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Sample records for spontaneous transvaginal small

  1. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound

    Directory of Open Access Journals (Sweden)

    Sharad M. Malvadkar

    2016-01-01

    Full Text Available Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS which was later confirmed on contrast enhanced computed tomography (CECT. An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis.

  2. Transvaginal ultrasound

    Science.gov (United States)

    ... ultrasound; Menstrual bleeding - transvaginal ultrasound; Infertility - transvaginal ultrasound; Ovarian - transvaginal ... benign and malignant epithelial and germ cell neoplasms, sex-cord stromal tumors. In: Lentz GM, Lobo RA, Gershenson DM, ...

  3. Short wave diathermy for small spontaneous pneumothorax

    OpenAIRE

    Ma, Y.; Li, J; Liu, Y.

    1997-01-01

    BACKGROUND: The treatment of small spontaneous pneumothorax can involve observation, tube thoracostomy, and surgery. This study evaluated the use of short wave diathermy as a method of accelerating the resolution of small pneumothoraces. METHODS: Twenty two patients with pneumothoraces of less than 30% by volume were randomly allocated to receive short wave diathermy for 25 minutes each day (n = 11) or observation with bed rest (n = 11). Chest radiographs were taken until the pneumothor...

  4. Sexual function after transvaginal cholecystectomy

    DEFF Research Database (Denmark)

    Donatsky, Anders M; Jørgensen, Lars N; Meisner, Søren

    2014-01-01

    INTRODUCTION: Despite several benefits, patients are concerned that transvaginal cholecystectomy has a negative impact on sexual health. The objective of this systematic review was to assess the impact of transvaginal cholecystectomy on postoperative dyspareunia and sexual function. METHOD: A lit...

  5. Spontaneous resolution of a small extradural haematoma in a child.

    LENUS (Irish Health Repository)

    Sinha, A K

    2009-02-01

    We report the rapid spontaneous resolution of a small extradural haematoma (EDH) in a 19-month-old child. The haematoma was managed conservatively. The child went on to make a full recovery. The authors discuss the significance of this surprising clinical finding.

  6. Incarcerated small bowel within a spontaneous lumbar hernia.

    Science.gov (United States)

    Teo, K A T; Burns, E; Garcea, G; Abela, J E; McKay, C J

    2010-10-01

    Lumbar hernias are rare, resulting from protrusion through the posterior abdominal wall that may be congenital, acquired or spontaneous. They very rarely present with acute bowel obstruction. We present a case of incarcerated small bowel within a spontaneous inferior (Petit's) lumbar hernia, treated by early open repair with mesh insertion. This case highlights the importance of thorough clinical examination and a high index of suspicion, even in the absence of previous surgery around the anatomical site of the suspected hernia, in order to effect an early repair before the onset of ischaemia in incarcerated contents.

  7. Twin transvaginal cervical length at 16-20 weeks and prediction of preterm birth.

    Science.gov (United States)

    Hester, Ashley E; Ankumah, Nana-Ama E; Chauhan, Suneet P; Blackwell, Sean C; Sibai, Baha M

    2017-10-08

    Our objective was to determine if transvaginal cervical length at 16-20 weeks is predictive of preterm birth preterm birth. Transvaginal cervical length was performed at 16-20-week gestation. The inclusion criteria were non-anomalous twins with transvaginal cervical length at 16-20 weeks. Receiver-operating characteristic (ROC) curves were generated to determine the transvaginal cervical length associated with preterm birth. Of 655 pregnancies, 27% (N = 178) women met our inclusion criteria. The rate of spontaneous preterm birth before 34 weeks was 16% (N = 29). A receiver operator characteristic curve was generated for all preterm birth preterm birth (n = 15) were excluded, the area under the curve was 0.59 (95% CI 0.47-0.70), indicating that transvaginal cervical length values were not a clinically useful test for the prediction of spontaneous preterm birth. A transvaginal cervical length of 30 mm from this model would produce a sensitivity of detecting spontaneous preterm birth of 95% and a specificity of 14%. In an asymptomatic twin population, a single transvaginal cervical length between 16 and 20 weeks was not predictive of spontaneous preterm birth before 34 weeks. Thus, our findings suggest that routine transvaginal cervical length screening of twins should not be performed between 16-20 weeks.

  8. Origin and nature of spontaneous shape fluctuations in "small" nanoparticles.

    Science.gov (United States)

    Yang, Ying; Zhang, Hao; Douglas, Jack F

    2014-07-22

    Normally chemically inert materials such as Au have been found to be catalytically active in the form of particles whose size is about 1 nm. Direct and indirect observations of various types of metal nanoparticles (NPs) in this size range, under catalytically relevant conditions for fuel-cell operation and catalysis, have indicated that such "small" particles can exhibit large spontaneous shape fluctuations and significant changes in shape and chemical activity in response to alterations in environmental conditions. NPs also normally exhibit facile coalescence when in proximity, impacting their stability and reactivity in applications. We perform molecular dynamics simulations on Ni nanoparticles, a commonly used NP in catalytic applications and carbon nanotube growth, in the ≈1 nm size regime where large-scale shape fluctuations have been observed experimentally. An analysis of the large-scale shape fluctuations observed in our simulations of these "small" NPs indicates that they are accompanied by collective motion of Ni atoms through the NP center, and we quantify these dynamic structures and their impact on NP shape. In contrast, stringlike collective atomic motion is confined to the NP interfacial region of NPs having a diameter greater than a few nanometers, and correspondingly, the overall NP shape remains roughly spherical, a case studied in our prior Ni NP simulations. Evidently, the large spontaneous NP shape fluctuations reflect a change in character of the collective atomic dynamics when the NPs become critically small in size.

  9. Transvaginal Appendectomy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Yagci

    2014-01-01

    Full Text Available Background. Natural orifice transluminal endoscopic surgery (NOTES is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes. Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.

  10. Spontaneous Formation and Stability of Small GaP Fullerenes

    NARCIS (Netherlands)

    Tozzinni, V.; Buda, F.; Safolino, A.

    2000-01-01

    An ab initio molecular dynamics simulation was used for the spontaneous formation of GaP fullerene cage. The stability of the heterofullerenes was analyzed through a study of the geometric and electronic properties of the neutral and ionized GaP clusters. It was found that the GaP fullerenes upto 28

  11. Spontaneous formation and stability of small GaP fullerenes

    OpenAIRE

    Tozzini, V.; Buda, F.; Fasolino, A.

    2000-01-01

    We report the spontaneous formation of a GaP fullerene cage in ab-initio Molecular Dynamics simulations starting from a bulk fragment. A systematic study of the geometric and electronic properties of neutral and ionized GaP clusters suggests the stability of hetero-fullerenes formed by a compound with zincblend bulk structure. We find that GaP fullerenes up to 28 atoms have high symmetry, closed electronic shells, large HOMO-LUMO energy gaps and do not dissociate when ionized. We compare our ...

  12. Transvaginal ultrasound during pregnancy: Perception and ...

    African Journals Online (AJOL)

    Introduction: There has been a tremendous increase in the use of transvaginal ultrasound (TVS) in pregnancy. With the use of high‑resolution transducers, the transvaginal probe has proved to be particularly useful for finding the location and dating of early pregnancies when compared with transabdominal sonography ...

  13. Transvaginal ultrasonography in persistent trophoblastic tumor

    National Research Council Canada - National Science Library

    Mangili, G; Spagnolo, D; Valsecchi, L; Maggi, R

    1993-01-01

    ... in the management of such neoplasia. Transvaginal ultrasonography was performed in six women with gestational trophoblastic tumor at initial diagnosis, during the cytotoxic course when negative beta-human chorionic gonadotrophin levels...

  14. Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

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    Gül Pamukçu Günaydın

    2015-01-01

    Full Text Available Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation. Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4. Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.

  15. Spontaneous transmesenteric hernia: a rare cause of small bowel obstruction in an adult

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    Poras Chaudhary

    2013-02-01

    Full Text Available The authors report a case of spontaneous transmesenteric hernia with strangulation in an adult. Transmesenteric hernia (TMH is a rare cause of small bowel obstruction and is seldom diagnosed preoperatively, and most TMHs in adults are related to predisposing factors, such as previous surgery, abdominal trauma, and peritonitis. TMH are more likely to develop volvulus and strangulation or ischemia. A brief review of etiology, clinical features, diagnosis, and treatment is discussed.

  16. Confirmation of Essure placement using transvaginal ultrasound.

    Science.gov (United States)

    Veersema, Sebastiaan; Vleugels, Michel; Koks, Caroline; Thurkow, Andreas; van der Vaart, Huub; Brölmann, Hans

    2011-01-01

    To evaluate the protocol for confirmation of satisfactory Essure placement using transvaginal ultrasound. Prospective multicenter cohort study (Canadian Task Force classification II-2). Outpatient departments of 4 teaching hospitals in the Netherlands. Eleven hundred forty-five women who underwent hysteroscopic sterilization using the Essure device between March 2005 and December 2007. Transvaginal ultrasound examination 12 weeks after uncomplicated successful bilateral placement or as indicated according to the transvaginal ultrasound protocol after 4 weeks, and hysterosalpingography (HSG) at 12 weeks to confirm correct placement of the device after 3 months. The rate of successful placement was 88.4% initially. In 164 women (15%), successful placement was confirmed at HSG according the protocol. In 9 patients (0.84%), incorrect position of the device was observed at HSG. The cumulative pregnancy rate after 18 months was 3.85 per thousand women. Transvaginal ultrasound should be the first diagnostic test used to confirm the adequacy of hysteroscopic Essure sterilization because it is minimally invasive, averts ionizing radiation, and does not decrease the effectiveness of the Essure procedure. Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.

  17. Transvaginal ultrasound during pregnancy: Perception and ...

    African Journals Online (AJOL)

    diagnostic hysteroscopy in the evaluation of patients with menorrhagia. Hum Reprod 1997;12:1768-71. 7. Atalabi OM, Morhason-Bello IO, Adekanmi AJ, Marinho AO,. Adedokun BO, Kalejaiye AO, et al. Transvaginal ultrasonography: A survey of the acceptability and its predictors among a native African women population.

  18. Transvaginal sonography in early human pregnancy

    NARCIS (Netherlands)

    R. Schats (Roel)

    1991-01-01

    textabstractEfforts to employ transvaginal sonography as a method to visualise the internal genitalia and their contents already date from the late 1960's, when it was used to detect the embryonic heart beat and to study the female genital tract. It was reported that embryonic cardiac activity

  19. TRANSVAGINAL ULTRASOUND IS A VALUABLE INVESTIGATION

    African Journals Online (AJOL)

    I after treatment of incontinence, while four patients were lost to follow-up. ... treatment of SUI. Key Words: stress incontinence, transvaginal ultrasound, voiding dysfunction. INTRODUCTION. The descent of the bladder neck and proximal urethra beyond ..... Bergman A, McKenzie CJ, Richmond J et al. Transrectal ultrasound ...

  20. IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery.

    Science.gov (United States)

    Baekelandt, Jan; Vercammen, Jona

    2017-01-01

    To demonstrate a new minimally invasive approach for the diagnosis and treatment of ectopic pregnancy. Stepwise explanation of the technique using original video footage. Hospital. Since 2014, 15 patients were treated transvaginally for ectopic pregnancy and pregnancy of unknown location (PUL). In case of a diagnosis of ectopic pregnancy on ultrasound, a 2.5-cm colpotomy is made under general anesthesia, and the ectopic pregnancy is treated by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) salpingectomy or salpingostomy. In case of a PUL on ultrasound, transvaginal hydrolaparoscopy (TVHL), an established technique for fertility exploration under local or general anesthesia, is used to investigate. If a tubal pregnancy is confirmed on TVHL, the colpotomy is extended to a 2.5-cm incision, and the ectopic pregnancy is treated transvaginally by vNOTES. If the TVHL investigation of the pelvis is negative (fallopian tubes and ovaries are normal), the procedure is stopped and the patient is followed up further. If the TVHL is inconclusive, the NaCl is drained and CO2 is insufflated (requiring general anesthesia) through the 4-mm TVHL port to improve visualization. Again, an ectopic pregnancy is then treated by vNOTES, and in case of a negative investigation the procedure is stopped and the patient is followed up further. Successful diagnosis and treatment of ectopic pregnancies. All patients were successfully operated without complications or conversions to standard laparoscopy. Twelve patients were treated by vNOTES for ectopic pregnancy. Three TVHL explorations for PUL were negative, and these patients were followed up; two patients developed a normal intrauterine pregnancy, and the third patient was treated with methotrexate for persistent asymptomatic raised hCG levels. Transvaginal hydrolaparoscopy and vNOTES are complementary techniques enabling gynecologic surgeons to explore PUL and treat ectopic pregnancies via minimally invasive

  1. Hybrid NOTES transvaginal intraperitoneal onlay mesh in abdominal wall hernias: an alternative to traditional laparoscopic procedures.

    Science.gov (United States)

    Descloux, Alexandre; Pohle, Sebastian; Nocito, Antonio; Keerl, Andreas

    2015-12-01

    Abdominal wall hernias are increasingly treated by laparoscopic placement of an intraperitoneal onlay mesh (IPOM). We present an alternative technique for women: the laparoscopic-assisted transvaginal IPOM. Before surgery, all patients underwent a gynecological examination. The patients agreed to IPOM repair via a transvaginal approach, and written informed consent for surgery was obtained. Pneumoperitoneum was established with a Veress needle at the umbilicus. This access was subsequently dilated to 5 mm (VersaStep), and a 5-mm laparoscope was inserted. Under laparoscopic view, the transvaginal trocars (12-mm VersaStep and 5-mm flexible accesses) were safely inserted after lifting the uterus with a uterus manipulator. After preparation of the falciform ligament, the ligamentum teres and the preperitoneal fat, a lightweight composite mesh was introduced through the transvaginal access and fixed with absorbable tacks using the double-crown technique. From September 2011 to December 2012, we performed six laparoscopic-assisted transvaginal IPOM procedures (one epigastric, three umbilical, two combined epigastric and umbilical hernias; all were primary hernias). In the initial phase, only patients with small or medium primary abdominal wall hernia were selected (max. 3 cm diameter). Median hospital stay was 3 days (range 2-6 days). One minor complication occurred perioperatively (second-degree skin burn to the labia majora). At 1-year follow-up, we identified one recurrence in a high-risk patient with a body mass index higher than 35 kg/m(2). No infection and no mortality were observed. Although no final conclusion can be made regarding the presumed non-inferiority of this technique in terms of recurrence and mesh infection compared with traditional laparoscopic IPOM, laparoscopic-assisted transvaginal IPOM is a feasible alternative to treat abdominal wall hernias.

  2. Recognizing spontaneous facial expressions of emotion in a small-scale society of Papua New Guinea.

    Science.gov (United States)

    Crivelli, Carlos; Russell, James A; Jarillo, Sergio; Fernández-Dols, José-Miguel

    2017-03-01

    We report 2 studies on how residents of Papua New Guinea interpret facial expressions produced spontaneously by other residents of Papua New Guinea. Members of a small-scale indigenous society, Trobrianders (Milne Bay Province; N = 32, 14 to 17 years) were shown 5 facial expressions spontaneously produced by members of another small-scale indigenous society, Fore (Eastern Highlands Province) that Ekman had photographed, labeled, and published in The Face of Man (1980), each as an expression of a basic emotion: happiness, sadness, anger, surprise, and disgust. Trobrianders were asked to use any word they wanted to describe how each person shown felt and to provide valence and arousal ratings. Other Trobrianders (N = 24, 12 to 14 years) were shown the same photographs but asked to choose their response from a short list. In both studies, agreement with Ekman's predicted labels was low: 0% to 16% and 13% to 38% of observers, respectively. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Transvaginal Single-Port Laparoscopy Sacrocolpopexy.

    Science.gov (United States)

    Chen, Yisong; Li, Junwei; Zhang, Ying; Hua, Keqin

    2017-10-26

    To describe our technique of transvaginal sacrocolpopexy using single-port laparoscopy for middle compartment Pelvic Organ Prolapse (POP). Step-by-step explanation of the procedure using video. More and more patients are pursuing minimally invasive surgery, which is becoming the trends for gynecological surgery nowadays. POP is not an exception. With application of natural orifice transluminal endoscopic surgery (NOTEs), minimally invasive transvaginal sacrocolpopexy surgery assisted by single-port laparoendoscopy for POP becomes feasible. We performed transvaginal single-port laparoscopy sacrocolpopexy for a 59-year-old woman from China, who diagnosed with pelvic organ prolapsed (POP-Q II III II). This patient complained of vaginal mass prolapsed for 3 months, with C+2. Institutional Review Board (IRB)/Ethics Committee approval was obtained. Vaginal hysterectomy was performed first. Preventative bilateral salpingo-oophorectomy was done after single-port platform was established. Right pelvic peritoneum was incised, from the promontory to the vault. Then we exposed the rectovaginal and vesicovaginal space after injection of water cushion. The Y-shaped mesh (ARTISYN(TM), Johnson, USA) was fixed to posterior vaginal wall and then to sacral promontory (S1). After closing the pelvic peritoneum, the anterior mesh was sutured. Before finishing the surgery, we closed the vaginal cuff. The operation last for about 2 hours, with the blood loss 50ml. The patient was discharged with complete recovery. Five-month follow-up showed there was neither prolapse, nor mesh erosion or other complications. Transvaginal single-port laparoscopic sacrocolpopexy is a considerable choice for middle compartment POP. However, more cases should be enrolled, and additional studies are required. Copyright © 2017. Published by Elsevier Inc.

  4. Women's positive perception of transvaginal NOTES surgery.

    Science.gov (United States)

    Peterson, Carrie Y; Ramamoorthy, Sonia; Andrews, Barbara; Horgan, Santiago; Talamini, Mark; Chock, Alana

    2009-08-01

    Two decades ago, minimally invasive surgery (MIS) was introduced and led to a revolution in modern surgery. Currently MIS procedures are the standard of care for many surgical interventions and patients often seek out surgeons with special training in MIS. Today, natural orifice transluminal endoscopic surgery (NOTES) appears to be on the threshold of another such revolution. We surmise that its advantages are similar to those of other MIS procedures, but there are no associated abdominal wall complications as there are no abdominal incisions. To date, there is no data evaluating women's perceptions of such a procedure and their willingness to consent to this type of surgical approach. We surveyed 100 women who were given a written description of MIS and NOTES surgery along with a 10-question survey exploring their concerns and opinions regarding transvaginal surgery. The majority of women (68%) indicated that they would want a transvaginal procedure in the future because of decreased risk of hernia and decreased operative pain (90 and 93%, respectively), while only 39% were concerned with the improved cosmesis of NOTES surgery. Of the women polled, nulliparous women and those under age 45 years were significantly more often concerned with how transvaginal surgery may affect healthy sexual life and fertility issues (p new surgical technique. Our study highlights a strong need for early reporting of outcomes data to enlighten ourselves, and our patients, about this exciting new technology.

  5. Transvaginal sonography of acute pelvic inflammatory disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Soo; Kim, Young Hwa; Shin, Hyung Chul; Han, Gun Soo; Kim, Il Young [Chonan Hospital, Soonchunhyang University College of Medicine, Chonan (Korea, Republic of)

    1999-12-15

    To determine the value of transvaginal sonography in evaluating women with acute pelvic inflammatory disease (PID). Transvaginal sonography was performed in 25 patients with clinically suggested PID during recent 36 months. The sonographic findings of fallopian tubes and ovaries were analyzed and correlated with pathological findings of 2 fallopian tubes and 19 ovaries in 16 patients who had operations. The correct diagnosis of acute PID was made in 20/25 (80%) by transvaginal sonography. the abnormal sonographic findings of the fallopian tube include tubal thickening or dilatation with internal echo. The sensitivity, specificity, and accuracy for tubal abnormality were 88%, 96%, and 86% , respectively. Ovarian changes were seen on TVS in 14/19 (73%), which include multiple follicular enlargement in 5, tubo-ovarian complex in 9 (tubo-ovarian adhesion in 3, tubo-ovarian abscess in 6). At surgery, the ovay was not involved in all three women who showed tubo-ovarian adhesion on TVS. Among 6 women who showed tubo-ovarian abscess on TVS, tubo-ovarian abscess was confirmed in 3 and the remaining 3 had ovarian cysts. Trandvaginal sonography, a facilitative and accurate modality, is highly sensitive in detecting the abnormality of the tube and useful in differentiating the tubo-ovarian complex in patients with acute PID.

  6. Small-Angle Neutron Scattering and Spontaneous Formation of Unilamellar Vesicles: Potential Vehicles for Drug Delivery

    Science.gov (United States)

    Katsaras, John

    2004-03-01

    Unilamellar vesicles (ULVs) are single-bilayer shells with radii commonly between 10 and 100 nm, and are widely used as model membranes, drug delivery systems, microreactors and substrates for a variety of enzymes and proteins. A common method of making ULVs is the extrusion of multilamellar vesicles (MLVs) through synthetic membranes of known pore size. These extruded ULVs are invariably unstable and in due time, revert back to MLVs. Over the years there have been reports of the spontaneous formation of stable ULVs in surfactant, lipid, and lipid/detergent mixtures. These ULVs have sometimes been shown to be monodisperse and their radii were found, almost without exception, to vary with concentration. We have carried-out small-angle neutron scattering (SANS) experiments on a biomimetic system composed of the phospholipids dimyristoyl and dihexanoyl phosphorylcholine (DMPC and DHPC, respectively). Doping DMPC/DHPC multilamellar vesicles with either the negatively charged lipid dimyristoyl phosphorylglycerol (DMPG, net charge -1) or the divalent cation, calcium (Ca2+) leads to the spontaneous formation of monodisperse unilamellar vesicles whose radii are concentration independent, in contrast to previous experimental observations.

  7. Spontaneous chylothorax complicating small cell lung cancer – Review of aetiology and diagnosis

    Directory of Open Access Journals (Sweden)

    S. Hanina

    2015-01-01

    Full Text Available We report the first case of spontaneous chylothorax complicating small cell lung cancer. A 52 year old female presented with exertional dyspnoea, left-sided chest and neck pain, and dysphagia. The chest X-ray on admission revealed a large left-sided pleural effusion. A subsequent CT chest showed a large anterior mediastinal mass with a left brachiocephalic and jugular vein thrombosis. The patient underwent medical thoracoscopy with chest drain insertion, which drained pleural fluid high in triglycerides, consistent with a chylothorax. Due to its uncommon nature, the management of chylothorax is not well defined. Alongside the case report, we provide a review of aetiology, mechanism and diagnosis with a brief summary of treatment options.

  8. A case of spontaneous pneumothorax following radiation therapy for non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Himanshu Bhardwaj

    2013-01-01

    Full Text Available Spontaneous pneumothorax (SPTX is a potentially devastating rare complication of the thoracic radiation therapy. Most of the cases in the medical literature, have been described in lymphoma patients receiving radiation therapy. The pathogenesis of this adverse event remains undefined although different mechanisms have been proposed. We present a case of post-radiation therapy SPTX in a non-small cell lung cancer (NSCLC, following intensity modulated radiation therapy (IMRT, which to our knowledge is the first such reported case related to this newer mode of radiation therapy. This report highlights the importance of keeping a close eye for this complication as timely treatment with chest tube insertion and drainage of the pneumothorax can be a lifesaving in these patients.

  9. Postcoital Transvaginal Evisceration After Hysterectomy: a Case Report

    Directory of Open Access Journals (Sweden)

    A.Oğuz Hasdemir

    2012-01-01

    Full Text Available Transvaginal evisceration is mostly seen at postmenopausal period in a case who had vaginal operation and at premenopausal period it ensues postcoitally after hysterectomy. A 47 year old patient presented to emergency department with a complaint of intestinal herniation through vagina after coitus that had total abdominal histerectomy two months ago. The patient was emergently operated. Her vaginal cuff was sutured transvaginally then laparoscopic irrigation and suction were performed. Although transvaginal cuff repair is sufficient laparoscopic irrigation and suction are thought to be relevant for the management of transvaginal evisceration to prevent peritonitis.

  10. Spontaneous sublingual and intramural small-bowel hematoma in a patient on oral anticoagulation

    Directory of Open Access Journals (Sweden)

    Mohamed Moftah

    2012-08-01

    Full Text Available Spontaneous sublingual hematoma and intramural small bowel hematoma are rare and serious complications of anticoagulant therapy. Though previously reported individually, there has been no previous report of the same two complications occurring in a single patient. A 71-year-old Caucasian man, who was on warfarin for atrial fibrillation, presented with difficulty in swallowing due to a sublingual hematoma. He was observed in our intensive care unit, his warfarin was held and he recovered with conservative management. He represented two months later with a two day history of abdominal pain and distension. An abdominopelvic computed tomography (CT scan now showed small bowel obstruction due to intramural small bowel hematoma and haemorrhagic ascites. Again, this was treated expectantly with a good outcome. In conclusion, life threatening haemorrhagic complications of oral anticoagulant therapy can recur. Conservative treatment is successful in most cases, but an accurate diagnosis is mandatory to avoid unnecessary surgery. CT scan is the investigation of choice for the diagnosis of suspected haemorrhagic complications of over coagulation.

  11. Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

    Directory of Open Access Journals (Sweden)

    Pimentel Anita M

    2012-01-01

    Full Text Available Abstract Background Some techniques of transvaginal ovarian drilling have been previously described. Nevertheless a monopolar transvaginal ovarian cauterization, that use the expertise and safety of transvaginal puncture for oocyte captation seems to be an easier and feasible approach. The aim of this study was to develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control, and to evaluate the safety of the transvaginal ovarian monopolar cauterization, female sheep at reproductive age were used as an experimental model. Findings An experimental study was performed in a university research center. Seventeen female sheep (15 Corriedale e 2 Suffolk in reproductive age were submitted to transvaginal ovarian cauterization with a monopolar Valleylab Force 2 electrocautery. Macroscopic and microscopic lesions were assessed. Ovarian size were 1.31 cm2 ± 0,43 (Corriedale and 3.41 cm2 ± 0,64 (Suffolk. From 30 ovaries from Corriedale sheep punctured, only 3 were cauterized, presenting macroscopic and typical microscopic lesion. In the Suffolk sheep group, only one ovary was cauterized. No lesion could be found in the needle path. Conclusions This is the first experimental animal model described for ovarian cauterization needle guided by transvaginal ultrasound. The sheep does not seem to be the ideal animal model to study this technique. Another animal model, whose ovaries are better identified by transvaginal ultrasound should be sought for this technique, theoretically less invasive, before it could be offered safely to women with polycystic ovary syndrome.

  12. Effects of melatonin and Pycnogenol on small artery structure and function in spontaneously hypertensive rats.

    Science.gov (United States)

    Rezzani, Rita; Porteri, Enzo; De Ciuceis, Carolina; Bonomini, Francesca; Rodella, Luigi F; Paiardi, Silvia; Boari, Gianluca E M; Platto, Caterina; Pilu, Annamaria; Avanzi, Daniele; Rizzoni, Damiano; Agabiti Rosei, Enrico

    2010-06-01

    It was suggested that oxidative stress has a key role in the development of endothelial dysfunction, as well as microvascular structural alterations. Therefore, we have investigated 2 substances with antioxidant properties: melatonin and Pycnogenol. We treated 7 spontaneously hypertensive rats (SHRs) with melatonin and 7 with Pycnogenol for 6 weeks. We compared results obtained with those observed in 7 SHRs and 7 Wistar-Kyoto normotensive control rats kept untreated. Mesenteric small resistance arteries were dissected and mounted on a wire myograph, and a concentration-response curve to acetylcholine was performed. Aortic contents of metalloproteinase 2, Bax, inducible NO synthase, and cyclooxygenase 2 were evaluated, together with the aortic content of total collagen and collagen subtypes and apoptosis rate. A small reduction in systolic blood pressure was observed. A significant improvement in mesenteric small resistance artery structure and endothelial function was observed in rats treated with Pycnogenol and melatonin. Total aortic collagen content was significantly greater in untreated SHRs compared with Wistar-Kyoto control rats, whereas a full normalization was observed in treated rats. Apoptosis rate was increased in the aortas of untreated SHRs compared with Wistar-Kyoto control rats; an even more pronounced increase was observed in treated rats. Bax and metalloproteinase 2 expressions changed accordingly. Cyclooxygenase 2 and inducible NO synthase were more expressed in the aortas of untreated SHRs compared with Wistar-Kyoto control rats; this pattern was normalized by both treatments. In conclusion, our data suggest that treatment with Pycnogenol and melatonin may protect the vasculature, partly independent of blood pressure reduction, probably through their antioxidant effects.

  13. Cerebral small vessel disease predisposes to temporal lobe epilepsy in spontaneously hypertensive rats.

    Science.gov (United States)

    Russo, Emilio; Leo, Antonio; Scicchitano, Francesca; Donato, Annalidia; Ferlazzo, Edoardo; Gasparini, Sara; Cianci, Vittoria; Mignogna, Chiara; Donato, Giuseppe; Citraro, Rita; Aguglia, Umberto; De Sarro, Giovambattista

    2017-04-01

    The link between cerebral small vessel disease (CSVD) and epilepsy has been poorly investigated. Some reports suggest that CSVD may predispose to temporal lobe epilepsy (TLE). Aim of this study was to evaluate whether spontaneously hypertensive rats (SHRs), an established model of systemic hypertension and CSVD, have a propensity to develop TLE more than generalized seizures. To this aim, amygdala kindling, as a model of TLE, and pentylenetetrazole (PTZ)-induced kindling, as a model of generalized seizures, have been used to ascertain whether SHRs are more prone to TLE as compared to Wistar Kyoto control rats. While young SHRs (without CSVD) do not differ from their age-matched controls in both models, old SHRs (with CSVD) develop stage 5 seizures in the amygdala kindling model (TLE) faster than age-matched control rats without CSVD. At odds, no differences between old SHRs and age-matched controls was observed in the development of PTZ kindling. Enalapril pre-treatment prevented the development of CSVD and normalized kindling development to control levels in SHRs. No difference was observed in the response to pharmacological treatment with carbamazepine or losartan. Overall, our study suggests that uncontrolled hypertension leading to CSVD might represent a risk factor for TLE. Further experimental studies are needed to unravel other risk factors that, along with CSVD, may predispose to TLE. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Helicobacter pylori colonization and pregnancies complicated by preeclampsia, spontaneous prematurity, and small for gestational age birth.

    Science.gov (United States)

    den Hollander, Wouter J; Schalekamp-Timmermans, Sarah; Holster, I Lisanne; Jaddoe, Vincent W; Hofman, Albert; Moll, Henriëtte A; Perez-Perez, Guillermo I; Blaser, Martin J; Steegers, Eric A P; Kuipers, Ernst J

    2017-04-01

    Preeclampsia (PE), small for gestational age (SGA), and spontaneous preterm birth (PTB) each may be complications of impaired placental function in pregnancy. Although their exact pathogenesis is still unknown, certain infectious agents seem to play a role. Helicobacter pylori (H. pylori) colonization has been associated with increased risk for PE. Our aim was to assess the association between H. pylori colonization and PE, SGA, and PTB. We measured IgG anti-H. pylori and CagA antibodies in serum of pregnant women (median 20.5 weeks, range 16.5-29.4) who participated in a population-based prospective cohort study. Delivery and medical records were assessed. Information on demographics, education, and maternal risk factors was collected by questionnaire. We used multivariate logistic regression analyses to assess associations between H. pylori colonization and PE, SGA, and PTB. In total, 6348 pregnant women were assessed. H. pylori positivity was found in 2915 (46%) women, of whom 1023 (35%) also were CagA-positive. Pregnancy was complicated by PE, SGA, or PTB in 927 (15%) women. H. pylori colonization was associated with PE (aOR 1.51; 95%CI 1.03-2.25). Differentiation according to CagA status revealed the same risk. H. pylori was positively related with SGA, mainly explained by CagA-positive strains (aOR 1.34; 1.04-1.71). No association was observed between H. pylori and PTB. Our data suggest that H. pylori colonization may be a risk factor for PE and SGA. If these associations are confirmed by future studies and shown to be causal, H. pylori eradication may reduce related perinatal morbidity and mortality. © 2016 John Wiley & Sons Ltd.

  15. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  16. The accuracy of transvaginal sonography to detect endometriosis cyst

    Science.gov (United States)

    Diantika, M.; Gunardi, E. R.

    2017-08-01

    Endometriosis is common in women of reproductive age. Late diagnosis is still the main concern. Currently, noninvasive diagnostic testing, such as transvaginal sonography, is recommended. The aim of the current study was to evaluate the accuracy of transvaginal sonography in diagnosing endometrial cysts in patients in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. This diagnostic study was carried out at Cipto Mangunkusumo Hospital between January 2014 and June 2015. Outpatients suspected have an endometrial cyst based on the patient history and a clinical examination was recruited. The patients were then evaluated using transvaginal sonography by an experienced sonologist, according to the research protocol. The gold standard test was a histological finding in the removed surgical mass. Ninety-eight patients were analyzed. An endometrial cyst was confirmed by histology in 85 patients (87%). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal sonography was established to be 85% (a range of 71-99%), 93%, 77%, 96%, and 63%, respectively. A significantly higher area under the curve was identified using transvaginal sonogpraphy compared to that achieved with a clinical examination alone (85% versus 79%). Transvaginal sonography was useful in diagnosing endometrial cysts in outpatients and is recommended in daily clinical practice.

  17. Total transvaginal endoscopic abdominal wall hernia repair: a NOTES survival study.

    Science.gov (United States)

    Lomanto, D; Dhir, U; So, J B Y; Cheah, W K; Moe, M A; Ho, K Y

    2009-08-01

    Natural orifice transluminal endoscopic surgery (NOTES) has gained widespread interest as a potentially less invasive alternative to laparoscopic surgery or, else, an evolution as the next-generation surgery. The main objective of this study was to assess the safety of transluminal abdominal wall hernia repair for potential human application by specifically investigating the feasibility and challenges of using a transvaginal approach. NOTES ventral hernia repair via a transvaginal approach. University Hospital (National University Health System, Singapore). The study utilized five female pigs (30-40 kg) between 5 and 7 months of age, which underwent abdominal wall hernia repair using a transvaginal approach. The procedures were performed using a double-channel endoscope under general endotracheal anesthesia. A mesh was placed and fixed to the abdominal wall using standard laparoscopic and endoscopic equipment. The animals survived for 2 weeks and were then euthanized and a necropsy performed. To assess the safety and feasibility of NOTES ventral hernia repair in a survival experimental model. All of the procedures could be safely performed using the standard equipment. At the necropsy, all meshes were well in place and mild adhesions were recorded in one animal with a small abscess in the subcutaneous area. This novel approach seems technically challenging but feasible using equipment and accessories currently available for conventional laparoscopic and interventional endoscopy with low intra-abdominal contamination and sepsis. New procedure-specific instruments and equipment need to be developed to allow the surgeon safer access and more degrees of instrument freedom.

  18. Spontaneous motility in preterm, small-for-gestational age infants - II. Qualitative aspects

    NARCIS (Netherlands)

    Bos, AF; van Loon, AJ; Hadders-Algra, M; Martijn, A; Okken, A; Prechtl, HFR

    1997-01-01

    In order to document in detail the developmental course of qualitative aspects of early spontaneous motility in intrauterine growth-retarded infants, sequential videotape recordings were made in 19 preterm infants with a birth weight below the 5th percentile. The quality of general movements (GMs)

  19. Parametric Mapping of Contrasted Ovarian Transvaginal Sonography

    Science.gov (United States)

    Korhonen, Katrina; Moore, Ryan; Lyshchik, Andrej; Fleischer, Arthur C.

    2014-01-01

    The purpose of this study was to assess the accuracy of parametric analysis of transvaginal contrast-enhanced ultrasound (TV-CEUS) for distinguishing benign versus malignant ovarian masses. A total of 48 ovarian masses (37 benign and 11 borderline/malignant) were examined with TV-CEUS (Definity, Lantheus, North Bilreca, MA; Philips iU22, Bothell, WA). Parametric images were created offline with a quantification software (Bracco Suisse SA, Geneva, Switzerland) with map color scales adjusted such that abnormal hemodynamics were represented by the color red and the presence of any red color could be used to differentiate benign and malignant tumors. Using these map color scales, low values of the perfusion parameter were coded in blue, and intermediate values of the perfusion parameter were coded in yellow. Additionally, for each individual color (red, blue, or yellow), a darker shade of that color indicated a higher intensity value. Our study found that the parametric mapping method was considerably more sensitive than standard ROI analysis for the detection of malignant tumors but was also less specific than standard ROI analysis. Parametric mapping allows for stricter cut-off criteria, as hemodynamics are visualized on a finer scale than ROI analyses, and as such, parametric maps are a useful addition to TV-CEUS analysis by allowing ROIs to be limited to areas of highest malignant potential. PMID:26002525

  20. Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management.

    Science.gov (United States)

    Mekaru, Keiko; Oishi, Sugiko; Akamine, Kozue; Heshiki, Chiaki; Aoki, Yoichi

    2017-01-01

    Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16-22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment.

  1. Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management

    Directory of Open Access Journals (Sweden)

    Keiko Mekaru

    2017-01-01

    Full Text Available Uterine arteriovenous malformation (AVM can cause massive hemorrhage and is often treated with uterine artery embolization (UAE, which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16–22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment.

  2. Differential gene expression in multiple neurological, inflammatory and connective tissue pathways in a spontaneous model of human small vessel stroke.

    Science.gov (United States)

    Bailey, Emma L; McBride, Martin W; Beattie, Wendy; McClure, John D; Graham, Delyth; Dominiczak, Anna F; Sudlow, Cathie L M; Smith, Colin; Wardlaw, Joanna M

    2014-12-01

    Cerebral small vessel disease (SVD) causes a fifth of all strokes plus diffuse brain damage leading to cognitive decline, physical disabilities and dementia. The aetiology and pathogenesis of SVD are unknown, but largely attributed to hypertension or microatheroma. We used the spontaneously hypertensive stroke-prone rat (SHRSP), the closest spontaneous experimental model of human SVD, and age-matched control rats kept under identical, non-salt-loaded conditions, to perform a blinded analysis of mRNA microarray, qRT-PCR and pathway analysis in two brain regions (frontal and mid-coronal) commonly affected by SVD in the SHRSP at age five, 16 and 21 weeks. We found gene expression abnormalities, with fold changes ranging from 2.5 to 59 for the 10 most differentially expressed genes, related to endothelial tight junctions (reduced), nitric oxide bioavailability (reduced), myelination (impaired), glial and microglial activity (increased), matrix proteins (impaired), vascular reactivity (impaired) and albumin (reduced), consistent with protein expression defects in the same rats. All were present at age 5 weeks thus predating blood pressure elevation. 'Neurological' and 'inflammatory' pathways were more affected than 'vascular' functional pathways. This set of defects, although individually modest, when acting in combination could explain the SHRSP's susceptibility to microvascular and brain injury, compared with control rats. Similar combined, individually modest, but multiple neurovascular unit defects, could explain susceptibility to spontaneous human SVD. © 2014 The Authors. Neuropathology and Applied Neurobiology published by John Wiley & Sons Ltd on behalf of British Neuropathological Society.

  3. Evidence to justify retention of transvaginal mesh: comparison between laparoscopic sacral colpopexy and transvaginal Elevate™ mesh.

    Science.gov (United States)

    To, Valérie; Hengrasmee, Pattaya; Lam, Alan; Luscombe, Georgina; Lawless, Anna; Lam, Justin

    2017-12-01

    To determine if laparoscopic sacral colpopexy (LSC) offers better apical support with a lower exposure rate than transvaginal mesh surgery with Elevate™. This was a retrospective cohort study comparing patients with apical prolapse (POP-Q point C ≥ -1) who underwent Elevate™ mesh repair (n = 146) with patients who underwent laparoscopic sacral colpopexy (n = 267). The sacral colpopexy group had a mean age of 59 years and a BMI of 25.7. Patients in the Elevate™ group were older, with a mean age of 63 and a BMI of 26.3. Most of the patients of both groups presented with pelvic organ prolapse stage III (LSC 73.8% and Elevate™ 87.0%) and their mean POP-Q point C were not significantly different (LSC 1.4 vs Elevate™ 1.2 cm). Operative time was longer in the LSC group (113 vs 91 min, p to 2.10, p = 0.21). One-year objective cure rate, defined as no descent beyond the hymen, was 97.0% in the LSC group and 96.6% in the Elevate™ group (p = .81). The overall recurrence (objective, subjective recurrence or reoperation) was also not different between the groups (LSC 4.5% vs Elevate 4.8%, p = 0.89). Transvaginal Elevate™ mesh delivers comparable apical support with a low exposure rate similar to that of laparoscopic sacral colpopexy.

  4. Transvaginal hybrid natural orifice transluminal endoscopic surgery kolecystektomi

    DEFF Research Database (Denmark)

    Boesen, Line; Meisner, Søren; Vilmann, Peter

    2016-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a minimally invasive surgical technique where access to the abdominal cavity is achieved through one of the natural orifices of the body. Based on experience from gynaecology, transvaginal access has been the easiest NOTES technique...

  5. Hybrid transvaginal natural orifice transluminal endoscopic surgery-kolecystektomi

    DEFF Research Database (Denmark)

    Boesen, Line; Meisner, Søren; Vilmann, Peter

    2016-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a minimally invasive surgical technique where access to the abdominal cavity is achieved through one of the natural orifices of the body. Based on experience from gynaecology, transvaginal access has been the easiest NOTES technique...

  6. Hybrid transvaginal natural orifice transluminal endoscopic surgery-kolecystektomi

    DEFF Research Database (Denmark)

    Boesen, Line; Meisner, Søren; Vilmann, Peter

    2016-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a minimally invasive surgical technique where access to the abdominal cavity is achieved through one of the natural orifices of the body. Based on experience from gynaecology, transvaginal access has been the easiest NOTES technique to im...

  7. Recurrent Transvaginal Leak of Dialysate as a Complication of ...

    African Journals Online (AJOL)

    Recurrent Transvaginal Leak of Dialysate as a Complication of Peritoneal Dialysis Catheter Tip Capture by Fallopian Tube after Tubal Occlusion. ... Mini laparotomy and tubal ligation with catheter removal were done and the patient was maintained on hemodialysis until she received a kidney transplant four months later.

  8. Pelvic abscess complicating transvaginal oocyte retrieval: A case ...

    African Journals Online (AJOL)

    Pelvic abscess complicating transvaginal oocyte retrieval for in vitro fertilization is uncommon. Difficulties and/or delays in diagnosis, attributable to the rarity of the pathology, are associated with complications that lead to severe maternal and perinatality morbidity and mortality. In this report, we present a 37 year old ...

  9. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    Science.gov (United States)

    Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Enokida, Yasuaki; Ozawa, Naoya

    2016-01-01

    Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures. PMID:27429831

  10. Transvaginal Ultrasound is a Valuable Investigation in Female ...

    African Journals Online (AJOL)

    Objectives: To evaluate the role of transvaginal ultrasound (TVUS) in studying the anatomical bases of genuine stress urinary incontinence (SUI) and understanding the causes of success and failure of operations aiming at the treatment of incontinence. Patients and Methods: This study included 15 continent females (Group ...

  11. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    Directory of Open Access Journals (Sweden)

    Takuya Shiraishi

    2016-01-01

    Full Text Available Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient’s postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures.

  12. Transvaginal sonography of cervix in high risk pregnant women for predicting preterm delivery: a prospective study

    Directory of Open Access Journals (Sweden)

    Marsosi V

    2010-02-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Preterm delivery is a relevant public health problem since it is an important factor determinant of morbidity and the main reason for neonatal mortality. Many publications have pointed at clinical methods, biological, biochemical and ultrasonographic markers, which applied in combination or on their own, aim at predicting spontaneous preterm delivery. Transvaginal sonography is an effective method for the study of uterine cervix during pregnancy since it permits to assess the cervical morphology and biometry in detail with a high degree of reliability. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD before 35 and 37 weeks of gestational age, in high risk population and the measurement of the cervix length and cervical funneling."n"nMethods: A prospective cohort of 200 women carrying high risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation."n"nResults: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence of cervical funneling presented a satistically significant association with spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated

  13. Radiative 3D MHD simulations of the spontaneous small-scale eruptions in the solar atmosphere

    Science.gov (United States)

    Kitiashvili, Irina N.

    2015-08-01

    Studying non-linear turbulent dynamics of the solar atmosphere is important for understanding mechanism of the solar and stellar brightness variations. High-resolution observations of the quiet Sun reveal ubiquitous distributions of high-speed jets, which are transport mass and energy into the solar corona and feeding the solar wind. However, the origin of these eruption events is still unknown. Using 3D realistic MHD numerical simulations we find that small-scale eruptions are produced by ubiquitous magnetized vortex tubes generated by the Sun's turbulent convection in subsurface layers. The swirling vortex tubes (resembling tornadoes) penetrate into the solar atmosphere, capture and stretch background magnetic field, and push the surrounding material up, generating shocks. Our simulations reveal complicated high-speed flow patterns and thermodynamic and magnetic structure in the erupting vortex tubes and shows that the eruptions are initiated in the subsurface layers and are driven by high-pressure gradients in the subphotosphere and photosphere and by the Lorentz force in the higher atmosphere layers. I will discuss about properties of these eruptions, their effects on brightness and spectral variations and comparison with observations.

  14. Diagnosis of cervical cancer with transvaginal color Doppler sonography

    OpenAIRE

    Li-bo DENG; Wei ZHOU; Chang, Shu-Fang; Lin, Ming-Jie

    2011-01-01

    Objective To investigate the imaging features of cervical cancer by transvaginal color Doppler sonography(TVCS),and evaluate the diagnostic value of TVCS.Methods A hundred and thirty cases of cervical intraepithelial neoplasia(CIN) grade Ⅰ-Ⅱ and cervical cancer,diagnosed by Thinprep cytologic test(TCT),cervical biopsy and pathological examination,received TVCS examination.The image characters and color Doppler flow imaging(CDFI) were collected and analyzed.Another 41 cases with normal cervice...

  15. Review of transvaginal natural orifice transluminal endoscopic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Naoyuki Yoshiki

    2017-02-01

    Full Text Available Recent technologic advances in endoscopic instrumentation and optics have allowed the development of a less invasive alternative to conventional laparoscopic surgery. During the past decade, natural orifice transluminal endoscopic surgery (NOTES flourished in the field of general surgery, and it has emerged as a new concept of minimally invasive surgery. NOTES yields access to the abdominal cavity without any incisions on the abdominal wall (scarless surgery, and the natural orifices of the body surface, such as the mouth and the vagina, serve as the gateway to the peritoneal cavity. In gynecology, the vagina of a woman can be considered as an additional route for surgery. Recently, clinical application of transvaginal NOTES has broadened significantly in gynecology. Using transvaginal NOTES by applying the method of single-incision laparoscopic surgery via the vaginal route, not only adnexal surgery and hysterectomy, but also myomectomy and oncologic surgery could be performed safely and effectively in selected patients. In future, further studies should be conducted to evaluate the true clinical feasibility and safety of transvaginal NOTES.

  16. [Transvaginal hybrid natural orifice translumenal endoscopic surgery appendectomy].

    Science.gov (United States)

    Wada, Norihito; Tanabe, Minoru; Kataoka, Fumio; Kitagawa, Yuko

    2013-11-01

    Natural orifice translumenal endoscopic surgery (NOTES) is considered the ultimate minimally invasive intervention for visceral disease. The transvaginal route is now the only one that can be used for NOTES procedures in daily clinical practice. We performed hybrid NOTES appendectomy that was preevaluated and approved by the Japan NOTES and Institutional Review Board. A 5-mm trocar was inserted transumbilically and used for laparoscope access. An additional transumbilical 2.3-mm port was placed, through which the surgeon inserted a grasper. We created a transvaginal port with a long 12-mm trocar. Laparoscopic instruments such as a vessel sealing system, surgical staplers, and a retrieval bag were introduced, and the surgical technique consequently became safer, although the access route was limited. The appendix was removed transvaginally. The patient did not need epidural anesthesia or any pain medication. The cosmetic results were better than that of conventional single-port surgery. Triangulation is achieved in this procedure, which makes the surgery easier. To generalize NOTES to many types of surgery and enable it to be performed in men, the transgastric approach is essential. The development of flexible instruments designed for NOTES is also necessary.

  17. Detection, characterization, and spontaneous differentiation in vitro of very small embryonic-like putative stem cells in adult mammalian ovary.

