascular lesions related to different mesh fixation techniques. Abdominal and perineal dissections of 10 fresh cadavers after prolapse surgery using transobturator/transgluteal versus single incision techniques. Neuro-vascular structures of obturator region and perineum were isolated. Distances between needles and anatomical structures were measured. During transobturator anterior repair, the superficial cannula passed 2.5 ± 0.6 cm medially to the obturator canal. The distance of superficial arm to the anterior obturator vessels was 2.2 ± 0.4 cm. The distance of deep cannula to the posterior obturator vessels branches was 1.3 ± 0.5 cm. In two of these cases we observed a lesion of posterior obturator vessels. During single incision repair the distance between the obturator canal and the superficial arms was 2.3 ± 0.7. The mean distances of superficial arms to the anterior and posterior obturator vessels were, respectively, 2.3 ± 0.5 cm and 3.2 ± 0.7 cm. During transgluteal posterior repair the distance between the cannula guide and the ischial spine was 1.7 ± 0.5 cm while it measured 2.3 ± 0.4 cm when single incision posterior device was placed. Anterior transobturator system presents an increased risk of posterior obturator vessels branches injury. During posterior transgluteal repair the distance of the ischio-anal fossa to sacrospinous ligament represents a way that could rule against the correct needle positioning with increased risk of pudendal lesions. Single incision approach offers an easier access to the sacrospinous ligament with lower risk of pudendal lesions. © 2017 Wiley Periodicals, Inc.

  20. Case-mix study of single incision laparoscopic surgery (SILS) vs. Conventional laparoscopic surgery in colonic cancer resections

    DEFF Research Database (Denmark)

    Mynster, Tommie; Wille-Jørgensen, Peer

    2013-01-01

    of administrations or amount of opioids were seen. Conclusion. With reservation of a small study group we find SILS is like worthy to CLS in colorectal cancer surgery and a benefit in postoperative recovery and pain is possible, but has to be investigated in larger randomised studies.......Single incision laparoscopic surgery (SILS) may be even less invasive to a patient than conventional laparoscopic surgery (CLS). Aim of the study of the applicability of the procedure, the first 1½ year of experiences and comparison with CLS for colonic cancer resections Material and methods. Since...

  1. Evaluating single-incision slings in female stress urinary incontinence: the usefulness of the CONSORT statement criteria.

    Science.gov (United States)

    Diallo, Stéphanie; Cour, Florence; Josephson, Anne; Vidart, Adrien; Botto, Henri; Lebret, Thierry; Bonan, Brigitte

    2012-09-01

    To evaluate the usefulness and applicability of the Consolidated Standards of Reporting Trials (CONSORT) for journal articles reporting randomized, controlled trials evaluating single-incision slings in the treatment of female stress urinary incontinence. Original articles reporting randomized, controlled trials assessing single-incision slings in the treatment of female stress urinary incontinence were searched for in the PubMed and Embase databases in 2011. Reporting quality was studied by 2 hospital pharmacists and 2 urologic surgeons. Primary outcome was the score out of 20 in the abstract CONSORT checklist. Secondary outcomes were the scores in the standard CONSORT checklist and the extension CONSORT additional items for trials assessing nonpharmacologic treatments. Among 135 articles retrieved, 8 met the inclusion criteria and were assessed. Abstract scores ranged from 4.7-14.1. Standard scores were >10.0 out of 20 for most articles; the extension scores did not exceed 5.0 out of 10. Four reported trials were not identified as randomized in the title. The interventions were incompletely reported. Four articles reported whether blinding was achieved but lack of blinding was never discussed as a potential source of bias. Few articles reported the operators and centers characteristics and their impact on statistical analysis. The combination of the 3 checklists was considered a useful guideline to enhance and assess the reporting quality of a surgical trial. Our results support the further use of CONSORT criteria as a basic standardized tool in all stages of clinical evaluation for any prosthetic device in female pelvic surgery. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Umbilical Hernia

    Science.gov (United States)

    ... 15, 2015. Umbilical hernia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  3. Umbilical Hernia

    Science.gov (United States)

    ... creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you ... doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful ...

  4. Observation, innovation and triangulation

    DEFF Research Database (Denmark)

    Hetmar, Vibeke

    2007-01-01

    In the article the focus is on classroom research which aims at offering some evidence-based description of the interplay between the logic of practice in school and schooling on the one hand and the teachers' efforts to realize notions of innovation and change on the other hand. Based on experie......In the article the focus is on classroom research which aims at offering some evidence-based description of the interplay between the logic of practice in school and schooling on the one hand and the teachers' efforts to realize notions of innovation and change on the other hand. Based...... on experiences from a pilot project in three different classrooms methodological possibilities and problems are presented and discussed: 1) educational criticism, including the concepts of positions, perspectives and connoisseurship, 2) classroom observations and 3) triangulation as a methodological tool....

  5. Introduction to causal dynamical triangulations

    DEFF Research Database (Denmark)

    Görlich, Andrzej

    2013-01-01

    The method of causal dynamical triangulations is a non-perturbative and background-independent approach to quantum theory of gravity. In this review we present recent results obtained within the four dimensional model of causal dynamical triangulations. We describe the phase structure of the mode...

  6. Volumes of polytopes without triangulations

    Science.gov (United States)

    Enciso, Michael

    2017-10-01

    The geometry of the dual amplituhedron is generally described in reference to a particular triangulation. A given triangulation manifests only certain aspects of the underlying space while obscuring others, therefore understanding this geometry without reference to a particular triangulation is desirable. In this note we introduce a new for-malism for computing the volumes of general polytopes in any dimension. We define new "vertex objects" and introduce a calculus for expressing volumes of polytopes in terms of them. These expressions are unique, independent of any triangulation, manifestly depend only on the vertices of the underlying polytope, and can be used to easily derive identities amongst different triangulations. As one application of this formalism, we obtain new expressions for the volume of the tree-level, n-point NMHV dual amplituhedron.

  7. Single-incision Laparoscopic Appendectomy for acute Appendicitis using a 10-mm Laparoscope and the Glove Port Technique.

    Science.gov (United States)

    Tsushimi, Takaaki; Mori, Hirohito; Sudo, Manabu; Minami, Yoshihide; Ueki, Koichi; Tamai, Makoto

    2017-01-01

    To evaluate the single incision laparoscopic appendectomy (SILA) using existing instruments, the 10-mm laparoscope, and glove port technique. SILA was performed on 16 patients (8 male cases, 8 female cases) between June 2012 and September 2015. A 20-mm incision was made in the umbilicus and a wound retractor was placed. A 10-mm trocar for the laparoscope and two 5-mm trocars were fixed to the three fingers of the latex gloves and it was attached to the wound retractor. Another thin forceps were inserted from right low abdomen. Average age of patients was 32.6 ± 17.7 years. Preoperative average white blood cell was 13,325 ± 4,584 /mm 3 , and average CRP was 1.81 ± 3.70 mg/dL. Preoperative body temperature was 36.8 ± 0.5°C. The mean appendix size was 9.6 ± 2.3 mm and none of the patients had an abscess on preoperative CT. The CT also revealed a fecal pellet in 5/16 (31%) of patients. Mean operation time was 66.4 ± 25.4 minutes, and minimal intraoperative bleeding was observed in all patients. Average hospital stay was 5.3 ± 1.9 days and none of the patients had complications. SILA using the 10-mm laparoscope and glove port technique may be a safe and feasible operation for mild to moderate appendicitis.

  8. Comparison of the clinical outcomes of transobturator and single-incision slings for stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Ling-Ying Wu

    2016-07-01

    Full Text Available The aim of this study was to compare the clinical outcomes of anti-incontinence surgeries employing the transobturator sling and single-incision sling (SIS. Our hypothesis is that the outcome of the SIS is not inferior to the obturator sling. This retrospective study reviewed the medical records of patients who underwent anti-incontinence surgery with the transobturator sling or SIS from July 2005 to November 2014. Patients who underwent concomitant pelvic organ reconstruction with an artificial mesh were excluded. Assessments included preoperative and postoperative urodynamic examinations, perioperative complications, and postoperative urogenital symptoms. A total of 122 women were recruited according to the inclusion and exclusion criteria. Among them, 68 patients underwent transobturator sling procedures while 54 patients underwent SIS procedures. The subjective failure rate of the transobturator sling and SIS were 10.2% and 18.5%, respectively (p = 0.292. The objective failure rate, defined as a pad test showing more than 2 g of urine, was 10.2% for the transobturator sling and 12.9% for the SIS (p = 0.777. SIS resulted in less blood loss, operative time, length of hospital stay, and transient voiding dysfunction after the operation. No major complication occurred after either surgical intervention. In conclusion, SIS and transobturator slings might have similar efficacy, safety, and effects on new-onset urogenital symptoms.

  9. Single-Incision Pediatric Endosurgery (SIPES oophoropexy in an adolescent with Hodgkin lymphoma prior to pelvic irradiation

    Directory of Open Access Journals (Sweden)

    Aaron D. Seims

    2015-07-01

    Full Text Available Oophoropexy for fertility preservation during pelvic irradiation dates back to the mid-1960s. For Hodgkin lymphoma (HL, this was performed during a staging laparotomy. Laparoscopic ovarian fixation has supplanted open pexy with advancements in technology and abandonment of staging laparotomies. Single-Incision Pediatric Endosurgery (SIPES is applicable to numerous multi-port operations. Use of this technique for oophoropexy prior to pelvic irradiation, however, has not been reported. A 19 year-old with stage IVb HL involving the left iliac node basin was to receive radiotherapy and was evaluated for bilateral oophoropexy. An Olympus TriPort™ was introduced at the umbilicus, through which a 5 mm zero-degree laparoscope and a needle driver were introduced. Transabdominal passage of a ski needle through a 2 mm nick in the skin of the anterolateral wall allowed for right sided fixation of the ovaries. Operative recovery was uncomplicated, and post-operative imaging demonstrated satisfactory positioning of the gonads outside the planned radiation field. In conclusion, SIPES oophoropexy is a technically simple method for fertility preservation that offers improved cosmesis.

  10. Triangulation Made Easy

    Energy Technology Data Exchange (ETDEWEB)

    Lindstrom, P

    2009-12-23

    We describe a simple and efficient algorithm for two-view triangulation of 3D points from approximate 2D matches based on minimizing the L2 reprojection error. Our iterative algorithm improves on the one by Kanatani et al. by ensuring that in each iteration the epipolar constraint is satisfied. In the case where the two cameras are pointed in the same direction, the method provably converges to an optimal solution in exactly two iterations. For more general camera poses, two iterations are sufficient to achieve convergence to machine precision, which we exploit to devise a fast, non-iterative method. The resulting algorithm amounts to little more than solving a quadratic equation, and involves a fixed, small number of simple matrixvector operations and no conditional branches. We demonstrate that the method computes solutions that agree to very high precision with those of Hartley and Sturm's original polynomial method, though achieves higher numerical stability and 1-4 orders of magnitude greater speed.

  11. Layered-triangulations of 3-manifolds

    OpenAIRE

    Jaco, William; Rubinstein, J. Hyam

    2006-01-01

    A family of one-vertex triangulations of 3-manifolds, layered-triangulations, is defined. Layered-triangulations are first described for handlebodies and then extended to all 3-manifolds via Heegaard splittings. A complete and detailed analysis of layered-triangulations is given in the cases of the solid torus and lens spaces, including the classification of all normal and almost normal surfaces in these triangulations. Minimal layered-triangulations of lens spaces provide a common setting fo...

  12. Planar stochastic hyperbolic infinite triangulations

    OpenAIRE

    Curien, Nicolas

    2014-01-01

    Pursuing the approach of Angel & Ray, we introduce and study a family of random infinite triangulations of the full-plane that satisfy a natural spatial Markov property. These new random lattices naturally generalize Angel & Schramm's Uniform Infinite Planar Triangulation (UIPT) and are hyperbolic in flavor. We prove that they exhibit a sharp exponential volume growth, are non-Liouville, and that the simple random walk on them has positive speed almost surely. We conjecture that these infinit...

  13. Single-incision laparoscopic surgery and conventional laparoscopic treatment of varicocele in adolescents: Comparison between two techniques

    Directory of Open Access Journals (Sweden)

    Antonio Marte

    2014-01-01

    Full Text Available Background: Single-incision laparoscopic surgery (SILS has gained great popularity in paediatric surgery due to its minimally invasive approach and improved cosmetic results. Notwithstanding, reports describing its adoption in children are still fragmentary and some perplexities have been raised by some surgeons. We reviewed our experience with the SILS Palomo varicocelectomy procedure (SIL-V in children and adolescents, comparing this group with a similar series operated using conventional laparoscopic varicocelectomy (CL-V. Patients and Methods: A total of 69 Palomo laparoscopic varicocelectomies were performed in patients aged 11-17 years from January 2011 to January 2013. Indications for surgery included grades II-III varicocele or ipsilateral testicular hypotrophy. The SIL-V procedure was performed in 44 patients with roticulating and conventional 5 mm instruments. Testicular vessels were isolated "en bloc," clipped and cut. Operating time, visual analogue scale and post-operative results were compared to a similar group of 25 patients operated with CL-V. Results: No patient of the SIL-V group required conversion to conventional laparoscopy, none to open surgery. Mean operative time was 22 min (range: 19-28 in the SIL-V group, not significantly different compared with CL-V (mean 21 min, range: 18-25. All patients experienced a smooth recovery from surgery without any complications, and were discharged on day 1. No difficulties were found in the SIL-V group. The post-operative pain score was significantly better in SIL-V. Conclusion: The SIL-V procedure is safe and effective and allows a fast and efficient isolation of the vascular bundle. The use of conventional instruments is technically feasible in SIL-V.

  14. Single-Incision Carpal Tunnel Release and Distal Radius Open Reduction and Internal Fixation: A Cadaveric Study.

    Science.gov (United States)

    Gaspar, Michael P; Sessions, Blane A; Dudoussat, Bryan S; Kane, Patrick M

    2016-08-01

    The safety of surgical approaches for single- versus double-incision carpal tunnel release in association with distal radius open reduction and internal fixation remains controversial. The purpose of this study was to identify critical structures to determine if a single-incision extension of the standard flexor carpi radialis (FCR) approach can be performed safely. Nine cadaveric arms with were dissected under loupe magnification, utilizing a standard FCR approach. After the distal radius exposure was complete, the distal portion of the FCR incision was extended to allow release of the carpal tunnel. Dissection of critical structures was performed, including the recurrent thenar motor branch of the median nerve, the palmar cutaneous branch of the median nerve (PCBm), the palmar carpal and superficial palmar branches of the radial artery, and proximally the median nerve proper. The anatomic relationship of these structures relative to the surgical approach was recorded. Extension of the standard FCR approach as described in this study did not damage any critical structure in the specimens dissected. The PCBm was noted to arise from the radial side of the median nerve an average of 6.01cm proximal to the proximal edge of the transverse carpal ligament. The PCBm became enveloped in the layers of the antebrachial fascia and the transverse carpal ligament at the incision site, protecting it from injury. The recurrent motor branch of the median nerve, branches of the radial artery and the median nerve proper were not at risk during extension of the FCR approach to release the carpal tunnel. Extension of the standard FCR approach to include carpal tunnel release can be performed with minimal risk to the underlying structures. This exposure may offer benefits in both visualization and extent of carpal tunnel release.

  15. Is There a Cosmetic Advantage to Single-Incision Laparoscopic Surgical Techniques Over Standard Laparoscopic Surgery? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Evans, Luke; Manley, Kate

    2016-06-01

    Single-incision laparoscopic surgery represents an evolution of minimally invasive techniques, but has been a controversial development. A cosmetic advantage is stated by many authors, but has not been found to be universally present or even of considerable importance by patients. This systematic review and meta-analysis demonstrates that there is a cosmetic advantage of the technique regardless of the operation type. The treatment effect in terms of cosmetic improvement is of the order of 0.63.

  16. Single-incision laparoscopic surgery using colon-lifting technique for colorectal cancer: a matched case-control comparison with standard multiport laparoscopic surgery in terms of short-term results and access instrument cost.

    Science.gov (United States)

    Fujii, Shoichi; Watanabe, Kazuteru; Ota, Mitsuyoshi; Watanabe, Jun; Ichikawa, Yasushi; Yamagishi, Shigeru; Tatsumi, Kenji; Suwa, Hirokazu; Kunisaki, Chikara; Taguri, Masataka; Morita, Satoshi; Endo, Itaru

    2012-05-01

    Single-incision laparoscopic surgery (SILS) has been used for colorectal cancer as a minimally invasive procedure. However, there are still difficulties concerning effective triangulation and countertraction. The study's purpose was to clarify the usefulness of the colon-lifting technique (CLT) in SILS for colorectal cancer. SILS was performed for cancer (cT2N0 or less) of the right-sided colon (near the ileocecum), sigmoid, or rectosigmoid. The SILS™ Port was used for transumbilical access. A suture string was inserted through the abdominal wall and passed through the mesocolon. The colon was retracted anteriorly and fixed to the abdominal wall. The main mesenteric vessels were placed under tension. Lymph node dissection was performed by medial approach. Short-term surgical outcomes and access port costs were compared between SILS (using CLT) and the standard multiport technique (MPT). The two groups were case-matched by propensity scoring. Analyzed variables included preoperative Dukes stage and tumor location. From June 2009 to April 2011, 27 patients underwent SILS, and from April 2005 to April 2011, 85 patients underwent MPT. Propensity scoring generated 23 matched patients per group for SILS versus MPT comparisons. There were no significant differences in operating time, blood loss, early complications, postoperative analgesic frequency, or length of hospital stay. One MPT patient was converted to open surgery (4.5%); no SILS patients were converted. There were no significant differences in the length of distal cut margin and the number of harvested lymph nodes, except incision length (SILS vs. MPT: 33 vs. 55 mm, P Japanese yen, P CLT was safe and effective in providing radical treatment of cT2N0 cancer in the right-sided colon, sigmoid, or rectosigmoid. SILS was advantageous with respect to cosmesis and lower cost of access instruments.

  17. TmTriangulate: A Tool for Phrase Table Triangulation

    Directory of Open Access Journals (Sweden)

    Hoang Duc Tam

    2015-10-01

    Full Text Available Over the past years, pivoting methods, i.e. machine translation via a third language, gained respectable attention. Various experiments with different approaches and datasets have been carried out but the lack of open-source tools makes it difficult to replicate the results of these experiments. This paper presents a new tool for pivoting for phrase-based statistical machine translation by so called phrase-table triangulation. Besides the tool description, this paper discusses the strong and weak points of various triangulation techniques implemented in the tool.

  18. Fundamental triangulation networks in Denmark

    DEFF Research Database (Denmark)

    Borre, Kai

    2014-01-01

    The first triangulation activity on Danish ground was carried out by the astronomer Tycho Brahe who resided on the island Hven. He wanted to determine the longitude difference of his observatory Uraniborg to Copenhagen. A by-product was a map of his island made in 1579. In 1761 the Royal Danish...... Academy of Sciences and Letters initiated a mapping project which should be based on the principle of triangulation. Eventually 24 maps were printed in varying scales, predominantly in 1:120 000. The last map was engraved in 1842. The Danish GradeMeasurement initiated remeasurements and redesign...

  19. Spanning quadrangulations of triangulated surfaces

    DEFF Research Database (Denmark)

    Kündgen, André; Thomassen, Carsten

    2017-01-01

    In this paper we study alternating cycles in graphs embedded in a surface. We observe that 4-vertex-colorability of a triangulation on a surface can be expressed in terms of spanninq quadrangulations, and we establish connections between spanning quadrangulations and cycles in the dual graph whic...

  20. Triangulation in Friedmann's cosmological model

    International Nuclear Information System (INIS)

    Fagundes, H.V.

    1977-01-01

    In Friedmann's model, physical 3-space has a curvature K = constant. In the cases of greatest interest (K different from 0) triangulation for the measurement of great distances should be based on non-Euclidean geometries: Riemannian (or doubly elliptic) geometry for a closed universe and Bolyai-Lobatchevsky's (or hiperbolic) geometry for an open universe [pt

  1. Robot-assisted single-site compared with laparoscopic single-incision cholecystectomy for benign gallbladder disease: protocol for a randomized controlled trial.

    Science.gov (United States)

    Grochola, Lukasz Filip; Soll, Christopher; Zehnder, Adrian; Wyss, Roland; Herzog, Pascal; Breitenstein, Stefan

    2017-02-09

    Recent advances in robotic technology suggest that the utilization of the da Vinci Single-Site™ platform for cholecystectomy is safe, feasible and results in a shorter learning curve compared to conventional single-incision laparoscopic cholecystectomy. Moreover, the robot-assisted technology has been shown to reduce the surgeon's stress load compared to standard single-incision laparoscopy in an experimental setup, suggesting an important advantage of the da Vinci platform. However, the above-mentioned observations are based solely on case series, case reports and experimental data, as high-quality clinical trials to demonstrate the benefits of the da Vinci Single-Site™ cholecystectomy have not been performed to date. This study addresses the question whether robot-assisted Single-Site™ cholecystectomy provides significant benefits over single-incision laparoscopic cholecystectomy in terms of surgeon's stress load, while matching the standards of the conventional single-incision approach with regard to peri- and postoperative outcomes. It is designed as a single centre, single-blinded randomized controlled trial, which compares both surgical approaches with the primary endpoint surgeon's physical and mental stress load at the time of surgery. In addition, the study aims to assess secondary endpoints such as operating time, conversion rates, additional trocar placement, intra-operative blood loss, length of hospital stay, costs of procedure, health-related quality of life, cosmesis and complications. Patients as well as ward staff are blinded until the 1 st postoperative year. Sample size calculation based on the results of a previously published experimental setup utilizing an estimated effect size of surgeon's comfort of 0.8 (power of 0.8, alpha-error level of 0.05, error margin of 10-15%) resulted in a number of 30 randomized patients per arm. The study is the first randomized controlled trial that compares the da Vinci Single Site™ platform to

  2. Hamiltonian Cycles on Random Eulerian Triangulations

    DEFF Research Database (Denmark)

    Guitter, E.; Kristjansen, C.; Nielsen, Jakob Langgaard

    1998-01-01

    A random Eulerian triangulation is a random triangulation where an even number of triangles meet at any given vertex. We argue that the central charge increases by one if the fully packed O(n) model is defined on a random Eulerian triangulation instead of an ordinary random triangulation....... Considering the case n -> 0, this implies that the system of random Eulerian triangulations equipped with Hamiltonian cycles describes a c=-1 matter field coupled to 2D quantum gravity as opposed to the system of usual random triangulations equipped with Hamiltonian cycles which has c=-2. Hence, in this case...... one should see a change in the entropy exponent from the value gamma=-1 to the irrational value gamma=(-1-\\sqrt{13})/6=-0.76759... when going from a usual random triangulation to an Eulerian one. A direct enumeration of configurations confirms this change in gamma....

  3. No difference in incidence of port-site hernia and chronic pain after single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Christoffersen, Mette W; Brandt, Erik; Oehlenschläger, Jacob

    2015-01-01

    and matched 1:2 with patients subjected to CLC using pre-defined criteria. Follow-up data were obtained from the Danish National Patient Registry, mailed patient questionnaires, and clinical examination. A port-site hernia was defined as a repair for a port-site hernia or clinical hernia located at one......BACKGROUND: Conventional laparoscopic cholecystectomy (CLC) is regarded as the gold standard for cholecystectomy. However, single-incision laparoscopic cholecystectomy (SLC) has been suggested to replace CLC. This study aimed at comparing long-term incidences of port-site hernia and chronic pain...... after SLC versus CLC. METHODS: We conducted a matched cohort study based on prospective data (Jan 1, 2009-June 1, 2011) from the Danish Cholecystectomy Database with perioperative information and clinical follow-up. Consecutive patients undergoing elective SLC during the study period were included...

  4. The feasibility and safety of single-incision totally extraperitoneal inguinal hernia repair after previous lower abdominal surgery: 350 procedures at a single center.

    Science.gov (United States)

    Wakasugi, Masaki; Suzuki, Yozo; Tei, Mitsuyoshi; Anno, Kana; Mikami, Tsubasa; Tsukada, Ryo; Koh, Masahiro; Furukawa, Kenta; Masuzawa, Toru; Kishi, Kentaro; Tanemura, Masahiro; Akamatsu, Hiroki

    2017-03-01

    To evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with previous lower abdominal surgery (PLAS). A retrospective analysis of 350 patients undergoing SILS-TEP for a primary inguinal hernia from January 2012 to December 2015 at Osaka Police Hospital was performed, and the outcomes of the patients with and without PLAS were compared. SILS-TEP was performed in 84 patients with PLAS and 266 patients without PLAS. Appendectomy was the most common previous operative procedure. There were more patients with an ASA score of ≥3 in the PLAS group than in the control group (p < 0.05). The mean operative time, and the rates of conversion and postoperative complications were comparable between the two groups. There were no cases of recurrence in either group. SILS-TEP could be safely performed in patients with PLAS and achieved better cosmetic outcomes than conventional laparoscopic surgery.

  5. Minimal contact triangulations of 3-manifolds

    OpenAIRE

    Datta, Basudeb; Kulkarni, Dheeraj

    2016-01-01

    In this paper, we explore minimal contact triangulations on contact 3-manifolds. We give many explicit examples of contact triangulations that are close to minimal ones. The main results of this article say that on any closed oriented 3-manifold the number of vertices for minimal contact triangulations for overtwisted contact structures grows at most linearly with respect to the relative $d^3$ invariant. We conjecture that this bound is optimal. We also discuss, in great details, contact tria...

  6. Representations of stack triangulations in the plane

    OpenAIRE

    Selig, Thomas

    2013-01-01

    Stack triangulations appear as natural objects when defining an increasing family of triangulations by successive additions of vertices. We consider two different probability distributions for such objects. We represent, or "draw" these random stack triangulations in the plane $\\R^2$ and study the asymptotic properties of these drawings, viewed as random compact metric spaces. We also look at the occupation measure of the vertices, and show that for these two distributions it converges to som...

  7. Single-incision laparoscopic surgery through the umbilicus is associated with a higher incidence of trocar-site hernia than conventional laparoscopy: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Antoniou, S A; Morales-Conde, S; Antoniou, G A; Granderath, F A; Berrevoet, F; Muysoms, F E

    2016-02-01

    Single-incision laparoscopic surgery has been developed with the objective to reduce surgical trauma, decrease associated surgical stress and to improve cosmetic outcome. However, concerns have been raised regarding the risk of trocar-site hernia following this approach. Previous meta-analyses have suggested a trend toward higher hernia rates, but have failed to demonstrate a significant difference between single-incision and conventional laparoscopic surgery. Medline, AMED, CINAHL and CENTRAL were searched up to May 2014. Randomized controlled trials comparing single-incision and conventional laparoscopic surgery were considered for inclusion. Studies with patients aged less than 18 years and those reporting on robotic surgery were disregarded. Pooled odds ratios with 95% confidence intervals were calculated to measure the comparative risk of trocar-site hernia following single-incision and conventional laparoscopic surgery. Nineteen randomized trials encompassing 1705 patients were included. Trocar-site hernia occurred in 2.2% of patients in the single-incision group and in 0.7% of patients in the conventional laparoscopic surgery group (odds ratio 2.26, 95% confidence interval 1.00-5.08, p = 0.05). Sensitivity analysis of quality randomized trials validated the outcome estimates of the primary analysis. There was no heterogeneity among studies (I2 = 0%) and no evidence of publication bias. Single-incision laparoscopic surgery involving entry into the peritoneal cavity through the umbilicus is associated with a slightly higher risk of trocar-site hernia than conventional laparoscopy. Its effect on long-term morbidity and quality of life is a matter for further investigation.

  8. Equivelar and d-Covered Triangulations of Surfaces. II. Cyclic Triangulations and Tessellations

    OpenAIRE

    Lutz, Frank H.

    2010-01-01

    With the $[0,1,2]$-family of cyclic triangulations we introduce a rich class of vertex-transitive triangulations of surfaces. In particular, there are infinite series of cyclic $q$-equivelar triangulations of orientable and non-orientable surfaces for every $q=3k$, $k\\geq 2$, and every $q=3k+1$, $k\\geq 3$. Series of cyclic tessellations of surfaces are derived from these triangulated series.

  9. Single incision device (TVT Secur) versus retropubic tension-free vaginal tape device (TVT) for the management of stress urinary incontinence in women: a randomized clinical trial.

    Science.gov (United States)

    Ross, Sue; Tang, Selphee; Schulz, Jane; Murphy, Magnus; Goncalves, Jose; Kaye, Stephen; Dederer, Lorel; Robert, Magali

    2014-12-22

    In 2006, Ethicon Inc. introduced a new minimally invasive single incision sling device for the surgical treatment of stress urinary incontinence, the Gynecare TVT Secur®. For device licensing, no new evidence of TVT Secur efficacy and safety was needed: rather evidence was provided of the long-term follow-up of patients who had a procedure using a predecate retropubic tension-free vaginal tape device. Before adopting TVT Secur into our routine clinical practice, we decided to evaluate it. The objective of our Canadian multi-centre pragmatic randomized controlled trial was to compare the effectiveness of the new single-incision device, TVT Secur, to the established TVT device, in terms of objective cure of stress urinary incontinence (SUI) at 12 months postoperatively. Other outcomes included: complications, symptoms, and incontinence-related quality of life. The sample size estimate for our trial was 300, but the trial stopped early because of poor recruitment. 74 women participated (40 allocated to TVT Secur, 34 to TVT). At 12 months postoperatively, 27/33(82%) of TVT Secur group were cured, compared with 25/28(89%) of the TVT group (relative risk 0.92, 95% confidence interval 0.75 to 1.13, p=0.49). Most women reported little or no SUI symptoms (35/37(95%) vs 29/30(97%), >0.999). Quality of life improved significantly from baseline for both groups (IIQ-7 mean change -25 for both groups) but did not differ between groups (p=0.880). Our small randomized trial did not find statistically significant differences in outcomes between women allocated to the TVT Secur device versus those allocated to the TVT device for stress urinary incontinence. Despite the discontinuation of TVT Secur in March 2013 for commercial reasons, the importance of our study lies in making evidence available for the many women who had a TVT Secur device implanted and their physicians who may be considering alternative treatments. Our experience illustrates the difficulty of undertaking research

  10. A safety study of transumbilical single incision versus conventional laparoscopic surgery for colorectal cancer: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Wang, Yanan; Liu, Ruoyan; Zhang, Ze; Xue, Qi; Yan, Jun; Yu, Jiang; Liu, Hao; Zhao, Liying; Mou, Tingyu; Deng, Haijun; Li, Guoxin

    2015-11-30

    Single-incision laparoscopic surgery (SILS) is an emerging minimally invasive surgery to reduce abdominal incisions. However, despite the increasing clinical application of SILS, no evidence from large-scale, randomized controlled trials is available for assessing the feasibility, short-term safety, oncological safety, and potential benefits of SILS compared with conventional laparoscopic surgery (CLS) for colorectal cancer. This is a single-center, open-label, noninferiority, randomized controlled trial. A total of 198 eligible patients will be randomly assigned to transumbilical single incision plus one port laparoscopic surgery (SILS plus one) group or to a CLS group at a 1:1 ratio. Patients ranging in age from 18 to 80 years with rectosigmoid cancer diagnosed as cT1-4aN0-2 M0 and a tumor size no larger than 5 cm are considered eligible. The primary endpoint is early morbidity, as evaluated by an independent investigator. Secondary outcomes include operative outcomes (operative time, estimated blood loss, and incision length), pathologic outcomes (tumor size, length of proximal and distal resection margins, and number of harvested lymph nodes), postoperative inflammatory and immune responses (white blood cells [WBC], neutrophil percentage [NE %], C-reactive protein [CRP], interleukin-6 [IL-6], and tumor necrosis factor-α [TNF-α]), postoperative recovery (time to first ambulation, flatus, liquid diet, soft diet, and duration of hospital stay), pain intensity, body image and cosmetic assessment, 3-year disease free survival (DFS), and 5-year overall survival (OS). Follow-up visits are scheduled for 1 and 3 months after surgery, then every 3 months for the first 2 years and every 6 months for the next 3 years. This trial will provide valuable clinical evidence for the objective assessment of the feasibility, safety, and potential benefits of SILS plus one compared with CLS for the radical resection of rectosigmoid cancer. The hypothesis is that SILS plus one is

  11. Umbilical cord and preeclampsia.

    Science.gov (United States)

    Olaya-C, M; Salcedo-Betancourt, J; Galvis, S H; Ortiz, A M; Gutierrez, S; Bernal, J E

    2016-01-01

    Preeclampsia is associated with abnormalities in the umbilical cord in several ways: morphological, biochemical and functional. Alteration in blood vessels of the placenta, decidua and circulatory system of the fetus might be related to factors that cause preeclampsia and may be associated with alterations of the umbilical cord. This study aimed to analyze the relationship between each type of umbilical cord abnormality and the different subtypes of hypertensive gestational disorders. We conducted a prospective study on consecutive autopsies and its placentas, looking for abnormalities in the umbilical cord's features and their clinical associations. Umbilical cord abnormalities including length, diameter, insertion, entanglements, knots and coils were associated with maternal gestational hypertension. In women with gestational hypertension, umbilical cord abnormalities are associated with fetal and neonatal consequences.

  12. The Role of Hand-Assisted Laparoscopic Technique in the Age of Single-Incision Laparoscopy: An Effective Alternative to Avoid Open Conversion in Colorectal Surgery.

    Science.gov (United States)

    Jung, Kyung Uk; Yun, Seong Hyeon; Cho, Yong Beom; Kim, Hee Cheol; Lee, Woo Yong; Chun, Ho-Kyung

    2018-04-01

    Continuous efforts to reduce the numbers and size of incisions led to the emergence of a new technique, single-incision laparoscopic surgery (SILS). It has been rapidly accepted as the preferred surgical approach in the colorectal area. In the age of SILS, what is the role of hand-assisted laparoscopic surgery (HALS)? We introduce the way to take advantage of it, as an effective alternative to avoid open conversion. This is a retrospective review of prospectively collected data of SILS colectomies performed by a single surgeon in Samsung Medical Center between August 2009 and December 2012. Out of 631 cases of SILS colectomy, 47 cases needed some changes from the initial approach. Among these, five cases were converted to HALS. Four of them were completed successfully without the need for open conversion. One patient with rectosigmoid colon cancer invading bladder was finally opened to avoid vesical trigone injury. The mean operation time of the 4 patients was 265.0 minutes. The mean estimated blood loss was 587.5 mL. The postoperative complication rate associated with the operation was 25%. Conversion from SILS to HALS in colorectal surgery was feasible and effective. It seemed to add minimal morbidity while preserving advantages of minimally invasive surgery. It could be considered an alternative to open conversion in cases of SILS, especially when the conversion to conventional laparoscopy does not seem to be helpful.

  13. Surgical Value of Elective Minimally Invasive Gallbladder Removal: A Cost Analysis of Traditional 4-Port vs Single-Incision and Robotically Assisted Cholecystectomy.

    Science.gov (United States)

    Newman, Richard M; Umer, Affan; Bozzuto, Bethany J; Dilungo, Jennifer L; Ellner, Scott

    2016-03-01

    As the cost of health care is subjected to increasingly greater scrutiny, the assessment of new technologies must include the surgical value (SV) of the procedure. Surgical value is defined as outcome divided by cost. The cost and outcome of 50 consecutive traditional (4-port) laparoscopic cholecystectomies (TLC) were compared with 50 consecutive, nontraditional laparoscopic cholecystectomies (NTLC), between October 2012 and February 2014. The NTLC included SILS (n = 11), and robotically assisted single-incision cholecystectomies (ROBOSILS; n = 39). Our primary outcomes included minimally invasive gallbladder removal and same-day discharge. Thirty-day emergency department visits or readmissions were evaluated as a secondary outcome. The direct variable surgeon costs (DVSC) were distilled from our hospital cost accounting system and calculated on a per-case, per item basis. The average DVSC for TLC was $929 and was significantly lower than NTLC at $2,344 (p day discharge. There were no differences observed in secondary outcomes in 30-day emergency department visits (TLC [2%] vs NTLC [6%], p = 0.61) or readmissions (TLC [4%] vs NTLC [2%], p > 0.05), respectively. The relative SV was significantly higher for TLC (1) compared with NTLC (0.34) (p < 0.05), and SILS (0.66) and ROBOSILS (0.36) (p < 0.05). Nontraditional, minimally invasive gallbladder removal (SILS and ROBOSILS) offers significantly less surgical value for elective, outpatient gallbladder removal. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  14. UAV PHOTOGRAMMETRY: BLOCK TRIANGULATION COMPARISONS

    Directory of Open Access Journals (Sweden)

    R. Gini

    2013-08-01

    Full Text Available UAVs systems represent a flexible technology able to collect a big amount of high resolution information, both for metric and interpretation uses. In the frame of experimental tests carried out at Dept. ICA of Politecnico di Milano to validate vector-sensor systems and to assess metric accuracies of images acquired by UAVs, a block of photos taken by a fixed wing system is triangulated with several software. The test field is a rural area included in an Italian Park ("Parco Adda Nord", useful to study flight and imagery performances on buildings, roads, cultivated and uncultivated vegetation. The UAV SenseFly, equipped with a camera Canon Ixus 220HS, flew autonomously over the area at a height of 130 m yielding a block of 49 images divided in 5 strips. Sixteen pre-signalized Ground Control Points, surveyed in the area through GPS (NRTK survey, allowed the referencing of the block and accuracy analyses. Approximate values for exterior orientation parameters (positions and attitudes were recorded by the flight control system. The block was processed with several software: Erdas-LPS, EyeDEA (Univ. of Parma, Agisoft Photoscan, Pix4UAV, in assisted or automatic way. Results comparisons are given in terms of differences among digital surface models, differences in orientation parameters and accuracies, when available. Moreover, image and ground point coordinates obtained by the various software were independently used as initial values in a comparative adjustment made by scientific in-house software, which can apply constraints to evaluate the effectiveness of different methods of point extraction and accuracies on ground check points.

  15. 3-colorability of pseudo-triangulations

    OpenAIRE

    Aichholzer, Oswin; Aurenhammer, Franz; Hackl, Thomas; Huemer, Clemens; Pilz, Alexander; Vogtenhuber, Birgit

    2015-01-01

    Electronic version of an article published as International Journal of Computational Geometry & Applications, Vol. 25, No. 4 (2015) 283–298 DOI: 10.1142/S0218195915500168 © 2015 World Scientific Publishing Company. http://www.worldscientific.com/worldscinet/ijcga Deciding 3-colorability for general plane graphs is known to be an NP-complete problem. However, for certain families of graphs, like triangulations, polynomial time algorithms exist. We consider the family of pseudo-triangulation...

  16. Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study.

    Science.gov (United States)

    ElSheemy, Mohammed S; Fathy, Hesham; Hussein, Hussein A; Hussein, Eman A; Hassan, Sarah Mohamed

    2015-06-01

    To compare safety and efficacy of surgeon-tailored polypropylene mesh through needleless single-incision technique (STM) versus tension-free vaginal tape-obturator (TVT-O) aiming to decrease cost of treatment of stress urinary incontinence (SUI). This is important in developing countries due to limited healthcare resources. A retrospective cohort study was done at Urology and Gynecology Departments (dual-center), Cairo University, from January 2011 to August 2013. STM was inserted in 72 females, while TVT-O was inserted in 48 females. Females evaluated by cough stress test, stress and urge incontinence quality of life questionnaire (SUIQQ), Q max and abdominal leak point pressure (ALPP) were included. Different factors were compared between both groups using paired t, Wilcoxon's signed rank, McNemar, Chi-square, Fisher's exact, independent t or Mann-Whitney tests. Age, parity, previous surgeries, ALPP, intrinsic sphincter deficiency (ISD), associated prolapse and associated prolapse repair were comparable in both groups. No significant difference was found between both groups in postoperative complications (except groin pain), cure, SUIQQ indices improvement and Q max decline. In total, 65 (90 %) cured, 6 (8 %) improved while failure was detected in one (1 %) patient in STM group, while 42 (87 %) cured, 4 (8 %) improved and failure was detected in two (4 %) patients in TVT-O group. Presence of ISD (p = 0.565), urgency (p = 0.496), UUI (p = 0.531), previous surgeries (p = 0.345), associated urogenital prolapse (p = 0.218) or associated prolapse repair (p = 0.592) did not lead to any significant difference in outcome between both groups. Cost of mesh decreased from US$500 (TVT-O) to US$10 (STM). Outcome of STM is comparable to TVT-O. Furthermore, STM is more economic.

  17. Contasure-Needleless® single incision sling compared with transobturator TVT-O® for the treatment of stress urinary incontinence: long-term results.

    Science.gov (United States)

    Martinez Franco, Eva; Amat Tardiu, Lluís

    2015-02-01

    This study compared transobturator tension-free vaginal tape (TVT-O®) and Contasure-Needleless (C-NDL®) at long-term follow-up . Non-inferiority, prospective, single-centre , quasi-randomised trial started in September 2006 and finished in April 2011 to compare C-NDL® with transobturator vaginal tape (TVT-O®) mesh in the treatment of stress urinary incontinence (SUI) . Epidemiological information, intraoperative and postoperative complications, subjective estimates of blood loss and pain levels were recorded. We also analysed the postoperative stress test, the subjective impression of improvement using the Sandvik Severity Index and the quality of life during follow-up using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) . Two hundred and fifty-seven women with primary SUI were scheduled to receive TVT-O® or C-NDL® and were followed up at least 3 years after the procedure . One hundred and eleven women in the C-NDL® group (84.7%) had a negative stress test, compared with 54 women (88.9%) in the TVT-O® group (p = 0.0065 for the non-inferiority test). The postoperative Sandvik Severity Index was 0 or better than the preoperative score in 90.7% of patients in the C-NDL® group and 95.4% of patients in the TVT-O® group (p = 0.0022). The complication rate was similar in both groups. There were significant differences (p = 0.02) in postoperative pain within the TVT-O® group. The degree of satisfaction was not statistically significant between the two groups. The outcomes for the C-NDL® group were similar to those of the TVT-O® group, adding the concept of "single incision tape" to the tension-free sling option.

  18. Analgesic efficacy of ultrasound guided transversus abdominis plane block versus local anesthetic infiltration in adult patients undergoing single incision laparoscopic cholecystectomy: A randomized controlled trial.

    Science.gov (United States)

    Bava, Ejas P; Ramachandran, Rashmi; Rewari, Vimi; Chandralekha; Bansal, Virinder Kumar; Trikha, Anjan

    2016-01-01

    Transversus abdominis plane (TAP) block has been used to provide intra- and post-operative analgesia with single incision laparoscopic (SIL) bariatric and gynecological surgery with mixed results. Its efficacy in providing analgesia for SIL cholecystectomy (SILC) via the same approach remains unexplored. The primary objective of our study was to compare the efficacy of bilateral TAP block with local anesthetic infiltration for perioperative analgesia in patients undergoing SILC. This was a prospective, randomized, controlled, double-blinded trial performed in a tertiary care hospital. Forty-two patients undergoing SILC were randomized to receive either ultrasound-guided (USG) bilateral mid-axillary TAP blocks with 0.375% ropivacaine or local anesthetic infiltration of the port site. The primary outcome measure was the requirement of morphine in the first 24 h postoperatively. The data were analyzed using t -test, Mann-Whitney test or Chi-square test. The 24 h morphine requirement (mean ± standard deviation) was 34.57 ± 14.64 mg in TAP group and 32.76 ± 14.34 mg in local infiltration group ( P = 0.688). The number of patients requiring intraoperative supplemental fentanyl in TAP group was 8 and in local infiltration group was 16 ( P = 0.028). The visual analog scale scores at rest and on coughing were significantly higher in the local infiltration group in the immediate postoperative period ( P = 0.034 and P = 0.007, respectively). USG bilateral TAP blocks were not effective in decreasing 24 h morphine requirement as compared to local anesthetic infiltration in patients undergoing SILC although it provided some analgesic benefit intraoperatively and in the initial 4 h postoperatively. Hence, the benefits of TAP blocks are not worth the effort and time spent for administering them for this surgery.

  19. Feasibility of single-incision thoracoscopic surgery using a modified chest wall pulley for primary spontaneous pneumothorax: a propensity score matching analysis.

    Science.gov (United States)

    Tsuboshima, Kenji; Nagata, Machiko; Wakahara, Teppei; Matoba, Yasumi; Maniwa, Yoshimasa

    2017-09-01

    Recently, single-incision thoracoscopic surgery (SITS) has been recognized as a favorable treatment choice for primary spontaneous pneumothorax (PSP) compared with conventional three-port video-assisted thoracoscopic surgery (VATS). However, conventional SITS bullectomy often results in collisions with surgical devices. Therefore, we devised a method of SITS using a chest wall pulley for lung excision (PulLE) and modified PulLE (mPulLE) system, which substitutes threads to eliminate such collisions. We compared the mPulLE system with conventional procedures using propensity score matching (PSM) to adjust for patient backgrounds. Using PSM, we evaluated the surgical results of 210 PSP patients who underwent VATS, including mPulLE (n = 23) and three-port VATS (n = 102), at our institution between January 2010 and August 2016. We selected 17 mPulLE cases and 17 three-port VATS. There were no marked differences between the groups in the patient backgrounds or surgical results. However, there was a significant difference between the mPulLE cases and the three-port VATS cases in the operative time (71.7 ± 15.7 vs. 85.9 ± 25.5 min, respectively, P = 0.0388) and the number of autosutures used (3.6 ± 1.2 vs. 4.5 ± 1.2, respectively, P = 0.0178). The surgical results of mPulLE in patients with PSP with multiple lesions were equivalent to those achieved with three-port VATS under the same conditions.

  20. Distal biceps brachii tendon repairs: a single-incision technique using a cortical button with interference screw versus a double-incision technique using suture fixation through bone tunnels.

    Science.gov (United States)

    Shields, Edward; Olsen, Joshua R; Williams, Richard B; Rouse, Lucien; Maloney, Michael; Voloshin, Ilya

    2015-05-01

    Distal biceps brachii tendon repairs performed with a tension slide technique using a cortical button (CB) and interference screw are stronger than those based on suture fixation through bone tunnels (BTs) in biomechanical studies. However, clinical comparison of these 2 techniques is lacking in the literature. To perform a clinical comparison of the single-incision CB and double-incision BT techniques. Cohort study; Level of evidence, 3. Distal biceps tendon ruptures repaired through either the single-incision CB or double-incision BT technique were retrospectively identified at a single institution. Patients>1 year out from surgery were assessed for range of motion, strength, and complications, and they completed a DASH questionnaire (Disabilities of the Arm, Shoulder, and Hand). Patients in the CB group (n=20) were older (52±9.5 vs 43.7±8.7 years; P=.008), had a shorter interval from surgery to evaluation (17.7±5 vs 30.8±16.5 months; P=.001), and were less likely to smoke (0% vs 28.5%; P=.02) compared with the BT patients (n=21). DASH scores were similar between groups (4.46±4.4 [CB] vs 5.7±7.5 [BT]; P=.65). Multivariate analysis revealed no differences in range of motion or strength between groups. More CB patients (30%; n=6) experienced a complication compared with those in the BT group (4.8%; n=1) (P=.04), and these complications were predominantly paresthesias of the superficial radial nerve that did not resolve. There were no reoperations or repair failures in either group. Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve. © 2015 The Author(s).

  1. Triangulation of pedicular instrumentation. A biomechanical analysis.

    Science.gov (United States)

    Ruland, C M; McAfee, P C; Warden, K E; Cunningham, B W

    1991-06-01

    Tensile load-to-failure pullout tests were performed on 54 cadaveric spinal segments. The vertebrae were grouped by adjacent levels and matched for bone mineral density (g/cm2), which was measured by dual-photon absorptiometry. Triangulation of Steffee screws and CD pedicle screws was accomplished by transverse plates specifically designed to increase fixation within the same vertebra before the longitudinal Steffee plate or CD rod was applied. A transverse plate with adjustable length was also tested to accommodate variable interpedicular distances. Comparative pullout load-to-failures were as follows: laminar hook, 809 SE 99.4 N; single CD pedicular screws, 863 SE 108 N; single Steffee pedicular screw, 1245 SE 75.3 N; adjustable transverse plate, 1341 SE 114; triangulated Steffee pedicle screws with a transverse plate, 1701 SE 151 N; and triangulated CD pedicle screws with a transverse plate, 2096 SE 115 N. Three triangulated constructs with pedicle screws and a transverse plate (CD, Steffee, and Kirschner) provided significantly greater fixation than conventional pedicular or laminar hook based instrumentation systems (P less than 0.05). Improved treatment of spinal deformities in the elderly and osteoporotic population is dependent on improving the fixation at the metal-bone interface of spinal implants Particularly in osteoporotic vertebrae, the strength of fixation of two triangulated pedicle screws is better than either laminar hooks or single pedicle screws. The strength of fixation of triangulated pedicle screws connected by a transverse plate is superior to a single pedicle screw because it is dependent on the mass of bone between the screws rather than simply the amount of bone within the screw thread.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Sexual function and quality of life following retropubic TVT and single-incision sling in women with stress urinary incontinence: results of a prospective study.

    Science.gov (United States)

    Naumann, Gert; Steetskamp, Joscha; Meyer, Mira; Laterza, Rosa; Skala, Christine; Albrich, Stefan; Koelbl, Heinz

    2013-05-01

    The objective of this prospective cohort study was to compare effectiveness, morbidity, quality of life (QoL) and sexual function in women treated with tension-free vaginal tape (TVT) versus single-incision sling (SIS) in the treatment of female stress urinary incontinence (SUI). Retropubic TVT sling or SIS was implanted in local anesthesia and patients were followed post-operatively for 6 months. Evaluation was performed to assess post-operative rate of continence, complications, changes in sexual function and patient reported quality of life. Female sexual function was evaluated before and after sling procedure using Female Sexual Function Index (FSFI) in sexually active patients. From January 2009 to December 2011, 150 patients were enrolled and underwent a procedure to implant the retropubic TVT (n = 75) or the MiniArc(®) and Ajust(®) SIS (n = 75). Overall, 93.3 % of the patients who successfully received SIS demonstrated total restoration (84 %) or improvement of continence (9.3 %) at the 6 month post-operative study visit. In TVT group we found 88 % total continence and 6.7 % improvement, respectively. Improvements were seen in the QoL scores related to global bladder feeling (89.3 %) in SIS group and 96 % for TVT. Post-operative FSFI score improves significantly and were comparable in both groups (SIS pre-operative 24.30 ± 4.56 to 27.22 ± 4.66 (P TVT 24.63 ± 6.62 to 28.47 ± 4.41, respectively). The SIS procedure appears to be as effective in improving incontinence-related quality of life and sexual function as the TVT through 6 months of post-operative follow-up. No differences in complications and sexual function were demonstrated between the groups.

  3. Tradeoffs in Design Research: Development Oriented Triangulation

    NARCIS (Netherlands)

    Koen van Turnhout; Sabine Craenmehr; Robert Holwerda; Mark Menijn; Jan-Pieter Zwart; René Bakker

    2013-01-01

    The Development Oriented Triangulation (DOT) framework in this paper can spark and focus the debate about mixed-method approaches in HCI. The framework can be used to classify HCI methods, create mixed-method designs, and to align research activities in multidisciplinary projects. The framework is

  4. Triangulation and the Square Root Law

    NARCIS (Netherlands)

    Marks, G.W.