    Science.gov (United States)

    Parte, Seema; Bhartiya, Deepa; Telang, Jyoti; Daithankar, Vinita; Salvi, Vinita; Zaveri, Kusum; Hinduja, Indira

    2011-08-01

    The present study was undertaken to detect, characterize, and study differentiation potential of stem cells in adult rabbit, sheep, monkey, and menopausal human ovarian surface epithelium (OSE). Two distinct populations of putative stem cells (PSCs) of variable size were detected in scraped OSE, one being smaller and other similar in size to the surrounding red blood cells in the scraped OSE. The smaller 1-3 μm very small embryonic-like PSCs were pluripotent in nature with nuclear Oct-4 and cell surface SSEA-4, whereas the bigger 4-7 μm cells with cytoplasmic localization of Oct-4 and minimal expression of SSEA-4 were possibly the tissue committed progenitor stem cells. Pluripotent gene transcripts of Oct-4, Oct-4A, Nanog, Sox-2, TERT, and Stat-3 in human and sheep OSE were detected by reverse transcriptase-polymerase chain reaction. The PSCs underwent spontaneous differentiation into oocyte-like structures, parthenote-like structures, embryoid body-like structures, cells with neuronal-like phenotype, and embryonic stem cell-like colonies, whereas the epithelial cells transformed into mesenchymal phenotype by epithelial-mesenchymal transition in 3 weeks of OSE culture. Germ cell markers like c-Kit, DAZL, GDF-9, VASA, and ZP4 were immuno-localized in oocyte-like structures. In conclusion, as opposed to the existing view of OSE being a bipotent source of oocytes and granulosa cells, mammalian ovaries harbor distinct very small embryonic-like PSCs and tissue committed progenitor stem cells population that have the potential to develop into oocyte-like structures in vitro, whereas mesenchymal fibroblasts appear to form supporting granulosa-like somatic cells. Research at the single-cell level, including complete gene expression profiling, is required to further confirm whether postnatal oogenesis is a conserved phenomenon in adult mammals.

  18. Chemoablated mouse seminiferous tubular cells enriched for very small embryonic-like stem cells undergo spontaneous spermatogenesis in vitro.

    Science.gov (United States)

    Anand, Sandhya; Patel, Hiren; Bhartiya, Deepa

    2015-04-18

    Extensive research is ongoing to empower cancer survivors to have biological parenthood. For this, sperm are cryopreserved prior to therapy and in younger children testicular biopsies are cryopreserved with a hope to mature the germ cells into sperm later on for assisted reproduction. In addition, lot of hope was bestowed on pluripotent embryonic and induced pluripotent stem cells to differentiate into sperm and oocytes. However, obtaining functional gametes from pluripotent stem cells still remains a distant dream and major bottle-neck appears to be their inefficient differentiation into primordial germ cells (PGCs). There exists yet another population of pluripotent stem cells termed very small embryonic-like stem cells (VSELs) in adult body organs including gonads. We have earlier reported that busulphan (25 mg/Kg) treatment to 4 weeks old mice destroys actively dividing cells and sperm but VSELs survive and differentiate into sperm when a healthy niche is provided in vivo. Mouse testicular VSELs that survived busulphan treatment were cultured for 3 weeks. A mix of surviving cells in seminiferous tubules (VSELs, possibly few spermatogonial stem cells and Sertoli cells) were cultured using Sertoli cells conditioned medium containing fetal bovine serum, follicle stimulating hormone and with no additional growth factors. Stem cells underwent proliferation and clonal expansion in culture and spontaneously differentiated into sperm whereas Sertoli cells attached and provided a somatic support. Transcripts specific for various stages of spermatogenesis were up-regulated by qRT-PCR studies on day 7 suggesting VSELs (Sca1) and SSCs (Gfra) proliferate (Pcna), undergo spermatogenesis (spermatocyte specific marker prohibitin), meiosis (Scp3) and differentiate into sperm (post-meiotic marker protamine). Process of spermatogenesis and spermiogenesis was replicated in vitro starting with testicular cells that survived busulphan treatment. We have earlier reported similar

  19. Esterilización tubaria transvaginal: serie de casos

    OpenAIRE

    Quinchavil A,Hernán; Kaplan D,Francisco; Martínez L,Magaly; Becerra A,Oscar; Hevia G,Tiare

    2011-01-01

    Antecedentes: La esterilización tubaria transvaginal, es una forma de abordar la esterilización quirúrgica, en la actualidad poco popularizada. Objetivo: Evaluar la colpotomía posterior como vía para la esterilización tubaria. Método: Análisis de 100 fichas clínicas de mujeres multíparas en estado no puerperal, a solicitud voluntaria de esterilización. Resultados: Hubo un 3% de complicaciones. Conversiones en el 4% y un tiempo operatorio promedio de 25,2 minutos. Conclusión: La colpotomía pos...

  20. Digital examination and transvaginal scan - competing or complementary for predicting preterm birth?

    DEFF Research Database (Denmark)

    Reiter, Eva; Nielsen, Kurt Aagaard; Fedder, Jens

    2012-01-01

    The transvaginal ultrasonographic cervix scan has partly replaced digital examination for diagnosing preterm birth; conflicting results are reported about their respective contribution to birth prediction.......The transvaginal ultrasonographic cervix scan has partly replaced digital examination for diagnosing preterm birth; conflicting results are reported about their respective contribution to birth prediction....

  1. Cervical length evaluation by transvaginal sonography in nongravid women with a history of preterm delivery.

    Science.gov (United States)

    Pardo, J; Yogev, Y; Ben-Haroush, A; Peled, Y; Kaplan, B; Hod, M

    2003-05-01

    To evaluate cervical length in the nongravid period in women with a past history of preterm delivery. The study population comprised 54 women who had delivered spontaneously before 34 weeks of gestation. Etiology of preterm delivery was suspected to be related to cervical incompetence, defined as a painless and progressive dilatation of the cervix in the absence of other causes. Patients with pre-eclampsia, intrauterine growth restriction, uterine anomalies, fetal anomalies, multiple gestation and similar complications were excluded. Shortening of the cervix was recorded during pregnancy in all study patients. One hundred and four women matched for age, parity and body mass index who had given birth at term served as the control group. Cervical length was evaluated in all women at least 12 weeks after delivery by transvaginal sonography in the mid-sagittal plane. The mean gestational age at delivery was 30.8 +/- 1.2 weeks in the study group and 38.8 +/- 2.1 weeks in the control group (P = 0.03). The mean cervical length in the two groups was 36 +/- 6 and 38 +/- 4 mm, respectively. This difference was not statistically significant (P = 0.9). In nongravid women with unexplained preterm delivery there is no difference in cervical length compared to patients who deliver at term. Shortening of the cervix is most probably a reversible phenomenon that occurs during pregnancy and represents a failure of the competence mechanism to adapt to pregnancy. Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.

  2. The impact of in situ methotrexate injection after transvaginal ultrasound-guided aspiration of ovarian endometriomas on ovarian response and reproductive outcomes during IVF-cycles

    Directory of Open Access Journals (Sweden)

    H.E. Shawki

    2012-06-01

    Conclusion(s: In situ methotrexate injection after transvaginal ultrasound-guided aspiration was a simple, safe and successful method for treating ovarian endometriomas with minimal effects on ovarian response. Short term effects on reproductive outcomes, risk of fetal loss or anomaly were minimal. Six months was enough as washout period of the drug prior to conception and was advisable to prevent the small chance of chromosomal abnormalities in the offspring.

  3. Small-Animal PET with a sigma-Ligand, C-11-SA4503, Detects Spontaneous Pituitary Tumors in Aged Rats

    NARCIS (Netherlands)

    Kuzhuppilly Ramakrishnan, Nisha; Rybczynska, Anna A.; Visser, Anniek K. D.; Marosi, Krisztina; Nyakas, Csaba J.; Kwizera, Chantal; Sijbesma, Jurgen W. A.; Elsinga, Philip H.; Ishiwata, Kiichi; Pruim, Jan; Dierckx, Rudi A. J. O.; van Waarde, Aren

    Pituitary tumors are often detected only after death or at late stages of the disease when they are macroadenomas with a low surgical cure rate. Spontaneous pituitary tumors occur in rats over 1 y of age. In an ongoing study of changes in sigma-1 agonist binding related to aging, several of our rats

  4. Transvaginal ultrasonography in ovarian cancer screening: current perspectives

    Directory of Open Access Journals (Sweden)

    van Nagell Jr JR

    2013-12-01

    Full Text Available John R van Nagell Jr, John T HoffDepartment of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center/Markey Cancer Center, Lexington, KY, USAAbstract: Transvaginal ultrasonography (TVS is an integral part of all major ovarian cancer screening trials. TVS is accurate in detecting abnormalities in ovarian volume and morphology, but is less reliable in differentiating benign from malignant ovarian tumors. When used as the only screening test, TVS is sensitive, but has a low positive predictive value. Therefore, serum biomarkers and tumor morphology indexing are used together with TVS to identify ovarian tumors at high risk for malignancy. This allows preoperative triage of high-risk cases to major cancer centers for therapy while decreasing unnecessary surgery for benign disease. Ovarian cancer screening has been associated with a decrease in stage at detection in most trials, thereby allowing treatment to be initiated when the disease is most curable.Keywords: ovarian cancer, ultrasound, screening, serum Ca-125

  5. Rambam Hospital is the Birthplace of the Modern Version of Transvaginal Ultrasound

    Directory of Open Access Journals (Sweden)

    Ilan E. Timor-Tritsch

    2017-04-01

    Full Text Available The worldwide use of the transvaginal scanning route has revolutionized obstetrical and gynecologic imaging. The long, slow, and at times challenging aspects of its acceptance by the obstetrical and gynecologic community are the subject of this article. From its inception to its recent use, the dedicated doctors in the Department of Obstetrics and Gynecology at Rambam Medical Center, Haifa, Israel, were instrumental in conceiving and then collaborating with an Israeli manufacturer in the construction and worldwide use of the transvaginal ultrasound probe, resulting in the now well-known field of transvaginal sonography.

  6. Biopsia hepática endoscópica transvaginal em cadelas Endoscopic transvaginal liver biopsy in bitches

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    Leonardo Alves Coutinho Souza

    2012-02-01

    Full Text Available Esse trabalho teve o objetivo de propor uma técnica de biopsia hepática endoscópica transvaginal em cadelas, evitando-se o acesso através da parede abdominal, técnica essa internacionalmente conhecida por NOTES (natural orifice transluminal endoscopic surgery. Para tanto, foram utilizadas sete cadelas, as quais foram submetidas a dois procedimentos. O primeiro constou de biopsia hepática pela técnica proposta. Para isso, realizou-se a incisão vaginal após exteriorização através da vulva. Pela ferida vaginal foi introduzido um endoscópio flexível de 11mm de diâmetro com dois canais de trabalho. Este foi empregado na obtenção das amostras hepáticas. O segundo procedimento foi de avaliação laparoscópica aos 53 dias após a biopsia. As variáveis analisadas para a verificação de viabilidade, segurança e qualidade dessa técnica foram: as dificuldades técnicas, as complicações cirúrgicas, o tempo operatório, a qualidade do material coletado, a formação de aderências vaginais e as alterações bioquímicas hepáticas. Conclui-se que a biópsia hepática por NOTES flexível transvaginal é viável em cães, pois permite a obtenção de fragmentos apropriados para o exame histológico sem ocasionar alterações significativas dos parâmetros de avaliação hepática e formação de aderências intraperitoneais.A technique of hepatic biopsy by transvaginal approach (NOTES - Natural Orifice Transluminal Endoscopic Surgery is proposed. Seven dogs were used, and the experiment was divided into two stages including the liver biopsy and the evaluation of laparoscopic abdominal conditions after biopsy (53 days after. The animals were submitted to vaginal incision after exposition through the vulva. Through the vaginal incision was introduced a flexible endoscope of 11mm with two working channels, was introduced through the vaginal incision and used to obtain liver samples. The variables analyzed to verify the feasibility of the

  7. True ovarian volume is underestimated by two-dimensional transvaginal ultrasound measurement

    DEFF Research Database (Denmark)

    Rosendahl, Mikkel; Ernst, Erik; Rasmussen, Per Emil

    2010-01-01

    OBJECTIVE: To investigate a possible difference between true ovarian volume and ovarian volume estimated with two-dimensional (2D) transvaginal ultrasound. DESIGN: Prospective clinical and laboratory study. SETTING: University hospital research laboratory. PATIENT(S): Premenopausal girls and women...

  8. Hybrid transvaginal cholecystectomy, clinical results and patient-reported outcomes of 50 consecutive cases

    NARCIS (Netherlands)

    Boezem, P.B. van den; Velthuis, S.; Lourens, H.J.; Samlal, R.A.; Cuesta, M.A.; Sietses, C.

    2013-01-01

    OBJECTIVE: The aim of this study was to report the clinical and cosmetic results of transvaginal hybrid cholecystectomy (TVC). BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) has been developed as a minimal invasive alternative for conventional laparoscopic cholecystectomy.

  9. Spontaneous mass generation and the small dimensions of the Standard Model gauge groups U(1, SU(2 and SU(3

    Directory of Open Access Journals (Sweden)

    Guillermo García Fernández

    2017-02-01

    The result follows from strong antiscreening of the running coupling for those larger groups (with an appropriately small number of flavors together with scaling properties of the Dyson–Schwinger equation for the fermion mass.

  10. Acceleration and suppression of banana-shaped-protein-induced tubulation by addition of small membrane inclusions of isotropic spontaneous curvatures

    Science.gov (United States)

    Noguchi, Hiroshi

    The membrane tubulation induced by banana-shaped protein rods is investigated by using coarse-grained meshless membrane simulations. It is found that the tubulation is promoted by laterally isotropic membrane inclusions that generate the same sign of spontaneous curvature as the adsorbed protein rods. The inclusions are concentrated in the tubules and reduce the bending energy of the tip of the tubules. On the other hand, the inclusions with an opposite curvature suppress the tubulation by percolated-network formation at a high protein-rod density while they induce a spherical membrane bud at a low rod density. When equal amounts of the two types of inclusions (with positive and negative curvatures) are added, their effects cancel each other for the first short period but later the tubulation is slowly accelerated. A positive surface tension suppresses the tubulation. Out results suggest that the cooperation of scaffolding of BAR (Bin/Amphiphysin/Rvs) domains and isotropic membrane inclusions is important for the tubulation.

  11. An evaluation of fresh gas flow rates for spontaneously breathing cats and small dogs on the Humphrey ADE semi-closed breathing system.

    Science.gov (United States)

    Gale, Elizabeth; Ticehurst, Kim E; Zaki, Sanaa

    2015-05-01

    To evaluate the fresh gas flow (FGF) rate requirements for the Humphrey ADE semi-closed breathing system in the Mapleson A mode; to determine the FGF at which rebreathing occurs, and compare the efficiency of this system to the Bain (Mapleson D) system in spontaneously breathing cats and small dogs. Prospective clinical study. Twenty-five healthy (ASA score I or II) client-owned cats and dogs (mean ± SD age 4.7 ± 5.0 years, and body weight 5.64 ± 3.26 kg) undergoing elective surgery or minor procedures. Anaesthesia was maintained with isoflurane delivered via the Humphrey ADE system in the A mode using an oxygen FGF of 100 mL kg(-1) minute(-1). The FGF was then reduced incrementally by 5-10 mL kg(-1) minute(-1) at approximately five-minute intervals, until rebreathing (inspired CO(2) >5 mmHg (0.7 kPa)) was observed, after which flow rates were increased. In six animals, once the minimum FGF at which rebreathing occurred was found, the breathing system was changed to the Bain, and the effects of this FGF delivery examined, before FGF was increased. Rebreathing did not occur at the FGF recommended by the manufacturer for the ADE. The mean ± SD FGF that resulted in rebreathing was 60 ± 20 mL kg(-1) minute(-1). The mean minimum FGF at which rebreathing did not occur with the ADE was 87 ± 39 mL kg(-1) minute(-1). This FGF resulted in significant rebreathing (inspired CO(2) 8.8 ± 2.6 mmHg (1.2 ± 0.3 kPa)) on the Bain system. The FGF rates recommended for the Humphrey ADE are adequate to prevent rebreathing in spontaneously breathing cats and dogs cats and small dogs. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  12. "Triangle of safety": anatomic considerations in transvaginal natural orifice surgery.

    Science.gov (United States)

    Roberts, Kurt; Solomon, Daniel; Bell, Robert; Duffy, Andrew

    2013-08-01

    The introduction of transvaginal (TV) natural orifice transluminal endoscopic surgery (NOTES) brings the loss of traditionally used cutaneous landmarks for safe peritoneal access. This video describes the use of landmarks within the posterior vaginal fornix to define a "triangle of safety" wherein the peritoneal cavity can be accessed while minimizing the risk of injury to surrounding structures. The triangle of safety is best identified in the following way. The cervix and posterior fornix are visualized. Then an imaginary clock located at the base of the cervix is envisioned. The superior two corners of the triangle are represented by the 4 and 8 o'clock positions on this imaginary clock. Sometimes the cervix needs to be grasped and elevated anteriorly so that the inferior apex of the triangle delineated by the center of the rectovaginal fold is better visualized. During hybrid TV NOTES, the rectovaginal pouch of Douglas is visualized from the umbilicus, and the vaginal port can then be safely passed through the center of the triangle. It is important that the vaginal port should be angled upward, aiming toward the umbilicus to avoid injury to the rectum. During pure TV NOTES, the incision is made with electrocautery from the 5 o'clock position to the 7 o'clock position within the triangle. The peritoneum is sharply entered, and the colpotomy is dilated with the surgeons' fingers. The triangle of safety defines a set of landmarks between the base of the cervix and the rectovaginal fold. It allows for a safe TV access for hybrid and pure TV NOTES while minimizing the risk of injury to surrounding structures.

  13. Patient perception of transvaginal mesh and the media.

    Science.gov (United States)

    Koski, Michelle Elaine; Chamberlain, Jennifer; Rosoff, James; Vaughan, Taylor; Kaufman, Melissa R; Winters, Jack C; Rovner, Eric S

    2014-09-01

    To assess the penetration of media-based information on transvaginal mesh (TVM) in our patient population and to determine whether exposure affects patient opinion. Since the 2011 Federal Drug Administration communication on TVM, many advertisements from legal practices have been directed toward patients. An 18-item survey was administered to female patients at 2 sites from August 2012 to April 2013. Patients presenting with new diagnoses of pelvic organ prolapse or stress urinary incontinence or patients who reported prior mesh surgery were excluded. Ninety-nine questionnaires were completed. Sixty-six of the patients (67%) were aware of TVM; and of these, 38 (58%) cited advertisements as the initial source of information. Only 12% were aware of the Food and Drug Administration's communication. Regarding opinion of TVM, 9% chose "it is a safe product," 9% "safety depends on factors related to patient," 4.5% "not a safe product," 1.5% "safety depends on the doctor," 68% "I don't know," and 4.5% marked 2 selections. Only 12% indicated knowing the difference in the use of TVM for pelvic organ prolapse vs stress urinary incontinence. When asked what influenced their opinion of TVM the most; responses were as follows: advertisement (33.3%), medical professional (22.7%), friends or family who underwent TVM procedure (12.1%), media article (6.1%), and "not sure" (25.8%). Advertisements of TVM lawsuits had a high penetration into our patient population but did not produce an overtly negative response in our sample. Clinicians should be aware of the impact of these advertisements on patient opinion and counsel patients accordingly with unbiased and scientifically accurate information. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Transvaginal Sonography: perception and attitude of Nigerian women.

    Science.gov (United States)

    Okeji, Mark C; Agwuna, Kennedy K; Ihudiebube-Splendor, Chika N; Izge, Iliyasu Y; Ekuma, Kelechi K; Emeter, Jennifer O

    2017-07-27

    To assess the attitude to and perception of transvaginal sonography (TVS) among Nigerian women of mixed educational status in order to ascertain factors that may prevent them from submitting to TVS when recommended. A Cross-sectional survey was adopted for the study. In all, one missionary, one government and eight private hospitals were enlisted. The instruments for data collection were visual analogue scale (VAS), to ascertain patients' pain/discomfort experience, and a researcher-developed semi-structured questionnaire. The level of pain/discomfort on the VAS was categorized into four on a scale of 100. The categories were: 0-5 (no pain), 6-40 (mild pain), 41-74 (moderate pain), and 75-100 (severe pain). Majority (50.6%) of the respondents who attained secondary education had positive attitude to TVS. Also majority of the respondents (63.1%) preferred female sonographers. Majority of the respondents (54.1%) perceived TVS as not embarrassing, 78% did not consider it stressful, 96.9% reported that the sonographers were professional, 46.7% felt that a chaperon was needed, 98.4% reported there were enough privacy and 84.7% reported they needed prior information. Most of the respondents (82%) were willing to consent to TVS in future, 90.5% reported no pain, 8.6% reported mild pain/discomfort and 0.9% reported moderate pain. Majority of our respondents had positive attitude to TVS and were willing to consent to TVS in future, hence it was acceptable to them. It was however observed that acceptability increased with increasing academic status.

  15. The small heat shock protein p26 aids development of encysting Artemia embryos, prevents spontaneous diapause termination and protects against stress.

    Directory of Open Access Journals (Sweden)

    Allison M King

    Full Text Available Artemia franciscana embryos enter diapause as encysted gastrulae, a physiological state of metabolic dormancy and enhanced stress resistance. The objective of this study was to use RNAi to investigate the function of p26, an abundant, diapause-specific small heat shock protein, in the development and behavior of encysted Artemia embryos (cysts. RNAi methodology was developed where injection of Artemia females with dsRNA specifically eliminated p26 from cysts. p26 mRNA and protein knock down were, respectively, confirmed by RT-PCR and immuno-probing of western blots. ArHsp21 and ArHsp22, diapause-related small heat shock proteins in Artemia cysts sharing a conserved α-crystallin domain with p26, were unaffected by injection of females with dsRNA for p26, demonstrating the specificity of protein knock down. Elimination of p26 delayed cyst release from females demonstrating that this molecular chaperone influences the development of diapause-destined embryos. Although development was slowed the metabolic activities of cysts either containing or lacking p26 were similar. p26 inhibited diapause termination after prolonged incubation of cysts in sea water perhaps by a direct effect on termination or indirectly because p26 is necessary for the preservation of diapause maintenance. Cyst diapause was however, terminated by desiccation and freezing, a procedure leading to high mortality within cyst populations lacking p26 and indicating the protein is required for stress tolerance. Cysts lacking p26 were also less resistant to heat shock. This is the first in vivo study to show that knock down of a small heat shock protein slows the development of diapause-destined embryos, suggesting a role for p26 in the developmental process. The same small heat shock protein prevents spontaneous termination of diapause and provides stress protection to encysted embryos.

  16. The small heat shock protein p26 aids development of encysting Artemia embryos, prevents spontaneous diapause termination and protects against stress.

    Science.gov (United States)

    King, Allison M; MacRae, Thomas H

    2012-01-01

    Artemia franciscana embryos enter diapause as encysted gastrulae, a physiological state of metabolic dormancy and enhanced stress resistance. The objective of this study was to use RNAi to investigate the function of p26, an abundant, diapause-specific small heat shock protein, in the development and behavior of encysted Artemia embryos (cysts). RNAi methodology was developed where injection of Artemia females with dsRNA specifically eliminated p26 from cysts. p26 mRNA and protein knock down were, respectively, confirmed by RT-PCR and immuno-probing of western blots. ArHsp21 and ArHsp22, diapause-related small heat shock proteins in Artemia cysts sharing a conserved α-crystallin domain with p26, were unaffected by injection of females with dsRNA for p26, demonstrating the specificity of protein knock down. Elimination of p26 delayed cyst release from females demonstrating that this molecular chaperone influences the development of diapause-destined embryos. Although development was slowed the metabolic activities of cysts either containing or lacking p26 were similar. p26 inhibited diapause termination after prolonged incubation of cysts in sea water perhaps by a direct effect on termination or indirectly because p26 is necessary for the preservation of diapause maintenance. Cyst diapause was however, terminated by desiccation and freezing, a procedure leading to high mortality within cyst populations lacking p26 and indicating the protein is required for stress tolerance. Cysts lacking p26 were also less resistant to heat shock. This is the first in vivo study to show that knock down of a small heat shock protein slows the development of diapause-destined embryos, suggesting a role for p26 in the developmental process. The same small heat shock protein prevents spontaneous termination of diapause and provides stress protection to encysted embryos.

  17. Transvaginal Repair of a Large Chronic Porcine Ventral Hernia with Synthetic Mesh Using NOTES

    OpenAIRE

    Powell, Ben; Whang, Susan H.; Bachman, Sharon L.; Andres Astudillo, J.; Sporn, Emanuel; Miedema, Brent W.; Thaler, Klaus

    2010-01-01

    Background: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Methods: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel...

  18. Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

    Directory of Open Access Journals (Sweden)

    Ayşe Figen Türkçapar

    2015-01-01

    Full Text Available We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy.

  19. Diagnóstico de sinéquias uterinas por histerossonografia transvaginal Diagnosis of uterine synechiae in patients with recurrent miscarriages: contribution of transvaginal hysterosonography

    Directory of Open Access Journals (Sweden)

    Hélio Antonio Guimarães Filho

    2006-10-01

    Full Text Available OBJETIVO: Avaliar a prevalência de sinéquias uterinas em pacientes com aborto recorrente e a acurácia diagnóstica da ultra-sonografia transvaginal (US-TV e da histerossonografia (HS. MÉTODOS: Sessenta pacientes não grávidas com passado de três ou mais abortos espontâneos consecutivos foram avaliadas por US-TV, HS e histeroscopia (HTC para a pesquisa de sinéquias uterinas. A HTC foi considerada o padrão ouro do estudo. A concordância dos achados da US-TV e da HS foram avaliadas pelo coeficiente Kappa e sua significância foi testada. O nível de significância adotado foi de 0,05 (alfa = 5%. Foram calculadas as medidas de sensibilidade, especificidade e valor preditivo positivo e negativo para cada um dos métodos. RESULTADOS: Observou-se a presença de sinéquias uterinas em 16 (26,7% pacientes. A acurácia da US-TV e da HS foram, respectivamente, de 78,9% e 92,7%. Comparativamente à US-TV, a HS foi muito superior quanto à sensibilidade (78,6% versus 20% e concordância com a HTC (Kappa = 80% versus Kappa = 27%. CONCLUSÃO: Observou-se boa concordância da HS e concordância ruim da US-TV em relação à HTC para o diagnóstico de sinéquias uterinas. Devido à sua baixa sensibilidade, a US-TV não demonstrou ser um método aplicável à investigação de sinéquias uterinas em pacientes com aborto recorrente. A HS, por sua vez, parece oferecer importante contribuição nesta pesquisa, particularmente por sua simplicidade técnica, baixo custo e elevada acurácia diagnóstica.BACKGROUND: The aim of this study was to determine the prevalence of uterine synechiae in patients with recurrent miscarriages and to evaluate the diagnostic accuracy of transvaginal ultrasound and of hysterosonography. METHODS: Sixty non-pregnant patients with a history of at least three previous consecutive miscarriages were evaluated by transvaginal ultrasound, hysterosonography and hysteroscopy to detect uterine synechiae. Hysteroscopy was considered the

  20. Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management.

    Science.gov (United States)

    MacDonald, Susan; Terlecki, Ryan; Costantini, Elisabetta; Badlani, Gopal

    2016-08-01

    Mesh-related complications following transvaginal management of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) have received significant attention in the last decade. We sought to identify patient, product, and technical factors associated with an increased risk of complications after mesh-based transvaginal repair of anterior POP and SUI. In this review we clarify the different pattern of complications after POP and SUI repairs. Our aim is to provide a practical evidence-based guide for physicians to prevent and, if necessary, manage product-associated complications in a stepwise manner. We conducted a comprehensive PubMed search of all English-language articles published from 2010 to June 2016, using these search terms: mesh, pelvic organ prolapse, and stress urinary incontinence. Expert opinion is also provided. Mesh-related complications are much lower after repair of SUI compared with POP, despite its more frequent use. Vaginal exposure is the most common mesh-specific complication. Patients may present with vaginal discharge, dyspareunia, pain, recurrent urinary tract infection, and/or hematuria. Conversely, patients may be asymptomatic. Small asymptomatic mesh exposures (urinary tract must be fully excised. Following excision, pain may persist in up to 50% of patients. Vaginal extrusion, persistent pain, and urethral and/or bladder erosion are the three most common product-specific complications following mesh-based repair for SUI or POP. Conservative therapies may be attempted, but most patients ultimately require partial or complete mesh excision. We reviewed the recent literature on mesh-related complications after repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Vaginal exposure, persistent pain, and erosion into the urinary tract are the most common. These often require surgical management, best suited to a urologist with training and experience in this area. Evidence supports mesh use for correction of

  1. Serial transvaginal ultrasound-guided biopsy of the porcine corpus luteum in vivo

    NARCIS (Netherlands)

    Björkman, S.; Yun, J.; Niku, M.; Oliviero, C.; Soede, N.M.; Peltoniemi, O.A.T.

    2017-01-01

    The aims of the present study was to develop and describe a transvaginal ultrasound-guided biopsy method for luteal tissue in the porcine and to evaluate the effects of the method on the reproductive tract, ovarian status and pregnancy status. Biopsies were performed in four multiparous sows on Days

  2. Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management

    OpenAIRE

    Mekaru, Keiko; Oishi, Sugiko; Akamine, Kozue; Heshiki, Chiaki; Aoki, Yoichi

    2017-01-01

    Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16–22 mm. If estradiol was >300 pg/mL when AVM was diagnosed,...

  3. Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dueholm, M; Forman, A; Jensen, ML

    2001-01-01

    OBJECTIVES: To evaluate whether saline contrast sonohysterography (SCSH) adds additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS: This was a two-center prosp...

  4. Spontaneous deregulation

    NARCIS (Netherlands)

    Edelman, Benjamin; Geradin, Damien

    Platform businesses such as Airbnb and Uber have risen to success partly by sidestepping laws and regulations that encumber their traditional competitors. Such rule flouting is what the authors call “spontaneous private deregulation,” and it’s happening in a growing number of industries. The authors

  5. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats

    OpenAIRE

    Kleinschnitz, Christoph; Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Schreiber, Stefanie

    2013-01-01

    Background Human cerebral small vessel disease (CSVD) has distinct histopathologic and imaging findings in its advanced stages. In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood–brain barrier and an activated coagulatory state resulting in capillary and arteriolar erythrocyte accumulations (stases). In ...

  6. Transvaginal mesh: a historical review and update of the current state of affairs in the United States.

    Science.gov (United States)

    Iyer, Shilpa; Botros, Sylvia M

    2017-04-01

    Transvaginal mesh usage has been at the forefront of popular media and academic debate for the past 10 years. Several US Food and Drug Administration (FDA) communications, society statements, and research articles have been written in an attempt to define and articulate the classification system, safety data, and efficacy of this approach to transvaginal surgery. In this review, we explore the history of transvaginal mesh surgery for pelvic organ prolapse (POP), review FDA and society statements, and research current practice in the United States. We searched the English language literature using PubMed for articles related to safety and monitoring of transvaginal mesh and reviewed all FDA publication and notices and gynecology and urogynecology society statements on its use in the United States. We then reviewed 22 articles and grouped them into several sections. Mesh used to augment transvaginal repair of POP was introduced in the United States in 2005 without clinical safety and efficacy data. In the subsequent years of use, both major and minor complications were increasingly reported, leading to several FDA notifications and warnings. The type of mesh used, reporting and classifications systems, and provider usage has varied widely over time. We present a historical review of transvaginal mesh use for pelvic organ prolapse in the United States from 2005 to 2016. There continues to be heated debate among practitioners about balancing the efficacy of mesh use to decrease recurrent prolapse and complications. Research into safety and efficacy, along with tighter FDA regulations, is ongoing.

  7. Appendicitis Diagnosed by Emergency Physician Performed Point-of-care Transvaginal Ultrasound: Case Series

    Directory of Open Access Journals (Sweden)

    Robert Bramante

    2013-09-01

    Full Text Available Lower abdominal pain in females of reproductive age continues to be a diagnostic dilemma for the emergency physician (EP. Point-of-care ultrasound (US allows for rapid, accurate, and safe evaluation of abdominal and pelvic pain in both the pregnant and non-pregnant patient. We present 3 cases of females presenting with right lower quadrant and adnexal tenderness where transvaginal ultrasonography revealed acute appendicitis. The discussion focuses on the use of EP-performed transvaginal US in gynecologic and intra-abdominal pathology and discusses the use of a staged approach to evaluation using US and computed tomography, as indicated. [West J Emerg Med. 2013;14(5:415-418.

  8. Significance of transvaginal Doppler ultrasonography for detection of malignant gestational trophoblastic disease

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    Nikolić Branka

    2005-01-01

    Full Text Available Transvaginal Doppler ultrasonography has an important role in detecting and confirming the gestational trophoblastic disease (GTD. It can also be helpful in early detection of the malignant cases of GTD such as the invasion and protrusion of trophoblastic tissue into the uterine wall. Ultrasonographic picture of the malignant GTD is also specific for the presence of prominent zones of vasculavization in the peritrophoblastic tissue, as well as in the uterine tissue in which malignant GTD is developed. Resistance Index (RI values were measured at the level of blood vessels of peritrophoblastic tissue and of suspected zones in the uterine tissue to detect neovascularization, which followed the malignant process. Theca luteal cysts were often detected by Transvaginal Doppler ultrasonography.

  9. OPPORTUNITIES OF TRANSVAGINAL ECHOCARDIOGRAPHY FOR EARLY PRENATAL DIAGNOSIS OF INBORN HEART DISEASES IN FETUS

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    E.A. Shevchenko

    2008-01-01

    Full Text Available According to the literature data, transvaginal echocardiography (Echocg is the method, used for the doppler diagnostics in early terms of pregnancy (if principles of safety are observed. This method allows detecting about 70–97% of all prognostic cally significant inborn heart diseases in fetus, beginning at 12 week of pregnancy. a scheme of research includes estimation of four chamber cut of fetus heart, and study of state of its main arteries. This is an expert investigation, because it needs special grounding of specialist, high resolution ultrasonic equipment, and considerable expense of time. Wile parameters are estimated, it is necessary to use normative rates of sizes of ventricles and main arteries of fetus, developed by Russian experts, taking into account individual variations.Key words: transvaginal echocardiography, diagnosis, inborn heart disease.

  10. [Transvaginal aspiration as first treatment of ovarian follicular cysts in dairy cattle under field circumstances].

    Science.gov (United States)

    Lievaart, J J; Parlevliet, J M; Dieleman, S J; Rientjes, S; Bosman, E; Vos, P L A M

    2006-06-15

    On dairy farms covered by the ambulatory service of the Department of Farm Animal Health, 55 Holstein-Friesian cows with suspected ovarian follicular cysts on the basis of rectal palpation underwent confirmatory transrectal ultrasonography. An ovarian follicular cyst was confirmed in 28 cows (50.9%) and was treated by single transvaginal-guided needle aspiration. Cows with a corpus luteum or a luteinized cyst were not treated. After aspiration, 82.1% (n=23) of the cows showed oestrus behaviour at 13.3 +/- 6.0 days. Artificial insemination was performed during the first heat after cyst aspiration and resulted in a pregnancy rate of 64.2%. In conclusion, single transvaginal-guided needle aspiration of ovarian follicular cysts is an easy and good method for the treatment of follicular cysts. Moreover, it is a safe and good alternative method for the manual, active rupturing of cysts during rectal palpation.

  11. Transobturator tapes are preferable over transvaginal tapes for the management of female stress urinary incontinence: Against

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    Arun Chawla

    2009-01-01

    Full Text Available Midurethral placement of tension-free vaginal tapes with a transvaginal route for stress urinary incontinence achieves higher and better long-term success rates than the transobturator route. Bladder perforations are reported more in transvaginal tape (TVT but incidences of vaginal erosions, extrusion, and groin pain are exceedingly more in TOT groups. There is no clear evidence that transobturator tape (TOT is associated with less post-operative voiding problems than TVT. Major complications such as bowel injuries and significant vascular injuries with TVT are rare. TVT has been found to be superior to TOT and preferable in technically demanding conditions such as prior anti-incontinence operation failures, obese women, and very elevated and scarred lateral cul-de sac. TVT is always preferred in severe grades of stress urinary incontinence and with patients of intrinsic sphincter deficiency (ISD with little or no urethral mobility.

  12. Comparative study of transperineal and transvaginal sonography for localization of placenta in antepartum haermorrhage

    OpenAIRE

    Pushpa Dahiya; Shaveta Jain; Neelam Gupta; Jyotsna sen; Nitin Jain

    2016-01-01

    Background: Haemorrhage is one of the leading causes of maternal mortality and morbidity in world in pregnant patients.Patients with antepartum haemorrhage confirmation of location of placenta by sonography is must for management. Transvaginal sonography(TVS) has main disadvantage of need of penetration of vagina and provoking vaginal haemorrhage It can also result in uterine contraction and requirement of special transducer. Transperineal sonography(TPS) is more convenient and safer means...

  13. Music Therapy on Anxiety, Stress and Maternal-fetal Attachment in Pregnant Women During Transvaginal Ultrasound

    OpenAIRE

    Shin, Hye Sook; Kim, Ju Hee

    2011-01-01

    The purpose of this study was to examine the effects of music therapy on anxiety, stress and maternal-fetal attachment in pregnant women during a transvaginal ultrasound. Methods: This study was a nonequivalent control group nonsynchronized design. Pregnant women (n =232) were assigned to experimental (n= 117) and control (n =116) groups respectively. The data were collected from August 2 to 27, 2010. The experimental group received general prenatal care and single 30-minute session of mus...

  14. Transvaginal liver resection (NOTES combined with minilaparoscopy Resección hepática transvaginal, fusión de NOTES y minilaparoscopia

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    J. F. Noguera

    2008-07-01

    Full Text Available Objective: to report on the first liver resection performed on a human being by a transvaginal NOTES approach combined with minilaparoscopy. Patients and methods: a sixty-one-year-old woman with a history of Wertheim's hysterectomy for endometrial carcinoma 10 years ago, and malignant melanoma correctly treated in 2006, had suspected segment-V liver metastasis near the gallbladder by CT-scan and MRI. The indication for a laparoscopic approach was made, and a combined transvaginal and minilaparoscopic resection was offered and accepted by the patient. The procedure was performed by a multidisciplinary team composed of surgeons and gastroenterologists. It involved creating a pneumoperitoneum by placing a Veres needle in the umbilical fundus, followed by the insertion of a 5-mm trocar. A second, 3-mm trocar was placed in the right upper quadrant. A lot of pelvic adhesions were found in the major pelvis, and it was necessary to place a third, 5-mm trocar in the left abdominal side. It was employed only for the adhesions, not for liver resection. Adhesions were removed to reveal the minor pelvis and the vaginal fornix. A colpotomy was performed with a 12-mm trocar placed inside the vagina, which allowed the insertion of the videogastroscope as far as the liver hilum. Results: liver resection (segment-V partial resection and cholecystectomy were performed by using a combination of working tools inserted through the entry port for the minilaparoscopy and the videogastroscope. The en bloc resection was removed transvaginally through the videogastroscope. There were no postoperative complications, and the patient was discharged after 48 hours. Conclusions: transvaginal liver resection is possible and safe when performed by a multidisciplinary team. Natural orifice transluminal endoscopic surgery (NOTES is an emerging modality that seeks to be less invasive, better tolerated, and more respectful of esthetics. It will probably open the way for very

  15. Transvaginal repair of a large chronic porcine ventral hernia with synthetic mesh using NOTES.

    Science.gov (United States)

    Powell, Ben; Whang, Susan H; Bachman, Sharon L; Astudillo, J Andres; Sporn, Emanuel; Miedema, Brent W; Thaler, Klaus

    2010-01-01

    Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar. A single-channel gastroscope with an endoscopic atraumatic grasper was used for grasping sutures. Further fascial sutures were placed every 5 cm. Mesh repair was feasible in all 7 animals. Mean operative time was 133 minutes. Technical difficulties were encountered. No gross contamination was seen at the time of necropsy. However, 5 animals had positive mesh cultures; 7 had positive cultures in the rectouterine space in enrichment broth or on direct culture. Transvaginal placement of synthetic mesh to repair a large porcine hernia using NOTES is challenging but feasible. Future studies need to be conducted to develop better techniques and determine the significance of mesh contamination.

  16. Transvaginal hybrid NOTES cholecystectomy--results of a randomized clinical trial after 6 months.

    Science.gov (United States)

    Bulian, Dirk Rolf; Knuth, Jurgen; Cerasani, Nicola; Lange, Jonas; Ströhlein, Michael Alfred; Sauerwald, Axel; Heiss, Markus Maria

    2014-08-01

    For cholecystectomy (CHE), both the needlescopic three-trocar technique with 2-3-mm instruments (needlescopic cholecystectomy (NC)) and the umbilically assisted transvaginal technique with rigid instruments (transvaginal cholecystectomy (TVC)) have been established for further reduction of the trauma remaining from laparoscopy. To compare the further outcome of both techniques for elective CHE in female patients, we analyzed the secondary end points of a prospective randomized single-center trial (needlescopic versus transvaginal cholecystectomy (NATCH) trial; ClinicalTrials.gov Identifier: NCT0168577), in particular, satisfaction with aesthetics, overall satisfaction, abdominal pain, and incidence of trocar hernias postoperatively at both 3 and 6 months. After 3 months, the domains "satisfaction" and "pain" of the German version of the Female Sexual Function Index (FSFI-d) were additionally evaluated to detect respective complications. A gynecological control examination was conducted in all TVC patients after 6 months. Forty patients were equally randomized into the therapy and the control groups between February 2010 and June 2012. No significant differences were found for overall satisfaction with the surgical result, abdominal pain, sexual function, and the rate of trocar hernias. However, aesthetics were rated significantly better by TVC patients both after 3 and after 6 months (P = 0.004 and P < 0.001). There were no postoperative pathological gynecological findings. Following TVC, there is a significantly better aesthetic result as compared to NC, even at 3 and 6 months after the procedure. No difference was found for sexual function.

  17. Endometrial abnormalities on transvaginal ultrasonography and histopathology in women after quinacrine sterilization

    Science.gov (United States)

    Afzal, Saira; Bukhari, Mulazim Hussain

    2014-01-01

    Objective: To describe endometrial abnormalities on transvaginal ultrasonography and histopathology in women after quinacrine sterilization. Methods: It was an analytical cross sectional study conducted during February 2012 to April 2013. The sample size calculated at 95% confidence level was 540. Sampling technique used was simple random sampling. The medical history, examination, transvaginal ultrasonography and biopsy of suspected lesion was performed in quinacrine sterilized women. Results: The calculation of statistics showed the mean age at quinacrine sterilization was 38.5 years, standard deviation 6.517, and standard error 0.461. The endometrium was regular and smooth with homogenous images in 86% (n= 466), irregular endometrium with heterogeneous images on transvaginal ultrasound in 9.4% (n =51) and endometrial growth with high level echoes in 4.2% women (n= 23). The histological findings included hyperplasia and well differentiated adenocarcinoma in two patients respectively. Conclusion: The irregular endometrium, adhesions, and growths were found after quinacrine sterilization. The risk of endometrial growth was more after 10 years duration of quinacrine sterilization. PMID:25097516

  18. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance

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    Kevin C. Ching

    2015-01-01

    Full Text Available Objectives. To evaluate clinical outcomes following transvaginal catheter placement using transabdominal ultrasound guidance for management of pelvic fluid collections. Methods. A retrospective review was performed for all patients who underwent transvaginal catheter drainage of pelvic fluid collections utilizing transabdominal ultrasound guidance between July 2008 and July 2013. 24 consecutive patients were identified and 24 catheters were placed. Results. The mean age of patients was 48.1 years (range = 27–76 y. 88% of collections were postoperative (n=21, 8% were from pelvic inflammatory disease (n=2, and 4% were idiopathic (n=1. Of the 24 patients, 83% of patients (n=20 had previously undergone a hysterectomy and 1 patient (4% was pregnant at the time of drainage. The mean volume of initial drainage was 108 mL (range = 5 to 570. Catheters were left in place for an average of 4.3 days (range = 1–17 d. Microbial sampling was performed in all patients with 71% (n=17 returning a positive culture. All collections were successfully managed percutaneously. There were no technical complications. Conclusions. Transvaginal catheter drainage of pelvic fluid collections using transabdominal ultrasound guidance is a safe and clinically effective procedure. Appropriate percutaneous management can avoid the need for surgery.

  19. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance.

    Science.gov (United States)

    Ching, Kevin C; Sumkin, Jules H

    2015-01-01

    Objectives. To evaluate clinical outcomes following transvaginal catheter placement using transabdominal ultrasound guidance for management of pelvic fluid collections. Methods. A retrospective review was performed for all patients who underwent transvaginal catheter drainage of pelvic fluid collections utilizing transabdominal ultrasound guidance between July 2008 and July 2013. 24 consecutive patients were identified and 24 catheters were placed. Results. The mean age of patients was 48.1 years (range = 27-76 y). 88% of collections were postoperative (n = 21), 8% were from pelvic inflammatory disease (n = 2), and 4% were idiopathic (n = 1). Of the 24 patients, 83% of patients (n = 20) had previously undergone a hysterectomy and 1 patient (4%) was pregnant at the time of drainage. The mean volume of initial drainage was 108 mL (range = 5 to 570). Catheters were left in place for an average of 4.3 days (range = 1-17 d). Microbial sampling was performed in all patients with 71% (n = 17) returning a positive culture. All collections were successfully managed percutaneously. There were no technical complications. Conclusions. Transvaginal catheter drainage of pelvic fluid collections using transabdominal ultrasound guidance is a safe and clinically effective procedure. Appropriate percutaneous management can avoid the need for surgery.

  20. Update on Instrumentations for Cholecystectomies Performed via Transvaginal Route: State of the Art and Future Prospectives

    Directory of Open Access Journals (Sweden)

    Elia Pulvirenti

    2010-01-01

    Full Text Available Natural Orifice Transluminal Endoscopic Surgery (NOTES is an innovative approach in which a flexible endoscope enters the abdominal cavity via the transesophageal, transgastric, transcolonic, transvaginal or transvescical route, combining the technique of minimally invasive surgery with flexible endoscopy. Several groups have described different modifications by using flexible endoscopes with different levels of laparoscopic assistance. Transvaginal cholecystectomy (TVC consists in accessing the abdominal cavity through a posterior colpotomy and using the vaginal incision as a visual or operative port. An increasing interest has arisen around the TVC; nevertheless, the most common and highlighted concern is about the lack of specific instruments dedicated to the vaginal access route. TVC should be distinguished between “pure”, in which the entire operation is performed through the transvaginal route, and “hybrid”, in which the colpotomy represents only a support to introduce instruments and the operation is performed mainly by the classic transabdominal-introduced instruments. Although this new technique seems very appealing for patients, on the other hand it is very challenging for the surgeon because of the difficulties related to the mode of access, the limited technology currently available and the risk of complications related to the organ utilized for access. In this brief review all the most recent advancements in the field of TVC's techniques and instrumentations are listed and discussed.

  1. Spontaneous Pneumothorax

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    John Costumbrado

    2017-09-01

    Full Text Available History of present illness: A 16-year-old male with asthma was brought to the emergency department by his parents for increasing right-sided chest pain associated with cough and mild dyspnea over the past week. Albuterol inhaler did not provide relief. He denied recent trauma, fever, sweats, and chills. The patient’s vitals and oxygen saturations were stable. Physical exam revealed a tall, slender body habitus with no signs of chest wall injuries. Bilateral breath sounds were present, but slightly diminished on the right. A chest radiograph was ordered to determine the etiology of the patient’s symptoms. Significant findings: Initial chest radiograph showed a 50% right-sided pneumothorax with no mediastinal shift, which can be identified by the sharp line representing the pleural lung edge (see arrows and lack of peripheral lung markings extending to the chest wall. While difficult to accurately estimate volume from a two-dimensional image, a 2 cm pneumothorax seen on chest radiograph correlates to approximately 50% volume.1 The patient underwent insertion of a pigtail pleural drain on the right and repeat chest radiograph showed resolution of previously seen pneumothorax. Ultimately the pigtail drain was removed and chest radiograph showed clear lung fields without evidence of residual pneumothorax or pleural effusion. Discussion: Pneumothorax is characterized by air between the lungs and the chest wall.2 Spontaneous pneumothorax (SP occurs when the pneumothorax is not due to trauma or any discernable etiology. 3 SP is multifactorial and may be associated with subpleural blebs, bullae, and other connective tissue changes that predispose the lungs to leak air into the pleural space.4 SP can be further subdivided into primary (no history of underlying lung disease or secondary (history of chronic obstructive pulmonary disease, tuberculosis, cystic fibrosis, lung malignancy, etc..2 It is estimated that the incidence of SP among US pediatric

  2. Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

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    Nayereh Ghomian

    2015-11-01

    Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

  3. Multivariate assessment of cervical invasion of endometrial carcinoma. Comparison of transvaginal ultrasonography, hysteroscopy, and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miyagi, Yasunari; Yamada, Shinako; Miyagi, Yuji [Okayama Univ. (Japan). School of Medicine] [and others

    1997-07-01

    From 1991 to 1995, 71 patients with endometrial cancer at Okayama University Medical School underwent transvaginal ultrasonography with a 6.5-MHz transducer, MRI at 1.5 T, and hysteroscopy using a rigid hysteroscope. The findings of these examinations were compared against pathologic results. The sensitivity/specificity/accuracy were 0.73/0.89/0.86 for transvaginal ultrasonography, 0.73/0.88/0.85 for MRI, and 0.73/0.80/0.79 for hysteroscopy. The coefficient values for transvaginal ultrasonography/MRI/hysteroscopy were 0.69/0.62/-0.21 and 1.99/1.89/0.79 in quantification theory second family analysis and logistic regression, respectively. Misdiagnosed cases had the following factors: large tumor volume; tumor near the internal os; tumor descending from the uterine cavity; polypoid tumor in the endocervix; artifacts due to the use of a cervix dilator made from stems of the seaweed Laminaria japonica; endocervical glandular involvement only; and atypical signals on MRI. For the preoperative assessment of cervical invasion, transvaginal ultrasonography and MRI were the most reliable. Hysteroscopy was least reliable, because of a large number of false-positive results. The use of these examinations in combination, especially transvaginal ultrasonography and MRI, would be of great value in surgical planning for endometrial cancer, considering the factors responsible for misdiagnosis. (K.H.)

  4. Spontaneous hemoperitoneum.

    Science.gov (United States)

    Lucha, P A

    1996-06-01

    Massive hemoperitoneum seen without an obvious precipitating event is rare. A 21-year-old man was seen with diffuse abdominal pain of 48 hours' duration. He had no fever, nausea, or vomiting, and most laboratory values were normal. Exploration of the abdomen revealed free intraperitoneal blood with clotting but failed to reveal a source. The patient could recall no trauma or other inciting event. The only abnormalities found during laparotomy were multiple adhesions of the omentum to the lateral abdominal wall and localization of most of the clot within the greater omentum. The author cautions that a high index of suspicion followed by laparotomy are the management tools for controlling spontaneous hemoperitoneum. Conservative management produces a high mortality rate.

  5. [Transvaginal Prosima mesh and high uterosacral ligament suspension in the treatment of severe pelvic organ prolapsey].

    Science.gov (United States)

    Wang, Wen-ying; Lu, Yong-xian; Hu, Xiao-juan; Liu, Xin; Shen, Wen-jie; Liu, Jing-xia; Ge, Jing; Zhang, Ying-hui; Zhao, Ying; Niu, Ke

    2012-07-01

    To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP). From July 2010 to February 2011, 70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital, General Hospital of People's Liberation Army. Clinical parameters of perioperation were collected. After 1 month and 2 - 3 months, perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane. Validated prolapse quality of life questionnaires, pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect. The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51, respectively. Median operation time was (195 ± 47) min and median blood loss was (160 ± 64) ml. All the patients were followed for a mean time of 13 months (2 - 19 months). Seven cases were found with mesh exposure with less than 1 cm(2). The objective cure rate was 100%. The mean score of post-operative PFIQ-7 and PFDI-20 were both 19, which were significantly lower than those of pre-operation (P < 0.05). Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination, and the second result of ultrasound scans was 2.8 cm at 2 - 3 month, which were both shortened 2.5 cm and 3.2 cm when compared with that of original size. Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication. Although mesh became shorter after 2 - 3 month, it did not affect surgery efficacy.

  6. Pure transvaginal natural orifice translumenal endoscopic surgery for renal cyst decortication: report of initial five cases.

    Science.gov (United States)

    Zou, Xiaofeng; Zhang, Guoxi; Yuan, Yuanhu; Xiao, Rihai; Xue, Yijun; Wu, Gengqing; Wang, Xiaoning; Long, Dazhi; Yang, Jun; Wu, Yuting; Xu, Hui; Liu, Folin; Liu, Min; Zhang, Xu

    2014-01-01

    To present our initial experience with pure transvaginal natural orifice translumenal endoscopic surgery renal cyst decortication. From December 2010 to July 2011, five female patients with symptomatic renal cyst in the anterior portion and lower pole of the kidney were submitted to pure transvaginal natural orifice translumenal endoscopic surgery renal cyst decortication in our center. Under general anesthesia, the patients were placed in the lithotomy position with the affected side elevated by 60°. A 3-cm incision was made at the posterior vaginal fornix and a modified three-channel port was deployed across the vaginal incision. The cyst was dissected and the cyst fluid was aspirated using a suction device. The cyst wall was circumferentially excised. All five procedures were successfully carried out without additional transabdominal trocars. The median operative time was 80 min (range 60-90 min). The median estimated blood loss was 25 mL (range 25-50 mL). The median visual analog scale score was 1 on postoperative day 1. None of the patients required narcotic pain medications beyond postoperative day 2. Intestinal function recovered on postoperative day 1-3. There was no intraoperative or postoperative complication in any of the patients. During the follow-up visits, all the patients were in good condition. All the patients reported unaltered sexual function after surgery by the Female Sexual Function Index questionnaire. Our initial experience suggests that pure transvaginal natural orifice translumenal endoscopic surgery renal cyst decortication is feasible and safe in selected patients. © 2013 The Japanese Urological Association.

  7. Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: A case series

    Directory of Open Access Journals (Sweden)

    Luciano A. Nunez Bragayrac

    2014-12-01

    Full Text Available Objective To describe a novel technique of repairing the VVF using the transperitoneal-transvaginal approach. Materials and Methods From June 2011 to October 2013, four patients with symptoms of urine leakage in the vagina underwent robotic repair of VVF with the transperitoneal-transvaginal approach. Cystoscopy revealed the fistula opening on the bladder. A ureteral stent was placed through the fistulous tract. After trocar placement, the omental flap was prepared and mobilized robotically. The vagina was identified and incised. The fistulous tract was excised. Cystorrhaphy was performed in two layers in an interrupted fashion. The vaginal opening was closed with running stitches. The omentum was interposed and anchored between the bladder and vagina. Finally, the ureteral catheters were removed in case they have been placed, and an 18 Fr urethral catheter was removed on the 14th postoperative day. Results The mean age was 46 years (range: 41 to 52 years. The mean fistula diameter was 1.5 cm (range 0.3 to 2 cm. The mean operative time was 117.5 min (range: 100 to 150 min. The estimated blood loss was 100 mL (range: 50 to 150 mL. The mean hospital stay was 1.75 days (range: 1 to 3 days. The mean Foley catheter duration was 15.75 days (range: 10 to 25 days. There was no evidence of recurrence in any of the cases. Conclusions The robot-assisted laparoscopic transperitoneal transvaginal approach for VVF is a feasible procedure when the fistula tract is identified by first intentionally opening the vagina, thereby minimizing the bladder incision and with low morbidity.

  8. Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: a case series.

    Science.gov (United States)

    Bragayrac, Luciano A Nunez; Azhar, Raed A; Fernandez, Golena; Cabrera, Marino; Saenz, Eric; Machuca, Victor; Andrade, Robert de; Carmona, Oswaldo; Sotelo, Rene

    2014-01-01

    To describe a novel technique of repairing the VVF using the transperitoneal-transvaginal approach. From June 2011 to October 2013, four patients with symptoms of urine leakage in the vagina underwent robotic repair of VVF with the transperitoneal-transvaginal approach. Cystoscopy revealed the fistula opening on the bladder. A ureteral stent was placed through the fistulous tract. After trocar placement, the omental flap was prepared and mobilized robotically. The vagina was identified and incised. The fistulous tract was excised. Cystorrhaphy was performed in two layers in an interrupted fashion. The vaginal opening was closed with running stitches. The omentum was interposed and anchored between the bladder and vagina. Finally, the ureteral catheters were removed in case they have been placed, and an 18 Fr urethral catheter was removed on the 14th postoperative day. The mean age was 46 years (range: 41 to 52 years). The mean fistula diameter was 1.5 cm (range 0.3 to 2 cm). The mean operative time was 117.5 min (range: 100 to 150 min). The estimated blood loss was 100 mL (range: 50 to 150 mL). The mean hospital stay was 1.75 days (range: 1 to 3 days). The mean Foley catheter duration was 15.75 days (range: 10 to 25 days). There was no evidence of recurrence in any of the cases. The robot-assisted laparoscopic transperitoneal transvaginal approach for VVF is a feasible procedure when the fistula tract is identified by first intentionally opening the vagina, thereby minimizing the bladder incision and with low morbidity.

  9. Drug-Induced Thrombocytopenia following a Transvaginal Oocyte Retrieval for In Vitro Fertilization

    Directory of Open Access Journals (Sweden)

    Ioanna A. Comstock

    2015-01-01

    Full Text Available Drug-induced immune thrombocytopenia has been associated with hundreds of medications and can lead to devastating consequences for the patient. We present a case of a healthy 33-year-old female undergoing in vitro fertilization who developed a severe drug-induced thrombocytopenia, petechiae, and a large hemoperitoneum after receiving Cefazolin antibiotic prophylaxis for a transvaginal oocyte retrieval. The patient was admitted to the intensive care unit for resuscitation with blood products. The presence of drug-dependent platelet antibodies to Cefazolin was confirmed serologically.

  10. Drug-Induced Thrombocytopenia following a Transvaginal Oocyte Retrieval for In Vitro Fertilization.

    Science.gov (United States)

    Comstock, Ioanna A; Longmire, Michelle; Aster, Richard H; Milki, Amin A

    2015-01-01

    Drug-induced immune thrombocytopenia has been associated with hundreds of medications and can lead to devastating consequences for the patient. We present a case of a healthy 33-year-old female undergoing in vitro fertilization who developed a severe drug-induced thrombocytopenia, petechiae, and a large hemoperitoneum after receiving Cefazolin antibiotic prophylaxis for a transvaginal oocyte retrieval. The patient was admitted to the intensive care unit for resuscitation with blood products. The presence of drug-dependent platelet antibodies to Cefazolin was confirmed serologically.

  11. Modification of the hand-held Vscan ultrasound and verification of its performance for transvaginal applications.

    Science.gov (United States)

    Troyano Luque, J M; Ferrer-Roca, O; Barco-Marcellán, M J; Sabatel López, R; Pérez-Medina, T; Pérez-Lopez, F R

    2013-01-01

    The purpose of this work was to validate a new clinical obstetrics and gynecology (OB-GYN) application for a hand-held ultrasound (US) device. We modified the smallest hand-held device on the market and tested the system for transvaginal (TV) use. This device was originally conceived for abdominal scanning only. The validation involved 80 successive patients examined by the same operator: 25 obstetric and 55 gynecologic cases. US examination was performed transvaginally with two US systems: the hand-held Vscan (General Electrics; GE Vingmed Ultrasound; Norway) for which an intravaginal gadget TTGP-2010® (Troyano transvaginal gadget probe) was designed, and the Voluson 730 Expert (multifrequency transvaginal ultrasound of 3-9MHz; GE Healthcare, Milwaukee, WI, USA). We performed the same measurements with both US systems in order to confirm whether or not their diagnostic capability was similar. Quantitative difference in measurements between the systems was assessed, as well as the overall diagnostic detection rate and suitability for telemedicine. Regarding lesion visibility with Vscan, optimal distance was 8-16cm depending on the examination type, and the total detection rate was 98.7%. The exception was an ovarian endometrioma, diagnosed as a follicular cyst using the hand-held device. Assessment of reproducibility in 180 measurements showed that the measurements obtained with Vscan were 0.3-0.4cm lower than those obtained with the high resolution US device (Voluson 730 Expert). Nevertheless, Pearson's correlation coefficient was high for biparietal diameter (0.72) and gynecological (GYN) (0.99) measurements, and for overall correlation (0.997). Image transport on USB and SD-flash cards proved convenient for telemedicine. A novel TV application of a hand-held US device is demonstrated for OB-GYN. Heart, abdominal and obstetrics presets of the Vscan together with color-Doppler enable a detection capability comparable to that of a high-definition US device. The

  12. Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    OpenAIRE

    Adriana Bittencourt Campaner; Sebastião Piato; Paulo Ayrosa Galvão Ribeiro; Tsutomo Aoki; Ricardo da Fonseca Nadais; Roberto Adelino de Almeida Prado

    2004-01-01

    OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19%) recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangram...

  13. Randomized Clinical Trial of Virtual Reality Simulation Training for Transvaginal Gynecologic Ultrasound Skills.

    Science.gov (United States)

    Chao, Coline; Chalouhi, Gihad E; Bouhanna, Philippe; Ville, Yves; Dommergues, Marc

    2015-09-01

    To compare the impact of virtual reality simulation training and theoretical teaching on the ability of inexperienced trainees to produce adequate virtual transvaginal ultrasound images. We conducted a randomized controlled trial with parallel groups. Participants included inexperienced residents starting a training program in Paris. The intervention consisted of 40 minutes of virtual reality simulation training using a haptic transvaginal simulator versus 40 minutes of conventional teaching including a conference with slides and videos and answers to the students' questions. The outcome was a 19-point image quality score calculated from a set of 4 images (sagittal and coronal views of the uterus and left and right ovaries) produced by trainees immediately after the intervention, using the same simulator on which a new virtual patient had been uploaded. Experts assessed the outcome on stored images, presented in a random order, 2 months after the trial was completed. They were blinded to group assignment. The hypothesis was an improved outcome in the intervention group. Randomization was 1 to 1. The mean score was significantly greater in the simulation group (n = 16; mean score, 12; SEM, 0.8) than the control group (n = 18; mean score, 9; SEM, 1.0; P= .0302). The quality of virtual vaginal images produced by inexperienced trainees was greater immediately after a single virtual reality simulation training session than after a single theoretical teaching session. © 2015 by the American Institute of Ultrasound in Medicine.

  14. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    Directory of Open Access Journals (Sweden)

    Argirović Rajka

    2011-01-01

    Full Text Available Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA. Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. Results. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13% patients isolated anterior mesh in 52 (54% patients and isolated posterior mesh in 32 (33% patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3% patients, shrinkage of mesh in 6 (6.2% patients and de novo urinary incontinence in 5 (5.2% patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic. Conclusion. Our study suggests that transvaginal polypropylene mesh applied with a tensionfree technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.

  15. The role and contribution of transvaginal endoscopy to diagnostics and treatment of infertility

    Directory of Open Access Journals (Sweden)

    Kopitović Vesna

    2013-01-01

    Full Text Available Transvaginal endoscopy (TVE presents minimal invasive endoscopic method that involves hysteroscopy, transvaginal laparoscopy and salpingoscopy. It gives a new approach to both basic evaluation of marital infertility and its treatment. The role of TVE is a subject of controversies regarding its justification as standard infertility treatment. Another aspect is a role of TVE prior to methods of assisted reproductive technologies (ART. The aim of this paper was to try, through the analysis of the available literature, to clarify the role of TVE in reproductive medicine, as well as to show our experience. The concept of one­day diagnostics, which is so­called one stop fertility clinic, is performed in the Clinical Center of Vojvodina, Department of Gynecology and Obstetrics on a daily basis. It consists of history, gynecology and ultrasound exam, spermiogram, hormone tests, and TVE. Patients are informed about results on the very same day and advised on the proper infertility treatment. By forming the infertility diagnostics protocols, which use the methods of TVE, we consider it possible to evaluate adequately and accurately the fertility within the shortest possible time. It replaced standard laparoscopy in certain indication fields; it eventually confirmed the necessity of its use in recurrent IVF implantation failure, raising the question of its routine use prior to the first IVF cycle that is a topic requiring further randomized trials.

  16. Transvaginal cholecystectomy: effect on quality of life and female sexual function.

    Science.gov (United States)

    Wood, Stephanie G; Solomon, Daniel; Panait, Lucian; Bell, Robert L; Duffy, Andrew J; Roberts, Kurt E

    2013-05-01

    Transvaginal cholecystectomy (TVC) is the leading natural orifice transluminal endoscopic surgery to date and has the potential to offer improved cosmesis, less pain, and shorter recovery times for female patients. To investigate quality of life and female sexual function in our patients undergoing TVC. A prospective cohort study from August 14, 2009, to June 12, 2012, of TVCs performed at our institution to date. Tertiary academic referral center. The first 47 consecutive female patients (aged 18-65 years) who received a TVC by a single surgeon. A hybrid TVC was performed by a 5-mm umbilical trocar and a 12-mm transvaginal trocar with standard laparoscopic instruments. Quality-of-life index (36-Item Short Form Health Survey) and female sexual function (Female Sexual Function Index) scores. A total of 47 TVCs were performed, with a mean age of 39 years, mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 31, and mean operative time of 65 minutes. No difference was noted in overall female sexual function from preoperatively to 1 and 3 months postoperatively. When comparing quality of life preoperatively vs 1 and 3 months postoperatively, there were significant improvements in physical function (P = .02), energy and fatigue (P = .001), emotional well-being (P = .01), pain (P sexual function is unchanged and quality of life either is unchanged or improves at 1 and 3 months following TVC. Undergoing TVC does not appear to negatively affect female sexual function or quality of life in the short term.

  17. Transvaginal ultrasound assessment of women presenting with infertility and menstrual irregularity in Calabar, Nigeria.

    Science.gov (United States)

    Ikpeme, A A; Udo, A E; Ani, N E

    2014-09-01

    This study was designed to document the Transvaginal Scan (TVS) findings in women presenting with infertility and menstrual irregularities at the University of Calabar Teaching Hospital. Subjects were women of reproductive age presenting at the University of Calabar Teaching Hospital with menstrual irregularities and infertility over a two year period, February 2011-January 2013. As part of their management, transvaginal scans were done and findings included a substantial number with polycystic ovarian cysts. Therefore the ovaries were further analysed with controls. Out of seventy-one women with age distribution of 22 to 46years, twenty- four(33.8%) presented with infertility, the rest presented with either menstrual irregularity alone or in combination with infertility. Polycystic ovaries (PCO), chronic pelvic inflammatory disease and fibroids were the main pathologies seen. PCO was by far the commonest. Ovarian volumes and follicular numbers were significantly higher in women with PCO than in controls, whereas their average follicular sizes were lower. PCO is the major finding in women with menstrual irregularity and infertility in the Calabar area. This hitherto poorly recorded pathology should be actively investigated in women representing with these symptoms by the use of TVS.

  18. Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

    Directory of Open Access Journals (Sweden)

    Hajishaiha M

    2011-10-01

    Full Text Available Masomeh Hajishaiha1, Mohammad Ghasemi-rad2, Nazila Karimpour1, Nikol Mladkova3, Farzaneh Boromand11Department of Gynecology, 2Student Research Committee (SRC, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran; 3Institute of Cell and Molecular Science, London, UKPurpose: Intrauterine lesions (IULs are a common finding in women of reproductive age, particularly infertile women. Transvaginal sonography (TVS is a popular tool for IUL detection, but there are conflicting data with respect to its accuracy.Methods: Five hundred and six women were enrolled into the study. Of these, 496 underwent hysterosalpingography and subsequent TVS six different times during the course of their menstrual cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG and hysteroscopy.Results: Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early luteal phase (days 16–19 of the menstrual cycle. Accuracy of TVS during different phases was largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine adhesions in two patients.Conclusion: Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle phase, with the ovulatory and early luteal phase being the optimal time for this examination.Keywords: menstrual cycle phase, space occupying lesions, transvaginal sonography

  19. Measuring leading placental edge to internal cervical os: Transabdominal versus transvaginal approach

    DEFF Research Database (Denmark)

    Westerway, Susan Campbell; Hyett, Jon; Henning Pedersen, Lars

    2017-01-01

    We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra-/interobserver var...... characteristics area between gestational weeks 16–23 was 0.81 (95% CI: 0.76–0.86). Conclusion The TA approach has a low sensitivity for detecting a low-lying placenta as choosing a TA cut-off with sensitivity >90% will decrease the specificity to 50%.......We aimed to compare the value of transabdominal (TA) and transvaginal (TV) approaches for assessing the risk of a low-lying placenta. This involved a comparison of TA and TV measurements between the leading placental edge and the internal cervical os. We also assessed the intra......-/interobserver variation for these measurements and the efficacy of TA measures in screening for a low placenta. Methodology Transabdominal and TV measurements of the leading placental edge to the internal cervical os were performed on 369 consecutive pregnancies of 16–41 weeks' gestation. The difference (TA-TV) from...

  20. Digital and transvaginal ultrasound cervical assessment for prediction of successful labor induction.

    Science.gov (United States)

    Tanir, H M; Sener, T; Yildiz, Z

    2008-01-01

    To compare the values of preinduction transvaginal cervical length measurements and Bishop score to predict successful labor induction. A prospective, observational trial of nulliparous women undergoing labor induction. Inclusion criteria were gestational age between 36 and 42 weeks, singleton cephalic presentation of the fetus, and intact membranes. Preinduction cervical ripening was performed using 25 microg intravaginal misoprostol (PGE1), repeated every 4 h, up to a maximum of 3 doses. Induction was subsequently continued by oxytocin and amniotomy. A total of 43 women met the inclusion criteria. Mean preinduction cervical length for women with successful or failed labor induction was 26 mm (95% Confidence interval [CI], 27-32) and 34 mm (95% CI, 33-38), respectively (P=0.002). Mean Bishop scores for successful and failed induction groups were 5.4 (95% CI, 5.2-6.2) and 3.1 (95% CI, 2.8-3.5), respectively (P=0.003). Digital examination and transvaginal ultrasound of the cervix predict successful labor induction with reasonable accuracy.

  1. Comparison of two- and three-dimensional transvaginal ultrasound in the visualisation of intrauterine devices.

    Science.gov (United States)

    Kerr, N K; Dunham, R; Wolstenhulme, S; Wilson, J

    2014-08-01

    The aims of the study were to evaluate whether three-dimensional transvaginal ultrasound (3D TV US) is superior to two-dimensional transvaginal ultrasound (2D TV US) at visualising intrauterine devices and determining their position. This prospective study included 52 participants with an intrauterine device fitted, who underwent 2D TV US and 3D TV US. 2D TV US and 3D-reconstructed coronal images were reviewed by two gynaecological radiologists to assess ease of visualisation and position of the intrauterine devices. Statistical analysis was performed using Wilcoxon signed-rank, McNemar and Chi-squared tests. The inter-observer agreement was measured using Cohen's Kappa. Intrauterine device visualisation scores were significantly higher with 2D TV US compared with 3D TV US (Radiologist 1 p = visualise an intrauterine device better than 2D TV US. The 3D-reconstructed coronal image of the uterus can reliably display cases of T-arm perforation into the adjacent myometrium, which could be missed on 2D TV US images. The 3D TV US should be used in addition to 2D TV US in all cases where an intrauterine device is under evaluation.

  2. Spontaneous heating

    Science.gov (United States)

    Increased use of large-rectangular or large-round balers has been observed throughout the US. In part, this move away from small (100-lb) rectangular hay bales has occurred because of the high cost and limited availability of labor required to handle these bales. Although the efficiency of harvest i...

  3. Spontaneous Fracture and Vaginal Expulsion of the Arm of Intra-Uterine Device: Case Report

    Directory of Open Access Journals (Sweden)

    Ižlknur Mutlu

    2016-04-01

    Full Text Available Intrauterine device (IUD is an effective and safe contraceptive method which is commonly used worldwide. However, spontaneous or iatrogenic IUD fracture was rarely occurred during usage. We present the case about spontaneous fracture of one arm of copper IUD and the spontaneous expulsion of the broken piece in a 30-year-old woman 2 years after insertion. The patient recoursed to our clinic due to finding of a foreign body at vaginal outlet. Copper IUD was dislocated in transvaginal ultrasonographic (TVUSG examination and echogenicity of left transverse arm was not identified in transvers section.Although IUD fracture seems rarely, it must be born in mind especially when dislocation exists. Distance to fundus and its location, besides the continuity of its echogenicity and integrity should be observed during routine controls.

  4. How to identify twins at low risk of spontaneous preterm delivery

    DEFF Research Database (Denmark)

    Sperling, Lene; Kiil, C; Larsen, L U

    2005-01-01

    OBJECTIVE: The aim of this study was to evaluate transvaginal sonographic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery...... delivery at different cut-off levels of cervical length were determined. RESULTS: Eighty-nine percent of the twins had dichorionic placentation and 58% were conceived after assisted reproduction. The rate of spontaneous preterm delivery was 2.3% (1.5% for dichorionic (DC) and 9.1% for (MC) monochorionic...... twins) before 28 weeks and 18.5% (17.1% for DC and 29.5% for MC twins) before 35 weeks. The screen-positive rate was 5% for a cervical length

  5. Optical antenna enhanced spontaneous emission.

    Science.gov (United States)

    Eggleston, Michael S; Messer, Kevin; Zhang, Liming; Yablonovitch, Eli; Wu, Ming C

    2015-02-10

    Atoms and molecules are too small to act as efficient antennas for their own emission wavelengths. By providing an external optical antenna, the balance can be shifted; spontaneous emission could become faster than stimulated emission, which is handicapped by practically achievable pump intensities. In our experiments, InGaAsP nanorods emitting at ∼ 200 THz optical frequency show a spontaneous emission intensity enhancement of 35 × corresponding to a spontaneous emission rate speedup ∼ 115 ×, for antenna gap spacing, d = 40 nm. Classical antenna theory predicts ∼ 2,500 × spontaneous emission speedup at d ∼ 10 nm, proportional to 1/d(2). Unfortunately, at d < 10 nm, antenna efficiency drops below 50%, owing to optical spreading resistance, exacerbated by the anomalous skin effect (electron surface collisions). Quantum dipole oscillations in the emitter excited state produce an optical ac equivalent circuit current, I(o) = qω|x(o)|/d, feeding the antenna-enhanced spontaneous emission, where q|x(o)| is the dipole matrix element. Despite the quantum-mechanical origin of the drive current, antenna theory makes no reference to the Purcell effect nor to local density of states models. Moreover, plasmonic effects are minor at 200 THz, producing only a small shift of antenna resonance frequency.

  6. The Effects of Simulation-based Transvaginal Ultrasound Training on Quality and Efficiency of Care

    DEFF Research Database (Denmark)

    Tolsgaard, Martin Grønnebæk; Ringsted, Charlotte; Rosthøj, Susanne

    2017-01-01

    OBJECTIVE: To explore the effect of adding simulation-based transvaginal ultrasound training to trainees' clinical training compared with only clinical training on quality of and efficiency of care. BACKGROUND: Simulation-based ultrasound training may be an effective adjunct to clinical training......, but no studies have examined its effects on quality and efficiency of care. METHODS: Trainees from 4 University Hospitals in East Denmark were included (N = 54). Participants were randomized to either simulation-based ultrasound training and clinical training (intervention group, n = 28), or to clinical training......, 33.5-55.1) and 19.8% (95% CI, 4.1-32.9) in the intervention and control group, respectively (P = 0.005). CONCLUSIONS: Simulation-based ultrasound training improved quality of care and reduced the need for repeated patient examination and trainee supervision....

  7. Transvaginal coloanal anastomosis after rectal resection for the treatment of a rectovaginal fistula induced by radiation.

    Science.gov (United States)

    Brezean, I

    2014-01-01

    Although decreasing in number, radiation induced rectovaginal fistulas are caused by some radiation injuries and chronic ischemic lesions. Most of the experienced authors recommend anterior rectal resection with coloanal anastomosis accessed through the abdominal-perineum area for high fistula. We present a patient with a fistula that developed 23 years after hysterectomy and radiotherapy. In this case we performed an abdominal-transvaginal rectal resection with transverse coloplastypouch, coloanal anastomosis and protection ileostomy three months after a terminal sigmoidostomy. The dissection of the distal rectum by posteriour colpotomy and coloanal transvaginalan astomosis is a technical variant that may prove advantage ous compared to the procedures featured in the literature as solutions by rectal resection for rectovaginal fistula. Celsius.

  8. Transvaginal natural-orifice transluminal endoscopic surgery: a new approach to myomectomy.

    Science.gov (United States)

    Baekelandt, Jan

    2018-01-01

    To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. Stepwise explanation of the technique with the use of original video footage. Hospital. Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. In case of a posterior myoma, a 2.5-cm posterior colpotomy was made under general anesthesia. The pouch of Douglas was opened and a vNOTES port was inserted transvaginally. In case of an anterior myoma, an anterior colpotomy was made and the peritoneum was opened between the uterus and the bladder. A vNOTES port was inserted transvaginally. A pneumoperitoneum was created and the myoma was identified. With the use of conventional endoscopic instruments and a standard endoscope, all inserted through the vNOTES port, the uterine serosa was incised over the myoma and the myoma was resected. After achieving hemostasis the uterine scar was sutured in two layers with the use of a standard absorbable suture or an autolocking suture. An adhesion-preventing barrier was applied over the uterine scar. The myoma was removed through the colpotomy in an endobag. The vNOTES port was removed and the colpotomy was sutured with the use of an absorbable suture. The following data were collected: age, body mass index, number of previous abdominal procedures, myoma size, myoma weight, operating time, length of hospital stay, visual analog scale pain score, and serum hemoglobin drop. Successful minimally invasive myomectomy via vNOTES without abdominal scars. All fibroids were successfully removed via vNOTES without complications or conversions to standard laparoscopy. No peri- or postoperative complications occurred. All patients were discharged within 24 hours, two of them within 12 hours. Anterior myomas can be resected through an anterior colpotomy and posterior myomas can be resected through a posterior colpotomy via the pouch

  9. Transvaginal Ultrasound in Fertile Patients with Suspected Appendicitis: An Experience Report of Current Practice

    Directory of Open Access Journals (Sweden)

    Malek Tabbara

    2012-01-01

    Full Text Available Background. Transvaginal ultrasound (TVU in female patients with acute right lower quadrant (RLQ abdominal pain is time and infrastructure intensive and not always available. This study aims to evaluate the role of TVU in these patients. Methods. Retrospective analysis identified 224 female patients with RLQ pain and TVU. Results. TVU revealed an underlying pathology in 34 (15% patients, necessitating a diagnostic laparoscopy in 12 patients. Six patients (2% had a true gynaecological emergency. The remaining 23 patients did not require surgery. The other 190 patients with RLQ pain had a bland TVU; 127 (67% were discharged, while 63 patients (33% received a diagnostic laparoscopy. Conclusion. The incidence of true gynaecological emergencies requiring urgent surgical intervention is very low in our patient cohort. TVU is a helpful tool if performed by a physician who is well trained in TVU.

  10. Off ice Hysteroscopy in Patients with Abnormal Uterine Bleeding and Normal Transvaginal Sonography

    Directory of Open Access Journals (Sweden)

    Mojgan Barati

    2008-01-01

    Full Text Available Background: Abnormal uterine bleeding (AUB is one of the most common clinical problemsin gynecology. Transvaginal sonography (TVS and hysteroscopy are two diagnostic methods forpatients with AUB. For most of the patients with AUB, diagnostic hysteroscopy can be done inclinic with minimal discomfort and much lower expense than operative room.Materials and Methods: In our clinical trial study, from March 21, 2005 to March 20, 2007,patients with AUB in Ahwaz Imam Khomayni hospital, after history and physical examinationsunderwent TVS. Of those, 147 patients with normal TVS entered the study and were considered foroutpatient hysteroscopy. Patients with endometrial cavity lesion were scheduled for operation room,and those with empty endometrial cavity aspiration biopsy were done outpatiently. Specimens weresent to pathologist for examination.Results: All the patients were divided into three groups: group 1 or minority was under 30 yearsold (7 women, group 2 was 30-40 years, and group 3 or majority was over 40 years old (96women. 115 patients (78.2% had normal and 32 patients (21.8% had abnormal hysteroscopicresults. 116 patients (78.8% had normal and 31 patients (21.2% had abnormal pathologic results;moreover, cervical canal polyp was the most common lesion hysteroscopically and pathologicallyin all groups.Conclusion: Of 147 patients (100% with AUB and normal TVS, 32 patients (21.8% wereabnormal hysteroscopically. Cervical canal polyps may be missed by transvaginal sonography, butcan be diagnosed by hysteroscopy. In patients with AUB and normal TVS, hysteroscopy can beused as the second step.

  11. Office hysteroscopy, transvaginal ultrasound and endometrial histology: a comparison in infertile patients

    Directory of Open Access Journals (Sweden)

    Devleta Balić

    2011-05-01

    Full Text Available Objective. To evaluate accuracy of transvaginal sonography (TVS and hysteroscopy in detection of intrauterine pathology in infertile women. Subjects and methods. This retrospective study was conducted in 56 infertile women with abnormal transvaginal ultrasound findings of the uterine cavity which was performed during the midfollicular phase as a part of routine infertility workup. Hysteroscopy was performed between 6th and 10th day of cycle. Results. The mean age of the subjects was 31.9±4.0. The most frequent ultrasound finding was endometrial polyp in 34 (60.7% patients, septate uterus in 8 (14.3% patients, submucosal myoma in 7 (12.5% patients, endometrial hyperplasia in 5 (8.9% patients and Syndroma Ascherman in 2 (3.6% patients. Hysteroscopy confirmed 20 (35.7% polyps, the same number of myomas, septate uterus and Syndroma Ascherman as detected by ultrasound, (7 (12.5%, 8 (14.3% and 2 (3.6%, respectively and 19 (33.9% endometrial hyperplasia. In 46 women with histological excamination, the sensitivity of TVS and hysteroscopy in the diagnosis of endometrial polyps were identical - 100%, while the specificity was higher in hysteroscopy than in TVS (92.3% versus 56.4%, p<0.001. The sensitivity of TVS in the diagnosis of endometrial hyperplasia was higher than that of hysteroscopy (86.4% versus 22.7%, p<0.001, while specificity was identical, of 100%. Accordance between hysteroscopy and histology was good (k=0.79, between ultrasound and histology was moderete (k=0.59. Conclusion. Hysteroscopy appeared to be more reliable in diagnosis than TVS. The use of a high frequency ultrasound probe leads us to a lack of diagnostic clarity between endometrial polyps and hyperplasia.

  12. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats.

    Science.gov (United States)

    Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Kleinschnitz, Christoph; Schreiber, Stefanie

    2013-01-01

    Human cerebral small vessel disease (CSVD) has distinct histopathologic and imaging findings in its advanced stages. In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood-brain barrier and an activated coagulatory state resulting in capillary and arteriolar erythrocyte accumulations (stases). In the present study, we investigated whether initial microvascular dysfunction and other stages of the pathologic CSVD cascade can be detected by serial magnetic resonance imaging (MRI). Fourteen SHRSP and three control (Wistar) rats (aged 26-44 weeks) were investigated biweekly by 3.0 Tesla (3 T) MRI. After perfusion, brains were stained with hematoxylin-eosin and histology was correlated with MRI data. Three SHRSP developed terminal CSVD stages including cortical, hippocampal, and striatal infarcts and macrohemorrhages, which could be detected consistently by MRI. Corresponding histology showed small vessel thromboses and increased numbers of small perivascular bleeds in the infarcted areas. However, 3 T MRI failed to visualize intravascular erythrocyte accumulations, even in those brain regions with the highest densities of affected vessels and the largest vessels affected by stases, as well as failing to detect small perivascular bleeds. Serial MRI at a field strength of 3 T failed to detect the initial microvascular dysfunction and subsequent small perivascular bleeds in SHRSP; only terminal stages of cerebral microangiopathy were reliably detected. Further investigations at higher magnetic field strengths (7 T) using blood- and flow-sensitive sequences are currently underway.

  13. Transvaginal ultrasonographic measurement of cervical length in asymptomatic high-risk women with a short cervical length in the previous pregnancy.

    Science.gov (United States)

    Crane, J M G; Hutchens, D

    2011-07-01

    To determine if asymptomatic women at high risk of preterm delivery who had a short cervical length in their previous pregnancy and delivered at term are at increased risk of having a short cervical length in their next pregnancy, and whether they are at increased risk of preterm birth. This retrospective cohort study included high-risk (those with a history of spontaneous preterm birth, uterine anomaly or excisional treatment for cervical dysplasia) asymptomatic women who were pregnant with a singleton gestation delivering between April 2003 and March 2010, who had had a previous pregnancy and who had transvaginal ultrasonographic cervical length measurement performed at 16-30 weeks' gestation in both pregnancies. Comparison was among women who had a short cervical length (pregnancy but delivered at term in that pregnancy (Short Term Group), women with a history of a normal cervical length (≥ 3.0 cm) in their previous pregnancy delivering at term (Long Term Group), and women who had a short cervical length (pregnancy delivering preterm (Short Preterm Group). Primary outcomes were spontaneous preterm birth at pregnancy compared with those in the Long Term Group (10/23 (43.5%) vs. 4/26 (15.4%), respectively) but not as likely as women in the Short Preterm Group (9/13 (69.2%); P=0.003). Women in the Short Term Group were not at an increased risk of spontaneous preterm birth at pregnancy compared with women in the Long Term Group (2/23 (8.7%) vs. 2/26 (7.7%), respectively), but women in the Short Preterm Group were at an increased risk (6/13 (46.2%); Prisk of threatened preterm labor (6/23 (26.1%) and 4/26 (15.4%) vs. 9/13 (69.2%), respectively; P=0.002) and of receiving corticosteroids for fetal lung maturation (6/23 (26.1%) and 4/26 (15.4%) vs. 11/13 (84.6%), respectively; Phigh-risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at increased risk of having a short cervix in their next pregnancy, they are not

  14. Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Yi-Hung Sun

    2017-05-01

    Conclusion: Patients with POP at an advanced stage during peritoneal dialysis who failed to be treated conservatively may require a surgical intervention. Uterus-sparing transvaginal mesh was a feasible minimal invasive option.

  15. High frequency of spontaneous acute myocardial infarction due to small coronary artery disease in dead (NZWxBXSB)F1 male mice.

    OpenAIRE

    Takemura, G; Fujiwara, H.; Yoshida, H; D.J. Wu; Matsuda, M.; Ishida, M.; Kawamura, A.; Fujiwara, T.; Kawai, C

    1989-01-01

    To determine whether or not male (NZWXBXSB)F1 [WXB)F1) mice exhibiting a lupus-like syndrome died of acute myocardial infarction (MI), and whether acute MI is directly related to small coronary artery disease, acute and old MIs were examined histologically in 55 dead (WXB)F1 male mice and 30 age-matched, surviving (WXB)F1 male mice used as a control group. In each heart from the 15 dead mice with MI and the five surviving mice without MI, 300 to 400 5-microns-thick serial sections were made; ...

  16. A case of laparoscopic surgery for endometrial cancer in a patient previously treated with a transvaginal mesh procedure for pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Kiyoshi Yoshino

    2017-11-01

    Full Text Available Transvaginal mesh (TVM surgery is an effective treatment option for women with pelvic organ prolapse (POP. Because the TVM procedure preserves the uterus, it is possible for endometrial cancer to occur at a later date. We herein present the first report of such an endometrial cancer, diagnosed well after TVM surgery for POP, and the use of laparoscopic surgery to conduct a simple total hysterectomy to treat it. Keywords: endometrial cancer, laparoscopic surgery, pelvic organ prolapse, transvaginal mesh

  17. Retrospective cine 3He ventilation imaging under spontaneous breathing conditions: a non-invasive protocol for small-animal lung function imaging.

    Science.gov (United States)

    Stupar, Vasile; Canet-Soulas, Emmanuelle; Gaillard, Sophie; Alsaid, Hasan; Beckmann, Nicolau; Crémillieux, Yannick

    2007-04-01

    A non-invasive and free-breathing hyperpolarized (HP) (3)He imaging protocol for small animals was implemented and validated on rats for lung function imaging. Animals were allowed to breathe a mixture of air and (3)He from a mask and a gas reservoir fitted to their heads. Radial imaging sequences were used, and MRI signal intensity changes were monitored for retrospective cine image reconstruction. The ventilation cycle of the animals was imaged with a 100 ms temporal resolution. The sliding window imaging technique was applied to reconstruct 5 ms time-shifted image series covering the complete breathing cycle. Image series were processed to extract quantitative ventilation parameters such as the gas arrival time. The reproducibility and the non-invasiveness of this ventilation imaging protocol were evaluated by multiple acquisitions on the same animals. c 2006 John Wiley & Sons, Ltd.

  18. Local management with methotrexate of cesarean scar ectopic pregnancy with live embryo guided by transvaginal ultrasound: A case report.

    Science.gov (United States)

    Leite, Juliana de Freitas; Fraietta, Renato; Elito Júnior, Júlio

    2016-04-01

    Cesarean scar ectopic pregnancy is a rare type of ectopic pregnancy with high morbidity and mortality. Use of conservative conducts, including medical management with methotrexate, has avoided mutilating surgeries such as hysterectomy and spared the fertility of women. We report the case of a 30-year old patient with a cesarean scar ectopic pregnancy, with a live embryo, who was treated locally with transvaginal ultrasound-guided injection of methotrexate, complemented with various doses of systemic methotrexate.

  19. Hybrid Natural Orifice Translumenal Endoscopic Surgery Transvaginal Nephrectomy in a Low-Resource Setting.

    Science.gov (United States)

    Firaza, Paul Nimrod B; Lorenzo, Enrique Ian S; Bardelosa, Juan Godofredo R; Reyes, Edgardo L; Patron, Nelson A

    2016-02-01

    Hybrid natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) reduces the invasiveness of conventional laparoscopic surgery and overcomes the limitation of pure NOTES, especially in the absence of angulated instruments. The patients were 66-, 69-, and 32-year-old women with complaints of recurrent flank pain and urinary tract infection due to an obstructed nonfunctioning kidney. Materials used were standard laparoscopic instruments and a 30° 10-mm high-definition laparoscope. Under general anesthesia, each patient was placed in a lithotomy position with the affected side up at 45°. A Veress needle was initially inserted through the umbilicus and was later replaced with a 10-mm laparoscopic port, with an additional 5-mm port also inserted at the affected lower quadrant site. The patient was then positioned in a steep Trendelenburg position, and a 10-mm port was inserted through the posterior vaginal wall under direct vision from the abdominal cavity that was later used for the laparoscope. Nephrectomy proceeded despite noted severe adhesions, and the kidney was placed in the specimen retrieval bag. The vaginal port site was enlarged to 3 cm for extraction of the specimen. A Penrose drain was placed at the lower quadrant 5-mm trocar site. The vaginal wound was repaired using running 2-0 absorbable sutures. Three cases of transvaginal hybrid NOTES nephrectomy were successfully completed with a median operative time of 310 minutes and mean estimated blood loss of 300 mL. Median renal dimensions were as follows: craniocaudal, 10.2 (range, 10.6-9) cm; laterolateral, 6.5 (range, 7-5.3) cm; and anteroposterior, 4.8 (range, 6.5-3.9) cm. The patients resumed regular diet as early as Day 1 postoperatively. The drain was removed prior to discharge. The mean date of discharge was Day 3 postoperatively. There were no noted

  20. Female population perception of conventional laparoscopy, transumbilical LESS, and transvaginal NOTES for cholecystectomy.

    Science.gov (United States)

    Bucher, Pascal; Ostermann, Sandrine; Pugin, François; Morel, Philippe

    2011-07-01

    Recent population survey has shown a preference for transumbilical laparoendoscopic single-site surgery (U-LESS) compared with natural orifice transluminal endoscopic surgery (NOTES) for cholecystectomy, assuming similar surgical risk. This study was designed to evaluate the perception and preference of women regarding conventional laparoscopy, U-LESS, and transvaginal NOTES (TV-NOTES) with particular interest to access perception. An anonymous questionnaire on laparoscopic, U-LESS, and TV-NOTES cholecystectomy, without regards to risks or advantages, was given to female medical/paramedical staff (n=100), patients (n=100), and the general population (n=100). Women participants (median age, 35 (range, 16-79) years) were queried about preference, perception of the different accesses, and personal informations. Of the respondents, 54% had children, 79% had stable relationships, and 96% were sexually active (vaginal intercourse). With similar operative risk, 87% preferred U-LESS, 4% TV-NOTES and 8% laparoscopy. LESS/NOTES choice was influenced by a desire of improved cosmetics (82%) and lower pain (44%). 96% had worries regarding transvaginal access, among them: dyspareunia (68%), decreased sensibility during intercourse (43%), refuse of short-term sexual abstinence (40%), and infertility (23%). Transumbilical access evocated worries in 35%: umbilical pain (19%), postoperative umbilical sensibility (15%), and incisional hernia (11%). Postoperative intercourse abstinence after TV-NOTES evocated worries in 76% (defined as 3 weeks in survey): feel less attractive (40%), less feminine (32%), tension with their intimate (35%), lover non-acceptation (20%), possible abortion of new relationship (26%), and feel less comfortable socially (16%). The high acceptation rate for U-LESS approach compared with TV-NOTES may be related to fears regarding postoperative sexuality and fertility. The importance of temporary postoperative sexual abstinence (vaginal intercourse) is high and

  1. Repeatability and reproducibility of measurements of the suburethral tape location obtained in pelvic floor ultrasound performed with a transvaginal probe

    Directory of Open Access Journals (Sweden)

    Maria Magdalena Dresler

    2017-06-01

    Full Text Available Introduction: Implants used to treat patients with urogynecological conditions are well visible in US examination. The position of the suburethral tape (sling is determined in relation to the urethra or the pubic symphysis. Aim of the study: The study was aimed at assessing the accuracy of measurements determining suburethral tape location obtained in pelvic US examination performed with a transvaginal probe. Material and methods: The analysis covered the results of sonographic measurements obtained according to a standardized technique in women referred for urogynecological diagnostics. Data from a total of 68 patients were used to analyse the repeatability and reproducibility of results obtained on the same day. Results: The intraclass correlation coefficient for the repeatability and reproducibility of the sonographic measurements of suburethral tape location obtained with a transvaginal probe ranged from 0.6665 to 0.9911. The analysis of the measurements confirmed their consistency to be excellent or good. Conclusions: Excellent and good repeatability and reproducibility of the measurements of the suburethral tape location obtained in a pelvic ultrasound performed with a transvaginal probe confirm the test’s validity and usefulness for clinical and academic purposes.

  2. Spontaneous EEG activity and spontaneous emotion regulation.

    Science.gov (United States)

    Tortella-Feliu, M; Morillas-Romero, A; Balle, M; Llabrés, J; Bornas, X; Putman, P

    2014-12-01

    Variability in both frontal and parietal spontaneous EEG activity, using α and β band power and θ/β and δ/β ratios, was explored in a sample of 96 healthy volunteers as a potential correlate of individual differences in spontaneous emotion regulation (SER). Following a baseline EEG recording, participants were asked to continuously rate their discomfort while looking at affective pictures, as well as for a period of time after exposure. Greater spontaneous β band power in parietal locations, lower frontal and parietal δ/β ratios, and lower parietal θ/β ratio were associated with lower ratings of discomfort after the offset of unpleasant pictures. Moreover, lower parietal δ/β ratio was also related to less time needed to recover from discomfort after exposure to aversive pictures, while only a greater frontal and parietal α band power appeared to be associated with faster recovery from discomfort induced by normative-neutral pictures. However, parietal δ/β ratio was the only predictor of both minimum discomfort ratings and time needed to downregulate following exposure to unpleasant pictures, and frontal α band power the only spontaneous EEG index that predicted variability in spontaneous down-regulation after the exposure to normative-neutral pictures. Results are discussed focusing on the utility of diverse spontaneous EEG measures in several cortical regions when capturing trait-like individual differences in emotion regulation capabilities and processes. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Music Therapy on Anxiety, Stress and Maternal-fetal Attachment in Pregnant Women During Transvaginal Ultrasound.

    Science.gov (United States)

    Shin, Hye Sook; Kim, Ju Hee

    2011-03-01

    The purpose of this study was to examine the effects of music therapy on anxiety, stress and maternal-fetal attachment in pregnant women during a transvaginal ultrasound. This study was a nonequivalent control group nonsynchronized design. Pregnant women (n =232) were assigned to experimental (n= 117) and control (n =116) groups respectively. The data were collected from August 2 to 27, 2010. The experimental group received general prenatal care and single 30-minute session of music therapy, while the control group received only general prenatal care. Anxiety, stress, and maternal-fetal attachment was assessed using three self-report measures by State scale of the State-Trait Anxiety Inventory (1976), Pregnant women's stress scale of Ahn (1984) and Cranley's (1981) maternal-fetal attachment scale. The music therapy group showed statistically significant decrease in anxiety compared to control group but no significant difference was identified in stress and maternal-fetal attachment. The finding provides evidence for use of nursing intervention in prenatal care unit to reduce pregnant women's anxiety. Further research is necessary to test the benefits of music therapy with different frequency and duration. Copyright © 2011 Korean Society of Nursing Science. Published by Elsevier B.V. All rights reserved.

  4. Diagnostic Accuracy of Transvaginal Sonography in Infertile Patients with Endometrial Polyps

    Directory of Open Access Journals (Sweden)

    Maryam Niknejadi

    2010-01-01

    Full Text Available Background: To evaluate the diagnostic accuracy of transvaginal sonography (TVS in infertilepatients and compare its results with hysteroscopy, as the gold standard.Materials and Methods: A total of 679 infertile women who underwent both TVS and diagnostichysteroscopy were retrospectively investigated. TVS was performed in the mid-follicular phase(days 5-8 of their cycles. Sensitivity, specificity, and positive and negative predictive valueswere calculated for TVS.Results: Hysteroscopy diagnosed endometrial polyps in 197 out of 679 cases (24.5%. TVSconfirmed the hysteroscopy findings in 174 of 197 (88.3% cases. The sensitivity, specificity,and positive and negative predictive values of TVS compared to hysteroscopy in the detection ofendometrial polyps were 88.3%, 91.9%, 81.6% and 90.8%, respectively.Conclusion: TVS is both a cost-effective and non-invasive method for the diagnosis of intrauterinelesions such as polyps. When used in conjunction with a saline infusion, it can be a properalternative for diagnostic hysteroscopy that saves time and enables the surgeon to perform theoperative hystroscopy procedure with greater accuracy.

  5. Comparative Analysis of miRNAs and Their Target Transcripts between a Spontaneous Late-Ripening Sweet Orange Mutant and Its Wild-Type Using Small RNA and Degradome Sequencing.