    2007-01-01

    This special issue of Electoral Studies evaluates the validity of expert, manifesto, and survey data on the positioning of national political parties. My purpose in this introduction is to examine the logic and limits of triangulation. In doing so, I make explicit the most important lesson of this

  5. Gaussian vector fields on triangulated surfaces

    DEFF Research Database (Denmark)

    Ipsen, John H

    2016-01-01

    proven to be very useful to resolve the complex interplay between in-plane ordering of membranes and membrane conformations. In the present work we have developed a procedure for realistic representations of Gaussian models with in-plane vector degrees of freedoms on a triangulated surface. The method...

  6. [A retrospective controlled clinical study of single-incision plus one port laparoscopic surgery for sigmoid colon and upper rectal cancer].

    Science.gov (United States)

    Li, G X; Li, J M; Wang, Y N; Deng, H J; Mou, T Y; Liu, H

    2017-07-01

    Objective: To evaluate the short-term and oncologic outcomes of single-incision plus one port laparoscopic surgery (SILS+ 1) for sigmoid colon and upper rectal cancer. Methods: The clinic data of 46 patients with sigmoid colon and upper rectal cancer underwent SILS+ 1 at Department of General Surgery, Nanfang Hospital, Southern Medical University from September 2013 to September 2014 were retrospectively reviewed (SILS+ 1 group). After generating 1∶1 ration propensity scores given the covariates of age, gender, body mass index, American Society of Anesthesiologists score, surgeons, tumor location, the distance of tumor from anal, tumor diameter, and pathologic TNM stage, 46 patients with sigmoid colon and upper rectal cancer underwent conventional laparoscopic surgery (CLS) in the same time were matched as CLS group. The baseline characteristics and short-term outcomes were compared using t test, χ(2) test or Wilcoxon signed ranks test. Kaplan-Meier survival curves and Log-rank tests demonstrated the distribution of disease free survival. Results: The two study groups were well balanced with respect to the baseline characteristics of the propensity score derivation model. As compared to the CLS group, patients in SILS+ 1 group had a smaller incision ((6.9±1.1) cm vs . (8.4±1.2) cm, t =6.502, P =0.000), less estimated blood loss (20(11) ml vs . 50(30) ml, Z =2.414, P =0.016), shorter intracorporeal operating time ((67.0±25.8) minutes vs . (75.5±27.7) minutes, t =2.062, P =0.042) and significantly faster recovery course including shorter time to first ambulation ((46.7±20.3) hours vs . (78.6±28.0) hours, t =6.255, P =0.000), shorter time to first oral diet ((64.7±28.8) hours vs . (77.1±30.0) hours, t =2.026, P =0.047), shorter time of postoperative hospital stay ((7.8±2.2) days vs . (6.5±2.2) days, t =2.680, P =0.009), and lower postoperative visual analogue scale scores ( F =4.721, P =0.032). No significant difference was observed in total operating

  7. Coefficient adaptive triangulation for strongly anisotropic problems

    Energy Technology Data Exchange (ETDEWEB)

    D`Azevedo, E.F.; Romine, C.H.; Donato, J.M.

    1996-01-01

    Second order elliptic partial differential equations arise in many important applications, including flow through porous media, heat conduction, the distribution of electrical or magnetic potential. The prototype is the Laplace problem, which in discrete form produces a coefficient matrix that is relatively easy to solve in a regular domain. However, the presence of anisotropy produces a matrix whose condition number is increased, making the resulting linear system more difficult to solve. In this work, we take the anisotropy into account in the discretization by mapping each anisotropic region into a ``stretched`` coordinate space in which the anisotropy is removed. The region is then uniformly triangulated, and the resulting triangulation mapped back to the original space. The effect is to generate long slender triangles that are oriented in the direction of ``preferred flow.`` Slender triangles are generally regarded as numerically undesirable since they tend to cause poor conditioning; however, our triangulation has the effect of producing effective isotropy, thus improving the condition number of the resulting coefficient matrix.

  8. Sprite initiation altitude measured by triangulation

    Science.gov (United States)

    Stenbaek-Nielsen, H. C.; Haaland, R.; McHarg, M. G.; Hensley, B. A.; Kanmae, T.

    2010-03-01

    High time resolution (10,000 frames per second) images of sprites combined with multistation concurrent video recordings have provided data for triangulation of the altitude of the initial sprite onset. The high-speed images were obtained from the Langmuir Laboratory, New Mexico, during summer campaigns in 2007 and 2008 with video observations from sites at Portales, New Mexico, and Las Vegas, New Mexico. Sprites start with one or more downward-propagating streamer heads. The triangulated onset altitudes of this initial downward streamer vary between 66 and 89 km. In some sprites the downward streamers are followed a little later by upward-propagating streamers. The upward streamers start from a lower altitude and existing luminous sprite structures and their triangulated altitudes vary from 64 to 78 km. The downward streamers create C sprite characteristics, while the upward streamers form the broad diffuse tops of carrot sprites. In the sprites analyzed the higher onset altitudes for the downward-propagating initial streamers were associated with C sprites and the lower with carrot sprites, but our larger data set indicates that this is not generally the case. It appears that the dominant sprite types vary from year to year, indicating that some longer-lasting environmental parameter, such as mesospheric conductivity and composition or thunderstorm cloud dynamics, may play an important role in determining the types of sprites observed.

  9. Marginal elasticity of periodic triangulated origami

    Science.gov (United States)

    Chen, Bryan; Sussman, Dan; Lubensky, Tom; Santangelo, Chris

    Origami, the classical art of folding paper, has inspired much recent work on assembling complex 3D structures from planar sheets. Origami, and more generally hinged structures with rigid panels, where all faces are triangles have special properties due to having a bulk balance of mechanical degrees of freedom and constraints. We study two families of periodic triangulated origami structures, one based on the Miura ori and one based on a kagome-like pattern due to Ron Resch. We point out the consequences of the balance of degrees of freedom and constraints for these ''metamaterial plates'' and show how the elasticity can be tuned by changing the unit cell geometry.

  10. Methodological triangulation in work life research

    DEFF Research Database (Denmark)

    Warring, Niels

    Based on examples from two research projects on preschool teachers' work, the paper will discuss potentials and challenges in methodological triangulation in work life research. Analysis of ethnographic and phenomenological inspired observations of everyday life in day care centers formed the basis...... for individual interviews and informal talks with employees. The interviews and conversations were based on a critical hermeneutic approach. The analysis of observations and interviews constituted a knowledge base as the project went in to the last phase: action research workshops. In the workshops findings from...

  11. TRIANGULATION OF METHODS OF CAREER EDUCATION

    Directory of Open Access Journals (Sweden)

    Marija Turnsek Mikacic

    2015-09-01

    Full Text Available This paper is an overview of the current research in the field of career education and career planning. Presented results constitute a model based on the insight into different theories and empirical studies about career planning as a building block of personal excellence. We defined credibility, transferability and reliability of the research by means of triangulation. As sources of data of triangulation we included essays of participants of education and questionnaires. Qualitative analysis represented the framework for the construction of the paradigmatic model and the formulation of the final theory. We formulated a questionnaire on the basis of our own experiences in the area of the education of individuals. The quantitative analysis, based on the results of the interviews, confirms the following three hypotheses: The individuals who elaborated a personal career plan and acted accordingly, changed their attitudes towards their careers and took control over their lives; in addition, they achieved a high level of self-esteem and self-confidence, in tandem with the perception of personal excellence, in contrast to the individuals who did not participate in career education and did not elaborate a career plan. We used the tools of NLP (neurolinguistic programming as an additional technique at learning.

  12. Implementing High-Performance Delaunay Triangulation In Java

    OpenAIRE

    Lund, Erik Thune

    2014-01-01

    The project is all about the design, documentation and implementation of a program to perform Delaunay triangulation. The program is written in Java and is focused on performance both with regard to run-time and memory usage. A goal for the program is to triangulate at least 10 million points within a reasonable amount of time. The program is designed for the development and testing of new sequential and parallel algorithms and data structures to be used when performing Delaunay triangulation.

  13. Ideal triangulations of 3-manifolds II: taut and angle structures

    OpenAIRE

    Kang, Ensil; Rubinstein, J. Hyam

    2005-01-01

    This is the second in a series of papers in which we investigate ideal triangulations of the interiors of compact 3-manifolds with tori or Klein bottle boundaries. Such triangulations have been used with great effect, following the pioneering work of Thurston. Ideal triangulations are the basis of the computer program SNAPPEA of Weeks and the program SNAP of Coulson, Goodman, Hodgson and Neumann. Casson has also written a program to find hyperbolic structures on such 3-manifolds, by solving T...

  14. Measuring and Controlling Fairness of Triangulations

    KAUST Repository

    Jiang, Caigui

    2016-09-30

    The fairness of meshes that represent geometric shapes is a topic that has been studied extensively and thoroughly. However, the focus in such considerations often is not on the mesh itself, but rather on the smooth surface approximated by it, and fairness essentially expresses a mesh’s suitability for purposes such as visualization or simulation. This paper focusses on meshes in the architectural context, where vertices, edges, and faces of meshes are often highly visible, and any notion of fairness must take new aspects into account. We use concepts from discrete differential geometry (star-shaped Gauss images) to express fairness, and we also demonstrate how fairness can be incorporated into interactive geometric design of triangulated freeform skins.

  15. Exploring Torus Universes in Causal Dynamical Triangulations

    DEFF Research Database (Denmark)

    Budd, Timothy George; Loll, R.

    2013-01-01

    Motivated by the search for new observables in nonperturbative quantum gravity, we consider Causal Dynamical Triangulations (CDT) in 2+1 dimensions with the spatial topology of a torus. This system is of particular interest, because one can study not only the global scale factor, but also global ....... Apart from setting the stage for the analysis of shape dynamics on the torus, the new set-up highlights the role of nontrivial boundaries and topology....... shape variables in the presence of arbitrary quantum fluctuations of the geometry. Our initial investigation focusses on the dynamics of the scale factor and uncovers a qualitatively new behaviour, which leads us to investigate a novel type of boundary conditions for the path integral. Comparing large...

  16. Employee-satisfaction: A triangulation approach

    Directory of Open Access Journals (Sweden)

    P. J. Visser

    1997-06-01

    Full Text Available The research on employee-satisfaction was conducted in the manufacturing industry. The sample consisted of 543 employees. The methodology could be described as a "triangulation approach" where a combination of quantitative and qualitative measurements were utilised and the results of both types of measurement integrated in the study of the construct. The research confirms existing findings that although the measurement of dimensions such as equitable rewards, working conditions, supportive colleagues, job content, etc. yield results on the level of employee-satisfaction, a single question, namely, "How satisfied are you with your job?" compares favourably with the general index. The findings also suggest the advantage of complimenting the quantitative data with qualitative information. The conclusions confirm the value of a qualitative method in cross-cultural research in an African environment. Opsomming Die navorsing omtrent werknemerstevredenheid is uitgevoer in die vervaardigingsbedryf. Die steekproef het bestaan uit 543 werknemers. Die metode van ondersoek kan beskryf word as 'n "driekantige benadering" (triangulation approach waar daar van kwantitatiewe en kwalitatiewe meting gebruik gemaak is en die resultate geihtegreer is in die bestudering van die konstruk. Die navorsing bevestig bestaande bevindinge dat die meting van dimensies soos vergelykbare belonings, werkstoestande, ondersteunende kollegas, inhoud van werk, ens. resultate lewer rakende die vlak van werknemerstevredenheid, 'n enkel vraag, naamlik, "Hoe tevrede is jy met jou werk?" gunstig vergelyk met die algemene indeks. Die bevindinge dui ook op die voordele van 'n benadering waar die kwantitatiewe data gekomplimenteer word deur kwalitatiewe inligting soos verkry uit individuele onderhoude. Die gevolgtrekkings bevestig die waarde wat die kwalitatiewe navorsingsmetode inhou vir kruis-kulturele navorsing in 'n Afrika konteks.

  17. Degree-regular triangulations of torus and Klein bottle

    Indian Academy of Sciences (India)

    Home; Journals; Proceedings – Mathematical Sciences; Volume 115; Issue 3 ... A triangulation of a connected closed surface is called degree-regular if each of its vertices have the same degree. ... In [5], Datta and Nilakantan have classified all the degree-regular triangulations of closed surfaces on at most 11 vertices.

  18. I/O-Efficient Construction of Constrained Delaunay Triangulations

    DEFF Research Database (Denmark)

    Agarwal, Pankaj Kumar; Arge, Lars; Yi, Ke

    2005-01-01

    In this paper, we designed and implemented an I/O-efficient algorithm for constructing constrained Delaunay triangulations. If the number of constraining segments is smaller than the memory size, our algorithm runs in expected O( N B logM/B NB ) I/Os for triangulating N points in the plane, where...

  19. Triangulation Processes Experienced by Children in Contemporary China

    Science.gov (United States)

    Wang, Meiping; Liu, Siwei; Belsky, Jay

    2017-01-01

    Most family-system research on triangulation processes has been undertaken in the West, with little known about this family dynamic in the East. The present cross-sectional study analysed 1,073 Chinese 3rd-12th-graders' self-reported exposure to three kinds of triangulation--cross-generation coalition, scapegoating, and parentification--in…

  20. Surface Triangulation for CSG in Mercury

    Energy Technology Data Exchange (ETDEWEB)

    Engel, Daniel [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Georgia Inst. of Technology, Atlanta, GA (United States); O' Brien, Matthew J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-08-26

    Visualization routines for rendering complicated geometries are very useful for engineers and scientists who are trying to build 3D prototypes of their designs. A common way to rapidly add interesting features to a 3D model is through the use of a concept called Constructive Solid Geometry. CSG uses compositions of the boolean set operations to manipulate basic geometric primitives to form more complicated objects. The most common boolean operations employed are union, intersection, and subtraction. Most computer-aided design software packages contain some sort of ability visualize CSG. The typical workflow for the user is as follows: The user specifies the individual primitive components, the user arbitrarily combines each of these primitives with boolean operations, the software generates a CSG tree structure which normally stores these solids implicitly with their defining equation, the tree is traversed and a general algorithm is applied to render the appropriate geometry onto the screen. Algorithms for visualizing CSG have been extensively developed for over a decade. Points sampled from the implicit solids are typically used as input by variations of algorithms like marching cubes and point-cloud surface reconstruction. Here, we explain a surface triangulation method from the graphics community that is being used for surface visualization in the framework of a Monte-Carlo neutron transport code called Mercury.

  1. From causal dynamical triangulations to astronomical observations

    Science.gov (United States)

    Mielczarek, Jakub

    2017-09-01

    This letter discusses phenomenological aspects of dimensional reduction predicted by the Causal Dynamical Triangulations (CDT) approach to quantum gravity. The deformed form of the dispersion relation for the fields defined on the CDT space-time is reconstructed. Using the Fermi satellite observations of the GRB 090510 source we find that the energy scale of the dimensional reduction is E* > 0.7 \\sqrt{4-d\\text{UV}} \\cdot 1010 \\text{GeV} at (95% CL), where d\\text{UV} is the value of the spectral dimension in the UV limit. By applying the deformed dispersion relation to the cosmological perturbations it is shown that, for a scenario when the primordial perturbations are formed in the UV region, the scalar power spectrum PS \\propto kn_S-1 , where n_S-1≈ \\frac{3 r (d\\text{UV}-2)}{(d\\text{UV}-1)r-48} . Here, r is the tensor-to-scalar ratio. We find that within the considered model, the predicted from CDT deviation from the scale invariance (n_S=1) is in contradiction with the up to date Planck and BICEP2.

  2. Strongly minimal triangulations of (S × S )#3 and (S S

    Indian Academy of Sciences (India)

    2011) 986–995). We show that there are exactly 12 such triangulations up to isomorphism, 10 of which are orientable. Keywords. Stacked sphere; tight neighbourly triangulation; minimal triangulation. 2000 Mathematics Subject Classification.

  3. Onomatopoeia characters extraction from comic images using constrained Delaunay triangulation

    Science.gov (United States)

    Liu, Xiangping; Shoji, Kenji; Mori, Hiroshi; Toyama, Fubito

    2014-02-01

    A method for extracting onomatopoeia characters from comic images was developed based on stroke width feature of characters, since they nearly have a constant stroke width in a number of cases. An image was segmented with a constrained Delaunay triangulation. Connected component grouping was performed based on the triangles generated by the constrained Delaunay triangulation. Stroke width calculation of the connected components was conducted based on the altitude of the triangles generated with the constrained Delaunay triangulation. The experimental results proved the effectiveness of the proposed method.

  4. Efficient triangulation of Poisson-disk sampled point sets

    KAUST Repository

    Guo, Jianwei

    2014-05-06

    In this paper, we present a simple yet efficient algorithm for triangulating a 2D input domain containing a Poisson-disk sampled point set. The proposed algorithm combines a regular grid and a discrete clustering approach to speedup the triangulation. Moreover, our triangulation algorithm is flexible and performs well on more general point sets such as adaptive, non-maximal Poisson-disk sets. The experimental results demonstrate that our algorithm is robust for a wide range of input domains and achieves significant performance improvement compared to the current state-of-the-art approaches. © 2014 Springer-Verlag Berlin Heidelberg.

  5. Looseness and Independence Number of Triangulations on Closed Surfaces

    Directory of Open Access Journals (Sweden)

    Nakamoto Atsuhiro

    2016-08-01

    Full Text Available The looseness of a triangulation G on a closed surface F2, denoted by ξ (G, is defined as the minimum number k such that for any surjection c : V (G → {1, 2, . . . , k + 3}, there is a face uvw of G with c(u, c(v and c(w all distinct. We shall bound ξ (G for triangulations G on closed surfaces by the independence number of G denoted by α(G. In particular, for a triangulation G on the sphere, we have

  6. Equivelar and d-Covered Triangulations of Surfaces. I

    OpenAIRE

    Lutz, Frank H.; Sulanke, Thom; Tiwari, Anand K.; Upadhyay, Ashish K.

    2010-01-01

    We survey basic properties and bounds for $q$-equivelar and $d$-covered triangulations of closed surfaces. Included in the survey is a list of the known sources for $q$-equivelar and $d$-covered triangulations. We identify all orientable and non-orientable surfaces $M$ of Euler characteristic $0>\\chi(M)\\geq -230$ which admit non-neighborly $q$-equivelar triangulations with equality in the upper bound $q\\leq\\Bigl\\lfloor\\tfrac{1}{2}(5+\\sqrt{49-24\\chi (M)})\\Bigl\\rfloor$. These examples give rise...

  7. Randomized trial of a comparison of the efficacy of TVT-O and single-incision tape TVT SECUR systems in the treatment of stress urinary incontinent women--2-year follow-up.

    Science.gov (United States)

    Masata, Jaromir; Svabik, Kamil; Zvara, Karel; Drahoradova, Petra; El Haddad, Rachid; Hubka, Petr; Martan, Alois

    2012-10-01

    The aim of this study was to compare the efficacy of the use of tension-free vaginal tape obturator (TVT-O) and single-incision TVT SECUR, hammock and U approach (TVT-S, H and U), in the treatment of urodynamic stress urinary incontinence (SUI). This single-center randomized three-arm trial compared the objective and subjective efficacy and early failure rate of the TVT-O and TVT-S H and U approach by objective criteria (cough test) and subjective criteria using the International Consultation on Incontinence Questionnaire--Short Form (ICIQ-UI SF). The objective efficacy rate was defined as the number of patients with a negative cough stress test. Subjective cure was defined by no stress leakage of urine after surgery based on the evaluation of ICIQ-UI SH (when patients ticked "Never"/"Urine does not leak" in answer to question 6: When does urine leak?). Objective and subjective efficacy were evaluated using Last Failure Carried Forward analysis, i.e., final analysis also included patients with early failure. To describe outcome at different time points, the Last Observation Carried Forward method was also implemented. One hundred ninety-seven women with proven SUI were randomized into three groups--TVT-O (n = 68), TVT-S H (n = 64), and TVT-S U (n = 65). Each patient allocated to a treatment group received the planned surgery. There were no differences in each group in preoperative characteristics. Median follow-up after surgery was 2 years (SD, 0.8; range, 0.1 to 3.8 years). Of the subjects, 92.6% in the TVT-O group, 68.8% in the TVT-S H group, and 69.2% in the TVT-S U group had negative stress test (p TVT-O group, 68.8% in the TVT-S H group, and 61.5% in the TVT-S U group were subjectively continent (p = 0.02). Our study demonstrated a significantly lower subjective and objective cure rate in the single-incision TVT group compared to the TVT-O group.

  8. Comparison of the efficacy of tension-free vaginal tape obturator (TVT-O) and single-incision tension-free vaginal tape (Ajust™) in the treatment of female stress urinary incontinence: a 1-year follow-up randomized trial.

    Science.gov (United States)

    Masata, Jaromir; Svabik, Kamil; Zvara, Karel; Hubka, Petr; Toman, Ales; Martan, Alois

    2016-10-01

    The aim of this study was to compare the efficacy of the tension-free vaginal tape obturator (TVT-O) and single-incision tension-free vaginal tape (Ajust™) in the treatment of stress urinary incontinence in a randomized two-arm study with a 1-year follow-up. This single-centre randomized trial compared the objective and subjective cure rates of TVT-O and Ajust using objective criteria (cough test) and subjective criteria (International Consultation on Incontinence Questionnaire short form, ICIQ-UI SF). The objective cure rate was defined as the number of patients with a negative cough stress test. Subjective cure was defined as no stress leakage of urine after surgery based on the ICIQ-UI SF. The primary outcome was to establish differences in objective and subjective cure rates between the TVT-O and Ajust groups. We also compared postoperative pain profiles using a visual analogue scale (VAS), improvement in quality of life using the ICIQ- UI SF and the Incontinence Quality of Life questionnaire, and overall satisfaction with the surgical procedure using a VAS and a five-item Likert scale. Inclusion criteria were age over 18 years, signed informed consent, and urodynamic stress urinary incontinence. Following a power calculation, 50 patients were enrolled into each group (Ajust and TVT-O). The mean follow-up after surgery was 445 days (SD 157.6 days) in the TVT-O group and 451.8 days (SD 127.6 days) in the Ajust group (p = 76.6 %). At 1 year, 47 patients were evaluated in the TVT-O group and 49 in the Ajust group. No differences in subjective cure rates or objective cure rates were observed. In the Ajust and TVT-O groups, the rates for no subjective stress leakage were 89.8 % and 91.5 %, respectively (p = 1.0, OR 1.22, 95 % CI 0.24 - 6.58), and the rates for a negative stress test were 89.8 % and 87.2 %, respectively (p = 0.76, OR 0.77, 95 % CI 0.17 - 3.32). In the Ajust group two patients reported de novo pain during sexual

  9. Umbilical hernia repair - series (image)

    Science.gov (United States)

    ... from the mother during development penetrate the fetal abdominal wall. ... Umbilical hernias are fairly common. They are obvious at birth and are ... (lining of the abdominal cavity) to protrude, and push ...

  10. Angiomyxoma of the Umbilical Cord

    Directory of Open Access Journals (Sweden)

    Hung-Pin Cheng

    2006-12-01

    Conclusion: Angiomyxoma is a rare tumor of the umbilical cord and should be considered when using prenatal ultrasound for detection of cystic lesion. Color Doppler imaging can easily and instantly detect perfusion through the umbilical vessels and assess cardiac function. In our case, application of color Doppler imaging for monitoring the relationship between the tumor and the adjacent vessels allowed the fetus to be delivered at term with a favorable outcome.

  11. Angiomyxoma of the Umbilical Cord

    OpenAIRE

    Cheng, Hung-Pin; Hsu, Chin-Yuan; Chen, Chih-Ping; Su, Tsung-Hsien

    2006-01-01

    Objective: Angiomyxoma is a rare tumor of the umbilical cord and is associated with increased perinatal morbidity and mortality. However, the management of these pregnancies in the third trimester is not clearly defined. We present a case of an angiomyxoma of the umbilical cord diagnosed in the second trimester, and highlight the contribution of color Doppler imaging to the early diagnosis of cord anomalies. Case Report: A 29 year-old, gravida 3, para 1, woman had elevated maternal serum a...

  12. TRIANGULATION OF THE INTERSTELLAR MAGNETIC FIELD

    Energy Technology Data Exchange (ETDEWEB)

    Schwadron, N. A.; Moebius, E. [University of New Hampshire, Durham, NH 03824 (United States); Richardson, J. D. [Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Burlaga, L. F. [Goddard Space Flight Center, Greenbelt, MD 20771 (United States); McComas, D. J. [Southwest Research Institute, San Antonio, TX 78228 (United States)

    2015-11-01

    Determining the direction of the local interstellar magnetic field (LISMF) is important for understanding the heliosphere’s global structure, the properties of the interstellar medium, and the propagation of cosmic rays in the local galactic medium. Measurements of interstellar neutral atoms by Ulysses for He and by SOHO/SWAN for H provided some of the first observational insights into the LISMF direction. Because secondary neutral H is partially deflected by the interstellar flow in the outer heliosheath and this deflection is influenced by the LISMF, the relative deflection of H versus He provides a plane—the so-called B–V plane in which the LISMF direction should lie. Interstellar Boundary Explorer (IBEX) subsequently discovered a ribbon, the center of which is conjectured to be the LISMF direction. The most recent He velocity measurements from IBEX and those from Ulysses yield a B–V plane with uncertainty limits that contain the centers of the IBEX ribbon at 0.7–2.7 keV. The possibility that Voyager 1 has moved into the outer heliosheath now suggests that Voyager 1's direct observations provide another independent determination of the LISMF. We show that LISMF direction measured by Voyager 1 is >40° off from the IBEX ribbon center and the B–V plane. Taking into account the temporal gradient of the field direction measured by Voyager 1, we extrapolate to a field direction that passes directly through the IBEX ribbon center (0.7–2.7 keV) and the B–V plane, allowing us to triangulate the LISMF direction and estimate the gradient scale size of the magnetic field.

  13. Reconstructing Surface Triangulations by Their Intersection Matrices 26 September 2014

    Directory of Open Access Journals (Sweden)

    Arocha Jorge L.

    2015-08-01

    Full Text Available The intersection matrix of a simplicial complex has entries equal to the rank of the intersecction of its facets. We prove that this matrix is enough to define up to isomorphism a triangulation of a surface.

  14. Triangulating' AMPATH: Demonstration of a multi-perspective ...

    African Journals Online (AJOL)

    Triangulating' AMPATH: Demonstration of a multi-perspective strategic programme evaluation method. TS Inui, JE Sidle, WM Nyandiko, VN Yebei, RM Frankel, DL Mossbarger, D Ayuku, J Ballidawa, R Ayikukwei ...

  15. Algebraic Error Based Triangulation and Metric of Lines.

    Science.gov (United States)

    Wu, Fuchao; Zhang, Ming; Wang, Guanghui; Hu, Zhanyi

    2015-01-01

    Line triangulation, a classical geometric problem in computer vision, is to determine the 3D coordinates of a line based on its 2D image projections from more than two views of cameras with known projection matrices. Compared to point features, line segments are more robust to matching errors, occlusions, and image uncertainties. In addition to line triangulation, a better metric is needed to evaluate 3D errors of line triangulation. In this paper, the line triangulation problem is investigated by using the Lagrange multipliers theory. The main contributions include: (i) Based on the Lagrange multipliers theory, a formula to compute the Plücker correction is provided, and from the formula, a new linear algorithm, LINa, is proposed for line triangulation; (ii) two optimal algorithms, OPTa-I and OPTa-II, are proposed by minimizing the algebraic error; and (iii) two metrics on 3D line space, the orthogonal metric and the quasi-Riemannian metric, are introduced for the evaluation of line triangulations. Extensive experiments on synthetic data and real images are carried out to validate and demonstrate the effectiveness of the proposed algorithms.

  16. Algebraic Error Based Triangulation and Metric of Lines.

    Directory of Open Access Journals (Sweden)

    Fuchao Wu

    Full Text Available Line triangulation, a classical geometric problem in computer vision, is to determine the 3D coordinates of a line based on its 2D image projections from more than two views of cameras with known projection matrices. Compared to point features, line segments are more robust to matching errors, occlusions, and image uncertainties. In addition to line triangulation, a better metric is needed to evaluate 3D errors of line triangulation. In this paper, the line triangulation problem is investigated by using the Lagrange multipliers theory. The main contributions include: (i Based on the Lagrange multipliers theory, a formula to compute the Plücker correction is provided, and from the formula, a new linear algorithm, LINa, is proposed for line triangulation; (ii two optimal algorithms, OPTa-I and OPTa-II, are proposed by minimizing the algebraic error; and (iii two metrics on 3D line space, the orthogonal metric and the quasi-Riemannian metric, are introduced for the evaluation of line triangulations. Extensive experiments on synthetic data and real images are carried out to validate and demonstrate the effectiveness of the proposed algorithms.

  17. A TQFT of Tuarev-Viro type on shaped triangulations

    Energy Technology Data Exchange (ETDEWEB)

    Kashaev, Rinat [Geneva Univ. (Switzerland); Luo, Feng [Rutgers Univ., Piscataway, NJ (United States). Dept. of Mathematics; Vartanov, Grigory [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2012-10-15

    A shaped triangulation is a finite triangulation of an oriented pseudo three manifold where each tetrahedron carries dihedral angles of an ideal hyberbolic tetrahedron. To each shaped triangulation, we associate a quantum partition function in the form of an absolutely convergent state integral which is invariant under shaped 3-2 Pachner moves and invariant with respect to shape gauge transformations generated by total dihedral angles around internal edges through the Neumann-Zagier Poisson bracket. Similarly to Turaev-Viro theory, the state variables live on edges of the triangulation but take their values on the whole real axis. The tetrahedral weight functions are composed of three hyperbolic gamma functions in a way that they enjoy a manifest tetrahedral symmetry. We conjecture that for shaped triangulations of closed 3-manifolds, our partition function is twice the absolute value squared of the partition function of Techmueller TQFT defined by Andersen and Kashaev. This is similar to the known relationship between the Turaev-Viro and the Witten-Reshetikhin-Turaev invariants of three manifolds. We also discuss interpretations of our construction in terms of three-dimensional supersymmetric field theories related to triangulated three-dimensional manifolds.

  18. Ultrasound, color - normal umbilical cord (image)

    Science.gov (United States)

    ... is a normal color Doppler ultrasound of the umbilical cord performed at 30 weeks gestation. The cord is ... the cord, two arteries and one vein. The umbilical cord is connected to the placenta, located in the ...

  19. Percutaneous umbilical cord blood sampling - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100196.htm Percutaneous umbilical cord blood sampling - series—Normal anatomy To use the ... or blood disorder, your doctor may recommend percutaneous umbilical cord blood sampling (PUBS), which is performed at 18 ...

  20. Generating families of surface triangulations. The case of punctured surfaces with inner degree at least 4

    OpenAIRE

    Chávez de Diego, María José; Negami, Seiya; Quintero Toscano, Antonio Rafael; Villar Liñán, María Trinidad

    2015-01-01

    We present two versions of a method for generating all triangulations of any punctured surface in each of these two families: (1) triangulations with inner vertices of degree ≥ 4 and boundary vertices of degree ≥ 3 and (2) triangulations with all vertices of degree ≥ 4. The method is based on a series of reversible operations, termed reductions, which lead to a minimal set of triangulations in each family. Throughout the process the triangulations remain within the corresponding family. Mo...

  1. The umbilical coiling index in normal pregnancy

    NARCIS (Netherlands)

    van Diik, C. C.; Franx, A.; de Laat, M. W. M.; Bruinse, H. W.; Visser, G. H. A.; Nikkels, P. G. J.

    2002-01-01

    To provide reference values for the umbilical coiling index in uncomplicated pregnancy. Umbilical cords were collected from livebom singleton infants born after uncomplicated pregnancies. The umbilical coiling index (UCI) was calculated as the number of coils divided by the cord length in

  2. The umbilical coiling index in complicated pregnancy

    NARCIS (Netherlands)

    de Laat, Monique W. M.; van Alderen, Elise D.; Franx, Arie; Visser, Gerard H. A.; Bots, Michiel L.; Nikkels, Peter G. J.

    2007-01-01

    To evaluate umbilical cord coiling in pregnancies with adverse outcome. Umbilical cords and hospital records of 565 consecutive cases with an indication for histological examination of the placenta were studied. The umbilical coiling index (UCI) was determined as the number of complete coils divided

  3. Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults - Technical Aspects and Short Term Results

    Directory of Open Access Journals (Sweden)

    Sanoop Koshy Zachariah

    2014-09-01

    Full Text Available Background: There is no gold standard technique for umbilical hernia repair .Conventional open umbilical hernia repair often produces an undesirable scar. Laparoscopic umbilical hernia repair requires multiple incisions beyond the umbilicus, specialized equipments, and expensive tissue separating mesh. We describe our technique of open umbilical hernia repair utilizing a small incision. The technique was derived from our experience with single incision laparoscopy. We report the technical details and short term results. Methods: This is a retrospective analysis of the first 20 patients who underwent minimal incision scar-less open umbilical hernia repair, from June 2011 to February 2014. A single intra-umbilical curved incision was used to gain access to the hernia sac. Primary suture repair was performed for defects upto 2cm.Larger defects were repaired using an onlay mesh. In patients with a BMI of 30 kg/m2 or greater, onlay mesh hernioplasty was performed irrespective of the defect size.Results: A total of 20 patients, 12 males and 8 females underwent the procedure. Mean age was 50 (range 29 - 82 years. Mean BMI was 26.27 (range 20. -33.1 kg/m2. Average size of the incision was 1.96 range (1.5 to 2.5 cm. Mesh hernioplasty was done in 9 patients. 11 patients underwent primary suture repair alone. There were no postoperative complications associated with his technique. Average post operative length of hospital stay was 3.9 (range 2-10 days. Mean follow-up was 29.94 months, (2 weeks to 2.78 years. On follow up there was no externally visible scar in any of the patients. There were no recurrences on final follow up. Conclusion: This technique provides a similar cosmetic effect as obtained from single port laparoscopy. It is easy to perform safe, offers good cosmesis, does not require incisions beyond the umbilicus and cost effective, with encouraging results on short term follow up. Further research is needed to assess the true potential of the

  4. Is umbilical coiling genetically determined?

    Science.gov (United States)

    Ayala, Nina K; Ernst, Linda M; Miller, Emily S

    2018-02-21

    Abnormal umbilical cord coiling is associated with adverse perinatal outcomes; however, the etiology of the umbilical coiling pattern is poorly understood. Retrospective cohort of all twin deliveries >20 weeks in 2014. Pregnancies were dichotomized by chorionicity and the umbilical coiling index (UCI) and placental cord insertion location were compared. In cases with one or both cords hypercoiled, the direction and pattern of coiling were compared by chorionicity. A similar analysis was performed stratified by zygosity. Three hundred sisty two twin pairs were included; 26 (7.2%) monochorionic and 174 (87.0%) definitively dizygotic. Concordance in the UCI and coiling category were similar between dichorionic and monochorionic as well as dizygous and monozygous gestations, (73.2% vs 80.8%, p = 0.399 and 71.4% vs 80.8%, p = 0.399, respectively). Analyses of the coiling direction and pattern also demonstrated no difference by chorionicity or zygosity. These data do not support a genetic basis for umbilical cord coiling.

  5. Internet information triangulation: Design theory and prototype evaluation

    NARCIS (Netherlands)

    Wijnhoven, Alphonsus B.J.M.; Brinkhuis, Michel

    2014-01-01

    Many discussions exist regarding the credibility of information on the Internet. Similar discussions happen on the interpretation of social scientific research data, for which information triangulation has been proposed as a useful method. In this article, we explore a design theory—consisting of a

  6. From binary cube triangulations to acute binary simplices

    NARCIS (Netherlands)

    Brandts, J.; van Hooff, J.; Kuiper, C.; Steenkamp, R.; Brandts, J.; Chleboun, J.; Korotov, S.; Segeth, K.; Šístek, J.; Vejchodský, T.

    2012-01-01

    Cottle's proof that the minimal number of 0=1-simplices needed to triangulate the unit 4-cube equals 16 uses a modest amount of computer generated results. In this paper we remove the need for computer aid, using some lemmas that may be useful also in a broader context. One of the 0=1-simplices

  7. A grand-canonical ensemble of randomly triangulated surfaces

    International Nuclear Information System (INIS)

    Jurkiewicz, J.; Krzywicki, A.; Petersson, B.

    1986-01-01

    An algorithm is presented generating the grand-canonical ensemble of discrete, randomly triangulated Polyakov surfaces. The algorithm is used to calculate the susceptibility exponent, which controls the existence of the continuum limit of the considered model, for the dimensionality of the embedding space ranging from 0 to 20. (orig.)

  8. Triangulating' AMPATH: Demonstration of a multi-perspective ...

    African Journals Online (AJOL)

    For strategic planning, the Kenyan HIV/AIDS programme AMPATH (Academic Model Providing Access to Healthcare) sought to evaluate its performance in 2006. The method used for this evaluation was termed 'triangulation,' because it used information from three different sources – patients, communities, and programme ...

  9. Degree-regular triangulations of torus and Klein bottle

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    torial 2-manifolds are the boundaries of the tetrahedron, the octahedron, the icosahedron and the 6-vertex real projective plane [4, 5]. The combinatorial manifolds T3,3,0 and T6,2,2. (in Examples 2 and 3) are combinatorially regular. Schulte and Wills [10, 11] have con- structed two combinatorially regular triangulations of ...

  10. The SIMS trial: adjustable anchored single-incision mini-slings versus standard tension-free midurethral slings in the surgical management of female stress urinary incontinence. A study protocol for a pragmatic, multicentre, non-inferiority randomised controlled trial

    Science.gov (United States)

    Abdel-Fattah, Mohamed; MacLennan, Graeme; Kilonzo, Mary; Assassa, R Phil; McCormick, Kirsty; Davidson, Tracey; McDonald, Alison; N’Dow, James; Wardle, Judith; Norrie, John

    2017-01-01

    Introduction Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up. Methods and analysis A pragmatic, multicentre, non-inferiority randomised controlled trial. Primary outcome measure The primary outcome measure is the patient-reported success rate measured by the Patient Global Impression of Improvement at 12 months. The primary economic outcome will be incremental cost per quality-adjusted life year gained at 12 months. Secondary outcome measures The secondary outcomes measures include adverse events, objective success rates, impact on other lower urinary tract symptoms, health-related quality of life profile and sexual function, and reoperation rates for SUI. Secondary economic outcomes include National Health Service and patient primary and secondary care resource use and costs, incremental cost-effectiveness and incremental net benefit. Statistical analysis The statistical analysis of the primary outcome will be by intention-to-treat and also a per-protocol analysis. Results will be displayed as estimates and 95% CIs. CIs around observed differences will then be compared with the prespecified non-inferiority margin. Secondary outcomes will be analysed similarly. Ethics and dissemination The North of Scotland Research Ethics Committee has approved this study (13/NS/0143). The dissemination plans include HTA monograph, presentation at international scientific meetings and publications in high-impact, open-access journals. The results will be included in the updates of the National

  11. Optical triangulation method for height measurements on water surfaces

    Science.gov (United States)

    Maas, Hans-Gerd; Hentschel, Bernd; Schreiber, Frank

    2003-01-01

    Optical triangulation methods based on a laser light sheet and a camera are frequently used as a surface measurement technique in a wide range of applications. They allow for the fast accurate determination of height profiles, based on relatively simple hardware and software configurations. Moreover, they can be implemented very efficiently and are especially suited for measurements on moving objects such as products on an assembly line. The study presented in the paper describes the adaptation of laser light sheet optical triangulation techniques to the task of water level profile measurements in hydromechanics experimental facilities. The properties of water surfaces necessitate several modifications of optical triangulation techniques to make them applicable: The mirror-like reflection properties of water surfaces form a contradiction to the assumption of diffuse reflection, on which standard light sheet triangulation techniques are based; this problem can be circumvented by using a diffuse reflecting projection plane to capture the mirror-like reflection of the laser line from the water surface. Due to the angle of incidence law, however, water surface tilts caused by waves will usually cause a strong degradation of the quality of the results when using reflected light; this effect can largely be compensated by processing max-store images derived from short image sequences rather than single images. These extensions of optical triangulation turned out to be crucial for the applicability of the method on water surfaces. Besides the theoretical concept and a sensitivity analysis of the method, a system configuration is outlined, and the results of a number of practical experiments are shown and discussed.

  12. Umbilical endosalpingiosis: a case report

    Directory of Open Access Journals (Sweden)

    Papavramidis Theodossis S

    2010-08-01

    Full Text Available Abstract Introduction Endosalpingiosis describes the ectopic growth of Fallopian tube epithelium. Pathology confirms the presence of a tube-like epithelium containing three types of cells: ciliated, columnar cells; non-ciliated, columnar secretory mucous cells; and intercalary cells. We report the case of a woman with umbilical endosalpingiosis and examine the nature and characteristics of cutaneous endosalpingiosis by reviewing and combining the other four cases existing in the international literature. Case presentation A 50-year-old Caucasian, Greek woman presented with a pale brown nodule in her umbilicus. The nodule was asymptomatic, with no cyclical discomfort or variation in size. Her personal medical, surgical and gynecologic history was uneventful. An excision within healthy margins was performed under local anesthesia. A cystic formation measuring 2.7×1.7×1 cm was removed. Histological examination confirmed umbilical endosalpingiosis. Conclusions Umbilical endosalpingiosis is a very rare manifestation of the non-neoplasmatic disorders of the Müllerian system. It appears with cyclic symptoms of pain and swelling of the umbilicus, but not always. The disease is diagnosed using pathologic findings and surgical excision is the definitive treatment.

  13. An overview of the stereo correlation and triangulation formulations used in DICe.

    Energy Technology Data Exchange (ETDEWEB)

    Turner, Daniel Z. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    This document provides a detailed overview of the stereo correlation algorithm and triangulation formulation used in the Digital Image Correlation Engine (DICe) to triangulate three dimensional motion in space given the image coordinates and camera calibration parameters.

  14. Religious perspectives on umbilical cord blood banking.

    Science.gov (United States)

    Jordens, Christopher F C; O'Connor, Michelle A C; Kerridge, Ian H; Stewart, Cameron; Cameron, Andrew; Keown, Damien; Lawrence, Rabbi Jeremy; McGarrity, Andrew; Sachedina, Abdulaziz; Tobin, Bernadette

    2012-03-01

    Umbilical cord blood is a valuable source of haematopoietic stem cells. There is little information about whether religious affiliations have any bearing on attitudes to and decisions about its collection, donation and storage. The authors provided information about umbilical cord blood banking to expert commentators from six major world religions (Catholicism, Anglicanism, Islam, Judaism, Hinduism and Buddhism) and asked them to address a specific set of questions in a commentary. The commentaries suggest there is considerable support for umbilical cord blood banking in these religions. Four commentaries provide moral grounds for favouring public donation over private storage. None attach any particular religious significance to the umbilical cord or to the blood within it, nor place restrictions on the ethnicity or religion of donors and recipients. Views on ownership of umbilical cord blood vary. The authors offer a series of general points for those who seek a better understanding of religious perspectives on umbilical cord blood banking.

  15. Umbilical coiling index & the perinatal outcome.

    Science.gov (United States)

    Devaru, Dakshayini; Thusoo, Meghna

    2012-02-01

    To correlate the perinatal outcome by noting the umbilical coiling index. The umbilical cords of the babies born to 100 women, who delivered either vaginally or by lower segment cesarean section, were examined and umbilical coiling index was calculated. There was significant correlation (p value 0.003) between the hypercoiled cords (UCI >90th percentile) and intrauterine growth restriction of the babies. Apgar score at 1 min UCI UCI UCI >10th percentile is associated with intra uterine growth restriction.

  16. Umbilical artery tone in maternal obesity

    OpenAIRE

    Hehir, Mark P; Moynihan, Audrey T; Glavey, Siobhan V; Morrison, John J

    2009-01-01

    Abstract Background The increasing prevalence of obesity constitutes a major health problem in obstetrics with implications for feto-maternal growth and wellbeing. This study investigated and compared the contractile properties of umbilical arteries excised from obese women, with those excised from women with a normal body mass index (BMI). Methods Sections of umbilical artery were obtained from umbilical cord samples immediately after delivery and mounted for isometric recording in organ tis...

  17. Levels of Fusion, Triangulation, and Adjustment in Families of College Students with Physical and Cognitive Disabilities.

    Science.gov (United States)

    Smith, James B.; Ray, Rose E.; Wetchler, Joseph L.; Mihail, Thomas

    1998-01-01

    Compares students with disabilities and students with no disabilities on the family systems measures of fusion and triangulation. Examines the relationships among fusion, triangulation, and college adjustment. Relationships between fusion and college adjustment and between triangulation and college adjustment were found. (Author/MKA)

  18. Adolescent Triangulation into Parental Conflicts: Longitudinal Implications for Appraisals and Adolescent-Parent Relations

    Science.gov (United States)

    Fosco, Gregory M.; Grych, John H.

    2010-01-01

    Although triangulation into parental conflict is a risk factor for child and adolescent maladjustment, little is known about how triangulation affects adolescents' functioning or the factors that lead children to be drawn into parental disagreements. This prospective study examined the relations between triangulation, appraisals of conflict, and…

  19. Random discrete Morse theory and a new library of triangulations

    DEFF Research Database (Denmark)

    Benedetti, Bruno; Lutz, Frank Hagen

    2014-01-01

    We introduce random discrete Morse theory as a computational scheme to measure the complexity of a triangulation. The idea is to try to quantify the frequency of discrete Morse matchings with few critical cells. Our measure will depend on the topology of the space, but also on how nicely the space...... is triangulated. The scheme we propose looks for optimal discrete Morse functions with an elementary random heuristic. Despite its naiveté, this approach turns out to be very successful even in the case of huge inputs. In our view, the existing libraries of examples in computational topology are “too easy......” for testing algorithms based on discrete Morse theory. We propose a new library containing more complicated (and thus more meaningful) test examples....

  20. Optimizing 3D Triangulations to Recapture Sharp Edges

    DEFF Research Database (Denmark)

    Bærentzen, Jakob Andreas

    2006-01-01

    sharp edges. The energy is minimized using edge swapping, and this can be done either in a greedy fashion or using simulated annealing. The latter is more costly, but effectively avoids local minima. The method has been used on a number of models. Particularly good results have been obtained on digital......In this report, a technique for optimizing 3D triangulations is proposed. The method seeks to minimize an energy defined as a sum of energy terms for each edge in a triangle mesh. The main contribution is a novel per edge energy which strikes a balance between penalizing dihedral angle yet allowing...... terrain models. It is demonstrated how the method has been able to recapture sharp edges which are clearly present in the data but not reflected by the original triangulation of the elevation points....

  1. Grounded theory, feminist theory, critical theory: toward theoretical triangulation.

    Science.gov (United States)

    Kushner, Kaysi Eastlick; Morrow, Raymond

    2003-01-01

    Nursing and social science scholars have examined the compatibility between feminist and grounded theory traditions in scientific knowledge generation, concluding that they are complementary, yet not without certain tensions. This line of inquiry is extended to propose a critical feminist grounded theory methodology. The construction of symbolic interactionist, feminist, and critical feminist variants of grounded theory methodology is examined in terms of the presuppositions of each tradition and their interplay as a process of theoretical triangulation.

  2. On-Line Metrology with Conoscopic Holography: Beyond Triangulation

    OpenAIRE

    Álvarez, Ignacio; Enguita, Jose M.; Frade, María; Marina, Jorge; Ojea, Guillermo

    2009-01-01

    On-line non-contact surface inspection with high precision is still an open problem. Laser triangulation techniques are the most common solution for this kind of systems, but there exist fundamental limitations to their applicability when high precisions, long standoffs or large apertures are needed, and when there are difficult operating conditions. Other methods are, in general, not applicable in hostile environments or inadequate for on-line measurement. In this paper we review the latest ...

  3. Image fusion and enhancement using triangulated irregular networks

    Science.gov (United States)

    Scarmana, G.

    2017-06-01

    A triangulated irregular network (TIN) is a viable structure for vector representation of raster image data. To visualize the image characterized by triangulation, it is required to fit a continuous surface of pixel brightness values in the triangulation (i.e. to interpolate data stored in its vertices). From this perspective, this paper presents a multi-frame image fusion and enhancement process that employs TIN structures rather than arrays of pixels as the original working units. The feasibility of this application relates to the fact that a TIN model offers a good quality digital image representation with a reduced density of pixel values as compared to a corresponding raster representation [4]. In the proposed process several low-resolution unregistered and compressed images (such as those extracted from a video footage) of a common scene are: (a) registered to a sub-pixel level (b) transformed to a TIN structure, (c) grouped or mapped globally within a singular framework to create a denser TIN composite, and (d) the TIN representation is used in reverse to reconstruct a higher resolution image in raster format with more details than any of the original input frames. Tests and subsequent results are shown to demonstrate the validity and accuracy of the proposed multi-frame image enhancement process. A comparison of this process of multi-frame image enhancement using various interpolation methods and practices is included.

  4. Excerpt from Triangulations: Narrative Strategies for Navigating Latino Identity

    Directory of Open Access Journals (Sweden)

    David J. Vázquez

    2011-12-01

    Full Text Available Just as mariners use triangulation, mapping an imaginary triangle between two known positions and an unknown location, so, David J. Vázquez contends, Latino authors in late twentieth-century America employ the coordinates of familiar ideas of self to find their way to new, complex identities. Through this metaphor, Vázquez reveals how Latino autobiographical texts, written after the rise of cultural nationalism in the 1960s, challenge mainstream notions of individual identity and national belonging in the United States.In a traditional autobiographical work, the protagonist frequently opts out of his or her community. In the works that Vázquez analyzes in Triangulations, protagonists instead opt in to collective groups—often for the express political purpose of redefining that collective. Reading texts by authors such as Ernesto Galarza, Jesús Colón, Piri Thomas, Oscar “Zeta” Acosta, Judith Ortiz Cofer, John Rechy, Julia Alvarez, and Sandra Cisneros, Vázquez engages debates about the relationship between literature and social movements, the role of cultural nationalism in projects for social justice, the gender and sexual problematics of 1960s cultural nationalist groups, the possibilities for interethnic coalitions, and the interpretation of autobiography. In the process, Triangulations considers the potential for cultural nationalism as a productive force for aggrieved communities of color in their struggles for equality.

  5. Summations over equilaterally triangulated surfaces and the critical string measure

    Science.gov (United States)

    Smit, Dirk-Jan

    1992-01-01

    We propose a new approach to the summation over dynamically triangulated Riemann surfaces which does not rely on properties of the potential in a matrix model. Instead, we formulate a purely algebraic discretization of critical string path integral. This is combined with a technique which assigns to each equilateral triangulation of a two-dimensional surface a Riemann surface defined over a certain finite extension of the field of rational numbers, i.e. an arthmetic surface. Thus we establish a new formulation in which the sum over randomly triangulated surfaces defines an invariant measure on the moduli space of arithmetic surfaces. It is shown that because of this it is far from obvious that this measure for large genera approximates the measure defined by the continuum theory, i.e. Liouville theory or critical string theory. In low genus this subtlety does not exist. In the case of critical string theory we explicity compute the volume of the moduli space of arithmetic surfaces in terms of the modular height function and show that for low genus it approximates correctly the continuum measure. We also discuss a continuum limit which bears some resemblance with a double scaling limit in matrix models.