    Science.gov (United States)

    Wu, Juxun; Zheng, Saisai; Feng, Guizhi; Yi, Hualin

    2016-01-01

    Fruit ripening in citrus is not well-understood at the molecular level. Knowledge of the regulatory mechanism of citrus fruit ripening at the post-transcriptional level in particular is lacking. Here, we comparatively analyzed the miRNAs and their target genes in a spontaneous late-ripening mutant, "Fengwan" sweet orange (MT) ( Citrus sinensis L. Osbeck), and its wild-type counterpart ("Fengjie 72-1," WT). Using high-throughput sequencing of small RNAs and RNA degradome tags, we identified 107 known and 21 novel miRNAs, as well as 225 target genes. A total of 24 miRNAs (16 known miRNAs and 8 novel miRNAs) were shown to be differentially expressed between MT and WT. The expression pattern of several key miRNAs and their target genes during citrus fruit development and ripening stages was examined. Csi-miR156k, csi-miR159, and csi-miR166d suppressed specific transcription factors ( GAMYBs, SPLs , and ATHBs ) that are supposed to be important regulators involved in citrus fruit development and ripening. In the present study, miRNA-mediated silencing of target genes was found under complicated and sensitive regulation in citrus fruit. The identification of miRNAs and their target genes provide new clues for future investigation of mechanisms that regulate citrus fruit ripening.

  6. Comparative analysis of miRNAs and their target transcripts between a spontaneous late-ripening sweet orange mutant and its wild-type using small RNA and degradome sequencing

    Directory of Open Access Journals (Sweden)

    Juxun Wu

    2016-09-01

    Full Text Available Fruit ripening in citrus is not well understood at the molecular level. Knowledge of the regulatory mechanism of citrus fruit ripening at the post-transcriptional level in particular is lacking. Here, we comparatively analyzed the miRNAs and their targeted genes in a spontaneous late-ripening mutant, ‘Fengwan’ sweet orange (MT (Citrus sinensis L. Osbeck, and its wild-type counterpart ('Fengjie 72-1', WT. Using high-throughput sequencing of small RNAs and RNA degradome tags, we identified 107 known and 21 novel miRNAs, as well as 225 target genes. A total of 24 miRNAs (16 known miRNAs and 8 novel miRNAs were shown to be differentially expressed between MT and WT. The expression pattern of several key miRNAs and their target genes during citrus fruit development and ripening stages was examined. Csi-miR156k, csi-miR159 and csi-miR166d suppressed specific transcription factors (GAMYBs, SPLs and ATHBs that are supposed to be important regulators involved in citrus fruit development and ripening. In the present study, miRNA-mediated silencing of target genes was found under complicated and sensitive regulation in citrus fruit. The identification of miRNAs and their target genes provide new clues for future investigation of mechanisms that regulate citrus fruit ripening.

  7. FEL gain optimisation and spontaneous radiation

    Energy Technology Data Exchange (ETDEWEB)

    Bali, L.M.; Srivastava, A.; Pandya, T.P. [Lucknow Univ. (India)] [and others

    1995-12-31

    Colson have evaluated FEL gains for small deviations from perfect electron beam injection, with radiation of the same polarisation as that of the wiggler fields. We find that for optimum gain the polarisation of the optical field should be the same as that of the spontaneous emission under these conditions. With a helical wiggler the axial oscillations resulting from small departures from perfect electron beam injection lead to injection dependent unequal amplitudes and phases of the spontaneous radiation in the two transverse directions. Viewed along the axis therefore the spontaneous emission is elliptically polarised. The azimuth of the ellipse varies with the difference of phase of the two transverse components of spontaneous emission but the eccentricity remains the same. With planar wigglers the spontaneous emission viewed in the axial direction is linearly polarised, again with an injection dependent azimuth. For optimum coherent gain of a radiation field its polarisation characteristics must be the same as those of the spontaneous radiation with both types of wiggler. Thus, with a helical wiggler and the data reported earlier, an increase of 10% in the FEL gain at the fundamental frequency and of 11% at the fifth harmonic has been calculated in the small gain per pass limit. Larger enhancements in gain may result from more favourable values of input parameters.

  8. Peritonitis - spontaneous bacterial

    Science.gov (United States)

    Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis ... who are on peritoneal dialysis for kidney failure. Peritonitis may have other causes . These include infection from ...

  9. MRI and "tenderness guided" transvaginal ultrasonography in the diagnosis of recto-sigmoid endometriosis.

    Science.gov (United States)

    Saba, Luca; Guerriero, Stefano; Sulcis, Rosa; Pilloni, Monica; Ajossa, Silvia; Melis, Gianbenedetto; Mallarini, Giorgio

    2012-02-01

    To compare the diagnostic accuracy of MRI and "tenderness-guided" transvaginal ultrasonography (tg-TVUS) in the identification of recto-sigmoid endometriosis. Institutional Review Board approval for this study was obtained, and written informed consent was given by all patients. This study is compliant with the STARD (Standards for Reporting of Diagnostic Accuracy) method. Fifty-nine patients (mean age, 33 years; range, 21-44 years) with clinical suspicion of deep pelvic endometriosis were prospectively enrolled. They underwent tg-TVUS and MRI before surgery. The characteristics of the MRI signal were analyzed. Mapping of recto-sigmoid endometriosis was performed and tg-TVUS and MR imaging results were compared with surgical and pathological findings. Sensitivity, specificity, and the positive and negative likelihood ratio (LR+ and LR-) were calculated. Inter-technique concordance was assessed using the Cohen statistic, and receiver operating characteristic (ROC) curves were obtained. Logistic regression analysis was performed. The prevalence of recto-sigmoid endometriosis was 51%. The specificity, sensitivity, and LR+ and LR- were 90%, 73%, 7.089 and 0.297, respectively, for MRI and 86%, 73%, 5.317 and 0.309, respectively, for tg-TVUS. The presence of a high T1 signal spot was an excellent specific finding (100%) but was associated with a low sensitivity (30%). Inter-technique concordance using the Cohen statistic indicated a kappa value of 0.658 (± 0.098 SD). According to the logistic regression equation obtained, the use of both tg-TVUS and MRI allows optimal diagnostic performance. MRI and tg-TVUS show similar results in the identification of recto-sigmoid endometriosis. The Cohen kappa value suggests that these methods may have complementary roles in the identification of recto-sigmoid endometriosis, depending on the site affected. Copyright © 2011 Wiley Periodicals, Inc.

  10. Women's quality of life and sexual function after transvaginal anterior repair with mesh insertion.

    Science.gov (United States)

    El Haddad, Rachid; Svabik, Kamil; Masata, Jaromir; Koleska, Tomas; Hubka, Petr; Martan, Alois

    2013-03-01

    Current evidence about the impact of pelvic floor surgery on sexual function is conflicting. Only a few studies have reported with validated questionnaires on sexual function after transvaginal mesh repair, with a discrepancy in reported outcomes. The aim of this study was to prospectively explore the impact of anterior repair (AR) with mesh insertion on sexual function, quality of life and dyspareunia. 69 women with symptomatic stage II or greater prolapse exclusively of the anterior compartment participated in a prospective study on safety and efficacy of two mesh implantation techniques for anterior vaginal wall prolapse repair between September 2007 and May 2009. They were invited to complete the validated condition-specific short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and quality of life (QoL) questionnaires (Pelvic Organ Prolapse (POP) Distress Inventory (POPDI), Urinary Distress Inventory (UDI), POP Impact Questionnaire (POPIQ), and Urinary Impact Questionnaire (UIQ)) pre-operatively and 6 months post-operatively. All data were processed and analyzed in Statistical Computing Environment R, version 2.9.1. A significant decrease of Qol scores and a significant increase of PISQ-12 scores occurred after surgery. All sexually active women resumed sexual activity postoperatively. The majority of non-sexually active women remained sexually inactive. Postoperatively the frequency of pain during intercourse increased in 31% of cases and decreased or stayed unchanged in 69% of cases. The incidence of de novo dyspareunia after mesh repair was 4% while the incidence of dyspareunia slightly increased from 25% to 29% postoperatively. The results of this study suggest no deterioration in sexual function, a significant improvement in quality of life and a low incidence of de novo dyspareunia six months after AR with mesh insertion. Despite these findings, the majority of non-sexually active women remain sexually inactive

  11. Incisionless Pubovaginal Fascial Sling Using Transvaginal Bone Anchors for the Treatment of Stress Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Sandip P. Vasavada

    2004-01-01

    Full Text Available Introduction: Bladder neck suspension (BNS for stress urinary incontinence (SUI can have significant morbidity, including bleeding, infection and pain. In an effort to reduce this potential morbidity, we have devised a technique which provides the same suburethral support as a standard anterior vaginal wall sling (AVWS, but without a vaginal or suprapubic incision. We describe this minimally invasive technique. Methods: From April 1998 to February 1999, 85 women underwent an incisionless suburethral fascial sling procedure. A transvaginal bone drill was used to place a bone anchor loaded with #1 prolene suture into the inferior aspect of the pubic bone on either side of the urethra. A subepithelial tunnel was created at the level of the bladder neck. A 2 x 7 cm segment of cadaveric fascia lata was placed through the subepithelial tunnel. The sutures were passed through the fascia 5mm from either edge, effectively creating a 6.0 cm sling. Finally, the sutures are tied up to the pubic symphysis.Results: Follow-up was via a self-administered questionnaire and patient interview. Recurrent SUI was noted in 2/85 (3%. New onset urge incontinence was present in 4/85 (5%. Permanent urinary retention has not occurred in either group. All procedures were performed on an outpatient basis and no operative complications occurred.Conclusions: Early results for the incisionless sling compare favorably with the long term results for the AVWS. This minimally invasive approach has thus far not been associated with any significant complications. Elimination of the vaginal and suprapubic incisions has not compromised efficacy, and appears to reduce the incidence of urge incontinence. Long term follow-up will establish the lasting efficacy of this novel surgical technique.

  12. Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

    Directory of Open Access Journals (Sweden)

    Serkan DİKİCİ

    2015-01-01

    Full Text Available Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower postoperative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these two important drawbacks of these currently available devices. For this reason, a3D scanned technique was used to get uterus sizes and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. Moreover, performances of different caps and LED systems will be evaluated. Furthermore, after integration of self-cutting and self-suturing mechanisms into our system, final prototype will be produced by using titanium which is biologically and mechanically appropriate. Therefore, aim of this study was to design and produce a new uterine manipulator with three dimensional movements, LED illumination, self-cutting and self-suturing systems to facilitate

  13. Spontaneous Intracapsular Tonsillar Hemorrhage

    Directory of Open Access Journals (Sweden)

    Güçlü Beriat

    2012-07-01

    Full Text Available In this case report, we discussed a case of spontaneous intracapsular tonsillar haemorrhage appearing as a tumor medial to the left palatine tonsil and clinging to the tonsillar tissue with a pedicle. The patient was a 30 years old healthy pregnant woman. She had a growing sensation of a lump in her oropharynx and dysphagia in the past three months. She had no history of acute and chronic tonsillitis or trauma. On examination, a mobile brown mass with a 2 cm diameter having a small pedicle at the upper pole of the left palatine tonsil was seen. Other laboratory results were normal. The mass was excised under general anesthesia. Histological evaluation revealed tonsillar intracapsular bleeding with lymphoepi-thelial tissue and acute hemorrhagic fields bounded by a capsule. A postpartum tonsillectomy was planned for our patient. Tonsillectomy must be performed to patients followed up with this diagnosis in order to differentiate between dyspha-gia, risks of bleeding and aspiration, and malignant tumors.

  14. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  15. Controlling spontaneous emission

    DEFF Research Database (Denmark)

    Lodahl, Peter

    Control over spontaneous emission of light is of great importance in quantum optics. It is essential for diverse applications such as miniature lasers, light-emitting diodes, and single-photon sources for quantum information. We present experimental studies on spontaneous emission of CdSe quantum...

  16. Human embryonal epithelial cells of the developing small intestinal crypts can express the Hodgkin-cell associated antigen Ki-1 (CD30 in spontaneous abortions during the first trimester of gestation

    Directory of Open Access Journals (Sweden)

    Tsikouras Panagiotis

    2005-01-01

    Full Text Available Abstract Background Ki-1 (CD30 antigen expression is not found on peripheral blood cells but its expression can be induced in vitro on T and B lymphocytes by viruses and lectins. Expression of CD30 in normal tissues is very limited, being restricted mainly to a subpopulation of large lymphoid cells; in particular, cells of the recently described anaplastic large cell lymphoma (ALCL, the Reed-Sternberg (RS cells of Hodgkin's lymphoma and scattered large parafollicular cells in normal lymphoid tissues. More recent reports have described CD30 expression in non-hematopoietic and malignant cells such as cultured human macrophages, human decidual cells, histiocytic neoplastic cells, mesothelioma cells, embryonal carcinoma and seminoma cells. Results We investigated the immunohistochemical expression of CD30 antigen in 15 paraffin-embedded tissue samples representing small intestines from fetuses after spontaneous abortion in the 8th, 10th and 12th weeks using the monoclonal antibody Ki-1. Hormones had been administered to all our pregnant women to support gestation. In addition, a panel of monoclonal antibodies was used to identify leukocytes (CD45/LCA, B-lymphocytes (CD20/L-26 and T-lymphocytes (CD3. Our findings were correlated with those obtained simultaneously from intestinal tissue samples obtained from 15 fetuses after therapeutic or voluntary abortions. Conclusions The results showed that: (1 epithelial cells in the developing intestinal crypts express the CD30 (Ki-1 antigen; (2 CD30 expression in these epithelial cells is higher in cases of hormonal administration than in normal gestation. In the former cases (hormonal support of gestation a mild mononuclear intraepithelial infiltrate composed of CD3 (T-marker-positive cells accompanies the CD30-positive cells.

  17. Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats

    National Research Council Canada - National Science Library

    Mencl, Stine; Garz, Cornelia; Niklass, Solveig; Braun, Holger; Göb, Eva; Homola, György; Heinze, Hans-Jochen; Reymann, Klaus G; Kleinschnitz, Christoph; Schreiber, Stefanie

    2013-01-01

    .... In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood-brain barrier...

  18. [Transvaginal/transumbilical hybrid NOTES appendicectomy : Comparison of techniques in uncomplicated and complicated appendicitis].

    Science.gov (United States)

    Bulian, D R; Knuth, J; Ströhlein, M A; Sauerwald, A; Heiss, M M

    2015-04-01

    Appendicectomy (AE), the most frequent emergency surgical procedure, can be performed as a transvaginal hybrid natural orifice translumenal endoscopic surgery (NOTES) technique (TVAE). The question of feasibility also arises in cases of advanced inflammation with perforation. Since May 2012 all female patients with suspected acute appendicitis were offered a TVAE as an alternative to the standard procedure. Preoperative, intraoperative and postoperative parameters were registered prospectively. Until October 2013 a total of 13 TVAEs had been performed. The median age of the patients was 41 years (range 20-76 years), median BMI was 23.1 (range 18.1-28.3 kg/m(2)) and the American Society of Anesthesiologists score (ASA) distribution (I/II/≥ III) was 8/5/0. Histology revealed three cases of perforated, one hemorrhagic necrotizing and seven phlegmonous appendicitis. Furthermore, there were two findings without inflammation, namely one neurogenic appendicopathy and one neuroendocrine tumor. For the three patients with perforated appendicitis, there was a trend for higher age (67.0 years versus 33.5 years, p=0.063) and a higher C-reactive protein (CRP) level on admission (134.4 mg/l versus 26.4 mg/l, p=0.043). Also, procedural time and hospital stay were longer (64 min versus 47 min, p=0.033 and 14 days versus 3 days, p=0.004, respectively). The former was mostly due to more extensive intraoperative flushing (volume 3000 ml versus 500 ml, p=0.013 and duration 13 min versus 2 min, p=0.011). None of the cases required conversion but two of the three postoperative complications occurred in patients with perforation, which also resulted in the longer hospital stay. Technically, TVAE seems feasible also in cases of perforated appendicitis. However, in these cases procedural time is prolonged due to more extensive flushing. Whether or not the longer hospital stay can be attributed to the perforation or if TVAE results in a higher rate of complications in cases of

  19. Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan [Hacettepe University School of Medicine, Department of Radiology, Ankara (Turkey); Koese, Faruk [Social Security Hospital, Department of Gynecology, Ankara (Turkey)

    2005-08-01

    The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

  20. Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

    Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

  1. Post-operative ovarian adhesion formation after ovarian drilling: a randomized study comparing conventional laparoscopy and transvaginal hydrolaparoscopy.

    Science.gov (United States)

    Giampaolino, Pierluigi; Morra, Ilaria; Tommaselli, Giovanni Antonio; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2016-10-01

    To compare conventional laparoscopic ovarian drilling (LOD) with transvaginal hydrolaparoscopy (THL) ovarian drilling in terms of ovarian adhesion formation, evaluated using office THL during follow-up in CC-resistant anovulatory patients affected by PCOS. Prospective randomized study on 246 CC-resistant women with PCOS. The patients enrolled were divided into two groups, 123 were scheduled to undergo LOD and 123 to undergo THL ovarian drilling. Six months after the procedure all patients were offered office transvaginal hydrolaparoscopy (THL) follow-up, under local anesthesia to evaluate adhesion formation. Duration of the procedure was significantly shorter in the THL group in comparison with LOD group (p operative complication was observed in any of the patients in both groups. Post-operative THL follow-up after 6 months showed that 15 (15.5 %) patients in the THL group and 73 (70.2 %) in the LOD group showed the presence of ovarian adhesion. This difference was highly significant with a p value drilling may reduce the risk of ovarian adhesion formation and could be used as a safe and effective option to reduce ovarian adhesion formation in patients undergoing ovarian drilling.

  2. Efficacy of Electrical Pudendal Nerve Stimulation versus Transvaginal Electrical Stimulation in Treating Female Idiopathic Urgency Urinary Incontinence.

    Science.gov (United States)

    Wang, Siyou; Lv, Jianwei; Feng, Xiaoming; Lv, Tingting

    2017-06-01

    We compared the efficacy of electrical pudendal nerve stimulation vs transvaginal electrical stimulation to treat female idiopathic urgency urinary incontinence. A total of 120 female patients with idiopathic urgency urinary incontinence refractory to medication were randomized at a ratio of 2:1 to group 1 of 80 patients and group 2 of 40. Groups 1 and 2 were treated with electrical pudendal nerve stimulation and transvaginal electrical stimulation, respectively. To perform electrical pudendal nerve stimulation long acupuncture needles were deeply inserted into 4 sacrococcygeal points and electrified to stimulate pudendal nerves. Outcome measures were the 24-hour pad test and a questionnaire to measure the severity of symptoms and quality of life in women with urgency urinary incontinence. The median severity of symptoms and quality of life score on the urgency urinary incontinence questionnaire (urgency urinary incontinence total score) was 13 (range 7 to 18.75) in group 1 and 11 (range 8 to 16) in group 2 before treatment, which decreased to 2 (range 0 to 6.75) in group 1 and 6.5 (range 3.25 to 10.75) in group 2 (both p incontinence total score was lower and the therapeutic effect was better in group 1 than in group 2 (both p incontinence. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Spontaneous Resolution of Massive Spontaneous Tubercular Pneumothorax

    Science.gov (United States)

    Kant, Surya; Saheer, S.; Hassan, G.; Parengal, Jabeed

    2011-01-01

    A 29-year-old female presented with complaints of fever and productive cough of three weeks duration. Pulmonary tuberculosis was diagnosed bacteriologically and she was prescribed antituberculosis drugs. During follow-up she developed massive pneumothorax, for which patient refused surgical management and was managed conservatively. After six months there was complete spontaneous resolution of pneumothorax. The unusual presentation and unexpected outcome prompted us to report this case. PMID:22937428

  4. Spontaneous rupture of pyometra

    National Research Council Canada - National Science Library

    Mallah, Fatemeh; Eftekhar, Tahere; Naghavi-Behzad, Mohammad

    2013-01-01

    Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen...

  5. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse

    DEFF Research Database (Denmark)

    Rudnicki, Martin; Laurikainen, E; Pogosean, R

    2016-01-01

    To compare the 1-year (previously published) and 3-year objective and subjective cure rates, and complications, related to the use of a collagen-coated transvaginal mesh for anterior vaginal wall prolapse against a conventional anterior repair. DESIGN: Randomised controlled study. SETTING: Six......-7) and the Pelvic Floor Distress Inventory (PFDI-20). MAIN OUTCOME MEASURES: Objective cure, defined as POP-Q stage

  6. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

    DEFF Research Database (Denmark)

    Woodward, E R; Sleightholme, H V; Considine, A M

    2007-01-01

    OBJECTIVE: To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. DESIGN: Retrospective audit. SETTING: NHS Trust. POPULATION: Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high-risk g...

  7. Spontaneous closure of muscular ventricular septal defects

    Directory of Open Access Journals (Sweden)

    Pejčić Ljiljana

    2017-01-01

    Full Text Available Introduction/Objective. Ventricular septal defect (VSD is the most frequently diagnosed congenital heart anomaly. The prognosis is usually good as it has spontaneous closure evolution, especially small muscular VSDs. The aim of this study was to determine the natural history of isolated muscular VSDs including the frequency of spontaneous closure in relation to location in the muscular septum and the age at the time of closure. Methods. The study included 96 children (52 girls and 44 boys with isolated muscular VSD diagnosed during the first month of life. We analyzed the tendency of spontaneous closure of these defects for the duration of childhood during a follow-up period of 16 years. Two-dimensional color Doppler echocardiography was performed to detect muscular VSD as a primary cardiac lesion. There was significant prevalence of small apical versus trabecular defects and their outcomes were evaluated. Results. Our study evaluated 91 children, 49 (53.8% girls and 42 (46.2% boys who did not undergo surgery. Apically located VSD was diagnosed in 68 (74.7%, while trabecular defects were found in 23 (25.3% children. Spontaneous closure occurred in 56 out of 91 cases (61.5%. The time of spontaneous closure was most commonly recorded during the first six months after birth (46.4%. The overall rate of spontaneous closure was 81.3% by the end of the first year. Apically located ventricular defects underwent spontaneous closure in the majority of patients, in comparison to trabecular ventricular defects (χ2 = 12.581; p < 0.001. Kaplan–Meier analysis demonstrated a significant difference in the average time required for spontaneous closure between the analyzed patient groups (log-rank = 9.64, p = 0.002. Conclusion. The frequency of spontaneous closure of muscular VSDs, especially apically located, is very high in the first six months, especially within the first year of life. It is advisable to detect them early on using color flow imaging and to

  8. Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy.

    Science.gov (United States)

    Bulian, Dirk R; Knuth, Jurgen; Lehmann, Kai S; Sauerwald, Axel; Heiss, Markus M

    2015-10-14

    To evaluate transvaginal hybrid-NOTES cholecystectomy (TVC) during its clinical establishment and compare it with the traditional laparoscopic technique (LC). The specific problems and benefits of TVC were reviewed using a registry analysis, a comparative cohort study and a randomized clinical trial. At first, feasibility, safety and specific complications of the TVC were analyzed based on the first 488 data sets of the German NOTES Registry (GNR). Hereafter, we compared the early postoperative results of our first 50 TVC-patients with those of 50 female LC-patients matched by age, BMI and ASA classification. The same cohort was contacted an average of two years later to evaluate long-term results concerning pain and satisfaction with the aesthetic results and the overall postoperative results as well as sexual intercourse by means of two domains of the German version of the Female Sexual Function Index (FSFI-d). Consequently, we performed a randomized clinical trial comparing 20 TVC-patients with 20 needlescopic/3-trocar cholecystectomies (NC) also concerning the early postoperative results as well as pain, satisfaction and quality of life by means of the Eypasch Gastrointestinal Quality of Life Index (GIQLI) in the later course. Finally, we discussed the results in accordance with other published studies. The complication (3.5%) and conversion rates (4.1%) for TVC were low in the GNR and comparable to those of the LC. Access related intraoperative complications included injuries to the bladder (n = 4; 0.8%) and bowel (n = 3; 0.6%). The study cohort revealed less postoperative pain after TVC comparing to the LC-patients on the day of surgery (NRS, 1.5/10 vs 3.1/10, P = 0.003), in the morning (NRS, 1.9/10 vs 2.8/10, P = 0.047) and in the evening (NRS, 1.1/10 vs 1.8/10, P = 0.025) of postoperative day (POD) one. The randomized clinical trial consistently found less cumulative pain until POD 2 (NRS, 8/40 vs 14/40, P = 0.043), as well as until POD 10 (NRS, 22/190 vs

  9. Application of transvaginal sacrospinous colpopexy in the treatment of pelvic organs prolapse

    Directory of Open Access Journals (Sweden)

    Argirović Rajka B.

    2005-01-01

    , such as the damage to the pudendal vessels and nerve, the sciatic nerve and rectum. The possibility of injury to the vessels and nearby nerves was preventid with the careful placement of suture through the sacrospinous ligament in the two fingerbreadths medial to its insertion in the ischial spine. In our series, we had 3 patients with conservation of the uterus. The 3 asymptomatic cystocele in our series were diagnosed 6 months after the operation. Our results were satisfactory, since we hade only one postoperative vault prolapse (2,7%. Conclusion. The results of numerous studies, as well as the results of our study, showed that transvaginal sacrospinous colpopexy could be performed along with vaginal hysterectomy and the anterior and posterior vaginal wall repair in the patients with uterovaginal prolapse because of its high success in the prevention of postoperative vaginal vault prolapse and the low intra- and postoperative complication rates. This operative technique is successful in prevention of repeated vaginal vault prolapse.

  10. 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

  11. Evolução do comprimento cervical uterino na gestação, avaliado pela ultra-sonografia transvaginal Changes in cervical length during pregnancy measured by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Reginaldo Antônio de Oliveira Freitas-Júnior

    2003-03-01

    Full Text Available OBJETIVO: analisar a evolução do comprimento cervical uterino, ao longo da gestação, avaliado por meio da ultra-sonografia transvaginal. MÉTODOS: foi realizado estudo prospectivo, longitudinal, no qual 82 gestantes hígidas foram acompanhadas desde o início da gestação, das quais 49 mantiveram o seguimento até o parto sem complicações da gravidez, sendo examinadas a cada quatro semanas, e agrupadas, conforme a paridade, em nulíparas ou com um ou mais partos anteriores. O comprimento do colo uterino foi avaliado em vista sagital pela ultra-sonografia transvaginal, com a medida linear da distância entre os orifícios cervicais interno e externo. RESULTADOS: as médias de comprimento do colo uterino, bem como os percentis 5, 25, 50, 75 e 95, em função da idade gestacional, não diferiram significativamente entre os grupos estudados (p>0.05. No intervalo entre a 20ª e a 24ª semana gestacional o comprimento cervical variou entre 28, 35 e 47,2 mm, com os percentis 5, 50 e 95, respectivamente. O comprimento cervical uterino diminuiu progressivamente ao longo da gestação normal, sendo esse encurtamento significativo após a 20ª semana de gravidez e mais expressivo após a 28ª semana (pPURPOSE: to establish a normality curve of cervical length during pregnancy measured by transvaginal ultrasonography. METHODS: we conducted a prospective, longitudinal study on 82 healthy pregnant women who were followed up from the beginning of pregnancy to delivery at four-week intervals, of whom 49 concluded the study. Patients were divided according to parity into nulliparous women and women with one or more previous deliveries. Cervical length was measured in a sagittal view by transvaginal ultrasonography, as the linear distance between internal and external cervical os. RESULTS: no significant difference was observed in mean cervical length or the 5th, 25, 50th, 75th, or 95th percentile according to gestational age between groups (p>0

  12. Spontaneous Perforation of Pyometra

    Directory of Open Access Journals (Sweden)

    Begüm Yildizhan

    2006-01-01

    Full Text Available Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01–0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy. Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.

  13. Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination

    DEFF Research Database (Denmark)

    Madsen, M E; Konge, L; Nørgaard, L N

    2014-01-01

    -6), corresponding to an average of 219 min (range, 150-251 min) of training. The test/retest reliability was high, with an intraclass correlation coefficient of 0.93. CONCLUSIONS: Competence in the performance of gynecological ultrasound examination can be assessed in a valid and reliable way using virtual-reality......OBJECTIVE: To assess the validity and reliability of performance measures, develop credible performance standards and explore learning curves for a virtual-reality simulator designed for transvaginal gynecological ultrasound examination. METHODS: A group of 16 ultrasound novices, along with a group...... simulation. The novices' performance improved with practice and their learning curves plateaued at the level of expert performance, following between 3 and 4 h of simulator training....

  14. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    2012-01-01

    The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice.

  15. Spontaneous renal artery dissection.

    Science.gov (United States)

    John, Santhosh G; Pillai, Unnikrishnan; Vaidyan, Philip B; Ishiyama, Takaaki

    2010-01-01

    Isolated spontaneous dissection of renal arteries or its branches are extremely rare. Most cases of renal artery dissection are associated with underlying pathology of the renal arteries. We report a case of spontaneous dissection of the left main renal artery and infarction of the left kidney with positive antiphospholipid antibody. Extensive work up of the patient including imaging studies confirmed the diagnosis of SRAD. Antiphospholipid antibodies may have a role in the pathogenesis of arterial dissection by causing endothelial dysfunction. This is a first literature report.

  16. Spontaneous Atraumatic Mediastinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd

    2013-04-01

    Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

  17. Treatment of Chronic Spontaneous Urticaria

    Science.gov (United States)

    2012-01-01

    Chronic spontaneous urticaria is defined as persistent symptoms of urticaria for 6 weeks or more. It is associated with autoimmunity in approximately 45 percent of patients. Therapy is often difficult however the initial approach should employ high-dose non-sedating antihistamines; 4-6 tablets/day may be necessary. It has been shown that the response to 4 tablets/day exceeds 3, and exceeds 2, which exceeds 1. However the dose that corresponds to the maximal dose of first generation antihistamines (hydroxyzine, diphenhydramine) used previously, is 6/day. Yet over half the patients are refractory to antihistamines and other agents should be tried next. Whereas current guidelines (published) often add leukotriene antagonists and/or H2 receptor antogonists next, these are of little utility. Likewise drugs effective for urticarial vasculitis (colchicine, dapsone, sulfasalazine, hydroxychloroquine) are effective in a small percentage of patients and no study suggests that the response rate of any of them exceeds the 30% placebo responses seen in most double-blind, placebo controlled studies. The drugs that are effective for antihistamine-resistant chronic spontaneous urticaria are corticosteroids, cyclosporine, and Omalizumab. Use of steroids is limited by toxicity. If used at all, a dose of no more than 10 mg/day should be employed with a weekly reduction of 1 mg. The response rates to cyclosporine and Omalizumab are each close to 75%. Cyclosporine can be used effectively if care is taken to monitor blood pressure, urine protein, blood urea nitrogen, and creatinine, every 6 weeks. Omalizumab has the best profile in terms of efficacy/toxicity and, once approved by federal agencies for use in chronic spontaneous urticaria, a dramatic change in the treatment paradigm, whether associated with autoimmunity or not, is predicted. A phase 3 trial is currently in place. Refractoriness to both Omalizumab and cyclosporine is expected to be less than 5 percent of patients. Other

  18. Transvaginal/Transumbilical Hybrid—NOTES—Versus 3-Trocar Needlescopic Cholecystectomy: Short-term Results of a Randomized Clinical Trial

    Science.gov (United States)

    Knuth, Jürgen; Cerasani, Nicola; Sauerwald, Axel; Lefering, Rolf; Heiss, Markus Maria

    2015-01-01

    Objective: For cholecystectomy, both the needlescopic cholecystectomy (NC) 3-trocar technique using 2 to 3 mm trocars and the umbilical-assisted transvaginal cholecystectomy (TVC) technique have found their way into clinical routine. This study compares these 2 techniques in female patients who are in need of an elective cholecystectomy. Background: Natural orifice transluminal endoscopic surgery (NOTES) is a surgical concept permitting scarless intra-abdominal operations through natural orifices, such as the vagina. Because of the lack of an adequately powered trial, we designed this first randomized controlled study for the comparison of TVC and NC. Methods: This prospective, randomized, nonblinded, single-center trial evaluates the safety and effectiveness of TVC (intervention), compared with NC (control) in female patients with symptomatic cholecystolithiasis. The primary endpoint was intensity of pain until the morning of postoperative day (POD) 2. Secondary outcomes were among others intra- and postoperative complications, procedural time, amount of analgesics used, pain intensity until POD 10, duration of hospital stay, satisfaction with the aesthetic result, and quality of life on POD 10 as quantified with the Eypasch Gastrointestinal Quality of Life Index (GIQLI). Results: Between February 2010 and June 2012, 40 patients were randomly assigned to the interventional or control group. All patients completed follow-up. Procedural time, length of postoperative hospital stay, and the rate of intra- and postoperative complications were similar in the 2 groups. However, significant advantages were found for the transvaginal access regarding pain until POD 2, but also until POD 10 (P = 0.043 vs P = 0.010) despite significantly less use of peripheral analgesics (P = 0.019). In the TVC group, patients were significantly more satisfied with the aesthetic result (P < 0.001) and had a significantly better GIQLI (P = 0.028). Conclusions: Although comparable in terms of

  19. Transvaginal/transumbilical hybrid--NOTES--versus 3-trocar needlescopic cholecystectomy: short-term results of a randomized clinical trial.

    Science.gov (United States)

    Bulian, Dirk Rolf; Knuth, Jürgen; Cerasani, Nicola; Sauerwald, Axel; Lefering, Rolf; Heiss, Markus Maria

    2015-03-01

    For cholecystectomy, both the needlescopic cholecystectomy (NC) 3-trocar technique using 2 to 3 mm trocars and the umbilical-assisted transvaginal cholecystectomy (TVC) technique have found their way into clinical routine. This study compares these 2 techniques in female patients who are in need of an elective cholecystectomy. Natural orifice transluminal endoscopic surgery (NOTES) is a surgical concept permitting scarless intra-abdominal operations through natural orifices, such as the vagina. Because of the lack of an adequately powered trial, we designed this first randomized controlled study for the comparison of TVC and NC. This prospective, randomized, nonblinded, single-center trial evaluates the safety and effectiveness of TVC (intervention), compared with NC (control) in female patients with symptomatic cholecystolithiasis. The primary endpoint was intensity of pain until the morning of postoperative day (POD) 2. Secondary outcomes were among others intra- and postoperative complications, procedural time, amount of analgesics used, pain intensity until POD 10, duration of hospital stay, satisfaction with the aesthetic result, and quality of life on POD 10 as quantified with the Eypasch Gastrointestinal Quality of Life Index (GIQLI). Between February 2010 and June 2012, 40 patients were randomly assigned to the interventional or control group. All patients completed follow-up. Procedural time, length of postoperative hospital stay, and the rate of intra- and postoperative complications were similar in the 2 groups. However, significant advantages were found for the transvaginal access regarding pain until POD 2, but also until POD 10 (P = 0.043 vs P = 0.010) despite significantly less use of peripheral analgesics (P = 0.019). In the TVC group, patients were significantly more satisfied with the aesthetic result (P < 0.001) and had a significantly better GIQLI (P = 0.028). Although comparable in terms of safety, TVC caused less pain, increased satisfaction

  20. Creating a Spontaneous Conversational Speech Corpus

    Directory of Open Access Journals (Sweden)

    Maria Husin

    2011-11-01

    Full Text Available Speech recognition and language analysis of spontaneous speech arising in naturally spoken conversations are becoming the subject of much research. However, there is a shortage of spontaneous speech corpora that are freely available for academics. We therefore undertook the building of a natural conversation speech database, recording over 200 hours of conversations in English by over 600 local university students. With few exceptions, the students used their own cell phones from their own rooms or homes to speak to one another, and they were permitted to speak on any topic they chose. Although they knew that they were being recorded and that they would receive a small payment, their conversations in the corpus are probably very close to being natural and spontaneous. This paper describes a detailed case study of the problems we faced and the methods we used to make the recordings and control the collection of these social science data on a limited budget.

  1. Spontaneous uterine rupture

    African Journals Online (AJOL)

    had had hysteroscopy and repeated curettage7, but it happened during labor and not before labor as in our case. Diagnosis of spontaneous uterine rupture during pregnancy occuring on a scarred uterus can be made by ultrasound scan in which case there can be protrusion of membranes at the site of the scar8. If possible ...

  2. Spontaneous Appendicocutaneous Fistula I

    African Journals Online (AJOL)

    M T0k0de* MB, BS and. Dr 0. A. AWOj0bi+ FMCS (Nig). ABSTRACT. Ruptured appendicitis is not a common cause of spontaneous enterocutaneous fistula. A case of ruptured retrocaecal appendicitis presenting as an enterocutaneous fistula in a Nigerian woman is presented. The literature on this disorder is also reviewed.

  3. Spontaneous Grammar Explanations.

    Science.gov (United States)

    Tjoo, Hong Sing; Lewis, Marilyn

    1998-01-01

    Describes one New Zealand university language teacher's reflection on her own grammar explanations to university-level students of Bahasa Indonesian. Examines form-focused instruction through the teacher's spontaneous answers to students' questions about the form of the language they are studying. The teacher's experiences show that it takes time…

  4. Spontaneous rib fractures.

    Science.gov (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber

    2015-07-01

    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  5. [Spontaneous bacterial peritonitis].

    Science.gov (United States)

    Velkey, Bálint; Vitális, Eszter; Vitális, Zsuzsanna

    2017-01-01

    Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III. generation cephalosporin. Nosocomial spontaneous bacterial peritonitis often caused by Gram-positive bacteria and multi-resistant pathogens can also be expected thus carbapenem should be the choice of the empiric treatment. Antibiotic prophylaxis should be considered. Norfloxacin is used most commonly, but changes are expected due to increase in quinolone resistance. As a primary prophylaxis, a short-term antibiotic treatment is recommended after gastrointestinal bleeding for 5 days, while long-term prophylaxis is for patients with low ascites protein, and advanced disease (400 mg/day). Secondary prophylaxis is recommended for all patients recovered from spontaneous bacterial peritonitis. Due to increasing antibiotic use of antibiotics prophylaxis is debated to some degree. Orv. Hetil., 2017, 158(2), 50-57.

  6. Spontaneous abortion and maternal work in greenhouses.

    Science.gov (United States)

    Settimi, Laura; Spinelli, Angela; Lauria, Laura; Miceli, Giuseppe; Pupp, Nicoletta; Angotzi, Giuliano; Fedi, Aldo; Donati, Serena; Miligi, Lucia; Osborn, John; Figà-Talamanca, Irene

    2008-04-01

    A positive association between maternal occupational exposure to pesticide and spontaneous abortion has been reported in some studies. Work in greenhouses may imply exposure of pregnant women to pesticides continuously and at elevated level. A total of 717 women working in greenhouses provided information on 973 pregnancies, including 110 spontaneous abortions. These pregnancies were classified as exposed or not exposed according to maternal occupation, re-entry activities and application of pesticides in greenhouses during at least 1 month in the first trimester of pregnancy. The ORs for spontaneous abortion were estimated through a generalised estimate equations model for all orders of pregnancy together, and through a logistic regression model limited to first pregnancies. Increased risks of spontaneous abortion were found for maternal re-entry activities within 24 hr after pesticides were applied (all orders of pregnancy: OR 3.2, 95% CI 1.3-7.7; first pregnancies: OR 3.8, 95% CI 1.0-13.9) and for those who applied pesticides (all orders of pregnancy: OR 2.6, 95% CI 1.0-6.6; first pregnancies: OR 3.7, 95% CI 0.7-20,6) The observed results support the hypothesis of an association between maternal work in greenhouses and spontaneous abortion. The main limitations of the study are lack of information on the specific chemicals used and the small number of pregnancies heavily exposed to pesticides. (c) 2008 Wiley-Liss, Inc.

  7. Spontaneous body movements in spatial cognition

    Directory of Open Access Journals (Sweden)

    Sergiu eTcaci Popescu

    2012-05-01

    Full Text Available People often perform spontaneous body movements during spatial tasks such as giving complex directions or orienting themselves on maps. How are these spontaneous gestures related to spatial problem-solving? We measured spontaneous movements during a perspective-taking task inspired by map reading. Analyzing the motion data to isolate rotation and translation components of motion in specific geometric relation to the task, we found out that most participants executed spontaneous miniature rotations of the head that were significantly related to the main task parameter. These head rotations were as if participants were trying to align themselves with the orientation on the map either in the image plane or on the ground plane, but with tiny amplitudes, typically below 1% of the actual movements. Our results are consistent with a model of sensorimotor prediction driving spatial reasoning. The efference copy of planned movements triggers this prediction mechanism. The movements themselves may then be mostly inhibited; the small spontaneous gestures that we measure are the visible traces of these planned but inhibited actions.

  8. Sangrado transvaginal durante el embarazo, como factor de riesgo para isoinmunización al antígeno Rhesus-D Transvaginal bleeding during pregnancy associated with Rhesus-D isoimmunization

    Directory of Open Access Journals (Sweden)

    Edgar Hernández-Andrade

    2003-12-01

    Full Text Available OBJETIVO: Evaluar el sangrado transvaginal en cualquier etapa del embarazo como factor de riesgo para la sensibilización al antígeno eritrocitario Rhesus-D en mujeres previamente no isoinmunizadas (Rh(-NI, como una alternativa para la aplicación rutinaria de gama-globulina anti-D a la semana 28 de gestación. MATERIAL Y MÉTODOS: Estudio de casos y controles consecutivos, efectuado en el Instituto Nacional de Perinatología de la Ciudad de México, en el periodo de 1995 a 2001.Casos (n=24, pacientes Rh(-NI que mostraron seroconversión positiva de anticuerpos contra el componente D del antígeno Rh durante el embarazo o en el puerperio inmediato. Controles (n=24, mujeres Rh(-NI, captadas consecutivamente y que no presentaron seroconversión positiva de anticuerpos Anti-D. En todos los casos los recién nacidos fueron Rh positivos. Ninguna de las pacientes recibió inmunoprofilaxis Anti-D a la semana 28 de gestación. Se evaluaron periodos de sangrado transvaginal en cualquier etapa del embarazo y antes del inicio del trabajo de parto. Se estimaron razones de probabilidad e intervalos de confianza de 95%. RESULTADOS: La presencia de sangrado transvaginal se observó en 18/24 (75% de los casos y en 5/24 de los controles (20%. La actividad uterina pretérmino y la amenaza de aborto fueron las causas más frecuentes identificadas como causa de este sangrado. La presencia de uno solo de estos eventos durante cualquier etapa del embarazo aumentó 11.4 veces (IC 95% 2.9-44.0 el riesgo de sensibilización al antígeno eritrocitario Rh-D, y si el sangrado se presentó después de la semana 20 el riesgo se incrementó 5.0 veces (IC 95% 1.3-19.1. La presencia de sangrado antes de la semana 20 no se asoció con un incremento significativo en el riesgo de sensibilización (OR=7.6, IC 95% 0.8-69.5. CONCLUSIONES: En presencia de cualquier sangrado transvaginal durante el embarazo en una paciente Rh-NI se recomienda la aplicación profiláctica de gama

  9. Detailed description of spontaneous emission

    Science.gov (United States)

    Guryev, M. V.

    2012-08-01

    The wave side of wave-photon duality, describing light as an electromagnetic field (EMF), is used in this article. The EMF of spontaneous light emission (SE) of a laser-excited atom is calculated from first principles for the first time. This calculation is done using the simple method of atomic quantum electrodynamics. The EMF of SE is also calculated for three types of polyatomic light sources excited by a laser. It is shown that light radiated by such sources can be coherent, which explains recent experiments on SE of laser-excited atoms. Small sources of SE can be superradiant, which also conforms to experiment. Thus, SE is shown not to be a random event itself. Random properties of natural light are simply explained as a result of thermal excitation randomness without additional hypotheses. The EMF of SE is described by simple complex functions, but not real ones.

  10. Single-incision and NOTES cholecystectomy, are there clinical or cosmetic advantages when compared to conventional laparoscopic cholecystectomy? A case-control study comparing single-incision, transvaginal, and conventional laparoscopic technique for cholecystectomy

    NARCIS (Netherlands)

    Boezem, P.B. van den; Velthuis, S.; Lourens, H.J.; Cuesta, M.A.; Sietses, C.

    2014-01-01

    BACKGROUND: The aim of the present study was to compare the clinical and cosmetic results of transvaginal hybrid cholecystectomy (TVC), single-port cholecystectomy (SPC), and conventional laparoscopic cholecystectomy (CLC). Recently, single-incision laparoscopic surgery and natural orifice

  11. [Augmented spontaneous breathing].

    Science.gov (United States)

    Hachenberg, T

    1996-09-01

    Impaired pulmonary gas exchange can result from lung parenchymal failure inducing oxygenation deficiency and fatigue of the respiratory muscles, which is characterized by hypercapnia or a combination of both mechanisms. Contractility of and coordination between the diaphragm and the thoracoabdominal respiratory muscles predominantly determine the efficiency of spontaneous breathing. Sepsis, cardiac failure, malnutrition or acute changes of the load conditions may induce fatigue of the respiratory muscles. Augmentation of spontaneous breathing is not only achieved by the application of different technical principles or devices; it also has to improve perfusion, metabolism, load conditions and contractility of the respiratory muscles. Intermittent mandatory ventilation (IMV) allows spontaneous breathing of the patient and augments alveolar ventilation by periodically applying positive airway pressure tidal volumes, which are generated by the respirator. Potential advantages include lower mean airway pressure (PAW), as compared with controlled mechanical ventilation, and improved haemodynamics. Suboptimal IMV systems may impose increased work and oxygen cost of breathing, fatigue of the respiratory muscles and CO2 retention. During pressure support ventilation (PSV), inspiratory alterations of PAW or gas flow (trigger) are detected by the respirator, which delivers a gas flow to maintain PAW at a fixed value (usually 5-20 cm H2O) during inspiration. PSV may be combined with other modalities of respiratory therapy such as IMV or CPAP. Claimed advantages of PSV include decreased effort of breathing, reduced systemic and respiratory muscle consumption of oxygen, prophylaxis of diaphragmatic fatigue and an improved extubation rate after prolonged periods of mechanical ventilation. Minimum alveolar ventilation is not guaranteed during PSV; thus, close observation of the patient is mandatory to avoid serious respiratory complications. Continuous positive airway pressure

  12. Spontaneous recovery from acalculia.

    Science.gov (United States)

    Basso, Anna; Caporali, Alessandra; Faglioni, Pietro

    2005-01-01

    A topic much considered in research on acalculia was its relationship with aphasia. Far less attention has been given to the natural course of acalculia. In this retrospective study, we examined the relationship between aphasia and acalculia in an unselected series of 98 left-brain-damaged patients and the spontaneous recovery from acalculia in 92 acalculic patients with follow-up. There was a significant association between aphasia and acalculia although 19 participants exhibited aphasia with no acalculia and six acalculia with no aphasia. We observed significant improvement between a first examination carried out between 1 and 5 months post-onset and a second examination carried out between 3 and 11 months later (mean: 5 months). The mechanisms of spontaneous recovery are discussed.

  13. Spontaneous Rupture of Pyometra

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    Fatemeh Mallah

    2013-01-01

    Full Text Available Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. In most cases, a correct and definite diagnosis can be made only by laparotomy. We report two cases of diffuse peritonitis caused by spontaneous perforated pyometra. The first case is a 78-year-old woman with abdominal pain for which laparotomy was performed because of suspected incarcerated hernia. The second case is a 61-year-old woman with abdominal pain for which laparotomy was performed because of symptoms of peritonitis. At laparotomy of both cases, 1 liter of pus with the source of uterine was found in the abdominal cavity. The ruptured uterine is also detected. More investigations revealed no malignancy as the reason of the pyometra.

  14. [Spontaneous pneumothorax in children].

    Science.gov (United States)

    Michel, J L

    2000-03-01

    Spontaneous pneumothorax is rare in childhood. Before 12 years of age the main underlying pathologies are asthma, cystic malformations, post infectious bullae, and infectious pneumoniae. After 12 years of age it is mainly associated with cystic fibrosis and constitutional slim morphology. Symptoms vary according to the extent of lung collapse and the diagnosis is confirmed on chest X rays. In mildly symptomatic pneumothorax, spontaneous resolution is achieved within few days. When cardiorespiratory difficulties are present, mechanical evacuation of air from the pleural cavity is necessary through a tube drainage maintained until complete pulmonary reexpansion. Surgical treatment is indicated in case of persisting air leakage after one week of efficient drainage, large cystic malformation or post infectious bullae, recurring or bilateral pneumothorax.

  15. [Spontaneous bilateral Petit hernia].

    Science.gov (United States)

    Fontoura, Rodrigo Dias; Araújo, Emerson Silveira de; Oliveira, Gustavo Alves de; Sarmenghi Filho, Deolindo; Kalil, Mitre

    2011-01-01

    Petit's lumbar hernia is an uncommon defect of the posterior abdominal wall that represents less than 1% of all abdominal wall hernias. It is more often unilateral and founded in young females, rarely containing a real herniated sac. There are two different approaches to repair: laparoscopy and open surgery. The goal of this article is to report one case of spontaneous bilateral lumbar Petit's hernia treated with open surgery.