  6. Summations over equilaterally triangulated surfaces and the critical string measure

    International Nuclear Information System (INIS)

    Smit, D.J.; Lawrence Berkeley Lab., CA

    1992-01-01

    We propose a new approach to the summation over dynamically triangulated Riemann surfaces which does not rely on properties of the potential in a matrix model. Instead, we formulate a purely algebraic discretization of critical string path integral. This is combined with a technique which assigns to each equilateral triangulation of a two-dimensional surface a Riemann surface defined over a certain finite extension of the field of rational numbers, i.e. an arithmetic surface. Thus we establish a new formulated in which the sum over randomly triangulated surfaces defines an invariant measure on the moduli space of arithmetic surfaces. It is shown that because of this it is far from obvious that this measure for large genera approximates the measure defined by the continuum theory, i.e. Liouville theory or critical string theory. In low genus this subtlety does not exist. In the case of critical string theory we explicitly compute the volume of the moduli space of arithmetic surfaces in terms of the modular height function and show that for low genus it approximates correctly the continuum measure. We also discuss a continuum limit which bears some resemblance with a double scaling limit in matrix models. (orig.)

  7. Totally Contact Umbilical Lightlike Hypersurfaces of Indefinite -Manifolds

    Directory of Open Access Journals (Sweden)

    Rachna Rani

    2013-01-01

    Full Text Available We study totally contact umbilical lightlike hypersurfaces of indefinite -manifolds and prove the nonexistence of totally contact umbilical lightlike hypersurface in indefinite -space form.

  8. Umbilical cord ulceration and jejunal atresia

    African Journals Online (AJOL)

    The association between umbilical cord ulceration and congenital intestinal atresia is being increasingly reported and carries a high mortality. We report on a case of jejunal atresia associated with massive fetal haemorrhage from an umbilical cord ulcer. Fetal distress noted on continuous fetal heart monitoring allowed for ...

  9. Fetal Umbilical Cord Length and Associated Intrapatum ...

    African Journals Online (AJOL)

    Shoulder dystocia, hand prolapse in a transverse lying fetus, abruptio placentae and prolonged second stage of labour had shorter cords while fetal distress, cord prolapse and mecunium stained liquor had longer cords when compared with the mean umbilical cord length of the study population. Conclusion: Umbilical cord ...

  10. Umbilical hernia in Xhosa infants and children.

    Science.gov (United States)

    James, T

    1982-01-01

    During the period 12 March 1980 to 10 March 1981 a consecutive series of 1200 Xhosa (Black) infants and young children, ranging in age from the newborn to the prepubertal, who attended the general outpatients department for a variety of medical complaints were examined for umbilical herniation. None had undergone any surgical operation, and patients with conditions possibly associated with umbilical herniation were excluded. Evidence of umbilical protrusion was found in 742 (61.8%), with a similar incidence in males and females. The overall incidence was reflected in each age group by a preponderance of children with umbilical hernia. This study confirms the validity of a generally-held impression that in Black children there is a strong tendency towards the persistence of umbilical hernia when it appears after separation of the cord. Images Figure 1. Figure 2. Figure 3. Figure 4. PMID:7086806

  11. Refining a triangulation of a planar straight-line graph to eliminate large angles

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, S.A.

    1993-05-13

    Triangulations without large angles have a number of applications in numerical analysis and computer graphics. In particular, the convergence of a finite element calculation depends on the largest angle of the triangulation. Also, the running time of a finite element calculation is dependent on the triangulation size, so having a triangulation with few Steiner points is also important. Bern, Dobkin and Eppstein pose as an open problem the existence of an algorithm to triangulate a planar straight-line graph (PSLG) without large angles using a polynomial number of Steiner points. We solve this problem by showing that any PSLG with {upsilon} vertices can be triangulated with no angle larger than 7{pi}/8 by adding O({upsilon}{sup 2}log {upsilon}) Steiner points in O({upsilon}{sup 2} log{sup 2} {upsilon}) time. We first triangulate the PSLG with an arbitrary constrained triangulation and then refine that triangulation by adding additional vertices and edges. Some PSLGs require {Omega}({upsilon}{sup 2}) Steiner points in any triangulation achieving any largest angle bound less than {pi}. Hence the number of Steiner points added by our algorithm is within a log {upsilon} factor of worst case optimal. We note that our refinement algorithm works on arbitrary triangulations: Given any triangulation, we show how to refine it so that no angle is larger than 7{pi}/8. Our construction adds O(nm+nplog m) vertices and runs in time O(nm+nplog m) log(m+ p)), where n is the number of edges, m is one plus the number of obtuse angles, and p is one plus the number of holes and interior vertices in the original triangulation. A previously considered problem is refining a constrained triangulation of a simple polygon, where p = 1. For this problem we add O({upsilon}{sup 2}) Steiner points, which is within a constant factor of worst case optimal.

  12. Bancos de cordón umbilical Umbilical cord banks

    OpenAIRE

    L. Madero

    2009-01-01

    La utilización de sangre de cordón como fuente de precursores hematológicos se remonta a 1983 cuando Boyse apuntó el potencial en progenitores existente en la sangre de cordón, realizándose un año más tarde las primeras experiencias sobre modelos murinos. Tuvieron que pasar más de cinco años para que Gluckman realizara la primera experiencia en humanos. Un niño afecto de anemia de Fanconi fue trasplantado con progenitores de sangre de cordón umbilical de su hermana HLA idéntica, realizándose ...

  13. Exact and approximate computations of watersheds on triangulated terrains

    DEFF Research Database (Denmark)

    Tsirogiannis, Konstantinos; de Berg, Mark

    2011-01-01

    or they perform computations using inexact arithmetic, which leads to inexact and sometimes inconsistent results. We perform a detailed study of various issues concerning the exact or approximate computation of watersheds according to the dsd model. Our main contributions are the following. • We provide the first...... implementation that computes watersheds on triangulated terrains following strictly the dsd model and using exact arithmetic, and we experimentally investigate its computational cost. Our experiments show that the algorithm cannot handle large data sets effectively, due to the bit-sizes needed in the exact...

  14. Laser triangulation method for measuring the size of parking claw

    Science.gov (United States)

    Liu, Bo; Zhang, Ming; Pang, Ying

    2017-10-01

    With the development of science and technology and the maturity of measurement technology, the 3D profile measurement technology has been developed rapidly. Three dimensional measurement technology is widely used in mold manufacturing, industrial inspection, automatic processing and manufacturing, etc. There are many kinds of situations in scientific research and industrial production. It is necessary to transform the original mechanical parts into the 3D data model on the computer quickly and accurately. At present, many methods have been developed to measure the contour size, laser triangulation is one of the most widely used methods.

  15. On-line metrology with conoscopic holography: beyond triangulation.

    Science.gov (United States)

    Alvarez, Ignacio; Enguita, Jose M; Frade, María; Marina, Jorge; Ojea, Guillermo

    2009-01-01

    On-line non-contact surface inspection with high precision is still an open problem. Laser triangulation techniques are the most common solution for this kind of systems, but there exist fundamental limitations to their applicability when high precisions, long standoffs or large apertures are needed, and when there are difficult operating conditions. Other methods are, in general, not applicable in hostile environments or inadequate for on-line measurement. In this paper we review the latest research in Conoscopic Holography, an interferometric technique that has been applied successfully in this kind of applications, ranging from submicrometric roughness measurements, to long standoff sensors for surface defect detection in steel at high temperatures.

  16. Recent development of micro-triangulation for magnet fiducialisation

    CERN Document Server

    Vlachakis, Vasileios; Mainaud Durand, Helene; CERN. Geneva. ATS Department

    2016-01-01

    The micro-triangulation method is proposed as an alternative for magnet fiducialisation. The main objective is to measure horizontal and vertical angles to fiducial points and stretched wires, utilising theodolites equipped with cameras. This study aims to develop various methods, algorithms and software tools to enable the data acquisition and processing. In this paper, we present the first test measurement as an attempt to demonstrate the feasibility of the method and to evaluate the accuracy. The preliminary results are very promising, with accuracy always better than 20 μm for the wire position, and of about40 μm/m for the wire orientation, compared with a coordinate measuring machine.

  17. Spectral Analysis for Weighted Iterated Triangulations of Graphs

    Science.gov (United States)

    Chen, Yufei; Dai, Meifeng; Wang, Xiaoqian; Sun, Yu; Su, Weiyi

    Much information about the structural properties and dynamical aspects of a network is measured by the eigenvalues of its normalized Laplacian matrix. In this paper, we aim to present a first study on the spectra of the normalized Laplacian of weighted iterated triangulations of graphs. We analytically obtain all the eigenvalues, as well as their multiplicities from two successive generations. As an example of application of these results, we then derive closed-form expressions for their multiplicative Kirchhoff index, Kemeny’s constant and number of weighted spanning trees.

  18. Hex-dominant mesh generation using 3D constrained triangulation

    Energy Technology Data Exchange (ETDEWEB)

    OWEN,STEVEN J.

    2000-05-30

    A method for decomposing a volume with a prescribed quadrilateral surface mesh, into a hexahedral-dominated mesh is proposed. With this method, known as Hex-Morphing (H-Morph), an initial tetrahedral mesh is provided. Tetrahedral are transformed and combined starting from the boundary and working towards the interior of the volume. The quadrilateral faces of the hexahedra are treated as internal surfaces, which can be recovered using constrained triangulation techniques. Implementation details of the edge and face recovery process are included. Examples and performance of the H-Morph algorithm are also presented.

  19. The Roach muscle bundle and umbilical cord coiling

    NARCIS (Netherlands)

    de Laat, Monique W. M.; Nikkels, Peter G. J.; Franx, Arie; Visser, Gerard H. A.

    2007-01-01

    To determine if presence of the Roach muscle, a small muscle bundle lying just beside the umbilical artery, contributes to umbilical cord coiling. 251 umbilical cords were examined. The umbilical coiling index (UCI) was calculated as the number of coils divided by the cord length in cm. Cords were

  20. Three-Dimensional Reconstruction Optical System Using Shadows Triangulation

    Science.gov (United States)

    Barba, J. Leiner; Vargas, Q. Lorena; Torres, M. Cesar; Mattos, V. Lorenzo

    2008-04-01

    In this work is developed a three-dimensional reconstruction system using the Shades3D tool of the Matlab® Programming Language and materials of low cost, such as webcam camera, a stick, a weak structured lighting system composed by a desk lamp, and observation plane in which the object is located. The reconstruction is obtained through a triangulation process that is executed after acquiring a sequence of images of the scene with a shadow projected on the object; additionally an image filtering process is done for obtaining only the part of the scene that will be reconstructed. Previously, it is necessary to develop a calibration process for determining the internal camera geometric and optical characteristics (intrinsic parameters), and the 3D position and orientation of the camera frame relative to a certain world coordinate system (extrinsic parameters). The lamp and the stick are used to produce a shadow which scans the object; in this technique, it is not necessary to know the position of the light source, instead the triangulation is obtained using shadow plane produced by intersection between the stick and the illumination pattern. The webcam camera captures all images with the shadow scanning the object, and Shades3D tool processes all information taking into account captured images and calibration parameters. Likewise, this technique is evaluated in the reconstruction of parts of the human body and its application in the detection of external abnormalities and elaboration of prosthesis or implant.

  1. Setting the Scale of Dimensional Reduction in Causal Dynamical Triangulations

    Science.gov (United States)

    Cooperman, Joshua

    2011-04-01

    Within the causal dynamical triangulations approach to quantization of gravity, striking evidence has emerged that the effective dimensionality of spacetime dynamically reduces at small scales. Specifically, in the case of topological sphericity, the expectation value of the spectral dimension decreases with the scale being probed from the topological value of four to an apparent value of two. Thus far the physical scale at which this dynamical dimensional reduction occurs has not been ascertained. In this talk I present the first determinations of this scale. By fitting the expectation value of the spacetime geometry to a classical minisuperspace model, I extract the triangulation lattice spacing in units of the Planck length and the effective cosmological constant in units of the inverse Planck length squared. The former value allows me to establish directly the scales probed by the random walk that defines the spectral dimension. The latter value allows me to establish indirectly these scales via the heat trace for the minisuperspace geometry. This work also yields preliminary indications of the flow of the cosmological constant within this model of quantum geometry.

  2. Aortic aneurysm secondary to umbilical artery catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Brill, P.W.; Winchester, P.; Griffith, A.Y.; Kazam, E.; Zirinsky, K.; Levin, A.R.

    1985-02-01

    A 14-month-girl presented with an asymptomatic posterior mediastinal mass. She had a history of prematurity, umbilical artery catheterization, and sepsis. The diagnosis of aortic aneurysm was made by dynamic computed tomography. The aneurysm was successfully resected.

  3. Standardizing umbilical catheter usage in preterm infants.

    Science.gov (United States)

    Shahid, Shaneela; Dutta, Sourabh; Symington, Amanda; Shivananda, Sandesh

    2014-06-01

    Absence of guidelines on umbilical arterial catheter (UAC) and umbilical venous catheter (UVC) use and inability to predict the hospital course may sway the frontline staff to overuse umbilical catheters in preterm infants. Our objective was to evaluate the feasibility of implementing guidelines standardizing the use of umbilical catheters and its impact on the incidence of sepsis and resource use. All inborn infants delivered at <33 weeks' gestation and admitted to the NICU were included in this quality improvement study. The primary outcome was proportion of infants receiving umbilical catheters. Secondary outcomes were central venous catheter (CVC) use and central line-associated bloodstream infection (CLABSI). The proportion of infants receiving UACs and UVCs was significantly lower in postintervention (sustainment) phase than in the preintervention phase (93 [42.3%] vs 52 [23.6%], P = .0001) and (137 [62.6%] vs 93 [42.3%], P = .0001), respectively. There was no corresponding increase in the proportion of infants receiving peripherally inserted central catheters (PICCs) or surgical CVCs (SCVCs) during the sustainment phase. There was a significant reduction in the proportion of infants receiving CVCs (UVC, PICC, and SCVC) in the sustainment phase. The incidence of CLABSI was similar in the preintervention and sustainment phases. Implementation of guidelines standardizing the use of umbilical catheters in the NICU is feasible. Fewer infants were exposed to the risk of UVC or UAC, and fewer resources were used. Copyright © 2014 by the American Academy of Pediatrics.

  4. Point data reduction in reverse engineering by delaunay triangulation

    International Nuclear Information System (INIS)

    Hur, Sung Min; Kim, Ho Chan; Lee, Seok Hee

    2001-01-01

    Reverse engineering has been widely used for the shape reconstruction of an object without CAD data and the measurement of clay or wood models for the development of new products. To generate a surface from measured points by a laser scanner, typical steps include the scanning of a clay or wood model and the generation of manufacturing data like STL file. A laser scanner has a great potential to get geometrical data of a model for its fast measuring speed and higher precision. The data from a laser scanner are composed of many line stripes of points. A new approach to remove point data with Delaunay triangulation is introduced to deal with problems during reverse engineering process. This approach can be used to reduce a number of measuring data from laser scanner within tolerance, thus it can avoid the time for handling point data during modelling process and the time for verifying and slicing STL model during RP process

  5. Triangulation-based edge measurement using polyview optics

    Science.gov (United States)

    Li, Yinan; Kästner, Markus; Reithmeier, Eduard

    2018-04-01

    Laser triangulation sensors as non-contact measurement devices are widely used in industry and research for profile measurements and quantitative inspections. Some technical applications e.g. edge measurements usually require a configuration of a single sensor and a translation stage or a configuration of multiple sensors, so that they can measure a large measurement range that is out of the scope of a single sensor. However, the cost of both configurations is high, due to the additional rotational axis or additional sensor. This paper provides a special measurement system for measurement of great curved surfaces based on a single sensor configuration. Utilizing a self-designed polyview optics and calibration process, the proposed measurement system allows an over 180° FOV (field of view) with a precise measurement accuracy as well as an advantage of low cost. The detailed capability of this measurement system based on experimental data is discussed in this paper.

  6. The Subjectivity Problem: Improving Triangulation Approaches in Metaphor Analysis Studies

    Directory of Open Access Journals (Sweden)

    Sonya L. Armstrong

    2011-06-01

    Full Text Available Metaphor analysis procedures for uncovering participant conceptualizations have been well-established in qualitative research settings since the early 1980s; however, one common criticism of metaphor analysis is the trustworthiness of the findings. Namely, accurate determination of the conceptual metaphors held by participants based on the investigation of linguistic metaphors has been identified as a methodological issue because of the subjectivity involved in the interpretation; that is, because they are necessarily situated in specific social and cultural milieus, meanings of particular metaphors are not universally constructed nor understood. In light of these critiques, this article provides examples of two different triangulation methods that can be employed to supplement the trustworthiness of the findings when metaphor analysis methodologies are used.

  7. Calibration procedure for a laser triangulation scanner with uncertainty evaluation

    Science.gov (United States)

    Genta, Gianfranco; Minetola, Paolo; Barbato, Giulio

    2016-11-01

    Most of low cost 3D scanning devices that are nowadays available on the market are sold without a user calibration procedure to correct measurement errors related to changes in environmental conditions. In addition, there is no specific international standard defining a procedure to check the performance of a 3D scanner along time. This paper aims at detailing a thorough methodology to calibrate a 3D scanner and assess its measurement uncertainty. The proposed procedure is based on the use of a reference ball plate and applied to a triangulation laser scanner. Experimental results show that the metrological performance of the instrument can be greatly improved by the application of the calibration procedure that corrects systematic errors and reduces the device's measurement uncertainty.

  8. Technique Triangulation for Validation in Directed Content Analysis

    Directory of Open Access Journals (Sweden)

    Áine M. Humble PhD

    2009-09-01

    Full Text Available Division of labor in wedding planning varies for first-time marriages, with three types of couples—traditional, transitional, and egalitarian—identified, but nothing is known about wedding planning for remarrying individuals. Using semistructured interviews, the author interviewed 14 couples in which at least one person had remarried and used directed content analysis to investigate the extent to which the aforementioned typology could be transferred to this different context. In this paper she describes how a triangulation of analytic techniques provided validation for couple classifications and also helped with moving beyond “blind spots” in data analysis. Analytic approaches were the constant comparative technique, rank order comparison, and visual representation of coding, using MAXQDA 2007's tool called TextPortraits.

  9. On-Line Metrology with Conoscopic Holography: Beyond Triangulation

    Directory of Open Access Journals (Sweden)

    Ignacio Álvarez

    2009-09-01

    Full Text Available On-line non-contact surface inspection with high precision is still an open problem. Laser triangulation techniques are the most common solution for this kind of systems, but there exist fundamental limitations to their applicability when high precisions, long standoffs or large apertures are needed, and when there are difficult operating conditions. Other methods are, in general, not applicable in hostile environments or inadequate for on-line measurement. In this paper we review the latest research in Conoscopic Holography, an interferometric technique that has been applied successfully in this kind of applications, ranging from submicrometric roughness measurements, to long standoff sensors for surface defect detection in steel at high temperatures.

  10. Evolution of umbilicals in Brazil: optimizing deepwater umbilical applications with thermoplastic hoses and steel tubes

    Energy Technology Data Exchange (ETDEWEB)

    Guerra Neto, Mauro Del [DuPont do Brasil S.A., Barueri, SP (Brazil)

    2008-07-01

    Subsea umbilicals in the past 25 years have evolved in parallel with other subsea oil and gas technologies, as the search for hydrocarbons needed to drive the global economy has led offshore exploration and development companies to seek reserves ever-farther from shore in water thousands of meters deep. Relegated to little more than afterthought status before the push into deep water, modern umbilicals have now become crucial components linking deep water producers to their subsea wells, controlling subsea production systems through hydraulic and electrical power and injecting production chemicals for corrosion-, scale-, and hydrate-inhibition at subsea well heads. Particularly in subsea developments involving several deep water wells, umbilicals today are integral to both the production-system design and the chosen operating strategy. Failure of an umbilical linking a subsea well head in deep water to a host production facility can inflict severe economic consequences upon an operator by impairing production operations or halting production altogether. The additional cost of repairing or replacing a failed umbilical can run into the millions of dollars. As offshore oil and gas production has moved into ever-deeper water, umbilical manufacturers have begun introducing new stronger materials to handle the inherently higher pressures and temperatures. Today, two types of construction are used for fluid conduits in umbilical systems deployed in deep water: thermoplastic hoses and steel tubes. Steel tubes are generally more expensive than thermoplastic hoses, relatively stiff and considered to have high tensile strength, while thermoplastic hoses are extremely flexible and exhibit lower tensile strength. This lower tensile strength of the hoses may be compensated by including steel wire armoring in the umbilical. This also provides the added benefits of additional mechanical protection compared with the equivalent unarmored steel-tubes umbilicals. When either

  11. Strongly minimal triangulations of (S × S )#3 and (S S

    Indian Academy of Sciences (India)

    Introduction. Minimal triangulations play an important role in combinatorial topology. In this regard, lower bounds on the number of vertices needed in a triangulation of a topological space, in terms of its topological invariants, are particulary important. For compact surfaces,. Heawood's inequality is one such lower bound, ...

  12. The Relationship between Marital Satisfaction, Marital Stability, Nuclear Family Triangulation, and Childhood Depression.

    Science.gov (United States)

    Wang, Linna; Crane, D. Russell

    2001-01-01

    Study examined the effect of triangulation on depression in children. Clinical samples and nonclinical samples were taken from Utah and Illinois. Results showed children's depressive symptoms to be most strongly linked to the father's level of marital satisfaction, marital stability, and perceived family triangulation. Mothers' variables did not…

  13. A REST Service for Triangulation of Point Sets Using Oriented Matroids

    Directory of Open Access Journals (Sweden)

    José Antonio Valero Medina

    2014-05-01

    Full Text Available This paper describes the implementation of a prototype REST service for triangulation of point sets collected by mobile GPS receivers. The first objective of this paper is to test functionalities of an application, which exploits mobile devices’ capabilities to get data associated with their spatial location. A triangulation of a set of points provides a mechanism through which it is possible to produce an accurate representation of spatial data. Such triangulation may be used for representing surfaces by Triangulated Irregular Networks (TINs, and for decomposing complex two-dimensional spatial objects into simpler geometries. The second objective of this paper is to promote the use of oriented matroids for finding alternative solutions to spatial data processing and analysis tasks. This study focused on the particular case of the calculation of triangulations based on oriented matroids. The prototype described in this paper used a wrapper to integrate and expose several tools previously implemented in C++.

  14. Evidence-based pathology: umbilical cord coiling.

    Science.gov (United States)

    Khong, T Y

    2010-12-01

    The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

  15. Umbilical artery tone in maternal obesity

    Directory of Open Access Journals (Sweden)

    Glavey Siobhan V

    2009-01-01

    Full Text Available Abstract Background The increasing prevalence of obesity constitutes a major health problem in obstetrics with implications for feto-maternal growth and wellbeing. This study investigated and compared the contractile properties of umbilical arteries excised from obese women, with those excised from women with a normal body mass index (BMI. Methods Sections of umbilical artery were obtained from umbilical cord samples immediately after delivery and mounted for isometric recording in organ tissue baths under physiological conditions. Cumulative additions of 5-Hydroxytryptamine (5-HT and Prostaglandin F-2alpha (PgF2alpha were added in the concentration range of 1 nmol/L to 10 micromol/L. Control vessels were exposed to Krebs physiological salt solution (PSS only. The resultant effects of each drug addition were measured using the Powerlab hardware unit. Results 5-HT exerted a significant effect on human umbilical artery tone at concentrations of 100 nmol/L, 1 micromol/L, and 10 micromol/L in normal (n = 5; P 0.05. Conclusion These findings support the hypothesis that endogenous regulation of umbilical artery tone is altered in association with maternal obesity. This may be linked to the cardiovascular effects of secretory products of adipose tissue, with implications for the feto-maternal circulation.

  16. Is umbilical cord milking always an advantage?

    Science.gov (United States)

    Kilicdag, Hasan; Gulcan, Hande; Hanta, Deniz; Torer, Birgin; Gokmen, Zeynel; Ozdemir, Sonay Incesoy; Antmen, Bulent Ali

    2016-01-01

    The role of cord milking as an alternative to delayed cord clamping is an area that requires more research. Purpose of this clinical trial was to investigate the impact of umbilical cord milking on the absolute neutrophil counts (ANCs) and the neutropenia frequency of preterm infants. Fifty-eight pregnant women were randomly assigned to one of the umbilical cord milking and control groups. A total of 54 preterm infants (gestational age ≤ 32 weeks) were enrolled into the study. The umbilical cords of 25 infants were clamped immediately after birth, and in 29 infants, umbilical cord milking was performed first. The ANCs were statistically significantly lower in the cord milking group compared with the control group on days 1, 3 and 7. The frequency of neutropenia was higher in the cord milking group compared with the control group. In our study, ANCs were lower in the cord milking group and the frequency of neutropenia was higher. Umbilical cord milking plays a role on the ANCs of preterm infants.

  17. Umbilical Cord Care: Do's and Don'ts for Parents

    Science.gov (United States)

    Healthy Lifestyle Infant and toddler health A newborn's umbilical cord stump typically falls off within about two weeks after birth. In the meantime, treat your baby's umbilical cord stump gently. By Mayo Clinic Staff Wonder how ...

  18. Alcohol application natural drying of umbilical cord

    International Nuclear Information System (INIS)

    Shafique, M.F.; Ali, S.; Roshan, E.; Jamal, S.

    2006-01-01

    To compare the outcome, between the application of Alcohol and natural drying to umbilical stump in low risk newborns. Newborns delivered in Military Hospital and Combined Military Hospital Rawalpindi were randomized into group A (70% Alcohol) and group B (No antiseptic). In group A, 70% Alcohol was applied once daily to the umbilical stump, whereas no antiseptic was applied in group B. These newborns were followed till four weeks of life. Age at separation of umbilical cord was noted. Cases showing signs of neonatal sepsis and omphalitis were documented. Of 100 singleton full-term newborns enrolled, 90 completed the study. No newborn in either group developed a cord infection or neonatal sepsis. The difference of cord separation time between the two groups was statistically significant. Evidence does not support continued use of alcohol for low risk newborn cord care. (author)

  19. A Delaunay Triangulation Approach For Segmenting Clumps Of Nuclei

    International Nuclear Information System (INIS)

    Wen, Quan; Chang, Hang; Parvin, Bahram

    2009-01-01

    Cell-based fluorescence imaging assays have the potential to generate massive amount of data, which requires detailed quantitative analysis. Often, as a result of fixation, labeled nuclei overlap and create a clump of cells. However, it is important to quantify phenotypic read out on a cell-by-cell basis. In this paper, we propose a novel method for decomposing clumps of nuclei using high-level geometric constraints that are derived from low-level features of maximum curvature computed along the contour of each clump. Points of maximum curvature are used as vertices for Delaunay triangulation (DT), which provides a set of edge hypotheses for decomposing a clump of nuclei. Each hypothesis is subsequently tested against a constraint satisfaction network for a near optimum decomposition. The proposed method is compared with other traditional techniques such as the watershed method with/without markers. The experimental results show that our approach can overcome the deficiencies of the traditional methods and is very effective in separating severely touching nuclei.

  20. 3D Laser Triangulation for Plant Phenotyping in Challenging Environments.

    Science.gov (United States)

    Kjaer, Katrine Heinsvig; Ottosen, Carl-Otto

    2015-06-09

    To increase the understanding of how the plant phenotype is formed by genotype and environmental interactions, simple and robust high-throughput plant phenotyping methods should be developed and considered. This would not only broaden the application range of phenotyping in the plant research community, but also increase the ability for researchers to study plants in their natural environments. By studying plants in their natural environment in high temporal resolution, more knowledge on how multiple stresses interact in defining the plant phenotype could lead to a better understanding of the interaction between plant responses and epigenetic regulation. In the present paper, we evaluate a commercial 3D NIR-laser scanner (PlantEye, Phenospex B.V., Herleen, The Netherlands) to track daily changes in plant growth with high precision in challenging environments. Firstly, we demonstrate that the NIR laser beam of the scanner does not affect plant photosynthetic performance. Secondly, we demonstrate that it is possible to estimate phenotypic variation amongst the growth pattern of ten genotypes of Brassica napus L. (rapeseed), using a simple linear correlation between scanned parameters and destructive growth measurements. Our results demonstrate the high potential of 3D laser triangulation for simple measurements of phenotypic variation in challenging environments and in a high temporal resolution.

  1. Triangulating Nucleic Acid Conformations Using Multicolor Surface Energy Transfer.

    Science.gov (United States)

    Riskowski, Ryan A; Armstrong, Rachel E; Greenbaum, Nancy L; Strouse, Geoffrey F

    2016-02-23

    Optical ruler methods employing multiple fluorescent labels offer great potential for correlating distances among several sites, but are generally limited to interlabel distances under 10 nm and suffer from complications due to spectral overlap. Here we demonstrate a multicolor surface energy transfer (McSET) technique able to triangulate multiple points on a biopolymer, allowing for analysis of global structure in complex biomolecules. McSET couples the competitive energy transfer pathways of Förster Resonance Energy Transfer (FRET) with gold-nanoparticle mediated Surface Energy Transfer (SET) in order to correlate systematically labeled points on the structure at distances greater than 10 nm and with reduced spectral overlap. To demonstrate the McSET method, the structures of a linear B-DNA and a more complex folded RNA ribozyme were analyzed within the McSET mathematical framework. The improved multicolor optical ruler method takes advantage of the broad spectral range and distances achievable when using a gold nanoparticle as the lowest energy acceptor. The ability to report distance information simultaneously across multiple length scales, short-range (10-50 Å), mid-range (50-150 Å), and long-range (150-350 Å), distinguishes this approach from other multicolor energy transfer methods.

  2. Branches of Triangulated Origami Near the Unfolded State

    Science.gov (United States)

    Chen, Bryan Gin-ge; Santangelo, Christian D.

    2018-01-01

    Origami structures are characterized by a network of folds and vertices joining unbendable plates. For applications to mechanical design and self-folding structures, it is essential to understand the interplay between the set of folds in the unfolded origami and the possible 3D folded configurations. When deforming a structure that has been folded, one can often linearize the geometric constraints, but the degeneracy of the unfolded state makes a linear approach impossible there. We derive a theory for the second-order infinitesimal rigidity of an initially unfolded triangulated origami structure and use it to study the set of nearly unfolded configurations of origami with four boundary vertices. We find that locally, this set consists of a number of distinct "branches" which intersect at the unfolded state, and that the number of these branches is exponential in the number of vertices. We find numerical and analytical evidence that suggests that the branches are characterized by choosing each internal vertex to either "pop up" or "pop down." The large number of pathways along which one can fold an initially unfolded origami structure strongly indicates that a generic structure is likely to become trapped in a "misfolded" state. Thus, new techniques for creating self-folding origami are likely necessary; controlling the popping state of the vertices may be one possibility.

  3. Branches of Triangulated Origami Near the Unfolded State

    Directory of Open Access Journals (Sweden)

    Bryan Gin-ge Chen

    2018-02-01

    Full Text Available Origami structures are characterized by a network of folds and vertices joining unbendable plates. For applications to mechanical design and self-folding structures, it is essential to understand the interplay between the set of folds in the unfolded origami and the possible 3D folded configurations. When deforming a structure that has been folded, one can often linearize the geometric constraints, but the degeneracy of the unfolded state makes a linear approach impossible there. We derive a theory for the second-order infinitesimal rigidity of an initially unfolded triangulated origami structure and use it to study the set of nearly unfolded configurations of origami with four boundary vertices. We find that locally, this set consists of a number of distinct “branches” which intersect at the unfolded state, and that the number of these branches is exponential in the number of vertices. We find numerical and analytical evidence that suggests that the branches are characterized by choosing each internal vertex to either “pop up” or “pop down.” The large number of pathways along which one can fold an initially unfolded origami structure strongly indicates that a generic structure is likely to become trapped in a “misfolded” state. Thus, new techniques for creating self-folding origami are likely necessary; controlling the popping state of the vertices may be one possibility.

  4. Sonographic Assessment of the Umbilical Cord

    Science.gov (United States)

    Bosselmann, S.; Mielke, G.

    2015-01-01

    The umbilical cord (UC) is a vital connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing the fetal mobility that is of great importance for fetal development in general and fetal neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus and these too can be explained to a large extent by the cordʼs structural characteristics. This review article discusses clinically relevant aspects of UC ultrasound. PMID:26366000

  5. Primary umbilical endometriosis: a case report | Muluka | Journal of ...

    African Journals Online (AJOL)

    Umbilical endometriosis is a rare presentation especially in the absence of prior pelvic surgery. This report presents a rare case of symptomatic primary umbilical endometriosis in a 28 year old female who presented with a 2 year history of umbilical mass associated with cyclical bleeding at the time of her menses.

  6. Flattening of the electrocardiographic T-wave is a sign of proarrhythmic risk and a reflection of action potential triangulation

    DEFF Research Database (Denmark)

    Bhuiyan, Tanveer Ahmed; Graff, Claus; Kanters, J.K.

    2013-01-01

    Drug-induced triangulation of the cardiac action potential is associated with increased risk of arrhythmic events. It has been suggested that triangulation causes a flattening of the electrocardiographic T-wave but the relationship between triangulation, T-wave flattening and onset of arrhythmia...

  7. Fast randomized point location without preprocessing in two- and three-dimensional Delaunay triangulations

    Energy Technology Data Exchange (ETDEWEB)

    Muecke, E.P.; Saias, I.; Zhu, B.

    1996-05-01

    This paper studies the point location problem in Delaunay triangulations without preprocessing and additional storage. The proposed procedure finds the query point simply by walking through the triangulation, after selecting a good starting point by random sampling. The analysis generalizes and extends a recent result of d = 2 dimensions by proving this procedure to take expected time close to O(n{sup 1/(d+1)}) for point location in Delaunay triangulations of n random points in d = 3 dimensions. Empirical results in both two and three dimensions show that this procedure is efficient in practice.

  8. A neonate with an intact congenital umbilical appendix: an alternative theory on the etiology of the appendico-umbilical fistula.

    NARCIS (Netherlands)

    Fuijkschot, J.; Wijnen, R.M.H.; Gerrits, G.P.; Dubois, S.V.; Rieu, P.N.M.A.

    2006-01-01

    Neonatal umbilical anomalies usually represent remains of the vitelline duct or the allantois. We describe a case of an umbilical appendix in a neonate. The vermiform appendix was found to be positioned in the umbilical cord. In a brief literature review we found eight other reports concerning

  9. Primary umbilical endometriosis successfully treated with dienogest.

    Science.gov (United States)

    Chew, Kah Teik; Norsaadah, Salim; Suraya, Aziz; Hing, Erica Yee; Ani Amelia, Zainuddin; Nor Azlin, Mohd Ismail; Nur Azurah, Abdul Ghani

    2017-02-01

    Primary umbilical endometriosis (PUE) is a rare gynaecological disorder. A majority of the reported cases were treated with surgical excision as medical treatment had been found to be less successful. We reported a case of PUE successfully treated with dienogest without any profound side effects from the drug.

  10. Relationship between sonographic umbilical cord size and ...

    African Journals Online (AJOL)

    2014-06-02

    Jun 2, 2014 ... Relationship between sonographic umbilical cord size and gestational age among preg- nant women in Enugu, Nigeria. Eze CU1, Ugwuja MC2, Eze CU3, Agwuna KK2, Ugwu GO4. 1. Department of Medical Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, University.

  11. Sonographic diagnosis and clinical significance of umbilical arterial atresia.

    Science.gov (United States)

    Ren, Jinhe

    2017-05-01

    To evaluate the feasibility of antenatal sonographic diagnosis of umbilical arterial atresia and its clinical significance. Data of 5 cases with umbilical arterial atresia diagnosed in our hospital were studied retrospectively. The antenatal ultrasonogram of umbilical arterial atresia was obtain, and the pathological examination of umbilical cords and the prognosis of neonates were analyzed. Among 5 cases with umbilical arterial atresia in this group, 1 case with double umbilical arterial atresia was found with dead fetus in uterus, and the rest 4 cases with single umbilical arterial atresia were found with survival fetuses. In the latter 4 cases with live fetus, once umbilical arterial atresia was diagnosed, cesarean section was performed to terminate pregnancy, and the 4 fetus were all healthy. The chromosome karyotypes and S/D value of umbilical arteries were showed normal in all 5 cases. Accurate antenatal diagnosis can be made according to the specific ultrasonogram of umbilical arterial atresia. Instant intervention should be performed upon observing umbilical arterial atresia with live fetus, so as to avoid dead fetus as much as possible.

  12. A study on the effect of different image centres on stereo triangulation accuracy

    CSIR Research Space (South Africa)

    De Villiers, J

    2015-11-01

    Full Text Available This paper evaluates the effect of mixing the distortion centre, principal point and arithmetic image centre on the distortion correction, focal length determination and resulting real-world stereo vision triangulation. A robotic arm is used...

  13. Explicating students’ personal professional theories in vocational education through multi-method triangulation

    NARCIS (Netherlands)

    Schaap, Harmen; De Bruijn, Elly; Van der Schaaf, Marieke; Baartman, Liesbeth; Kirschner, Paul A.

    2011-01-01

    Schaap, H., De Bruijn, E., Van der Schaaf, M. F., Baartman, L. K. J., & Kirschner, P. A. (2011). Explicating students’ personal professional theories in vocational education through multi-method triangulation. Scandinavian Journal of Educational Research, 55, 567-586.

  14. A multicentre prospective randomised study of single-incision mini-sling (Ajust®) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes.

    Science.gov (United States)

    Mostafa, Alyaa; Agur, Wael; Abdel-All, Mohamed; Guerrero, Karen; Lim, Chi; Allam, Mohamed; Yousef, Mohamed; N'Dow, James; Abdel-fattah, Mohamed

    2012-11-01

    To compare the postoperative pain profile, peri-operative details, and short-term patient-reported and objective success rates of single-incision mini-slings (SIMS) versus standard mid-urethral slings (SMUS). In a multicentre prospective randomised trial in six UK centres in the period between October 2009 and October 2010, 137 women were randomised to either adjustable SIMS (Ajust®, C. R. Bard Inc., NJ, USA), performed under local anaesthesia as an opt-out policy (n=69), or SMUS (TVT-O™, Ethicon Inc., Somerville, USA) performed under general anaesthesia (n=68). Randomisation was done through number-allocation software and using telephone randomisation. Postoperative pain profile (primary outcome) was assessed on a ten-point visual analogue scale at fixed time-points. Pre- and post operatively (4-6 months) women completed symptom severity, urgency perception scale (UPS), quality of life and sexual function questionnaires. In addition, women completed a Patient Global Impression of Improvement Questionnaire and underwent a cough stress test at 4-6 months follow up. Sample size calculation was performed and data were analysed using SPSS 18. Descriptive analyses are given and between-group comparisons were performed using chi-square, Fischer exact test and Mann-Whitney test as appropriate. Significance level was set at 5%. Women in the SIMS Ajust® group had a significantly lower postoperative pain profile up to 4 weeks (p=TVT-O™ groups respectively. There was a trend towards higher rates of de novo urgency or worsening of pre-existing urgency in the SIMS Ajust® group (21.7% versus 8.8%) but this did not reach statistical significance (p=0.063). Women in the SIMS Ajust® group had shorter hospital stay (median (IQR) 3.65 (2.49, 4.96)) compared to (4.42 (3.16, 5.56)) the TVT-O™ group 95% CI (-0.026, 1.326), with significantly earlier return to normal activities (p=0.025) and to work (p=0.006). The adjustable single-incision mini-sling (Ajust®) is associated

  15. Thickness and topographic inspection of RPG contact lenses by optical triangulation

    Science.gov (United States)

    Costa, Manuel F. M.

    2001-06-01

    Optical triangulation as a non-destructive test method extensively proved its usefulness on the dimensional and topographic inspection of a large range of objects and surfaces. In this communication the issue of microtopographic and thickness inspection of hard contact lenses (RPG) is addressed. The use of optical triangulation is discussed based on the results of the application of our MICROTOP.03.MFC microtopographer to this kind of tasks will be presented.

  16. The site of attachment of umbilical cord and branching pattern of umbilical arteries within the placenta.

    Science.gov (United States)

    Begum, T; Khalil, M; Rahman, M M; Shen, S; Sultana, S Z; Mannan, S; Ara, Z G; Chowdhury, A I; Haque, M A; Ara, A

    2014-10-01

    Placenta is the mirror of maternal and fetal status; it reflects the changes due to complication in pregnancy of mother. Numerous common and uncommon findings of the placenta, umbilical cord and membranes are associated with abnormal fetal development and perinatal morbidity. So, the examination of the placenta can yield information that may be important in the immediate and later management of mother and newborn. This information may also be essential for protecting the attending physician in the event of an adverse maternal or fetal outcome. This cross sectional descriptive study was carried out to determine the incidence of different types of placenta depending on attachment site and branching pattern of arteries of umbilical cord in Bangladeshi Women. To achieve this aim sixty placenta with umbilical cord were collected. Placenta was from 28 weeks to 42 weeks gestational age of normal pregnancy during normal labour at gynaecology and obstetric department of Mymensingh Medical College Hospital. After preservation in 10% formol saline, study was done in the Department of Anatomy of Mymensingh Medical College. In the present study, incidence of different types of placenta depending on attachment site of umbilical cord was 50% Central, 46% Paracentral and 18% Marginal in type. In this study it was also observed that 58% placenta were Disperse in type and 42% were Magistral in type depending on the distribution of umbilical arteries. Observed findings of this study were compared with those of Western and Bangladeshi researchers.

  17. Postpartum deaths: piglet, placental, and umbilical characteristics.

    Science.gov (United States)

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2013-06-01

    The fetal growth of the piglet is highly dependent on its placenta, and the newborn piglet birth weight is highly associated with postpartum death. However, there is little information available in the literature on the assessment of the placenta in relation to postpartum death in piglets. The aim of this study was to evaluate the impact of the placental area and placental weight, status of the umbilical cord, and piglet birth characteristics, such as blood parameters, vitality score, and birth weight on postpartum death. All live born piglets in litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each was recorded, including placental area and placental weight and blood variables obtained from the piglets and umbilical veins. Out of the 386 live-born piglets, 16.8% died before weaning at 5 wk. Among these, 78.5% died within the first 3 d of life. Mean blood concentration of lactate was increased in piglets that did not survive to weaning (P = 0.003). Concentrations of hemoglobin and hematocrit were decreased (P vitality score vs. piglets born with an intact umbilical cord (P = 0.021), and they had an increased probability of dying before weaning (P = 0.050). Mean birth weight, body mass index, placental area (P live litter size. Blood concentrations of IgG and albumin recorded at d 1 were decreased in piglets that died before weaning (P < 0.01), and blood concentration of albumin was positively associated with placental area (P < 0.001). We conclude that placental area and placental weight, status of the umbilical cord, birth weight, body mass index, blood concentrations of lactate, hemoglobin, and hematocrit recorded at birth, and blood concentrations of IgG and albumin recorded at d 1 were associated with postpartum death in this study. These results may indicate that there is an upper uterine limitation of litter size and that placental area and placental weight influence postpartum survival.

  18. The recurrent true umbilical cord knots: a case report

    Directory of Open Access Journals (Sweden)

    I Naghi

    2012-11-01

    Full Text Available Background: True umbilical cord knot is one of the abnormalities of the umbilical cord. Active fetal movements create cord knotting. True umbilical cord knots are rare but may be associated with fetal distress and stillbirth. True umbilical cord knots are capable of impeding blood flow to the fetus.Case presentation: A 26-year old primigravid woman was first treated for genital herpes simplex virus (HSV type 2 at 36 weeks of gestational age. She received oral acyclovir (400 mg three times daily for 10 days. At the gestational age of 38 weeks and 5 days, fetal activity decreased and NST was nonreactive. She was delivered by cesarean section and a true umbilical cord knot was found. Four years later, in her second pregnancy, another true knot was seen.Conclusion: Excessively long umbilical cords are more likely to be associated with true knots. Genetics has an important role in determining cord length and occurrence of true knots.

  19. Umbilical Cord Blood: Counselling, Collection, and Banking.

    Science.gov (United States)

    Armson, B Anthony; Allan, David S; Casper, Robert F

    2015-09-01

    To review current evidence regarding umbilical cord blood counselling, collection, and banking and to provide guidelines for Canadian health care professionals regarding patient education, informed consent, procedural aspects, and options for cord blood banking in Canada. Selective or routine collection and banking of umbilical cord blood for future stem cell transplantation for autologous (self) or allogeneic (related or unrelated) treatment of malignant and non-malignant disorders in children and adults. Cord blood can be collected using in utero or ex utero techniques. Umbilical cord blood counselling, collection, and banking, education of health care professionals, indications for cord blood collection, short- and long-term risk and benefits, maternal and perinatal morbidity, parental satisfaction, and health care costs. Published literature was retrieved through searches of Medline and PubMed beginning in September 2013 using appropriate controlled MeSH vocabulary (fetal blood, pregnancy, transplantation, ethics) and key words (umbilical cord blood, banking, collection, pregnancy, transplantation, ethics, public, private). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to September 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Umbilical cord blood is a readily available source of hematopoetic stem cells used with increasing frequency as an alternative to

  20. [Origin and development of umbilical therapy in traditional Chinese medicine].

    Science.gov (United States)

    Zhang, Xue-Wei; Jia, Hong-Ling

    2014-06-01

    The origin and development of umbilical therapy in traditional Chinese medicine is explored from related literature in the history. As a result, the Shang period is regarded as initial period of umbilical therapy, while periods from Han Dynasty, Jin Dynasty and Southern-Northern Dynasties to Sui Dynasty and Tang Dynasty could be taken as stage of primary development. Time from Song Dynasty, Jin Dynasty and Yuan Dynasty to Ming and Qing Dynasties is believed as mature stage. Also the manipulation, application principle, indications and contraindications of umbilical therapy are explained. A brief overview of modern development of umbilical therapy is also described.

  1. Single-incision laparoscopic surgery and conventional laparoscopic ...

    African Journals Online (AJOL)

    Indications for surgery included grades II-III varicocele or ipsilateral testicular hypotrophy. The SIL-V procedure was performed in 44 patients with roticulating and conventional 5 mm instruments. Testicular vessels were isolated “en bloc,” clipped and cut. Operating time, visual analogue scale and post-operative results were ...

  2. Bariatric single incision laparoscopic surgery – review of initial experience

    Directory of Open Access Journals (Sweden)

    Agata Frask

    2011-03-01

    Full Text Available The aim of this review was to assess the results of published experience with bariatric SILS surgery, with a particular focus on treatment feasibility and safety. An EMBASE and MEDLINE database search was performed identifying 13 articles totalling 87 patients in the laparoscopic adjustable gastric banding (LAGB group, 10 patients in the laparoscopic sleeve gastrectomy (LSG group, and 1 patient in the Roux-en-Y SILS group. In most series the learning curve was steep and operating times halved with time, reaching 53 min for LAGB and 90 min for LSG. In single case reports using strict selection criteria patients were discharged up to 24 hours following surgery. Treatment safety was satisfactory. Only two studies reported some minor complications with rates of up to 9.8%, including port malposition, port site infection, and seroma or haematoma formation. There were no complications in other studies. LAGB, LSG and Roux-en-Y surgeries were feasible although technically demanding and difficult.

  3. Single Incision Laparoscopic Surgery for a Large Endometriotic Cyst

    African Journals Online (AJOL)

    In the last decade, laparoscopy has become the standard treatment for many gynecological conditions.[1,2] Today, laparoscopy is hailed as the standard approach in the surgical treatment of benign adnexal pathology.[1,2] Attempts to minimize access-related injuries and complications resulted in development of single port ...

  4. Triangulation and the importance of establishing valid methods for food safety culture evaluation.

    Science.gov (United States)

    Jespersen, Lone; Wallace, Carol A

    2017-10-01

    The research evaluates maturity of food safety culture in five multi-national food companies using method triangulation, specifically self-assessment scale, performance documents, and semi-structured interviews. Weaknesses associated with each individual method are known but there are few studies in food safety where a method triangulation approach is used for both data collection and data analysis. Significantly, this research shows that individual results taken in isolation can lead to wrong conclusions, resulting in potentially failing tactics and wasted investments. However, by applying method triangulation and reviewing results from a range of culture measurement tools it is possible to better direct investments and interventions. The findings add to the food safety culture paradigm beyond a single evaluation of food safety culture using generic culture surveys. Copyright © 2017. Published by Elsevier Ltd.

  5. Robotic tool positioning process using a multi-line off-axis laser triangulation sensor

    Science.gov (United States)

    Pinto, T. C.; Matos, G.

    2018-03-01

    Proper positioning of a friction stir welding head for pin insertion, driven by a closed chain robot, is important to ensure quality repair of cracks. A multi-line off-axis laser triangulation sensor was designed to be integrated to the robot, allowing relative measurements of the surface to be repaired. This work describes the sensor characteristics, its evaluation and the measurement process for tool positioning to a surface point of interest. The developed process uses a point of interest image and a measured point cloud to define the translation and rotation for tool positioning. Sensor evaluation and tests are described. Keywords: laser triangulation, 3D measurement, tool positioning, robotics.

  6. Differences in newborn umbilical cord care

    Directory of Open Access Journals (Sweden)

    Sanja Kanisek

    2015-08-01

    Full Text Available Aim To investigate the frequency of different cord care practices as well recommendations to parents on cord care, along with the need to identify as well as reach the consensus on best cord care practices and other procedures in newborn care among health workers. Methods The study was conducted among 110 health care workers at the nursery departments in two general hospitals, six community-health nursing services and 16 pediatric practices in Eastern Croatia. The questionnaire created for this research has evaluated different cord care practices and recommendations to parents, a need to identify, as well as reach the consensus on best practices in cord care and other procedures in newborn care. Results Statistically significant differences have been found among respondent groups in three “dry“ cord practices (p=0.000, p=0.002, and p=0.004, respectively and three “wet“ cord practices (p=0.000, p=0.001, and p=0.000, respectively. Significant differences were determined in three types of recommendations to parents about the care of ”dry” cord (p=0.000, p=0.000, and p=0.002, respectively and two recommendations for ”wet” cord (p =0.000, p=0.000, respectively. The majority of respondents stressed the need for publishing guidelines on cord care, 104 (94.5%, and for other procedures in newborn care, 108 (98.2%. More than a half of respondents, 63 (57.3%, declared the need to reach a national agreement on guidelines for umbilical cord care. Conclusion Healthcare workers employ, as well as recommend, different umbilical cord care practices. It is necessary to prepare and reach a national agreement on written guidelines for umbilical cord care as well as for other procedures in newborn care.