  16. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-10-01

    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  17. Spontaneous Perforation of Pyometra

    OpenAIRE

    Sharma, Nalini; Singh, Ahanthem Santa; Bhaphiralyne, Wankhar

    2016-01-01

    Pyometra is collection of purulent material which occurs when there is interference with its normal drainage. It is an uncommon condition with incidence of 0.1 to 0.5% of all gynecological patients. Spontaneous rupture of uterus is an extremely rare complication of pyometra. A 65-year-old lady presented with pain abdomen and purulent vaginal discharge. Preoperative diagnosis of pyometra was made by magnetic resonance imaging (MRI). Laparotomy followed by peritoneal lavage and repair of perfor...

  18. Early Detection of Cleft Lip by Three-Dimensional Transvaginal Ultrasound in Niche Mode in a Fetus With Trisomy 18 Diagnosed by Celocentesis.

    Science.gov (United States)

    Tonni, Gabriele; Rosignoli, Lucia; Palmisano, Marcella; Sepulveda, Waldo

    2016-11-01

    Transabdominal ultrasound examination carried out at 11.3 weeks' gestation suggested the diagnosis of holoprosencephaly (HPE). Transvaginal three-dimensional (3D) scan performed using the niche-mode technique enabled diagnosis of HPE, hypotelorism, and cleft lip (CL). The fetus was diagnosed with trisomy 18 by means of transvaginal celocentesis at the time of pregnancy termination. Although prenatal diagnosis of orofacial cleft can be enhanced by 3D ultrasound, only a few cases have been detected early in pregnancy. Here, we report a first-trimester case in which 3D ultrasound in niche mode improved the antenatal diagnosis of CL. Early fetal karyotyping can be accomplished by celocentesis in these cases.

  19. Risk of spontaneous preterm birth in IVF-conceived twin pregnancies.

    Science.gov (United States)

    Saccone, Gabriele; Zullo, Fabrizio; Roman, Amanda; Ward, Andrew; Maruotti, Giuseppe; Martinelli, Pasquale; Berghella, Vincenzo

    2017-09-21

    To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included. Mean TVU CLs were compared between IVF-conceived twin pregnancies and spontaneously-conceived twin pregnancies. The relationship of TVU CL with gestational age at delivery was assessed. Incidence of short TVU CL, defined as TVU CL ≤30 mm, was also calculated in the two groups. The primary outcome was the mean of TVU CL. Distribution of CL was determined and normality was examined in both groups Results: A total of 668 women with diamniotic twin pregnancies who underwent TVU CL screening between 18 0/6 and 23 6/7 weeks were included. 158 (23.7%) were IVF-conceived pregnancies, and 510 (76.3%) were spontaneously-conceived pregnancies. No women received progesterone, pessary, or cerclage for preterm birth prevention during pregnancy. The mean TVU CL was significantly lower in the IVF-conceived group (32.2 ± 10.5 mm) compared to the spontaneously-conceived group (34.1 ± 9.1 mm) (mean difference (MD) - 1.90 mm, 95%CI -3.72 to -0.08). The incidence of TVU CL ≤30 mm was 30.4% in the IVF-conceived group and 21.6% in the spontaneously-conceived group (adjusted odds ratio (aOR) 1.59, 95%CI 1.06-2.37). IVF-conceived twins had a significantly higher risk of spontaneous preterm birth IVF-conceived twins was earlier by about 1 week on average compared with spontaneously-conceived twins. The higher rate of spontaneous preterm birth in IVF-conceived twin pregnancies is predicted by lower midtrimester TVU CL, as well as by the lower gestational age at birth per any

  20. Approach to the patient with spontaneous hypoglycemia.

    Science.gov (United States)

    Martens, Pieter; Tits, Jos

    2014-06-01

    Hypoglycemia is common in daily clinical practice and often occurs during the treatment of diabetes mellitus. However, a small minority of hypoglycemia encountered in clinical practice is spontaneous and thus not induced by glycemic lowering agents. These spontaneous hypoglycemic events confront the clinician with a diagnostic enigma. Although the trained clinician can recognize the autonomic and neuroglycopenic symptoms of hypoglycemia even in a patient not on insulin, it remains challenging to decipher the etiology of a spontaneous hypoglycemic event. A logical and stepwise approach to the spontaneous hypoglycemic event allows for a conclusive diagnosis. This diagnostic process consists of adequately diagnosing hypoglycemia by fulfilling Whipple's triad, stratifying patients according to their clinical status and analyzing a full hypoglycemic blood panel. A complete hypoglycemic blood panel should include the analysis of glucose, insulin, C-peptide, pro-insulin, insulin antibodies and the presence of oral hypoglycemic agents. For patients with episodes of hypoglycemia induced by excessive endogenous insulin, additional imaging is often required to detect the presence of an underlying insulinoma. By diagnosing the underlying cause of the spontaneous hypoglycemia, the physician also diagnosis the mechanism by which the hypoglycemic event occurs. Allowing for a problem orientated therapeutic approach. The present review is based upon a comprehensive PubMed search between 1985 and 2013. This uses search terms of spontaneous hypoglycemia, insulinoma, nesidioblastosis, insulin auto-immunity, noninsulinoma pancreatogenous hypoglycemia syndrome, hormone deficiency, pro-IGF II, and pro-insulin growth factor II, and cross reference searching of pivotal articles in the subject. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  1. [Asymmetric obstructed uterus didelphys/incomplete Herlyn-Werner-Wunderlich syndrome/diagnosed by transvaginal 3D ultrasound--a case report].

    Science.gov (United States)

    Markov, D; Slavchev, B; Markov, P; Apostolova, M

    2009-01-01

    Asymmetric obstructed uterus didelphys (Herlyn-Werner-Wunderlich syndrome-HWWS) is a rare congenital Müllerian anomaly consisting of uterus didelphys, hemivaginal septum and ipsilateral renal agenesis. We present a case of an incomplete HWWS diagnosed by 3D transvaginal ultrasound in a 22 year old patient with absence of the hemivaginal septum. The most contributive diagnostic factors as well as the appropriate therapeutic management in such cases are discussed.

  2. Laparoscopic-Assisted Tension-free Vaginal Mesh: An Innovative Approach to Placing Synthetic Mesh Transvaginally for Surgical Correction of Pelvic Organ Prolapse

    OpenAIRE

    Watanabe, Toyohiko; Inoue, Miyabi; Ishii, Ayano; Yamato, Toyoko; Yamamoto, Masumi; Sasaki, Katsumi; Kobayashi, Yasuyuki; Araki, Motoo; Uehara, Shinya; Saika, Takashi; Kumon, Hiromi

    2012-01-01

    Polypropylene mesh implants for the correction of pelvic organ prolapse (POP) are now available in Japan. We developed an innovative approach for correcting POP by placing polypropylene mesh transvaginally with laparoscopic assistance. From June 2007 through March 2010, sixteen consecutive patients with symptomatic stage 2 or 3 pelvic organ prolapse underwent the laparoscopic-assisted tension-free vaginal mesh procedure at Okayama University Hospital. All patients were evaluated before and at...

  3. Concentration-Independent Spontaneously Forming Biomimetric Vesicles

    Science.gov (United States)

    Nieh, M.-P.; Harroun, T. A.; Raghunathan, V. A.; Glinka, C. J.; Katsaras, J.

    2003-10-01

    In this Letter we present small-angle neutron scattering data from a biomimetic system composed of the phospholipids dimyristoyl and dihexanoyl phosphorylcholine (DMPC and DHPC, respectively). Doping DMPC-DHPC multilamellar vesicles with either the negatively charged lipid dimyristoyl phosphorylglycerol (DMPG, net charge -1) or the divalent cation, calcium (Ca2+), leads to the spontaneous formation of energetically stabilized monodisperse unilamellar vesicles whose radii are concentration independent and in contrast with previous experimental observations.

  4. Transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery: report of four cases.

    Science.gov (United States)

    Luo, Guo-De; Cao, Yong-Kuan; Wang, Yong-Hua; Zhang, Guo-Hu; Wang, Pei-Hong; Gong, Jia-Qing

    2014-01-01

    To investigate the feasibility and superiority of transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery. The clinical data of four cases of rectovaginal fistula following rectal cancer surgery were retrospectively analyzed in our center. After adequate preoperative preparation, the patients underwent transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube under continuous epidural anesthesia. After surgery and before discharge, anti-infection and nutritional support was administered for 2 d, and fluid diet and anal tube vacuum aspiration continued for 7 d. All the four cases healed. Three of them healed after one operation, and the other patient had obvious shrinkage of the fistular orifice after the first operation and underwent the same operation for a second time before complete healing. The duration of postoperative follow-up was 2, 7, 8 and 9 months respectively. No recurrence or abnormal sex life was reported. Early transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube are feasible for rectovaginal fistula following rectal cancer surgery. This operation has many advantages, such as minimal invasiveness, short durations of operation, short treatment cycles, and easy acceptance by the patient. In addition, it does not necessitate colostomy for feces shunt and a secondary colostomy and reduction.

  5. Spontaneous Thigh Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Khan, Sameer K

    2011-02-01

    Full Text Available A young man presented with a painful and swollen thigh, without any history of trauma, illness, coagulopathic medication or recent exertional exercise. Preliminary imaging delineated a haematoma in the anterior thigh, without any fractures or muscle trauma. Emergent fasciotomies were performed. No pathology could be identified intra-operatively, or on follow-up imaging. A review of thigh compartment syndromes described in literature is presented in a table. Emergency physicians and traumatologists should be cognisant of spontaneous atraumatic presentations of thigh compartment syndrome, to ensure prompt referral and definitive management of this limb-threatening condition. [West J Emerg Med. 2011;12(1:134-138].

  6. Less pain after transvaginal/transumbilical cholecystectomy than after the classical laparoscopic technique: short-term results of a matched-cohort study.

    Science.gov (United States)

    Bulian, Dirk Rolf; Trump, Linda; Knuth, Jürgen; Siegel, Robert; Sauerwald, Axel; Ströhlein, Michael A; Heiss, Markus Maria

    2013-02-01

    Natural orifice surgery (NOS) is gaining acceptance as an alternative to the traditional laparoscopic technique, especially for cholecystectomy through the transvaginal route. However, NOS remains controversial concerning expected advantages in terms of short- and long-term outcomes and potential side effects. This study was designed to compare short-term outcomes between transvaginal/transumbilical and classical laparoscopic cholecystectomy (LC). A prospective matched-cohort study compared the authors' first 50 transvaginal/transumbilical cholecystectomies (TVC) with a group of 50 classical LCs from the corresponding period matched in terms of age, body mass index, and American Society of Anesthesiology classification. In both groups, elective surgery was performed for symptomatic cholecystolithiasis. In the NOS group, a hybrid procedure was performed with one transumbilical rigid instrument and two transvaginal rigid instruments. A numeric rating scale was used for daily pain assessment, initiated postoperatively in the recovery room. Both groups were compared with regard to length of surgery, intra- and postoperative complications, length of hospital stay, postoperative pain, and consumption of analgesics. The length of surgery and the rate of complications were similar in the two groups. But significant advantages were found for the transvaginal access in terms of pain using Numeric Rating Scale (NRS) on the day of surgery (NRS, 1.5/10 vs 3.1/10; p = 0.003) as well as in the morning (NRS, 1.9/10 vs 2.8/10; p = 0.047) and in the evening (NRS, 1.1/10 vs 1.8/10; p = 0.025) of postoperative day 1, and with regard to the length of the postoperative hospital stay (2.7 vs 3.4 days; p = 0.035). The findings show that TVC is a safe procedure for female patients. It has a risk comparable with that of classic LC, causes significantly less pain in the early postoperative period, and leads to a significantly shorter hospital stay. Prospective randomized trials are necessary

  7. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: systematic review and meta-analysis.

    Science.gov (United States)

    Guerriero, S; Ajossa, S; Orozco, R; Perniciano, M; Jurado, M; Melis, G B; Alcazar, J L

    2016-03-01

    To review the diagnostic accuracy of transvaginal ultrasound (TVS) in the preoperative detection of rectosigmoid endometriosis in patients with clinical suspicion of deep infiltrating endometriosis (DIE), comparing enhanced (E-TVS) and non-enhanced approaches. An extensive search was performed in MEDLINE (PubMed) and EMBASE for studies published between January 1989 and December 2014. The eligibility criterion was use of TVS for preoperative detection of rectosigmoid endometriosis in women with clinical suspicion of DIE, using surgical data as the reference standard. Study quality was assessed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Our extended search identified a total of 801 citations, among which 19 studies (n = 2639) were considered eligible and included in the meta-analysis. Overall pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of TVS for detecting DIE in the rectosigmoid were 91% (95%CI, 85-94%), 97% (95%CI, 95-98%), 33.0 (95%CI, 18.6-58.6) and 0.10 (95%CI, 0.06-0.16), respectively. Significant heterogeneity was found for sensitivity (I(2) , 90.8%; Cochran Q, 195.2; P design are needed. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  8. Comparison of Sensitivity & Specificity of Transvaginal Sonography, Saline Infusion Sonohysterography and Hysteroscopy in Evaluation of Women with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    K Shojaie

    2009-10-01

    Full Text Available Introduction: Bleeding disorders are a common problem in daily practice, especially in premenopausal women. In our investigation, we compared the sensitivity and specificity of three different diagnostic methods Trans-vaginal sonography(TVS, saline infusion sonohystrography(SIS and Hysteroscopy. Methods: It was a cross- sectional study with a study population of ninety-nine women suffering fromAUB attending the outpatient clinic of Imam and Razi hospital in Ahvaz- Iran. They were evaluated by three different diagnostic methods and the results were compared. This study started from March 2008 to December 2008. The sensitivity, specificity, positive predictive and negative predictive values were measured in TVS, SIS, and finally these two methods were compared with hysteroscopy (as a gold standard. Results: The sensitivity and specificity of TVS was 74.2% and 49.7%, respectively, while that of SIS was 91.6% and 86%, respectively. The positive predictive value and negative predictive value of TVS was 71.9% and 54.3%, respectively, while that of SIS was 85.9% and 85.75%, respectively. The sensitivity, specificity, the positive predictive and negative predictive values of SIS was more than TVS, and it was similar to hysteroscopy. Conclusion: The findings obtained in the present study indicate that in AUB, sensitivity, specificity, positive and negative predictive value of SIS is more than TVS and therefore can be considered as a first step for diagnosis of AUB.

  9. TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    K. G. M. Premleel

    2016-06-01

    Full Text Available OBJECTIVES To evaluate whether saline contrast sonohysterography (SCSH improved the diagnostic accuracy of transvaginal sonography (TVS for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS The uterine cavity was evaluated with TVS and SCSH in 60 premenopausal patients with abnormal uterine bleeding. All 58 patients underwent operative hysteroscopy or hysterectomy within 4 months which provided a detailed description of the uterine cavity and was used as the true value for exclusion of polyps and submucous myomas. RESULT Out of 60 patients, 45 had uterine abnormalities on TVS and SCSH and rest of the patients who appeared normal but had other abnormalities such as ovarian haemorrhagic cyst. Out of the 45 patients, 9 patients had submucous myomas and 9 were diagnosed as endometrial polyp. The findings were confirmed using hysterectomy/hysteroscopy/endometrial sampling. CONCLUSION The use of TVS without saline contrast left nine submucosal fibroids and five in nine of the polyps undiagnosed in referred patients with complaints of abnormal bleeding. It also helps in reducing the rate of more invasive procedures such as hysteroscopy. However, studies carried out for longer duration and large study population are required to validate our findings

  10. Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography Avaliação de varizes pélvicas por Doppler colorido: comparação dos resultados obtidos com ultrassom dos membros inferiores, ultrassom transvaginal e flebografia

    Directory of Open Access Journals (Sweden)

    Fanilda Souto Barros

    2010-06-01

    Full Text Available Introduction: Pelvic varicose veins, one of the main causes of chronic pelvic pain and dyspareunia, are an important source of reflux for lower limb varicose veins, especially in recurrent cases. Color Doppler ultrasound of the lower limbs and transvaginal ultrasound are the noninvasive diagnostic methods most commonly used to assess pelvic venous insufficiency, whereas phlebography is still considered as the gold standard. Objectives: To determine the prevalence of lower limb varicose veins originating from the pelvis in a group of female patients and to determine the agreement between results obtained via color Doppler ultrasound of the lower limbs, transvaginal ultrasound, and phlebography. Methods: The sample comprised female patients referred to a vascular laboratory for lower limb screening. Patients diagnosed with deep venous thrombosis were excluded. Data analysis included kappa coefficient of agreement, McNemar's test, sensitivity and specificity values. Results: Of a total of 1,020 patients, 124 (12.2% had findings compatible with reflux of pelvic origin. Among these patients, 51 (41.2% were recurrent cases. A total of 249 were submitted to transvaginal ultrasound. There was significant agreement between lower limb ultrasonographic findings and transvaginal findings. Phlebography was performed in 54 patients. The comparison between transvaginal ultrasound and phlebography was associated with a 96.2% sensitivity and 100% specificity. Conclusions: The authors draw attention to the relatively high prevalence of lower limb varicose veins originating from the pelvis, suggesting an important but underdiagnosed cause of recurrent varicose veins.Introdução: AS VARIZES Pélvicas, uma das principais causas de dor pélvica crônica e dispareunia, são uma importante fonte de refluxo para as varizes dos membros inferiores, especialmente em casos recorrentes. O Doppler colorido dos membros inferiores e o ultrassom transvaginal são os m

  11. Effect of Cervical Pessary on Spontaneous Preterm Birth in Women With Singleton Pregnancies and Short Cervical Length: A Randomized Clinical Trial.

    Science.gov (United States)

    Saccone, Gabriele; Maruotti, Giuseppe Maria; Giudicepietro, Antonia; Martinelli, Pasquale

    2017-12-19

    Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation. Parallel-group, nonblinded, randomized clinical trial conducted from March 1, 2016, to May 25, 2017, at a single center in Italy. Asymptomatic women with singleton gestations, no previous spontaneous preterm births, and cervical lengths of 25 mm or less at 18 weeks 0 days to 23 weeks 6 days of gestation were eligible. Patients were randomized 1:1 to receive either cervical pessary (n = 150) or no pessary (n = 150). The pessary was removed between 37 weeks 0 days and 37 weeks 6 days of gestation or earlier if clinically indicated. The control group received standard care. For cervical length of 20 mm or shorter, women in both groups were prescribed vaginal progesterone, 200 mg/d, until 36 weeks 6 days of gestation. No bed rest or activity restriction was recommended. The primary end point was spontaneous preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse events. Among 300 women who were randomized (mean age, 29 [SD, 6.3] years; mean gestational age, 22 [SD, 1.3] weeks), 100% completed the trial. The primary end point occurred in 11 women (7.3%) in the pessary group and 23 women (15.3%) in the control group (between-group difference, -8.0% [95% CI, -15.7% to -0.4]; relative risk, 0.48 [95% CI, 0.24-0.95]). During follow-up, the pessary group had a higher rate of increased or new vaginal discharge (86.7% vs 46.0%; between-group difference, +40.7% [95% CI, +30.1%-+50.3%]; relative risk, 1.88 [95% CI, 1.57-2.27]). Among women without prior spontaneous preterm birth who had asymptomatic

  12. A Case Report and Literature Review of Spontaneous Perforation of Pyometra.

    Science.gov (United States)

    Uno, Kaname; Tano, Sho; Yoshihara, Masato; Mayama, Michinori; Ukai, Mayu; Kishigami, Yasuyuki; Nishikawa, Yoshitomo; Takeichi, Yasushi; Oguchi, Hidenori

    2016-05-01

    Pyometra is defined as an accumulation of purulent material in the uterine cavity. Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. We report a rare and difficult case of peritonitis in an elderly female that was caused by a spontaneous perforation of pyometra. A 90-year-old postmenopausal woman was referred to our hospital with complaints of vomiting, fever, and abdominal pain. Computed tomography revealed a large amount of ascites, cystic mass in the uterus, and intraperitoneal and intrauterine air. Transvaginal ultrasound demonstrated a thin area around the fundus. An emergency laparotomy was performed for the suspected gastrointestinal perforation or perforation of pyometra. At laparotomy, copious purulent fluid was present in the peritoneal cavity; however, no perforation of the gastrointestinal tract was observed. We identified a perforation site over the uterine fundus and purulent material exuding from the cavity. Subsequently, hysterectomy and bilateral salpingo-oophorectomy were performed. The patient was discharged on postoperative day 13 with no complications. Histopathologic studies revealed endometritis and myometritis with no evidence of malignancy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With diffuse peritonitis, ruptured pyometra should be considered, even in elderly female patients. This case illustrates the importance of clinical knowledge of acute gynecologic diseases. Here we also review the perforation of pyometra with no evidence of malignancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Spying on spontaneous combustion

    Energy Technology Data Exchange (ETDEWEB)

    1994-11-01

    The British Coal Technical Services and Research Executive (TSRE) has carried out a project to investigate potential applications of fibre optic based distributed temperature sensing (DTS) technology within a mining environment. The objective was to determine whether DTS could identify and locate spontaneous combustion earlier than conventional systems. The trials took place in a British mine from April to September 1992 and from August to November 1993 using a commercially available system from York Sensors Ltd. Results indicate that DTS is capable of very sensitive temperature monitoring, revealing sub-degree thermal trends resulting from various activities and local heatings. DTS has several prospective mining applications, e.g. monitoring known hot spots, investigating ventilation and heat flow through mine workings. The trials show that the system can be installed, calibrated, operated and maintained by relatively inexperienced personnel. 1 photo.

  14. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial.

    Science.gov (United States)

    Barber, Matthew D; Brubaker, Linda; Burgio, Kathryn L; Richter, Holly E; Nygaard, Ingrid; Weidner, Alison C; Menefee, Shawn A; Lukacz, Emily S; Norton, Peggy; Schaffer, Joseph; Nguyen, John N; Borello-France, Diane; Goode, Patricia S; Jakus-Waldman, Sharon; Spino, Cathie; Warren, Lauren Klein; Gantz, Marie G; Meikle, Susan F

    2014-03-12

    More than 300,000 surgeries are performed annually in the United States for pelvic organ prolapse. Sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are commonly performed transvaginal surgeries to correct apical prolapse. Little is known about their comparative efficacy and safety, and it is unknown whether perioperative behavioral therapy with pelvic floor muscle training (BPMT) improves outcomes of prolapse surgery. To compare outcomes between (1) SSLF and ULS and (2) perioperative BPMT and usual care in women undergoing surgery for vaginal prolapse and stress urinary incontinence. Multicenter, 2 × 2 factorial, randomized trial of 374 women undergoing surgery to treat both apical vaginal prolapse and stress urinary incontinence was conducted between 2008 and 2013 at 9 US medical centers. Two-year follow-up rate was 84.5%. The surgical intervention was transvaginal surgery including midurethral sling with randomization to SSLF (n = 186) or ULS (n = 188); the behavioral intervention was randomization to receive perioperative BPMT (n = 186) or usual care (n = 188). The primary outcome for the surgical intervention (surgical success) was defined as (1) no apical descent greater than one-third into vaginal canal or anterior or posterior vaginal wall beyond the hymen (anatomic success), (2) no bothersome vaginal bulge symptoms, and (3) no re-treatment for prolapse at 2 years. For the behavioral intervention, primary outcome at 6 months was urinary symptom scores (Urinary Distress Inventory; range 0-300, higher scores worse), and primary outcomes at 2 years were prolapse symptom scores (Pelvic Organ Prolapse Distress Inventory; range 0-300, higher scores worse) and anatomic success. At 2 years, surgical group was not significantly associated with surgical success rates (ULS, 59.2% [93/157] vs SSLF, 60.5% [92/152]; unadjusted difference, -1.3%; 95% CI, -12.2% to 9.6%; adjusted odds ratio [OR], 0.9; 95% CI, 0.6 to 1

  15. Transvaginal cervical length and amniotic fluid index: can it predict delivery latency following preterm premature rupture of membranes?

    Science.gov (United States)

    Mehra, Suwan; Amon, Erol; Hopkins, Sarah; Gavard, Jeffrey A; Shyken, Jaye

    2015-03-01

    We sought to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROM). This was a prospective observational study of TVCL measurements in 106 singleton pregnancies with PPROM between 23-33 weeks. Delivery latency was defined as the period (in days) from the initial TVCL after PPROM to delivery of the infant, with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression. Sensitivity, specificity, and predictive values were used to examine whether the presence of a short TVCL, AFI, or a combination of both affected the risk of delivery within 7 days. Delivery within 7 days occurred in 51/106 (48%) of pregnancies. Median duration (interquartile range) from PPROM to delivery and TVCL to delivery was 8 days (4.0-16.0) and 8 days (3.0-15.0), respectively. Using multiple regression TVCL as a continuous variable (odds ratio, 0.65; 95% confidence interval, 0.44-0.97; P 7 days for TVCL >2 cm alone was 61%. This predictive value changed when analyzed in conjunction with an AFI ≤5 cm and >5 cm at 42% and 89%, respectively. A shorter TVCL and an AFI ≤5 cm independently predict delivery within 7 days in women presenting with PPROM. The combination of an AFI >5 cm and TVCL >2 cm greatly improved the potential to remain undelivered at 7 days following cervical length assessment. These findings may be helpful for counseling and optimizing maternal and neonatal care in women with PPROM. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 360-degree 3D transvaginal ultrasound system for high-dose-rate interstitial gynaecological brachytherapy needle guidance

    Science.gov (United States)

    Rodgers, Jessica R.; Surry, Kathleen; D'Souza, David; Leung, Eric; Fenster, Aaron

    2017-03-01

    Treatment for gynaecological cancers often includes brachytherapy; in particular, in high-dose-rate (HDR) interstitial brachytherapy, hollow needles are inserted into the tumour and surrounding area through a template in order to deliver the radiation dose. Currently, there is no standard modality for visualizing needles intra-operatively, despite the need for precise needle placement in order to deliver the optimal dose and avoid nearby organs, including the bladder and rectum. While three-dimensional (3D) transrectal ultrasound (TRUS) imaging has been proposed for 3D intra-operative needle guidance, anterior needles tend to be obscured by shadowing created by the template's vaginal cylinder. We have developed a 360-degree 3D transvaginal ultrasound (TVUS) system that uses a conventional two-dimensional side-fire TRUS probe rotated inside a hollow vaginal cylinder made from a sonolucent plastic (TPX). The system was validated using grid and sphere phantoms in order to test the geometric accuracy of the distance and volumetric measurements in the reconstructed image. To test the potential for visualizing needles, an agar phantom mimicking the geometry of the female pelvis was used. Needles were inserted into the phantom and then imaged using the 3D TVUS system. The needle trajectories and tip positions in the 3D TVUS scan were compared to their expected values and the needle tracks visualized in magnetic resonance images. Based on this initial study, 360-degree 3D TVUS imaging through a sonolucent vaginal cylinder is a feasible technique for intra-operatively visualizing needles during HDR interstitial gynaecological brachytherapy.

  17. Value of endometrial thickness assessed by transvaginal ultrasound for the prediction of endometrial cancer in patients with postmenopausal bleeding.

    Science.gov (United States)

    Schramm, Amelie; Ebner, Florian; Bauer, Emanuel; Janni, Wolfgang; Friebe-Hoffmann, Ulrike; Pellegrino, Miriam; De Gregorio, Nikolaus; Friedl, Thomas W P

    2017-08-01

    Histological confirmation of endometrial cancer by dilatation/curettage (D/C) in women with postmenopausal bleeding (PMB) can be challenging due to anesthesiological and/or surgical risks. Thus, less invasive methods for diagnostics are required to identify patients with minimal risk for endometrial cancer (EC) to avoid unnecessary surgical intervention. The objective of this single-center cohort study was to assess the diagnostic validity of transvaginal ultrasound (TVUS) measurements of endometrial thickness (ET) in patients with PMB for the detection of EC. A retrospective analysis of data from patients presenting between January 2005 and August 2014 at the Department of Obstetrics and Gynecology, University Hospital Ulm, Germany, with PMB and subsequent D/C was performed. Complete data with TVUS documentation of ET and histological results of tissue samples were available from 254 patients. In addition, data on age, body mass index (BMI), ASA-score, diabetes, hypertension, and hematological laboratory values (for a smaller subsample) were recorded. To identify independent risk factors, a multivariate logistic regression with endometrial cancer as binary response variable (yes/no) was performed. Diagnostic efficacy data for different ET cutoff points (≤1 to ≤26 mm) were obtained by a receiver operator characteristic (ROC) curve analysis. The multivariate logistic regression revealed a significant independent predictive value for age and ET. However, none of the analyzed ET cutoff points showed optimal diagnostic validity, as all cutoff points with sensitivity rates above 90% (≤1 to ≤5 mm) had false positive rates of 70% and higher. There is no ET cutoff point that provides good diagnostic accuracy and/or reliably excludes the presence of endometrial cancer in patients with PMB. Thus, our data analysis supports the actual German approach of histological evaluation of any PMB to confirm or exclude EC.

  18. Perifollicular vascularity as a potential variable affecting outcome in stimulated intrauterine insemination treatment cycles: a study using transvaginal power Doppler.

    Science.gov (United States)

    Bhal, P S; Pugh, N D; Gregory, L; O'Brien, S; Shaw, R W

    2001-08-01

    The aim of the present study was to assess any potential relationship between perifollicular vascularity and outcome in an in-vivo environment following human chorionic gonadotrophin (HCG) administration. A total of 182 unselected consecutive patients undergoing stimulated intrauterine insemination (IUI) cycles was recruited where the perifollicular vascularity of follicles > or =16 mm was studied using a subjective grading system and transvaginal power Doppler ultrasonography, 36 h after HCG administration. A total of 601 follicles was studied. The incidence of follicles showing high-grade perifollicular vascularity (3 and 4) was higher than those with low-grade vascularity (1 and 2) (80 versus 20%). Treatment cycles were divided according to uniformity of vascularity grades of follicles > or =16 mm on the day of IUI [55% all high (3/4) grade; 33% mixed (1/2 and 3/4) and 12% all low (1/2) grade]. The mean age and duration of subfertility were significantly higher (P or =16 mm pre/post HCG, serum oestradiol and incidence of ultrashort gonadotrophin-releasing hormone (GnRH) agonist use were all significantly lower (P cycles with uniformly low follicular vascularity grades compared with mixed or uniformly high-grade cycles. However, on subjecting the data to multiple logistic regression analysis, the only independent variables that affected pregnancy rates appeared to be serum oestradiol (OR 1.28, 1.01--1.62) and high-grade follicular vascularity (OR 2.41, 1.08--5.40). These data would suggest that perifollicular vascularity has an important role to play in the outcome of IUI cycles, and that power Doppler has the potential to refine the management of assisted reproduction treatment cycles.

  19. Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan [Aju University SChool of Medicine, Suwon (Korea, Republic of)

    1999-06-15

    To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

  20. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  1. Bacterial vaginosis in early pregnancy is associated with low birth weight and small for gestational age, but not with spontaneous preterm birth: A population-based study on Danish women

    DEFF Research Database (Denmark)

    Thorsen, Poul; Vogel, Ida; Olsen, Jørn

    2006-01-01

    Objective. To analyze the association between bacterial vaginosis (BV) in early pregnancy and preterm birth, low birth weight (LBW) and small for gestational age (SGA) in a Danish population. Methods. A geographically defined population-based prospective study of Danish-speaking pregnant women over...

  2. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal

    OpenAIRE

    Campaner, Adriana Bittencourt; Piato,Sebastião; Ribeiro, Paulo Ayrosa Galvão; Aoki, Tsutomo; Nadais, Ricardo da Fonseca; Prado,Roberto Adelino de Almeida

    2004-01-01

    OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19%) recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangram...

  3. Sangrado transvaginal durante el embarazo, como factor de riesgo para isoinmunización al antígeno Rhesus-D

    Directory of Open Access Journals (Sweden)

    Hernández-Andrade Edgar

    2003-01-01

    Full Text Available OBJETIVO: Evaluar el sangrado transvaginal en cualquier etapa del embarazo como factor de riesgo para la sensibilización al antígeno eritrocitario Rhesus-D en mujeres previamente no isoinmunizadas (Rh(-NI, como una alternativa para la aplicación rutinaria de gama-globulina anti-D a la semana 28 de gestación. MATERIAL Y MÉTODOS: Estudio de casos y controles consecutivos, efectuado en el Instituto Nacional de Perinatología de la Ciudad de México, en el periodo de 1995 a 2001.Casos (n=24, pacientes Rh(-NI que mostraron seroconversión positiva de anticuerpos contra el componente D del antígeno Rh durante el embarazo o en el puerperio inmediato. Controles (n=24, mujeres Rh(-NI, captadas consecutivamente y que no presentaron seroconversión positiva de anticuerpos Anti-D. En todos los casos los recién nacidos fueron Rh positivos. Ninguna de las pacientes recibió inmunoprofilaxis Anti-D a la semana 28 de gestación. Se evaluaron periodos de sangrado transvaginal en cualquier etapa del embarazo y antes del inicio del trabajo de parto. Se estimaron razones de probabilidad e intervalos de confianza de 95%. RESULTADOS: La presencia de sangrado transvaginal se observó en 18/24 (75% de los casos y en 5/24 de los controles (20%. La actividad uterina pretérmino y la amenaza de aborto fueron las causas más frecuentes identificadas como causa de este sangrado. La presencia de uno solo de estos eventos durante cualquier etapa del embarazo aumentó 11.4 veces (IC 95% 2.9-44.0 el riesgo de sensibilización al antígeno eritrocitario Rh-D, y si el sangrado se presentó después de la semana 20 el riesgo se incrementó 5.0 veces (IC 95% 1.3-19.1. La presencia de sangrado antes de la semana 20 no se asoció con un incremento significativo en el riesgo de sensibilización (OR=7.6, IC 95% 0.8-69.5. CONCLUSIONES: En presencia de cualquier sangrado transvaginal durante el embarazo en una paciente Rh-NI se recomienda la aplicación profiláctica de gama

  4. Spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Haritanti, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Karacostas, D. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: bneurol@med.auth.gr; Drevelengas, A. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Kanellopoulos, V. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)], E-mail: vasikanel@hotmail.com; Paraskevopoulou, E. [Department of Neurology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece); Lefkopoulos, A.; Economou, I.; Dimitriadis, A.S. [Department of Radiology, Aristotele' s University School of Medicine, AHEPA University Hospital, 54636 Thessaloniki (Greece)

    2009-02-15

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches.

  5. Spontaneous fission of the heaviest elements

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D.C.

    1989-04-01

    Although spontaneous fission was discovered in /sup 238/U in 1940, detailed studies of the process were first made possible in the 1960's with the availability of milligram quantities of /sup 252/Cf. The advent of solid-state detectors made it possible to perform measurements of coincident fission fragments from even very short-lived spontaneous fission activities or those available in only very small quantities. Until 1971 it was believed that the main features of the mass and kinetic-energy distributions were essentially the same as those for thermal neutron-induced fission and that all low-energy fission proceeded via asymmetric mass division with total kinetic energies which could be derived by linear extrapolation from those of lighter elements. In 1971, measurements of /sup 257/Fm showed an increase in symmetric mass division with anomalously high TKE's. Subsequent experiments showed that in /sup 258/Fm and /sup 259/Fm, the most probable mass split was symmetric with very high total kinetic energy. Measurements for the heavier elements have shown symmetric mass distributions with both high and low total kinetic energies. Recent results for spontaneous fission properties of the heaviest elements are reviewed and compared with theory. 31 refs., 8 figs., 1 tab.

  6. Ziprasidone-induced spontaneous orgasm.

    Science.gov (United States)

    Boora, K; Chiappone, K; Dubovsky, S; Xu, J

    2010-06-01

    Neuroleptic treatment in schizophrenic patients has been associated with sexual dysfunction, including impotence and decreased libido. Spontaneous ejaculation without sexual arousal during typical antipsychotic treatment is a rare condition that has been described with zuclopentixol, trifluoperazine, and thiothixene. Here, we are reporting a case of spontaneous orgasm with ziprasidone in a bipolar patient. This patient began to repeatedly experience spontaneous sexual arousal and orgasm, which she had never experienced in the past. Ziprasidone might be causing an increase in sexual orgasm by 5-HT2 receptor antagonism, which preclinical evidence suggests that it facilitates dopamine release in the cortex.

  7. Spontaneous intraorbital hematoma: case report

    Directory of Open Access Journals (Sweden)

    Vinodan Paramanathan

    2010-12-01

    Full Text Available Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as severe ocular pains, eyelid edema, proptosis, and diplopia, without a history of trauma. Computer tomography demonstrated a fairly well defined extraconal lesion with opacification of the paranasal sinuses. The principal differential based on all findings was that of a spreading sinus infection and an extraconal tumor. An unprecedented finding of a spontaneous orbital hematoma was discovered when the patient was taken to theater. We discuss the rarity of this condition and its management.Keywords: hemorrhage, ophthalmology, spontaneous, intra-orbital, hematoma

  8. Comparison of the clinical and quality-of-life outcomes after the inside-out TVT-O procedure with or without concomitant transvaginal gynaecological surgery.

    Science.gov (United States)

    Cho, M K; Kim, C H; Kang, W D; Kim, J W; Kim, S M; Kim, Y H

    2012-04-01

    The study was undertaken to compare the clinical and quality-of-life (QoL) outcomes of the inside-out transobturator vaginal tape (TVT-O)-only procedures and TVT-O procedures with concomitant transvaginal gynaecological surgery for the treatment of stress urinary incontinence (SUI). A review of charts from January 2006 to March 2010 identified 305 patients with urodynamic stress incontinence for whom we performed the TVT-O. Of the initial 305 patients, 272 (89.2%) were re-examined for complications 1 month, 4 months, 1 year and 2-4 years postoperatively (122 TVT-O only; 150 TVT-O + other transvaginal gynaecological surgery). They were also evaluated with the Urogenital Distress Inventory Questionnaire (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) 1-4 years after the procedure. The median follow-up was 37.3 months. The success rate was 89.3% in the TVT-O-only group vs 93.3% in the TVT-O with concomitant gynaecological surgery group (p =0.729). The QoL score was quite good for 91.8% of the TVT-O-only patients and for 96.7% of the TVT-O with concomitant gynaecologic surgery patients (p =0.405). In conclusion, gynaecological operations performed concomitantly with the TVT-O procedure do not affect the clinical and QoL outcomes of the TVT-O procedure.

  9. Sonoembryology of the fetal posterior fossa at 11 + 3 to 13 + 6 gestational weeks on three-dimensional transvaginal ultrasound.

    Science.gov (United States)

    Altmann, Reinhard; Scharnreitner, Iris; Scheier, Thomas; Mayer, Richard; Arzt, Wolfgang; Scheier, Matthias

    2016-08-01

    To describe the sonographic appearance and temporal changes of the structures of the posterior cranial fossa in fetuses at a crown-rump length (CRL) between 45 and 84 mm in transvaginal acquired three-dimensional volume blocks. This was a prospective, cross-sectional, observational study including 80 fetuses, whose mothers attended Kepler University Hospital Linz or the Ambulatorium für Fetalmedizin Feldkirch for first-trimester sonography. Three-dimensional volume blocks were acquired in a standardized way and after processing the sonographic characteristics of the brainstem, cerebellar vermis, choroid plexus, anterior membranous area (AMA) and Blake's metapore were described. Measurements of the length of the cerebellar vermis, the length of the AMA and the medulla-oblongata-pons angle (MOPA) were performed. In 20 fetuses the intra- and interobserver repeatability was calculated. The sonomorphologic characteristics of posterior fossa structures as cerebellar vermis, AMA, Blake's metapore, choroid plexus, pons and medulla oblongata were described. There is a significant correlation between CRL and vermis length, CRL and MOPA and CRL and AMA. Transvaginal three-dimensional sonography allows a detailed depiction of the structures of the posterior fossa and their temporal course in early pregnancy. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  10. Laparoscopic-assisted tension-free vaginal mesh: an innovative approach to placing synthetic mesh: transvaginally for surgical correction of pelvic organ prolapse.

    Science.gov (United States)

    Watanabe, Toyohiko; Inoue, Miyabi; Ishii, Ayano; Yamato, Toyoko; Yamamoto, Masumi; Sasaki, Katsumi; Kobayashi, Yasuyuki; Araki, Motoo; Uehara, Shinya; Saika, Takashi; Kumon, Hiromi

    2012-01-01

    Polypropylene mesh implants for the correction of pelvic organ prolapse (POP) are now available in Japan. We developed an innovative approach for correcting POP by placing polypropylene mesh transvaginally with laparoscopic assistance. From June 2007 through March 2010, sixteen consecutive patients with symptomatic stage 2 or 3 pelvic organ prolapse underwent the laparoscopic-assisted tension-free vaginal mesh procedure at Okayama University Hospital. All patients were evaluated before and at 1, 3, 6, and 12 months after surgery. Female sexual function was also evaluated with the Female Sexual Function Index (FSFI). The procedure was performed successfully without significant complications. Fifteen of 16 patients were considered anatomically cured (93.8%) at 12 months postoperatively. One patient with a recurrent stage 3 vaginal vault prolapse required sacral colpopexy six months postoperatively. Total FSFI scores improved significantly from 10.3 ± 1.3 at baseline to 18.0 ± 1.2 at 12 months after surgery. The laparoscopic-assisted trans-vaginal mesh is a safe, effective, and simple procedure for POP repairs. The procedure not only restores anatomic relationships but also improves sexual function.

  11. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  12. Bowel prolapse following spontaneous rupture of a femoral hernia.

    Science.gov (United States)

    Sein, Tin Aung; Damodaran, Ashok

    2012-09-01

    This case presents a rare complication of the spontaneous rupture of a femoral hernia in an elderly woman without causing much systemic effect despite the herniated bowel being necrosed and perforated, giving rise to an enterocutaneous fistula. The small bowel had also prolapsed through the fistula opening, making it a very rare and alarming presentation.

  13. Lazzaro Spallanzani and his refutation of the theory of spontaneous generation

    National Research Council Canada - National Science Library

    Mancini, Renata; Nigro, Mario; Ippolito, Giuseppe

    2007-01-01

    .... The English Catholic priest claimed to have demonstrated the validity of the theory of spontaneous generation after observing the growth of small organisms in some chicken broth placed in sealed flasks and heated for 30 minutes. Spallanzani found significant errors in the experiments conducted by Needham and, after trying several variations on them, disproved the theory of spontaneous generation.

  14. The Relationship among Spontaneity, Impulsivity, and Creativity

    Science.gov (United States)

    Kipper, David A.; Green, Doreen J.; Prorak, Amanda

    2010-01-01

    The present study was designed to investigate two characteristics of spontaneity, its relationship to creativity and to impulsivity. We hypothesized a positive relationship between spontaneity and creativity, consistent with Moreno, 1953 "canon of spontaneity-creativity." We also predicted a negative relationship between spontaneity and…

  15. Spontaneous Rupture of Umbilical Hernia in Pregnancy: A Case Report

    OpenAIRE

    Yahaya Ukwenya; Garba Stephen; Adamu Ahmed

    2011-01-01

     A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to ...

  16. Pseudoarachnoiditis in Spontaneous Intracranial Hypotension

    Directory of Open Access Journals (Sweden)

    Özlem Alkan

    2011-03-01

    Full Text Available Spontaneous intracranial hypotension is an important cause of new daily persistent headaches in young and middle-aged individuals. The diagnosis is made based on low cerebrospinal fluid pressure with characteristic findings upon brain and spinal magnetic resonance imaging (MRI. We present the case of a 15-year-old boy with spontaneous intracranial hypotension. Although his brain MRI was normal, his lumbar spinal MRI showed clustering of the nerve roots characteristic of arachnoiditis. Radionuclide cisternography revealed an epidural leak, which was treated with an epidural blood patch. The patient reached a near-full recovery within 24 h, and the lumbar spinal MRI findings mimicking arachnoiditis disappeared.

  17. Spontaneous waves in muscle fibres

    Energy Technology Data Exchange (ETDEWEB)

    Guenther, Stefan; Kruse, Karsten [Department of Theoretical Physics, Saarland University, 66041 Saarbruecken (Germany); Max Planck Institute for the Physics of Complex Systems, Noethnitzer Street 38, 01187 Dresden (Germany)

    2007-11-15

    Mechanical oscillations are important for many cellular processes, e.g. the beating of cilia and flagella or the sensation of sound by hair cells. These dynamic states originate from spontaneous oscillations of molecular motors. A particularly clear example of such oscillations has been observed in muscle fibers under non-physiological conditions. In that case, motor oscillations lead to contraction waves along the fiber. By a macroscopic analysis of muscle fiber dynamics we find that the spontaneous waves involve non-hydrodynamic modes. A simple microscopic model of sarcomere dynamics highlights mechanical aspects of the motor dynamics and fits with the experimental observations.

  18. Spontaneous isolated celiac artery dissection

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2011-01-01

    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  19. Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele.

    Science.gov (United States)

    Chung, Choon Sik; Yu, Sang Hwa; Lee, Jeong Eun; Lee, Dong Keun

    2012-06-01

    This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure. Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months. On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 ± 0.20 vs. 2.25 ± 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (≥4 cm) after the procedure (P = 0.001) In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased.

  20. Quality of life in women of non-reproductive age with transvaginal mesh repair for pelvic organ prolapse: A cohort study.

    Science.gov (United States)

    Hüsch, Tanja; Mager, René; Ober, Erika; Bentler, Ralf; Ulm, Kurt; Haferkamp, Axel

    2016-09-01

    Transvaginal mesh repair has been discredited due to high complications rates in the past years. Therefore, we evaluated the quality of life (QoL) and complication rates after transvaginal mesh (TVM) repair for pelvic organ prolapse (POP). A total of 148 women who underwent TVM repair for symptomatic POP were retrospectively enrolled. Complication rates and functional outcomes were retrospectively assessed and validated, standardised questionnaires were used prospectively for evaluation of QoL. Univariate analysis by the chi(2)-test as well as a multivariate Cox regression analysis was conducted to predict mesh exposure using various variables as predictors. Intraoperative complications with bowel or bladder injury appeared in 3.4%. Mesh exposure occurred in 2.7% whereas surgical revision was necessary only in 1.4%. No predictor for mesh exposure could be identified. Postoperative complications according to Clavien-Dindo classification ≥ III occurred in only 2.8%. An improvement of POP-symptoms was reported by 84.6% according the "patients' global impression of improvement" (PGI-I) and 88.2% women would repeat the surgery. The results of the "prolapse-quality of life"-questionnaire were comparable to asymptomatic women. Only 33% reported vaginal pain with a mean vaginal pain score of 0.6 according the international index of pain. Of sexually active women, 29% reported sexual impairments and mean score of sexual impairment was 1.52. Low complication rates and a quality of life comparable to asymptomatic women following TVM repair could be achieved in our cohort. However, a high number of sexual impairments was identified although the impact of impairment was marginal. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Accuracy of pre operative real time dynamic transvaginal ultrasound sliding sign in prediction of pelvic adhesions in women with previous abdominopelvic surgery. A prospective multicenter double blinded study.

    Science.gov (United States)

    Ayachi, Amira; Bouchahda, Rim; Derouich, Sadok; Mkaouer, Lassaad; Kehila, Mehdi; Abouda, Hassine; Channoufi, Badis; Bouyahia, Maha; Braham, Marouen; Zhioua, Fethi; Bouchahda, Haifa; Mourali, Mechaal

    2017-03-13

    To highlight the role of the transvaginal ultrasound sliding sign in predicting pelvic adhesions in women with a previous history of abdominopelvic surgery. Multicenter prospective, interventional, double blinded study. Patients were examined before the laparoscopy or laparotomy, in gynaecological position, with transvaginal ultrasound (TVU) probe to assess vesico uterine pouch, uterus, ovaries, pouch of Douglas by analysing the gliding between two structures. Ultrasounds findings, medical and surgical data were recorded. Accuracy of preoperative TVU sliding sign in diagnosis of pelvic adhesions for each compartment were calculated using sensitivity, specificity, PPV, NPV, LR+, LR- and ROC curves were analysed. During the study period, complete TVU sliding sign and laparoscopic or laparotomy data were available for 107 women. The mean age of our patients in this study was 43.96 (95% CI 41.56-46.35) (range 20 to 79 years). The mean parity was 1.97 (95% CI 1.66-2.29) (range 0 to 9). The mean number of previous abdominal surgeries was 1.33 (95% CI 1.20-1.45) (range 0 to 4). Adhesions were noted at 27/107 (25.23 %) patients with history of abdominopelvic surgery. In our study, the sliding sign technique had a total sensitivity of 96.3% and a total specificity of 92.6%. A significant relationship was noticed between adhesions in each compartment and the ultrasound pelvic sliding sign (p sign could help in the planning and counselling of the surgery for patients with previous abdominopelvic surgery. This article is protected by copyright. All rights reserved.

  2. Biomarkers of spontaneous preterm birth

    DEFF Research Database (Denmark)

    Polettini, Jossimara; Cobo, Teresa; Kacerovsky, Marian

    2017-01-01

    Despite decades of research on risk indicators of spontaneous preterm birth (PTB), reliable biomarkers are still not available to screen or diagnose high-risk pregnancies. Several biomarkers in maternal and fetal compartments have been mechanistically linked to PTB, but none of them are reliable...