  7. Umbilicoplasty in children with huge umbilical hernia

    Directory of Open Access Journals (Sweden)

    Akakpo-Numado Gamedzi Komlatsè

    2014-01-01

    Full Text Available Background: Huge umbilical hernias (HUH are voluminous umbilical hernia (UH that are frequent in black African children. Several surgical techniques are used in their treatment for umbilical reconstruction, but techniques using skin flaps provide better aesthetic results. In this study, we presented our technique of umbilicoplasty in HUH, and its results. Patients and Methods: It is a retrospective study on children treated for HUH, from January 2012 to December 2013. The UH was called HUH when its basis diameter (BD exceeds 3 cm. Every HUH was characterised by its height, BD and morphology. Our technique was a two lateral flaps technique; the flaps are symmetrical and drawn so as to reconstitute the different parts of the umbilicus. The results were appreciated with criteria, including the peripheral ring and the central depression of the neo-umbilicus. Results : Twelve children were concerned (7 boys and 5 girls. Their mean age was 5 years and 6 months. The mean BD was 5.6 cm (extremes 3 and 8 cm, and the mean height of the HUH was 7.45 cm (extremes 3 and 9 cm. All underwent umbilicoplasty. In early post-operative period, two children presented a transitory subcutaneous hematoma. Late complications were granulation tissue with two children, and cheloid scar with one. With a mean follow-up of 10 months, we had 10 excellent results and two fair results according to our criteria. Conclusion: Our two lateral flaps umbilicoplasty is well-adapted to HUH in children. It is simple and assures a satisfactory anatomical and cosmetic result.

  8. umbilical cord parameters in ilorin: correlates and foetal outcome

    African Journals Online (AJOL)

    2014-08-08

    Aug 8, 2014 ... The foetal outcomes were assessed by APGAR scores, birth weight, admission to neonatal intensive ... between the umbilical cord parameters and perinatal events such as Apgar scores and birth weight. .... Suzuki S, Fuse Y. Length of the Umbilical Cord and. Perinatal Outcomes in Japanese Singleton ...

  9. Y-to-V umbilicoplasty for proboscoid umbilical hernia

    African Journals Online (AJOL)

    Background/purpose Several techniques are proposed for reconstruction of proboscoid umbilical hernia in the pediatric patients. In this work, we reported our experience with Y-to-V umbilicoplasty in the surgical repair of proboscoid umbilical hernia in infants and children. Patients and methods A 3-year prospective study.

  10. Haemorheological parameters of umbilical cord blood of Nigerian ...

    African Journals Online (AJOL)

    Background: Published reports of haemorheological values of umbilical cord blood in Nigerian newborns are relatively scanty. The present study therefore aimed to determine the values of some basic haemorheological parameters in the umbilical cord blood of Nigerian neonates and in the venous blood of their respective ...

  11. The umbilical coiling index, a review of the literature

    NARCIS (Netherlands)

    de Laat, Monique W. M.; Franx, Arie; van Alderen, Elise D.; Nikkels, Peter G. J.; Visser, Gerard H. A.

    2005-01-01

    Our aim was to review the literature on umbilical cord coiling. Relevant articles in English published between 1966 and 2003 were retrieved by a Medline search and cross-referencing. The normal umbilical cord coiling index (UCI) is 0.17 (+/- 0.009) spirals completed per cm. Abnormal cord coiling,

  12. Evaluation of home care management of umbilical cord stumps by ...

    African Journals Online (AJOL)

    Background: Umbilical cord care is an integral part of neonatal care in all communities and cultures and appropriate cord care reduces the risk of infection in the newborn infant. Objective: The present study assessed the home care management of the umbilical stump by the mothers at Ilesa, Southwestern Nigeria. Subjects ...

  13. Umbilical site for temporary colostomy in anorectal malformations: is ...

    African Journals Online (AJOL)

    Umbilical site for temporary colostomy in anorectal malformations: is it cosmetically preferable? Taha Alkhatrawi, Radi Elsherbini and Djamal Ouslimane. Purpose In an attempt to minimize the scars and improve the cosmetic outcome in children, the umbilical site has been chosen for colostomy formation in patients with.

  14. umbilical cord parameters in ilorin: correlates and foetal outcome

    African Journals Online (AJOL)

    2014-08-08

    Aug 8, 2014 ... hydrocele, achondroplasia, choanal atresia. In addition, there was no statistical correlation between the umbilical cord parameters and perinatal events such as Apgar scores and birth weight. Table 3. The comparison between the umbilical cord parameters and occurrence of congenital abnormalities.

  15. Certain Red Blood Cell Indices of Maternal and Umbilical Cord ...

    African Journals Online (AJOL)

    Uche

    blood samples were obtained immediately after delivery of the baby. The umbilical blood samples were collected from the umbilical cord of the baby at the end of the second stage of labour. The haemoglobin (Hb) concentration and packed cell volume (PCV) were determined using standard procedures. The mean ...

  16. Y-to-V umbilicoplasty for proboscoid umbilical hernia | Almetaher ...

    African Journals Online (AJOL)

    Background/purpose Several techniques are proposed for reconstruction of proboscoid umbilical hernia in the pediatric patients. In this work, we reported our experience with Y-to-V umbilicoplasty in the surgical repair of proboscoid umbilical hernia in infants and children. Patients and methods A 3-year prospective study ...

  17. Umbilicoplasty in children with huge umbilical hernia | Komlatsè ...

    African Journals Online (AJOL)

    With a mean follow-up of 10 months, we had 10 excellent results and two fair results according to our criteria. Conclusion: Our two lateral fl aps umbilicoplasty is well-adapted to HUH in children. Itis simple and assures a satisfactory anatomical and cosmetic result. Key words: Children, huge umbilical hernia, Togo, umbilical ...

  18. Umbilical cord ulceration and jejunal atresia | Mackay | South ...

    African Journals Online (AJOL)

    The association between umbilical cord ulceration and congenital intestinal atresia is being increasingly reported and carries a high mortality. We report on a case of jejunal atresia associated with massive fetal haemorrhage from an umbilical cord ulcer. Fetal distress noted on continuous fetal heart monitoring allowed for ...

  19. Correlation between Umbilical Cord Length, Birth Weight and ...

    African Journals Online (AJOL)

    Background: The umbilical cord and placenta have been considered to significantly contribute to the perinatal outcome. However, in our environment attempt at exploring its use has been limited due to sociocultural believes. This study aimed to identify the relationship between the umbilical cord length, newborn length and ...

  20. Risk factors and perinatal outcome of umbilical cord prolapse in ...

    African Journals Online (AJOL)

    2001-07-01

    Aim: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse. Materials and Methods: During the period of the study (from July 1, 2001 and June 30, 2007), forty-six cases of umbilical cord prolapse were identified from the labor ...

  1. Congenital hernia of the umbilical cord associated with extracelomic ...

    African Journals Online (AJOL)

    Congenital hernia of the umbilical cord (CHUC) is a rare congenital entity compared to more common post-natally occurring umbilical hernia. Although recognized as a distinct entity since 1920s, CHUC is often misdiagnosed as a small omphalocele, resulting in its underreporting. We present the first case report of CHUC ...

  2. Umbilical cord parameters in Ilorin: correlates and foetal outcome ...

    African Journals Online (AJOL)

    Background: The anthropometric parameters of the umbilical cord have clinical significance. Current parameters of the cord, its correlates and related foetal outcome are lacking in our parturients. Objectives: To describe the anthropometric parameters and abnormalities of the umbilical cord; and determine their maternal ...

  3. Cost-effectiveness of private umbilical cord blood banking.

    Science.gov (United States)

    Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

    2009-10-01

    To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

  4. Laparoscopy-Assisted Appendectomy via the patent umbilical ring ...

    African Journals Online (AJOL)

    Umbilical hernia aswell as acute appendicitis are two of the most common problems seen by paediatric surgeons, although rarely simultaneously. When detected the operative approach is adjusted. We perform the a laparoscopically assisted appendectomy trough through the an excised umbilical hernia sac opening.

  5. Survey of Umbilical Cord care and Separation time in Healthy ...

    African Journals Online (AJOL)

    Background: The interval between delivery and umbilical cord separation varies worldwide. Some maternal, foetal and perinatal factors including cord care practices are known to affect this interval. Objectives: To establish the mean umbilical cord separation time and the effect of maternal and infant characteristics, perinatal ...

  6. CMS ECAL Endcap (EE) - Preparatory work for umbilical noise studies

    CERN Multimedia

    Lodge, T

    2007-01-01

    Possible mapping solution, done inside connector, top and bottom sides of MB MB with umbilical + free pins, all identical until position on Dee known Then pins to connector in specific order for that position. All SC umbilicals to mating connector identical.

  7. Umbilical cord coiling index and perinatal outcome.

    Science.gov (United States)

    Patil, Nivedita S; Kulkarni, Sunanda R; Lohitashwa, Renu

    2013-08-01

    To evaluate the perinatal outcome with the abnormal umbilical cord coiling index. This prospective study was carried out in the department of OBG at Adichunchangiri Institute of Medical Sciences, B.G.Nagara, Mandya, Karnataka, India from January 2008 to August 2010. 200 patients who were in active labour with term gestations, irrespective of their parities, who had singleton pregnancies with live babies who were either delivered by vaginal or LSCS were included in the study. Umbilical cord coiling index was calculated and it was correlated with various perinatal parameters like birth weight, meconium stained liquor, Apgar score, ponderal index and foetal growth restriction. Chi square and Fisher exact tests were used to find the significance of study parameters. There was a significant correlation between the hypercoiled cords (UCI >90(th) percentile) and IUGR of the babies (p value of UCI which was UCI which was > 90(th) percentile was associated with IUGR and low ponderal indices. Hypocoiled cords or UCI which was <10th percentile was associated with meconium staining, Apgar score at 1 min of <4 and at 5 min of <7, more LSCS rates and more NICU admissions.

  8. Human umbilical cord derivatives regenerate intervertebral disc.

    Science.gov (United States)

    Beeravolu, Naimisha; Brougham, Jared; Khan, Irfan; McKee, Christina; Perez-Cruet, Mick; Chaudhry, G Rasul

    2016-09-30

    Intervertebral disc (IVD) degeneration is characterized by the loss of nucleus pulposus (NP), which is a common cause for lower back pain. Although, currently, there is no cure for the degenerative disc disease, stem cell therapy is increasingly being considered for its treatment. In this study, we investigated the feasibility and efficacy of human umbilical cord mesenchymal stem cells (MSCs) and chondroprogenitor cells (CPCs) derived from those cells to regenerate damaged IVD in a rabbit model. Transplanted cells survived, engrafted and dispersed into NP in situ. Significant improvement in the histology, cellularity, extracellular matrix proteins, and water and glycosaminoglycan contents in IVD recipients of CPCs was observed compared to MSCs. In addition, IVDs receiving CPCs exhibited higher expression of NP-specific human markers, SOX9, aggrecan, collagen 2, FOXF1 and KRT19. The novelty of the study is that in vitro differentiated CPCs derived from umbilical cord MSCs, demonstrated far greater capacity to regenerate damaged IVDs, which provides basis and impetus for stem cell based clinical studies to treat degenerative disc disease. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Making the Most of Obesity Research: Developing Research and Policy Objectives through Evidence Triangulation

    Science.gov (United States)

    Oliver, Kathryn; Aicken, Catherine; Arai, Lisa

    2013-01-01

    Drawing lessons from research can help policy makers make better decisions. If a large and methodologically varied body of research exists, as with childhood obesity, this is challenging. We present new research and policy objectives for child obesity developed by triangulating user involvement data with a mapping study of interventions aimed at…

  10. Modelling and calibration of the laser beam-scanning triangulation measurement system

    NARCIS (Netherlands)

    Wang, G.Y.; Zheng, Bing; Li, Xin; Houkes, Z.; Regtien, Paulus P.L.

    2002-01-01

    We present an approach of modelling and calibration of an active laser beam-scanning triangulation measurement system. The system works with the pattern of two-dimensional beam-scanning illumination and one-dimensional slit-scanning detection with a photo-multiplier tube instead of a CCD camera. By

  11. The Marginalized "Model" Minority: An Empirical Examination of the Racial Triangulation of Asian Americans

    Science.gov (United States)

    Xu, Jun; Lee, Jennifer C.

    2013-01-01

    In this article, we propose a shift in race research from a one-dimensional hierarchical approach to a multidimensional system of racial stratification. Building upon Claire Kim's (1999) racial triangulation theory, we examine how the American public rates Asians relative to blacks and whites along two dimensions of racial stratification: racial…

  12. Generation of triangulated random surfaces by the Monte Carlo method in the grand canonical ensemble

    International Nuclear Information System (INIS)

    Zmushko, V.V.; Migdal, A.A.

    1987-01-01

    A model of triangulated random surfaces which is the discrete analog of the Polyakov string is considered. An algorithm is proposed which enables one to study the model by the Monte Carlo method in the grand canonical ensemble. Preliminary results on the determination of the critical index γ are presented

  13. The Movement of Conflict in Organizations: The Joint Dynamics of Splitting and Triangulation.

    Science.gov (United States)

    Smith, Kenwyn K.

    1989-01-01

    Based on a long-term public school system study, the paper examines the sociopsychological process through which conflicts move around in organizations and are transported from one place to another. The conceptualization draws on "triangulation" from social psychology and family therapy and "splitting," developed in…

  14. New lower bounds for the number of straight-edge triangulations of a planar point set

    OpenAIRE

    McCabe, Paul; Seidel, Raimund

    2004-01-01

    We present new lower bounds on the number of straight-edge triangulations that every set of n points in plane must have. These bounds are better than previous bounds in case of sets with either many or few extreme points.

  15. Explicating Students' Personal Professional Theories in Vocational Education through Multi-method Triangulation.

    NARCIS (Netherlands)

    P. Kirschner; Prof.Dr. Elly de Bruijn; Dr. Liesbeth Baartman; M. van der Schaaf; Dr. Harmen Schaap

    2011-01-01

    In competence-based vocational education, personal professional theories, in which students integrate different types of knowledge and beliefs, are seen as important. Exactly how these theories can be measured is the main focus of this study, which uses a multi-method triangulation approach, an

  16. Evaluation of methods to test chemicals suitability for umbilical applications

    Energy Technology Data Exchange (ETDEWEB)

    Allenson, S. J.; Lindeman, O. E.; Cenegy, L. M.

    2006-03-15

    Offshore deep-water projects are increasingly deploying chemicals to sub-sea wellheads through umbilical lines. There is no margin for error in umbilical chemical treatment programs since any flow blockage in a sub-sea line would result in a multi-million dollar problem. Chemicals for umbilical delivery must also meet strict requirements in their performance and especially their handling properties. Umbilical delivery must be effective at low concentrations in preventing corrosion, scale, hydrates, asphaltenes, paraffin and a host of other problems. Chemical transiting an umbilical can experience pressures as high as 15,000 psi and temperatures ranging from near 0 deg C to greater than 120 deg C. Since some umbilicals are as long as 80 km, a week or more can elapse from the time the chemical is injected at the platform until it reaches the sub-sea well. Therefore, the chemical must not only be stable under all temperature and pressure conditions that it may experience in the umbilical line, it must also be stable under these conditions for a long period of time. Since many umbilical lines actually terminate into sub-sea valves and connectors that are only a few hundred microns in diameter, it is critical that the injected chemical have a low viscosity at sub-sea temperatures and pressures and that it be completely free of particles. These issues present substantial challenges in formulating and manufacturing chemicals for umbilical applications that must be addressed prior to approval of a product for use. Each of these challenges was taken into consideration and a series of tests were developed to assure reliable chemical pump ability through an umbilical line. The tests developed included enhanced formulation stability tests under umbilical temperature and pressure conditions, NAS Class rating, extensive material compatibility testing to include all metals and elastomers that may be used in umbilical injection systems and comprehensive physical property testing

  17. Application of 3D triangulations of airborne laser scanning data to estimate boreal forest leaf area index

    Science.gov (United States)

    Majasalmi, Titta; Korhonen, Lauri; Korpela, Ilkka; Vauhkonen, Jari

    2017-07-01

    We propose 3D triangulations of airborne Laser Scanning (ALS) point clouds as a new approach to derive 3D canopy structures and to estimate forest canopy effective LAI (LAIe). Computational geometry and topological connectivity were employed to filter the triangulations to yield a quasi-optimal relationship with the field measured LAIe. The optimal filtering parameters were predicted based on ALS height metrics, emulating the production of maps of LAIe and canopy volume for large areas. The LAIe from triangulations was validated with field measured LAIe and compared with a reference LAIe calculated from ALS data using logarithmic model based on Beer's law. Canopy transmittance was estimated using All Echo Cover Index (ACI), and the mean projection of unit foliage area (β) was obtained using no-intercept regression with field measured LAIe. We investigated the influence species and season on the triangulated LAIe and demonstrated the relationship between triangulated LAIe and canopy volume. Our data is from 115 forest plots located at the southern boreal forest area in Finland and for each plot three different ALS datasets were available to apply the triangulations. The triangulation approach was found applicable for both leaf-on and leaf-off datasets after initial calibration. Results showed the Root Mean Square Errors (RMSEs) between LAIe from triangulations and field measured values agreed the most using the highest pulse density data (RMSE = 0.63, the coefficient of determination (R2) = 0.53). Yet, the LAIe calculated using ACI-index agreed better with the field measured LAIe (RMSE = 0.53 and R2 = 0.70). The best models to predict the optimal alpha value contained the ACI-index, which indicates that within-crown transmittance is accounted by the triangulation approach. The cover indices may be recommended for retrieving LAIe only, but for applications which require more sophisticated information on canopy shape and volume, such as radiative transfer models, the

  18. Doppler ultrasound scan during normal gestation: umbilical circulation; Ecografia Doppler en la gestacion normal: circulacion umbilical

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz, T.; Sabate, J.; Martinez-Benavides, M. M.; Sanchez-Ramos, J. [Hospital Virgen Macarena. Sevilla (Spain)

    2002-07-01

    To determine normal umbilical circulation patterns by means of Doppler ultrasound scan in a healthy gestating population without risk factors and with normal perinatal results, and to evaluate any occurring modifications relative to gestational age by obtaining records kept during pregnancy. One hundred and sixteen pregnant women carrying a single fetus have been studied. These women had no risk factors, with both clinical and analytical controls, as well as ultrasound scans, all being normal. There were performed a total of 193 Doppler ultrasound scans between weeks 15 and 41 of gestation, with blood-flow analysis in the arteries and vein of the umbilical cord. The obtained information was correlated with parameters that evaluate fetal well-being (fetal monitoring and/or oxytocin test) and perinatal result (delivery type, birth weight, Apgar score). Statistical analysis was performed with the programs SPSS 6.0.1 for Windows and EPIINFO 6.0.4. With pulsed Doppler, the umbilical artery in all cases demonstrated a biphasic morphology with systolic and diastolic components and without retrograde blood flow. As the gestation period increased, there was observed a progressive decrease in resistance along with an increase in blood-flow velocity during the diastolic phase. The Doppler ultrasound scan is a non-invasive method that permits the hemodynamic study of umbilical blood circulation. A knowledge of normal blood-flow signal morphology, as well as of the normal values for Doppler indices in relation to gestational age would permit us to utilize this method in high-risk pregnancies. (Author) 30 refs.

  19. Maternal diabetes induces changes in the umbilical cord gene expression.

    Science.gov (United States)

    Koskinen, A; Lehtoranta, L; Laiho, A; Laine, J; Kääpä, P; Soukka, H

    2015-07-01

    Since maternal diabetes may affect fetal development and the umbilical cord provides an extension of the fetal vasculature, we decided to investigate cords' biological responses to maternal diabetic milieu. Using microarray analysis, we determined the gene expression profiles in the umbilical cords of six neonates born to type 1 diabetic mothers and in six control cords. Umbilical cord tissue was collected immediately after elective cesarean section. Expression data were confirmed by real-time polymerase chain reaction (11 genes). Additionally, the same umbilical cords were analyzed histologically. Two hundred eighty six genes were differentially expressed in the umbilical cords from diabetic pregnancies compared to the controls (fold change ±1.5 and P umbilical cord expression of genes involved in the regulation of vascular development and function with simultaneous umbilical vessel muscle layer thickening. These alterations suggest vascular phenotypic modifications, which in turn may lead to long-term vascular consequences in various tissues in infants of diabetic mothers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Maternal predictors and quality of umbilical cord blood units.

    Science.gov (United States)

    Bielec-Berek, Beata; Jastrzębska-Stojko, Żaneta; Drosdzol-Cop, Agnieszka; Jendyk, Cecylia; Boruczkowski, Dariusz; Ołdak, Tomasz; Nowak-Brzezińska, Agnieszka; Stojko, Rafał

    2018-03-01

    The aim of the study was to determine the relationship between the maternal age at delivery and selected properties of the cord blood stem cells. The study included 50 pregnant women aged between 18 and 38 years in which spontaneous labors or elective cesarean sections were performed. Umbilical cord blood was collected immediately after the women were delivered of newborns. The samples were analyzed in the Polish Stem Cells Bank in Warsaw. The highest mean WBC level (p umbilical cord blood collected from patients aged 35 and more. There were no statistically significant correlations between the CD34+ cells count and mean cell viability in the umbilical cord blood and the maternal age. With the significance level at p umbilical cord blood of patients aged 35 and more after spontaneous labors. In the same group, the umbilical cord blood was also characterized by the highest mean cell viability (98.72%). The number of nucleated cells in the umbilical cord blood collected in the perinatal period increases together with the maternal age. In the course of physiological spontaneous labors, the collected umbilical cord blood has more nucleated cells as compared with elective caesarian sections.

  1. MANAGEMENT OF OMPHALOPHLEBITIS AND UMBILICAL HERNIA IN THREE NEONATAL GIRAFFE (GIRAFFA CAMELOPARDALIS).

    Science.gov (United States)

    Selig, Michael; Lewandowski, Albert; Burton, Michael S; Ball, Ray L

    2015-12-01

    Umbilical disorders, including omphalophlebitis, omphaloarteritis, external umbilical abscesses, urachal abscesses, patent urachus, and umbilical hernias, represent a significant challenge to the health and well-being of a neonate. The three neonatal giraffe (Giraffa camelopardalis) in this report were evaluated for umbilical swellings. Two developed omphalophlebitis, and one had an uncomplicated umbilical hernia. Omphalophlebitis is an inflammation and/or infection of the umbilical vein. Giraffe calves with a failure of passive transfer may be predisposed and should be thoroughly evaluated for the condition. Umbilical hernias result from a failure of the umbilical ring to close after parturition or from malformation of the umbilical ring during embryogenesis. These problems were surgically corrected for all three individuals, although one died due to postsurgical complications. The risks involved include anesthetic complications, surgical dehiscence, and maternal rejection. Early detection and surgical intervention are recommended for the correction of omphalophlebitis and umbilical hernias in neonatal giraffe.

  2. Spontaneous umbilical artery haematoma diagnosed in the third trimester: a case report.

    Science.gov (United States)

    Feng, Dan; He, Wei

    2018-01-31

    Spontaneous haematoma of the umbilical cord is a rare, unpreventable maternal event. The complications of this anomaly are an uneventful pregnancy, foetal distress or even an intrauterine foetal death. Umbilical cord haematoma usually results from the rupture of the umbilical vein, rarely of the umbilical arteries. We present the case of spontaneous umbilical cord haematoma diagnosed antenatally with ultrasonography, with the baby being successfully delivered by caesarean section.

  3. Cardiac arrhythmias associated with umbilical venous catheterisation in neonates

    Science.gov (United States)

    Verheij, Gerdina; Smits-Wintjens, Vivianne; Rozendaal, Lieke; Blom, Nico; Walther, Frans; Lopriore, Enrico

    2009-01-01

    Umbilical venous catheters (UVCs) are commonly used in the management of severely ill neonates. Several life-threatening complications have been described, including catheter-related infections, myocardial perforation, pericardial effusion and cardiac arrhythmias. This report describe two neonates with cardiac arrhythmias due to umbilical venous catheterisation. One neonate had a supraventricular tachycardia requiring treatment with intravenous adenosine administration. Another neonate had an atrial flutter and was managed successfully with synchronised cardioversion. The primary cause of cardiac arrhythmias after umbilical venous catheterisation is inappropriate position of the UVC within the heart and the first step to treat them should be to pull back or even remove the catheter. Cardiac arrhythmia is a rare but potentially severe complication of umbilical venous catheterisation in neonates. PMID:21691401

  4. Histological study on the effect of transplanted human umbilical cord ...

    African Journals Online (AJOL)

    Histological study on the effect of transplanted human umbilical cord blood CD34+ stem cells on albino rats subjected to myocardial infarction. Z. Abdelhadi, M. Naeim, Y. El-Wazir, M. Ibrahim, S. Hosny ...

  5. Drug repurposing by integrated literature mining and drug–gene–disease triangulation

    DEFF Research Database (Denmark)

    Sun, Peng; Guo, Jiong; Winnenburg, Rainer

    2017-01-01

    Drug design is expensive, time-consuming and becoming increasingly complicated. Computational approaches for inferring potentially new purposes of existing drugs, referred to as drug repositioning, play an increasingly important part in current pharmaceutical studies. Here, we first summarize rec...... that utilizing drug–gene–disease triangulation coupled to sophisticated text analysis is a robust approach for identifying new drug candidates for repurposing.......Drug design is expensive, time-consuming and becoming increasingly complicated. Computational approaches for inferring potentially new purposes of existing drugs, referred to as drug repositioning, play an increasingly important part in current pharmaceutical studies. Here, we first summarize...... recent developments in computational drug repositioning and introduce the utilized data sources. Afterwards, we introduce a new data fusion model based on n-cluster editing as a novel multi-source triangulation strategy, which was further combined with semantic literature mining. Our evaluation suggests...

  6. Quantum triangulations moduli space, quantum computing, non-linear sigma models and Ricci flow

    CERN Document Server

    Carfora, Mauro

    2017-01-01

    This book discusses key conceptual aspects and explores the connection between triangulated manifolds and quantum physics, using a set of case studies ranging from moduli space theory to quantum computing to provide an accessible introduction to this topic. Research on polyhedral manifolds often reveals unexpected connections between very distinct aspects of mathematics and physics. In particular, triangulated manifolds play an important role in settings such as Riemann moduli space theory, strings and quantum gravity, topological quantum field theory, condensed matter physics, critical phenomena and complex systems. Not only do they provide a natural discrete analogue to the smooth manifolds on which physical theories are typically formulated, but their appearance is also often a consequence of an underlying structure that naturally calls into play non-trivial aspects of representation theory, complex analysis and topology in a way that makes the basic geometric structures of the physical interactions involv...

  7. Triangulation of the monophasic action potential causes flattening of the electrocardiographic T-wave

    DEFF Research Database (Denmark)

    Bhuiyan, Tanveer Ahmed; Graff, Claus; Thomsen, Morten Bækgaard

    2012-01-01

    It has been proposed that triangulation on the cardiac action potential manifests as a broadened, more flat and notched T-wave on the ECG but to what extent such morphology characteristics are indicative of triangulation is more unclear. In this paper, we have analyzed the morphological changes...... of the action potential under the effect of the IKr blocker sertindole and associated these changes to concurrent changes in the morphology of electrocardiographic T-waves in dogs. We show that, under the effect of sertindole, the peak changes in the morphology of action potentials occur at time points similar...... to those observed for the peak changes in T-wave morphology on the ECG. We further show that the association between action potential shape and ECG shape is dose-dependent and most prominent at the time corresponding to phase 3 of the action potential....

  8. Caregivers, young people with complex needs, and multiple service providers: a study of triangulated relationships.

    Science.gov (United States)

    Ungar, Michael; Liebenberg, Linda; Landry, Nicole; Ikeda, Janice

    2012-06-01

    Five patterns of service provider-caregiver-adolescent interaction are discussed using qualitative interviews and file review data from 44 youth with complex needs who were clients of more than one psychosocial service (child welfare, mental health, addictions, juvenile justice, and special education). Findings show that young people and their families become triangulated with service providers, either engaging with, or resisting, interventions. For young people with complex needs involved with multiple service providers, both positive and negative patterns of interaction contribute to the complexity of caregiver-child interactions. According to young people themselves, the most functional of these patterns, empowerment, was experienced as protective when it helped them to meet their personal needs and enhance communication. In contrast, four problematic patterns produced triangulations described as conflictual or unsupportive. The implications of these patterns for family therapy are discussed with an emphasis on the therapist as both clinician and advocate for better services from multiple providers. © FPI, Inc.

  9. Public health triangulation: approach and application to synthesizing data to understand national and local HIV epidemics

    Directory of Open Access Journals (Sweden)

    Aberle-Grasse John

    2010-07-01

    Full Text Available Abstract Background Public health triangulation is a process for reviewing, synthesising and interpreting secondary data from multiple sources that bear on the same question to make public health decisions. It can be used to understand the dynamics of HIV transmission and to measure the impact of public health programs. While traditional intervention research and metaanalysis would be ideal sources of information for public health decision making, they are infrequently available, and often decisions can be based only on surveillance and survey data. Methods The process involves examination of a wide variety of data sources and both biological, behavioral and program data and seeks input from stakeholders to formulate meaningful public health questions. Finally and most importantly, it uses the results to inform public health decision-making. There are 12 discrete steps in the triangulation process, which included identification and assessment of key questions, identification of data sources, refining questions, gathering data and reports, assessing the quality of those data and reports, formulating hypotheses to explain trends in the data, corroborating or refining working hypotheses, drawing conclusions, communicating results and recommendations and taking public health action. Results Triangulation can be limited by the quality of the original data, the potentials for ecological fallacy and "data dredging" and reproducibility of results. Conclusions Nonetheless, we believe that public health triangulation allows for the interpretation of data sets that cannot be analyzed using meta-analysis and can be a helpful adjunct to surveillance, to formal public health intervention research and to monitoring and evaluation, which in turn lead to improved national strategic planning and resource allocation.

  10. Incremental Reconstruction of Urban Environments by Edge-Points Delaunay Triangulation

    OpenAIRE

    Romanoni, Andrea; Matteucci, Matteo

    2016-01-01

    Urban reconstruction from a video captured by a surveying vehicle constitutes a core module of automated mapping. When computational power represents a limited resource and, a detailed map is not the primary goal, the reconstruction can be performed incrementally, from a monocular video, carving a 3D Delaunay triangulation of sparse points; this allows online incremental mapping for tasks such as traversability analysis or obstacle avoidance. To exploit the sharp edges of urban landscape, we ...

  11. Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

    Science.gov (United States)

    Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

    2015-07-01

    The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

  12. Excerpt from Triangulations: Narrative Strategies for Navigating Latino Identity

    Directory of Open Access Journals (Sweden)

    David J. Vázquez

    2011-12-01

    Full Text Available

    Just as mariners use triangulation, mapping an imaginary triangle between two known positions and an unknown location, so, David J. Vázquez contends, Latino authors in late twentieth-century America employ the coordinates of familiar ideas of self to find their way to new, complex identities. Through this metaphor, Vázquez reveals how Latino autobiographical texts, written after the rise of cultural nationalism in the 1960s, challenge mainstream notions of individual identity and national belonging in the United States.

    In a traditional autobiographical work, the protagonist frequently opts out of his or her community. In the works that Vázquez analyzes in Triangulations, protagonists instead opt in to collective groups—often for the express political purpose of redefining that collective. Reading texts by authors such as Ernesto Galarza, Jesús Colón, Piri Thomas, Oscar “Zeta” Acosta, Judith Ortiz Cofer, John Rechy, Julia Alvarez, and Sandra Cisneros, Vázquez engages debates about the relationship between literature and social movements, the role of cultural nationalism in projects for social justice, the gender and sexual problematics of 1960s cultural nationalist groups, the possibilities for interethnic coalitions, and the interpretation of autobiography. In the process, Triangulations considers the potential for cultural nationalism as a productive force for aggrieved communities of color in their struggles for equality.

  13. Chromatic polynomials of planar triangulations, the Tutte upper bound and chromatic zeros

    International Nuclear Information System (INIS)

    Shrock, Robert; Xu Yan

    2012-01-01

    Tutte proved that if G pt is a planar triangulation and P(G pt , q) is its chromatic polynomial, then |P(G pt , τ + 1)| ⩽ (τ − 1) n−5 , where τ=(1+√5 )/2 and n is the number of vertices in G pt . Here we study the ratio r(G pt ) = |P(G pt , τ + 1)|/(τ − 1) n−5 for a variety of planar triangulations. We construct infinite recursive families of planar triangulations G pt,m depending on a parameter m linearly related to n and show that if P(G pt,m , q) only involves a single power of a polynomial, then r(G pt,m ) approaches zero exponentially fast as n → ∞. We also construct infinite recursive families for which P(G pt,m , q) is a sum of powers of certain functions and show that for these, r(G pt,m ) may approach a finite nonzero constant as n → ∞. The connection between the Tutte upper bound and the observed chromatic zero(s) near to τ + 1 is investigated. We report the first known graph for which the zero(s) closest to τ + 1 is not real, but instead is a complex-conjugate pair. Finally, we discuss connections with the nonzero ground-state entropy of the Potts antiferromagnet on these families of graphs. (paper)

  14. Comprehensive imaging review of abnormalities of the umbilical cord.

    Science.gov (United States)

    Moshiri, Mariam; Zaidi, Sadaf F; Robinson, Tracy J; Bhargava, Puneet; Siebert, Joseph R; Dubinsky, Theodore J; Katz, Douglas S

    2014-01-01

    A complete fetal ultrasonographic (US) study includes assessment of the umbilical cord for possible abnormalities. Knowledge of the normal appearance of the umbilical cord is necessary for the radiologist to correctly diagnose pathologic conditions. Umbilical cord abnormalities can be related to cord coiling, length, and thickness; the placental insertion site; in utero distortion; vascular abnormalities; and primary tumors or masses. These conditions may be associated with other fetal anomalies and aneuploidies, and their discovery should prompt a thorough fetal US examination. Further workup and planning for a safe fetal delivery may include fetal echocardiography and karyotype analysis. Doppler US is a critical tool for assessment and diagnosis of vascular cord abnormalities. US also can be used for follow-up serial imaging evaluation of conditions that could result in fetal demise. Recent studies suggest that three- or four-dimensional Doppler US of the fetal umbilical cord and abdominal vasculature allows more accurate diagnosis of vascular abnormalities. Doppler US also is invaluable in assessment of fetal growth restriction since hemodynamic changes in the placenta or fetus would appear as a spectral pattern of increased resistance to forward flow in the fetal umbilical artery. Early detection of umbilical cord abnormalities and close follow-up can reduce the risk of morbidity and mortality and assist in decision making. ©RSNA, 2014.

  15. Poorly understood and often miscategorized congenital umbilical cord hernia: an alternative repair method.

    Science.gov (United States)

    İnce, E; Temiz, A; Ezer, S S; Gezer, H Ö; Hiçsönmez, A

    2017-06-01

    Umbilical cord hernia is poorly understood and often miscategorized as "omphalocele minor". Careless clamping of the cord leads to iatrogenic gut injury in the situation of umbilical cord hernia. This study aimed to determine the characteristics and outcomes of umbilical cord hernias. We also highlight an alternative repair method for umbilical cord hernias. We recorded 15 cases of umbilical cord hernias over 10 years. The patients' data were retrospectively reviewed, and preoperative preparation of the newborn, gestational age, birth weight, other associated malformations, surgical technique used, enteral nutrition, and length of hospitalization were recorded. This study included 15 neonates with umbilical cord hernias. The mean gestational age at the time of referral was 38.2 ± 2.1 umbilical cord hernia, the body folds develop normally and form the umbilical ring. The double purse-string technique is easy to apply and produces satisfactory cosmetic results in neonates with umbilical cord hernias.

  16. Umbilical cord blood lead levels in California

    Energy Technology Data Exchange (ETDEWEB)

    Satin, K.P.; Neutra, R.R.; Guirguis, G.; Flessel, P. (California Department of Health Services, Berkeley (USA))

    1991-05-01

    During the fall of 1984, we conducted a survey of umbilical cord blood lead levels of 723 live births that occurred at 5 hospitals located in 5 cities in California. Historical ambient air lead levels were used as a qualitative surrogate of air and dust exposure. The area-specific cord blood means (all means {approximately} 5 micrograms/dl), medians, deciles, and distributions did not vary among locations. The California distributions included means that were lower than the 6.6 micrograms/dl reported in Needleman et al.'s Boston study in 1979. Indeed, the entire California distribution was shifted to the left of the Boston study distribution, even though 3% of the California cord lead levels exceeded 10 micrograms/dl--the level above which Needleman et al. have documented psychoneurological effects in children during the first few years of life. Fourteen percent of premature babies had cord blood lead levels above 10 micrograms/dl. The association between prematurity (i.e., less than 260 d gestation) and elevated (greater than 5 micrograms/dl) cord blood lead was observed in all hospitals and yielded a relative risk of 2.9 (95% CI: .9, 9.2) and a population attributable risk of 47%. Further research is needed to confirm this association and to explore the roles of endogenous and exogenous sources of lead exposure to the mothers who give birth to premature infants.

  17. Large N Limits in Tensor Models: Towards More Universality Classes of Colored Triangulations in Dimension d≥2

    Science.gov (United States)

    Bonzom, Valentin

    2016-07-01

    We review an approach which aims at studying discrete (pseudo-)manifolds in dimension d≥ 2 and called random tensor models. More specifically, we insist on generalizing the two-dimensional notion of p-angulations to higher dimensions. To do so, we consider families of triangulations built out of simplices with colored faces. Those simplices can be glued to form new building blocks, called bubbles which are pseudo-manifolds with boundaries. Bubbles can in turn be glued together to form triangulations. The main challenge is to classify the triangulations built from a given set of bubbles with respect to their numbers of bubbles and simplices of codimension two. While the colored triangulations which maximize the number of simplices of codimension two at fixed number of simplices are series-parallel objects called melonic triangulations, this is not always true anymore when restricting attention to colored triangulations built from specific bubbles. This opens up the possibility of new universality classes of colored triangulations. We present three existing strategies to find those universality classes. The first two strategies consist in building new bubbles from old ones for which the problem can be solved. The third strategy is a bijection between those colored triangulations and stuffed, edge-colored maps, which are some sort of hypermaps whose hyperedges are replaced with edge-colored maps. We then show that the present approach can lead to enumeration results and identification of universality classes, by working out the example of quartic tensor models. They feature a tree-like phase, a planar phase similar to two-dimensional quantum gravity and a phase transition between them which is interpreted as a proliferation of baby universes. While this work is written in the context of random tensors, it is almost exclusively of combinatorial nature and we hope it is accessible to interested readers who are not familiar with random matrices, tensors and quantum

  18. Non-degenerated Ground States and Low-degenerated Excited States in the Antiferromagnetic Ising Model on Triangulations

    Science.gov (United States)

    Jiménez, Andrea

    2014-02-01

    We study the unexpected asymptotic behavior of the degeneracy of the first few energy levels in the antiferromagnetic Ising model on triangulations of closed Riemann surfaces. There are strong mathematical and physical reasons to expect that the number of ground states (i.e., degeneracy) of the antiferromagnetic Ising model on the triangulations of a fixed closed Riemann surface is exponential in the number of vertices. In the set of plane triangulations, the degeneracy equals the number of perfect matchings of the geometric duals, and thus it is exponential by a recent result of Chudnovsky and Seymour. From the physics point of view, antiferromagnetic triangulations are geometrically frustrated systems, and in such systems exponential degeneracy is predicted. We present results that contradict these predictions. We prove that for each closed Riemann surface S of positive genus, there are sequences of triangulations of S with exactly one ground state. One possible explanation of this phenomenon is that exponential degeneracy would be found in the excited states with energy close to the ground state energy. However, as our second result, we show the existence of a sequence of triangulations of a closed Riemann surface of genus 10 with exactly one ground state such that the degeneracy of each of the 1st, 2nd, 3rd and 4th excited energy levels belongs to O( n), O( n 2), O( n 3) and O( n 4), respectively.

  19. Hypercoiling of the umbilical cord in uncomplicated singleton pregnancies.

    Science.gov (United States)

    Ma'ayeh, Marwan; McClennen, Evan; Chamchad, Dmitri; Geary, Michael; Brest, Norman; Gerson, Andrew

    2017-06-26

    The umbilical coiling index (UCI) is a measure of the number of coils in the umbilical cord in relation to its length. Hypercoiled cords with a UCI of >0.3 coils/cm have been associated with adverse fetal and neonatal outcomes. The primary aim is to determine the accuracy of UCI measured on second trimester ultrasound in predicting UCI at birth. The secondary outcome is to investigate the association between hypercoiling of the umbilical cord on prenatal ultrasound and adverse maternal, fetal and neonatal outcomes. This was a prospective cohort study of uncomplicated singleton pregnancies. Seventy two patients were included in the study. UCI was measured in the second trimester ultrasound, and compared to UCI measured postnatally. Outcomes of patients with hypercoiled cords on ultrasound were compared to outcomes of patients with normocoiled cords. Our results failed to show a strong correlation between the UCI determined with ultrasound, and the UCI determined with examination of the umbilical cord after delivery. We also did not demonstrate that measurement of the UCI on second trimester ultrasound is able to predict adverse maternal, fetal or neonatal outcomes. This study suggests that measurement of the umbilical coiling index should not be part of routine second trimester sonography in patients with uncomplicated singleton pregnancies, with no other medical or surgical comorbidities.

  20. Obstetricians' attitudes and beliefs regarding umbilical cord clamping.

    Science.gov (United States)

    Jelin, Angie C; Kuppermann, Miriam; Erickson, Kristine; Clyman, Ronald; Schulkin, Jay

    2014-09-01

    Although delayed umbilical cord clamping has been demonstrated to reduce the incidence of intraventricular hemorrhage and neonatal sepsis, and decrease the need for neonatal transfusions (without affecting cord pH, Apgar scores or the need for phototherapy), the extent to which this practice is being employed is unknown. We conducted a survey of US obstetricians to assess their attitudes and beliefs about cord clamping. Questionnaires were randomly mailed to members of the American College of Obstetricians and Gynecologists (ACOG), and the Collaborative Ambulatory Research Network (CARN). The data were analyzed using Chi-square and Student t tests. The response rates for the CARN and other ACOG members were 47% and 21%, respectively. Most (88%) responders reported their hospital had no umbilical cord clamping policy. The most frequent response for optimal timing of umbilical cord clamping, regardless of gestational age, was "don't know". Potential for neonatal red blood cell transfusion was the only concern cited as a reason for being somewhat or very inclined to delay umbilical cord clamping (51%). Delayed neonatal resuscitation (76%) was listed as a reason to clamp the cord immediately, despite the paucity of literature to support immediate cord clamping in this cohort. Despite substantial evidence supporting the practice of delayed cord clamping, few institutions have policies regarding this practice. Moreover, obstetricians' beliefs about the appropriate timing for umbilical cord clamping are not consistent with the evidence that demonstrates its beneficial impact on neonatal outcomes.

  1. Eau de Dalibour vs. alcohol for umbilical cord care.

    Science.gov (United States)

    Habibi, Morteza; Mahyar, Abolfazl; Heidari, Reza; Javadi, Amir; Mahyar, Shifteh

    2014-08-01

    This study was conducted to compare the effects of Eau de Dalibour and ethanol on preventing omphalitis and also on umbilical cord separation time in neonates. In this clinical trial, 178 randomly selected, healthy term neonates were investigated. To disinfect the umbilical cords, Eau de Dalibour was used for 84 infants (case group) and ethanol for 94 infants (control group). No cases of omphalitis were observed in either group. Umbilical cord separation time was significantly shorter in the Eau de Dalibour group than in the ethanol group: 4.04 ± 1.61 days vs. 6.3 ± 1.82 days, p = 0.001. This study revealed that although Eau de Dalibour and ethanol were equally effective in preventing the incidence of omphalitis in neonates, Eau de Dalibour induced the separation of umbilical cord significantly quicker in the infants. Thus, Eau de Dalibour could be used as a suitable replacement for ethanol in neonates' umbilical cord care. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Measuring teamwork in primary care: Triangulation of qualitative and quantitative data.

    Science.gov (United States)

    Brown, Judith Belle; Ryan, Bridget L; Thorpe, Cathy; Markle, Emma K R; Hutchison, Brian; Glazier, Richard H

    2015-09-01

    This article describes the triangulation of qualitative dimensions, reflecting high functioning teams, with the results of standardized teamwork measures. The study used a mixed methods design using qualitative and quantitative approaches to assess teamwork in 19 Family Health Teams in Ontario, Canada. This article describes dimensions from the qualitative phase using grounded theory to explore the issues and challenges to teamwork. Two quantitative measures were used in the study, the Team Climate Inventory (TCI) and the Providing Effective Resources and Knowledge (PERK) scale. For the triangulation analysis, the mean scores of these measures were compared with the qualitatively derived ratings for the dimensions. The final sample for the qualitative component was 107 participants. The qualitative analysis identified 9 dimensions related to high team functioning such as common philosophy, scope of practice, conflict resolution, change management, leadership, and team evolution. From these dimensions, teams were categorized numerically as high, moderate, or low functioning. Three hundred seventeen team members completed the survey measures. Mean site scores for the TCI and PERK were 3.87 and 3.88, respectively (of 5). The TCI was associated will all dimensions except for team location, space allocation, and executive director leadership. The PERK was associated with all dimensions except team location. Data triangulation provided qualitative and quantitative evidence of what constitutes teamwork. Leadership was pivotal in forging a common philosophy and encouraging team collaboration. Teams used conflict resolution strategies and adapted to the changes they encountered. These dimensions advanced the team's evolution toward a high functioning team. (c) 2015 APA, all rights reserved).

  3. Lymphoscintigraphy and triangulated body marking for morbidity reduction during sentinel node biopsy in breast cancer.

    Science.gov (United States)

    Krynyckyi, Borys R; Shafir, Michail K; Kim, Suk Chul; Kim, Dong Wook; Travis, Arlene; Moadel, Renee M; Kim, Chun K

    2005-11-08

    Current trends in patient care include the desire for minimizing invasiveness of procedures and interventions. This aim is reflected in the increasing utilization of sentinel lymph node biopsy, which results in a lower level of morbidity in breast cancer staging, in comparison to extensive conventional axillary dissection. Optimized lymphoscintigraphy with triangulated body marking is a clinical option that can further reduce morbidity, more than when a hand held gamma probe alone is utilized. Unfortunately it is often either overlooked or not fully understood, and thus not utilized. This results in the unnecessary loss of an opportunity to further reduce morbidity. Optimized lymphoscintigraphy and triangulated body marking provides a detailed 3 dimensional map of the number and location of the sentinel nodes, available before the first incision is made. The number, location, relevance based on time/sequence of appearance of the nodes, all can influence 1) where the incision is made, 2) how extensive the dissection is, and 3) how many nodes are removed. In addition, complex patterns can arise from injections. These include prominent lymphatic channels, pseudo-sentinel nodes, echelon and reverse echelon nodes and even contamination, which are much more difficult to access with the probe only. With the detailed information provided by optimized lymphoscintigraphy and triangulated body marking, the surgeon can approach the axilla in a more enlightened fashion, in contrast to when the less informed probe only method is used. This allows for better planning, resulting in the best cosmetic effect and less trauma to the tissues, further reducing morbidity while maintaining adequate sampling of the sentinel node(s).

  4. TRIANGULATION OF INSTRUMENTATION AND DATA SOURCE: A STRONGER METHOD IN ASSESSING ENGLISH LANGUAGE NEEDS

    Directory of Open Access Journals (Sweden)

    Meedy Nugraha

    2002-01-01

    Full Text Available This paper proposes the importance of multiple instrumentation and data source (triangulation in a needs analysis. Various data gathering methods developed in assessing learners' English language needs are reviewed. The justification of employing more than a single data gathering method and data source in a needs analysis is also presented by examining the strengths and weaknesses of each method and evaluating previous needs analyses carried out in some Asian countries. Highlights are then given to the methodology mostly implemented in assessing English needs in Indonesia and a recommendation is addressed to further studies on learners's needs in Indonesia

  5. Development of the delyed-neutron triangulation technique for locating failed fuel in LMFBR

    International Nuclear Information System (INIS)

    Kryter, R.C.

    1975-01-01

    Two major accomplishments of the ORNL delayed neutron triangulation program are (1) an analysis of anticipated detector counting rates and sensitivities to unclad fuel and erosion types of pin failure, and (2) an experimental assessment of the accuracy with which the position of failed fuel can be determined in the FFTF (this was performed in a quarter-scale water mockup of realistic outlet plenum geometry using electrolyte injections and conductivity cells to simulate delayed-neutron precursor releases and detections, respectively). The major results and conclusions from these studies are presented, along with plans for further DNT development work at ORNL for the FFTF and CRBR. (author)

  6. Scaling analyses of the spectral dimension in 3-dimensional causal dynamical triangulations

    Science.gov (United States)

    Cooperman, Joshua H.

    2018-05-01

    The spectral dimension measures the dimensionality of a space as witnessed by a diffusing random walker. Within the causal dynamical triangulations approach to the quantization of gravity (Ambjørn et al 2000 Phys. Rev. Lett. 85 347, 2001 Nucl. Phys. B 610 347, 1998 Nucl. Phys. B 536 407), the spectral dimension exhibits novel scale-dependent dynamics: reducing towards a value near 2 on sufficiently small scales, matching closely the topological dimension on intermediate scales, and decaying in the presence of positive curvature on sufficiently large scales (Ambjørn et al 2005 Phys. Rev. Lett. 95 171301, Ambjørn et al 2005 Phys. Rev. D 72 064014, Benedetti and Henson 2009 Phys. Rev. D 80 124036, Cooperman 2014 Phys. Rev. D 90 124053, Cooperman et al 2017 Class. Quantum Grav. 34 115008, Coumbe and Jurkiewicz 2015 J. High Energy Phys. JHEP03(2015)151, Kommu 2012 Class. Quantum Grav. 29 105003). I report the first comprehensive scaling analysis of the small-to-intermediate scale spectral dimension for the test case of the causal dynamical triangulations of 3-dimensional Einstein gravity. I find that the spectral dimension scales trivially with the diffusion constant. I find that the spectral dimension is completely finite in the infinite volume limit, and I argue that its maximal value is exactly consistent with the topological dimension of 3 in this limit. I find that the spectral dimension reduces further towards a value near 2 as this case’s bare coupling approaches its phase transition, and I present evidence against the conjecture that the bare coupling simply sets the overall scale of the quantum geometry (Ambjørn et al 2001 Phys. Rev. D 64 044011). On the basis of these findings, I advance a tentative physical explanation for the dynamical reduction of the spectral dimension observed within causal dynamical triangulations: branched polymeric quantum geometry on sufficiently small scales. My analyses should facilitate attempts to employ the spectral

  7. Triangulating laser profilometer as a navigational aid for the blind: optical aspects

    Science.gov (United States)

    Farcy, R.; Denise, B.; Damaschini, R.

    1996-03-01

    We propose a navigational aid approach for the blind that relies on active optical profilometry with real-time electrotactile interfacing on the skin. Here we are concerned with the optical parts of this system. We point out the particular requirements the profilometer must meet to meet the needs of blind people. We show experimentally that an adequate compromise is possible that consists of a compact class I IR laser-diode triangulation profilometer with the following angular resolution, 20-ms acquisition time per measure of distance, 60 degrees angular scanning field.

  8. Relationship Between Short Umbilical Cord Length and Adverse Pregnancy Outcomes.

    Science.gov (United States)

    Yamamoto, Yuriko; Aoki, Shigeru; Oba, Mari S; Seki, Kazuo; Hirahara, Fumiki

    2016-01-01

    To investigate how umbilical cord length relates to pregnancy outcomes, we retrospectively analyzed data from 89,042 deliveries recorded in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System. We included term deliveries in which vaginal birth was attempted. Umbilical cord length was categorized into four groups: less than the first percentile, from the first percentile to less than the 10th percentile, from the 10th percentile to less than 25th percentile, and from the 25th percentile to less than the 75th percentile, which constituted the control group. Cord lengths of 33, 43, 48, 63 cm corresponded to the first, 10th, 25th, and 75th percentile values of the cord length distribution, respectively. Statistically significant differences were observed in the rate of unplanned cesarean delivery for all three short cord groups compared to control. There was a higher odds ratio for unplanned cesarean delivery as the umbilical cord became shorter.

  9. Aberrant course of the umbilical vein in a newborn with Cornelia de Lange syndrome

    International Nuclear Information System (INIS)

    Toomayan, Glen A.; Gaca, Ana Maria

    2009-01-01

    Congenital anomalies of the umbilical vein are rare. We describe an aberrant course of the umbilical vein discovered by identifying an unusual umbilical venous catheter course on abdominal radiography in a patient with Cornelia de Lange syndrome. The umbilical vein bypassed the liver to insert directly into a right pelvic vein. Use of the lateral abdominal radiograph and sonography were helpful in determining the catheter location after identifying the unusual course of the catheter on the frontal radiograph. (orig.)

  10. Aberrant course of the umbilical vein in a newborn with Cornelia de Lange syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Toomayan, Glen A.; Gaca, Ana Maria [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2009-04-15

    Congenital anomalies of the umbilical vein are rare. We describe an aberrant course of the umbilical vein discovered by identifying an unusual umbilical venous catheter course on abdominal radiography in a patient with Cornelia de Lange syndrome. The umbilical vein bypassed the liver to insert directly into a right pelvic vein. Use of the lateral abdominal radiograph and sonography were helpful in determining the catheter location after identifying the unusual course of the catheter on the frontal radiograph. (orig.)

  11. Prenatal diagnosis of placenta and umbilical cord pathologies by three-dimensional ultrasound: pictorial essay.

    Science.gov (United States)

    de Castro Rezende, Guilherme; Araujo Júnior, Edward

    2015-12-01

    The authors present their experience in prenatal diagnosis of placental and umbilical cord pathologies, using three-dimensional ultrasound (3DUS) in the rendering and tomography ultrasound imaging (TUI) modes, associated with color Doppler in some cases. Cases of placenta accreta/placenta previa, circumvallate placenta, succenturiate lobe, true knot of the umbilical cord, nuchal cord, and marginal/velamentous umbilical cord insertion are presented. 3DUS can contribute to improve the accuracy of prenatal diagnosis of placenta and umbilical cord pathologies.

  12. Umbilical Cord Coiling and Zygosity: Is there a Link?

    Science.gov (United States)

    Coetzee, André Joannou; Castro, Eumenia; Peres, Luiz Cesar

    2015-01-01

    The aim of this study was to analyze abnormalities of umbilical coiling index (UCI) in twin gestation to test whether the coiling is genetically influenced by zygosity. Data retrieved comprised gestational age (GA), chorionicity, fetal gender, and UCI. The mean UCI of hypercoiled cords in monochorionic placentas was 0.55 coils/cm and 0.49 coils/cm in dichorionic placentas with discordant fetal gender (P = 0.2629). In conclusion, no significant statistical difference between UCI in monochorionic and dichorionic twin placentas with discordant fetal gender was identified, suggesting that zygosity does not play a role in umbilical coiling induction.

  13. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Science.gov (United States)

    Peyman, A.; Gabriel, C.; Benedickter, H. R.; Fröhlich, J.

    2011-04-01

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 °C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields.

  14. Dielectric properties of human placenta, umbilical cord and amniotic fluid

    Energy Technology Data Exchange (ETDEWEB)

    Peyman, A [Physical Dosimetry Department, Health Protection Agency, Chilton, Didcot OX11 0RQ (United Kingdom); Gabriel, C [MCL-P, Newbury RG14 5PY, Berkshire (United Kingdom); Benedickter, H R; Froehlich, J, E-mail: Azadeh.peyman@hpa.org.uk [Electromagnetic Fields and Microwave Electronics Laboratory, Swiss Federal Institute of Technology, Zurich (Switzerland)

    2011-04-07

    The dielectric properties of freshly delivered human placenta, umbilical cord and amniotic fluid have been acquired at 37 deg. C and in the frequency range of 200 MHz-10 GHz. The experimental data were fitted to a Cole-Cole expression. The results show that dielectric properties of the umbilical cord are significantly higher than placenta due to the presence of high water content Wharton's jelly. The results also demonstrate large differences in the dielectric properties of amniotic and cerebrospinal fluids. The data presented can be used in numerical simulations of the exposure of pregnant women to electromagnetic fields. (note)

  15. Indirect measurement of molten steel level in tundish based on laser triangulation

    Science.gov (United States)

    Su, Zhiqi; He, Qing; Xie, Zhi

    2016-03-01

    For real-time and precise measurement of molten steel level in tundish during continuous casting, slag level and slag thickness are needed. Among which, the problem of slag thickness measurement has been solved in our previous work. In this paper, a systematic solution for slag level measurement based on laser triangulation is proposed. Being different from traditional laser triangulation, several aspects for measuring precision and robustness have been done. First, laser line is adopted for multi-position measurement to overcome the deficiency of single point laser range finder caused by the uneven surface of the slag. Second, the key parameters, such as installing angle and minimum requirement of the laser power, are analyzed and determined based on the gray-body radiation theory to fulfill the rigorous requirement of measurement accuracy. Third, two kinds of severe noises in the acquired images, which are, respectively, caused by heat radiation and Electro-Magnetic Interference (EMI), are cleaned via morphological characteristic of the liquid slag and color difference between EMI and the laser signals, respectively. Fourth, as false target created by stationary slag usually disorders the measurement, valid signals of the slag are distinguished from the false ones to calculate the slag level. Then, molten steel level is obtained by the slag level minus the slag thickness. The measuring error of this solution is verified by the applications in steel plants, which is ±2.5 mm during steady casting and ±3.2 mm at the end of casting.

  16. Relationship between newborn Acid-Base status and umbilical cord morphology

    Directory of Open Access Journals (Sweden)

    Marssosi V

    2001-06-01

    Full Text Available ess the relationship between umbilical cord blood gases at birth and morphology of umbilical cord, in a prospective study of 200 consecutive term delivery, we investigated the relationship between umbilical cord morphology characteristics (umbilical crd length, number of vascular coil, coiling index and color of amniotic fluid and umbilical vessel blood gases. Statistically significant linear correlation was found between umblicial venous PH and the umbilical cord length (r=0.39, 95% CI 0.25, 0.53, P<0.03, umber of vascular coils (r=0.45 95% CI 0.31-0.59 P<0.012, and coiling index (r=0.34, 95% CI 0.12-0.48, P<0.04, and also negative linear correlation was found between umbilical venous partial pressure of carbon dioxide & of coli (r=0.3, 95% CI –0.44, -0.16 P<0.03. No relation was found between umbilical cord indices and meconium staining of amniotic fluid.Placental weight also correlated with umbilical cord length (r=0.17, 95% CI 0.03-0.31, P<0.03, but not with umbilical cord coils or coiling index.Umbilical venous pH is related to umbilical cord morphology but umbilical venous PCO2 was only related to the number of coils and umbilicat artery pH wa only related to the number of coils and not related to length or coiling index of umbilical cord morphology. The morphology of umbilical cord can affect maternal-fetal gas exchange

  17. Histological study on the effect of transplanted human umbilical cord ...

    African Journals Online (AJOL)

    This study aimed at examining the regenerative effect of intravenously transplanted human umbilical cord blood CD34+ stem cell in a rat model of acute MI. Methods: Forty adult female rats were equally randomized into 5 groups. Groups I and II received saline alone or saline followed by isolation buffer respectively to serve ...

  18. Upcycling umbilical cords: bridging regenerative medicine with neonatology.

    Science.gov (United States)

    Moreira, Alvaro; Alayli, Yasmeen; Balgi, Saloni; Winter, Caitlyn; Kahlenberg, Samuel; Mustafa, Shamimunisa; Hornsby, Peter

    2017-11-27

    Preterm birth is a major health concern that affects 10% of all worldwide deliveries. Many preterm infants are discharged from the hospital with morbidities that lead to an increased risk for neurodevelopmental impairment, recurrent hospitalizations, and life-long conditions. Unfortunately, the treatment of these conditions is palliative rather than curative, which calls for novel and innovative strategies. Progress in regenerative medicine has offered therapeutic options for many of these conditions. Specifically, human umbilical cord mesenchymal stem cells (MSCs) and cord blood (UCB) cells have shown promise in treating adult-onset diseases. Unlike bone-marrow and embryonic derived stem cells, umbilical cord-derived cells are easily and humanely obtained, have low immunogenicity, and offer the potential of autologous therapy. While there are several studies to uphold the efficacy of umbilical cord MSCs in adult therapies, there remains an unmet need for the investigation of its use in treating neonates. The purpose of this review is to provide a summary of current information on the potential therapeutic benefits and clinical applicability of umbilical cord MSCs and UCB cells. Promising preclinical studies have now led to a research movement that is focusing on cell-based therapies for preterm infants.

  19. Complicated umbilical hernia in childhood | Brown | South African ...

    African Journals Online (AJOL)

    mass. Eleven of the 19 children who had an abdominal radiograph showed radiological evidence of small-bowel obstruction and in 5 children there was radiological evidence of pica. Two patients had ischaemic omentum that required resection. Patients who present with localised abdominal pain or an irreducible umbilical ...

  20. Presentation and Management Outcome of Umbilical Hernia in ...

    African Journals Online (AJOL)

    Background: This study was aimed at determine the epidemiology, clinical and treatment outcome of childhood umbilical hernia at the University Hospital of Brazzaville. Methods: It was a retrospective study undertaken conducted over a 15 months period from 1st January 2014 to 31st March 2015 in the pediatric surgery ...

  1. Correlation between placenta and umbilical cord morphplogy and ...

    African Journals Online (AJOL)

    Context: The ability of the fetus to grow and thrive in-utero depends on a number of factors of which the placenta is a contributor. The umbilical cord is an essential organ connecting the fetus to the placenta and a healthy placenta is essential for good perinatal outcome. Objectives: The study aims at determining the ...

  2. In vitro differentiation of human umbilical cord blood mesenchymal ...

    African Journals Online (AJOL)

    May H. Hasan

    2016-08-05

    Aug 5, 2016 ... Abstract Mesenchymal stem cells (MSCs) were isolated by gradient density centrifugation from umbilical cord blood. Spindle-shaped adherent cells were permitted to grow to 70% confluence in primary culture media which was reached by day 12. Induction of differentiation started by cul- turing cells with ...

  3. In vitro differentiation of human umbilical cord blood mesenchymal ...

    African Journals Online (AJOL)

    Mesenchymal stem cells (MSCs) were isolated by gradient density centrifugation from umbilical cord blood. Spindle-shaped adherent cells were permitted to grow to 70% confluence in primary culture media which was reached by day 12. Induction of differentiation started by culturing cells with differentiation medium ...

  4. Primary umbilical endometriosis: To scope or not to scope?

    African Journals Online (AJOL)

    Background. Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 - 1% of all cases of extragenital endometriosis. The method of using routine laparoscopic inspection of the pelvis to exclude pelvic endometriosis has been applied extensively over the years. It has been demonstrated that even patients who ...

  5. Primary umbilical endometriosis: To scope or not to scope ...

    African Journals Online (AJOL)

    Background. Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 - 1% of all cases of extragenital endometriosis. The method of using routine laparoscopic inspection of the pelvis to exclude pelvic endometriosis has been applied extensively over the years. It has been demonstrated that even patients who ...

  6. Umbilical cord blood banking ethico-legal issues: review article ...

    African Journals Online (AJOL)

    The recent discovery that umbilical cord blood has a high concentration of haematopoeitic stem cells has led to cord blood being used to treat a variety of disorders. Collection of cord blood is easy, non-invasive and generally does not interfere with the delivery process. However, there are various ethical and logistical ...

  7. True Umbilical Cord Knot Leading to Fetal Demise

    African Journals Online (AJOL)

    Ikechebelu, et al.: True umbilical cord knot. 156. Annals of Medical and Health Sciences Research | Jul-Aug 2014 | Vol 4 | Special Issue 2 | non‑reactive. She tested negative to Human immune‑deficiency virus I and II. The fasting blood sugar and 2 h post prandial were normal. She received two courses, each of intermittent.

  8. Umbilical artery doppler velocimetry study on prediction of adverse ...

    African Journals Online (AJOL)

    Background: Doppler velocimetry studies of pregnant women with diabetes mellitus can predict adverse pregnancy outcomes. Objective: To identify pregnant women with diabetes mellitus for second trimester umbilical artery Doppler velocimetry to predict adverse pregnancy outcomes. Methods: It was a prospective study ...

  9. Assessment of Uterine and Umbilical Arteries Doppler Indices in ...

    African Journals Online (AJOL)

    Pregnancy induced hypertension (PIH) is a major cause of maternal and perinatal morbidity and mortality in developing countries including Nigeria. Doppler velocimetric indices of the uterine and umbilical arteries may predict the impact of PIH on perfusion of the uteroplacental and fetoplacental circulations respectively.

  10. Umbilical cord blood glucose levels in full-term newborns

    Directory of Open Access Journals (Sweden)

    A. L. Karpova

    2014-01-01

    Full Text Available The purpose of the investigation was to determine the umbilical cord venous blood level of glucose in full-term newborns and its relationship to the mode of delivery. The investigation included 102 full-term newborn infants, including 33 and 69 babies born via cesar-ean and vaginal delivery, respectively. Umbilical cord serum glucose levels were determined by the glucose oxidase test using a Sap-phire-400 biochemical analyzer. In healthy full-term newborns, the mean umbilical cord blood glucose levels were 4,29±0,88 mmol/1 (minimum, 2,9 mmol/1 and maximum, 5,9 mmol/1. In the babies born via cesarean delivery, the umbilical cord blood concentration of glucose was ascertained to be significantly lower than in those born vaginally (3,84+0,71 mmol/1 versus 4,51+0,87 mmol/1; /><0,0001. Abdominal delivery can be apparently considered to be a risk factor for hypoglycemia in neonatal infants.

  11. Charleston Pouch with In-Situ Appendix and Concealed Umbilical ...

    African Journals Online (AJOL)

    Cancer recurrence was recorded in 3 patients at 12, 27 and 32 months. Conclusions: The Charleston pouch with in-situ appendix is an efficient versatile technique for the creation of a catheterizable continent cutaneous urinary reservoir. The umbilical stoma with triangular skin flap provides excellent cosmetic results.

  12. Trans-umbilical Laparoscopic Appendectomy for Acute Appendicitis ...

    African Journals Online (AJOL)

    We discuss a useful modification of trans-umbilical appendectomy for acute appendicitis using routine instruments. Materials and Methods: From August 2009 to March 2011, 164 patients were operated by this method at our rural center. Out of them, 102 were males and 62, females. Mean age for males was 27.5 years ...

  13. Umbilical site for temporary colostomy in anorectal malformations: is ...

    African Journals Online (AJOL)

    None of the patients developed stenosis or prolapse. Surgical revision of the colostomy was not required in any of the cases. All umbilical colostomies were reversed, with no postoperative complications such as wound infection, incisional hernia, or bowel obstruction. The cosmetic appearance after colostomy closure was ...

  14. Levels Of Haemoglobin And Packed Cell Volumes In Umbilical Cord ...

    African Journals Online (AJOL)

    The Hb concentration was determined by the indirect colorimetric method, and the PCV by the microhaematocrit centrifuge method. The mean values obtained were Hb 12.13 ± 0.11 g/dl and PCV 37.95 ± 0.49%. The mean umbilical cord blood haemoglobin and packed cell volumes were compared with those of the mothers ...

  15. Umbilical cord prolapse and perinatal outcome in a tertiary institution

    African Journals Online (AJOL)

    A review of thirty eight (38) cases of foetal umbilical cord prolapse, managed at the UPTH, Port Harcourt, Nigeria from January 1st, 2009 to December 31st, 2013. Data was analyzed using SPSS windows version 20 and results presented in frequencies and percentages. There were 15,840 deliveries with 38 cases of cord ...

  16. Anogenital distance and umbilical cord testosterone level in ...

    African Journals Online (AJOL)

    In this study, the anogenital distance (AGD) and anthropometric measurements such as birth weight, birth length, head circumference and placenta weight of 200 newborns (100 male, 100 female) were taken and umbilical cord serum was assayed for testosterone concentration using Radioimmunoassay (Microwell).

  17. Determination of the therapeutic potential of human umbilical cord ...

    African Journals Online (AJOL)

    This research was conducted to evaluate the therapeutic potential of human umbilical cord blood, by determining their effect on bacterial pathogens which included: Streptobacillus sp, Corynebacterium diphtheriae, Staphylococcus aureus, Salmonella typhimurium, and Escherichia coli. Cord blood samples were obtained ...

  18. Ethical and regulatory issues surrounding umbilical cord blood ...

    African Journals Online (AJOL)

    Recent medical advances in the field of regenerative medicine and tissue transplantation have highlighted the importance of umbilical cord blood (UCB) as a valuable alternative source of haematopoietic stem cells, which are potentially life-saving in a vast array of clinical applications. Although less controversial than the ...

  19. Double half-cone flap umbilicoplasty for proboscoid umbilical hernia ...

    African Journals Online (AJOL)

    Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was ...

  20. Prospect for application of umbilical cord blood to clinical treatment of radiation sickness

    International Nuclear Information System (INIS)

    Jia Tingzhen; Ke Xiaoyan

    1998-01-01

    Objective: To look forward to the prospect for application of umbilical cord blood to clinical treatment of radiation sickness by analyzing the results using umbilical cord blood in laboratory experiments and clinical research. Method: The data on umbilical cord blood published in literature are reviewed. Results: The umbilical blood is rich in hematopoietic stem/progenitor cells, low in immunological activity of lymphocytes, expanded significantly ex vivo under selected culture condition readily available and collected easily. Conclusion: With the above advantages, the prospect for application of umbilical cord blood is encouraging, particularly in the clinical treatment of radiation sickness

  1. Estimation of the total number of mast cells in the human umbilical cord. A methodological study

    DEFF Research Database (Denmark)

    Engberg Damsgaard, T M; Windelborg Nielsen, B; Sørensen, Flemming Brandt

    1992-01-01

    The aim of the present study was to estimate the total number of mast cells in the human umbilical cord. Using 50 microns-thick paraffin sections, made from a systematic random sample of umbilical cord, the total number of mast cells per cord was estimated using a combination of the optical...... disector and fractionated sampling. The mast cell of the human umbilical cord was found in Wharton's jelly, most frequently in close proximity to the three blood vessels. No consistent pattern of variation in mast cell numbers from the fetal end of the umbilical cord towards the placenta was seen....... The total number of mast cells found in the umbilical cord was 5,200,000 (median), range 2,800,000-16,800,000 (n = 7), that is 156,000 mast cells per gram umbilical cord (median), range 48,000-267,000. Thus, the umbilical cord constitutes an adequate source of mast cells for further investigation...

  2. Zur Rekonstruktion einer Typologie jugendlichen Medienhandelns gemäß dem Leitbild der Triangulation

    Directory of Open Access Journals (Sweden)

    Klaus Peter Treumann

    2017-09-01

    Full Text Available Die im Folgenden dargestellten Ergebnisse sind im Rahmen des von der DFG geförderten Forschungsprojekts „Eine Untersuchung zum Mediennutzungsverhalten 12- bis 20-Jähriger und zur Entwicklung von Medienkompetenz im Jugendalter“ entstanden, das gemeinsam von Klaus Peter Treumann, Uwe Sander und Dorothee Meister geleitet wird. Das Forschungsprojekt untersucht das Medienhandeln Jugendlicher sowohl hinsichtlich Neuer als auch alter Medien. Zum einen fragen wir dabei nach den Ausprägungen von Medienkompetenz in verschiedenen Dimensionen und zum anderen konzentrieren wir uns auf die Entwicklung einer empirisch fundierten Typologie jugendlichen Medienhandelns. Methodologisch ist die Untersuchung an dem Leitbild der Triangulation orientiert und kombiniert qualitative und quantitative Zugänge zum Forschungsfeld in Form von Gruppendiskussionen, leitfadengestützten Einzelinterviews und einer Repräsentativerhebung.

  3. Measurements of indoor/outdoor atmospheric turbulence through optical triangulation method

    International Nuclear Information System (INIS)

    De Oliveira, Gúbio; Silva, Vinicius N H; Barbero, Andrés P L; Ribeiro, Ricardo M; Coelho, Thiago V N; Dos Santos, A Bessa

    2017-01-01

    Atmospheric turbulence degrades the performance of wireless optical communication links. This phenomenon distorts the light wave-front, and changes the spatial optical power distribution, spread and wander of the beam on the receiver plane. In this paper we present measurements of indoor and outdoor atmospheric turbulence taken using a simple and low-cost device based on an optical triangulation method. The device tracks a Gaussian beam due to the beam wander effect and measures the effective Gaussian width due to beam spread in order to calculate the refractive index structure constant in real time. Thus, the device operation principle, the outdoor/indoor turbulence profile during the day, the hotspot dispersion and the beam width variation are shown. (paper)

  4. A Road Map Refinement Method Using Delaunay Triangulation for Big Trace Data

    Directory of Open Access Journals (Sweden)

    Luliang Tang

    2017-02-01

    Full Text Available With the rapid development of urban transportation, people urgently need high-precision and up-to-date road maps. At the same time, people themselves are an important source of road information for detailed map construction, as they can detect real-world road surfaces with GPS devices in the course of their everyday life. Big trace data makes it possible and provides a great opportunity to extract and refine road maps at relatively low cost. In this paper, a new refinement method is proposed for incremental road map construction using big trace data, employing Delaunay triangulation for higher accuracy during the GPS trace stream fusion process. An experiment and evaluation were carried out on the GPS traces collected by taxis in Wuhan, China. The results show that the proposed method is practical and improves upon existing incremental methods in terms of accuracy.

  5. Introductory review on `Flying Triangulation': a motion-robust optical 3D measurement principle

    Science.gov (United States)

    Ettl, Svenja

    2015-04-01

    'Flying Triangulation' (FlyTri) is a recently developed principle which allows for a motion-robust optical 3D measurement of rough surfaces. It combines a simple sensor with sophisticated algorithms: a single-shot sensor acquires 2D camera images. From each camera image, a 3D profile is generated. The series of 3D profiles generated are aligned to one another by algorithms, without relying on any external tracking device. It delivers real-time feedback of the measurement process which enables an all-around measurement of objects. The principle has great potential for small-space acquisition environments, such as the measurement of the interior of a car, and motion-sensitive measurement tasks, such as the intraoral measurement of teeth. This article gives an overview of the basic ideas and applications of FlyTri. The main challenges and their solutions are discussed. Measurement examples are also given to demonstrate the potential of the measurement principle.

  6. A Novel Model of Conforming Delaunay Triangulation for Sensor Network Configuration

    Directory of Open Access Journals (Sweden)

    Yan Ma

    2015-01-01

    Full Text Available Delaunay refinement is a technique for generating unstructured meshes of triangles for sensor network configuration engineering practice. A new method for solving Delaunay triangulation problem is proposed in this paper, which is called endpoint triangle’s circumcircle model (ETCM. As compared with the original fractional node refinement algorithms, the proposed algorithm can get well refinement stability with least time cost. Simulations are performed under five aspects including refinement stability, the number of additional nodes, time cost, mesh quality after intruding additional nodes, and the aspect ratio improved by single additional node. All experimental results show the advantages of the proposed algorithm as compared with the existing algorithms and confirm the algorithm analysis sufficiently.

  7. Triangulation and Gender Perspectives in ‘Falling Man’ by Don DeLillo

    Directory of Open Access Journals (Sweden)

    Noemi Abe

    2011-09-01

    Susannah Radstone argues that the rhetorical response to 9/11 by the Bush administration is based on the opposition of two father figures: “the 'chastened' but powerful 'good' patriarchal father” Vs. “the 'bad' archaic father”. She explains: “In this Manichean fantasy can be glimpsed the continuing battle between competing versions of masculinity” (2002:459 that leaves women on the margins. The battle of the fathers of Bush’s rhetoric is counterposed in Falling Man by a battle between two men that stands for an unaccomplished fatherhood. Furthermore, the dualistic vision engendered by post-9/11 rhetoric and reflected in the novel should be evaluated in a trilateral dimension, given that at its core lies a triangulation built upon three stereotypical representations: the white middle-class man; the Arab terrorist; and a composite character in the middle, the woman, who shifts from ally, to victim, to a plausible supporter of the enemy.

  8. Two Strategies for Qualitative Content Analysis: An Intramethod Approach to Triangulation.

    Science.gov (United States)

    Renz, Susan M; Carrington, Jane M; Badger, Terry A

    2018-04-01

    The overarching aim of qualitative research is to gain an understanding of certain social phenomena. Qualitative research involves the studied use and collection of empirical materials, all to describe moments and meanings in individuals' lives. Data derived from these various materials require a form of analysis of the content, focusing on written or spoken language as communication, to provide context and understanding of the message. Qualitative research often involves the collection of data through extensive interviews, note taking, and tape recording. These methods are time- and labor-intensive. With the advances in computerized text analysis software, the practice of combining methods to analyze qualitative data can assist the researcher in making large data sets more manageable and enhance the trustworthiness of the results. This article will describe a novel process of combining two methods of qualitative data analysis, or Intramethod triangulation, as a means to provide a deeper analysis of text.

  9. The Extraction of Road Boundary from Crowdsourcing Trajectory Using Constrained Delaunay Triangulation

    Directory of Open Access Journals (Sweden)

    YANG Wei

    2017-02-01

    Full Text Available Extraction of road boundary accurately from crowdsourcing trajectory lines is still a hard work.Therefore,this study presented a new approach to use vehicle trajectory lines to extract road boundary.Firstly, constructing constrained Delaunay triangulation within interpolated track lines to calculate road boundary descriptors using triangle edge length and Voronoi cell.Road boundary recognition model was established by integrating the two boundary descriptors.Then,based on seed polygons,a regional growing method was proposed to extract road boundary. Finally, taxi GPS traces in Beijing were used to verify the validity of the novel method, and the results also showed that our method was suitable for GPS traces with disparity density,complex road structure and different time interval.

  10. Thermal Entanglement and Critical Behavior of Magnetic Properties on a Triangulated Kagomé Lattice

    Directory of Open Access Journals (Sweden)

    N. Ananikian

    2011-01-01

    Full Text Available The equilibrium magnetic and entanglement properties in a spin-1/2 Ising-Heisenberg model on a triangulated Kagomé lattice are analyzed by means of the effective field for the Gibbs-Bogoliubov inequality. The calculation is reduced to decoupled individual (clusters trimers due to the separable character of the Ising-type exchange interactions between the Heisenberg trimers. The concurrence in terms of the three qubit isotropic Heisenberg model in the effective Ising field in the absence of a magnetic field is non-zero. The magnetic and entanglement properties exhibit common (plateau, peak features driven by a magnetic field and (antiferromagnetic exchange interaction. The (quantum entangled and non-entangled phases can be exploited as a useful tool for signalling the quantum phase transitions and crossovers at finite temperatures. The critical temperature of order-disorder coincides with the threshold temperature of thermal entanglement.

  11. Triangulation and Parent-Adolescent Relationships: Implications for Adolescent Dating Competence and Abuse.

    Science.gov (United States)

    Fosco, Gregory M; Xia, Mengya; Lynn, Mark G; Grych, John H

    2016-09-01

    This study focuses on family predictors of conflict behavior in adolescent dating relationships, drawing on family systems and socialization perspectives. Mother-adolescent, father-adolescent, and triadic relationships each was examined as predictors of adolescent dating outcomes that hold importance for developmental and prevention science (positive conflict resolution, verbal abuse, and physical abuse). We conducted a longitudinal analysis using a 6-month longitudinal design with 236 ethnically diverse high school students. Findings indicate that triangulation into parental conflicts was related to increases in positive conflict resolution and with increases in verbally abusive behavior with dating partners over time. Parent-adolescent closeness and conflict each was related to positive conflict resolution and verbal abuse, but these associations were only found for boys. © 2015 The Authors. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.

  12. International participatory research framework: triangulating procedures to build health research capacity in Brazil

    Science.gov (United States)

    Pinto, Rogério M.; da Silva, Sueli Bulhões; Penido, Cláudia; Spector, Anya Y.

    2012-01-01

    This study advances Community-based Participatory Research (CBPR) by presenting a set of triangulated procedures (steps and actions) that can facilitate participatory research in myriad international settings. By using procedural triangulation—the combination of specific steps and actions as the basis for the International Participatory Research Framework (IPRF)—our approach can improve the abilities of researchers and practitioners worldwide to systematize the development of research partnerships. The IPRF comprises four recursive steps: (i) contextualizing the host country; (ii) identifying collaborators in the host country; (iii) seeking advice and endorsement from gatekeepers and (iv) matching partners’ expertise, needs and interests. IPRF includes the following sets of recursive participatory actions: (A1) becoming familiar with local languages and culture; (A2) sharing power, ideas, influence and resources; (A3) gathering oral and written information about partners; (A4) establishing realistic expectations and (A5) resolving personal and professional differences. We show how these steps and actions were used recursively to build a partnership to study the roles of community health workers (CHWs) in Brazil's Family Health Program (PSF). The research conducted using IPRF focused on HIV prevention, and it included nearly 200 CHWs. By using the IPRF, our partnership achieved several participatory outcomes: community-defined research aims, capacity for future research and creation of new policies and programs. We engaged CHWs who requested that we study their training needs, and we engaged CHWs’ supervisors who used the data collected to modify CHW training. Data collected from CHWs will form the basis for a grant to test CHW training curricula. Researchers and community partners can now use the IPRF to build partnerships in different international contexts. By triangulating steps and actions, the IPRF advances knowledge about the use of CBPR methods

  13. Determination of Shift/Bias in Digital Aerial Triangulation of UAV Imagery Sequences

    Science.gov (United States)

    Wierzbicki, Damian

    2017-12-01

    Currently UAV Photogrammetry is characterized a largely automated and efficient data processing. Depicting from the low altitude more often gains on the meaning in the uses of applications as: cities mapping, corridor mapping, road and pipeline inspections or mapping of large areas e.g. forests. Additionally, high-resolution video image (HD and bigger) is more often use for depicting from the low altitude from one side it lets deliver a lot of details and characteristics of ground surfaces features, and from the other side is presenting new challenges in the data processing. Therefore, determination of elements of external orientation plays a substantial role the detail of Digital Terrain Models and artefact-free ortophoto generation. Parallel a research on the quality of acquired images from UAV and above the quality of products e.g. orthophotos are conducted. Despite so fast development UAV photogrammetry still exists the necessity of accomplishment Automatic Aerial Triangulation (AAT) on the basis of the observations GPS/INS and via ground control points. During low altitude photogrammetric flight, the approximate elements of external orientation registered by UAV are burdened with the influence of some shift/bias errors. In this article, methods of determination shift/bias error are presented. In the process of the digital aerial triangulation two solutions are applied. In the first method shift/bias error was determined together with the drift/bias error, elements of external orientation and coordinates of ground control points. In the second method shift/bias error was determined together with the elements of external orientation, coordinates of ground control points and drift/bias error equals 0. When two methods were compared the difference for shift/bias error is more than ±0.01 m for all terrain coordinates XYZ.

  14. Comparing the effects of interparticle friction coefficient and intermediate stress ratio on critical-state DEM simulations using Delaunay triangulations

    Science.gov (United States)

    Hanley, Kevin J.; Huang, Xin; O'Sullivan, Catherine

    2017-06-01

    Strong force chains form when any granular material is subjected to load. A prior study used Delaunay triangulations to investigate the role of interparticle friction coefficient, μ, in stabilising the strong force chains [1]. In this follow-on paper, the effects of μ and the intermediate stress ratio, b, are compared. Numerical samples were sheared triaxially until critical state was attained. The contact networks and Delaunay triangulations of the particle centroids were both obtained at the end of each simulation. As μ is increased, the numbers of contacts in the contact networks decrease consistently. The numbers of edges, faces or tetrahedra in the Delaunay triangulations all increase with increasing μ up to 0.25 and become approximately constant thereafter. Changing b has no significant effect. The percentage of faces in the triangulation comprising three contacts shows a linearly-decreasing trend with increasing angle of shearing resistance. This is because only orthogonal loads are applied. Triangular structures require larger lateral supporting forces to maintain their stability than columnar structures when subjected to an axial load; hence, σ3' is expected to be larger relative to σ1' when triangular motifs are more prevalent. An increased proportion of triangular structures therefore leads to a lower ϕcv'.

  15. Generation of triangulated random surfaces by means of the Monte Carlo method in the grand canonical ensemble

    International Nuclear Information System (INIS)

    Zmushko, V.V.; Migdal, A.A.

    1987-01-01

    A model of triangulated random surfaces which is the discrete analogue of the Polyakov string is considered in the work. An algorithm is proposed which enables one to study the model by means of the Monte Carlo method in the grand canonical ensemble. Preliminary results are presented on the evaluation of the critical index γ

  16. Umbilical cord clamping at birth--practice in Norwegian maternity wards.

    Science.gov (United States)

    Lundberg, Camilla; Øian, Pål; Klingenberg, Claus

    2013-11-26

    The timing and practice used for umbilical cord clamping of neonates are controversial internationally as well as in Norway. We therefore wished to investigate routines and practices for umbilical cord clamping of neonates in Norway. A web-based questionnaire was sent to heads of departments of all maternity wards in Norway (n = 52). They were asked about their practice with regard to umbilical cord clamping of neonates and whether written routines had been prepared for this purpose. We defined early umbilical cord clamping as immediate or within 30 seconds and late clamping as ≥ 1 minute or not until pulsation in the umbilical cord had ceased. Fifty (96%) of the maternity institutions returned a completed questionnaire. Twelve institutions (24%) reported to clamp the umbilical cord of full-term neonates early, and 38 (76%) reported to practise late clamping. Nineteen maternity wards (38%) followed written routines for umbilical cord clamping of full-term neonates, and among these, early umbilical cord clamping was practised in nine (47%). In the 31 maternity wards that had no written routines, early umbilical cord clamping was practised in three (10%). Twenty-seven of the maternity wards reported that the child is placed on the maternal abdomen before clamping of the umbilical cord, 14 reported that the child commonly is held below the introitus before umbilical cord clamping, and the rest did not report any consistent practice. There is wide variation in the practice for umbilical cord clamping in Norwegian maternity wards, many of which have no written guidelines. We argue that national guidelines for umbilical cord clamping of neonates should be established.

  17. Umbilical cord cysts in the first trimester: are they associated with pregnancy complications?

    Science.gov (United States)

    Hannaford, Karen; Reeves, Shane; Wegner, Elisabeth

    2013-05-01

    To determine whether umbilical cord cysts found by transvaginal sonography in the first trimester of pregnancy are associated with poor pregnancy outcomes. We conducted a matched cohort study between July 2006 and July 2008. Patients with umbilical cord cysts found on transvaginal sonography in the first trimester were matched to patients with normal umbilical cords. After the completion of these pregnancies, medical histories and pregnancy outcomes were reviewed from the hospital's electronic record. Sonograms were reviewed to obtain descriptive information about the umbilical cord cysts. Outcomes between the cohorts were compared. Forty-five patients with umbilical cord cysts were identified and compared to 85 patients with normal umbilical cords. The mean gestational age of the cysts ± SD at diagnosis was 8 weeks 3 days ± 3.5 days. The mean cyst diameter was 3 ± 2.1 mm. All cysts resolved on follow-up sonography, which was performed between 9 weeks 4 days and 20 weeks 5 days. Patients with umbilical cord cysts were found to have a lower body mass index than those with normal umbilical cords. There was no significant difference in abnormal sonographic findings between cohorts. Five sonographic fetal abnormalities were found in the umbilical cord cyst cohort (11.1%) and 8 in the normal umbilical cord cohort (9.4%). There were 2 intrauterine fetal demises in the umbilical cord cyst cohort and 1 in the normal umbilical cord cohort. There was no difference between the cohorts when comparing gestational age at delivery and birth weight. There does not appear to be an association between poor pregnancy outcomes and umbilical cord cysts during the first trimester.

  18. Primary umbilical endometriosis - Diagnosis by fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Hilda Fernandes

    2011-01-01

    Full Text Available Primary (spontaneous umbilical endometriosis is very rare with an estimated incidence of 0.5-1% of all patients with endometrial ectopia. Endometriosis is a common gynecological condition, the pelvis being the most common site of the disease. Extrapelvic site is less common and even more difficult to diagnose due to the extreme variability in presentation. A 38-year-old woman presented with a blackish nodule over the umbilicus of 3 years duration. Fine needle aspiration cytology of the lesion showed cells in clusters and sheets with background of scant stromal fragment, hemosiderin laden macrophages and RBCs, leading to a suggestion of umbilical endometriosis. Histopathological examination of the excised lesion confirmed the same.

  19. Umbilical hemorrhage as first manifestation in a case of cirrhosis.

    Science.gov (United States)

    Harish, K; Harikumar, R; Kumar, R Sunil; Sandesh, K; Rajendran, V; Thomas, Varghese

    2005-01-01

    Portal hypertension is often associated with an extensive collateral circulation. The paraumbilical vein is a relatively common collateral pathway recognized in these patients but cutaneous bleeding from the umbilicus is rare; the same as first manifestation of cirrhosis is exceptional. We report a case of umbilical venous bleed causing hemodynamic compromise, which turned out to be a case of alcoholic cirrhosis with portal hypertension. The patient was managed with suture ligation of the vessels.

  20. Umbilical Hernia Repair and Pregnancy: Before, during, after…

    Science.gov (United States)

    Kulacoglu, Hakan

    2018-01-01

    Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation. PMID:29435451

  1. Is "Delayed Umbilical Cord Clamping" Beneficial for Premature Newborns?

    Directory of Open Access Journals (Sweden)

    Amir-Mohammad Armanian

    2017-05-01

    Full Text Available Background: The appropriate moment for clamping the umbilical cord is controversial. Immediate cord clamping (ICC is an item of active management of the third stage of labor (AMTSL. Unclamped umbilical cord may cause inconvenience in preterm neonates because they commonly need some levels of emergent services. Some studies revealed delayed cord clamping (DCC of preterm neonates results in better health conditions like lower rates of respiratory distress syndrome (RDS, less morbidities in labor room and lower risk of postpartum hemorrhage. The aim of the present study was to determine the effect of delayed umbilical cord clamping on premature neonatal outcomes. Materials and Methods: In this single‑center randomized control trial study, sixty premature neonates (gestational age ≤ 34 weeks were randomly assigned to ICC (cord clamped at 5–10 seconds or DCC (30–45 seconds groups and followed up in neonatal intensive care unit (NICU. Primary outcomes were 1st and 5th minute Apgar score, average of level of hematocrit after birth, intra ventricle hemorrhage and need some levels of resuscitation. Results: Differences in demographic characteristics were not statistically significant. After birth, neonates who had delayed clamping had significantly higher mean hematocrit after at 4-hour of birth (49.58+5.15gr/dl vs. 46.58+5.40gr/dlin DCC vs. ICC groups, respectively (P=0.031. Delayed cord clamping reduced the duration of need to nasal continues positive airway pressure (NCPAP (86.7% and 60.0% in ICC and DCC groups, respectively, P= 0.039. Attractively, the results showed lower incidence of clinical sepsis in delayed cord clamping neonates (53.3% vs. 23.3% in ICC and DCC groups, respectively, P=0.033. Conclusion: Prematurity complications might decrease by delay umbilical cord clamping which improve the hematocrit, duration of need to NCPAP and incidence of clinical sepsis. Furthermore, DCC may have no negative impact on neonatal resuscitation.

  2. Damage control apronectomy for necrotising fasciitis and strangulated umbilical hernia.

    LENUS (Irish Health Repository)

    Coyle, P

    2012-01-31

    We present a case of a 50-year-old morbidly obese woman who presented with a case of necrotizing fasciitis of the anterior abdominal wall due to a strangulated umbilical hernia. The case was managed through damage control surgery (DCS) with an initial surgery to stabilise the patient and a subsequent definitive operation and biological graft hernia repair. We emphasise the relevance of DCS principles in the management of severe abdominal sepsis.

  3. Doppler ultrasound scan during normal gestation: umbilical circulation

    International Nuclear Information System (INIS)

    Ruiz, T.; Sabate, J.; Martinez-Benavides, M. M.; Sanchez-Ramos, J.

    2002-01-01

    To determine normal umbilical circulation patterns by means of Doppler ultrasound scan in a healthy gestating population without risk factors and with normal perinatal results, and to evaluate any occurring modifications relative to gestational age by obtaining records kept during pregnancy. One hundred and sixteen pregnant women carrying a single fetus have been studied. These women had no risk factors, with both clinical and analytical controls, as well as ultrasound scans, all being normal. There were performed a total of 193 Doppler ultrasound scans between weeks 15 and 41 of gestation, with blood-flow analysis in the arteries and vein of the umbilical cord. The obtained information was correlated with parameters that evaluate fetal well-being (fetal monitoring and/or oxytocin test) and perinatal result (delivery type, birth weight, Apgar score). Statistical analysis was performed with the programs SPSS 6.0.1 for Windows and EPIINFO 6.0.4. With pulsed Doppler, the umbilical artery in all cases demonstrated a biphasic morphology with systolic and diastolic components and without retrograde blood flow. As the gestation period increased, there was observed a progressive decrease in resistance along with an increase in blood-flow velocity during the diastolic phase. The Doppler ultrasound scan is a non-invasive method that permits the hemodynamic study of umbilical blood circulation. A knowledge of normal blood-flow signal morphology, as well as of the normal values for Doppler indices in relation to gestational age would permit us to utilize this method in high-risk pregnancies. (Author) 30 refs

  4. The prevalence of umbilical and epigastric hernia repair

    DEFF Research Database (Denmark)

    Burcharth, J; Pedersen, M.S.; Pommergaard, H C

    2015-01-01

    PURPOSE: Umbilical and epigastric hernia repair are common surgical procedures; however, the nationwide gender and age-specific prevalence of these repairs is unknown, and this knowledge could form the basis for new studies. METHODS: A nationwide register-based study covering all people living...... population covered 5,639,885 persons (49 % males). A total of 10,107 patients (68 % males) were operated for an umbilical hernia and 2412 patients (55 % males) were operated for an epigastric hernia. The age-specific 5-year prevalence differed for both hernia types. The highest 5-year prevalence of umbilical...... hernia repairs was seen in males aged 60-70 years with a 5-year prevalence of 0.53 % (95 % CI 0.51-0.56 %) and the highest age-specific 5-year prevalence of epigastric hernia repair was seen in 40-50 year females with a 5-year prevalence of 0.086 % (95 % CI 0.077-0.095 %). CONCLUSION: The gender and age...

  5. Associations between intrapartum death and piglet, placental, and umbilical characteristics.

    Science.gov (United States)

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2012-12-01

    Intrapartum death in multiparous gestations in sows (Sus scrofa) is often caused by hypoxia. There is little information in the literature on the assessment of the placenta in relation to intrapartum death in piglets. The aim of this study was to evaluate the impact of the placental area and weight upon piglet birth characteristics and intrapartum death. Litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each piglet was recorded, including blood parameters of piglets and their umbilical veins. Of 413 piglets born, 6.5% were stillborn. Blood concentrations of glucose, lactate, and CO(2) partial pressure were increased in the stillborn piglets (P live-born piglets, whereas pH and base excess were decreased (P live (P live-born piglets (P = 0.631), whereas mean body mass index was reduced (P live-born piglets (P = 0.662 and P = 0.253, respectively). Blood concentrations of lactate, hemoglobin, and hematocrit recorded in all piglets pooled were associated with placental area (P 0.2). Piglet BW was positively correlated with placental area and placental weight (P vitality than placental weight. Because umbilical cord rupture and prolonged birth time were associated with being born dead, umbilical cord rupture and placental detachment seem to be probable causes of intrapartum death.

  6. Good practices in collecting umbilical cord and placental blood

    Directory of Open Access Journals (Sweden)

    Lauren Auer Lopes

    Full Text Available Abstract Objective: to identify the factors related to the quality of umbilical cord and placental blood specimens, and define best practices for their collection in a government bank of umbilical cord and placental blood. Method: this was a descriptive study, quantitative approach, performed at a government umbilical cord and placental blood bank, in two steps: 1 verification of the obstetric, neonatal and operational factors, using a specific tool for gathering data as non-participant observers; 2 definition of best practices by grouping non-conformities observed before, during and after blood collection. The data was analyzed using descriptive statistics and the following statistical software: Statistica(r and R(r. Results: while there was a correlation with obstetrical and neonatal factors, there was a larger correlation with operational factors, resulting in the need to adjust the professional practices of the nursing staff and obstetrical team involved in collecting this type of blood. Based on these non-conformities we defined best practices for nurses before, during and after blood collection. Conclusion: the best practices defined in this study are an important management tool for the work of nurses in obtaining blood specimens of high cell quality.

  7. Musculoskeletal tissue engineering with human umbilical cord mesenchymal stromal cells

    Science.gov (United States)

    Wang, Limin; Ott, Lindsey; Seshareddy, Kiran; Weiss, Mark L; Detamore, Michael S

    2011-01-01

    Multipotent mesenchymal stromal cells (MSCs) hold tremendous promise for tissue engineering and regenerative medicine, yet with so many sources of MSCs, what are the primary criteria for selecting leading candidates? Ideally, the cells will be multipotent, inexpensive, lack donor site morbidity, donor materials should be readily available in large numbers, immunocompatible, politically benign and expandable in vitro for several passages. Bone marrow MSCs do not meet all of these criteria and neither do embryonic stem cells. However, a promising new cell source is emerging in tissue engineering that appears to meet these criteria: MSCs derived from Wharton’s jelly of umbilical cord MSCs. Exposed to appropriate conditions, umbilical cord MSCs can differentiate in vitro along several cell lineages such as the chondrocyte, osteoblast, adipocyte, myocyte, neuronal, pancreatic or hepatocyte lineages. In animal models, umbilical cord MSCs have demonstrated in vivo differentiation ability and promising immunocompatibility with host organs/tissues, even in xenotransplantation. In this article, we address their cellular characteristics, multipotent differentiation ability and potential for tissue engineering with an emphasis on musculoskeletal tissue engineering. PMID:21175290

  8. Acquired umbilical hernias in four captive polar bears (Ursus maritimus).

    Science.gov (United States)

    Velguth, Karen E; Rochat, Mark C; Langan, Jennifer N; Backues, Kay

    2009-12-01

    Umbilical hernias are a common occurrence in domestic animals and humans but have not been well documented in polar bears. Surgical reduction and herniorrhaphies were performed to correct acquired hernias in the region of the umbilicus in four adult captive polar bears (Ursus maritimus) housed in North American zoos. Two of the four bears were clinically unaffected by their hernias prior to surgery. One bear showed signs of severe discomfort following acute enlargement of the hernia. In another bear, re-herniation led to acute abdominal pain due to gastric entrapment and strangulation. The hernias in three bears were surgically repaired by debridement of the hernia ring and direct apposition of the abdominal wall, while the large defect in the most severely affected bear was closed using polypropylene mesh to prevent excessive tension. The cases in this series demonstrate that while small hernias may remain clinically inconsequential for long periods of time, enlargement or recurrence of the defect can lead to incarceration and acute abdominal crisis. Umbilical herniation has not been reported in free-ranging polar bears, and it is suspected that factors such as body condition, limited exercise, or enclosure design potentially contribute to the development of umbilical hernias in captive polar bears.

  9. Triangulation of language-cognitive impairments, naming errors and their neural bases post-stroke

    Directory of Open Access Journals (Sweden)

    Ajay D. Halai

    2018-01-01

    Full Text Available In order to gain a better understanding of aphasia one must consider the complex combinations of language impairments along with the pattern of paraphasias. Despite the fact that both deficits and paraphasias feature in diagnostic criteria, most research has focused only on the lesion correlates of language deficits, with minimal attention on the pattern of patients' paraphasias. In this study, we used a data-driven approach (principal component analysis - PCA to fuse patient impairments and their pattern of errors into one unified model of chronic post-stroke aphasia. This model was subsequently mapped onto the patients' lesion profiles to generate the triangulation of language-cognitive impairments, naming errors and their neural correlates. Specifically, we established the pattern of co-occurrence between fifteen error types, which avoids focussing on a subset of errors or the use of experimenter-derived methods to combine across error types. We obtained five principal components underlying the patients' errors: omission errors; semantically-related responses; phonologically-related responses; dysfluent responses; and a combination of circumlocutions with mixed errors. In the second step, we aligned these paraphasia-related principal components with the patients' performance on a detailed language and cognitive assessment battery, utilising an additional PCA. This omnibus PCA revealed seven unique fused impairment-paraphasia factors: output phonology; semantics; phonological working memory; speech quanta; executive-cognitive skill; phonological (input discrimination; and the production of circumlocution errors. In doing so we were able to resolve the complex relationships between error types and impairments. Some are relatively straightforward: circumlocution errors formed their own independent factor; there was a one-to-one mapping for phonological errors with expressive phonological abilities and for dysfluent errors with speech fluency. In

  10. Euclidean Dynamical Triangulation revisited: is the phase transition really 1st order?

    International Nuclear Information System (INIS)

    Rindlisbacher, Tobias; Forcrand, Philippe de

    2015-01-01

    The transition between the two phases of 4D Euclidean Dynamical Triangulation (http://dx.doi.org/10.1016/0370-2693(92)90709-D) was long believed to be of second order until in 1996 first order behavior was found for sufficiently large systems (http://dx.doi.org/10.1016/0550-3213(96)00214-3, http://dx.doi.org/10.1016/S0370-2693(96)01277-4). However, one may wonder if this finding was affected by the numerical methods used: to control volume fluctuations, in both studies (http://dx.doi.org/10.1016/0550-3213(96)00214-3, http://dx.doi.org/10.1016/S0370-2693(96)01277-4) an artificial harmonic potential was added to the action and in (http://dx.doi.org/10.1016/S0370-2693(96)01277-4) measurements were taken after a fixed number of accepted instead of attempted moves which introduces an additional error. Finally the simulations suffer from strong critical slowing down which may have been underestimated. In the present work, we address the above weaknesses: we allow the volume to fluctuate freely within a fixed interval; we take measurements after a fixed number of attempted moves; and we overcome critical slowing down by using an optimized parallel tempering algorithm (http://dx.doi.org/10.1088/1742-5468/2010/01/P01020). With these improved methods, on systems of size up to N 4 =64k 4-simplices, we confirm that the phase transition is 1 st order. In addition, we discuss a local criterion to decide whether parts of a triangulation are in the elongated or crumpled state and describe a new correspondence between EDT and the balls in boxes model. The latter gives rise to a modified partition function with an additional, third coupling. Finally, we propose and motivate a class of modified path-integral measures that might remove the metastability of the Markov chain and turn the phase transition into 2 nd order.