  3. THE RATE OF SPONTANEOUS MUTATION

    Indian Academy of Sciences (India)

    The Rate of Spontaneous Mutation of a Human Gene. (Published on 1935 J. Genet. 31, 317-326). J. B. S. Haldane. J. Genet. Classic Volume 83 Issue 3 December 2004 pp 235-244. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/jgen/083/03/0235-0244. Author Affiliations.

  4. Spontaneously disappearing lumbar disc protrusion

    OpenAIRE

    Ushewokunze, Shungu; Abbas, Naeem; Dardis, Ronan; Killeen, Ian

    2008-01-01

    Spontaneous disappearance of a herniated lumbar disc is known to occur. This case study describes a 45-year-old patient whose symptoms of lumbar radiculopathy resolved and follow-up imaging showed complete disappearance of the disc prolapse. This phenomenon strengthens the role of conservative treatment in the management of lumbar disc protrusions.

  5. Spontaneous fission of superheavy nuclei

    Indian Academy of Sciences (India)

    and penetrability for binary nuclear configurations typical for fission processes. The deformed two- ... Finally, the WKB method is used to calculate penetrabilities and spontaneous fission half-lives. Calculations ... the mass tensor components contain binary character of the process, because the pairing. Pramana – J. Phys.

  6. Shell theorem for spontaneous emission

    DEFF Research Database (Denmark)

    Kristensen, Philip Trøst; Mortensen, Jakob Egeberg; Lodahl, Peter

    2013-01-01

    and therefore is given exactly by the dipole approximation theory. This surprising result is a spontaneous emission counterpart to the shell theorems of classical mechanics and electrostatics and provides insights into the physics of mesoscopic emitters as well as great simplifications in practical calculations....

  7. Spontaneous complete chorioamniotic membrane separation ...

    African Journals Online (AJOL)

    Apart from the association with Down syndrome, other complications include preterm labour, premature rupture of membranes, IUGR, fetal malformation and fetal death. Such pregnancies require close fetal surveillance and occasionally inpatient management. Case: We present a case of spontaneous complete CAS and ...

  8. Prediction of Spontaneous Preterm Birth

    NARCIS (Netherlands)

    Dijkstra, Karolien

    2002-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

  9. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  10. Glioblastoma Multiforme Presenting as Spontaneous Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Cagatay Ozdol

    2014-06-01

    Full Text Available Brain tumors with concomitant intracerebral hemorrhage are rarely encountered. Hemorrhage as the initial presentation of a brain tumour may pose some diagnostic problems, especially if the tumour is small or the hemorrhage is abundant. We present a 47-year-old man who admitted to the emergency department with sudden onset headache, right blurred vision and gait disturbance. A non-contrast cranial computerized tomography scan performed immediately after his admission revealed a well circumscribed right occipitoparietal haematoma with intense peripheral edema causing compression of the ipsilateral ventricles. On 6th hour of his admission the patient%u2019s neurological status deteriorated and he subsequently underwent emergent craniotomy and microsurgical evacuation of the haematoma. The histopathological examination of the mass was consistent with a glioblastoma multiforme. Neoplasms may be hidden behind each case of spontaneous intracerebral hemorrhage. Histological sampling and investigation is mandatory in the presence of preoperative radiological features suggesting a neoplasm.

  11. Spontaneous creation of the universe from nothing

    CERN Document Server

    He, Dongshan; Cai, Qing-yu

    2014-01-01

    An interesting idea is that the universe could be spontaneously created from nothing, but no rigorous proof has been given. In this paper, we present such a proof based on the analytic solutions of the Wheeler-DeWitt equation (WDWE). Explicit solutions of the WDWE for the special operator ordering factor p=-2 (or 4) show that, once a small true vacuum bubble is created by quantum fluctuations of the metastable false vacuum, it can expand exponentially no matter whether the bubble is closed, flat or open. The exponential expansion will end when the bubble becomes large and thus the early universe appears. With the de Broglie-Bohm quantum trajectory theory, we show explicitly that it is the quantum potential that plays the role of the cosmological constant and provides the power for the exponential expansion of the true vacuum bubble. So it is clear that the birth of the early universe completely depends on the quantum nature of the theory.

  12. Ion cyclotron emission by spontaneous emission

    Energy Technology Data Exchange (ETDEWEB)

    Da Costa, O. [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking; Gresillon, D. [Ecole Polytechnique, 91 - Palaiseau (France). Lab. de Physique des Milieux Ionises

    1994-07-01

    The goal of the study is to examine whether the spontaneous emission can account for ICE (ion cyclotron emission) experimental results, or part of them. A straightforward approach to plasma emission is chosen, investigating the near equilibrium wave radiation by gyrating ions, and thus building from the majority and fast fusion ions the plasma fluctuations and emission on the fast magnetoacoustic or compressional Alfven wave mode in the IC frequency range. Similarities with the ICE experiments are shown: the emission temperature in the presence of fast ions (even in a very small amount), the strong fast ion emission increase with the harmonic, the fine double-line splitting of each peak, the linear but not proportional increase of the peak width with the harmonic. 3 refs., 2 figs.

  13. Spontaneous Retropharyngeal Emphysema: A Case Report | Chi ...

    African Journals Online (AJOL)

    ... is a rare clinical condition in pediatric otolaryngology. The predominant symptoms are sore throat, odynophagia, dysphagia, and neck pain. Here, we report a case of spontaneous retropharyngeal emphysema. Keywords: Iatrogenic injury, retropharyngeal emphysema, spontaneous retropharyngeal emphysem, trauma ...

  14. Lunar Cycle Influences Spontaneous Delivery in Cows

    OpenAIRE

    Yonezawa, Tomohiro; Uchida, Mona; Tomioka, Michiko; Matsuki, Naoaki

    2016-01-01

    There is a popular belief that the lunar cycle influences spontaneous delivery in both humans and cattle. To assess this relationship, we investigated the synodic distribution of spontaneous deliveries in domestic Holstein cows. We used retrospective data from 428 spontaneous, full-term deliveries within a three-year period derived from the calving records of a private farm in Hokkaido, Japan. Spontaneous birth frequency increased uniformly from the new moon to the full moon phase and decreas...

  15. The moral significance of spontaneous abortion.

    OpenAIRE

    Murphy, T F

    1985-01-01

    Spontaneous abortion is rarely addressed in moral evaluations of abortion. Indeed, 'abortion' is virtually always taken to mean only induced abortion. After a brief review of medical aspects of spontaneous abortion, I attempt to articulate the moral implications of spontaneous abortion for the two poles of the abortion debate, the strong pro-abortion and the strong anti-abortion positions. I claim that spontaneous abortion has no moral relevance for strict pro-abortion positions but that the ...

  16. Spontaneous Photon Emission in Cavities

    Directory of Open Access Journals (Sweden)

    Alber G.

    2014-01-01

    Full Text Available We investigate spontaneous photon emission processes of two-level atoms in parabolic and ellipsoidal cavities thereby taking into account the full multimode scenario. In particular, we calculate the excitation probabilities of the atoms and the energy density of the resulting few-photon electromagnetic radiation field by using semiclassical methods for the description of the multimode scenario. Based on this approach photon path representations are developed for relevant transition probability amplitudes which are valid in the optical frequency regime where the dipole and the rotating-wave approximations apply. Comparisons with numerical results demonstrate the quality of these semiclassical results even in cases in which the wave length of a spontaneously emitted photon becomes comparable or even larger than characteristic length scales of the cavity. This is the dynamical regime in which diffraction effects become important so that geometric optical considerations are typically not applicable.

  17. Spontaneous rupture of the ureter

    Science.gov (United States)

    Eken, Alper; Akbas, Tugana; Arpaci, Taner

    2015-01-01

    Spontaneous rupture of the ureter is a very rare condition and usually results from ureteral obstruction by a calculus. Only theoretical mecha­nisms have been proposed and no possible explanation has yet been reported in the literature. Intravenous contrast-enhanced computed tomography is the most informative study with high sensitivity. Treatment should be individualised, and depends on the state of the patient. Minimally invasive endourological procedures with double-J catheter placement and percutaneous drainage offer excellent results. Conservative management with analgesics and antibiotic coverage may be an alternative to surgery. Herein, we present a case of spontaneous rupture of the proximal ureter with no evidence of an underlying pathological condition. PMID:25715862

  18. Spontaneous regression of colon cancer.

    Science.gov (United States)

    Kihara, Kyoichi; Fujita, Shin; Ohshiro, Taihei; Yamamoto, Seiichiro; Sekine, Shigeki

    2015-01-01

    A case of spontaneous regression of transverse colon cancer is reported. A 64-year-old man was diagnosed as having cancer of the transverse colon at a local hospital. Initial and second colonoscopy examinations revealed a typical cancer of the transverse colon, which was diagnosed as moderately differentiated adenocarcinoma. The patient underwent right hemicolectomy 6 weeks after the initial colonoscopy. The resected specimen showed only a scar at the tumor site, and no cancerous tissue was proven histologically. The patient is alive with no evidence of recurrence 1 year after surgery. Although an antitumor immune response is the most likely explanation, the exact nature of the phenomenon was unclear. We describe this rare case and review the literature pertaining to spontaneous regression of colorectal cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Spontaneous Rotational Inversion in Phycomyces

    KAUST Repository

    Goriely, Alain

    2011-03-01

    The filamentary fungus Phycomyces blakesleeanus undergoes a series of remarkable transitions during aerial growth. During what is known as the stagea IV growth phase, the fungus extends while rotating in a counterclockwise manner when viewed from above (stagea IVa) and then, while continuing to grow, spontaneously reverses to a clockwise rotation (stagea IVb). This phase lasts for 24-48Ah and is sometimes followed by yet another reversal (stageAIVc) before the overall growth ends. Here, we propose a continuum mechanical model of this entire process using nonlinear, anisotropic, elasticity and show how helical anisotropy associated with the cell wall structure can induce spontaneous rotation and, under appropriate circumstances, the observed reversal of rotational handedness. © 2011 American Physical Society.

  20. Spontaneous Perforation of Rectosigmoid Colon

    Directory of Open Access Journals (Sweden)

    Farhad Haj Sheikholeslami

    2010-12-01

    Full Text Available Spontaneous perforation of the sigmoid colon or rectom is definedas a sudden perforation of the colon in the absence of diseasessuch as tumors, diverticulosis or external injury. It is avery rare finding, and if neglected, results in severe peritonitisand high mortality. The causes of this rare condition are numerous,and in this case it might be due to the chronic constipationinduced by an anticholinergic antipsychotic.Iran J Med Sci 2010; 35(4: 339-341.

  1. Spontaneous esophageal-pleural fistula

    Directory of Open Access Journals (Sweden)

    Sameer Vyas

    2011-01-01

    Full Text Available Spontaneous esophageal-pleural fistula (EPF is a rare entity. We describe a case in a middle-aged female who presented with severe retrosternal chest pain and shortness of breadth. Chest computed tomography showed right EPF and hydropneumothorax. She was managed conservatively keeping the chest tube drainage and performing feeding jejunostomy. A brief review of the imaging finding and management of EPF is discussed.

  2. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  3. Spontaneous rupture of umbilical hernia in pregnancy: a case report.

    Science.gov (United States)

    Ahmed, Adamu; Stephen, Garba; Ukwenya, Yahaya

    2011-07-01

    A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to end anastomosis done. The hernia sac was excised and the 12 cm defect repaired. Six weeks later, she had spontaneous vaginal delivery of a live baby. We advocate that large umbilical hernias should be routinely repaired when seen in women of child bearing age.

  4. Amniotic fluid "sludge"; prevalence and clinical significance of it in asymptomatic patients at high risk for spontaneous preterm delivery.

    Science.gov (United States)

    Adanir, Ilknur; Ozyuncu, Ozgur; Gokmen Karasu, Ayse Filiz; Onderoglu, Lutfu S

    2018-01-01

    The aim of our study is to determine prevalence and clinical significance of the presence of amniotic fluid "sludge" among asymptomatic patients at high-risk for spontaneous preterm delivery, prospectively. In our study, 99 patients at high risk for spontaneous preterm delivery were evaluated for the presence of amniotic fluid sludge with transvaginal ultrasonography at 20-22, 26-28, and 32-34 gestational weeks, prospectively; between August 2009 and October 2010 in Hacettepe University Hospital. And, these patients were followed up for their delivery weeks and pregnancy outcomes. We defined the high-risk group as the patients possessing one or more of the followings; a history of spontaneous preterm delivery, recent urinary tract infections, polyhydramnios, uterine leiomyomas, müllerian duct anomalies, and history of cone biyopsy or LEEP. Patients with multiple gestations, placenta previa, fetal anomalies, or symptoms of preterm labor at first examination were excluded. We have obtained ethical board approval from Hacettepe University (16.07.2009-HEK/No:09-141-59). The prevalence of amniotic fluid sludge in the study population was 19,6% (18/92). The rates of spontaneous preterm delivery at preterm delivery (p = 0.002). A higher proportion of neonates born to patients with amniotic fluid sludge had a neonatal morbidity (50% (9/18) vs. 24,3% (18/74), p = 0.044) and died in the perinatal period, (p = 0,013) than those born to patients without sludge. When we combined sludge and cervical lenght (CL) (preterm delivery; it catched more women with preterm delivery, (p = 0.000). While sensitivity of sludge was 37,5%, and sensitivity of CL was 34%, sensitivity of "sludge positive or CL ≤25 mm" was 56% for preterm birth (PTB) in high-risk group. The prevalence of amniotic fluid sludge is 19,6% and "sludge" is an independent risk factor for spontaneous preterm delivery among asymptomatic patients at high-risk for spontaneous preterm delivery. PTB is

  5. Ultra-sonografia transvaginal do colo para a predição do parto pré-termo em pacientes sintomáticas com bolsa íntegra Transvaginal ultrasound of the cervix for predicting premature delivery in symptomatic patients with intact membranes

    Directory of Open Access Journals (Sweden)

    Lívia Teresa Moreira Rios

    2006-11-01

    Full Text Available OBJETIVOS: avaliar a utilidade do comprimento cervical ultra-sonográfico para a predição do parto em gestantes com contrações uterinas persistentes e bolsa íntegra. MÉTODOS: realizou-se estudo observacional, prospectivo, do tipo coorte no qual foram incluídas 45 gestantes internadas em nossa instituição entre a 22ª e a 34ª semana. Ultra-sonografia transvaginal do colo foi realizada uma única vez, após completado um ciclo de tocólise endovenosa, com aferição do comprimento, conforme critérios descritos previamente. Os achados ultra-sonográficos não foram utilizados para o diagnóstico ou conduta obstétrica. O desfecho estudado foi a ocorrência de parto pré-termo (PURPOSE: to assess the role of ultrasonographic cervical length in predicting premature labor in patients presenting persistent uterine contractions and intact membranes. METHODS: a prospective observational cohort study was performed in 45 women admitted to our hospital between 22 and 34 weeks of gestation. Transvaginal sonographic evaluation of the cervix was performed once in the women who had completed a course of parenteral tocolysis. The cervical length was obtained according to criteria reported previously. Cervical sonographic findings were not used in diagnosis and management. Outcome variable was the occurrence of preterm delivery (<37 weeks. Statistical analysis consisted of univariate method with the purpose of determining the significant contribution of cervical length to the prediction of preterm delivery. The adopted significance level was 5% (p<0,05 and the confidence interval was 95% (95% CI. RESULTS: the incidence of preterm delivery was 51.11% (23/45. Cervical length was significantly associated with the outcome (p<0.0001. Receiver operating characteristic curve analysis showed that a cervical length of 20 mm was the best cutoff in predicting preterm delivery (sensitivity 86.9%; specificity 81.8%; positive predictive value 83.3%; negative

  6. Anomaly in Spontaneous Discharging of Glass Dust

    Science.gov (United States)

    Vaverka, J.; Vysinka, M.; Pavlu, J.; Safrankova, J.; Nemecek, Z.

    2012-04-01

    Small bodies (dust) coexist with plasma of various parameters in space as well as in laboratories and industrial facilities. The mutual interaction of plasma particles with dust grains leads to their charging. Especially, small or irregularly shaped grains can achieve a high surface electric field even under a moderate charge. When the positive electric field is strong, the accumulated charge becomes spontaneously released. This process is known as field ion emission and can limit a maximum charge of the grain exposed to the plasma environment. We study this process experimentally in laboratory conditions using single spherical glass grains trapped in the electrodynamic quadrupole and compare obtained results with previous measurements on carbon and gold grains. Although the field emission current would be controlled by the surface electric field and thus it would decrease in time as the grain total charge does, we observed an unexpected increase of the discharging current at the beginning of discharging after electron charging of non-conducting glass grains. This increase was observed only for electron charging of non-conducting grains and can be probably attributed to the way of the charge transport toward the grain surface.

  7. Cultural Differences and Students' Spontaneous Models of the Water Cycle: A Case Study of Jewish and Bedouin Children in Israel

    Science.gov (United States)

    Ben-Zvi Assaraf, Orit; Eshach, Haim; Orion, Nir; Alamour, Yousif

    2012-01-01

    The present research aims at pinpointing differences in spontaneous and non-spontaneous mental models of water cycle conceptions of two 4th grade student groups: the Jewish residents of a small provincial town and a group of students from an indigenous Bedouin community. Students' conceptions were elicited using the Repertory Grid technique as…

  8. To Classify Spontaneous Motion Intention of Step Size by Using Cerebral Hemoglobin Information

    OpenAIRE

    Zhu Kai; Li Chun-Guang; Jin Hedian; Li Juan; Hu Haiyan; Sun Lining; Qu Wei

    2017-01-01

    To improve the effect of walking-assistive devices, there is a need for it to develop devices controlled by spontaneous intention of patients. In recent study, we identified spontaneous motion intention of walking step based on cerebral hemoglobin information. Twenty healthy subjects performed walking tasks in three levels of step size (small, normal and large). According to distribution features of signals’ power spectral-density, six frequency bands (0-0.18Hz with an interval of 0.03Hz for ...

  9. Spontaneous Biliary Peritonitis in Children

    Directory of Open Access Journals (Sweden)

    Supreethi Kohli

    2013-01-01

    Full Text Available Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG, Contrast enhanced computed tomography (CECT, and Magnetic Resonance Imaging (MRI. The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.

  10. Does Unilateral Oocyte Retrieval due to Transvaginally Inaccessible Ovaries, Contrary to Common Beliefs, Affect IVF/ICSI Treatment Outcomes That Much?

    Directory of Open Access Journals (Sweden)

    Safak Olgan

    2016-01-01

    Full Text Available Objective. To investigate in vitro fertilization (IVF treatment outcomes of unilateral oocyte retrieval in patients with transvaginally inaccessible ovaries. Study Design. Ninety-two women who underwent unilateral oocyte retrieval were retrospectively matched for age, antral follicle count, and body mass index with 184 women who underwent bilateral oocyte retrieval. Each patient in bilateral oocyte retrieval group had the same number of cumulus oophorus complexes (COCs from single ovary and had comparable number of follicles (±2 on contralateral site where follicular aspiration was performed. Results. The number of COCs, metaphase-2 oocytes, 2-pronuclei, and top-quality embryos was significantly lower in unilateral oocyte retrieval group. However, proportion of patients with an embryo transfer of at least one top-quality embryo was found to be comparable between unilateral and bilateral oocyte retrieval. Subsequently, clinical pregnancy and live birth rates were found to be similar between the groups. The ROC curve analysis revealed (AUC = 0.74, 95% CI 0.63–0.86, p=0.001 that retrieved COCs ≥ 5 from single ovary had sensitivity of 76.0% and specificity of 64.2% for occurrence of a clinical pregnancy. Conclusion. The patients with unilateral oocyte retrieval have reasonable chance of success with IVF. The retrieval of ≥5 COCs from accessible ovary might result in better treatment outcomes among these patients.

  11. Impact of transvaginal hydrolaparoscopy ovarian drilling on ovarian stromal blood flow and ovarian volume in clomiphene citrate-resistant PCOS patients: a case-control study.

    Science.gov (United States)

    Giampaolino, Pierluigi; Morra, Ilaria; De Rosa, Nicoletta; Cagnacci, Angelo; Pellicano, Massimiliano; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2017-09-01

    Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in gynecology. In PCOS patients vascularization parameters are altered. Transvaginal hydrolaparoscopy (THL) is a mini-invasive approach for ovarian drilling in PCOS patients. In this study, we assessed the effect of ovarian drilling using THL on ovarian volume (OV) and vascularization index (VI) using 3D power Doppler ultrasonography in CC-resistant PCOS patients. A case-control study on 123 CC-resistant PCOS women who underwent THL ovarian drilling was performed. Patients underwent 3D ultrasound and power Doppler to measure VI, flow index (FI), vascularization flow index (VFI) and to evaluate OV before and after the procedure, at six months, and on the early follicular phase of the menstrual cycle. After THL ovarian drilling, OV and power Doppler flow indices were significantly reduced compared to pre-operative values (OV: 7.85 versus 11.72 cm 3 , p PCOS patients resistant to medical therapy.

  12. Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose Derived Stem Cells for Treatment of Female Stress Urinary Incontinence: A Phase One Clinical Trial.

    Science.gov (United States)

    Arjmand, Babak; Safavi, Majid; Heidari, Reza; Aghayan, Hamidreza; T Bazargani, Soroush; Dehghani, Sanaz; Goodarzi, Parisa; Mohammadi-Jahani, Fereshteh; Heidari, Fariba; Payab, Moloud; Pourmand, Gholamreza

    2017-06-01

    Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (Pincontinence. Further studies with longer follow up are needed to confirm its long term efficacy.

  13. A Case of Multiple Spontaneous Keloid Scars

    Directory of Open Access Journals (Sweden)

    Abdulhadi Jfri

    2015-07-01

    Full Text Available Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body.

  14. Spontaneous germinal centers and autoimmunity.

    Science.gov (United States)

    Domeier, Phillip P; Schell, Stephanie L; Rahman, Ziaur S M

    2017-02-01

    Germinal centers (GCs) are dynamic microenvironments that form in the secondary lymphoid organs and generate somatically mutated high-affinity antibodies necessary to establish an effective humoral immune response. Tight regulation of GC responses is critical for maintaining self-tolerance. GCs can arise in the absence of purposeful immunization or overt infection (called spontaneous GCs, Spt-GCs). In autoimmune-prone mice and patients with autoimmune disease, aberrant regulation of Spt-GCs is thought to promote the development of somatically mutated pathogenic autoantibodies and the subsequent development of autoimmunity. The mechanisms that control the formation of Spt-GCs and promote systemic autoimmune diseases remain an open question and the focus of ongoing studies. Here, we discuss the most current studies on the role of Spt-GCs in autoimmunity.

  15. Crows spontaneously exhibit analogical reasoning.

    Science.gov (United States)

    Smirnova, Anna; Zorina, Zoya; Obozova, Tanya; Wasserman, Edward

    2015-01-19

    Analogical reasoning is vital to advanced cognition and behavioral adaptation. Many theorists deem analogical thinking to be uniquely human and to be foundational to categorization, creative problem solving, and scientific discovery. Comparative psychologists have long been interested in the species generality of analogical reasoning, but they initially found it difficult to obtain empirical support for such thinking in nonhuman animals (for pioneering efforts, see [2, 3]). Researchers have since mustered considerable evidence and argument that relational matching-to-sample (RMTS) effectively captures the essence of analogy, in which the relevant logical arguments are presented visually. In RMTS, choice of test pair BB would be correct if the sample pair were AA, whereas choice of test pair EF would be correct if the sample pair were CD. Critically, no items in the correct test pair physically match items in the sample pair, thus demanding that only relational sameness or differentness is available to support accurate choice responding. Initial evidence suggested that only humans and apes can successfully learn RMTS with pairs of sample and test items; however, monkeys have subsequently done so. Here, we report that crows too exhibit relational matching behavior. Even more importantly, crows spontaneously display relational responding without ever having been trained on RMTS; they had only been trained on identity matching-to-sample (IMTS). Such robust and uninstructed relational matching behavior represents the most convincing evidence yet of analogical reasoning in a nonprimate species, as apes alone have spontaneously exhibited RMTS behavior after only IMTS training. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Spontaneous Bilateral Tubal Gestation: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Marwah Sheeba

    2016-01-01

    Full Text Available Here a case is presented where the woman after a positive pregnancy test underwent medical abortion for unwanted pregnancy without ultrasound confirmation of intrauterine pregnancy. On persistence of symptoms, a second opinion was procured, when examination and a transvaginal ultrasound scan revealed ruptured unilateral tubal ectopic pregnancy. However upon subsequent laparotomy (considering deteriorating hemodynamic status of the patient, intraoperatively it turned out to be a bilateral tubal ectopic gestation.

  17. The spontaneous puncture of thick liquid films

    Science.gov (United States)

    Néel, Baptiste; Villermaux, Emmanuel

    2016-11-01

    We call thick those films for which the disjoining pressure is ineffective. Water films with thickness h in the 1-10 μm range are thick, but it is also known that, paradoxically, they nucleate holes spontaneously. We have uncovered a mechanism solving the paradox. Most natural films are dirty to some extent, and we show that if a spot of dissolved substance lowers locally the surface tension of the liquid, the corresponding Marangoni stress may lead to a self-sustained instability triggering film rupture. When deposited with size a, the spot dissipates by molecular diffusion (coefficient D) along the film in a time a2 / D . Before doing so, the surface tension gradient Δσ / a between the spot center (tension σ - Δσ) and the rest of the film (tension σ) induces an inhomogeneous outward interstitial flow which digs the spot, and reinforces the tension gradient. Hence the instability, which occurs within a timescale τ √{ ρa2 h / Δσ } , with ρ the liquid density. When the Péclet number Pe =a2 / Dτ is small, diffusion regularizes the film, which remains flat: clean films don't break, while for Pe > 1 , the film punctures. This new scenario will be illustrated by several experiments.

  18. Spontaneous Discharging of Carbon and Glass Dust

    Science.gov (United States)

    Vaverka, J.; Beranek, M.; Pavlu, J.; Richterova, I.; Vysinka, M.; Safrankova, J.; Nemecek, Z.

    2011-12-01

    Micrometer-sized bodies (dust) coexist with plasma of various parameters in the space as well as in laboratories and industrial facilities. The mutual interactions of plasma particles with dust grains lead to their charging. Especially small or irregularly shaped grains can achieve a high surface electric field even under the moderate potential. When the positive electric field is strong, the accumulated charge becomes spontaneously released. This process is known as field ion emission and can limit a maximum charge of the grain exposed to the plasma environment. We study this process experimentally under laboratory conditions using single spherical glassy carbon and glass grains trapped in the electrodynamic quadrupole. We have investigated relative contributions of the field ionization of the surrounding gas, the gas leaving the grain surface due to desorption, and atoms that were already implanted to the grain in course of ion bombardment. We have found that the probability of ionization of particles leaving the grain surface is significantly higher than that of the surrounding gas. The contribution of the field evaporation of the grain bulk material was found to be negligible.

  19. Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion.

    Science.gov (United States)

    Liu, Yinglin; Liu, Yukun; Li, Xuejiao; Jiao, Xuedan; Zhang, Rui; Zhang, Jianping

    2016-10-01

    To examine peak serum levels of the β-subunit of human chorionic gonadotropin (β-hCG) for prediction of early pregnancy outcomes among women with recurrent spontaneous abortion (RSA). In a retrospective study, the medical records of pregnant women with a history of RSA treated at Sun Yat-sen Memorial Hospital, China, between January 2011 and July 2013 were reviewed. Serum β-hCG had been measured twice weekly from 5 to 13weeks of pregnancy, and pregnancy was monitored by transvaginal ultrasonography to 13(+6)weeks. Optimal cutoff for peak β-hCG level was determined by receiver operator characteristic curve analysis and Youden index. Women were divided into four groups on the basis of optimal peak β-hCG cutoff and pregnancy outcome (pregnancy at 13weeks or spontaneous abortion). Peak β-hCG levels and length of pregnancy at this peak were examined. Overall, 1240 patients were included. The optimal cutoff value of peak β-hCG was 88 468IU/L, with a sensitivity, specificity, positive predictive value, and negative predictive value for successful pregnancy of 95.6%, 88.0%, 95.6%, and 89.0%, respectively. A faster rise in β-hCG, higher peak β-hCG, and longer pregnancy length at peak β-hCG were associated with successful early pregnancy. A cutoff value of serum β-hCG of 88 000IU/L could be used to predict early pregnancy outcomes for women with a history of RSA. Copyright © 2016. Published by Elsevier Ireland Ltd.

  20. Children's Spontaneous Vocalisations during Play: Aesthetic Dimensions

    Science.gov (United States)

    Countryman, June; Gabriel, Martha; Thompson, Katherine

    2016-01-01

    This paper explores the phenomenon of spontaneous vocalisations in the self-chosen, unstructured outdoor play of children aged 3-12. Spontaneous vocalisations encompass the whole range of children's unprompted, natural, expressive vocal soundings beyond spoken language. Non-participant observations at childcare centres and on elementary school…

  1. The spontaneous in the therapeutic theater

    OpenAIRE

    Silva, Marisa Schmidt

    2012-01-01

    The author makes considerations about the historic influences on the creation of Spontaneous theater by Jacob Levy Moreno and the psychotherapy conditions of this theater, nowadays revigoratade in whole world. The author consider the specific way to deal with Spontaneous theater of "Troupe de Psicodramatores" in Curitiba, Parana.

  2. A new class of spontaneously polarized materials

    DEFF Research Database (Denmark)

    Field, David; Plekan, Oksana; Cassidy, Andrew

    2011-01-01

    Very large electric fields form spontaneously within films of seemingly prosaic chemicals such as nitrous oxide or propane.We describe how the discovery of this unexpected phenomenon took place and how we attempt to understand the nature of the new class of spontaneously polarized materials...

  3. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  4. Mathematical models of spontaneous symmetry breaking

    OpenAIRE

    Sardanashvily, G.

    2008-01-01

    The Higgs mechanism of mass generation is the main ingredient in the contemporary Standard Model and its various generalizations. However, there is no comprehensive theory of spontaneous symmetry breaking. We summarize the relevant mathematical results characterizing spontaneous symmetry breaking phenomena in algebraic quantum theory, axiomatic quantum field theory, group theory, and classical gauge theory.

  5. Spontaneous CP violation and CPT violation

    OpenAIRE

    Qian, Yu Kun

    2011-01-01

    At first we give a little formalism to show some features of spontaneous CP violation theory. Then we give a convincing argument show that Cronin etc's experiment is a evidence of CPT violation and spontaneous CP violation is absolutely necessary. Final we discuss some possible CPT violation mechanism.

  6. Spontaneous emission in nanoscopic dielectric particles.

    Science.gov (United States)

    Rogobete, Lavinia; Schniepp, Hannes; Sandoghdar, Vahid; Henkel, Carsten

    2003-10-01

    We report on theoretical studies of the inhibition of the spontaneous emission process in subwavelength dielectric media. We discuss the modification of the spontaneous emission rate as a function of the size and shape of the medium as well as the position of the emitter in it.

  7. Spontaneity and Equilibrium II: Multireaction Systems

    Science.gov (United States)

    Raff, Lionel M.

    2014-01-01

    The thermodynamic criteria for spontaneity and equilibrium in multireaction systems are developed and discussed. When N reactions are occurring simultaneously, it is shown that G and A will depend upon N independent reaction coordinates, ?a (a = 1,2, ..., N), in addition to T and p for G or T and V for A. The general criteria for spontaneity and…

  8. Spontaneous Retroperitoneal Hematoma: A Rare Devastating ...

    African Journals Online (AJOL)

    Spontaneous Retroperitoneal Hematoma: A Rare Devastating. Clinical Entity of a Pleiada of Less Common Origins. Definition of Wunderlich syndrome, also known as spontaneous retroperitoneal hemorrhage. (SRH), was first given in 1700 by ... of SRH as a complication of tumors, however, is low. In renal cell carcinoma, ...

  9. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  10. Spontaneous pneumomediastinum after bench press training.

    Science.gov (United States)

    Nishino, Tomoya

    2017-04-01

    Spontaneous pneumomediastinum is often associated with asthma and mainly affects adolescent males with a tall, thin body habitus. A 17-year-old man complained of chest and pharyngeal pain after bench press training and spontaneous pneumomediastinum was diagnosed. It should be considered in the differential diagnosis of chest pain of uncertain cause.

  11. Early pregnancy angiogenic markers and spontaneous abortion

    DEFF Research Database (Denmark)

    Andersen, Louise B; Dechend, Ralf; Karumanchi, S Ananth

    2016-01-01

    BACKGROUND: Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy and may be associated to spontaneous abortion. OBJECTIVE: We investigated the association between...... maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. STUDY DESIGN: In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week ..., interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum

  12. The (perceived) meaning of spontaneous thoughts.

    Science.gov (United States)

    Morewedge, Carey K; Giblin, Colleen E; Norton, Michael I

    2014-08-01

    Spontaneous thoughts, the output of a broad category of uncontrolled and inaccessible higher order mental processes, arise frequently in everyday life. The seeming randomness by which spontaneous thoughts arise might give people good reason to dismiss them as meaningless. We suggest that it is precisely the lack of control over and access to the processes by which they arise that leads people to perceive spontaneous thoughts as revealing meaningful self-insight. Consequently, spontaneous thoughts potently influence judgment. A series of experiments provides evidence supporting two hypotheses. First, we hypothesize that the more a thought is perceived to be spontaneous, the more it is perceived to provide meaningful self-insight. Participants perceived more spontaneous kinds of thought (e.g., intuition) to reveal greater self-insight than did more controlled kinds of thought in Study 1 (e.g., deliberation). In Studies 2 and 3, participants perceived thoughts with the same content and target to reveal greater self-insight when spontaneously rather than deliberately generated (i.e., childhood memories and impressions formed). Second, we hypothesize that the greater self-insight attributed to thoughts that are (perceived to be) spontaneous leads those thoughts to more potently influence judgment. Participants felt more sexually attracted to an attractive person whom they thought of spontaneously than deliberately in Study 4, and reported their commitment to a current romantic relationship would be more affected by the spontaneous rather than deliberate recollection of a good or bad experience with their romantic partner in Study 5. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Spontaneous hemopneumothorax: our experience with surgical management.

    Science.gov (United States)

    Tay, Cheong Kiat Julian; Yee, Yong Chen; Asmat, Atasha

    2015-03-01

    Spontaneous hemopneumothorax is rare, accounting for only 1%-12% of patients presenting with spontaneous pneumothorax. The optimal management of these patients remains controversial with no definitive guidelines on patient selection and timing of surgery. The aim of this study was to review our institution's surgical experience in the management of patients with spontaneous hemopneumothorax. We performed a retrospective review of all patients with spontaneous hemopneumothorax who underwent surgery from January 2000 to June 2013. Patient data were obtained from our institution's primary spontaneous pneumothorax database. Of 510 patients who underwent surgery for spontaneous pneumothorax, 33 (6.4%) developed spontaneous hemopneumothorax. The mean age was 24.0 years (range 16-40 years). In 30 (90.9%) patients, it was their first presentation of pneumothorax. There were 25 (75.8%) patients with Vanderschueren stage III spontaneous pneumothorax. Blood loss ranged from 250 to 3000 mL (mean 1280 mL). In 28 patients, a torn adhesion band was the source of bleeding. Thoracotomy was the surgical approach in 9 (27.3%) patients, and video-assisted thoracic surgery was used in 24 (72.7%). One patient required reoperation for retained clots. There was no mortality. Our results suggest that surgical management of spontaneous hemopneumothorax can be undertaken with minimal morbidity and mortality. With the increasing use of video-assisted thoracic surgery, definitive surgical management of spontaneous hemopneumothorax can be instituted earlier. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Prediction of pouch of Douglas obliteration in women with suspected endometriosis using a new real-time dynamic transvaginal ultrasound technique: the sliding sign.

    Science.gov (United States)

    Reid, S; Lu, C; Casikar, I; Reid, G; Abbott, J; Cario, G; Chou, D; Kowalski, D; Cooper, M; Condous, G

    2013-06-01

    To evaluate preoperative real-time dynamic transvaginal sonography (TVS) in the prediction of pouch of Douglas (POD) obliteration in women undergoing laparoscopy for suspected endometriosis. This was a multicenter prospective observational study undertaken from January 2009 to November 2011. All women with symptoms suggestive of endometriosis who were scheduled for laparoscopy underwent detailed preoperative TVS, in particular to ascertain whether the POD was obliterated. POD obliteration was assessed using a real-time TVS technique called the 'sliding sign'. Preoperative TVS sliding sign findings were then compared to gold standard laparoscopic POD findings. One hundred consecutive women with preoperative TVS and laparoscopic outcomes were included in the final analysis. Mean age was 32.8 years and mean age at diagnosis of endometriosis was 27.4 years. At laparoscopy, 84/100 (84%) were found to have some form of endometriosis (73% peritoneal endometriosis, 35% ovarian endometrioma(s), 33% deep infiltrating endometriosis). At laparoscopy, 30/100 (30%) had an obliterated POD and 19/30 (63.3%) of these women also had evidence of bowel endometriosis. The sonographic sliding sign technique had an accuracy of 93.0%, sensitivity of 83.3%, specificity of 97.1%, positive predictive value of 92.6%, negative predictive value of 93.2%, positive likelihood ratio of 29.2 and negative likelihood ratio of 0.17 in the prediction of POD obliteration (P = 1.8E-16). Preoperative real-time dynamic TVS evaluation using the sliding sign seems to establish with a high degree of certainty whether the POD is obliterated. Given the increased risk of deep infiltrating endometriosis in women with POD obliteration, the TVS sliding sign technique may also be useful in the identification of women who may be at a higher risk for bowel endometriosis. Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.

  15. The Diagnostic Value of Transvaginal Sonograph (TVS), Color Doppler, and Serum Tumor Marker CA125, CEA, and AFP in Ovarian Cancer.

    Science.gov (United States)

    Zhang, Fang; Zhang, Zhou-Long

    2015-06-01

    The purpose of this study is to investigate the diagnostic value of transvaginal sonograph (TVS), color Doppler, and serum tumor marker CA125, CEA, and AFP in ovarian cancer. From June, 2011 to May, 2013, 102 cases with adnexal mass were recruited in this study (32 cases of malignant ovarian cancer and 70 cases of benign ovarian tumor according to pathological diagnosis). TVS, color Doppler, and serum tumor markers were used for tumor diagnosis. The sensitivity, specifity, positive prediction, negative prediction, and Youden's index were analyzed. Of the 102 patients, 32 were diagnosed with malignant ovarian cancer and 70 were diagnosed with benign ovarian tumor according to pathological diagnosis. Based on TVS results, 37 cases were malignant while 65 cases were benign. Based on color Doppler results, 34 cases were malignant while 68 cases were benign. Based on TVS and color Doppler results, 35 cases were malignant while 65 were benign. Based on CA125 test results, 34 cases were malignant while 68 cases were benign. Based on CEA test results, 8 cases were malignant and 94 cases were benign. Bases on AFP test results, 9 cases were malignant while 93 cases were benign. Based on the results of combination tumor marker test, 38 cases were malignant while 64 cases were benign. The combination of TVS, color Doppler, and tumor marker test showed optimal diagnostic value with a sensitivity of 90.63 %, specificity of 97.14 %, positive prediction of 93.94 %, negative prediction of 98.55 %, and Youden's index of 94.02 %. The combination of TVS, color Doppler, and tumor marker test is of great diagnostic value, which should be widely used in clinical practice.

  16. A COMPARATIVE STUDY OF TRANSVAGINAL SONOHYSTERO-SALPINGOGRAPHY (TV-SH AND HYSTERO-SALPINGOGRAPHY (HSG FOR ASSESSMENT OF TUBAL PATENCY IN INFERTILITY PATIENTS

    Directory of Open Access Journals (Sweden)

    Thirupurasundari Rangaswamy

    2011-12-01

    Full Text Available There has been a significant increase in cases of infertility and sterility in the last decade. Approximately, 10-15% of couples in reproductive age are affected by the inability to conceive and bear a child. Amongst all causes, anatomical defect linked to the fallopian pathological conditions contributes considerably to female infertility. The evaluation of tubal patency is traditionally considered fundamental in the study of cases of infertility and it represents one third of the total cost in the management of infertility. Tubal patency is routinely assessed by hysterosalpingograpgy (HSG and/or laparoscopy. However, other techniques are nowadays being investigated to obtain high efficacy, with low cost and risk, and also can be used as office procedures at an outpatient infertility clinic. Transvaginal sonohysterosalpingography (Tv-Sh is one of such promising procedure which can be simultaneously performed in place of HSG at the time of conventional ultrasonogram in the initial workup of infertile patients. It also provides additional information regarding intracavitary and intramyomentrial components of submucous myomas as well as information about adnexae. The present study encompasses the comparative diagnostic accuracy of Tv-Sh and HSG in evaluating uterine cavity and tubal patency in women of reproductive age group. The compatibility between Tv-Sh and HSG was found to be 87% and efficacy in diagnosis of hydrosalpinx by both procedures was the same. There was also no significant difference in the diagnosis of congenital malformations of uterus or intracavity adhesions. The study concludes that Tv-Sh can be used as a “first choice” screening procedure without any risk of ionizing radiation.

  17. Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose Derived Stem Cells for Treatment of Female Stress Urinary Incontinence: A Phase One Clinical Trial

    Directory of Open Access Journals (Sweden)

    Babak Arjmand

    2017-08-01

    Full Text Available Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001 and ICIQ-SF scores (P<0.001, especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002. This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy.

  18. Surgical time and complications of total transvaginal (total-NOTES, single-port laparoscopic-assisted and conventional ovariohysterectomy in bitches

    Directory of Open Access Journals (Sweden)

    M.A.M. Silva

    2015-06-01

    Full Text Available The recently developed minimally invasive techniques of ovariohysterectomy (OVH have been studied in dogs in order to optimize their benefits and decrease risks to the patients. The purpose of this study was to compare surgical time, complications and technical difficulties of transvaginal total-NOTES, single-port laparoscopic-assisted and conventional OVH in bitches. Twelve bitches were submitted to total-NOTES (NOTES group, while 13 underwent single-port laparoscopic-assisted (SPLA group and 15 were submitted to conventional OVH (OPEN group. Intra-operative period was divided into 7 stages: (1 access to abdominal cavity; (2 pneumoperitoneum; approach to the right (3 and left (4 ovarian pedicle and uterine body (5; (6 abdominal or vaginal synthesis, performed in 6 out of 12 patients of NOTES; (7 inoperative time. Overall and stages operative times, intra and postoperative complications and technical difficulties were compared among groups. Mean overall surgical time in NOTES (25.7±6.8 minutes and SPLA (23.1±4.0 minutes groups were shorter than in the OPEN group (34.0±6.4 minutes (P<0.05. The intraoperative stage that required the longest time was the approach to the uterine body in the NOTES group and abdominal and cutaneous sutures in the OPEN group. There was no difference regarding the rates of complications. Major complications included postoperative bleeding requiring reoperation in a bitch in the OPEN group, while minor complications included mild vaginal discharge in four patients in the NOTES group and seroma in three bitches in the SPLA group. In conclusion, total-NOTES and SPLA OVH were less time-consuming then conventional OVH in bitches. All techniques presented complications, which were properly managed.

  19. [Lazzaro Spallanzani and his refutation of the theory of spontaneous generation].

    Science.gov (United States)

    Mancini, Renata; Nigro, Mario; Ippolito, Giuseppe

    2007-09-01

    The development and refinement of microscopy in the 17th century revealed to science a whole new world of microorganisms, until then unknown, that appeared to arise spontaneously, and fuelled a controversy that had seemed definitively resolved by Francesco Redi's experiments, the question of the spontaneous generation and origin of life. At the half of the 18th century a young Italian abbot, Lazzaro Spallanzani, Professor of Physics and Mathematics at the University of Reggio Emilia, started repeating the experiments of John Turberville Needham. The English Catholic priest claimed to have demonstrated the validity of the theory of spontaneous generation after observing the growth of small organisms in some chicken broth placed in sealed flasks and heated for 30 minutes. Spallanzani found significant errors in the experiments conducted by Needham and, after trying several variations on them, disproved the theory of spontaneous generation.

  20. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  1. Spontaneous prosocial choice by chimpanzees.

    Science.gov (United States)

    Horner, Victoria; Carter, J Devyn; Suchak, Malini; de Waal, Frans B M

    2011-08-16

    The study of human and primate altruism faces an evolutionary anomaly: There is ample evidence for altruistic preferences in our own species and growing evidence in monkeys, but one of our closest relatives, the chimpanzee (Pan troglodytes), is viewed as a reluctant altruist, acting only in response to pressure and solicitation. Although chimpanzee prosocial behavior has been reported both in observational captive studies and in the wild, thus far Prosocial Choice Tests have failed to produce evidence. However, methodologies of previous Prosocial Choice Tests may have handicapped the apes unintentionally. Here we present findings of a paradigm in which chimpanzees chose between two differently colored tokens: one "selfish" token resulting in a reward for the actor only (1/0), and the other "prosocial" token rewarding both the actor and a partner (1/1). Seven female chimpanzees, each tested with three different partners, showed a significant bias for the prosocial option. Prosocial choices occurred both in response to solicitation by the partner and spontaneously without solicitation. However, directed requests and pressure by the partner reduced the actor's prosocial tendency. These results draw into question previous conclusions indicating that chimpanzees have a limited sensitivity to the needs of others and behave prosocially only in response to significant prompting.

  2. Effective temperature and spontaneous collective motion of active matter

    Science.gov (United States)

    Wang, Shenshen; Wolynes, Peter

    2012-02-01

    Spontaneous directed motion, a hallmark of cell biology, is unusual in classical statistical physics. Here we study, using both numerical and analytical methods, organized motion in models of the cytoskeleton in which constituents are driven by energy-consuming motors. Although systems driven by small-step motors are described by an effective temperature and are thus quiescent, at higher order in step size, both homogeneous and inhomogeneous, flowing and oscillating behavior emerges. Motors that respond with a negative susceptibility to imposed forces lead to an apparent negative temperature system in which beautiful structures form resembling the asters seen in cell division.

  3. Noncritically squeezed light via spontaneous rotational symmetry breaking.

    Science.gov (United States)

    Navarrete-Benlloch, Carlos; Roldán, Eugenio; de Valcárcel, Germán J

    2008-05-23

    We predict squeezed light generation through the spontaneous rotational symmetry breaking occurring in a degenerate optical parametric oscillator (DOPO) pumped above threshold. We show, within the linearized theory, that a DOPO with spherical mirrors, in which the signal and idler fields correspond to first-order Laguerre-Gauss modes, produces a perfectly squeezed vacuum with the shape of a Hermite-Gauss mode. This occurs at any pumping level above threshold; hence, the phenomenon is noncritical. Imperfections of the rotational symmetry, due, e.g., to cavity anisotropy, are shown to have a small impact.

  4. Optical Instabilities and Spontaneous Light Emission by Polarizable Moving Matter

    Directory of Open Access Journals (Sweden)

    Mário G. Silveirinha

    2014-07-01

    Full Text Available One of the most extraordinary manifestations of the coupling of the electromagnetic field and matter is the emission of light by charged particles passing through a dielectric medium: the Vavilov-Cherenkov effect. Here, we theoretically predict that a related phenomenon may be observed when neutral fast polarizable particles travel near a metal surface supporting surface plasmon polaritons. Based on a classical formalism, we find that at some critical velocity, even if the initial optical field is vanishingly small, the system may become unstable and may start spontaneously emitting light such that in some initial time window the electromagnetic field grows exponentially with time.

  5. STUDENTS’ SPONTANEOUS SMILE IN EFL CLASSROOM

    Directory of Open Access Journals (Sweden)

    Daniela Gomes de Araújo Nóbrega

    2012-12-01

    Full Text Available This article discusses the importance of the students’ spontaneous smile in EFL classroom interaction, and its implication to their oral production. Findings proved that the students’ spontaneous smile served as a fundamental interactive nonverbal sign for it not only favors a closer relation among students, but also helps them in the co-construction of oral activities in group works. In sum, the students’ spontaneous smile appeared to be a nonverbal indicative of proximity and of increasing oral interaction among them.

  6. Herpetic viruses and spontaneous recovery in melanoma.

    Science.gov (United States)

    Motofei, I G

    1996-08-01

    The malignant melanoma may display extremely variable forms of development, from clinical forms with a lethal course to the unforeseeable situations of spontaneous cures. The basic immunotherapeutic procedures, as well as hypotheses regarding the mechanisms involved in courses towards spontaneous regressions, are presented. Since viruses of the herpes genus are involved in the mechanisms assumed to be at the basis of spontaneous regressions, it is suggested that these viruses (selected strains) be used in the clinic, in order to check the advanced hypothesis, an opportunity which could permit to study also the very probable therapeutic alternative offered by this virus, namely the association of the well-known immunotherapeutic methods.

  7. Clock frequency estimation under spontaneous emission

    Science.gov (United States)

    Qin, Xi-Zhou; Huang, Jia-Hao; Zhong, Hong-Hua; Lee, Chaohong

    2018-02-01

    We investigate the quantum dynamics of a driven two-level system under spontaneous emission and its application in clock frequency estimation. By using the Lindblad equation to describe the system, we analytically obtain its exact solutions, which show three different regimes: Rabi oscillation, damped oscillation, and overdamped decay. From the analytical solutions, we explore how the spontaneous emission affects the clock frequency estimation. We find that under a moderate spontaneous emission rate, the transition frequency can still be inferred from the Rabi oscillation. Our results enable potential practical applications in frequency measurement and quantum control under decoherence.

  8. Spontaneous emission from active dielectric microstructures

    DEFF Research Database (Denmark)

    Søndergaard, Thomas; Tromborg, Bjarne

    2001-01-01

    Spontaneous emission is one of the key factors that determine the noise properties of photonic devices and the pump power threshold of lasers. The spontaneous emission in dielectric microstructures (micro-cavities, photonic crystals, optical waveguides, etc.) can to some extend be controlled...... and engineered due to the dependence of the emission rate on the location and polarisation of the emitters in the structure. This paper addresses the methods of quantum electrodynamics of dielectric media which enable calculation of the local rate of spontaneous emission in active microstructures....

  9. Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Dalip Gupta

    2013-11-01

    Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

  10. Ultrasonographic features of spontaneous breast tumor infarction.

    Science.gov (United States)

    Oh, Hyeon Jeong; Kim, Sung Hun; Kang, Bong Joo; Lee, A Won; Song, Byung Joo; Kim, Hyen Sook; Cha, Eun Suk

    2015-11-01

    The aim of this paper is to evaluate the ultrasonographic features of spontaneous breast tumor infarction. The pathologic information system database of the Department of Radiology was retrospectively searched. Between 2009 and 2011, nine cases in eight patients were pathologically confirmed as spontaneous breast tumor infarctions. Mammographic images and the ultrasonographic images were acquired. Two other radiologists analyzed the mammographic and ultrasonographic findings. Most common features were oval, indistinct, heterogeneously hypoechoic mass with posterior enhancement. All lesions were classified as C4 (suspicious finding) except one case. Spontaneous breast tumor infarction should be included in the differential diagnoses of hetereogeneously hypoechoic suspicious solid lesions mimicking malignancy.

  11. Does Spontaneous Favorability to Power (vs. Universalism) Values Predict Spontaneous Prejudice and Discrimination?

    Science.gov (United States)

    Souchon, Nicolas; Maio, Gregory R; Hanel, Paul H P; Bardin, Brigitte

    2017-10-01

    We conducted five studies testing whether an implicit measure of favorability toward power over universalism values predicts spontaneous prejudice and discrimination. Studies 1 (N = 192) and 2 (N = 86) examined correlations between spontaneous favorability toward power (vs. universalism) values, achievement (vs. benevolence) values, and a spontaneous measure of prejudice toward ethnic minorities. Study 3 (N = 159) tested whether conditioning participants to associate power values with positive adjectives and universalism values with negative adjectives (or inversely) affects spontaneous prejudice. Study 4 (N = 95) tested whether decision bias toward female handball players could be predicted by spontaneous attitude toward power (vs. universalism) values. Study 5 (N = 123) examined correlations between spontaneous attitude toward power (vs. universalism) values, spontaneous importance toward power (vs. universalism) values, and spontaneous prejudice toward Black African people. Spontaneous positivity toward power (vs. universalism) values was associated with spontaneous negativity toward minorities and predicted gender bias in a decision task, whereas the explicit measures did not. These results indicate that the implicit assessment of evaluative responses attached to human values helps to model value-attitude-behavior relations. © 2016 The Authors. Journal of Personality Published by Wiley Periodicals, Inc.

  12. [Ischemic stroke related to spontaneous].

    Science.gov (United States)

    Benamer, H; Bouzid, M A; Dufay, A; Akodad, M; Russel, S; Halna du Fretay, X; Haziza, F

    2017-12-01

    Cardiovascular disease in women is a particularly complex pathology especially in the youngest population. The clinical presentation of acute coronary syndromes is sometimes misleading and does not necessarily point to the potential presence of cardiac disease given the frequent absence of cardiovascular risks. Such complexity results in delayed diagnosis, which worsens the outcome of myocardial infarction and generates complications related to the absence of coronary revascularization. We report the case of a patient who suffered an (undiagnosed) apical myocardial infarction that went undetected and was complicated by a voluminous intraventricular thrombus with embolus migration in the cerebral circulation resulting in an ischemic accident. The combination of these two pathologies make their therapeutic management particularly difficult. As widely reported in the literature, the outcome of myocardial infarction in women is poorer than in their male counterparts for a number of reasons. We can assume that in the youngest patients, another physiopathological mechanism is often involved, namely, the occurrence of hematoma and spontaneous coronary dissection. Diagnosis is often difficult even with coronary angiography diagnosis. As shown in the case reported here, initial examination results, if not thoroughly analyzed, may be erroneously interpreted as normal. It is also likely that the presence of hematoma or coronary wall dissection without any plaque rupture may negatively influence the outcome owing to the implementation of inappropriate treatments. In conclusion, in patients presenting with an ischemic cerebral accident, meticulous cardiac examination must be performed even in young women with no cardiovascular risk factors given that the occurrence of hematoma or coronary dissection may contribute to the formation of mural thrombi in the setting of myocardial infarction. Cardiac MRI seems to be particularly effective in the diagnosis of myocardial infarction

  13. Sleep in spontaneous dwarf rats.

    Science.gov (United States)

    Peterfi, Zoltan; Obal, Ferenc; Taishi, Ping; Gardi, Janos; Kacsoh, Balint; Unterman, Terry; Krueger, James M

    2006-09-07

    Spontaneous dwarf rats (SDRs) display growth hormone (GH) deficiency due to a mutation in the GH gene. This study investigated sleep in SDRs and their somatotropic axis and compared to Sprague-Dawley rats. SDRs had almost undetectable levels of plasma GH. Hypothalamic GH-releasing hormone (GHRH) mRNA was increased, whereas GHRH-receptor (GHRH-R) and somatostatin mRNAs were decreased in SDRs. Hypothalamic GHRH and somatostatin peptide content decreased in SDRs. Quantitative immunohistochemistry for GHRH and GHRH-R corroborated and extended these findings. In the arcuate nucleus, the number of GHRH-positive cells was significantly higher, whereas GHRH-R-positive perikarya were diminished in SDRs. Cortical GHRH and GHRH-R measurements showed similar expression characteristics as those found in the hypothalamus. SDRs had less rapid eye movement sleep (REMS) and more non-REMS (NREMS) than the control rats during the light period. The electroencephalogram (EEG) delta and theta power decreased during NREMS in the SDRs. After 4-h of sleep deprivation, SDRs had a significantly reduced REMS rebound compared to the controls, whereas NREMS rebound was normal in SDRs. The enhancement in delta power was significantly less than in the control group during recovery sleep. Intracerebroventricular (icv) administration of GHRH promoted NREMS in both strains of rats; however, increased REMS and EEG delta activity was observed only in control rats. Icv injection of insulin-like growth factor 1 increased NREMS in control rats, but not in the SDRs. These results support the ideas that GHRH is involved in NREMS regulation and that GH is involved in the regulation of REMS and in EEG slow wave activity regulation during NREMS.

  14. Spontaneous Toroidal Rotation in Tokamaks

    Science.gov (United States)

    Haines, Malcolm

    2007-11-01

    When two-fluid MHD theory of stability is employed the resulting growth rates are complex, and the perturbing magnetic fields move with a velocity that depends both on the components of the electron drift and heat flux perpendicular to the equilibrium magnetic field and on the diamagnetic velocity. On diffusing into a resistive wall a drag force is exerted on the wall which is proportional to the square-root of the velocity of the perturbing fields. The equal and opposite force or torque will be on the plasma, centred at the singular rational surface for each mode[1]. For typical experimental conditions this leads to a spontaneous, or intrinsic toroidal rotation of 20km/s occurring in a few milliseconds for perturbing magnetic fields of 0.0025tesla. The induced poloidal rotation by this mechanism is generally much larger, but there is considerable poloidal damping due to trapped particles on the ion-ion collision time- scale[2]. Furthermore poloidal angular momentum is in general not conserved for an isolated plasma, and any up-down asymmetry can act as a source or sink[3]; for example, Pfirsch-Schluter diffusion [3 damping by trapped particles[2] and the Ware pinch[4]. [1] J.B.Taylor, Phys.Rev.Lett. 91, 115002 (2003). [2] R.C.Morris, M.G.Haines and R.J.Hastie, Phys.Plasmas 3, 4513 (1996). [3] M.G.Haines, Phys.Rev.Lett. 25, 1480 (1970). [4] M.G.Haines and P.Martin, Phys.Plasmas 3, 4536 (1996).

  15. Lunar Cycle Influences Spontaneous Delivery in Cows.

    Science.gov (United States)

    Yonezawa, Tomohiro; Uchida, Mona; Tomioka, Michiko; Matsuki, Naoaki

    2016-01-01

    There is a popular belief that the lunar cycle influences spontaneous delivery in both humans and cattle. To assess this relationship, we investigated the synodic distribution of spontaneous deliveries in domestic Holstein cows. We used retrospective data from 428 spontaneous, full-term deliveries within a three-year period derived from the calving records of a private farm in Hokkaido, Japan. Spontaneous birth frequency increased uniformly from the new moon to the full moon phase and decreased until the waning crescent phase. There was a statistically significant peak between the waxing gibbous and full moon phases compared with those between the last quarter and the waning crescent. These changes were clearly observed in deliveries among multiparous cows, whereas they were not evident in deliveries among nulliparous cows. These data suggest the utility of dairy cows as models for bio-meteorological studies, and indicate that monitoring lunar phases may facilitate comprehensive understanding of parturition.

  16. Spontaneous Trait Inferences on Social Media.

    Science.gov (United States)

    Levordashka, Ana; Utz, Sonja

    2017-01-01

    The present research investigates whether spontaneous trait inferences occur under conditions characteristic of social media and networking sites: nonextreme, ostensibly self-generated content, simultaneous presentation of multiple cues, and self-paced browsing. We used an established measure of trait inferences (false recognition paradigm) and a direct assessment of impressions. Without being asked to do so, participants spontaneously formed impressions of people whose status updates they saw. Our results suggest that trait inferences occurred from nonextreme self-generated content, which is commonly found in social media updates (Experiment 1) and when nine status updates from different people were presented in parallel (Experiment 2). Although inferences did occur during free browsing, the results suggest that participants did not necessarily associate the traits with the corresponding status update authors (Experiment 3). Overall, the findings suggest that spontaneous trait inferences occur on social media. We discuss implications for online communication and research on spontaneous trait inferences.

  17. Rapid and spontaneous recovery in autistic disorder

    OpenAIRE

    Sitholey, Prabhat; Agarwal, Vivek; Pargaonkar, Amol

    2009-01-01

    Recovery in autistic disorder is rare. There are few reports of recovery from autistic disorder after a few years of therapeutic intervention. We report here a case of autistic disorder who recovered spontaneously without any intervention in 13 days.

  18. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  19. Recurrent spontaneous pneumoperitoneum: A surgical dilemma

    Directory of Open Access Journals (Sweden)

    Polly Estridge

    2017-01-01

    Conclusion: A trial of conservative management may be appropriate in patients with spontaneous pneumoperitoneum but it must always be borne in mind that clinical deterioration represents an indication for surgical intervention.

  20. Spontaneous coronary artery dissection during cabergoline therapy.

    Science.gov (United States)

    Mehta, Nishaki Kiran; Malkani, Samir; Ockene, Ira

    2012-01-01

    Although spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, it should be considered during the evaluation of patients who have chest pain. Coronary vasospasm can lead to spontaneous dissection. The dopamine agonist cabergoline is known to cause digital vasospasm. Herein, we report a case of spontaneous right coronary artery dissection in a 43-year-old woman who was taking cabergoline as therapy for prolactinoma. To our knowledge, this is the first report of an apparent relationship between cabergoline therapy and spontaneous coronary artery dissection. The possible association of cabergoline with coronary artery spasm and dissection should be considered in patients who present with chest pain while taking this medication.

  1. Depressive disorder and grief following spontaneous abortion.

    Science.gov (United States)

    Kulathilaka, Susil; Hanwella, Raveen; de Silva, Varuni A

    2016-04-12

    Abortion is associated with moderate to high risk of psychological problems such as depression, use of alcohol or marijuana, anxiety, depression and suicidal behaviours. The increased risk of depression after spontaneous abortion in Asian populations has not been clearly established. Only a few studies have explored the relationship between grief and depression after abortion. A study was conducted to assess the prevalence and risk factors of depressive disorder and complicated grief among women 6-10 weeks after spontaneous abortion and compare the risk of depression with pregnant women attending an antenatal clinic. Spontaneous abortion group consisted of women diagnosed with spontaneous abortion by a Consultant Obstetrician. Women with confirmed or suspected induced abortion were excluded. The comparison group consisted of randomly selected pregnant, females attending the antenatal clinics of the two hospitals. Diagnosis of depressive disorder was made according to ICD-10 clinical criteria based on a structured clinical interview. This assessment was conducted in both groups. The severity of depressive symptoms were assessed using the Patients Health Questionnaire (PHQ-9). Grief was assessed using the Perinatal Grief Scale which was administered to the women who had experienced spontaneous abortion. The sample consisted of 137 women in each group. The spontaneous abortion group (mean age 30.39 years (SD = 6.38) were significantly older than the comparison group (mean age 28.79 years (SD = 6.26)). There were more females with ≥10 years of education in the spontaneous abortion group (n = 54; SD = 39.4) compared to the comparison group (n = 37; SD = 27.0). The prevalence of depression in the spontaneous abortion group was 18.6 % (95 CI, 11.51-25.77). The prevalence of depression in the comparison group was 9.5 % (95 CI, 4.52-14.46). Of the 64 women fulfilling criteria for grief, 17 (26.6 %) also fulfilled criteria for a depressive episode. The relative risk of

  2. Spontaneous regression of metastatic Merkel cell carcinoma.

    LENUS (Irish Health Repository)

    Hassan, S J

    2010-01-01

    Merkel cell carcinoma is a rare aggressive neuroendocrine carcinoma of the skin predominantly affecting elderly Caucasians. It has a high rate of local recurrence and regional lymph node metastases. It is associated with a poor prognosis. Complete spontaneous regression of Merkel cell carcinoma has been reported but is a poorly understood phenomenon. Here we present a case of complete spontaneous regression of metastatic Merkel cell carcinoma demonstrating a markedly different pattern of events from those previously published.

  3. Spontaneous Trait Inferences on Social Media

    OpenAIRE

    Levordashka, Ana; Utz, Sonja

    2016-01-01

    The present research investigates whether spontaneous trait inferences occur under conditions characteristic of social media and networking sites: nonextreme, ostensibly self-generated content, simultaneous presentation of multiple cues, and self-paced browsing. We used an established measure of trait inferences (false recognition paradigm) and a direct assessment of impressions. Without being asked to do so, participants spontaneously formed impressions of people whose status updates they sa...

  4. Spontaneous intracranial epidural hematoma during rivaroxaban treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ruschel, Leonardo Gilmone; Rego, Felipe Marques Monteiro do; Milano, Jeronimo Buzetti; Jung, Gustavo Simiano; Silva Junior, Luis Fernando; Ramina, Ricardo, E-mail: leonardoruschel@yahoo.com.br [Instituto de Neurologia de Curitiba (INC), Curitiba, PR (Brazil)

    2016-11-15

    According to our research, this is the first case described in the literature of spontaneous intracranial epidural hematoma secondary to the use of Xarelto®. Spontaneous intracranial epidural hematomas are rarely described in the literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura mater and metastasis to the skull. Long-term post-marketing monitoring and independent reports will probably detect the full spectrum of hemorrhagic complications of the use of rivaroxaban. (author)

  5. Spontaneous mirror symmetry breaking via enantioselective autocatalysis

    Energy Technology Data Exchange (ETDEWEB)

    Avetisov, V.A. [N. N. Semenov Institute of Chemical Physics of the Russian Academy of Sciences, ul.Kossvgina 4, 11-7977 Moscow (Russia)

    1996-07-01

    The conditions for spontaneous generation of optically active product under autocatalytic type reactions is considered on the base of the general kinetic model of enantioselective autocatalytic stages. It is shown that the spontaneous generation of optical activity mostly depends on the enantioselectivity of catalytic transformations. The properties of autocatalytic reactions, which are needed for an experiment, as well as the necessary chemical conditions, are discussed. {copyright} {ital 1996 American Institute of Physics.}

  6. Symptomatic tarlov cyst following spontaneous subarachnoid hemorrhage.

    Science.gov (United States)

    Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan

    2011-08-01

    Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

  7. Symptomatic Tarlov Cyst Following Spontaneous Subarachnoid Hemorrhage

    OpenAIRE

    Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan

    2011-01-01

    Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

  8. Spontaneous lung herniation after a single cough

    Energy Technology Data Exchange (ETDEWEB)

    Tack, D.; Delcour, C. [Dept. of Radiology, C. H. U. de Charleroi (Belgium); Wattiez, A. [Dept. of Pneumology, C. H. U. de Charleroi (Belgium); Schtickzelle, J.C. [Dept. of Emergency Medicine, C. H. U. de Charleroi (Belgium)

    2000-03-01

    Herniation of the lung is commonly caused by congenital rib abnormalities, blunt trauma, or thoracic surgery. Spontaneous hernias are rarely described in the literature. We report a case of a spontaneous intercostal pulmonary hernia following a single cough. In addition, a review of the literature is presented which outlines the classification, causes, and incidence of lung hernias. Some reference is made to possible methods of treatment. (orig.)

  9. Prevention of Preterm Birth with Pessary in Singletons (PoPPS): a randomized controlled trial.

    Science.gov (United States)

    Dugoff, Lorraine; Berghella, Vincenzo; Sehdev, Harish; Mackeen, A Dhanya; Goetzl, Laura; Ludmir, Jack

    2017-09-20

    To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18 0 -23 6 weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary. Pessaries were inserted by trained maternal fetal medicine staff.. Vaginal progesterone was recommended to women with a cervical length ≤20mm. The primary outcome was preterm birth preterm birth preterm birth preterm birth preterm birth in women with singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth in this small underpowered randomized controlled trial. This trial was registered on ClinicalTrials.gov, number NCT 02056652. This article is protected by copyright. All rights reserved.

  10. Characteristics of patients with spontaneous splenic rupture.

    Science.gov (United States)

    Kocael, Pinar Cigdem; Simsek, Osman; Bilgin, Ismail Ahmet; Tutar, Onur; Saribeyoglu, Kaya; Pekmezci, Salih; Goksoy, Ertugrul

    2014-01-01

    In the present study, we aim to share our clinical experience in patients with spontaneous splenic rupture. Splenic rupture without trauma is known as spontaneous splenic rupture. The major problems in the management of spontaneous splenic rupture are missed or delayed diagnosis due to the lack of trauma in most cases. The records of all patients, who were admitted to Cerrahpaşa Medical Faculty, Istanbul University, were retrospectively reviewed from January 2000 to March 2013. Twelve patients were admitted to the emergency department and they were diagnosed with spontaneous splenic rupture. The mean age was 47.6 years. All patients had complaints of abdominal pain. The mean hematocrit value was 22%. Radiologic assessment revealed hemoperitoneum and/or subcapsular hematoma in 8 patients while splenic abscess was diagnosed in 2 patients. Eleven patients underwent splenectomy whereas one was managed conservatively. The most common cause of spontaneous splenic rupture was determined to be use of anticoagulants. Etiology was considered to be idiopathic in 1 patient. Two patients died in the postoperative period. Although rare, spontaneous splenic rupture must be suspected in emergency patients who have used especially anticoagulants and antiaggregants and who have had no recent history of trauma. One of the important causes of mortality is missed or delayed diagnosis.

  11. Prediction of Delivery in Women with Threatening Preterm Labour using Phosphorylated Insulin-Like Growth Factor Binding Protein-1 and Cervical Length using Transvaginal Ultrasound.

    Science.gov (United States)

    Kumari, Amrita; Saini, Vandana; Jain, P K; Gupta, Mamta

    2017-09-01

    Preterm delivery remains a challenge in Obstetrics as it is responsible for significant cause of perinatal morbidity and mortality. At present there is no standard test for prediction of preterm labour for timely referral to a center with NICU facilities. To evaluate the effectiveness of the cervical phosphorylated insulin like growth factor binding protein-1(phIGFBP-1), cervical length measurement and combination of phIGFBP-1 with cervical length for Predicting Preterm Labour (PTL). It was a observational prospective study done from January 2014 to April 2015 in Department of Obstetrics and Gynaecology, NDMC Medical College and Hindu Rao Hospital, Delhi, India. A total of 100 women with singleton pregnancy, between 24 and 36 weeks of gestation with complaint of uterine contractions were randomly selected. These women were subjected to detect phIGFBP-1 in cervical secretions and cervical length measurement by Transvaginal Sonography (TVS). Result of the test, cervical length and time lapse between test and delivery was noted and the results were analysed. The cervical length less than 25 mm was used as a cut off point for predicting pre-term delivery. Data was analysed using SPSS software version 20.0. The Negative Predictive Value (NPV) of phIGFBP-1 and cervical length was similar (95.2% vs 94.05%) respectively for prediction of preterm labour within one week of admission and 93.92% vs 94.80% at 37 weeks of gestational age. Combined test had higher NPV of 96.38% at 34 weeks of gestation and 94% within two days of admission. Positive Predictive Value (PPV) was low for both the test and combining the two-test did not have any advantage as far as PPV was concerned. Receiver Operating Characteristic (ROC) curve showed that the combined test had a superior result in predicting PTL compared to either phIGFBP-1 or cervical length. The combined test had steepest ROC curve at preterm delivery independently. The combined use of phIGFBP-1 and TVS for cervical length shows an

  12. Prediction of Tubal Ectopic Pregnancy Using Offline Analysis of 3-Dimensional Transvaginal Ultrasonographic Data Sets: An Interobserver and Diagnostic Accuracy Study.

    Science.gov (United States)

    Infante, Fernando; Espada Vaquero, Mercedes; Bignardi, Tommaso; Lu, Chuan; Testa, Antonia C; Fauchon, David; Epstein, Elisabeth; Leone, Francesco P G; Van den Bosch, Thierry; Martins, Wellington P; Condous, George

    2017-12-08

    To assess interobserver reproducibility in detecting tubal ectopic pregnancies by reading data sets from 3-dimensional (3D) transvaginal ultrasonography (TVUS) and comparing it with real-time 2-dimensional (2D) TVUS. Images were initially classified as showing pregnancies of unknown location or tubal ectopic pregnancies on real time 2D TVUS by an experienced sonologist, who acquired 5 3D volumes. Data sets were analyzed offline by 5 observers who had to classify each case as ectopic pregnancy or pregnancy of unknown location. The interobserver reproducibility was evaluated by the Fleiss κ statistic. The performance of each observer in predicting ectopic pregnancies was compared to that of the experienced sonologist. Women were followed until they were reclassified as follows: (1) failed pregnancy of unknown location; (2) intrauterine pregnancy; (3) ectopic pregnancy; or (4) persistent pregnancy of unknown location. Sixty-one women were included. The agreement between reading offline 3D data sets and the first real-time 2D TVUS was very good (80%-82%; κ = 0.89). The overall interobserver agreement among observers reading offline 3D data sets was moderate (κ = 0.52). The diagnostic performance of experienced observers reading offline 3D data sets had accuracy of 78.3% to 85.0%, sensitivity of 66.7% to 81.3%, specificity of 79.5% to 88.4%, positive predictive value of 57.1% to 72.2%, and negative predictive value of 87.5% to 91.3%, compared to the experienced sonologist's real-time 2D TVUS: accuracy of 94.5%, sensitivity of 94.4%, specificity of 94.5%, positive predictive value of 85.0%, and negative predictive value of 98.1%. The diagnostic accuracy of 3D TVUS by reading offline data sets for predicting ectopic pregnancies is dependent on experience. Reading only static 3D data sets without clinical information does not match the diagnostic performance of real time 2D TVUS combined with clinical information obtained during the scan. © 2017 by the American

  13. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis.

    Science.gov (United States)

    Guerriero, S; Ajossa, S; Minguez, J A; Jurado, M; Mais, V; Melis, G B; Alcazar, J L

    2015-11-01

    To review the diagnostic accuracy of transvaginal ultrasound (TVS) in the preoperative detection of endometriosis in the uterosacral ligaments (USL), rectovaginal septum (RVS), vagina and bladder in patients with clinical suspicion of deep infiltrating endometriosis (DIE). An extensive search was performed in MEDLINE (PubMed) and EMBASE for studies published between January 1989 and December 2014. Studies were considered eligible if they reported on the use of TVS for the preoperative detection of endometriosis in the USL, RVS, vagina and bladder in women with clinical suspicion of DIE using the surgical data as a reference standard. Study quality was assessed using the PRISMA guidelines and QUADAS-2 tool. Of the 801 citations identified, 11 studies (n = 1583) were considered eligible and were included in the meta-analysis. For detection of endometriosis in the USL, the overall pooled sensitivity and specificity of TVS were 53% (95%CI, 35-70%) and 93% (95%CI, 83-97%), respectively. The pretest probability of USL endometriosis was 54%, which increased to 90% when suspicion of endometriosis was present after TVS examination. For detection of endometriosis in the RVS, the overall pooled sensitivity and specificity were 49% (95%CI, 36-62%) and 98% (95%CI, 95-99%), respectively. The pretest probability of RVS endometriosis was 24%, which increased to 89% when suspicion of endometriosis was present after TVS examination. For detection of vaginal endometriosis, the overall pooled sensitivity and specificity were 58% (95%CI, 40-74%) and 96% (95%CI, 87-99%), respectively. The pretest probability of vaginal endometriosis was 17%, which increased to 76% when suspicion of endometriosis was present after TVS assessment. Substantial heterogeneity was found for sensitivity and specificity for all these locations. For detection of bladder endometriosis, the overall pooled sensitivity and specificity were 62% (95%CI, 40-80%) and 100% (95%CI, 97-100%), respectively. Moderate

  14. Frequencies of spontaneous breast development and spontaneous menarche in Turner syndrome in Japan

    Science.gov (United States)

    Tanaka, Toshiaki; Igarashi, Yutaka; Ozono, Keiichi; Ohyama, Kenji; Ogawa, Masamichi; Osada, Hisao; Onigata, Kazumichi; Kanzaki, Susumu; Kohno, Hitoshi; Seino, Yoshiki; Takahashi, Hiroaki; Tajima, Toshihiro; Tachibana, Katsuhiko; Tanaka, Hiroyuki; Nishi, Yoshikazu; Hasegawa, Tomonobu; Fujita, Keinosuke; Yorifuji, Tohru; Horikawa, Reiko; Yokoya, Susumu

    2015-01-01

    Abstract. The Growject® database on human GH treatment in Turner syndrome was analyzed in the Turner Syndrome Research Collaboration, and the relationships of the frequencies of spontaneous breast development and spontaneous menarche with karyotype and GH treatment were investigated. One hundred and three cases started GH treatment with 0.5 IU/kg/ week (0.5 IU group), and their dose was increased to 0.35 mg/kg/wk midway through the treatment course. Another 109 cases started GH at a dose of 0.35 mg/kg/wk (0.35 mg group). Spontaneous breast development was observed in 77 (36.3%) of the 212 patients, and spontaneous menarche occurred in 31 patients (14.6%). The frequency of spontaneous breast development was significantly lower in patients with the 45,X karyotype and significantly higher in patients with a structural abnormality of the second X chromosome. The frequency of spontaneous menarche was significantly higher in patients with mosaicism characterized by X monosomy and a cellular line with no structural abnormality of the X chromosome. No significant differences in frequencies of spontaneous breast development and spontaneous menarche were observed between the two dose groups, indicating that GH treatment does not increase the frequency of spontaneous puberty. PMID:26568657

  15. Dynamics of spontaneous otoacoustic emissions

    Science.gov (United States)

    Bergevin, Christopher; Salerno, Anthony

    2015-12-01

    Spontaneous otoacoustic emissions (SOAEs) have become a hallmark feature in modern theories of an `active' inner ear, given their numerous correlations to auditory function (e.g., threshold microstructure, neurophysiological tuning curves), near universality across tetrapod classes, and physiological correlates at the single hair cell level. However, while several different classes of nonlinear models exist that describe the mechanisms underlying SOAE generation (e.g., coupled limit-cycle oscillators, global standing waves), there is still disagreement as to precisely which biophysical concepts are at work. Such is further compounded by the idiosyncratic nature of SOAEs: Not all ears emit, and when present, SOAE activity can occur at seemingly arbitrary frequencies (though always within the most sensitive range of the audiogram) and in several forms (e.g., peaks, broad `baseline' plateaus). The goal of the present study was to develop new signal processing and stimulation techniques that would allow for novel features of SOAE activity to be revealed. To this end, we analyzed data from a variety of different species: human, lizard, and owl. First, we explored several strategies for examining SOAE waveforms in the absence of external stimuli to further ascertain what constitutes `self-sustained sinusoids' versus `filtered noise'. We found that seemingly similar peaks in the spectral domain could exhibit key differences in the time domain, which we interpret as providing critical information about the underlying oscillators and their coupling. Second, we introduced dynamic stimuli (swept-tones, tone bursts) at a range of levels, whose interaction with SOAEs could be visualized in the time-frequency domain. Aside from offering a readily accessible way to visualize many previously reported effects (e.g., entrainment, facilitation), we observed several new features such as subharmonic distortion generation and competing pulling/pushing effects when multiple tones were

  16. Methodology in Aristotle's Theory of Spontaneous Generation.

    Science.gov (United States)

    Zwier, Karen R

    2017-10-10

    Aristotle's theory of spontaneous generation offers many puzzles to those who wish to understand his theory both within the context of his biology and within the context of his more general philosophy of nature. In this paper, I approach the difficult and vague elements of Aristotle's account of spontaneous generation not as weaknesses, but as opportunities for an interesting glimpse into the thought of an early scientist struggling to reconcile evidence and theory. The paper has two goals: (1) to give as charitable and full an account as possible of what Aristotle's theory of spontaneous generation was, and to examine some of its consequences; and (2) to reflect on Aristotle as a scientist, and what his comments reveal about how he approached a difficult problem. In particular, I propose that the well-recognized problem of the incompatibility between Aristotle's concept of spontaneity and his theory of spontaneous generation presents an opportunity for insight into his scientific methodology when approaching ill-understood phenomena.

  17. Spontaneous intracranial hypotension: diagnosis to management.

    Science.gov (United States)

    Limaye, Kaustubh; Samant, Rohan; Lee, Ricky W

    2016-06-01

    Spontaneous Intracranial Hypotension typically occurs from spontaneous CSF leak. CSF volume depletion rather than decrease in CSF pressure is thought to be the main causative feature for intracranial hypotension. More and more cases of intracranial hypotension are getting diagnosed with the advances in the imaging. The advances in the imaging have also led to the better understanding of the dynamic changes that occur with intracranial hypotension. The old theories of CSF overproduction or CSF underproduction have not been substantially associated with intracranial hypotension. It has also led to the fore different atypical clinical features and presentations. Although, it has been known for a long time, the diagnosis is still challenging and dilemma persists over one diagnostic modality over other and the subsequent management. Spontaneous CSF leaks occur at the spinal level and the skull base and other locations are rare. The anatomy of spontaneous intracranial hypotension is a very complex process with significant overlap in connective tissue disorders, previous dural weakness or meningeal diverticula. To localize the location of the CSF leak-CT myelography is the modality of choice. CSF cysternography may provide additional confirmation in uncertain cases and also MRI spine imaging may be of significant help in some cases. Spontaneous intracranial hypotension continues to be a diagnostic dilemma and our effort was to consolidate available information on the clinical features, diagnostics, and management for a practicing neurologist for a "15-20 min quick update of the topic".

  18. Model for the spontaneous heating of coal

    Energy Technology Data Exchange (ETDEWEB)

    Schmal, D.; Duyzer, J.H.; Heuven, J.W. van

    1985-07-01

    As part of an investigation into the spontaneous heating of coal piles, a one-dimensional model has been developed to describe the spontaneous heating process at relatively low temperatures (less than about 100 C). The ultimate unsteady-state model takes into account depletion of oxygen and production of heat by chemisorption of oxygen in the coal, transport of oxygen by diffusion and convection and transport of heat by conduction, convection and evaporation/condensation of coal moisture. It consists of four differential equations, for conservation of oxygen mass, of coal moisture and of heat and rate of reaction of oxygen with coal. Calculations using data from laboratory and field experiments give results that describe the process of spontaneous heating semiquantitatively. The most important parameters in the process of spontaneous heating, particularly for the time between stacking and spontaneous ignition, are the porosity of the pile (degree of compaction), the initial temperature of the coal and the evaporation and condensation of coal moisture. The influence of other parameters (e.g. reactivity of the coal, thermal conductivity) is much less pronounced. 12 references.

  19. Spontaneous Regression of Lumbar Herniated Disc

    Directory of Open Access Journals (Sweden)

    Chun-Wei Chang

    2009-12-01

    Full Text Available Intervertebral disc herniation of the lumbar spine is a common disease presenting with low back pain and involving nerve root radiculopathy. Some neurological symptoms in the majority of patients frequently improve after a period of conservative treatment. This has been regarded as the result of a decrease of pressure exerted from the herniated disc on neighboring neurostructures and a gradual regression of inflammation. Recently, with advances in magnetic resonance imaging, many reports have demonstrated that the herniated disc has the potential for spontaneous regression. Regression coincided with the improvement of associated symptoms. However, the exact regression mechanism remains unclear. Here, we present 2 cases of lumbar intervertebral disc herniation with spontaneous regression. We review the literature and discuss the possible mechanisms, the precipitating factors of spontaneous disc regression and the proper timing of surgical intervention.

  20. Spontaneous hemothorax: primary pleural epithelioid angiosarcoma

    Directory of Open Access Journals (Sweden)

    Amit Panjwani

    2016-01-01

    Full Text Available Spontaneous hemothorax is a rare condition seen in coagulation and vascular disorders. Uncommonly, malignant neoplasms may cause spontaneous hemothorax. Primary pleural epithelioid angiosarcomas (excluding the cases with pleuropulmonary or chest wall involvement are extremely rare pleural tumors, which may be mistaken for mesothelioma or adenocarcinoma, and only 19 cases (one of them from India have been reported in the English literature, to date. It commonly occurs in older men, has a nonspecific clinicoradiological presentation, and carries a poor prognosis with no survivors beyond a year of establishing the diagnosis. We report a case of primary pleural epithelioid angiosarcoma presenting as a life-threatening spontaneous hemothorax. We also present a brief literature review on pleural angiosarcoma.

  1. Spontaneous Perforation of Pyometra: A Case Report

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01–0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy. Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.

  2. Ultrafast spontaneous emission source using plasmonic nanoantennas

    Science.gov (United States)

    Hoang, Thang B.; Akselrod, Gleb M.; Argyropoulos, Christos; Huang, Jiani; Smith, David R.; Mikkelsen, Maiken H.

    2015-07-01

    Typical emitters such as molecules, quantum dots and semiconductor quantum wells have slow spontaneous emission with lifetimes of 1-10 ns, creating a mismatch with high-speed nanoscale optoelectronic devices such as light-emitting diodes, single-photon sources and lasers. Here we experimentally demonstrate an ultrafast (gold film separated by a thin polymer spacer layer and colloidal core-shell quantum dots, a stable and technologically relevant emitter. We show an increase in the spontaneous emission rate of a factor of 880 and simultaneously a 2,300-fold enhancement in the total fluorescence intensity, which indicates a high radiative quantum efficiency of ~50%. The nanopatch antenna geometry can be tuned from the visible to the near infrared, providing a promising approach for nanophotonics based on ultrafast spontaneous emission.

  3. Spontaneous loosening of hydroxyapatite peg sleeves.

    Science.gov (United States)

    Jordan, D R

    2001-11-01

    To report a new complication associated with pegging hydroxyapatite orbital implants: spontaneous loosening of the sleeve. Retrospective noncomparative case series. Four patients ranging in age from 38 to 60 years participated. Four patients are described who successfully received hydroxyapatite orbital implants with motility peg and sleeve systems. In each case spontaneous loosening of the sleeve developed. Clinical and surgical outcomes were assessed. Three patients had the peg and sleeve removed followed by repair of the peg hole, and one patient had placement of a larger diameter peg and sleeve system. All patients did well. Problems have been reported when motility coupling pegs are used with hydroxyapatite orbital implants. Spontaneous loosening of the sleeve is another potential complication to discuss with the patient considering an implant peg.

  4. Spontaneous abortion and physical strain around implantation

    DEFF Research Database (Denmark)

    Hjollund, N H; Jensen, T K; Bonde, J P

    2000-01-01

    Existing studies of physical strain and spontaneous abortion are mainly retrospective or based only on pregnancies that have survived the first trimester. Furthermore, almost all studies have relied on averaged measures of physical strain, which tend to blur an effect if peak values during short...... pregnancy the women recorded physical strain prospectively in a structured diary. Physical strain around the time of implantation was associated with later spontaneous abortion. The adjusted risk ratio for women who reported physical strain higher than average at day 6 to 9 after the estimated date...

  5. Spontaneous conversion of first onset atrial fibrillation

    DEFF Research Database (Denmark)

    Lindberg, Søren Østergaard; Hansen, Sidsel; Nielsen, Tonny

    2011-01-01

    consecutive patients admitted to hospital with first onset AF from January 1, 2006, to December 31, 2009. The patients were divided into two groups, recent onset AF defined as AF defined as AF > 48 hours. Spontaneous conversion occurred in 54%, (n = 203; 95% CI: 49 - 59......%). In the group with first onset AF 48 hours. Logistic regression analysis identified duration of AF as a highly significant predictor of spontaneous conversion to sinus rhythm (OR 5.9; 95% CI; 4.0 - 8.6, P

  6. Spontaneous Bilateral Meningoencephalocoeles of the Temporal Bones

    Directory of Open Access Journals (Sweden)

    Oliver Rose

    2013-01-01

    Full Text Available Spontaneous tegmen tympani defects are rare with even rarer bilateral cases. The symptoms are nonspecific; hence, a high index of suspicion is required to prevent serious intracranial complications. We present a case of spontaneous bilateral tegmen tympani defects with associated meningoencephalocoeles in a 54-year-old male who presented with the signs and symptoms of severe meningitis. After careful workup which included a lumbar puncture, CT and MRI scans, both defects were repaired using a middle fossa approach. The patient made an uneventful recovery with complete cessation of otorrhoea and improvement in his hearing.

  7. Spontaneous lung lobe torsion in two pugs.

    Science.gov (United States)

    Rooney, M B; Lanz, O; Monnet, E

    2001-01-01

    Two, young adult, male pugs presented for spontaneous left-cranial lung lobe torsions. Clinical signs associated with these two cases included increased weakness, increased respiratory effort, tachypnea, acute collapse, lethargy, anorexia, and cyanosis. The torsed lung lobes were excised using a thoracoabdominal stapling device without detorsing the lobes. Both dogs recovered uneventfully, and at least one year postoperatively, no clinical abnormalities were noted by their owners. Results of this report suggest that spontaneous lung lobe torsion in pugs occurs and should be a differential diagnosis for pugs with increased respiratory effort, tachypnea, nonproductive cough, acute collapse, cyanosis, and lethargy. Surgical excision may be curative.

  8. Spontaneous symmetry breaking in gauge theories.

    Science.gov (United States)

    Kibble, T W B

    2015-01-13

    The aim of this historical article is to describe the development of the idea of spontaneous symmetry breaking in gauge theories as seen from my perspective as a member of Abdus Salam's group at Imperial College London, UK. Beginning with an account of particle physics in the years after the Second World War, I describe early attempts at constructing a unified theory of weak and electromagnetic interactions, the obstacles encountered and how they were eventually overcome with the mass-generating mechanism incorporating the idea of spontaneous symmetry breaking, one of whose features is the now-famous Higgs boson.

  9. Spontaneous subdural hematoma associated to Duret hemorrhage

    Directory of Open Access Journals (Sweden)

    William Alves Martins, MD

    2015-03-01

    Full Text Available Subdural hematoma (SH is a neurosurgical emergency, usually caused by head trauma. Non-traumatic causes include aneurysm or arterial–venous malformation rupture, coagulopathy and others. We report the case of a 66 year-old man who developed apparently unprovoked signs of increased intracranial pressure. Brain computed tomography scan showed an acute spontaneous SH, surgically treated. Throughout surgery, a ruptured cortical artery with intensive bleeding appeared and was cauterized. After surgery, patient remained comatose and a new CT demonstrated Duret hemorrhage at the brainstem. Acute spontaneous SH of arterial origin is rare and highly lethal, in which a good prognosis relies on early diagnosis and treatment.

  10. Primer on spontaneous heating and pyrophoricity

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This primer was prepared as an information resource for personnel responsible for operation of DOE nuclear facilities. It has sections on combustion principles, spontaneous heating/ignition of hydrocarbons and organics, pyrophoric gases and liquids, pyrophoric nonmetallic solids, pyrophoric metals (including Pu and U), and accident case studies. Although the information in this primer is not all-encompassing, it should provide the reader with a fundamental knowledge level sufficient to recognize most spontaneous combustion hazards and how to prevent ignition and widespread fires. This primer is provided as an information resource only, and is not intended to replace any fire protection or hazardous material training.

  11. Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers

    DEFF Research Database (Denmark)

    Hedevang Olesen, Winnie; Katballe, Niels; Sindby, Jesper Eske

    2017-01-01

    OBJECTIVES: Previous smaller case series suggested that cannabis smoking may cause spontaneous pneumothorax, but this finding remains controversial. We investigated the possible association between smoking tobacco and cannabis and the risk of having a primary spontaneous pneumothorax in a large...... tobacco and cannabis were obtained from questionnaires presented on admittance. We compared our findings with those of a population-based control group matched by age, sex and geographical area. Calculated odds ratios were compared using the Fisher’s exact test for small frequencies and the χ2 test.......61–14.14, P cannabis and tobacco in men increased the risk of spontaneous pneumothorax significantly (odds ratio = 8.74, 95% confidence interval: 4.30–19.51, P 

  12. Echocardiographic Follow-Up of Patent Foramen Ovale and the Factors Affecting Spontaneous Closure.

    Science.gov (United States)

    Yildirim, Ali; Aydin, Alperen; Demir, Tevfik; Aydin, Fatma; Ucar, Birsen; Kilic, Zubeyir

    2016-11-01

    The aim of the present study was to evaluate the echocardiographic follow-up of patent foramen ovale, which is considered a potential etiological factor in various diseases, and to determine the factors affecting spontaneous closure. Between January 2000 and June 2012, records of 918 patients with patent foramen ovale were retrospectively reviewed. Patency of less than 3 mm around the fossa ovalis is called patent foramen ovale. Patients with cyanotic congenital heart diseases, severe heart valve disorders and severe hemodynamic left to right shunts were excluded from the study. The patients were divided into three groups based on age; 1 day-1 month in group 1, 1 month-12 months in group 2, and more than 12 months in group 3. Of the 918 patients, 564 (61.4%) had spontaneous closure, 328 (35.8%) had patent foramen ovale continued, 15 (1.6%) patients had patent foramen ovale enlarged to 3-5 mm, 6 patients were enlarged to 5-8 mm, and in one patient patent foramen ovale reached to more than 8 mm size. Defect was spontaneously closed in 65.9% of the patients in group 1, 66.7% of the patients in group 2, and 52.3% of the patients in group 3. There was a negative correlation between the age of diagnosis and spontaneous closure (p Gender, prematurity and coexisting malformations such as patent ductus arteriosus and atrial septal aneurysm did not have any effect on spontaneous closure of patent foramen ovale (p > 0.05). However, ventricular septal defect and spontaneous closure of patent foramen ovale had a positive correlation (p patent foramen ovale is high. Furthermore, a positive correlation was found between spontaneous closure of patent foramen ovale with early diagnosis and small defect size.

  13. Influence of Internal and External Noise on Spontaneous Visuomotor Synchronization.

    Science.gov (United States)

    Varlet, Manuel; Schmidt, R C; Richardson, Michael J

    2016-01-01

    Historically, movement noise or variability is considered to be an undesirable property of biological motor systems. In particular, noise is typically assumed to degrade the emergence and stability of rhythmic motor synchronization. Recently, however, it has been suggested that small levels of noise might actually improve the functioning of motor systems and facilitate their adaptation to environmental events. Here, the authors investigated whether noise can facilitate spontaneous rhythmic visuomotor synchronization. They examined the influence of internal noise in the rhythmic limb movements of participants and external noise in the movement of an oscillating visual stimulus on the occurrence of spontaneous synchronization. By indexing the natural frequency variability of participants and manipulating the frequency variability of the visual stimulus, the authors demonstrated that both internal and external noise degrade synchronization when the participants' and stimulus movement frequencies are similar, but can actually facilitate synchronization when the frequencies are different. Furthermore, the two kinds of noise interact with each other. Internal noise facilitates synchronization only when external noise is minimal and vice versa. Too much internal and external noise together degrades synchronization. These findings open new perspectives for better understanding the role of noise in human rhythmic coordination.

  14. Spontaneous regression of intracranial malignant lymphoma. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kojo, Nobuto; Tokutomi, Takashi; Eguchi, Gihachirou; Takagi, Shigeyuki; Matsumoto, Tomie; Sasaguri, Yasuyuki; Shigemori, Minoru.

    1988-05-01

    In a 46-year-old female with a 1-month history of gait and speech disturbances, computed tomography (CT) demonstrated mass lesions of slightly high density in the left basal ganglia and left frontal lobe. The lesions were markedly enhanced by contrast medium. The patient received no specific treatment, but her clinical manifestations gradually abated and the lesions decreased in size. Five months after her initial examination, the lesions were absent on CT scans; only a small area of low density remained. Residual clinical symptoms included mild right hemiparesis and aphasia. After 14 months the patient again deteriorated, and a CT scan revealed mass lesions in the right frontal lobe and the pons. However, no enhancement was observed in the previously affected regions. A biopsy revealed malignant lymphoma. Despite treatment with steroids and radiation, the patient's clinical status progressively worsened and she died 27 months after initial presentation. Seven other cases of spontaneous regression of primary malignant lymphoma have been reported. In this case, the mechanism of the spontaneous regression was not clear, but changes in immunologic status may have been involved.

  15. Spontaneous massive hemopneumothorax: Double trouble with a twist

    Directory of Open Access Journals (Sweden)

    Milta Kuriakose

    2017-01-01

    Full Text Available Spontaneous hemopneumothorax (SHP is observed in 3%–7% cases of spontaneous pneumothorax where the tear of an adhesion can lead to bleeding with associated hemothorax. This condition has been reported in patients with hemophilia, sarcoidosis, congenital cystic adenomatoid malformation, systemic lupus erythematosus, etc., Here, we describe an unusual case of acute massive SHP in a 62-year-old male who underwent a percutaneous transluminal coronary angioplasty (PTCA and presented with worsening dyspnea over the next 3 days. On evaluation, he had a massive hemopneumothorax which was considered to be secondary to the use of anticoagulants during the PTCA procedure. Pleural fluid analysis revealed frank blood and was consistent with the diagnosis of hemothorax. Surprisingly, the pleural fluid cytology revealed malignant cells. As the patient had a normal chest X-ray 3 days ago, thoracoscopic pleural biopsy was taken which confirmed the diagnosis of an epithelioid mesothelioma. Although post-PTCA or mesothelioma-associated hemothorax has been rarely reported, these two conditions have not been associated with SHP. Since the patient had no prior clinicoradiological features of mesothelioma, the procedure, and the anticoagulants probably contributed to the massive and rapid accumulation of blood. The presence of small amount of air added further confusion to the dual etiology and has not been described earlier.

  16. Proteomic Biomarkers for Spontaneous Preterm Birth

    DEFF Research Database (Denmark)

    Kacerovsky, Marian; Lenco, Juraj; Musilova, Ivana

    2014-01-01

    This review aimed to identify, synthesize, and analyze the findings of studies on proteomic biomarkers for spontaneous preterm birth (PTB). Three electronic databases (Medline, Embase, and Scopus) were searched for studies in any language reporting the use of proteomic biomarkers for PTB published...

  17. Maternal Factors Associated With Early Spontaneous Singleton ...

    African Journals Online (AJOL)

    Background: Knowledge of the maternal factors predisposing to preterm deliveries should affect the anticipatory care of mothers at risk of delivering preterm babies and improve perinatal outcome. Objective: To determine the maternal socio-biological characteristics associated with the delivery of early spontaneous ...

  18. Spontaneous Hedonic Reactions to Social Media Cues.

    Science.gov (United States)

    van Koningsbruggen, Guido M; Hartmann, Tilo; Eden, Allison; Veling, Harm

    2017-05-01

    Why is it so difficult to resist the desire to use social media? One possibility is that frequent social media users possess strong and spontaneous hedonic reactions to social media cues, which, in turn, makes it difficult to resist social media temptations. In two studies (total N = 200), we investigated less-frequent and frequent social media users' spontaneous hedonic reactions to social media cues using the Affect Misattribution Procedure-an implicit measure of affective reactions. Results demonstrated that frequent social media users showed more favorable affective reactions in response to social media (vs. control) cues, whereas less-frequent social media users' affective reactions did not differ between social media and control cues (Studies 1 and 2). Moreover, the spontaneous hedonic reactions to social media (vs. control) cues were related to self-reported cravings to use social media and partially accounted for the link between social media use and social media cravings (Study 2). These findings suggest that frequent social media users' spontaneous hedonic reactions in response to social media cues might contribute to their difficulties in resisting desires to use social media.