  11. The Development and Implementation of the Kennedy Space Center Umbilical Clearance Tool

    Science.gov (United States)

    Chesnutt, David

    2016-01-01

    In preparation for NASAs upcoming Space Launch System program, the Kennedy Space Center is currently developing subsystems to provide fuel, purges and communications to the flight vehicle, known as umbilicals. It is vital to the crew and mission that these umbilicals release at T-0 without re-contacting the vehicle as it is accelerating from the launch pad. To help ensure this requirement is met by the program, a methodology of evaluating the moving bodies was developed and implemented into a tool using MATLAB. The tool, known as the KSC Umbilical Clearance Tool, takes a given elevation of interest and an umbilical retract profile within the plane to evaluate the clearance between the umbilical arm and thousands of independent flight vehicle drift profiles from a Monte Carlo analysis. The presentation will delve into the challenges associated with developing and implementing the tool framed in the context of evaluating the clearance for one of the SLS umbilicals.

  12. Severe Hemorrhage from the Umbilical Cord at Birth: A Preventable Cause of Neonatal Shock

    OpenAIRE

    Singh, Neetu; Suresh, Gautham

    2013-01-01

    Posthemorrhagic anemia is a rare but important cause of anemia in neonates, second only to hemolytic anemia of newborn. Most cases of posthemorrhagic anemia are reported from fetomaternal hemorrhage or umbilical cord accidents in utero. This case report describes a preterm infant who developed severe anemia and shock immediately after delivery related to an acute hemorrhage through patent umbilical cord vessels secondary to a tear in the umbilical cord at the site of cord clamping. We believe...

  13. PERFORMANCE ANALYSIS OF A LOW-COST TRIANGULATION-BASED 3D CAMERA: MICROSOFT KINECT SYSTEM

    Directory of Open Access Journals (Sweden)

    J. C. K. Chow

    2012-07-01

    Full Text Available Recent technological advancements have made active imaging sensors popular for 3D modelling and motion tracking. The 3D coordinates of signalised targets are traditionally estimated by matching conjugate points in overlapping images. Current 3D cameras can acquire point clouds at video frame rates from a single exposure station. In the area of 3D cameras, Microsoft and PrimeSense have collaborated and developed an active 3D camera based on the triangulation principle, known as the Kinect system. This off-the-shelf system costs less than $150 USD and has drawn a lot of attention from the robotics, computer vision, and photogrammetry disciplines. In this paper, the prospect of using the Kinect system for precise engineering applications was evaluated. The geometric quality of the Kinect system as a function of the scene (i.e. variation of depth, ambient light conditions, incidence angle, and object reflectivity and the sensor (i.e. warm-up time and distance averaging were analysed quantitatively. This system's potential in human body measurements was tested against a laser scanner and 3D range camera. A new calibration model for simultaneously determining the exterior orientation parameters, interior orientation parameters, boresight angles, leverarm, and object space features parameters was developed and the effectiveness of this calibration approach was explored.

  14. Limits of Active Laser Triangulation as an Instrument for High Precision Plant Imaging

    Directory of Open Access Journals (Sweden)

    Stefan Paulus

    2014-02-01

    Full Text Available Laser scanning is a non-invasive method for collecting and parameterizing 3D data of well reflecting objects. These systems have been used for 3D imaging of plant growth and structure analysis. A prerequisite is that the recorded signals originate from the true plant surface. In this paper we studied the effects of species, leaf chlorophyll content and sensor settings on the suitability and accuracy of a commercial 660 nm active laser triangulation scanning device. We found that surface images of Ficus benjamina leaves were inaccurate at low chlorophyll concentrations and a long sensor exposure time. Imaging of the rough waxy leaf surface of leek (Allium porrum was possible using very low exposure times, whereas at higher exposure times penetration and multiple refraction prevented the correct imaging of the surface. A comparison of scans with varying exposure time enabled the target-oriented analysis to identify chlorotic, necrotic and healthy leaf areas or mildew infestations. We found plant properties and sensor settings to have a strong influence on the accuracy of measurements. These interactions have to be further elucidated before laser imaging of plants is possible with the high accuracy required for e.g., the observation of plant growth or reactions to water stress.

  15. Limits of active laser triangulation as an instrument for high precision plant imaging.

    Science.gov (United States)

    Paulus, Stefan; Eichert, Thomas; Goldbach, Heiner E; Kuhlmann, Heiner

    2014-02-05

    Laser scanning is a non-invasive method for collecting and parameterizing 3D data of well reflecting objects. These systems have been used for 3D imaging of plant growth and structure analysis. A prerequisite is that the recorded signals originate from the true plant surface. In this paper we studied the effects of species, leaf chlorophyll content and sensor settings on the suitability and accuracy of a commercial 660 nm active laser triangulation scanning device. We found that surface images of Ficus benjamina leaves were inaccurate at low chlorophyll concentrations and a long sensor exposure time. Imaging of the rough waxy leaf surface of leek (Allium porrum) was possible using very low exposure times, whereas at higher exposure times penetration and multiple refraction prevented the correct imaging of the surface. A comparison of scans with varying exposure time enabled the target-oriented analysis to identify chlorotic, necrotic and healthy leaf areas or mildew infestations. We found plant properties and sensor settings to have a strong influence on the accuracy of measurements. These interactions have to be further elucidated before laser imaging of plants is possible with the high accuracy required for e.g., the observation of plant growth or reactions to water stress.

  16. Solving the Einstein constraint equations on multi-block triangulations using finite element methods

    International Nuclear Information System (INIS)

    Korobkin, Oleg; Pazos, Enrique; Aksoylu, Burak; Holst, Michael; Tiglio, Manuel

    2009-01-01

    In order to generate initial data for nonlinear relativistic simulations, one needs to solve the Einstein constraints, which can be cast into a coupled set of nonlinear elliptic equations. Here we present an approach for solving these equations on three-dimensional multi-block domains using finite element methods. We illustrate our approach on a simple example of Brill wave initial data, with the constraints reducing to a single linear elliptic equation for the conformal factor ψ. We use quadratic Lagrange elements on semi-structured simplicial meshes, obtained by triangulation of multi-block grids. In the case of uniform refinement the scheme is superconvergent at most mesh vertices, due to local symmetry of the finite element basis with respect to local spatial inversions. We show that in the superconvergent case subsequent unstructured mesh refinements do not improve the quality of our initial data. As proof of concept that this approach is feasible for generating multi-block initial data in three dimensions, after constructing the initial data we evolve them in time using a high-order finite-differencing multi-block approach and extract the gravitational waves from the numerical solution.

  17. A new approach for categorizing pig lying behaviour based on a Delaunay triangulation method.

    Science.gov (United States)

    Nasirahmadi, A; Hensel, O; Edwards, S A; Sturm, B

    2017-01-01

    Machine vision-based monitoring of pig lying behaviour is a fast and non-intrusive approach that could be used to improve animal health and welfare. Four pens with 22 pigs in each were selected at a commercial pig farm and monitored for 15 days using top view cameras. Three thermal categories were selected relative to room setpoint temperature. An image processing technique based on Delaunay triangulation (DT) was utilized. Different lying patterns (close, normal and far) were defined regarding the perimeter of each DT triangle and the percentages of each lying pattern were obtained in each thermal category. A method using a multilayer perceptron (MLP) neural network, to automatically classify group lying behaviour of pigs into three thermal categories, was developed and tested for its feasibility. The DT features (mean value of perimeters, maximum and minimum length of sides of triangles) were calculated as inputs for the MLP classifier. The network was trained, validated and tested and the results revealed that MLP could classify lying features into the three thermal categories with high overall accuracy (95.6%). The technique indicates that a combination of image processing, MLP classification and mathematical modelling can be used as a precise method for quantifying pig lying behaviour in welfare investigations.

  18. Performance Analysis of a Low-Cost Triangulation-Based 3d Camera: Microsoft Kinect System

    Science.gov (United States)

    . K. Chow, J. C.; Ang, K. D.; Lichti, D. D.; Teskey, W. F.

    2012-07-01

    Recent technological advancements have made active imaging sensors popular for 3D modelling and motion tracking. The 3D coordinates of signalised targets are traditionally estimated by matching conjugate points in overlapping images. Current 3D cameras can acquire point clouds at video frame rates from a single exposure station. In the area of 3D cameras, Microsoft and PrimeSense have collaborated and developed an active 3D camera based on the triangulation principle, known as the Kinect system. This off-the-shelf system costs less than 150 USD and has drawn a lot of attention from the robotics, computer vision, and photogrammetry disciplines. In this paper, the prospect of using the Kinect system for precise engineering applications was evaluated. The geometric quality of the Kinect system as a function of the scene (i.e. variation of depth, ambient light conditions, incidence angle, and object reflectivity) and the sensor (i.e. warm-up time and distance averaging) were analysed quantitatively. This system's potential in human body measurements was tested against a laser scanner and 3D range camera. A new calibration model for simultaneously determining the exterior orientation parameters, interior orientation parameters, boresight angles, leverarm, and object space features parameters was developed and the effectiveness of this calibration approach was explored.

  19. Coupling a point-like mass to quantum gravity with causal dynamical triangulations

    Energy Technology Data Exchange (ETDEWEB)

    Khavkine, I; Loll, R; Reska, P, E-mail: i.khavkine@uu.n, E-mail: r.loll@uu.n, E-mail: p.m.reska@uu.n [Spinoza Institute and Institute for Theoretical Physics, Utrecht University, Leuvenlaan 4, NL-3584 CE Utrecht (Netherlands)

    2010-09-21

    We present a possibility of coupling a point-like, non-singular, mass distribution to four-dimensional quantum gravity in the nonperturbative setting of causal dynamical triangulations (CDT). In order to provide a point of comparison for the classical limit of the matter-coupled CDT model, we derive the spatial volume profile of the Euclidean Schwarzschild-de Sitter space glued to an interior matter solution. The volume profile is calculated with respect to a specific proper-time foliation matching the global time slicing present in CDT. It deviates in a characteristic manner from that of the pure-gravity model. The appearance of coordinate caustics and the compactness of the mass distribution in lattice units put an upper bound on the total mass for which these calculations are expected to be valid. We also discuss some of the implementation details for numerically measuring the expectation value of the volume profiles in the framework of CDT when coupled appropriately to the matter source.

  20. Triangulation of Qualitative Methods for the Exploration of Activity Systems in Ergonomics

    Directory of Open Access Journals (Sweden)

    Monika Hackel

    2008-08-01

    Full Text Available Research concerning ergonomic issues in interdisciplinary projects often raises several very specific questions depending on project objectives. To answer these questions the application of research methods should be thoroughly considered, regarding both the expenditure and the options within the scope of the given resources. The project AQUIMO develops an adaptable modelling tool for mechatronical engineering and creates a related qualification program. The task of social scientific research within this project is to identify requirements viewed from the perspective of the subsequent users. This formative evaluation is based on the approach of "developmental work research" as set forth by ENGESTRÖM and, thus, is a form of "action research". This paper discusses the triangulation of several qualitative methods addressing the examination of difficulties in interdisciplinary collaboration in mechatronical engineering. After a description of both background and analytic approach within the project AQUIMO, the methods are briefly described concerning their advantages and critical points. Their application within the research project AQUIMO is explained from an activity theoretical perspective. URN: urn:nbn:de:0114-fqs0803158

  1. Solving the Einstein constraint equations on multi-block triangulations using finite element methods

    Energy Technology Data Exchange (ETDEWEB)

    Korobkin, Oleg; Pazos, Enrique [Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA 70803 (United States); Aksoylu, Burak [Center for Computation and Technology, Louisiana State University, Baton Rouge, LA 70803 (United States); Holst, Michael [Department of Mathematics, University of California at San Diego 9500 Gilman Drive La Jolla, CA 92093-0112 (United States); Tiglio, Manuel [Department of Physics, University of Maryland, College Park, MD 20742 (United States)

    2009-07-21

    In order to generate initial data for nonlinear relativistic simulations, one needs to solve the Einstein constraints, which can be cast into a coupled set of nonlinear elliptic equations. Here we present an approach for solving these equations on three-dimensional multi-block domains using finite element methods. We illustrate our approach on a simple example of Brill wave initial data, with the constraints reducing to a single linear elliptic equation for the conformal factor psi. We use quadratic Lagrange elements on semi-structured simplicial meshes, obtained by triangulation of multi-block grids. In the case of uniform refinement the scheme is superconvergent at most mesh vertices, due to local symmetry of the finite element basis with respect to local spatial inversions. We show that in the superconvergent case subsequent unstructured mesh refinements do not improve the quality of our initial data. As proof of concept that this approach is feasible for generating multi-block initial data in three dimensions, after constructing the initial data we evolve them in time using a high-order finite-differencing multi-block approach and extract the gravitational waves from the numerical solution.

  2. Euclidean Dynamical Triangulation revisited: is the phase transition really 1st order? (extended version)

    CERN Document Server

    Rindlisbacher, Tobias

    2015-01-01

    The transition between the two phases of 4D Euclidean Dynamical Triangulation [1] was long believed to be of second order until in 1996 first order behavior was found for sufficiently large systems [5,9]. However, one may wonder if this finding was affected by the numerical methods used: to control volume fluctuations, in both studies [5,9] an artificial harmonic potential was added to the action; in [9] measurements were taken after a fixed number of accepted instead of attempted moves which introduces an additional error. Finally the simulations suffer from strong critical slowing down which may have been underestimated. In the present work, we address the above weaknesses: we allow the volume to fluctuate freely within a fixed interval; we take measurements after a fixed number of attempted moves; and we overcome critical slowing down by using an optimized parallel tempering algorithm [12]. With these improved methods, on systems of size up to 64k 4-simplices, we confirm that the phase transition is first ...

  3. 3D digitization methods based on laser excitation and active triangulation: a comparison

    Science.gov (United States)

    Aubreton, Olivier; Mériaudeau, Fabrice; Truchetet, Frédéric

    2016-04-01

    3D reconstruction of surfaces is an important topic in computer vision and corresponds to a large field of applications: industrial inspection, reverse engineering, object recognition, biometry, archeology… Because of the large varieties of applications, one can find in the literature a lot of approaches which can be classified into two families: passive and active [1]. Certainly because of their reliability, active approaches, using imaging system with an additional controlled light source, seem to be the most commonly used in the industrial field. In this domain, the 3D digitization approach based on active 3D triangulation has had important developments during the last ten years [2] and seems to be mature today if considering the important number of systems proposed by manufacturers. Unfortunately, the performances of active 3D scanners depend on the optical properties of the surface to digitize. As an example, on Fig 1.a, a 3D shape with a diffuse surface has been digitized with Comet V scanner (Steinbichler). The 3D reconstruction is presented on Fig 1.b. The same experiment was carried out on a similar object (same shape) but presenting a specular surface (Fig 1.c and Fig 1.d) ; it can clearly be observed, that the specularity influences of the performance of the digitization.

  4. Simultaneous hierarchical segmentation and vectorization of satellite images through combined data sampling and anisotropic triangulation

    Energy Technology Data Exchange (ETDEWEB)

    Grazzini, Jacopo [Los Alamos National Laboratory; Prasad, Lakshman [Los Alamos National Laboratory; Dillard, Scott [PNNL

    2010-10-21

    The automatic detection, recognition , and segmentation of object classes in remote sensed images is of crucial importance for scene interpretation and understanding. However, it is a difficult task because of the high variability of satellite data. Indeed, the observed scenes usually exhibit a high degree of complexity, where complexity refers to the large variety of pictorial representations of objects with the same semantic meaning and also to the extensive amount of available det.ails. Therefore, there is still a strong demand for robust techniques for automatic information extraction and interpretation of satellite images. In parallel, there is a growing interest in techniques that can extract vector features directly from such imagery. In this paper, we investigate the problem of automatic hierarchical segmentation and vectorization of multispectral satellite images. We propose a new algorithm composed of the following steps: (i) a non-uniform sampling scheme extracting most salient pixels in the image, (ii) an anisotropic triangulation constrained by the sampled pixels taking into account both strength and directionality of local structures present in the image, (iii) a polygonal grouping scheme merging, through techniques based on perceptual information , the obtained segments to a smaller quantity of superior vectorial objects. Besides its computational efficiency, this approach provides a meaningful polygonal representation for subsequent image analysis and/or interpretation.

  5. Umbilical hypercoiling in 2nd- and 3rd-trimester intrauterine fetal death.

    Science.gov (United States)

    Dutman, Annemiek C; Nikkels, Peter G J

    2015-01-01

    Cases of unexplained intrauterine fetal death (IUFD) can be reduced by full placental examination, with or without autopsy. Determination of the umbilical coiling index (UCI) is considered to be a part of full placental examination. Umbilical hypercoiling (UCI above 0.30 coils/cm) is associated with IUFD. In a large retrospective study, we found an incidence of 18% umbilical hypercoiling in IUFD. We explored the association between umbilical hypercoiling and 2nd- and 3rd-trimester IUFD in 77 cases. There was a significant negative correlation between the UCI and gestational age of IUFD (PUCI should be part of the routine placental examination of cases of IUFD.

  6. Investigation of possible maternal and fetal factors which affect umbilical coiling index.

    Science.gov (United States)

    Namli Kalem, Muberra; Kalem, Ziya; Akgun, Nilufer; Yuce, Ebru; Aktas, Hatice

    2017-11-06

    The aim of this study was to investigate the possible maternal and fetal factors, which affect the Umbilical Coiling Index (UCI). This prospective, observational, analytic study was conducted using the data of 380 women with term pregnancy and newborns who presented at a University Hospital. Hemoglobin (Hb), ferritin, iron, and the total iron binding capacity (TIBC) of the maternal blood were measured, and transferrin saturation was estimated based on the ratio between serum iron and TIBC. Blood gases, ferritin, iron, and TIBC of the umbilical cord were also measured, and the transferrin saturation was calculated. The length and thickness of the umbilical cord, numbers of coilings, weight of placenta, neonatal weight were registered. The UCI was calculated dividing the total number of coils by the length of the umbilical cord (in cm). A positive, linear, and statistically significant relationship was found between the UCI scores and the umbilical cord blood transferrin saturation, umbilical cord thickness, and the first- and fifth-min APGAR scores (p = .044, p UCI scores (p = .472). In addition, there was no statistically significant relationship between the UCI scores and maternal ferritin, maternal transferrin saturation and umbilical cordon ferritin levels (p = .940, p = .681, and p = .975, respectively). A positive correlation was found between the UCI and umbilical cord transferrin saturation and between the newborn APGAR scores. However, this finding is not sufficient to explain the relationship of the umbilical cord dynamics with the newborn wellbeing and coiling.

  7. Umbilical endometriosis mimicking as papilloma to general surgeons: A case report

    Directory of Open Access Journals (Sweden)

    A Singh

    2012-05-01

    Full Text Available IntroductionCutaneous or umbilical endometriosis is a rare entity that isoften overlooked because of chronic abdominal pain. Wepresent a case of umbilical hernia that presented to thegeneral surgeons due to chronic abdominal pain and nodulein the umbilicus, which was clinically diagnosed as umbilicalpapilloma.Case presentationA 48-year old multiparous Caucasian woman presented withpainful nodule in the umbilicus for two and half years. Thenodule was excised and the histopathological diagnosis wasumbilicus endometriosis.ConclusionUmbilical endometriosis is a very rare disease but should beconsidered as a differential diagnosis in women presentingwith umbilical swelling.

  8. Severe hemorrhage from the umbilical cord at birth: a preventable cause of neonatal shock.

    Science.gov (United States)

    Singh, Neetu; Suresh, Gautham

    2013-01-01

    Posthemorrhagic anemia is a rare but important cause of anemia in neonates, second only to hemolytic anemia of newborn. Most cases of posthemorrhagic anemia are reported from fetomaternal hemorrhage or umbilical cord accidents in utero. This case report describes a preterm infant who developed severe anemia and shock immediately after delivery related to an acute hemorrhage through patent umbilical cord vessels secondary to a tear in the umbilical cord at the site of cord clamping. We believe that umbilical cord bleeding from errors in cord clamping could be an important cause of acute blood loss in the delivery room and that it may result in significant clinical morbidity, especially in extremely premature infants.

  9. Mercury in the Umbilical Cord: Implications for Risk Assessment for Minamata Disease

    DEFF Research Database (Denmark)

    Dalgård, Christine; Grandjean, Philippe; Jørgensen, Poul Jørgen

    1994-01-01

    Umbilical cord tissue was obtained from 50 births in the Faroe Islands, where high mercury intake is due to ingestion of pilot whale meat. The mercury concentration correlated significantly with the frequency of maternal whale meat dinners during pregnancy and with mercury concentrations...... in umbilical cord blood and in maternal hair. The results were compared with published values for mercury in umbilical cord tissue from 12 infants diagnosed with congenital methylmercury poisoning in Minamata, Japan. From the regression coefficients obtained in the Faroese samples, the median umbilical cord...

  10. The umbilical cutaneous “Y-to-V” plastic surgery in the care of pedunculated umbilical hernia in the infant and the child

    Directory of Open Access Journals (Sweden)

    Aloïse Sagna

    2014-10-01

    Full Text Available Pedunculated umbilical hernia in the African infant and child raise an important cosmetic problem by the skin excess they present. Several solutions are proposed from simple reduction to complete cutaneous excision followed by skin grafting. In this paper we report our experience of umbilical cutaneous “Y-to-V” plasty in surgical hernia repair in the infant and the child in Senegal. A two years prospective study includes hernia with diameters included in 2–5 cm and a height or cutaneous projection of at least 1.5 cm. The surgical procedure starts with pencil drawings; follows a primary incision of the vertical branch of the “Y” and a circular subcutaneous undermining. Then, herniorrhaphy is performed and umbilical skin excess resected according to lateral twin isosceles triangles flaps making the “V”. Finally we perform subcutaneous quilting stitches of the umbilical residual flap and intradermal running suture of the wound. Aesthetic variables such as scar quality, shape and depth of the new umbilical valley, aspects of peripheral landscape, are itemized and analyzed. The cohort was made up of 80 children; 50 females and 30 males, among which 60 infants aged between one to six months. The age average is 5 months with extremes of 1 month and 7 years. The operations were performed by the same surgeon. The post-operative follow up has had no repercussions, except in five cases where we have noticed superficial suppuration. The recorded results using evaluation criteria are good in 70 cases (New umbilical valley well-drawn, peripheral landscape with clear outlines, scar hidden away, satisfactory in 7 cases (New umbilical valley little-drawn, prominent peripheral landscape, visible scar and bad in 3 cases (Nonexistent umbilical valley, hypertrophic peripheral landscape, unsightly scar. The authors of this paper highlight the need for aesthetic surgery together with parietal defect repair and give precise different umbilical cosmetic

  11. Effect of body position and ventilation on umbilical artery and venous blood flows during delayed umbilical cord clamping in preterm lambs.

    Science.gov (United States)

    Hooper, Stuart B; Crossley, Kelly J; Zahra, Valerie A; van Vonderen, Jeroen; Moxham, Alison; Gill, Andrew W; Kluckow, Martin; Te Pas, Arjan B; Wallace, Euan M; Polglase, Graeme R

    2017-07-01

    While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows. Lambs were placed either 10 cm below or 10 cm above the ewe. Ventilation commenced 2-3 min before UCC and continued for 30 min after UCC. Gravity reduced umbilical and cerebral flows when lambs were placed below the midline, but the reduction in UaBF and UvBF was similar. Ventilation during delayed UCC reduced UvBF and UaBF by similar amounts, irrespective of the lamb's position, such that flows into and out of the placenta remained balanced. The effects of ventilation on umbilical flows were much greater than the effects of gravity, but no net placental to lamb blood transfusion could be detected under any condition. Cardiovascular parameters, cerebral oxygen kinetics and final blood volumes were similar in both groups 5 min after UCC. Gravity caused small transient effects on umbilical and cerebral flow, but given changes were similar in umbilical arteries and veins, no net placental transfusion was detected. Ventilation during delayed UCC has a markedly greater influence on cardiovascular function in the newborn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Direct percutaneous endoscopic jejunostomy in pediatric age with a pexies triangulation system: report of a case and literature review

    Directory of Open Access Journals (Sweden)

    Fernando Alberca-de-las-Parras

    2015-04-01

    Full Text Available Direct percutaneous endoscopic jejunostomy (DPEJ is an infrequent procedure as it is not always easy to obtain transillumination, being this the main reason for failure of this technique. In patients with previous surgery, this procedure is more complex and there are only 6 reported cases in pediatric population. In our case, we provide the use of an endoscopic triangulation system with "T" pexies not used before in these cases. With this technique, we guarantee not to replace the introduction system afterwards, obtaining the placement of a balloon fixation system initially. We also provide several improvements that helped us developing the procedure: Placement of the jejunostomy through a gastrostomy; use of water column to avoid penetration in hollow viscus; use of a guide wire, and a triangulation pexy system.

  13. Triangulation and age as predictors of children's perception of the destructive effects of parental conflict on the family system

    Directory of Open Access Journals (Sweden)

    Trbojević Jovana Đ.

    2017-01-01

    Full Text Available The child's confidence in the family system contributes to the development of emotional security, which in turn has a positive effect on the child's development. Parental conflicts can have a negative impact on the child's perception of the family system and can lead to the development of emotional insecurity. Triangulation, or the involvement of the child in parental conflict, is an additional risk factor for the development of the child's destructive perceptions of the family. Our study focused on the links between triangulation and the child's perception of parental conflict as destructive for the family system, as well as on the moderating role of the child's age. The sample consisted of 146 children, with an average age of thirteen. The respondents were asked to complete the following questionnaires: The child's perception of parental conflict and Security within the parental subsystem. The findings of moderation analysis show that triangulation is a significant individual predictor of destructive perceptions of the family (β=-.068, p<.01, and that age is a significant moderator of the effects of triangulation on destructive perceptions of the family (β=.167, p<.05. Young adolescents are more likely than children in middle adolescence to perceive that parental conflict is destructive to the family system if they play the role of passive observer. Age differences can be explained by the cognitive immaturity of younger children and their inability to foresee the consequences of conflict and the reasons for its occurrence. The findings highlight the importance of age-appropriate parental actions in situations of marital conflict.

  14. RECONSTRUCTION, QUANTIFICATION, AND VISUALIZATION OF FOREST CANOPY BASED ON 3D TRIANGULATIONS OF AIRBORNE LASER SCANNING POINT DATA

    Directory of Open Access Journals (Sweden)

    J. Vauhkonen

    2015-03-01

    Full Text Available Reconstruction of three-dimensional (3D forest canopy is described and quantified using airborne laser scanning (ALS data with densities of 0.6–0.8 points m-2 and field measurements aggregated at resolutions of 400–900 m2. The reconstruction was based on computational geometry, topological connectivity, and numerical optimization. More precisely, triangulations and their filtrations, i.e. ordered sets of simplices belonging to the triangulations, based on the point data were analyzed. Triangulating the ALS point data corresponds to subdividing the underlying space of the points into weighted simplicial complexes with weights quantifying the (empty space delimited by the points. Reconstructing the canopy volume populated by biomass will thus likely require filtering to exclude that volume from canopy voids. The approaches applied for this purpose were (i to optimize the degree of filtration with respect to the field measurements, and (ii to predict this degree by means of analyzing the persistent homology of the obtained triangulations, which is applied for the first time for vegetation point clouds. When derived from optimized filtrations, the total tetrahedral volume had a high degree of determination (R2 with the stem volume considered, both alone (R2=0.65 and together with other predictors (R2=0.78. When derived by analyzing the topological persistence of the point data and without any field input, the R2 were lower, but the predictions still showed a correlation with the field-measured stem volumes. Finally, producing realistic visualizations of a forested landscape using the persistent homology approach is demonstrated.

  15. Improved laser-based triangulation sensor with enhanced range and resolution through adaptive optics-based active beam control.

    Science.gov (United States)

    Reza, Syed Azer; Khwaja, Tariq Shamim; Mazhar, Mohsin Ali; Niazi, Haris Khan; Nawab, Rahma

    2017-07-20

    Various existing target ranging techniques are limited in terms of the dynamic range of operation and measurement resolution. These limitations arise as a result of a particular measurement methodology, the finite processing capability of the hardware components deployed within the sensor module, and the medium through which the target is viewed. Generally, improving the sensor range adversely affects its resolution and vice versa. Often, a distance sensor is designed for an optimal range/resolution setting depending on its intended application. Optical triangulation is broadly classified as a spatial-signal-processing-based ranging technique and measures target distance from the location of the reflected spot on a position sensitive detector (PSD). In most triangulation sensors that use lasers as a light source, beam divergence-which severely affects sensor measurement range-is often ignored in calculations. In this paper, we first discuss in detail the limitations to ranging imposed by beam divergence, which, in effect, sets the sensor dynamic range. Next, we show how the resolution of laser-based triangulation sensors is limited by the interpixel pitch of a finite-sized PSD. In this paper, through the use of tunable focus lenses (TFLs), we propose a novel design of a triangulation-based optical rangefinder that improves both the sensor resolution and its dynamic range through adaptive electronic control of beam propagation parameters. We present the theory and operation of the proposed sensor and clearly demonstrate a range and resolution improvement with the use of TFLs. Experimental results in support of our claims are shown to be in strong agreement with theory.

  16. Sonographic Measurement of the Umbilical Cord and Its Vessels and Their Relation with Fetal Anthropometric Measurements

    Science.gov (United States)

    Rostamzadeh, Sheida; Kalantari, Mojgan; Shahriari, Mona; Shakiba, Madjid

    2015-01-01

    Background: It has been established that presence of lean umbilical cord with reduced Wharton’s jelly in sonographic scans is a fetal marker for risk of small for gestational age at birth. With improvement of ultrasound techniques, more studies have been investigating the alterations of the umbilical cord on pregnancy outcomes. Objectives: To determine the reference ranges of the umbilical cord area during pregnancy and to find out the association between umbilical cord morphometry and fetal anthropometric measurements. Patients and Methods: A cross sectional study was carried out on a study population of 278 low-risk pregnant women between 15 and 41 weeks of gestational age. Fetal anthropometric measurements including biparietal diameter, abdominal circumference, and femur length were calculated. The measurements of the cross-sectional area (CSA) and circumference of the umbilical cord, vein and arteries were done on an adjacent plane to the insertion of umbilical cord into the fetus’s abdomen. The mean and standard deviation of the CSA of the umbilical cord and the 5th, 10th, 50th, 90th, 95th percentiles of it were calculated for each gestational age. Pearson correlation coefficient was used to assess the correlation between the measures of the cord and fetal anthropometric measurements. Polynomial regression analysis was performed for curves. Results: The values of the CSA of the umbilical cord, umbilical vein and Wharton’s jelly (WJ) increase consistently until 30 weeks of gestation, after which they reach a plateau. There was a significant correlation between anthropometric measurements and umbilical cord measurements especially with the CSA of the umbilical cord, umbilical vein and WJ. The regression equation for the umbilical cord CSA according to gestational age up to 30 weeks was y = -0.2159 x2 + 23.828x-325.59 (R2 = 0.6334) and for the WJ area according to gestational age up to 30 weeks, it was y = -0.2124 x 2 +17.613x-221.66 (R2 = 0

  17. Accurate measurement of surface areas of anatomical structures by computer-assisted triangulation of computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Allardice, J.T.; Jacomb-Hood, J.; Abulafi, A.M.; Williams, N.S. (Royal London Hospital (United Kingdom)); Cookson, J.; Dykes, E.; Holman, J. (London Hospital Medical College (United Kingdom))

    1993-05-01

    There is a need for accurate surface area measurement of internal anatomical structures in order to define light dosimetry in adjunctive intraoperative photodynamic therapy (AIOPDT). The authors investigated whether computer-assisted triangulation of serial sections generated by computed tomography (CT) scanning can give an accurate assessment of the surface area of the walls of the true pelvis after anterior resection and before colorectal anastomosis. They show that the technique of paper density tessellation is an acceptable method of measuring the surface areas of phantom objects, with a maximum error of 0.5%, and is used as the gold standard. Computer-assisted triangulation of CT images of standard geometric objects and accurately-constructed pelvic phantoms gives a surface area assessment with a maximum error of 2.5% compared with the gold standard. The CT images of 20 patients' pelves have been analysed by computer-assisted triangulation and this shows the surface area of the walls varies from 143 cm[sup 2] to 392 cm[sup 2]. (Author).

  18. A Parallel Non-Overlapping Domain-Decomposition Algorithm for Compressible Fluid Flow Problems on Triangulated Domains

    Science.gov (United States)

    Barth, Timothy J.; Chan, Tony F.; Tang, Wei-Pai

    1998-01-01

    This paper considers an algebraic preconditioning algorithm for hyperbolic-elliptic fluid flow problems. The algorithm is based on a parallel non-overlapping Schur complement domain-decomposition technique for triangulated domains. In the Schur complement technique, the triangulation is first partitioned into a number of non-overlapping subdomains and interfaces. This suggests a reordering of triangulation vertices which separates subdomain and interface solution unknowns. The reordering induces a natural 2 x 2 block partitioning of the discretization matrix. Exact LU factorization of this block system yields a Schur complement matrix which couples subdomains and the interface together. The remaining sections of this paper present a family of approximate techniques for both constructing and applying the Schur complement as a domain-decomposition preconditioner. The approximate Schur complement serves as an algebraic coarse space operator, thus avoiding the known difficulties associated with the direct formation of a coarse space discretization. In developing Schur complement approximations, particular attention has been given to improving sequential and parallel efficiency of implementations without significantly degrading the quality of the preconditioner. A computer code based on these developments has been tested on the IBM SP2 using MPI message passing protocol. A number of 2-D calculations are presented for both scalar advection-diffusion equations as well as the Euler equations governing compressible fluid flow to demonstrate performance of the preconditioning algorithm.

  19. Amnioinfusion for potential or suspected umbilical cord compression in labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A

    2012-01-18

    Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. To assess the effects of amnioinfusion for potential or suspected umbilical cord compression on maternal and perinatal outcome . We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011). Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression in labour. The original review had one author only (Justus Hofmeyr (GJH)). For this update, two authors (GJH and T Lawrie) assessed 13 additional trial reports for eligibility and quality. We extracted data and checked for accuracy. We have included 19 studies, with all but two studies having fewer than 200 participants. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: caesarean section overall (13 trials, 1493 participants; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.46 to 0.83); fetal heart rate (FHR) decelerations (seven trials, 1006 participants; average RR 0.53, 95% CI 0.38 to 0.74); Apgar score less than seven at five minutes (12 trials, 1804 participants; average RR 0.47, 95% CI 0.30 to 0.72); meconium below the vocal cords (three trials, 674 participants, RR 0.53, 95% CI 0.31 to 0.92); postpartum endometritis (six trials, 767 participants; RR 0.45, 95% CI 0.25 to 0.81) and maternal hospital stay greater than three days (four trials, 1051 participants; average RR 0.45, 95% CI 0.25 to 0.78). Transabdominal amnioinfusion showed similar trends, though numbers studied were small.Mean cord umbilical artery pH was higher in the amnioinfusion group (seven trials, 855 participants; average mean difference 0.03, 95% CI 0.00 to 0.06) and there was a trend toward fewer neonates with a low cord arterial pH (less than 7.2 or as defined by trial authors) in the amnioinfusion group (eight trials, 972

  20. Antenatal umbilical coiling index as a predictor of perinatal outcome.

    Science.gov (United States)

    Mittal, Ankita; Nanda, Smiti; Sen, Jyotsna

    2015-04-01

    To evaluate the relationship between sonographic measurements of umbilical cord coiling index during late second trimester of pregnancy and perinatal outcome. This prospective study was conducted on two hundred pregnant women with uncomplicated, singleton pregnancy between 20 to 24 weeks of gestation. The antenatal umbilical coiling index (UCI) was calculated by doing a transabdominal ultrasound at the time of induction into the study as the reciprocal of the pitch of one complete vascular coil. The patients were followed up till delivery and any adverse antenatal and/or perinatal event was noted. The mean value for the UCI was noted to be 0.36 + 0.07 coils/cm with a 95% CI of 0.35-0.37. The values for the 10th and the 90th percentile were 0.26 and 0.46 coils/cm respectively. Accordingly the cases were divided into three groups- hypocoiled (UCI UCI between 10th-90th percentile)-162 and hypercoiled (UCI >90th percentile)-20. Hypocoiling was observed to be significantly associated with preterm labour pains (P value 0.0344), oligohydramnios (P value 0.0021), intrapartum foetal heart rate abnormalities (P value 0.0012), instrumental vaginal delivery (P value 0.0275) and low birth weight (P value 0.0344). Hypercoiling was found to be significantly associated with intrauterine growth restriction (P value 0.0323), foetal heart rate abnormalities during labour (0.0399) and low birth weight (P value 0.0095). Abnormal umbilical coiling index in the form of either hypo- or hypercoiling is associated with several adverse antenatal and neonatal outcomes.

  1. L1 Use in EFL Classes with English-only Policy: Insights from Triangulated Data

    Directory of Open Access Journals (Sweden)

    Seyyed Hatam Tamimi Sa’d

    2015-06-01

    Full Text Available This study examines the role of the use of the L1 in EFL classes from the perspective of EFL learners. The triangulated data were collected using class observations, focus group semi-structured interviews and the learners’ written reports of their perceptions and attitudes in a purpose-designed questionnaire. The participants consisted of sixty male Iranian EFL learners who constituted three classes. The results indicated a strong tendency among the participants toward L1 and its positive effects on language learning; while only a minority of the learners favoured an English-only policy, the majority supported the judicious, limited and occasional use of the L1, particularly on the part of the teacher. The participants mentioned the advantages as well as the disadvantages of the use/non-use of the L1. While the major advantage and the main purpose of L1 use was said to be the clarification and intelligibility of instructions, grammatical and lexical items, the main advantages of avoiding it were stated as being the improvement of speaking and listening skills, aximizing learners’ exposure to English and their becoming accustomed to it. The study concludes that, overall and in line with the majority of the previous research studies, a judicious, occasional and limited use of the L1 is a better approach to take in EFL classes than to include or exclude it totally. In conclusion, a re-examination of the English-only policy and a reconsideration of the role of the L1 are recommended. Finally, the commonly held assumption that L1 is a hindrance and an impediment to the learners’ language learning is challenged.

  2. Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study.

    Science.gov (United States)

    Wellard, Sally Jane; Rasmussen, Bodil; Savage, Sally; Dunning, Trisha

    2013-07-01

    This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.

  3. Umbilical mass as the sole presenting symptom of pancreatic cancer: a case report Nódulo umbilical como única apresentação clínica de tumor pancreático: relato de caso

    OpenAIRE

    Fábio Crescentini; Fernanda Deutsch; Carlos Walter Sobrado; Sérgio de Araújo

    2004-01-01

    Umbilical nodes are rare. The metastatic involvement of the region was first described in 1846. Sister Mary Joseph was the first observer to establish the correlation between carcinomas and umbilical nodes. The umbilical node may be the sole presenting sign of cancer and is usually associated with advanced disease and poor prognosis. A 64-year-old woman, previously healthy, presented vague abdominal discomfort and a hard umbilical nodule for 1 week, which was first diagnosed as an incarcerate...

  4. Umbilical cord antiseptics for preventing sepsis and death among newborns.

    Science.gov (United States)

    Imdad, Aamer; Bautista, Resti Ma M; Senen, Kathlynne Anne A; Uy, Ma Esterlita V; Mantaring, Jacinto Blas; Bhutta, Zulfiqar A

    2013-05-31

    The umbilical cord is a structure made of blood vessels and connective tissue that connects the baby and placenta in utero. The umbilical cord is cut after birth, which separates the mother and her baby both physically and symbolically. Omphalitis is defined as infection of the umbilical cord stump. Tracking of bacteria along the umbilical vessels may lead to septicaemia that can result in neonatal morbidity and mortality, especially in developing countries. To determine the effect of application of antimicrobials on newborn's umbilical cord versus routine care for prevention of morbidity and mortality in hospital and community settings. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 October 2012). In addition, we also searched LILACS (1982 to 11 October 2012) and HERDIN NeON (October 2012) We included randomized, cluster-randomized and quasi-randomized controlled trials of topical cord care compared with no topical care, and comparisons between different forms of care. Two review authors independently assessed trials for inclusion, trial quality and subsequently extracted data. Data were checked for accuracy. The search identified 77 trials. We included 34 trials in the review involving 69,338 babies, five studies are awaiting classification and there are two ongoing community trials. Included studies were conducted in both developed and developing countries. Among the 34 included trials, three were large, cluster-randomized trials conducted in community settings in developing countries and 31 studies were conducted in hospital settings mostly in developed countries. Data for community and hospital studies were analyzed separately. The three trials conducted in community settings contributed 78% of the total number of children included in this review. Of the trials conducted in hospital settings, the majority had small sample sizes. There were 22 different interventions studied across the included trials and the most commonly studied

  5. Good practices in collecting umbilical cord and placental blood.

    Science.gov (United States)

    Lopes, Lauren Auer; Bernardino, Elizabeth; Crozeta, Karla; Guimarães, Paulo Ricardo Bittencourt

    2016-08-18

    to identify the factors related to the quality of umbilical cord and placental blood specimens, and define best practices for their collection in a government bank of umbilical cord and placental blood. this was a descriptive study, quantitative approach, performed at a government umbilical cord and placental blood bank, in two steps: 1) verification of the obstetric, neonatal and operational factors, using a specific tool for gathering data as non-participant observers; 2) definition of best practices by grouping non-conformities observed before, during and after blood collection. The data was analyzed using descriptive statistics and the following statistical software: Statistica(r) and R(r). while there was a correlation with obstetrical and neonatal factors, there was a larger correlation with operational factors, resulting in the need to adjust the professional practices of the nursing staff and obstetrical team involved in collecting this type of blood. Based on these non-conformities we defined best practices for nurses before, during and after blood collection. the best practices defined in this study are an important management tool for the work of nurses in obtaining blood specimens of high cell quality. identificar fatores relacionados à qualidade das amostras do sangue de cordão umbilical e placentário e definir boas práticas para sua coleta em um banco público de sangue de cordão umbilical e placentário. pesquisa descritiva, abordagem quantitativa, realizada em um banco público de sangue de cordão umbilical e placentário, desenvolvida em duas etapas: 1) verificação dos fatores obstétricos, neonatais e operacionais, obtidos por coleta em instrumento próprio e observação não participante; 2) definição das boas práticas, por meio do agrupamento de não-conformidades observadas antes, durante e após a coleta do sangue. Os dados foram analisados por meio da estatística descritiva, utilizando-se dos softwares Statistica(r) e R(r). houve

  6. Absence of robust ischemic preconditioning by five 1-minute total umbilical cord occlusions in fetal sheep.

    NARCIS (Netherlands)

    Lotgering, F.K.; Bishai, J.M.; Struijk, P.C.; Blood, A.B.; Hunter, C.J.; Oberg, K.C.; Power, G.G.; Longo, L.D.

    2004-01-01

    OBJECTIVE: To determine to what extent a series of five 1-minute total umbilical cord occlusions, intended to induce ischemic preconditioning (IP), affects the physiologic responses to a 10-minute total umbilical cord occlusion (damaging insult [DI]) 1 hour later and provides cardio- and

  7. Umbilical hypercoiling in 2nd- and 3rd-trimester intrauterine fetal death

    NARCIS (Netherlands)

    Dutman, Annemiek C.; Nikkels, Peter G J

    2015-01-01

    Cases of unexplained intrauterine fetal death (IUFD) can be reduced by full placental examination, with or without autopsy. Determination of the umbilical coiling index (UCI) is considered to be a part of full placental examination. Umbilical hypercoiling (UCI above 0.30 coils/cm) is associated with

  8. Serum levels of caffeine in umbilical cord and apnea of prematurity.

    Science.gov (United States)

    Hentges, Cláudia Regina; Guedes, Renata Rostirola; Silveira, Rita C; Procianoy, Renato S

    2010-01-01

    To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence. A prospective cohort study with preterm newborns with birth weight lower than 2,000 g was undertaken. Exclusion criteria were: mothers who received opioids; mechanical ventilation during the first 4 days of life; cerebral and major cardiac malformations; perinatal asphyxia; severe periintraventricular hemorrhage; exchange transfusion before the fourth day of life; and those who received methylxanthine prior to extubation. Neonates were divided into detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells. Eighty-seven newborns with and 40 without detectable caffeine in umbilical cord blood were studied. Median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 microg/mL (0.2-9.4 microg/mL). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had borderline later apnea (66.3+/-4.14 hours) than those with undetectable levels (54.2+/-6.26 hours). Detected levels of caffeine in umbilical cord blood did not decrease occurrence of apnea of prematurity, but it had a borderline effect delaying its occurrence, suggesting that even a low level of caffeine in umbilical cord blood might delay occurrence of apnea spells.

  9. Use of otoscope as a diagnostic and therapeutic aid in umbilical ...

    African Journals Online (AJOL)

    Introduction: Umbilical disorders are frequently encountered in general surgical practice. Although the sacrococcygeal region is the most common site for pilonidal sinus disease, it can be seen occasionally in periumbilical area. Treatment is mostly conservative for umbilical pilonidal sinus in contrast to the sacrococcygeal ...

  10. Nationwide prospective study on readmission after umbilical or epigastric hernia repair

    DEFF Research Database (Denmark)

    Helgstrand, F; Jørgensen, L N; Rosenberg, J

    2013-01-01

    The primary aim of the present study was to investigate risk factors for readmission after elective umbilical and epigastric hernia repair and secondarily to evaluate causes for readmission.......The primary aim of the present study was to investigate risk factors for readmission after elective umbilical and epigastric hernia repair and secondarily to evaluate causes for readmission....

  11. Umbilical Cord Mercury Concentration as Biomarker of Prenatal Exposure to Methylmercury

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Budtz-Jørgensen, Esben; Jørgensen, Poul J.

    2005-01-01

    biomarker, exposure assessment, food contamination, hair analysis, mercury/analysis, methylmercury compounds/analysis, organomercury compounds/blood, pregnancy, prenatal exposure delayed effects, preschool child, seafood, umbilical cord.......biomarker, exposure assessment, food contamination, hair analysis, mercury/analysis, methylmercury compounds/analysis, organomercury compounds/blood, pregnancy, prenatal exposure delayed effects, preschool child, seafood, umbilical cord....

  12. What is the definition of pulsatile umbilical venous flow in twin-twin transfusion syndrome?

    Science.gov (United States)

    Russell, Zoi; Quintero, Rubén A; Kontopoulos, Eftichia V

    2008-12-01

    The aim of the study was to derive an objective definition of pulsatile umbilical venous flow (PUVF). Pulsed Doppler waveform analysis of the umbilical vein was performed in stages III and IV twin-twin transfusion syndrome (TTTS) patients. In patients with PUVF, the umbilical vein maximum (Vmax) and the umbilical vein minimum velocity (Vmin) and the resistance index for the umbilical vein (UVRI) = (100 x [Vmax - Vmin]/Vmax) were assessed. PUVF was noted in 130 of 226 stages III and IV TTTS patients. Digital images were available for analysis in 65 of 130 patients (50%). The minimum UVRI associated with PUVF was 16% for stages III and IV TTTS. There was a trend for increasing UVRI with stage (P = .052). Stage IV patients were more likely to have an UVRI greater than 30% (P = .02). PUVF can be defined as an UVRI greater than 15%. A scale definition of PUVF may further facilitate assessment of the degree of fetal hemodynamic compromise.

  13. Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants

    DEFF Research Database (Denmark)

    Dahl, Marianne; Holmskov, Uffe; Husby, Steffen

    2006-01-01

    and capillary blood was measured using ELISA technique. The median concentration of SP-D in umbilical cord blood was twice as high as in mature infants, 769 ng/mL (range 140-2,551), with lowest values in infants with intrauterine growth retardation (IUGR) and rupture of membranes (ROM). The median concentration...... of premature infants and to relate the levels to perinatal conditions. A total of 254 premature infants were enrolled in the present study. Umbilical cord blood was drawn at the time of birth and capillary blood at regular intervals throughout the admission. The concentration of SP-D in umbilical cord blood...... treatment and susceptibility to infections. We conclude that SP-D concentrations in umbilical cord blood and capillary blood in premature infants are twice as high as in mature infants and depend on several perinatal conditions. High SP-D levels in umbilical cord blood and capillary blood on day 1 were...

  14. Ultrasound Assessment of Umbilical Cord Morphology in the First Trimester: A Feasibility Study

    DEFF Research Database (Denmark)

    Narayan, Rajit; Saaid, Rahmah; Pedersen, Lars Henning

    2015-01-01

    Objective: The aim of this study was to determine whether morphology and measurement of the umbilical cord could be accurately assessed at the time of the 11- to 13+6-week scan. Methods: We conducted a prospective study of 100 consecutive women with singleton pregnancies at 11-13+6 weeks' gestation...... who were seen for routine aneuploidy screening. Transabdominal ultrasound scans were performed, and the distance between two adjacent coils of the umbilical artery was measured in a free loop of umbilical cord. The antenatal umbilical coiling index (aUCI) was calculated as the inverse...... velocity also increased with gestation. Interobserver consistency in the objective measurement of the aUCI was poor (kappa 0.146). However, the Sepulveda classification system was found to be applicable and reproducible at this period of gestation (kappa 0.601). Conclusions: Umbilical cord morphology can...

  15. Furcate Umbilical Cord Insertion: Disparate Outcomes of a Rare Obstetrical Finding. A Case Report.

    Science.gov (United States)

    Lamale-Smith, Leah M; Snuttjer, Michael J; Harper, Teresa C

    2015-01-01

    Furcate umbilical cord insertions are rare obstetrical findings. This variant is defined by an umbilical cord which branches prior to contacting the placental surface. The vessels are left vulnerable to injury as they often separate from the cord substance. In case 1, a duplex placenta and bifurcate umbilical cord were diagnosed at routine anatomy ultrasound, and no significant fetal anomalies were associated with these findings. There was difficulty with placental extraction, leading to postpartum dilation and curettage. In case 2, the furcate umbilical cord was diagnosed on postpartum evaluation after emergent delivery. It was found in conjunction with VACTERL association of the fetus. Abnormal placentation and umbilical cord insertion can be diagnosed prenatally. Earlier recognition will allow for earlier identification of possible associated fetal anomalies, delivery planning, and close observation for maternal and fetal complications.

  16. Optoacoustic measurements of human placenta and umbilical blood oxygenation

    Science.gov (United States)

    Nanovskaya, T. N.; Petrov, I. Y.; Petrov, Y.; Patrikeeva, S. L.; Ahmed, M. S.; Hankins, G. D. V.; Prough, D. S.; Esenaliev, R. O.

    2016-03-01

    Adequate oxygenation is essential for normal embryogenesis and fetal growth. Perturbations in the intrauterine oxidative environment during pregnancy are associated with several pathophysiological disorders such as pregnancy loss, preeclampsia, and intrauterine growth restriction. We proposed to use optoacoustic technology for monitoring placental and fetal umbilical blood oxygenation. In this work, we studied optoacoustic monitoring of oxygenation in placenta and umbilical cord blood ex vivo using technique of placenta perfusion. We used a medical grade, nearinfrared, tunable, optoacoustic system developed and built for oxygenation monitoring in blood vessels and in tissues. First, we calibrated the system for cord blood oxygenation measurements by using a CO-Oximeter (gold standard). Then we performed validation in cord blood circulating through the catheters localized on the fetal side of an isolated placental lobule. Finally, the oxygenation measurements were performed in the perfused placental tissue. To increase or decrease blood oxygenation, we used infusion of a gas mixture of 95% O2 + 5% CO2 and 95% N2 + 5% CO2, respectively. In placental tissue, up to four cycles of changes in oxygenation were performed. The optoacoustically measured oxygenation in circulating cord blood and in placental lobule closely correlated with the actual oxygenation data measured by CO-Oximeter. We plan to further test the placental and cord blood oxygenation monitoring with optoacoustics in animal and clinical studies.

  17. Specificity of intraabdominal endoprosthesis of umbilical and postoperative ventral hernias

    Directory of Open Access Journals (Sweden)

    Grigoriev S.G.

    2012-03-01

    Full Text Available The research work objective was to examine the results of intraperitoneal plastics in the hernias of anterior abdominal wall. The experience of treatment of 89 patients with uncomplicated umbilical and postoperative ventral hernias was analized. The surgical treatment included an open intraperitoneal prosthetic hernioplasty. The hernial sac was not removed during the operation. The original techniques of treatment of hernia sac were used. Anatomical and morphological features in the structure of middle ventral hernias and their pathophysiological assessment were revealed. Practical recommendations for technology of intraperitoneal prosthesis were given. The early postoperative complications occurred: seroma (n=2, the outflow of serous fluid drainage for 5 days (n=1, infiltration of the umbilical area (n=3, suppuration of wounds (n=1. Vacuum drainage was performed in 24 patients after removal of large hernial defects. During the period from 6 months to 4 years recurrences were not revealed. The intraperitoneal surgery using a complex of musculo-aponeurotic tissues provided hernial implant fixation. Operation without the removal of the hernial sac reduced the trauma intervention. Method of suturing the surgical wound reduced the time of drainage and reduced the number of wound complications

  18. Neonatal oxidative stress depends on oxygen blood pressure in umbilical artery.

    Science.gov (United States)

    Proietti, F; De Bernardo, G; Longini, M; Sordino, D; Scaramuzzini, G; Tataranno, M L; Belvisi, E; Bazzini, F; Perrone, S; Buonocore, G

    2016-01-01

    With advancing gestation, partial pressure of oxygen (pO2) and pH fall significantly. Hypoxia is a main factor inducing free radical generation and thereby oxidative stress (OS). Placental and fetal tissue response when oxygen becomes restricted is complex and partially known. We tested the hypothesis that changes in umbilical artery and vein blood gas concentrations modulate OS occurrence in the newborn. Seventy umbilical artery and vein plasma samples were collected from healthy term newborns immediately after delivery. F2 Isoprostanes (F2-Isop) were measured in all samples as reliable markers of lipid peroxidation. Significantly lower pCO2 and higher pO2 and pH were found in umbilical vein than in artery, as expected. A positive correlation was detected between pH and pO2 only in umbilical artery (p=0.019). F2-Isop levels were no different between artery and vein in cord blood. Significant correlations were found between F2-Isop and pCO2 (p=0.025) as well as between F2-Isop and pH in umbilical vein (p=0.027). F2-Isop correlated with pCO2 (p=0.007) as well as with pO2 values (p=0.005) in umbilical artery blood. Oxidative stress (OS) in newborns depends on oxygen concentrations in umbilical artery. OS biomarkers significantly correlate with pO2 and in umbilical artery but not in umbilical vein. In normoxic conditions fetal-maternal gas exchanges occurring in placenta re-establish normal higher oxygen levels in umbilical vein than artery, with a normal production of free radicals without any deleterious effects.

  19. [Extramucosal pylorotomy via the umbilical route under general anesthesia and para-umbilical cord: evaluation of intra- and postoperative analgesia].

    Science.gov (United States)

    Courrèges, P; Poddevin, F; Lecoutre, D

    1998-01-01

    To assess both intra- and postoperative analgesia in infants undergoing extramucosal pylorotomy via a circumumbilical incision under general anaesthesia with neither opioid nor muscle relaxant, associated with a paraumbilical block. Open prospective study covering a 1-year period. The study included 32 infants (age = 1.1 +/- 0.7 months, body weight = 4,427 +/- 876 g). General anaesthesia was induced with either thiopentone or halothane and, after tracheal intubation, maintained with halothane in a N2O-O2 50 vol% mixture. Para-umbilical block was obtained using 0.5 mL.kg-1 of 1% lidocaine with epinephrine. Pain was assessed using time course of respiratory rate, heart rate and mean arterial pressure. A change of more than 20% in one of these variables was considered as criterion for poor analgesia. Intraoperative analgesia was adequate in all patients but one, 3 minutes after incision. Surgical conditions were considered as being good or satisfactory in 76% and 24% of cases, respectively. Postoperative analgesia, assessed 1 and 6 hours after completion of surgery, was convenient in 90% of infants, the end of the action of the local anaesthetic resulting in a poor analgesia at the 6th hour in four of them. Provided a short bevel needle is used and basic safety rules of local anaesthesia are followed, the para-umbilical block provides adequate intra and postoperative analgesia in infants undergoing extramucosal pylorotomy via circumumbilical route.

  20. Cell therapy of congenital corneal diseases with umbilical mesenchymal stem cells: lumican null mice.

    Directory of Open Access Journals (Sweden)

    Hongshan Liu

    Full Text Available BACKGROUND: Keratoplasty is the most effective treatment for corneal blindness, but suboptimal medical conditions and lack of qualified medical personnel and donated cornea often prevent the performance of corneal transplantation in developing countries. Our study aims to develop alternative treatment regimens for congenital corneal diseases of genetic mutation. METHODOLOGY/PRINCIPAL FINDINGS: Human mesenchymal stem cells isolated from neonatal umbilical cords were transplanted to treat thin and cloudy corneas of lumican null mice. Transplantation of umbilical mesenchymal stem cells significantly improved corneal transparency and increased stromal thickness of lumican null mice, but human umbilical hematopoietic stem cells failed to do the same. Further studies revealed that collagen lamellae were re-organized in corneal stroma of lumican null mice after mesenchymal stem cell transplantation. Transplanted umbilical mesenchymal stem cells survived in the mouse corneal stroma for more than 3 months with little or no graft rejection. In addition, these cells assumed a keratocyte phenotype, e.g., dendritic morphology, quiescence, expression of keratocyte unique keratan sulfated keratocan and lumican, and CD34. Moreover, umbilical mesenchymal stem cell transplantation improved host keratocyte functions, which was verified by enhanced expression of keratocan and aldehyde dehydrogenase class 3A1 in lumican null mice. CONCLUSIONS/SIGNIFICANCE: Umbilical mesenchymal stem cell transplantation is a promising treatment for congenital corneal diseases involving keratocyte dysfunction. Unlike donated corneas, umbilical mesenchymal stem cells are easily isolated, expanded, stored, and can be quickly recovered from liquid nitrogen when a patient is in urgent need.

  1. Relationship between sonographic umbilical cord size and gestational age among pregnant women in Enugu, Nigeria.

    Science.gov (United States)

    Eze, Charles; Ugwuja, Mabel; Eze, Cletus; Ugwu, George; Agwuna, Kennedy; Ituk-Ozalla

    2014-06-01

    Common fetal parameters for gestational age (GA) estimation have pitfalls especially in advanced pregnancy and pregnancy complicated by fetal structural anomaly. To assess the relationship between umbilical cord size and gestational age of the fetus. A sonographic cross sectional study involving 300 pregnant women with GA between 14 weeks to 40 weeks was done in Enugu, Nigeria. Gestational ages were first estimated by use of Naegele's formula for GA estimation based on the date of onset of each subject's last menstrual period. Fetal parameters such as biparietal diameter, femur length, head circumference and abdominal circumference were measured and also used to estimate GA. Umbilical cord diameters were measured and used to compute the umbilical cord cross-sectional area. The mean umbilical cord diameter and cross-sectional area were 14.5mm ± 7.2mm and 201.6mm ± 139.5mm(2) respectively. Umbilical cord growth rate of 1.0mm/week was noted between the 14(th) and 35(th) week of pregnancy. There were significant correlations (p umbilical cord size and other fetal parameters for GA estimation. Umbilical cord size had strong linear relationship with common fetal GA estimation parameters and could be used to compliment these parameters for GA estimation.

  2. The effects of isolated single umbilical artery on first and second trimester aneuploidy screening test parameters.

    Science.gov (United States)

    Tulek, Firat; Kahraman, Alper; Taskin, Salih; Ozkavukcu, Esra; Soylemez, Feride

    2015-04-01

    Reliability of first and second trimester screening tests largely depends on accurate estimation of maternal serum marker values. Reduced reliability could lead redundant invasive tests or misdiagnosis. Adjustments of serum marker values for confounding factors like insulin-dependent diabetes, maternal weight or maternal rhesus status are essential. We aimed to investigate whether isolated single umbilical artery alters first and second trimester test parameters or not. Routine detailed obstetric ultrasonographies performed were retrospectively screened for this study. Among spontaneously conceived singleton pregnancies, women who were found to have single umbilical artery without any additional structural anomalies or aneuploidies were selected. First and second trimester screening test results were accessible for 98 and 102 of the cases with isolated single umbilical artery, respectively. Among first trimester screening test parameters, PAPP-A (pregnancy-associated plasma protein A) MoMs were found significantly higher in isolated single umbilical artery group. AFP MoMs were found significantly elevated in isolated single umbilical artery group in second trimester quadruple tests. Existence of single umbilical artery could alter the estimation of MoM values of maternal serum markers. Reliability of prenatal screening tests could be improved by adjusting these parameters in accordance with isolated single umbilical artery.

  3. Predicting intrapartum fetal compromise using the fetal cerebro-umbilical ratio.

    Science.gov (United States)

    Sabdia, S; Greer, R M; Prior, T; Kumar, S

    2015-05-01

    The aim of this study was to explore the association between the cerebro-umbilical ratio measured at 35-37 weeks and intrapartum fetal compromise. This retrospective cross sectional study was conducted at the Mater Mothers' Hospital in Brisbane, Australia. Maternal demographics and fetal Doppler indices at 35-37 weeks gestation for 1381 women were correlated with intrapartum and neonatal outcomes. Babies born by caesarean section or instrumental delivery for fetal compromise had the lowest median cerebro-umbilical ratio 1.60 (IQR 1.22-2.08) compared to all other delivery groups (vaginal delivery, emergency delivery for failure to progress, emergency caesarean section for other reasons or elective caesarean section). The percentage of infants with a cerebro-umbilical ratio cerebro-umbilical ratio between the 10th-90th centile and 9.6% of infants with a cerebro-umbilical ratio > 90th centile required delivery for the same indication (p cerebro-umbilical ratio was associated with an increased risk of emergency delivery for fetal compromise, OR 2.03 (95% CI 1.41-2.92), p cerebro-umbilical ratio measured at 35-37 weeks is associated with a greater risk of intrapartum compromise. This is a relatively simple technique which could be used to risk stratify women in diverse healthcare settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Ethical issues relating the the banking of umbilical cord blood in Mexico

    Directory of Open Access Journals (Sweden)

    Valdez-Martinez Edith

    2009-08-01

    Full Text Available Abstract Background Umbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico. Discussion A number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord. Summary Conflicts between moral principles and economic interests (non-moral principles cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks

  5. Pluripotent stem cells isolated from umbilical cord form embryonic like bodies in a mesenchymal layer culture.

    Science.gov (United States)

    Tsagias, Nikos; Kouzi-Koliakos, Kokkona; Karagiannis, Vasileios; Tsikouras, P; Koliakos, George G

    2015-03-01

    Recently the matrix of umbilical cord began to use as an alternative source of stem cells additionally to the blood of umbilical cord. Umbilical cord has been used mainly for mesenchymal stem cell banking. The immunological characteristics of mesenchymal stem cells in combination with their ability to avoid rejection make them an attractive biological material for transplantations. In this study the isolation of small in size pluripotent stem cells from umbilical cord expressing early transcription factors with characteristics that resemble to embryonic stem cells is investigated. Pluripotent stem cells were isolated from human umbilical cords, by a new strategy method based on unique characteristics such as the small size and the positivity on early transcription factors OCT and Nanog. An enriched population of CXCR4(+) OCT(+) Nanog(+) CD45(-) small stem cells from the cord was isolated. This fraction was able to create alkaline phosphatase positive like spheres forms in a mesenchymal layer with multilineage differentiation capacity. Our results were assessed by RT PCR and electophoresis for the pluripotent genes. These data suggest that umbilical cord provides an attractive source not only of mesenchymal stem cells but moreover of pluripotent stem cells. The method described herein should be applied in the field of stem cell banking in addition to the classical umbilical cord harvesting method. Isolation of a population of cells with pluripotent characteristics from umbilical cord. Adoption of a second centrifugation step for the pluripotent stem isolation. Increasing the value of the cord and explaining the pluripotency. This work will enhance the value of umbilical cord harvesting.

  6. Isolation of mesenchymal stem cells from equine umbilical cord blood

    DEFF Research Database (Denmark)

    Koch, Thomas Gadegaard; Heerkens, Tammy; Thomsen, Preben Dybdahl

    2007-01-01

    . The hypothesis of this study was that equine MSCs could be isolated from fresh whole equine cord blood. Results: Cord blood was collected from 7 foals immediately after foaling. The mononuclear cell fraction was isolated by Ficoll density centrifugation and cultured in a DMEM low glucose based media at 38.5o......Background: There are no published studies on stem cells from equine cord blood although commercial storage of equine cord blood for future autologous stem cell transplantations is available. Mesenchymal stem cells (MSC) have been isolated from fresh umbilical cord blood of humans collected non......-invasively at the time of birth and from sheep cord blood collected invasively by a surgical intrauterine approach. Mesenchymal stem cells isolation percentage from frozen-thawed human cord blood is low and the future isolation percentage of MSCs from cryopreserved equine cord blood is therefore expectedly low...

  7. Human Umbilical Cord Blood Cell Transplantation in Neuroregenerative Strategies

    Science.gov (United States)

    Galieva, Luisa R.; Mukhamedshina, Yana O.; Arkhipova, Svetlana S.; Rizvanov, Albert A.

    2017-01-01

    At present there is no effective treatment of pathologies associated with the death of neurons and glial cells which take place as a result of physical trauma or ischemic lesions of the nervous system. Thus, researchers have high hopes for a treatment based on the use of stem cells (SC), which are potentially able to replace dead cells and synthesize neurotrophic factors and other molecules that stimulate neuroregeneration. We are often faced with ethical issues when selecting a source of SC. In addition to precluding these, human umbilical cord blood (hUCB) presents a number of advantages when compared with other sources of SC. In this review, we consider the key characteristics of hUCB, the results of various studies focused on the treatment of neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis), ischemic (stroke) and traumatic injuries of the nervous system and the molecular mechanisms of hUCB-derived mononuclear and stem cells. PMID:28951720

  8. Isolation of Multipotent Mesenchymal Stromal Cells from Cryopreserved Human Umbilical Cord Tissue.

    Science.gov (United States)

    Romanov, Yu A; Balashova, E E; Volgina, N E; Kabaeva, N V; Dugina, T N; Sukhikh, G T

    2016-02-01

    Umbilical cord stroma is an easily available, convenient, and promising source of multipotent mesenchymal stromal cells for regenerative medicine. Cryogenic storage of umbilical cord tissue provides more possibilities for further isolation of multipotent mesenchymal stromal cells for autologous transplantation or scientific purposes. Here we developed a protocol for preparation of the whole umbilical cord tissue for cryogenic storage that in combination with the previously described modified method of isolation of multipotent mesenchymal stromal cells allowed us to isolate cells with high proliferative potential, typical phenotype, and preserved differentiation potencies.

  9. Spectrophotometric analysis in umbilical cords of infants with meconium aspiration syndrome.

    Science.gov (United States)

    Tuncer, Oguz; Peker, Erdal; Demir, Nihat; Akbayram, Sinan; Kirimi, Ercan

    2013-07-01

    We compared spectrophotometric analysis of the umbilical cords of infants with meconium aspiration syndrome (MAS) or with meconium-stained amniotic fluid (MSAF) and healthy infants. In a prospective study, 15 infants with MAS and 37 infants with MSAF were enrolled. Twenty healthy infants formed a control group. The absorption peak of umbilical cords with meconium was significantly higher in the infants with MAS or MSAF than in controls. Spectrophotometric analysis of the umbilical cords with meconium may be useful to identify developed neonates with MAS or MSAF.

  10. Proposed NRC portable target case for short-range triangulation-based 3D imaging systems characterization

    Science.gov (United States)

    Carrier, Benjamin; MacKinnon, David; Cournoyer, Luc; Beraldin, J.-Angelo

    2011-03-01

    The National Research Council of Canada (NRC) is currently evaluating and designing artifacts and methods to completely characterize 3-D imaging systems. We have gathered a set of artifacts to form a low-cost portable case and provide a clearly-defined set of procedures for generating characteristic values using these artifacts. In its current version, this case is specifically designed for the characterization of short-range (standoff distance of 1 centimeter to 3 meters) triangulation-based 3-D imaging systems. The case is known as the "NRC Portable Target Case for Short-Range Triangulation-based 3-D Imaging Systems" (NRC-PTC). The artifacts in the case have been carefully chosen for their geometric, thermal, and optical properties. A set of characterization procedures are provided with these artifacts based on procedures either already in use or are based on knowledge acquired from various tests carried out by the NRC. Geometric dimensioning and tolerancing (GD&T), a well-known terminology in the industrial field, was used to define the set of tests. The following parameters of a system are characterized: dimensional properties, form properties, orientation properties, localization properties, profile properties, repeatability, intermediate precision, and reproducibility. A number of tests were performed in a special dimensional metrology laboratory to validate the capability of the NRC-PTC. The NRC-PTC will soon be subjected to reproducibility testing using an intercomparison evaluation to validate its use in different laboratories.

  11. Umbilical cord blood lactate: a valuable tool in the assessment of fetal metabolic acidosis

    DEFF Research Database (Denmark)

    Gjerris, Anne Cathrine Roslev; Staer-Jensen, Jette; Jørgensen, Jan Stener

    2008-01-01

    The aim of the present study was (1) to evaluate the relationship between umbilical cord arterial blood lactate and pH, standard base excess (SBE), and actual base excess (ABE) at delivery and (2) to suggest a cut-off level of umbilical cord arterial blood lactate in predicting fetal asphyxia usi...... ROC-curves, where an ABE value less than -12 was used as "gold standard" for significant intrapartum asphyxia.......The aim of the present study was (1) to evaluate the relationship between umbilical cord arterial blood lactate and pH, standard base excess (SBE), and actual base excess (ABE) at delivery and (2) to suggest a cut-off level of umbilical cord arterial blood lactate in predicting fetal asphyxia using...

  12. Total parenteral alimentation via indwelling umbilical catheters in the newborn period.

    Science.gov (United States)

    Hall, R T; Rhodes, P G

    1976-01-01

    Total parenteral alimentation (TPA) was delivered to 80 infants via indwelling umbilical artery and to 9 via indwelling umbilical venous catheters. The primary indication for catheter placement and maintenance was monitoring of arterial blood gases (umbilical venous catheter tip in left atrium) in a group of sick neonates requiring increased inspired oxygen or assisted ventilation. Results were compared with those from 23 infants who had tunnelled jugular catheters for a variety of chronic medical and surgical problems preventing gastric or intestinal feeding. A mean weight gain was achieved in both groups. Mortality and morbidity rates were similar in both groups. The most common complications were infection and thrombotic phenomena. Metabolic complications were few. It is concluded that infusing TPA solutions via indwelling umbilical catheters presents no greater risk than infusion via tunnelled jugular catheters, and provides a method for supplying adequate caloric intake for growth during the acute stage of illness. PMID:827978

  13. Absence of maternal cell contamination in mesenchymal stromal cell cultures derived from equine umbilical cord tissue

    Czech Academy of Sciences Publication Activity Database

    Vacková, Irena; Czerneková, V.; Tománek, M.; Navrátil, J.; Moško, Tibor; Nováková, Z.

    2014-01-01

    Roč. 35, č. 8 (2014), s. 655-657 ISSN 0143-4004 Institutional support: RVO:68378041 Keywords : maternal cell contamination * mesenchymal stromal cells * umbilical cord tissue Subject RIV: FH - Neurology Impact factor: 2.710, year: 2014

  14. A nationwide study on readmission, morbidity, and mortality after umbilical and epigastric hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, T; Kehlet, H; Bay-Nielsen, M

    2011-01-01

    BACKGROUND: Repair for umbilical and epigastric hernia is a minor and common surgical procedure. Early outcomes are not well documented. METHODS: All patients =18 years operated on for umbilical or epigastric hernia in Denmark during a 2-year period (2005-2006) were analysed according to hospital......, complications and mortality occurred in 4.1% (open 3.7%; laparoscopic 8.2%) and 0.1% (open 0.1%; laparoscopic 0.4%), respectively. CONCLUSION: This first prospective nationwide study on elective umbilical and epigastric hernia repair found low morbidity and mortality but a high readmission rate mostly because...... of wound problems, seroma formation, or pain. Future research should focus on early outcomes in terms of wound problems, seroma formation, and pain after umbilical and epigastric hernia repair....

  15. Severe Hemorrhage from the Umbilical Cord at Birth: A Preventable Cause of Neonatal Shock

    Directory of Open Access Journals (Sweden)

    Neetu Singh

    2013-01-01

    Full Text Available Posthemorrhagic anemia is a rare but important cause of anemia in neonates, second only to hemolytic anemia of newborn. Most cases of posthemorrhagic anemia are reported from fetomaternal hemorrhage or umbilical cord accidents in utero. This case report describes a preterm infant who developed severe anemia and shock immediately after delivery related to an acute hemorrhage through patent umbilical cord vessels secondary to a tear in the umbilical cord at the site of cord clamping. We believe that umbilical cord bleeding from errors in cord clamping could be an important cause of acute blood loss in the delivery room and that it may result in significant clinical morbidity, especially in extremely premature infants.

  16. Immunoglobulin G (IgG) Expression in Human Umbilical Cord Endothelial Cells

    Science.gov (United States)

    Zhao, Yingying; Liu, Yuxuan; Chen, Zhengshan; Korteweg, Christine; Gu, Jiang

    2011-01-01

    Traditional views hold that immunoglobulin G (IgG) in the human umbilical cord is internalized by human umbilical endothelial cells for passive immunity. In this study, the protein and mRNA transcripts of IgG were found in the cytoplasm of human umbilical endothelial cells by immunohistochemistry, in situ hybridization, and reverse transcription PCR (RT-PCR). The essential enzymes for IgG synthesis and assembling, RAG1 (recombination activating gene 1), RAG2, and variable (V), diversity (D), and joining (J) segments for recombination of IgG, were also found in these cells by RT-PCR and real-time PCR. These results indicate that umbilical endothelial cells are capable of synthesizing IgG with properties similar to those of immune cells and that they may play additional roles besides lining the vessels and transporting IgG. PMID:21430258

  17. Comparison of complication rates between umbilical and peripherally inserted central venous catheters in newborns

    NARCIS (Netherlands)

    Arnts, I.J.J.; Bullens, L.M.; Groenewoud, H.; Liem, K.D.

    2014-01-01

    OBJECTIVE: To compare the complication rates between umbilical central venous catheters and peripherally inserted central venous catheters in newborns and to investigate whether other variables might increase complication rates. DESIGN: A retrospective observational study. SETTING: A Level III

  18. Amniotic band syndrome with sacral agenesis and umbilical cord entrapment: A case report emphasizing the value of evaluation of umbilical cord.

    Science.gov (United States)

    Gupta, Kanika; Venkatesan, Bhuvaneswari; Chandra, Tushar; Rajeswari, Kathiah; Devi, Thangammal Kandasamy Renuka

    2015-03-01

    Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts by fibrous amniotic bands in utero. The congenital anomalies seen in this syndrome vary widely and defects may be isolated or multiple and do not follow a specific pattern. Asymmetric distribution of defects is the hallmark of this syndrome. The diagnosis is difficult to make on ultrasound and relies on identification of amniotic bands. We report a case of amniotic band syndrome with sacral agenesis diagnosed on routine antenatal ultrasound scan in the second offspring of a recently diagnosed diabetic mother. The associated features were entrapment of umbilical cord, caudal adhesions and lower limb anomalies. Medical termination of pregnancy was done and all the fetal anomalies as well as umbilical cord abnormalities were confirmed. The importance of meticulous scanning to evaluate for amniotic bands and the umbilical cord in addition to the fetal structures is emphasized.

  19. Experimental and numeric studies of one electro-optical flexible pipe (umbilical); Estudos numericos e experimentais de um umbilical eletro-optico

    Energy Technology Data Exchange (ETDEWEB)

    Lepore, Paula Ferreira; Buelta Martinez, Miguel Angel [Sao Paulo Univ., SP (Brazil). Escola Politecnica

    2005-07-01

    This work had as objective to develop, to implant, to survey and to test an experimental and numerical model of structural, applicable analysis of umbilical structures. An ample study of the behavior of its constituent layers was carried through, in special of its nucleus and material constituents, when operating under different conditions of tensions and deformations. As support for this work, experimental tests for one type of electro-optic umbilical with typical transversal section had been carried through. This was made with the intention to optimize the developed numerical model. With this model of structural analysis, the project of umbilicals could highly improved, in terms of the total weight of the handle, which is one of the great problems for its use in great depths, with the maximum of efficiency and the minimum of losses, foreseeing and hindering operation imperfections that can come to occur due to extreme deformation or electric rupture of the layers, hoses or handles. (author)

  20. Use of Otoscope as a Diagnostic and Therapeutic Aid in Umbilical Pilonidal Sinus: A Novel Technique

    OpenAIRE

    Farhanul Huda; Sudhir Kumar Singh

    2018-01-01

    Introduction: Umbilical disorders are frequently encountered in general surgical practice. Although the sacrococcygeal region is the most common site for pilonidal sinus disease, it can be seen occasionally in periumbilical area. Treatment is mostly conservative for umbilical pilonidal sinus in contrast to the sacrococcygeal sinus where it is always surgical. In the era of endoscopy and minimally invasive surgery, we describe the use of otoscope as a novel technique for the diagnosis and trea...

  1. Umbilical Cord-Derived Mesenchymal Stem Cells Relieve Hindlimb Ischemia through Enhancing Angiogenesis in Tree Shrews

    OpenAIRE

    Cunping Yin; Yuan Liang; Jian Zhang; Guangping Ruan; Zian Li; Rongqing Pang; Xinghua Pan

    2016-01-01

    Hindlimb ischemia is still a clinical problem with high morbidity and mortality. Patients suffer from consequent rest pain, ulcers, cool limbs, and even amputation. Angiogenesis is a promising target for the treatment of ischemic limbs, providing extra blood for the ischemic region. In the present study, we investigated the role of umbilical cord-derived mesenchymal stem cells (UC-MSCs) in regulating angiogenesis and relieving hindlimb ischemia. UC-MSCs were isolated from the umbilical cord o...

  2. Umbilical Cord as Prospective Source for Mesenchymal Stem Cell-Based Therapy

    Science.gov (United States)

    2016-01-01

    The paper presents current evidence on the properties of human umbilical cord-derived mesenchymal stem cells, including origin, proliferative potential, plasticity, stability of karyotype and phenotype, transcriptome, secretome, and immunomodulatory activity. A review of preclinical studies and clinical trials using this cell type is performed. Prospects for the use of mesenchymal stem cells, derived from the umbilical cord, in cell transplantation are associated with the need for specialized biobanking and transplant standardization criteria. PMID:27651799

  3. The umbilical cutaneous “Y-to-V” plastic surgery in the care of pedunculated umbilical hernia in the infant and the child

    OpenAIRE

    Sagna, Aloïse; Ly, Aïssata; Fall, Ibrahima

    2014-01-01

    Pedunculated umbilical hernia in the African infant and child raise an important cosmetic problem by the skin excess they present. Several solutions are proposed from simple reduction to complete cutaneous excision followed by skin grafting. In this paper we report our experience of umbilical cutaneous “Y-to-V” plasty in surgical hernia repair in the infant and the child in Senegal. A two years prospective study includes hernia with diameters included in 2–5 cm and a height or cutaneous proje...

  4. Changing pattern of causative factors in development of umbilical infections (omphalitis) in newborns

    International Nuclear Information System (INIS)

    Nadeem, A.Z.; Malik, R.

    2010-01-01

    Despite the drastic decrease in the incidence of neonatal tetanus due to better aseptic techniques in cutting and tying of umbilical cord at birth, an increase in the prevalence of umbilical infections has been noticed. Objectives The objectives were to assess the ongoing practices in umbilical care, detect the prevailing causative factors responsible for umbilical infections in newborns and suggest measures for minimizing these infections. Design setting This descriptive study was a collaborative effort at CMH Nowshera, Mardan and Lahore from January 2007 through 2009. Patients and Methods Three hundred consecutive cases of umbilical sepsis ( omphalitis), infants less than 20 days old were included irrespective of place of delivery and severity of infection. Those with congenital anomalies of umbilicus were excluded. A detailed questionnaire was filled for every patient covering related aspects. Results Antisepsis (mainly spirit) was used in 91 % cases irrespective of place of delivery. Major tool for cutting the cord was surgical or new common blade (277 cases). Clamp was used in 138 cases. Cord was intentionally attended in subsequent weeks after birth in only 48 cases. Hand washing practice was found in only 62 parents in subsequent weeks after birth. Diapers were used in 261 cases, majority of these were found covering the umbilicus or umbilical stump when initially examined (81 %). 48% of infected unshed cords were more than 3 inches long. Use of unwarranted substances applied on cord was found in only 16 cases. (author)

  5. Impact of ethanol, dry care and human milk on the time for umbilical cord separation

    International Nuclear Information System (INIS)

    Golshan, M.; Hossein, N.

    2013-01-01

    Objective: To compare the extraction time and infection rate of umbilical cord by applying ethanol, human milk or dry care. Method: The parallel single-blinded randomised clinical trial was performed on 300 neonates at Shahid Sadougi University of Medical Sciences and Health Service, Yazd, Iran, between March and September 2010. The neonates were divided into three random but numerically equal groups. Each group was assigned the application of ethanol or mother's milk or to keep the stump dry. The neonates were visited on the 3rd and the 7th day after birth and follow-up was maintained telephonically until umbilical separation. Umbilical separation time and umbilical local infection frequency were considered as the study outcome, which was compared among the three groups according to age, gender and delivery type of the neonates. Results: Umbilical separation time in neonates of the human milk group had significant difference with the ethanol group (p=0.0001) and drying groups (p=0.003). Frequency of omphalitis had no significant difference among the three groups. Conclusion: Topical usage of human milk on umbilical cord stamp decreased separation time and incidence rate of omphalitis. (author)

  6. Ultrasound measurements of umbilical cord transverse area in normal pregnancies and pregnancies complicated by diabetes mellitus.

    Science.gov (United States)

    Pietrygal, Marek; Brazert, Jacek; Wender-Ozegowskal, Ewa; Zawiejska, Agnieszka; Brazert, Maciej; Dubiel, Mariusz; Gudmundsson, Saemundur

    2014-11-01

    A voluminous umbilical cord has been described in diabetic pregnancies. The aim of this studywas to see if measurements of cord diameters might be of value in the evaluation of diabetic pregnancies and especially those suspected of a large for gestational age (LGA) fetus. In an observational, prospective study umbilical cord areas and vessel diameters were measured between gestational age of 22 and 40 weeks in transverse ultrasound images of the central part of the cord in 141 normal and 135 diabetic pregnancies of which 30 were suspected of being LGA. Wharton's jelly area was calculated by subtracting the vessel area from the total transverse cord area. Normal reference curves were constructed for gestational age. Umbilical cord and Wharton's jelly areas increased with gestation. The vessel area leveled out at 32-33 weeks of gestation and the umbilical vein area decreased after 36 weeks of gestation. The umbilical cord parameters in diabetic pregnancies did not differ from controls. Cord areas were enlarged in 1/3 of the LGA fetuses. Umbilical cord area measurements are of limited value for the evaluation of diabetic pregnancies suspected having a LGA-fetus.

  7. Decreased umbilical orexin-A level is associated with idiopathic polyhydramnios.

    Science.gov (United States)

    Cho, Geum Joon; Hong, Hye-Ri; Kim, Suhng Wook; Hong, Soon Cheol; Oh, Min-Jeong; Kim, Hai Joon

    2015-03-01

    To evaluate the association between orexin-A level and idiopathic polyhydramnios. Case-control study. Tertiary-level university hospital. Ten term pregnant women with idiopathic polyhydramnios and, as the control group, 20 pregnant women with normal amniotic fluid levels. Amniotic fluid level was measured at admission for delivery using enzyme-linked immunosorbent assay. Maternal blood was obtained from a cannulated vein immediately before delivery, and umbilical blood was collected at the time of delivery, before the separation of the placenta. Maternal and umbilical levels of orexin-A. Mean umbilical serum orexin-A level was significantly lower than maternal serum orexin-A level. Umbilical serum orexin-A level was positively correlated with maternal serum orexin-A level, but negatively correlated with amniotic fluid index and birthweight. Umbilical serum orexin-A level was lower in the idiopathic polyhydramnios group than in the control group. However, no difference in maternal serum orexin-A level was observed between the two groups. Idiopathic polyhydramnios was associated with decreased umbilical serum orexin-A levels. Our results provide evidence that orexin-A expression may be involved in amniotic fluid regulation, causing polyhydramnios by downregulation. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Multiple versus single lumen umbilical venous catheters for newborn infants.

    Science.gov (United States)

    Kabra, N S; Kumar, M; Shah, S S

    2005-07-20

    Multiple lumen umbilical venous catheters (ML-UVCs) instead of single lumen UVCs (SL-UVCs) may decrease the need for additional venous lines. Although it seems self-evident that ML-UVCs would reduce the need of additional venous lines, the rates of associated complications might be different. To compare the effectiveness and the safety of ML-UVCs versus SL-UVCs in terms of need of additional vascular access, rates of complications, morbidity and mortality in newborn infants. Randomized and quasi-randomized trials were identified by searching the MEDLINE (1966 - February 2005), EMBASE (1980- February 2005), CINAHL (1982 - February 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004) and Science Direct (subject area: medicine, journal and abstract database; 1967 to February 2005). Literature search also included a manual search of the abstracts of scientific meetings published in Pediatric Research (1990-2004). Additional citations were sought using references in articles retrieved from searches. Subject experts were contacted to identify the unpublished and ongoing studies. Randomized and quasi-randomized controlled clinical trials comparing safety and efficacy of multiple versus single lumen umbilical venous catheter in neonates (both term and preterm) who were in need of umbilical venous catheter insertion for vascular access in first four weeks of life. Each review author performed data extraction independently and differences were resolved by discussion. The following outcomes were determined: total number of additional peripheral intravenous lines per baby in first week and first four weeks of life, total number of additional percutaneously and surgically placed central venous lines per baby in first four weeks of life, and other safety and efficacy measures. The treatment effect estimators used were RR, RD, and WMD when appropriate along with their 95% CI. If RD was statistically significant, then number

  9. Double suicide genes selectively kill human umbilical vein endothelial cells

    Directory of Open Access Journals (Sweden)

    Liu Lunxu

    2011-02-01

    Full Text Available Abstract Background To construct a recombinant adenovirus containing CDglyTK double suicide genes and evaluate the killing effect of the double suicide genes driven by kinase domain insert containing receptor (KDR promoter on human umbilical vein endothelial cells. Methods Human KDR promoter, Escherichia coli (E. coli cytosine deaminase (CD gene and the herpes simplex virus-thymidine kinase (TK gene were cloned using polymerase chain reaction (PCR. Plasmid pKDR-CDglyTK was constructed with the KDR promoter and CDglyTK genes. A recombinant adenoviral plasmid AdKDR-CDglyTK was then constructed and transfected into 293 packaging cells to grow and harvest adenoviruses. KDR-expressing human umbilical vein endothelial cells (ECV304 and KDR-negative liver cancer cell line (HepG2 were infected with the recombinant adenoviruses at different multiplicity of infection (MOI. The infection rate was measured by green fluorescent protein (GFP expression. The infected cells were cultured in culture media containing different concentrations of prodrugs ganciclovir (GCV and/or 5-fluorocytosine (5-FC. The killing effects were measured using two different methods, i.e. annexin V-FITC staining and terminal transferase-mediated dUTP nick end-labeling (TUNEL staining. Results Recombinant adenoviruses AdKDR-CDglyTK were successfully constructed and they infected ECV304 and HepG2 cells efficiently. The infection rate was dependent on MOI of recombinant adenoviruses. ECV304 cells infected with AdKDR-CDglyTK were highly sensitive to GCV and 5-FC. The cell survival rate was dependent on both the concentration of the prodrugs and the MOI of recombinant adenoviruses. In contrast, there were no killing effects in the HepG2 cells. The combination of two prodrugs was much more effective in killing ECV304 cells than GCV or 5-FC alone. The growth of transgenic ECV304 cells was suppressed in the presence of prodrugs. Conclusion AdKDR-CDglyTK/double prodrog system may be a useful

  10. Metabolic profiling of umbilical cord blood in macrosomia.

    Science.gov (United States)

    Sun, H; Wang, Y; Wang, C; Xu, X; Wang, Y; Yan, H; Yang, X

    2017-11-21

    The term macrosomia is used to describe neonates with a birth weight of 4000 g or more. Macrosomia is a potential risk factor for obesity and metabolic syndromes in postnatal and adult life, yet little is known about its associations with metabolic difference in the early-age. We performed metabolic profiling of umbilical cord blood to discover differential metabolites of macrosomia. We conducted a case-control study of full-term singletons with normal maternal glucose tolerance [50 cases (macrosomia, birth weight ⩾4000 g); 50 controls (normal weight, birth weight 2500-3999 g)]. Metabolites in umbilical cord blood were detected using an untargeted metabolomic approach based on gas chromatography/mass spectrometry. We performed logistic regression to evaluate the associations between metabolites and macrosomia. We also performed pathway analysis based on KEGG and MBRole. Compared with controls, the macrosomia cases had a greater male proportion, gestational age, paternal BMI, and maternal pre-pregnancy BMI. Forty-two metabolites differed between the cases and controls. After multivariable adjustment, 2-methylfumarate [adjusted odds ratio (AOR)=1.232, 95% confidence interval (CI): 1.102-1.376], uracil (AOR=38.494, 95% CI: 5.635-262.951), elaidic acid (AOR=0.834, 95% CI: 0.761-0.915), ribose (AOR=0.089, 95% CI: 0.021-0.378), lactulose (AOR=0.815, 95% CI: 0.743-0.894), and 4-aminobutyric acid (AOR=0.835, 95% CI: 0.764-0.912) remained significantly associated with macrosomia. Pyrimidine metabolism and pentose and glucuronate interconversions were the two top-ranking pathways enriched with those metabolites (-log P-value=3.49 and 2.47, respectively). Levels of 2-methylfumarate, uracil, ribose, elaidic acid, lactulose, and 4-aminobutyric acid were associated with the incidence of macrosomia. The alteration of pathways involving those factors might be linked with the incidence of macrosomia and relevant metabolic syndromes later in life, and further studies are

  11. Umbilical Cord Prostaglandins in Term and Preterm Parturition

    Science.gov (United States)

    Hong, J.-S.; Romero, R.; Lee, D.-C.; Than, N. G.; Yeo, L.; Chaemsaithong, P.; Ahn, S.; Kim, J.-S.; Kim, C. J.; Kim, Y.M.

    2017-01-01

    Objective Prostaglandins (PGs) are considered the universal mediators of parturition. Amniotic fluid PGE2 and PGF2α concentrations increase before the onset of spontaneous labor at term, as well as during labor. This study was conducted to determine if the concentrations of umbilical cord PGE2 and PGF2α change with advancing gestational age, spontaneous labor at term, and preterm labor (with and without funisitis). Methods Umbilical cord (UC) tissue samples were obtained from women (N=158) with singleton pregnancies in the following groups: 1) term deliveries without labor (TNL; n=20); 2) term deliveries with labor (TIL; n= 20); 3) spontaneous preterm deliveries (sPTD) with (n=20) and without acute funisitis (n=20); and 4) preeclampsia without labor (n=78). The concentrations of PGs were determined in different locations of the UC. PGE2 and PGF22α were measured by specific immunoassays. Non-parametric statistics were used for analysis. Results 1) In spontaneous preterm deliveries, the median UC PGE2 concentration was higher in cases with funisitis than in those without funisitis (233.7 pg/μg vs. 87.4 pg/μg of total protein, p=0.001); 2) the median UC PGE2 concentration in sPTD with funisitis was also higher than that obtained from samples who had undergone labor at term (233.7 pg/μg vs. 116.1 pg/μg of total protein, p=0.03); 3) the UC PGE2 and PGF2α concentration increased as a function of advancing gestational age before 36 weeks (PGE2: rho = 0.59, pumbilical cord are higher in the presence of acute funisitis than in the absence of this lesion; 2) spontaneous labor at term was not associated with a change in the UC concentration of PGE2 and PGF2α; and 3) the UC concentrations of PGE2 and PGF2α increased as a function of gestational age. We propose that UC PGs act as inflammatory mediators generated in the context of fetal systemic inflammation. PMID:25758616

  12. The structure of chromatic polynomials of planar triangulations and implications for chromatic zeros and asymptotic limiting quantities

    International Nuclear Information System (INIS)

    Shrock, Robert; Xu Yan

    2012-01-01

    We present an analysis of the structure and properties of chromatic polynomials P(G pt,m-vector, q) of one-parameter and multi-parameter families of planar triangulation graphs G pt,m-vector , where m-vector = (m 1 ,…,m p ) is a vector of integer parameters. We use these to study the ratio of |P(G pt,m-vector, τ+1)| to the Tutte upper bound (τ − 1) n−5 , where τ=(1+√5)/2 and n is the number of vertices in G pt,m-vector . In particular, we calculate limiting values of this ratio as n → ∞ for various families of planar triangulations. We also use our calculations to analyze zeros of these chromatic polynomials. We study a large class of families G pt,m-vector with p = 1 and p = 2 and show that these have a structure of the form P(G pt,m ,q) = c G pt ,1 λ 1 m + c G pt ,2 λ 2 m + c G pt ,3 λ 3 m for p = 1, where λ 1 = q − 2, λ 2 = q − 3, and λ 3 = −1, and P(G pt,m-vector ,q) =Σ i 1 =1 3 Σ i 2 =1 3 c G pt ,i 1 i 2 λ i 1 m 1 λ i 2 m 2 for p = 2. We derive properties of the coefficients c G pt ,i-vector and show that P(G pt,m-vector ,q) has a real chromatic zero that approaches (1/2)(3+√5) as one or more of the m i → ∞. The generalization to p ⩾ 3 is given. Further, we present a one-parameter family of planar triangulations with real zeros that approach 3 from below as m → ∞. Implications for the ground-state entropy of the Potts antiferromagnet are discussed. (paper)

  13. Tle Triangulation Campaign by Japanese High School Students as a Space Educational Project of the Ssh Consortium Kochi

    Science.gov (United States)

    Yamamoto, Masa-Yuki; Okamoto, Sumito; Miyoshi, Terunori; Takamura, Yuzaburo; Aoshima, Akira; Hinokuchi, Jin

    As one of the space educational projects in Japan, a triangulation observation project of TLE (Transient Luminous Events: sprites, elves, blue-jets, etc.) has been carried out since 2006 in collaboration between 29 Super Science High-schools (SSH) and Kochi University of Technol-ogy (KUT). Following with previous success of sprite observations by "Astro High-school" since 2004, the SSH consortium Kochi was established as a national space educational project sup-ported by Japan Science and Technology Agency (JST). High-sensitivity CCD camera (Watec, Neptune-100) with 6 mm F/1.4 C-mount lens (Fujinon) and motion-detective software (UFO-Capture, SonotaCo) were given to each participating team in order to monitor Northern night sky of Japan with almost full-coverage. During each school year (from April to March in Japan) since 2006, thousands of TLE images were taken by many student teams, with considerably large numbers of successful triangulations, i.e., (School year, Numbers of TLE observations, Numbers of triangulations) are (2006, 43, 3), (2007, 441, 95), (2008, 734, 115), and (2009, 337, 78). Note that, school year in Japan begins on April 1 and ends on March 31. The observation campaign began in December 2006, numbers are as of Feb. 28, 2010. Recently, some high schools started wide field observations using multiple cameras, and others started VLF observations using handmade loop antennae and amplifiers. Infomation exchange among the SSH consortium Kochi is frequently communicated with scientific discussion via KUT's mailing lists. Also, interactions with amateur observers in Japan are made through an internet forum of "SonotaCo Network Japan" (http://sonotaco.jp). Not only as an educational project but also as a scientific one, the project is also in success. In February 2008, simultaneous observations of Elves were obtained, in November 2009 a Giant "Graft-shaped" Sprites driven by Jets was clearly imaged with VLF signals. Most recently, ob-servations of Elves

  14. Discrepancies between qualitative and quantitative evaluation of randomised controlled trial results: achieving clarity through mixed methods triangulation.

    Science.gov (United States)

    Tonkin-Crine, Sarah; Anthierens, Sibyl; Hood, Kerenza; Yardley, Lucy; Cals, Jochen W L; Francis, Nick A; Coenen, Samuel; van der Velden, Alike W; Godycki-Cwirko, Maciek; Llor, Carl; Butler, Chris C; Verheij, Theo J M; Goossens, Herman; Little, Paul

    2016-05-12

    Mixed methods are commonly used in health services research; however, data are not often integrated to explore complementarity of findings. A triangulation protocol is one approach to integrating such data. A retrospective triangulation protocol was carried out on mixed methods data collected as part of a process evaluation of a trial. The multi-country randomised controlled trial found that a web-based training in communication skills (including use of a patient booklet) and the use of a C-reactive protein (CRP) point-of-care test decreased antibiotic prescribing by general practitioners (GPs) for acute cough. The process evaluation investigated GPs' and patients' experiences of taking part in the trial. Three analysts independently compared findings across four data sets: qualitative data collected view semi-structured interviews with (1) 62 patients and (2) 66 GPs and quantitative data collected via questionnaires with (3) 2886 patients and (4) 346 GPs. Pairwise comparisons were made between data sets and were categorised as agreement, partial agreement, dissonance or silence. Three instances of dissonance occurred in 39 independent findings. GPs and patients reported different views on the use of a CRP test. GPs felt that the test was useful in convincing patients to accept a no-antibiotic decision, but patient data suggested that this was unnecessary if a full explanation was given. Whilst qualitative data indicated all patients were generally satisfied with their consultation, quantitative data indicated highest levels of satisfaction for those receiving a detailed explanation from their GP with a booklet giving advice on self-care. Both qualitative and quantitative data sets indicated higher patient enablement for those in the communication groups who had received a booklet. Use of CRP tests does not appear to engage patients or influence illness perceptions and its effect is more centred on changing clinician behaviour. Communication skills and the patient

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

    Directory of Open Access Journals (Sweden)

    Arne Dietrich

    2014-02-01

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

  16. Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Toru Obuchi

    2018-01-01

    Conclusion: Our findings show that obesity, intended as a BMI ≥30 kg/m2, does not have an adverse impact on the technical difficulty and post-operative outcomes of SILC. Obesity-related comorbidities did not increase the risks for SILC.

  17. Single Incision Distal Biceps Repair With Hemi-Krackow Suture Technique: Surgical Technique and Early Outcomes

    OpenAIRE

    Goljan, Peter; Patel, Nimit; Stull, Justin D.; Donnelly, Brandon P.; Culp, Randall W.

    2016-01-01

    Background: Many surgical methods exist for distal biceps repair. We present the technique and early outcomes of a series of distal biceps repairs completed with a novel suturing technique utilizing a hemi-Krackow locking stitch at the tendon-bone interface. Methods: A retrospective review was performed of patients who underwent primary distal biceps repair using a single anterior incision with 2 suture anchors utilizing a hemi-Krackow stitch. With both anchors, a locking stitch along the ten...

  18. Single incision versus reduced port splenectomy--searching for the best alternative to conventional laparoscopic splenectomy.

    Science.gov (United States)

    Monclova, Julio Lopez; Targarona, Eduardo M; Vidal, Pablo; Peraza, Yerald; Garcia, Francisco; Otero, Carlos Rodriguez; Pallares, Luis; Balague, Carmen; Trias, Manuel

    2013-03-01

    Laparoscopic splenectomy (LS) is a well accepted approach for the treatment of multiple hematologic diseases. Single port access splenectomy (SPAS) emphasizes the concept of surgery through one small incision. The reduced port access splenectomy (RPAS) entails the use of fewer trocars of smaller sizes. The aim of this study was to compare the clinical outcomes after LS, SPAS, and RPAS, and to analyze the aesthetic result and patient satisfaction. We included patients who underwent LS (group 1, n = 15), SPAS (group 2, n = 8), and RPAS (group 3, n = 10) between June 2008 and February 2012, whose final spleen weight was less of 500 g. The outcome parameters analyzed were operative time, need of additional trocars, blood loss, blood transfusion, weight of the spleen, postoperative complications, and duration of hospital stay. To evaluate the cosmetic result, patients were asked to take the Body Image Questionnaire. Patients in group 3 were younger than group 1. Operative time was significantly longer in group 2 compared to groups 1 and 3 (83 ± 19 vs. 131 ± 43 vs. 81 ± 22 min, p = 0.01). There was no need to convert to open surgery in any group, nor were there differences in intra- or postoperative outcome. There were no differences between the groups in relation to the analgesic requirements. Twenty-two out of the 33 patients answered the questionnaire. There was a significant advantage in group 2 and 3 in the body image index with respect to group 1. There were no differences between groups 2 and 3 (7.3 ± 2.8 vs. 5.8 ± 1.3 vs. 5.1 ± 0.4, p RPAS is a good alternative to LS and SPAS. It improves the aesthetic results as compared to LS, whereas minimizes the technical challenges faced with SPAS.

  19. Marker-less reconstruction of dense 4-D surface motion fields using active laser triangulation for respiratory motion management.

    Science.gov (United States)

    Bauer, Sebastian; Berkels, Benjamin; Ettl, Svenja; Arold, Oliver; Hornegger, Joachim; Rumpf, Martin

    2012-01-01

    To manage respiratory motion in image-guided interventions a novel sparse-to-dense registration approach is presented. We apply an emerging laser-based active triangulation (AT) sensor that delivers sparse but highly accurate 3-D measurements in real-time. These sparse position measurements are registered with a dense reference surface extracted from planning data. Thereby a dense displacement field is reconstructed which describes the 4-D deformation of the complete patient body surface and recovers a multi-dimensional respiratory signal for application in respiratory motion management. The method is validated on real data from an AT prototype and synthetic data sampled from dense surface scans acquired with a structured light scanner. In a study on 16 subjects, the proposed algorithm achieved a mean reconstruction accuracy of +/- 0.22 mm w.r.t. ground truth data.

  20. Flying triangulation--an optical 3D sensor for the motion-robust acquisition of complex objects.

    Science.gov (United States)

    Ettl, Svenja; Arold, Oliver; Yang, Zheng; Häusler, Gerd

    2012-01-10

    Three-dimensional (3D) shape acquisition is difficult if an all-around measurement of an object is desired or if a relative motion between object and sensor is unavoidable. An optical sensor principle is presented-we call it "flying triangulation"-that enables a motion-robust acquisition of 3D surface topography. It combines a simple handheld sensor with sophisticated registration algorithms. An easy acquisition of complex objects is possible-just by freely hand-guiding the sensor around the object. Real-time feedback of the sequential measurement results enables a comfortable handling for the user. No tracking is necessary. In contrast to most other eligible sensors, the presented sensor generates 3D data from each single camera image. © 2012 Optical Society of America

  1. An evaluation of orthopaedic nurses’ participation in an educational intervention promoting research usage – a triangulation convergence model

    DEFF Research Database (Denmark)

    Berthelsen, Connie; Hølge-Hazelton, Bibi

    2016-01-01

    is the lack of participation. A previous survey identified 32 orthopaedic nurses as interested in participating in nursing research. An educational intervention was conducted to increase the orthopaedic nurses' research knowledge and competencies. However, only an average of six nurses participated. DESIGN......AIMS AND OBJECTIVES: To describe the orthopaedic nurses' experiences regarding the relevance of an educational intervention and their personal and contextual barriers to participation in the intervention. BACKGROUND: One of the largest barriers against nurses' research usage in clinical practice......: A triangulation convergence model was applied through a mixed methods design to combine quantitative results and qualitative findings for evaluation. METHODS: Data were collected from 2013-2014 from 32 orthopaedic nurses in a Danish regional hospital through a newly developed 21-item questionnaire and two focus...

  2. Identifying the 630 nm auroral arc emission height: A comparison of the triangulation, FAC profile, and electron density methods

    Science.gov (United States)

    Megan Gillies, D.; Knudsen, D.; Donovan, E.; Jackel, B.; Gillies, R.; Spanswick, E.

    2017-08-01

    We present a comprehensive survey of 630 nm (red-line) emission discrete auroral arcs using the newly deployed Redline Emission Geospace Observatory. In this study we discuss the need for observations of 630 nm aurora and issues with the large-altitude range of the red-line aurora. We compare field-aligned currents (FACs) measured by the Swarm constellation of satellites with the location of 10 red-line (630 nm) auroral arcs observed by all-sky imagers (ASIs) and find that a characteristic emission height of 200 km applied to the ASI maps gives optimal agreement between the two observations. We also compare the new FAC method against the traditional triangulation method using pairs of all-sky imagers (ASIs), and against electron density profiles obtained from the Resolute Bay Incoherent Scatter Radar-Canadian radar, both of which are consistent with a characteristic emission height of 200 km.

  3. Proposals for the Operationalisation of the Discourse Theory of Laclau and Mouffe Using a Triangulation of Lexicometrical and Interpretative Methods

    Directory of Open Access Journals (Sweden)

    Georg Glasze

    2007-05-01

    Full Text Available The discourse theory of Ernesto LACLAU and Chantal MOUFFE brings together three elements: the FOUCAULTian notion of discourse, the (post- MARXist notion of hegemony, and the poststructuralist writings of Jacques DERRIDA and Roland BARTHES. Discourses are regarded as temporary fixations of differential relations. Meaning, i.e. any social "objectivity", is conceptualised as an effect of such a fixation. The discussion on an appropriate operationalisation of such a discourse theory is just beginning. In this paper, it is argued that a triangulation of two linguistic methods is appropriate to reveal temporary fixations: by means of corpus-driven lexicometric procedures as well as by the analysis of narrative patterns, the regularities of the linkage of elements can be analysed (for example, in diachronic comparisons. The example of a geographic research project shows how, in so doing, the historically contingent constitution of an international community and "world region" can be analysed. URN: urn:nbn:de:0114-fqs0702143

  4. One-time umbilical cord milking after cord cutting has same effectiveness as multiple-time umbilical cord milking in infants born at <29 weeks of gestation: a retrospective study.

    Science.gov (United States)

    Hosono, S; Mugishima, H; Takahashi, S; Takahashi, S; Masaoka, N; Yamamoto, T; Tamura, M

    2015-08-01

    To compare two strategies to potentiate the effects of placental transfusion in infants born at umbilical cord milking after umbilical cord cutting were compared with 20 infants from a previous study group who received multiple-time umbilical cord milking. The primary outcome measurements were the probability of not needing a red blood cell (RBC) transfusion during the hospital stay and the total number of RBC transfusions within 21 days after birth. There was no significant difference in the probability of not needing a transfusion during the hospital stay (P=0.75) and the mean number of RBC transfusions given within the first 21 days of life (1.1±1.8 for the one-time umbilical cord-milking group vs 0.7±1.2 for the multiple-time umbilical cord-milking group, P=0.48). One-time umbilical cord milking after umbilical cord cutting had similar beneficial effects to multiple-time umbilical cord milking before umbilical cord cutting in very premature infants.

  5. Umbilical cord entanglement's frequency and its impact on the newborn.

    Science.gov (United States)

    Walla, Tatjana; Rothschild, Markus A; Schmolling, Jan C; Banaschak, Sibylle

    2018-05-01

    Neonaticide is a serious allegation that needs a complete chain of criminal investigations. In this context, a nuchal cord is considered to be responsible for an infant's death, but there is a clear lack of evidence. The purpose of our study is to reveal if a nuchal cord can be responsible for stillbirth, poor perinatal outcome, or neonatal death in the forensic aspect. We conducted a prospective study in collaboration with the Augustinian Sisters' Hospital in Cologne, Germany in the period from February 2014 to May 2016. Four-hundred eighty-six children were enrolled. All births were assessed regarding the occurrence of an umbilical cord entanglement, and perinatal outcome was measured by arterial blood gas analysis, Apgar after 1, 5, and 10 min after birth as well as the general vitality. The prevalence of a nuchal cord was 16.87%. Apgar decrease and acidosis were significantly associated with a nuchal cord. No adverse perinatal outcome was recorded in this constellation. There was no child death regarding the first 24 h, and no mother experienced a syncope while giving birth. We can conclude that a nuchal cord is not associated with adverse perinatal outcome.

  6. Improving engraftment and immune reconstitution in umbilical cord blood transplantation

    Directory of Open Access Journals (Sweden)

    Robert eDanby

    2014-02-01

    Full Text Available Umbilical cord blood (UCB is an important source of haematopoietic stem cells (HSC for allogeneic transplantation when HLA-matched sibling and unrelated donors (MUD are unavailable. Although the overall survival rates of UCB transplantation are comparable to the results with MUD, UCB transplants are associated with slow engraftment, delayed immune reconstitution, and increased opportunistic infections. While this may be a consequence of the lower cell dose in UCB grafts, it also reflects the relative immaturity of cellular immunity within cord blood. Furthermore, the limited number of cells and the non-availability of donor lymphocyte infusions (DLI currently prevent the use of post-transplant cellular immunotherapy to boost donor-derived immunity to treat infection, mixed chimerism and disease relapse. Therefore, to further develop UCB transplantation, many strategies to enhance engraftment and immune reconstitution are currently under investigation. This review summarises our current understanding of engraftment and immune recovery following UCB transplantation and why this differs from allogeneic transplants using other sources of HSC. It also provides an comprehensive overview of the promising techniques being used to improve myeloid and lymphoid recovery, including expansion, homing, and delivery of UCB HSC; combined use of UCB with third party donors; isolation and expansion of NK cells, pathogen specific T cells, and regulatory T cells; methods to protect and/or improve thymopoiesis. As many of these strategies are now in clinical trials, it is anticipated that UCB transplantation will continue to advance, further expanding our understanding of UCB biology and HSC transplantation.

  7. Cutting the Army’s Umbilical Cord: A Study of Emerging Fuel Technologies and Their Impact on National Security

    Science.gov (United States)

    2011-12-01

    Cutting the Army’s Umbilical Cord A Study of Emerging Fuel Technologies and their Impact on National Security A Monograph by MAJ Matthew A...blank) 15 July 2011 SAMS Monograph, June 2010 - March 2011 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Cutting the Army’s Umbilical Cord A Study of...APPROVAL Major Matthew A. Price Title of Monograph: Cutting the Army’s Umbilical Cord Approved by: :r~z__J:W Bruce E. Stanley G. Scott Gorman, Ph

  8. Hematoma del cordón umbilical: a propósito de un caso interesante Umbilical cord hematoma: an interesting case

    Directory of Open Access Journals (Sweden)

    Angelicia Crespo Campos

    2009-06-01

    Full Text Available Se presenta el caso de un recién nacido que presentó tumoración del cordón umbilical, de 3 x 4 cm, coloración rojo violácea, consistencia blanda, no dolorosa, a 1 cm de la pared abdominal. En su evolución se observó disminución gradual de tamaño, sangramiento escaso y como complicación se presentó un granuloma umbilical, con retardo en la caída del cordón (21 días. A los 45 días de edad el ombligo estaba normal. Se realiza una caracterización clínica de la patología y se ofrece una revisión actualizada sobre el tema.Authors present the case of a newborn presenting a 3 x 4 cm umbilical cord tumor of red-violet color, soft consistency and painless located at 1 cm of abdominal wall. During its evolution there was a gradual decrease size, low bleeding, and as a complication the presence of an umbilical granuloma and delay of fall cord (21 days. At 45 days the navel was normal. We performed a clinical catheterization of the pathology and also offer updated review on this matter.

  9. Hexachlorocyclohexanes (HCHs) in placenta and umbilical cord blood and dietary intake for women in Beijing, China

    International Nuclear Information System (INIS)

    Yu, Yanxin; Wang, Bin; Wang, Xilong; Wang, Rong; Wang, Wentao; Shen, Guofeng; Shen, Huizhong; Li, Wei; Wong, Minghong; Liu, Wenxin; Tao, Shu

    2013-01-01

    Placenta and umbilical cord blood are important media for investigating maternal–fetal exposure to environmental pollutants. Historically hexachlorocyclohexanes (HCHs) were once widely-used in China. In this study, residues of HCHs were measured in placenta and umbilical cord blood samples for 40 women from Beijing. The measured median values of HCHs were 62.0 and 68.8 ng/g fat in placenta and umbilical cord blood, respectively. Concentrations of HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural group due to enhanced consumption of fish, meat, and milk. Residues of HCHs in placenta were significantly correlated with total food consumption, dietary intake, and maternal age, and could be predicted using the parameters dependent upon ingestion of meat and milk. The transplacental exposure of fetuses to HCHs was revealed by a close association between the residual levels in the paired placenta and the paired umbilical cord blood samples. -- Highlights: •Medians of HCH in placenta and umbilical cord blood of 40 puerperal women from Beijing were 62.0 and 68.8 ng/g⋅fat. •HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural one. •HCH residues in placenta were significantly correlated with total food consumption, daily dietary intake, and maternal age. •The transplacental exposure of fetus to HCHs was revealed. -- HCHs in placenta of women in Beijing were significantly correlated with total food consumption, dietary intake, and maternal age

  10. Reference Values for Umbilical Cord Blood Gases of Newborns Delivered by Elective Cesarean Section.

    Science.gov (United States)

    Manomayangkul, Kattiya; Siriussawakul, Arunotai; Nimmannit, Akarin; Yuyen, Thassayu; Ngerncham, Sopapan; Reesukumal, Kanit

    2016-05-01

    Umbilical cord blood gas values are better indicators of perinatal asphyxia than Apgar scores. Many studies have reported normal ranges of umbilical cord blood gases, which vary greatly due to many factors. This study aimed to establish the reference values of umbilical cord blood gases of normal cesarean newborns in a university hospital setting. Blood samples from the umbilical artery and vein were collected from 160 newborns delivered by elective cesarean section. The indications for caesarean section were not due to fetal distress, intrauterine growth retardation, or non-reassuring fetal heart rate. The blood samples were collected immediately after birth in the operating room and then sent for blood-gas analysis. The blood-gas values were statistically analyzed and reported. The cord blood collected from 160 newborns was analyzed in this study. Seventy-eight percent (115) of the parturients were hypotensive before delivery. All Apgar scores at one and five minutes after delivery were at least 7. The calculated reference range of the umbilical arterial pH was 7.18-7.42, of pO₂was 6.43-29.43 mmHg, of pCO₂was 33.44-66.56 mmHg, and of HCO₃was 15.60-30.70 mEq/L. The reference range obtained for the umbilical venous pH was 7.28-7.44,for pO₂was 13.97-37.13 mmHg, for pCO₂was 30.70-57.0 mmHg, and for HCO₃was 18.50-29.90 mEq/L. The study determined normal reference values as a result of umbilical cord blood gas analyses.

  11. Use of Otoscope as a Diagnostic and Therapeutic Aid in Umbilical Pilonidal Sinus: A Novel Technique

    Directory of Open Access Journals (Sweden)

    Farhanul Huda

    2018-01-01

    Full Text Available Introduction: Umbilical disorders are frequently encountered in general surgical practice. Although the sacrococcygeal region is the most common site for pilonidal sinus disease, it can be seen occasionally in periumbilical area. Treatment is mostly conservative for umbilical pilonidal sinus in contrast to the sacrococcygeal sinus where it is always surgical. In the era of endoscopy and minimally invasive surgery, we describe the use of otoscope as a novel technique for the diagnosis and treatment of umbilical pilonidal sinus. Subject and Method: In this prospective study, patients with a clinical suspicion of umbilical pilonidal sinus were included and diagnosis was confirmed on the basis of otoscopic finding. All patients were planned for conservative management i.e. extraction of hair fragments with the help of an otoscope followed by oral antibiotics treatment. On follow-up, response of treatment was noted by evaluation of symptoms and otoscopic examination.Result: Total 15 patients were included in this study. By using otoscope for removal of hair fragments from umbilical sinus, we found successful result in all patients with conservative treatment. Discussion: In umbilical pilonidal sinus, the success of conservative treatment depends on the effective extraction of hair and maintenance of personal hygiene by the patient. Our study showed 100% successful result of conservative treatment, probably due to proper and complete extraction of hair fragment with the help of the otoscope. Conclusion: Otoscopic examination and hair extraction for umbilical pilonidal sinus is a simple, cost-effective, and easy treatment that can be done in the outpatient department and does not require any formal training for its use.

  12. Use of Otoscope as a Diagnostic and Therapeutic Aid in Umbilical Pilonidal Sinus: A Novel Technique.

    Science.gov (United States)

    Huda, Farhanul; Singh, Sudhir Kumar

    2018-01-01

    Umbilical disorders are frequently encountered in general surgical practice. Although the sacrococcygeal region is the most common site for pilonidal sinus disease, it can be seen occasionally in periumbilical area. Treatment is mostly conservative for umbilical pilonidal sinus in contrast to the sacrococcygeal sinus where it is always surgical. In the era of endoscopy and minimally invasive surgery, we describe the use of otoscope as a novel technique for the diagnosis and treatment of umbilical pilonidal sinus. In this prospective study, patients with a clinical suspicion of umbilical pilonidal sinus were included and diagnosis was confirmed on the basis of otoscopic finding. All patients were planned for conservative management i.e. extraction of hair fragments with the help of an otoscope followed by oral antibiotics treatment. On follow-up, response of treatment was noted by evaluation of symptoms and otoscopic examination. Total 15 patients were included in this study. By using otoscope for removal of hair fragments from umbilical sinus, we found successful result in all patients with conservative treatment. In umbilical pilonidal sinus, the success of conservative treatment depends on the effective extraction of hair and maintenance of personal hygiene by the patient. Our study showed 100% successful result of conservative treatment, probably due to proper and complete extraction of hair fragment with the help of the otoscope. Otoscopic examination and hair extraction for umbilical pilonidal sinus is a simple, cost-effective, and easy treatment that can be done in the outpatient department and does not require any formal training for its use.

  13. Retrospective evaluation of risk factors and perinatal outcome of umbilical cord prolapse during labor.

    Science.gov (United States)

    Kaymak, O; Iskender, C; Ibanoglu, M; Cavkaytar, S; Uygur, D; Danisman, N

    2015-07-01

    Umbilical cord prolapse has a reported prevalence of 0.1-0.6%. In previous studies, risk factors for umbilical prolapse have been identified as multiparity, preterm delivery, non-vertex presentation, and obstetric manipulation for labor induction. In the present study, we aimed to investigate the risk factors for umbilical cord prolapse and to determine the factors that may relate to neonatal morbidity in these patients. This study consisted of recorded cases of umbilical cord prolapse at Dr Zekai Tahir Burak Research and Training Hospital between January 2008 and May 2013. Clinical and demographic data were obtained by reviewing the patients' medical records. Student's t test was performed for parametric variables between groups, and a Chi-square test was performed for nonparametric variables between groups. A logistic regression was performed to investigate the effects of clinical parameters such as gestational age, diagnosis to delivery interval, and fetal presentation on neonatal morbidity. The patients with umbilical cord prolapse during labor had higher rates of preterm deliveries, low-birth-weight infants, and non-vertex presentations than the control group did. Preterm delivery, non-vertex presentation, presence of polyhydramnios, and spontaneous membrane rupture increased the risk of umbilical cord prolapse significantly. In the regression analysis, gestational age and diagnosis to delivery interval greater than 10 minutes predicted adverse neonatal outcomes independently. Umbilical cord prolapse is more common in cases of preterm delivery, non-vertex fetal presentation, and spontaneous rupture of membranes. A diagnosis to delivery interval greater than ten minutes is independently associated with an adverse neonatal outcome.

  14. Tratamento de hérnia umbilical em bovinos

    Directory of Open Access Journals (Sweden)

    Luiz Antônio Franco da Silva

    2012-02-01

    Full Text Available Bovinos jovens são frequentemente acometidos por hérnias umbilicais. Neste trabalho, avaliou-se a ocorrência e estabeleceu-se o tratamento cirúrgico para hérnias umbilicais em bovinos jovens, empregando 78 bezerros distribuídos em seis grupos. Em GI e GIV, na laparorrafia, utilizou-se sutura jaquetão; em GII e GV, jaquetão modificado e, em GIII e GVI, sutura separada simples com pontos de relaxamento. Em GI, GII e GIII utilizou-se fio de algodão e, em GIV, GV e GVI, de náilon. Dados não paramétricos, envolvendo a recuperação dos animais e sua independência ou associações com o padrão de sutura foram analisados pelo teste do Qui-quadrado e Exato de Fisher, fazendo-se uso do programa computacional Statistical Analysis System, a 5% (p < 0,05. Os demais resultados foram analisados descritivamente. A ocorrência de hérnia umbilical em bovinos foi expressiva e a herniorrafia, empregando-se fio de algodão, apresentou maiores complicações pós-operatórias; porém a maioria dos animais recuperou-se. O fio e o padrão de sutura, manejo pós-operatório, resposta individual e o tamanho do anel herniário influenciam na reabilitação dos animais e na redução das complicações pós-operatórias.

  15. Umbilical cord blood banks. Ethical aspects. Public versus private banks.

    Science.gov (United States)

    Aznar Lucea, Justo

    2012-01-01

    The creation of umbilical cord blood (UCB) banks raises interesting medical, social, economic and ethical issues. This paper reviews the ethical problems specifically. In this respect, it evaluates: a) whether there are advantages to the use of UCB compared to bone marrow, b) whether or not it is ethical to create UCB banks, c) whether their creation is ethically acceptable in terms of their clinical usefulness or d) the use made of them for therapeutic purposes, and finally e) whether their creation is ethically justified from a cost/profitability point of view. We focus primarily on evaluating the ethical controversy between public and private banks, particularly on whether it is ethical to bank autologous blood in private UCB banks, on the basis of its limited possibilities for use by the cord blood donor. We can conclude that, from an ethical point of view, autologous blood banks have limited acceptance among specialised researchers, scientific societies and other public institutions. Therefore, we believe that it is ethically more acceptable to support the creation of public UCB banks for medical and social reasons and, above all, based on the principle of justice and human solidarity. Nevertheless, there is no definitive ethical argument why a couple, according to their autonomy and freedom, cannot bank their child's UCB in a private bank. An equally acceptable solution could be the creation of mixed banks, such as that proposed by the Virgin Health Bank or like the Spanish system where autologous samples can be stored in public banks but with the proviso that if at any time the stored sample is required by any person other than the donor, it would have to be given to them.

  16. Organizational behavior of human umbilical vein endothelial cells.

    Science.gov (United States)

    Maciag, T; Kadish, J; Wilkins, L; Stemerman, M B; Weinstein, R

    1982-09-01

    Culture conditions that favor rapid multiplication of human umbilical vein endothelial cells (HUV-EC) also support long-term serial propagation of the cells. This is routinely achieved when HUV-EC are grown in Medium 199 (M-199) supplemented with fetal bovine serum (FBS) and endothelial cell growth factor (ECGF), on a human fibronectin (HFN) matrix. The HUV-EC can shift from a proliferative to an organized state when the in vitro conditions are changed from those favoring low density proliferation to those supporting high density survival. When ECGF and HFN are omitted, cultures fail to achieve confluence beyond the first or second passage: the preconfluent cultures organize into tubular structures after 4-6 wk. Some tubes become grossly visible and float in the culture medium, remaining tethered to the plastic dish at either end of the tube. On an ultrastructural level, the tubes consist of cells, held together by junctional complexes, arranged so as to form a lumen. The smallest lumens are formed by one cell folding over to form a junction with itself. The cells contain Weibel-Palade bodies and factor VIII-related antigen. The lumens contain granular, fibrillar and amorphous debris. Predigesting the HFN matrix with trypsin (10 min, 37 degrees C) or plasmin significantly accelerates tube formation. Thrombin and plasminogen activator had no apparent effect. Disruption of the largest tubes with trypsin/EDTA permits the cells to revert to a proliferative state if plated on HFN, in M-199, FBS, and ECGF. These observations indicate that culture conditions that do not favor proliferation permit attainment of a state of nonterminal differentiation (organization) by the endothelial cell. Furthermore, proteolytic modification of the HFN matrix may play an important role in endothelial organization.

  17. Self-Assembled Matrix by Umbilical Cord Stem Cells

    Directory of Open Access Journals (Sweden)

    Biagio Saitta

    2011-09-01

    Full Text Available Corneal integrity is critical for vision. Corneal wounds frequently heal with scarring that impairs vision. Recently, human umbilical cord mesenchymal stem cells (cord stem cells have been investigated for tissue engineering and therapy due to their availability and differentiation potential. In this study, we used cord stem cells in a 3-dimensional (3D stroma-like model to observe extracellular matrix organization, with human corneal fibroblasts acting as a control. For 4 weeks, the cells were stimulated with a stable Vitamin C (VitC derivative ±TGF-b1. After 4 weeks, the mean thickness of the constructs was ~30 mm; however, cord stem cell constructs had 50% less cells per unit volume, indicating the formation of a dense matrix. We found minimal change in decorin and lumican mRNA, and a significant increase in perlecan mRNA in the presence of TGF-b1. Keratocan on the other hand decreased with TGF-b1 in both cell lineages. With both cell types, the constructs possessed aligned collagen fibrils and associated glycosaminoglycans. Fibril diameters did not change with TGF-b1 stimulation or cell lineage; however, highly sulfated glycosaminoglycans associated with the collagen fibrils significantly increased with TGF-b1. Overall, we have shown that cord stem cells can secrete their own extracellular matrix and promote the deposition and sulfation of various proteoglycans. Furthermore, these cells are at least comparable to commonly used corneal fibroblasts and present an alternative for the 3D in vitro tissue engineered model.

  18. Electrocardiographic changes following umbilical cord occlusion in the midgestation fetal sheep.

    Science.gov (United States)

    Welin, Anna-Karin; Blad, Sofia; Hagberg, Henrik; Rosén, K G; Kjellmer, Ingemar; Mallard, Carina

    2005-02-01

    Clinical studies show that analysis of the fetal electrocardiographic (FECG) ST waveform at term gives important information on the myocardial response to intrapartum asphyxia. However, it is not known whether the preterm fetus responds in a similar fashion. The objective of the present study was to evaluate the FECGST response to umbilical cord occlusion in the preterm fetal sheep. Fetal sheep at midgestation were subjected to 25 min umbilical cord occlusion (n = 7) and compared to controls (n = 5). Changes in the FECGST waveform were recorded together with arterial blood pressure, heart rate, and acid base status during the occlusion and for 3 days afterward. Umbilical cord occlusion resulted in immediate bradycardia (control: 187 +/- 7 bpm versus occlusion: 102 +/- 7 bpm), hypertension (control: 43.2 +/- 1.1 mmHg versus occlusion: 59.8 +/- 2.2 mmHg), and an initial increase in the T/QRS ratio (control: 0.10 +/- 0.02 versus occlusion: 0.60 +/- 0.10, P sheep has the capacity to react to umbilical cord occlusion with a significant increase in the amplitude of the ST waveform together with an augmentation of blood pressure, which then subsides as the occlusion continues. The appearance of negative ST segment appears to signify significant cardiac dysfunction. The characteristic progression of ST-waveform changes in response to umbilical cord occlusion in midgestation fetal sheep, suggests that monitoring the ST waveform may contribute clinically important information also in the preterm individual.

  19. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-05-03

    Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

  20. Fathers' emotional involvement with the neonate: impact of the umbilical cord cutting experience.

    Science.gov (United States)

    Brandão, Sónia; Figueiredo, Bárbara

    2012-12-01

    This paper is a report on a study analysing the effect of the umbilical cord cutting experience on fathers' emotional involvement with their infants. Participation in childbirth offers an opportunity for father and mother to share the childbirth experience, so it is vital that midwives improve the fathers' participation in this event. A quasi-experimental study with a quantitative methodology was implemented. One hundred and five fathers were recruited as part of a convenience sample in a Maternity Public Hospital in a Metropolitan City in Portugal, between January and May of 2008. The Bonding Scale, the Portuguese version of the 'Mother-to-Infant Bonding Scale' was used to evaluate the fathers' emotional involvement with the neonate at different moments: before childbirth, first day after childbirth and first month after childbirth. After childbirth, the fathers were divided into three separate groups depending on their umbilical cord cutting experience. The results demonstrate that the emotional involvement between father and child tends to increase during the first days after childbirth and to decrease when evaluated 1 month after birth, for fathers who did not cut the umbilical cord. However, fathers who cut the umbilical cord demonstrate an improvement in emotional involvement 1 month later. Results suggest that the umbilical cord cutting experience benefits the father's emotional involvement with the neonate, supporting the benefits of his participation and empowerment in childbirth. © 2012 Blackwell Publishing Ltd.

  1. Design of the Core Stage Inter-Tank Umbilical {CSITU) Compliance Mechanism

    Science.gov (United States)

    Smith, Kurt R.

    2013-01-01

    Project Goals: a) Design the compliance mechanism for the CSITU system to a 30% level -3D models completed in Pro/Engineer -Relevant design analysis b) Must meet all system requirements and establish basis for proceeding with detailed design. Tasks to be completed: A design that meets requirements for the 30% design review, 01/16/2013. Umbilical arms provide commodities to the launch vehicle prior to T-0. Commodities can range anywhere from hydraulics, pneumatics, cryogenic, electrical, ECS, etc ... Umbilicals commonly employ truss structures to deliver commodities to vehicle. Common configurations include: -Tilt-up -Swing Arm -Hose Drape -Drop Arm Umbilical arms will be mounted to Mobile Launch Platform. SLS currently has 9 T-0 umbilical arms. The compliance refers to the ability of the umbilical to adjust to minor changes in vehicle location. The compliance mechanism refers to the mechanism on the ground support equipment {GSE) that compensates for these changes. For the CSITU, these minor changes, or vehicle excursions, can be up to +4 in. Excursions refer to movements of the vehicle caused by wind loads and thermal expansion. It is ideal to have significant vertical compliance so a passive secondary release mechanism may be implemented.

  2. [Concentrations of cortisol and dehydroepiandrosterone sulfate in fetal umbilical cord blood for term labor].

    Science.gov (United States)

    Pan, Ling-yun; Xiao, Qun; Yuan, Qiao-ling

    2003-01-01

    To study the effect of cortisol and dehydroepiandrosterone sulfate (DHEA-S) in fetal umbilical cord blood on term labor. Cortisol and DHEA-S concentrations were measured By radioimmunoassay in 100 term fetal umbilical cord blood. They were divided into four groups. Group A selective cesarean section without any birth pain (n = 18), Group B cesarean section in latent phase (n = 10), Group C cesarean section in active phase (n = 12), Group D spontaneous vaginal deliver (n = 60). The concentrations of fetal umbilical cord cortisol in spontaneous vaginal deliver group was gradually increased with gestational week. The peak level was in the 39th gestation week, by the 42nd gestation week, the concentration of cortisol declined to the 37th gestation week. DHEA-S changed paralleled with cortisol (r = 0.46, P pain was associated with increased fetal umbilical cortisol concentration, but not with DHEA-S. The concentrations of fetal umbilical cord cortisol in vaginal deliver group was higher than all the cesarean section groups. Concentrations of cortisol and DHEA-S played an important role in the initiation and acceleration of labor.

  3. Umbilical cord sparing technique for repair of congenital hernia into the cord and small omphalocele.

    Science.gov (United States)

    Ceccanti, Silvia; Falconi, Ilaria; Frediani, Simone; Boscarelli, Alessandro; Musleh, Layla; Cozzi, Denis A

    2017-01-01

    Current repair of small omphaloceles and hernias into the umbilical cord is a straightforward procedure, whose repair may result in a suboptimal cosmetic outcome. We describe a novel repair technique retaining the umbilical cord elements in an attempt to improve the cosmetic appearance of the umbilicus. Eight neonates were consecutively treated more than a ten-year period. Size of the fascial defects ranged 1 to 3cm (median, 2). Present technique entails incision of the amniotic sac without its detachment from the skin, reduction of the extruded contents under direct vision, and closure of the abdominal wall defect by circumferential suturing of peritoneum and fascia around the base of the amniotic sac. The amniotic sac is then re-approximated and folded to create an umbilical stump, which is trimmed and left to shed naturally. All patients achieved a scarless abdomen with a normal appearing umbilicus in 6. The remaining 2 patients are awaiting surgery for persisting umbilical hernia repair and umbilicoplasty, respectively. Poor esthetic outcome was significantly associated with initial fascial defect ≥2.5cm in size (p=0.03). Present technique is a simple and cosmetically appealing repair for umbilical cord hernias and small omphaloceles, especially effective when the size of the fascial defect is less than 2.5cm. IV (Treatment Study). Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Comparison of hematologic indices and markers of infection in umbilical cord and neonatal blood.

    Science.gov (United States)

    Rotshenker-Olshinka, Keren; Shinwell, Eric S; Juster-Reicher, Ada; Rosin, Ilya; Flidel-Rimon, Orna

    2014-04-01

    Evaluation of a neonate for suspected early neonatal sepsis routinely includes blood tests such as complete blood count, C-reactive protein (CRP) and culture. In order to obviate the need for venepuncture, we prospectively compared these tests in paired samples from umbilical cord and peripheral venous blood drawn during the first hours after birth in both preterm and term infants. Paired blood samples were studied from asymptomatic neonates with risk factors for early sepsis. Data were collected on maternal and neonatal factors that may have influenced the correlation between the tests. Three hundred fifty pairs of samples were studied. Significant correlation between umbilical cord and peripheral venous samples was found for white blood cell (WBC; r = 0.683) and platelets (PLT) (r = 0.54). Correlation for hemoglobin was lower (r = 0.36). No cases of early neonatal sepsis were detected. However, contamination rates were 12% in umbilical cord blood and 2.5% in peripheral venous blood cultures. WBC rose after birth and the 90th percentile rose from 22 500 in umbilical cord blood to 29 700 in peripheral blood. Screening for sepsis with umbilical cord CBC may be useful provided normal ranges are adjusted accordingly.

  5. Galectin-3 binding protein in human preterm infant umbilical cord plasma.

    Science.gov (United States)

    Chan, C; Bode, L; Kim, J

    2015-01-01

    Galectin-3 binding protein (Gal3BP) is a glycoprotein isolated in colostrum that may be an immunologically active component with effects on the neonatal immune system. This compound has been found in the blood of term newborn infants, but has not been studied in preterm infants. Compare umbilical cord plasma Gal3BP concentration between preterm and term infants. Observational study of mother-infant pairs consented at UCSD Medical Center comparing umbilical cord plasma Gal3BP concentration in preterm and term infants. Umbilical cord plasma was collected at birth and stored at -80°C before Gal3BP analysis by ELISA. This study was powered to evaluate differences in preterm and term infant Gal3BP concentration. The secondary aim was to determine the effect of maternal and infant clinical factors on Gal3BP concentration. A total of 64 preterm and 30 term umbilical cord plasma samples were analyzed. By univariate analysis, Gal3BP concentration was elevated in the setting of prematurity, maternal diabetes, antenatal steroid exposure, and increasing maternal parity (p Umbilical cord plasma Gal3BP concentration is elevated in prematurity. This may reflect inflammatory states in infant and mother, but further study is warranted.

  6. Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities.

    Science.gov (United States)

    Nasiell, Josefine; Papadogiannakis, Nikos; Löf, Erika; Elofsson, Fanny; Hallberg, Boubou

    2016-03-01

    Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE. A prospective cohort study of the placenta and umbilical cord of infants treated with hypothermia (HT) due to hypoxic brain injury and follow-up at 12 months of age has been carried out. The study population included 41 infants treated for HT whose placentas were submitted for histopathological analysis. Main outcome measures were infant development at 12 months, classified as normal, cerebral palsy, or death. A healthy group of 100 infants without HIE and normal follow-up at 12 months of age were used as controls. A velamentous or marginal umbilical cord insertion and histological abruption was associated with the risk of severe HIE, OR = 5.63, p = 0.006, respectively, OR = 20.3, p = 0.01 (multiple-logistic regression). Velamentous or marginal umbilical cord insertion was found in 39% among HIE cases compared to 7% in controls. Placental and umbilical cord abnormalities have a profound association with HIE. A prompt examination of the placentas of newborns suffering from asphyxia can provide important information on the pathogenesis behind the incident and contribute to make a better early prognosis.

  7. Expression of epithelial markers by human umbilical cord stem cells. A topographical analysis.

    Science.gov (United States)

    Garzón, I; Alfonso-Rodríguez, C A; Martínez-Gómez, C; Carriel, V; Martin-Piedra, M A; Fernández-Valadés, R; Sánchez-Quevedo, M C; Alaminos, M

    2014-12-01

    Human umbilical cord stem cells have inherent differentiation capabilities and potential usefulness in regenerative medicine. However, the epithelial differentiation capability and the heterogeneity of these cells have not been fully explored to the date. We analyzed the expression of several undifferentiation and epithelial markers in cells located in situ in different zones of the umbilical cord -in situ analysis- and in primary ex vivo cell cultures of Wharton's jelly stem cells by microarray and immunofluorescence. Our results demonstrated that umbilical cord cells were heterogeneous and had intrinsic capability to express in situ stem cell markers, CD90 and CD105 and the epithelial markers cytokeratins 3, 4, 7, 8, 12, 13, 19, desmoplakin and zonula occludens 1 as determined by microarray and immunofluorescence, and most of these markers remained expressed after transferring the cells from the in situ to the ex vivo cell culture conditions. However, important differences were detected among some cell types in the umbilical cord, with subvascular zone cells showing less expression of stem cell markers and cells in Wharton's jelly and the amnioblastic zones showing the highest expression of stem cells and epithelial markers. These results suggest that umbilical cord mesenchymal cells have intrinsic potential to express relevant epithelial markers, and support the idea that they could be used as alternative cell sources for epithelial tissue engineering. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. In vitro cardiomyogenic potential of human umbilical vein-derived mesenchymal stem cells

    International Nuclear Information System (INIS)

    Kadivar, Mehdi; Khatami, Shohreh; Mortazavi, Yousef; Shokrgozar, Mohammad Ali; Taghikhani, Mohammad; Soleimani, Masoud

    2006-01-01

    Cardiomyocyte loss in the ischemically injured human heart often leads to irreversible defects in cardiac function. Recently, cellular cardiomyoplasty with mesenchymal stem cells, which are multipotent cells with the ability to differentiate into specialized cells under appropriate stimuli, has emerged as a new approach for repairing damaged myocardium. In the present study, the potential of human umbilical cord-derived mesenchymal stem cells to differentiate into cells with characteristics of cardiomyocyte was investigated. Mesenchymal stem cells were isolated from endothelial/subendothelial layers of the human umbilical cords using a method similar to that of human umbilical vein endothelial cell isolation. Isolated cells were characterized by transdifferentiation ability to adipocytes and osteoblasts, and also with flow cytometry analysis. After treatment with 5-azacytidine, the human umbilical cord-derived mesenchymal stem cells were morphologically transformed into cardiomyocyte-like cells and expressed cardiac differentiation markers. During the differentiation, cells were monitored by a phase contrast microscope and their morphological changes were demonstrated. Immunostaining of the differentiated cells for sarcomeric myosin (MF20), desmin, cardiac troponin I, and sarcomeric α-actinin was positive. RT-PCR analysis showed that these differentiated cells express cardiac-specific genes. Transmission electron microscopy revealed a cardiomyocyte-like ultrastructure and typical sarcomers. These observations confirm that human umbilical cord-derived mesenchymal stem cells can be chemically transformed into cardiomyocytes and can be considered as a source of cells for cellular cardiomyoplasty

  9. Genomic biomarkers of prenatal intrauterine inflammation in umbilical cord tissue predict later life neurological outcomes.

    Directory of Open Access Journals (Sweden)

    Sloane K Tilley

    Full Text Available Preterm birth is a major risk factor for neurodevelopmental delays and disorders. This study aimed to identify genomic biomarkers of intrauterine inflammation in umbilical cord tissue in preterm neonates that predict cognitive impairment at 10 years of age.Genome-wide messenger RNA (mRNA levels from umbilical cord tissue were obtained from 43 neonates born before 28 weeks of gestation. Genes that were differentially expressed across four indicators of intrauterine inflammation were identified and their functions examined. Exact logistic regression was used to test whether expression levels in umbilical cord tissue predicted neurocognitive function at 10 years of age.Placental indicators of inflammation were associated with changes in the mRNA expression of 445 genes in umbilical cord tissue. Transcripts with decreased expression showed significant enrichment for biological signaling processes related to neuronal development and growth. The altered expression of six genes was found to predict neurocognitive impairment when children were 10 years old These genes include two that encode for proteins involved in neuronal development.Prenatal intrauterine inflammation is associated with altered gene expression in umbilical cord tissue. A set of six of the differentially expressed genes predict cognitive impairment later in life, suggesting that the fetal environment is associated with significant adverse effects on neurodevelopment that persist into later childhood.

  10. Umbilical Coiling Index as a Marker of Perinatal Outcome: An Analytical Study

    Directory of Open Access Journals (Sweden)

    T. Chitra

    2012-01-01

    Full Text Available Objectives. To measure umbilical coiling index (UCI postnatally and to study the association of normocoiling, hypocoiling and hypercoiling to maternal and perinatal outcome. Method(s. One thousand antenatal women who went into labour were studied and umbilical coiling index calculated at the time of delivery. UCI was determined by dividing the total number of coils by the total umbilical cord length in centimeters. Its association with various maternal and perinatal risk factors were noted. The statistical tests were the Chi-square test and assessed with SPSS version 13.0 software and statistically analyzed. P value of less than 0.05 was regarded as statistically significant. Results. The mean umbilical coiling index was found to be 0.24 ± 0.09. Hypocoiling (0.36 was found to be associated with diabetes mellitus, polyhydramnios, cesarean delivery, congenital anomalies, and respiratory distress of the newborn. Conclusion. Abnormal umbilical coiling index is associated with several antenatal and perinatal adverse features.

  11. Methadone, Cocaine, Opiates and Metabolite Disposition in Umbilical Cord and Correlations to Maternal Methadone Dose and Neonatal Outcomes

    Science.gov (United States)

    de Castro, Ana; Jones, Hendreé E.; Johnson, Rolley E.; Gray, Teresa R; Shakleya, Diaa M; Huestis, Marilyn A

    2011-01-01

    Objectives To explore methadone and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) umbilical cord disposition, correlate with maternal methadone dose and neonatal outcomes, and evaluate the window of drug detection in umbilical cord of in utero illicit drug exposure. Methods Subjects, 19 opioid-dependent pregnant women from two clinical studies, one comparing methadone and buprenorphine pharmacotherapy for opioid-dependence treatment, and the second examining monetary reinforcement schedules to maintain drug abstinence. Correlations were calculated for methadone and EDDP umbilical cord concentrations and maternal methadone dose, and neonatal outcomes. Cocaine- and opiate-positive umbilical cord concentrations were compared to those in placenta and meconium, and urine specimens collected throughout gestation. Results Significant positive correlations were found for umbilical cord methadone concentrations and methadone mean daily dose, mean dose during the 3rd trimester and methadone cumulative daily dose. Umbilical cord EDDP concentrations and EDDP/methadone concentration ratios were positively correlated to newborn length, peak neonatal abstinence syndrome (NAS) score and time-to-peak NAS score. Methadone concentrations and EDDP/methadone ratios in umbilical cord and placenta were positively correlated. Meconium identified many more cocaine and opiate positive specimens than umbilical cord. Conclusion Umbilical cord methadone concentrations were correlated to methadone doses. Also, our results indicate that methadone and EDDP concentrations might help to predict NAS severity. Meconium proved to be more suitable than umbilical cord to detect in utero exposure to cocaine and opiates; however, umbilical cord could be useful when meconium is unavailable due to in utero or delayed expulsion. PMID:21743375

  12. Tracheal restoration in dogs with umbilical cord membrane of bovine preserved in glicerin

    Directory of Open Access Journals (Sweden)

    Alexandre Mazzanty

    2000-01-01

    Full Text Available The viability of the use the bovine umbilical membrane preserved in 98% glycerin implanted in the cervical trachea was studied. Seven adult mongrel dogs, three males and four females weighting 6 to 14 kg, were used. After the usual anesthesia protocol and asseptic technique, three tracheal rings were partially removed for implantation of a segment of the umbilical membrane. The animals were observed during 30 days and then reoperated for macroscopic observations and for fragment collection for histological evaluation. It occurred a repair of the tracheal lesion, with formation of granulation tissue rich in collagen fibers linking the extremities of the tracheal cartilages. Epithelial migration over the tracheal surface was also seen. It is concluded that the segment of the bovine umbilical cord preserved in 98% glycerin can be used in the repair of tracheal defects. It offers a temporary support for granulation tissue formation and epithelization in the implanted area.

  13. Abnormal systemic venous connection possibly associated with a persistent right umbilical vein; a case report

    Directory of Open Access Journals (Sweden)

    Smevik Bjarne

    2004-04-01

    Full Text Available Abstract Background Abnormal venous connections involving a persistent right umbilical vein are rare. In a minority of cases the liver is entirely bypassed and the condition is associated with multiple congenital malformations. Case presentation The described case illustrates a systemic venous drainage that was severely abnormal in a newborn girl with a truncus arteriosus type II congenital heart defect. Injection of contrast medium through the umbilical vein catheter revealed a very peculiar venous connection that passed anterio-laterally through the right hemithorax before crossing in an oblique fashion towards the superior vena cava. Conclusions This venous drainage may be the result of a persistent right umbilical vein connecting with the superior vena cava.

  14. Umbilical metastasis (Sister Mary Joseph's nodule diagnosed by fine-needle aspiration

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    Tatomirović Željka

    2004-01-01

    Full Text Available Sister Mary Joseph’s nodule is the eponym for metastatic involvement of the umbilicus. This less common entity is the sign of disseminated malignant disease, mainly of digestive and gynecologic origin, and is associated with a poor prognosis. A case of Sister Mary Joseph’s nodule in a 76-year-old woman in whom the umbilical metastasis was the first sign of malignant disease in presented. The diagnosis of metastatic adenocarcinoma was established by fine needle aspiration cytology of the umbilical nodule. Radiological and ultrasonographic investigation disclosed carcinoma of the gallbladder with pancreas, stomach, and colon invasion as well as peritoneal dissemination. The diagnosis was confirmed by exploratory laparatomy and histological examination of the excised umbilical nodule.

  15. Chondrogenic potential of mesenchymal stromal cells derived from equine bone marrow and umbilical cord blood

    DEFF Research Database (Denmark)

    Berg, Lise Charlotte; Koch, Thomas Gadegaard; Heerkens, T.

    2009-01-01

    including bone marrow and umbilical cord blood. The objective of this study was to provide an in vitro comparison of the chondrogenic potential in MSC derived from adult bone marrow (BM-MSC) and umbilical cord blood (CB-MSC). Results: MSC from both sources produced tissue with cartilage-like morphology...... CB- and BM-MSC pellets. Protein concentration of cartilage-derived retinoic acid sensitive protein was higher in culture medium from CB- than BM-MSC pellets. Conclusion: CB-MSC and BM-MSC were both capable of producting hyaline-like cartilage in vitro. Howeverm, in this study the MSC from umbilical...... cord blood appeared to have more chondrogenic potential than the BM-MSC based on the cells tested and parameters measured....

  16. Optimized Protocol for Isolation of Multipotent Mesenchymal Stromal Cells from Human Umbilical Cord.

    Science.gov (United States)

    Romanov, Yu A; Balashova, E E; Volgina, N E; Kabaeva, N V; Dugina, T N; Sukhikh, G T

    2015-11-01

    Extraembryonic tissues, in particular, umbilical cord stroma are promising sources of multipotent mesenchymal stromal cells for regenerative medicine. In recent years, methods for isolation of mesenchymal stromal cells from different compartments of the umbilical cords based on enzymatic disaggregation of the tissue or on tissue explants have been proposed. Here we propose a protocol of isolation of multipotent mesenchymal stromal cells from the whole umbilical cord that combines the advantages of each approach and ensures sufficient cell yield for further experimental and clinical applications. A combination of short-term incubation of tissue fragments on cold collagenase solution followed by their culturing in the form of explants significantly increased the yield of cells with high proliferative activity, typical pluripotent mesenchymal stromal cell phenotype, and preserved differentiation capacity.

  17. [Neonatal prognosis for pulsating umbilical cord prolapse at the Befelatanana hospital of Madagascar].

    Science.gov (United States)

    Rakotozanany, B; Randriambololona, D M A; Razafimadimby, F; Rakotomalala, N Z; Randriambelomanana, J A; Andrianampanalinarivo, H R

    2015-01-01

    Umbilical cord prolapse is an obstetrical emergency that is life-threatening for the fetus. This retrospective cross-sectional study examined cases of pulsating umbilical cord prolapses at our level-3 maternity unit over the past three years and sought to assess their prognosis. Cord prolapse occurred in 0.27% of deliveries. The women's mean age was 28 years, and 51% of the women were multiparous. Cesarean deliveries were performed in 96% of cases. Factors affecting neonatal outcome were the degree of cord prolapse (p = 0.0002981) and the appearance of amniotic fluid (p = 0.004078). The neonatal complications included admission to neonatal intensive care (33%), perinatal asphyxia (31%), prematurity (29%), neonatal infection (4%), and neonatal mortality (10%). The fetus must be delivered rapidly, especially when the umbilical cord drops outside the mother's body and the amniotic fluid is meconial.

  18. The feasibility of local anesthesia for the surgical treatment of umbilical hernia: a systematic review of the literature

    NARCIS (Netherlands)

    A.P. Jairam (An); R. Kaufmann (Ruth); F.E. Muysoms (Filip); J. Jeekel (Hans); J.F. Lange (Johan)

    2017-01-01

    markdownabstractBackground: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well.

  19. A Comparative Study of Blood Culture Sampling from Umbilical Catheter Line versus Peripheral Site

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    Abdolkarim Hamedi

    2010-08-01

    Full Text Available Neonatal sepsis is an important cause of death and morbidity in newborns and is diagnosed by isolation of organism in blood culture. In several reports,reliablity of blood cultures were done from umbi lical catheters,have been demonstrated. The objective of the present study was to determine,wether an inde welling umbilical catheter, could be an alternative site for blood culture. In a prospective study over 6 months during 2006,141 paired blood cultures from 134 infant,were done simultaneously from peripheral site and umbilical catheter (mostly U. V. C,during the first four days of life. Majority of these infants were preterm and admitted to NICU for special care. these infants had indwelling umbilical line and had indication of sepsis workup. A total of 141 pairs of blood cultures were obtained from 134 infants. In 16 infants blood culture pairs were positive for one organism in both peripheral vein and umbilical site. 71. 6% of total cultures (n=11pairs were negative in boths site. A total of 22 pairs were positive in one site only,with 5 positive from peripheral vein only and the other 17 from umblical site. Two pairs were positve in boths site with two different organism. In over all 16 infant (11%of blood were considered to be contaminated. Contamination rate were 2. 4% and 9. 2% for peripheral and umbilical catheter site. Contamination rate increased after 48 hours of age in umbilical catheter. The result showed that after 2 days contamination rate for blood culture taken from catheter line increased and specifity decreased. We recommended that blood culture via umblical catheter in first 2 days in sick neonates with indwelling catheter can be a alternate site of blood culture sampelling.

  20. Evaluation of three high abundance protein depletion kits for umbilical cord serum proteomics

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    Nie Jing

    2011-05-01

    Full Text Available Abstract Background High abundance protein depletion is a major challenge in the study of serum/plasma proteomics. Prior to this study, most commercially available kits for depletion of highly abundant proteins had only been tested and evaluated in adult serum/plasma, while the depletion efficiency on umbilical cord serum/plasma had not been clarified. Structural differences between some adult and fetal proteins (such as albumin make it likely that depletion approaches for adult and umbilical cord serum/plasma will be variable. Therefore, the primary purposes of the present study are to investigate the efficiencies of several commonly-used commercial kits during high abundance protein depletion from umbilical cord serum and to determine which kit yields the most effective and reproducible results for further proteomics research on umbilical cord serum. Results The immunoaffinity based kits (PROTIA-Sigma and 5185-Agilent displayed higher depletion efficiency than the immobilized dye based kit (PROTBA-Sigma in umbilical cord serum samples. Both the PROTIA-Sigma and 5185-Agilent kit maintained high depletion efficiency when used three consecutive times. Depletion by the PROTIA-Sigma Kit improved 2DE gel quality by reducing smeared bands produced by the presence of high abundance proteins and increasing the intensity of other protein spots. During image analysis using the identical detection parameters, 411 ± 18 spots were detected in crude serum gels, while 757 ± 43 spots were detected in depleted serum gels. Eight spots unique to depleted serum gels were identified by MALDI- TOF/TOF MS, seven of which were low abundance proteins. Conclusions The immunoaffinity based kits exceeded the immobilized dye based kit in high abundance protein depletion of umbilical cord serum samples and dramatically improved 2DE gel quality for detection of trace biomarkers.