  19. Controlling spontaneous combustion in surface coal mines

    Energy Technology Data Exchange (ETDEWEB)

    Eroglu, N.

    2005-07-01

    The Witbank Coalfield in South Africa has historically been mined out using the bord-and-pillar method, with typically low coal-recovery ratios, leaving significant amounts of coal in pillars and as floor and roof coal. These pillars are being re-extracted by underground and surface mining methods. During surface mining, air enters through the cracks and bords into the old workings, causing spontaneous combustion of coal. Over the long term, air will also enter the old underground bord-and-pillar workings at shallow depth through sinkholes caused by bord collapse underground. The resulting environmental problems may necessitate future rehabilitation at great cost. Existing knowledge about spontaneous combustion in opencast collieries indicates that there is no typical fire and certainly no standard technique for preventing it from happening. However, with current measures it is possible to control the spontaneous combustion of coal in opencast collieries. A project supported by Coaltech 2020, a South African coal mining Collaborative Research Programme, has been completed to develop methods for minimising and controlling spontaneous combustion in old workings by surface mining methods and applications. However, the findings and recommendations of this study, which focused on the Witbank Coalfield, can be adapted to other surface coal mines. 11 figs.

  20. Association between Nutritional Status with Spontaneous Abortion

    Directory of Open Access Journals (Sweden)

    Rahimeh Ahmadi

    2016-11-01

    Full Text Available Background: Spontaneous abortion is the most common adverse pregnancy outcome. We aimed to investigate a possible link between nutrient deficiencies and the risk of spontaneous abortion. Materials and Methods: This case-control study included the case group (n=331 experiencing a spontaneous abortion before 14 weeks of pregnancy and the control group (n=331 who were healthy pregnant women over 14 weeks of pregnancy. The participants filled out Food Frequency Questionnaire (FFQ, in which they reported their frequency of consumption for a given serving of each food item during the past three months, on a daily, weekly or monthly basis. The reported frequency for each food item was converted to a daily intake. Then, consumption of nutrients was compared between the two groups. Results: There are significant differences between the two groups regarding consumed servings/day of vegetables, bread and cereal, meat, poultry, fish, eggs, beans, fats, oils and dairy products (P=0.012, P<0.001, P=0.004, P<0.001, P=0.019, respectively. There are significant differences between the two groups in all micronutrient including folic acid, iron, vitamin C, vitamin B6, vitamin B12 and zinc (P<0.001. Conclusion: Poor nutrientions may be correlated with increased risk of spontaneous abortion

  1. Synchronization of cubic distortion spontaneous otoacoustic emissions

    NARCIS (Netherlands)

    van Dijk, P; Wit, HP

    A spontaneous otoacoustic emission spectrum may contain equally spaced emission peaks. Then, two peaks, at frequencies, f(1) and f(2), respectively, apparently generate a distortion product at f(d)=2f(1)-f(2) [or 2f(2)-f(1)]. For the three emission peaks of nine of such triplets tin six emission

  2. Spontaneous regression of an intraspinal disc cyst

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Eerens, I.; Wilms, G. [University Hospital, Leuven (Belgium). Dept. of Radiology; Goffin, J. [Dept. of Neurosurgery, University Hospitals, Leuven (Belgium)

    2001-11-01

    We present a patient with a so-called disc cyst. Its location in the ventrolateral epidural space and its communication with the herniated disc are clearly shown. The disc cyst developed rapidly and regressed spontaneously. This observation, which has not been reported until now, appears to support focal degeneration with cyst formation as the pathogenesis. (orig.)

  3. Spontaneous Monochorionic Tetra‑amniotic Quadruplet Pregnancy ...

    African Journals Online (AJOL)

    Ron-El R, Mor Z, Weinraub Z, Schreyer P, Bukovsky I, Dolphin Z, et al. Triplet, quadruplet and quintuplet pregnancies: Management and outcome. Acta Obstet Gynaecol Scand 1992;71:347-50. How to cite this article: Nnadi D, Ibrahim A, Nwobodo E. Spontaneous monochorionic tetra-amniotic quadruplet pregnancy at term.

  4. Ovarian hyperstimulation syndrome in a spontaneous pregnancy ...

    African Journals Online (AJOL)

    It is known that most cases of Ovarian Hyperstimulation Syndrome (OHSS) are associated with the therapies for ovulation induction. However, OHSS may rarely be associated with a spontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism or polycystic ovary syndrome. We report a case of ...

  5. Surgical management of spontaneous ruptured hepatocellular adenoma

    Directory of Open Access Journals (Sweden)

    Marcelo Augusto Fontenelle Ribeiro Junior

    2009-01-01

    Full Text Available AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006 with a proven diagnosis of hepatocellular adenoma (HA. Three (10.7% of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation, as well as intraperitoneal abscess (re-operation and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.

  6. Spontaneous Dimensional Reduction in Quantum Gravity

    CERN Document Server

    Carlip, S

    2016-01-01

    Hints from a number of different approaches to quantum gravity point to a phenomenon of "spontaneous dimensional reduction" to two spacetime dimensions near the Planck scale. I examine the physical meaning of the term "dimension" in this context, summarize the evidence for dimensional reduction, and discuss possible physical explanations.

  7. A Case of Idiopathic Spontaneous Intratesticular Hemorrhage

    Directory of Open Access Journals (Sweden)

    Takumi Takeuchi

    2017-09-01

    On visual inspection, the whole testis was black. The spermatic cord was neither distorted nor black. Testicular torsion could not be completely ruled out; thus, left orchiectomy was performed. Histopathology revealed diffuse intratesticular hemorrhage without the necrosis of seminiferous tubular cells. We encountered a case of idiopathic spontaneous intratesticular hemorrhage.

  8. Spontaneous Sourcing among Students Reading Multiple Documents

    Science.gov (United States)

    Stromso, Helge I.; Braten, Ivar; Britt, M. Anne; Ferguson, Leila E.

    2013-01-01

    This study used think-aloud methodology to explore undergraduates' spontaneous attention to and use of source information while reading six documents that presented conflicting views on a controversial social scientific issue in a Google-like environment. Results showed that students explicitly and implicitly paid attention to sources of documents…

  9. Spontaneous Type 2 Diabetic Rodent Models

    Directory of Open Access Journals (Sweden)

    Yang-wei Wang

    2013-01-01

    Full Text Available Diabetes mellitus, especially type 2 diabetes (T2DM, is one of the most common chronic diseases and continues to increase in numbers with large proportion of health care budget being used. Many animal models have been established in order to investigate the mechanisms and pathophysiologic progress of T2DM and find effective treatments for its complications. On the basis of their strains, features, advantages, and disadvantages, various types of animal models of T2DM can be divided into spontaneously diabetic models, artificially induced diabetic models, and transgenic/knockout diabetic models. Among these models, the spontaneous rodent models are used more frequently because many of them can closely describe the characteristic features of T2DM, especially obesity and insulin resistance. In this paper, we aim to investigate the current available spontaneous rodent models for T2DM with regard to their characteristic features, advantages, and disadvantages, and especially to describe appropriate selection and usefulness of different spontaneous rodent models in testing of various new antidiabetic drugs for the treatment of type 2 diabetes.

  10. Spontaneous type 2 diabetic rodent models.

    Science.gov (United States)

    Wang, Yang-Wei; Sun, Guang-Dong; Sun, Jing; Liu, Shu-Jun; Wang, Ji; Xu, Xiao-Hong; Miao, Li-Ning

    2013-01-01

    Diabetes mellitus, especially type 2 diabetes (T2DM), is one of the most common chronic diseases and continues to increase in numbers with large proportion of health care budget being used. Many animal models have been established in order to investigate the mechanisms and pathophysiologic progress of T2DM and find effective treatments for its complications. On the basis of their strains, features, advantages, and disadvantages, various types of animal models of T2DM can be divided into spontaneously diabetic models, artificially induced diabetic models, and transgenic/knockout diabetic models. Among these models, the spontaneous rodent models are used more frequently because many of them can closely describe the characteristic features of T2DM, especially obesity and insulin resistance. In this paper, we aim to investigate the current available spontaneous rodent models for T2DM with regard to their characteristic features, advantages, and disadvantages, and especially to describe appropriate selection and usefulness of different spontaneous rodent models in testing of various new antidiabetic drugs for the treatment of type 2 diabetes.

  11. [Spontaneous remission of objective tinnitus (author's transl)].

    Science.gov (United States)

    Chilla, R; Nordeck, E

    1975-09-01

    The presence of a systolic loud tinnitus over the right mastoid in a 21 year old male was established by auscultation and phonocardiograph recording. Selective angiography of the carotids excluded a vascular abnormality. The tinnitus, which persited for 1 year, disappeared spontaneously over a 4 week period. The cause and the course of this tinnitus are discussed.

  12. Massive Spontaneous Hemothorax, Giant Intrathoracic Meningocele ...

    African Journals Online (AJOL)

    Massive Spontaneous Hemothorax, Giant Intrathoracic. Meningocele, and Kyphoscoliosis in Neurofibromatosis Type 1. Ayodeji Salman Yusuf, Ashok Pillai1, Sajesh K. Menon1, Dilip Panikar1. INTRODUCTION. Neurofibromatosis type 1 (NF‑1) is an autosomal dominant disease with an incidence ranging from. 1 in 2500 to ...

  13. Spontaneous emission from saturated parametric amplifiers

    DEFF Research Database (Denmark)

    Rottwitt, Karsten; Ott, Johan Raunkjær; Steffensen, Henrik

    2009-01-01

    Noise performance of parametric amplifiers is typically calculated assuming un-depleted operation. However, in many applications especially when applied as regenerative amplifiers in systems based on phase shift keyed modulation schemes, this assumption is not valid. Here we show the impact...... on accumulated spontaneous emission for a parametric amplifier operated in saturation....

  14. Identical Twin Primigravid Sisters -Spontaneous Labour and ...

    African Journals Online (AJOL)

    We report 2 cases of identical twin sisters, the older sibling getting married 14 months earlier but both got pregnant for their first child at about the same time and were managed by the same Obstetrician and fell into spontaneous labour within a few hours of each other. Both were delivered by emergency caesarean section ...

  15. Influence of spontaneous fermentation on some quality ...

    African Journals Online (AJOL)

    Spontaneous fermentation has been identified to improve the quality characteristics of foods derived from them. When combined with cowpea fortification and nixtamalization, it is expected to improve the nutritional, functional, physico- chemical and sensory qualities of maize based foods thereby improving the qualities as ...

  16. Spontaneous Non-verbal Counting in Toddlers

    Science.gov (United States)

    Sella, Francesco; Berteletti, Ilaria; Lucangeli, Daniela; Zorzi, Marco

    2016-01-01

    A wealth of studies have investigated numerical abilities in infants and in children aged 3 or above, but research on pre-counting toddlers is sparse. Here we devised a novel version of an imitation task that was previously used to assess spontaneous focusing on numerosity (i.e. the predisposition to grasp numerical properties of the environment)…

  17. Spatial Memory in Spontaneously Hypertensive Rats (SHR)

    NARCIS (Netherlands)

    Sontag, Thomas-A.; Fuermaier, Anselm B. M.; Hauser, Joachim; Kaunzinger, Ivo; Tucha, Oliver; Lange, Klaus W.

    2013-01-01

    The spontaneously hypertensive rat (SHR) is an established animal model of ADHD. It has been suggested that ADHD symptoms arise from deficits in executive functions such as working memory, attentional control and decision making. Both ADHD patients and SHRs show deficits in spatial working memory.

  18. Spontaneous baroreflex sensitivity in (pre)adolescents

    NARCIS (Netherlands)

    Dietrich, A; Riese, H; van Roon, AM; van Engelen, K; Ormel, J; Neeleman, J; Rosmalen, JGM

    Objective To present normal spontaneous baroreflex sensitivity (BRS) values and investigate the influence of posture, sex, age, pubertal stage, body mass index (BMI), , and physical activity level on BRS in (pre)adolescents. BRS is a sensitive measure of both sympathetic and parasympathetic

  19. Massive Spontaneous Hemothorax, Giant Intrathoracic Meningocele ...

    African Journals Online (AJOL)

    Neurofibromatosis type 1 (NF‑1) is a heterogeneous autosomal dominant disease with an incidence ranging from 1 in 2500 to 1 in 3000. Rare intrathoracic vascular disorders resulting in massive spontaneous hemothorax with fatal consequences may occur in these patients, so also are various types of skeletal dysplasia ...

  20. Spontaneous Language Markers of Spanish Language Impairment

    Science.gov (United States)

    Simon-Cereijido, Gabriela; Gutierrez-Clellen, Vera F.

    2007-01-01

    Spanish-speaking (SS) children with language impairment (LI) present with deficits in morphology and verb argument structure. These language areas may be useful for clinical identification of affected children. This study aimed to evaluate the discrimination accuracy of spontaneous language measures with SS preschoolers to tease out what…

  1. PERIODIC-SOLUTIONS IN SPONTANEOUSLY BROKEN THEORIES

    NARCIS (Netherlands)

    BRIHAYE, Y; KUNZ, J

    A class of spontaneously broken field theories is proposed, and the occurrence of their periodic, classical solutions is investigated in detail. The emergence of multiple solutions is observed, their normal modes of oscillation are studied, and the bifurcations of the classical energy functional are

  2. Editorial: Spontaneous bacterial peritonitis | Lule | East African ...

    African Journals Online (AJOL)

    Journal Home > Vol 81, No 3 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editorial: Spontaneous bacterial peritonitis. GN Lule. Abstract. No Abstract Available. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT ...

  3. Spontaneous hedonic reactions to social media cues

    NARCIS (Netherlands)

    Koningsbruggen, G.M. van; Hartmann, T.; Eden, A.; Veling, H.P.

    2017-01-01

    Why is it so difficult to resist the desire to use social media? One possibility is that frequent social media users possess strong and spontaneous hedonic reactions to social media cues, which, in turn, makes it difficult to resist social media temptations. In two studies (total N = 200), we

  4. Silicon photonic crystals and spontaneous emission

    NARCIS (Netherlands)

    Dood, Michiel Jacob Andries de

    2002-01-01

    Photonic crystals, i.e. materials that have a periodic variation in refractive index, form an interesting new class of materials that can be used to modify spontaneous emission and manipulate optical modes in ways that were impossible so far. This thesis is divided in three parts. Part I discusses

  5. Small Data

    NARCIS (Netherlands)

    S. Pemberton (Steven)

    2014-01-01

    htmlabstractThe term “Open Data” often goes hand in hand with the term “Big Data”, where large data sets get released allowing for analysis, but the Cinderella of the Open Data ball is Small Data, small amounts of data, nonetheless possibly essential, that are too small to be put in some database or

  6. Anemonia sulcata toxin (ATX II) enhances spontaneous electrical activity and tension in chronically denervated rat diaphragm.

    Science.gov (United States)

    Ravens, U; Wiese, R

    1985-09-01

    In isolated strips of rat diaphragm denervated 9-21 days prior to experimentation, spontaneous action potentials were recorded extracellularly and twitch and resting tension were measured. The sea anemone toxin ATX II enhances the occurrence of spontaneous action potentials, increases resting tension and depresses twitch tension. These effects are essentially irreversible. In low sodium solution substituted with sucrose the effects of ATX II are attenuated, however, they fully develop upon return to normal sodium solution with a marked transient increase in the incidence of spontaneous action potentials and in resting tension. ATX II remains uneffective after pretreatment with tetrodotoxin. Reelevation of the extracellular sodium concentration after exposure to low sodium solution per se causes a marked increase in occurrence of fibrillation potentials, however the transient increase in resting tension was much smaller than in the presence of ATX II. Substitution of chloride with the impermeable anion methylsulphate enhances spontaneous activity and resting tension without an effect on twitch tension. Addition of ATX II elevates resting tension although the concomitant further increase in incidence of spontaneous action potentials is small. It is concluded that the increase in resting tension reflects a summation of the fibrillatory activity, but fibrillations become more effective when the preparations are exposed to ATX II. This finding points at the possible rôle of sodium ions in excitation contraction coupling of denervated skeletal muscle.

  7. Spontaneous Symmetry Breaking in Nonrelativistic Systems

    Science.gov (United States)

    Watanabe, Haruki

    The subject of condensed matter physics is very rich --- there are an infinite number of parameters producing a diversity of exciting phenomena. As a theorist, my goal is to distill general principles out of this complexity --- to construct theories that can coherently explain many known examples altogether. This thesis is composed of several attempts to develop such theories in topics related to spontaneously symmetry breaking. A remarkable feature of many-body interacting systems is that although they are described by equations respecting various symmetries, they may spontaneously organize into a state that explicitly breaks symmetries. Examples are numerous: various types of crystalline and magnetic orders, Bose-Einstein condensates of cold atoms, superfluids of liquid helium, chiral symmetry in QCD, neutron stars, and cosmic inflation. These systems with spontaneously broken continuous symmetries have gapless excitations, so called Nambu-Goldstone bosons (NGBs). Although the properties of NGBs are well understood in Lorentz-invariant systems, surprisingly, some basic properties of NGBs such as their number and dispersion in nonrelativistic systems have not been discussed from a general perspective. In the first part of this thesis, we solve this issue by developing and analyzing an effective Lagrangian that coherently captures the low-energy, long-distance physics of many different symmetry-breaking states all at once. Next, we examine whether these NGBs originating from spontaneous symmetry breaking remain to be well-defined excitations inside a metal, where low-energy electrons near Fermi surface can collide with them. Our result is a one equation criterion that specifies whether the interactions between electrons and NGBs can be ignored, or whether it completely changes their character. In the latter case, unusual phases of matter such as non-Fermi liquids may arise; in that case, NGBs are overdamped and cannot form particle-like excitations in spite of the

  8. A prospective study on transvaginal ultrasound of cervical length (CL) in the first and second trimester in a low-risk population

    DEFF Research Database (Denmark)

    Wulff, C B; Rode, L; Rosthøj, S

    2017-01-01

    CL in the second trimester was 50% at a 10% false-positive rate. More than 1500 women would need to be CL screened at 19-21 weeks to prevent one case of spontaneous preterm delivery before 34 weeks in a population like ours. CONCLUSION: Our data showed an association between first-trimester CL...... and the risk of short cervix in the second trimester. Once a short CL was observed the risk of preterm delivery (PTD) was highly increased. Whether universal CL screening should be implemented in our low risk population must however depend on a cost-benefit analysis taking into account the low proportions...

  9. Ultra-sonografia transvaginal com dopplervelocimetria no estudo do volume, da espessura do estroma e da vascularização dos ovários na síndrome dos ovários policísticos

    OpenAIRE

    Marcelo Afonso Gonçalves

    2007-01-01

    INTRODUÇÃO - A síndrome dos ovários policísticos (SOP) é uma das mais controversas entidades da endocrinologia ginecológica. Após o simpósio de Rotterdam, em 2003, ficou evidente a importância da morfologia ovariana para o diagnóstico e para a composição dos fenótipos. A ultra-sonografia transvaginal com dopplervelocimetria pode ajudar a analisar as variáveis implicadas na vascularização e a monitorar os ovários. OBJETIVO - Avaliar o volume, a espessura do estroma e a vascularização dos ovári...

  10. Genetic polymorphisms and spontaneous preterm birth.

    Science.gov (United States)

    Gibson, Catherine S; MacLennan, Alastair H; Dekker, Gustaaf A; Goldwater, Paul N; Dambrosia, James M; Munroe, David J; Tsang, Shirley; Stewart, Claudia; Nelson, Karin B

    2007-02-01

    To examine whether selected genetic polymorphisms in the infant are associated with spontaneous preterm birth (less than 37 weeks) among children with or without later-diagnosed cerebral palsy. Exploratory case-control study investigating the relationship of gestational age at delivery to 31 single nucleotide polymorphisms measured in newborn screening bloodspots. Among all 443 children with later-diagnosed cerebral palsy born to white women in South Australia in 1986-1999, 234 were born after spontaneous onset of labor, and 108 of these were preterm (gestational age less than 37 weeks). The comparison group was 549 infants born after spontaneous onset of labor, of whom 147 were preterm. Distributions of genotypic frequencies were examined in preterm compared with term infants with and without cerebral palsy. Genotyping was performed using a Taqman assay. In children without cerebral palsy, preterm birth after spontaneous onset of labor was more frequent in association with a variant of the beta2 adrenergic receptor gene (ADRB2 Q27E, P=.003), inducible nitric oxide synthase (iNOS or NOS2A, P=.042), or thrombomodulin (G127A, P=.006). Among children with cerebral palsy, preterm birth was associated with polymorphisms in genes for endothelial nitric oxide synthase (eNOS -922, P=.012), plasminogen activator inhibitor-2 (P=.015 and .019), and alpha adducin (ADD1, P=.047). We confirm previous observations that variants of the beta adrenergic receptor and of nitric oxide synthase are associated with prematurity, and suggest that genetic variants of the placental antifibrinolytic plasminogen activator inhibitor-2, and thrombomodulin and alpha adducin may be contributors to risk of spontaneous preterm birth. II.

  11. Spontaneous sensorimotor coupling with multipart music.

    Science.gov (United States)

    Hurley, Brian K; Martens, Peter A; Janata, Petr

    2014-08-01

    Music often evokes spontaneous movements in listeners that are synchronized with the music, a phenomenon that has been characterized as being in "the groove." However, the musical factors that contribute to listeners' initiation of stimulus-coupled action remain unclear. Evidence suggests that newly appearing objects in auditory scenes orient listeners' attention, and that in multipart music, newly appearing instrument or voice parts can engage listeners' attention and elicit arousal. We posit that attentional engagement with music can influence listeners' spontaneous stimulus-coupled movement. Here, 2 experiments-involving participants with and without musical training-tested the effect of staggering instrument entrances across time and varying the number of concurrent instrument parts within novel multipart music on listeners' engagement with the music, as assessed by spontaneous sensorimotor behavior and self-reports. Experiment 1 assessed listeners' moment-to-moment ratings of perceived groove, and Experiment 2 examined their spontaneous tapping and head movements. We found that, for both musically trained and untrained participants, music with more instruments led to higher ratings of perceived groove, and that music with staggered instrument entrances elicited both increased sensorimotor coupling and increased reports of perceived groove. Although untrained participants were more likely to rate music as higher in groove, trained participants showed greater propensity for tapping along, and they did so more accurately. The quality of synchronization of head movements with the music, however, did not differ as a function of training. Our results shed new light on the relationship between complex musical scenes, attention, and spontaneous sensorimotor behavior.

  12. Spontaneous formation of aqueous droplets in complex coacervate systems

    Science.gov (United States)

    Ali, Samim; Prabhu, Vivek

    Complex coacervation occurs when a solution of two oppositely charged polymers undergoes liquid-liquid phase separation under suitable conditions. The coacervate forms the highly viscoelastic polymer-rich phase that exhibits very low interfacial tension with the polymer-poor supernatant. This presentation will describe the spontaneous formation of micron-sized aqueous droplets in the polymer-rich coacervate domain as the temperature of the system is increased above a critical value. The spherical droplets, initiated at the liquid-liquid interface, propagates into the bulk coacervate domain. Moreover, the average size of the droplets increases monotonically with increase in temperature. This results in an optically turbid appearance of the coacervate. We evaluate the role of liquid-liquid interface and polymer structure inside the coacervate phase during such transition using rheological techniques and small-angle neutron scattering. These observations provide a foundation to understand coacervate properties at conditions useful to encapsulation, delivery media, and wet adhesives.

  13. Spontaneous remission of hepatocellular carcinoma without any treatment

    Directory of Open Access Journals (Sweden)

    Shao-Ciao Luo

    2016-12-01

    A 61 year old asymptomatic woman visited our outpatient clinic (OPC with a high alpha-fetal protein (AFP level. A computed tomogram (CT revealed a 4.1 cm hypervascular tumor (arterial phase at S4 of the liver and washed out in venous phase. Her Hepatitis B Surface Antigen (HBsAg was negative and Hepatitis C Antibody (anti-HCV was positive. This patient also had esophageal varices. She refused any treatment and returned to our OPC about 2 years later. Her AFP level was 11.8 ng/ml. The following CT scan revealed a small amount of cirrhosis, but no mass, in the liver, so that spontaneous remission of HCC was determined. She was treated by oral diuretics. Here we report the case and review of literature.

  14. Directive and enhanced spontaneous emission using shifted cubes nanoantenna

    Energy Technology Data Exchange (ETDEWEB)

    Bahari, B.; Tellez-Limon, R.; Kante, B., E-mail: bkante@ucsd.edu [Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, California 92093-0407 (United States)

    2016-09-07

    Recent studies have demonstrated that nano-patch antennas formed by metallic nanocubes placed on top of a metallic film largely enhance the spontaneous emission rate of quantum emitters due to the confinement of the electromagnetic field in the small nanogap cavity. The popularity of this architecture is, in part, due to the ease in fabrication. In this contribution, we theoretically demonstrate that a dimer formed by two metallic nanocubes embedded in a dielectric medium exhibits enhanced emission rate compared to the nano-patch antenna. Furthermore, we compare the directivity and radiation efficiency of both nanoantennas. From these characteristics, we obtained information about the “material efficiency” and the coupling mismatch efficiency between a dipole emitter and the nanoantenna. These quantities provide a more intuitive insight than the Purcell factor or localized density of states, opening new perspectives in nanoantenna design for ultra-directive light emission.

  15. Spontaneous self-coating of a water drop by flaky copper powders: critical role of the particle shape.

    Science.gov (United States)

    Chang, Cheng-Chung; Wu, Cyuan-Jhang; Sheng, Yu-Jane; Tsao, Heng-Kwong

    2015-06-14

    The self-coating process of solid particles over a liquid drop is important for the formation of a liquid marble. Generally, some external forces such as rolling or flipping are used to cover a drop by small particles. In this work, it is observed that flaky copper powders can spontaneously spread over the planar water surface and form a dense flat cluster with a fractal dimension of 2. Moreover, flaky copper powders can cover the water pendant and sessile drops spontaneously and rapidly. This powder-coated drop can roll on an inclined plane at a relatively high speed. However, spontaneous self-coating disappears for spheroidal copper powders. To explain our observations, the shape factors of particles are introduced into the spreading coefficient S for powders on the liquid surface. The flaky powders have the lowest shape factors and therefore spontaneous self-coating formation, with S > 0.

  16. Spontaneous magnetic reconnection. Collisionless reconnection and its potential astrophysical relevance

    Science.gov (United States)

    Treumann, R. A.; Baumjohann, W.

    2015-10-01

    The present review concerns the relevance of collisionless reconnection in the astrophysical context. Emphasis is put on recent developments in theory obtained from collisionless numerical simulations in two and three dimensions. It is stressed that magnetic reconnection is a universal process of particular importance under collisionless conditions, when both collisional and anomalous dissipation are irrelevant. While collisional (resistive) reconnection is a slow, diffusive process, collisionless reconnection is spontaneous. On any astrophysical time scale, it is explosive. It sets on when electric current widths become comparable to the leptonic inertial length in the so-called lepton (electron/positron) "diffusion region", where leptons de-magnetise. Here, the magnetic field contacts its oppositely directed partner and annihilates. Spontaneous reconnection breaks the original magnetic symmetry, violently releases the stored free energy of the electric current, and causes plasma heating and particle acceleration. Ultimately, the released energy is provided by mechanical motion of either the two colliding magnetised plasmas that generate the current sheet or the internal turbulence cascading down to lepton-scale current filaments. Spontaneous reconnection in such extended current sheets that separate two colliding plasmas results in the generation of many reconnection sites (tearing modes) distributed over the current surface, each consisting of lepton exhausts and jets which are separated by plasmoids. Volume-filling factors of reconnection sites are estimated to be as large as {sheet. Lepton currents inside exhausts may be strong enough to excite Buneman and, for large thermal pressure anisotropy, also Weibel instabilities. They bifurcate and break off into many small-scale current filaments and magnetic flux ropes exhibiting turbulent magnetic power spectra of very flat power-law shape W_b∝ k^{-α } in wavenumber k with power becoming as low as α ≈ 2

  17. Socioeconomic position and the risk of spontaneous abortion

    DEFF Research Database (Denmark)

    Norsker, Filippa Nyboe; Espenhain, Laura; A Rogvi, Sofie

    2012-01-01

    To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion.......To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion....

  18. Spontaneous Perinephric Hemorrhage Associated with Urolithiasis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Leah P. McMann

    2004-01-01

    Full Text Available Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

  19. Detection of target phonemes in spontaneous and read speech

    NARCIS (Netherlands)

    Mehta, G.; Cutler, A.

    1988-01-01

    Although spontaneous speech occurs more frequently in most listeners' experience than read speech, laboratory studies of human speech recognition typically use carefully controlled materials read from a script. The phonological and prosodic characteristics of spontaneous and read speech differ

  20. Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

    DEFF Research Database (Denmark)

    Huys, Raoul; Jirsa, Viktor K; Darokhan, Ziauddin

    2016-01-01

    attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization...

  1. [Bacterial vaginosis and spontaneous preterm birth].

    Science.gov (United States)

    Brabant, G

    2016-12-01

    To determine if bacterial vaginosis is a marker for risk of spontaneous preterm delivery and if its detection and treatment can reduce this risk. Consultation of the database Pubmed/Medline, Science Direct, and international guidelines of medical societies. Bacterial vaginosis (BV) is a dysbiosis resulting in an imbalance in the vaginal flora through the multiplication of anaerobic bacteria and jointly of a disappearance of well-known protective Lactobacilli. His diagnosis is based on clinical Amsel criteria and/or a Gram stain with establishment of the Nugent score. The prevalence of the BV extraordinarily varies according to ethnic and/or geographical origin (4-58 %), in France, it is close to 7 % in the first trimester of pregnancy (EL2). The link between BV and spontaneous premature delivery is low with an odds ratio between 1.5 and 2 in the most recent studies (EL3). Metronidazole or clindamycin is effective to treat BV (EL3). It is recommended to prescribe one of these antibiotics in the case of symptomatic BV (Professional Consensus). The testing associated with the treatment of BV in the global population showed no benefit in the prevention of the risk of spontaneous preterm delivery (EL2). Concerning low-risk asymptomatic population (defined by the absence of antecedent of premature delivery), it has been failed profit to track and treat the BV in the prevention of the risk of spontaneous preterm delivery (EL1). Concerning the high-risk population (defined by a history of preterm delivery), it has been failed profit to track and treat the VB in the prevention of the risk of spontaneous preterm delivery (EL3). However, in the sub population of patients with a history of preterm delivery occurred in a context of materno-fetal bacterial infection, there may be a benefit to detect and treat early and systematically genital infection, and in particular the BV (Professional Consensus). The screening and treatment of BV during pregnancy in asymptomatic low

  2. Ultra-sonografia transvaginal com doppler colorido para seleção das pacientes para tratamento conservador da gravidez ectópica íntegra Transvaginal ultrasonography with color doppler to select the patients for conservative treatment of unruptured ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Julio Elito Junior

    1999-04-01

    Full Text Available Objetivo: avaliar a eficiência da ultra-sonografia (US transvaginal com Doppler colorido para a previsão dos resultados do tratamento sistêmico da gravidez ectópica íntegra com dose única de metotrexato. Pacientes e método: vinte pacientes com diagnóstico de gravidez ectópica foram incluídas no estudo. Os critérios de inclusão foram: estabilidade hemodinâmica, massa anexial com diâmetro Purpose: to evaluate the efficacy of color Doppler in the prediction of results of the systemic treatment of unruptured ectopic pregnancy with a single dose of methotrexate. Methodology: twenty patients with a diagnosis of ectopic pregnancy were included in the study. The inclusion criteria were: hemodynamic stability, adnexal mass < 5.0 cm and decline of the titers of beta-hCG less than 15% in an interval of 24 h. The exclusion criteria were hepatic or renal disease and blood dyscrasias. Follow-up was by serial determinations of beta-hCG on days 4 and 7 after the beginning of the treatment, and weekly until the titers were negative. The patients were classified into 3 groups according to color Doppler: high risk (trophoblastic flow covering more than 2/3 of the mass, medium risk (when trophoblastic flow compromised 1/3 to 2/3 of tubal mass and low risk (when trophoblastic flow covered less than 1/3 of the mass. Results: the success of the treatment with a single dose was 75% (15/20; when a second dose of MTX was used, the success rate was 85%. When comparing color Doppler with the results of the medical treatment, we had high risk in 4 patients and in all the treatment failed; medium and low risk in 16 patients, and in 15 the treatment was successful. Conclusion: color Doppler showing high risk indicated an unfavorable situation for the medical treatment with MTX, while medium and low risk in color doppler were favorable situations for the clinical treatment. However, these results should always be analyzed in association with the evolution curve

  3. F. VON HAYEK’S THEORY OF SPONTANEOUS ORDER

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    О. Nesterenko

    2013-04-01

    Full Text Available The essence and the genesis of spontaneous order are disclosed in the context of critical analysis of constructivism. The author’s approach to the definition of the characteristic features of the spontaneous order is proposed. The dichotomy of the order is revealed towards the economic sphere in form of spontaneous order and organization.

  4. The prediction of pouch of Douglas obliteration using offline analysis of the transvaginal ultrasound 'sliding sign' technique: inter- and intra-observer reproducibility.

    Science.gov (United States)

    Reid, S; Lu, C; Casikar, I; Mein, B; Magotti, R; Ludlow, J; Benzie, R; Condous, G

    2013-05-01

    What is the inter-/intra-observer agreement and diagnostic accuracy among gynaecological and non-gynaecological ultrasound specialists in the prediction of pouch of Douglas (POD) obliteration (secondary to endometriosis) at offline analysis of two-dimensional videos using the dynamic real-time transvaginal ultrasound (TVS) 'sliding sign' technique? The inter-/intra-observer agreement and diagnostic accuracy for the interpretation of the TVS 'sliding sign' in the prediction of POD obliteration was found to be very acceptable, ranging from substantial to almost perfect agreement for the observers who specialized in gynaecological ultrasound. Women with POD obliteration at laparoscopy are at an increased risk of bowel endometriosis; therefore, the pre-operative diagnosis of POD obliteration is important in the surgical planning for these women. Previous studies have used TVS to predict POD obliteration prior to laparoscopy, with a sensitivity of 72-83% and specificity of 97-100%. However, there have not been any reproducibility studies performed to validate the use of TVS in the prediction of POD obliteration pre-operatively. This was a reproducibility study which involved the offline viewing of pre-recorded video sets of 30 women presenting with chronic pelvic pain, in order to determine POD obliteration using the TVS 'sliding sign' technique. The videos were selected on real-time representative quality/quantity; they were not obtained from sequential patients. There were a total of six observers, including four gynaecological ultrasound specialists and two fetal medicine specialists. The study was conducted over a period of 1 month (March 2012-April 2012). The four gynaecological ultrasound observers performed daily gynaecological scanning, while the other two observers were primarily fetal medicine sonologists. Each sonologist viewed the TVS 'sliding sign' video in two anatomical locations (retro-cervix and posterior uterine fundus), i.e. 60 videos in total. The

  5. Gravid med spontan ruptur af arteria uterina

    DEFF Research Database (Denmark)

    Jònsdòttir, Fjòla; Pinborg, Anja; Wilken-Jensen, Charlotte

    2014-01-01

    Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo-dynami......-dynamic instable 24 hours after vaginal delivery, and emergency laparotomi revealed a spontaneous rupture of the right uterine artery. Spontaneous rupture of the uterine artery is rare but should be considered as a possible cause of acute abdominal pain in pregnant women.......Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo...

  6. Spontaneously disappearing large herniated lumbar disc fragment

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    Umamaheswara V. Reddy

    2014-01-01

    Full Text Available There are reports of spontaneous regression of large extruded disc; however, the exact underlying mechanism and management of such cases remains controversial. We report a 40-year-old female who opted for conservative management for a large extruded lumbar disc. Follow-up magnetic resonance imaging (MRI showed complete disappearance of the disc fragment; however, there were degenerative changes in the upper and lower adjacent margins of the vertebral body. Spine surgeons should be aware of spontaneous regression of the disc phenomenon as a patient with a large extruded disc who opted for the conservative management initially can have persistence pain, but there may not be an underlying protruded disc.

  7. Characteristics of spontaneous fission of 250No

    Science.gov (United States)

    Svirikhin, A. I.; Andreev, A. V.; Yeremin, A. V.; Izosimov, I. N.; Isaev, A. V.; Kuznetsov, A. N.; Kuznetsova, A. A.; Malyshev, O. N.; Popeko, A. G.; Popov, Y. A.; Sokol, E. A.; Chelnokov, M. L.; Chepigin, V. I.; Schneidman, T. M.; Gall, B.; Dorvaux, O.; Brione, P.; Hauschild, K.; Lopez-Martenz, A.; Rezynkina, K.; Mullins, S.; Jones, P.; Mosat, P.

    2017-07-01

    This study describes an experiment on investigating the properties of spontaneous fission of shortlived neutron-deficient nuclei synthesized in the reaction of complete fusion 48Ca + 204Pb = 252No*. The experiment is performed using the SHELS separator and the beam of multicharged ions at U-400 accelerator (LNR, JINR). Two activities undergoing spontaneous fission, which can be related to the ground and isomeric states of 250No nucleus, are registered. The half-lives, total kinetic energies of fission fragments, and neutron multiplicities are measured for the short-lived nuclei. The average number of neutrons per fission for the activity with t 1/2 = 5.1 ± 0.3 μs is = 4.38 ± 0.13 μs, and for nuclei with the half-life t 1/2 = 36 ± 3 μs it is xxxxx.

  8. Spontaneous abortion and physical strain around implantation

    DEFF Research Database (Denmark)

    Hjøllund, Niels Henrik Ingvar; Jensen, T.K.; Bonde, J.P.

    2000-01-01

    Existing studies of physical strain and spontaneous abortion are mainly retrospective or based only on pregnancies that have survived the first trimester. Furthermore, almost all studies have relied on averaged measures of physical strain, which tend to blur an effect if peak values during short...... time periods are the relevant measure. We followed a cohort of first pregnancy planners from termination of birth control until pregnancy for a maximum of six menstrual cycles. The analyses include 181 pregnancies, of which 32 were subclinical pregnancies detected by hCG analysis only. During early...... pregnancy the women recorded physical strain prospectively in a structured diary. Physical strain around the time of implantation was associated with later spontaneous abortion. The adjusted risk ratio for women who reported physical strain higher than average at day 6 to 9 after the estimated date...

  9. Spontaneous breaking of continuous translational invariance

    Science.gov (United States)

    Watanabe, Haruki; Brauner, Tomáš

    2012-04-01

    Unbroken continuous translational invariance is often taken as a basic assumption in discussions of spontaneous symmetry breaking (SSB), which singles out SSB of translational invariance itself as an exceptional case. We present a framework that allows us to treat translational invariance on the same footing as other symmetries. It is shown that existing theorems on SSB can be straightforwardly extended to this general case. As a concrete application, we analyze the Nambu-Goldstone modes in a (ferromagnetic) supersolid. We prove on the ground of the general theorems that the Bogoliubov mode stemming from a spontaneously broken internal U(1) symmetry and the longitudinal phonon due to a crystalline order are distinct physical modes.

  10. Spontaneous stress fractures of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Dorne, H.L.; Lander, P.H.

    1985-02-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head.

  11. Laboratory observations of spontaneous magnetic reconnection.

    Science.gov (United States)

    Egedal, J; Fox, W; Katz, N; Porkolab, M; Reim, K; Zhang, E

    2007-01-05

    Detailed measurements of spontaneous magnetic reconnection are presented. The experimental data, which were obtained in the new closed Versatile Toroidal Facility magnetic configuration, document the profile evolution of the plasma density, magnetic flux function, reconnection rate, and the current density during a spontaneous reconnection event in the presence of a strong guide magnetic field. The reconnection process is at first slow, which allows magnetic stress to build in the system while the current channel becomes increasingly narrow and intense. The onset of a fast reconnection event occurs as the width of the current channel approaches the ion-sound-Larmor radius rho s. During the reconnection event magnetically stored energy is channeled into energetic ion outflows and a rapid increase in the electron temperature.

  12. Motivational Projections of Russian Spontaneous Speech

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    Galina M. Shipitsina

    2017-06-01

    Full Text Available The article deals with the semantic, pragmatic and structural features of words, phrases, dialogues motivation, in the contemporary Russian popular speech. These structural features are characterized by originality and unconventional use. Language material is the result of authors` direct observation of spontaneous verbal communication between people of different social and age groups. The words and remarks were analyzed in compliance with the communication system of national Russian language and cultural background of popular speech. Studies have discovered that in spoken discourse there are some other ways to increase the expression statement. It is important to note that spontaneous speech identifies lacunae in the nominative language and its vocabulary system. It is proved, prefixation is also effective and regular way of the same action presenting. The most typical forms, ways and means to update language resources as a result of the linguistic creativity of native speakers were identified.

  13. Leadership and persistency in spontaneous dishonesty

    OpenAIRE

    Braun, Susanne; Hornuf, Lars

    2015-01-01

    Extensive evidence shows that when given the opportunity, people cheat for monetary rewards, but only to the extent that they can keep a positive selfconcept. In this study, we investigate various factors that may influence the degree to which people can keep their positive self-concept while cheating for monetary gains. We find that authentic leadership, gender, cheating norm, experience of cheating, and expectations of others' cheating behavior have no effect on participants' spontaneous di...

  14. Spontaneous intracranial hypotension: use of unenhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Quinones Tapia, D.; Lopez-Ibor, L. [Dept. of Neuroradiology, Clinica de La Zarzuela, Aravaca, Madrid (Spain); Pardo, J.; Anciones, V. [Dept. of Neurology, Clinica de La Zarzuela, Aravaca, Madrid (Spain); Serrano, J.M. [Dept. of Ophthalmology, Fundacion Jimenez Diaz, Madrid (Spain)

    2000-07-01

    We report a case of spontaneous intracranial hypotension diagnosed with unenhanced cranial MRI, showing laminar subdural fluid and engorgement of the hypophysis and perisellar sinuses. Cerebrospinal fluid pressure was low. MRI was normal after resolution of symptoms. Prior reports emphasise the enhancing pachymeninges seen in this syndrome. We maintain that, when subdural collections and perisellar engorgement are detected on unenhanced MRI in the proper clinical setting, contrast enhancement may not be necessary for the diagnosis. (orig.)

  15. Spontaneous remission of MAOI-induced anorgasmia.

    Science.gov (United States)

    Nurnberg, H G; Levine, P E

    1987-06-01

    The authors present three case reports illustrating that a conservative approach to anorgasmia induced by effective treatment with the monoamine oxidase inhibitor (MAOI) phenelzine can result in spontaneous remission. Precipitously stopping phenelzine or adding another medication to counteract the side effect can be avoided. The apparent synchrony between the development of the side effect of anorgasmia and positive treatment response may represent a valuable clinical marker.

  16. Spontaneous bladder rupture in acute alcohol intoxication

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    Bahjat Barakat

    2014-03-01

    Full Text Available Spontaneous bladder rupture is a rare condition that can be followed by an acute alcohol intoxication and can be associated with significant morbidity and mortality. We report a case diagnosed in a alcoholic young male who was admitted to our emergency room for epigastric pain. The case demonstrates the difficulties with diagnosis and the need for physicians who work in an emergency room to be aware of this condition.

  17. Spontaneous Regression of a Cervical Disk Herniation

    Directory of Open Access Journals (Sweden)

    Emre Delen

    2014-03-01

    Full Text Available A 54 years old female patient was admitted to our outpatient clinic with a two months history of muscle spasms of her neck and pain radiating to the left upper extremity. Magnetic resonance imaging had shown a large left-sided paracentral disk herniation at the C6-C7 disk space (Figure 1. Neurological examination showed no obvious neurological deficit. She received conservative treatment including bed rest, rehabilitation, and analgesic drugs. After 13 months, requested by the patient, a second magnetic resonance imaging study showed resolution of the disc herniation.(Figure 2 Although the literature contains several reports about spontaneous regression of herniated lumbar disc without surgical intervention, that of phenomenon reported for herniated cervical level is rare, and such reports are few[1]. In conclusion, herniated intervertebral disc have the potential to spontaneously regress independently from the spine level. With further studies, determining the predictive signs for prognostic evaluation for spontaneous regression which would yield to conservative treatment would be beneficial.

  18. Spontaneous globe luxation in iatrogenic Cushing syndrome.

    Science.gov (United States)

    Ortega-Evangelio, Leticia; Navarrete-Sanchis, Javier; Williams, Basil K; Tomas-Torrent, Juan Miguel

    2015-10-01

    We report a rare case of spontaneous eyeball luxation associated with exophthalmos due to iatrogenic Cushing syndrome (CS). The normalization of serum hormones led to the regression of the picture. A 64-year-old man presented with spontaneous globe luxation of the left eye after a 6-month history of bilateral, painless, and slowly progressive exophthalmos. The patient had been receiving weekly infusions of methylprednisone over the previous 6 months. His best-corrected visual acuity (BCVA) at presentation was 20/40 in the right eye and 20/20 in the left eye. The patient demonstrated full extraocular motility. The intraocular pressure (IOP) was elevated in the right eye (24 mHg) and normal in the left eye (18 mmHg). Exophthalmometry demonstrated bilateral proptosis with measurements of 27 mm in the right eye and 28 mm in the left eye. Computed tomography scan of the brain and orbits revealed increased orbital and cervical fat. Clinical, radiographic and serologic findings ruled out potential diagnoses including orbital metastasis, thyroid orbitopathy, carotid-cavernous fistula, and idiopathic orbital pseudotumor. Clinical suspicion of iatrogenic CS was high, and additional serologic testing confirmed the diagnosis. Exophthalmos is an uncommon sign of CS, but to our knowledge, this is the first reported case of spontaneous globe luxation secondary to CS. In our case, normalization of cortisol was sufficient to resolve the clinical symptoms and eliminated the need for surgical intervention such as orbital decompression surgery.

  19. Spontaneous droplet trampolining on rigid superhydrophobic surfaces

    Science.gov (United States)

    Schutzius, Thomas M.; Jung, Stefan; Maitra, Tanmoy; Graeber, Gustav; Köhme, Moritz; Poulikakos, Dimos

    2015-11-01

    Spontaneous removal of condensed matter from surfaces is exploited in nature and in a broad range of technologies to achieve self-cleaning, anti-icing and condensation control. But despite much progress, our understanding of the phenomena leading to such behaviour remains incomplete, which makes it challenging to rationally design surfaces that benefit from its manifestation. Here we show that water droplets resting on superhydrophobic textured surfaces in a low-pressure environment can self-remove through sudden spontaneous levitation and subsequent trampoline-like bouncing behaviour, in which sequential collisions with the surface accelerate the droplets. These collisions have restitution coefficients (ratios of relative speeds after and before collision) greater than unity despite complete rigidity of the surface, and thus seemingly violate the second law of thermodynamics. However, these restitution coefficients result from an overpressure beneath the droplet produced by fast droplet vaporization while substrate adhesion and surface texture restrict vapour flow. We also show that the high vaporization rates experienced by the droplets and the associated cooling can result in freezing from a supercooled state that triggers a sudden increase in vaporization, which in turn boosts the levitation process. This effect can spontaneously remove surface icing by lifting away icy drops the moment they freeze. Although these observations are relevant only to systems in a low-pressure environment, they show how surface texturing can produce droplet-surface interactions that prohibit liquid and freezing water-droplet retention on surfaces.

  20. Spontaneously emerging cortical representations of visual attributes

    Science.gov (United States)

    Kenet, Tal; Bibitchkov, Dmitri; Tsodyks, Misha; Grinvald, Amiram; Arieli, Amos

    2003-10-01

    Spontaneous cortical activity-ongoing activity in the absence of intentional sensory input-has been studied extensively, using methods ranging from EEG (electroencephalography), through voltage sensitive dye imaging, down to recordings from single neurons. Ongoing cortical activity has been shown to play a critical role in development, and must also be essential for processing sensory perception, because it modulates stimulus-evoked activity, and is correlated with behaviour. Yet its role in the processing of external information and its relationship to internal representations of sensory attributes remains unknown. Using voltage sensitive dye imaging, we previously established a close link between ongoing activity in the visual cortex of anaesthetized cats and the spontaneous firing of a single neuron. Here we report that such activity encompasses a set of dynamically switching cortical states, many of which correspond closely to orientation maps. When such an orientation state emerged spontaneously, it spanned several hypercolumns and was often followed by a state corresponding to a proximal orientation. We suggest that dynamically switching cortical states could represent the brain's internal context, and therefore reflect or influence memory, perception and behaviour.

  1. The spontaneous market order and evolution.

    Science.gov (United States)

    Beck, Naomi

    2016-08-01

    Darwin's theory of natural selection and the idea of a spontaneous order share a fundamental feature: the claim that apparent design or order do not necessarily imply a designer or rational planning. But they also present important differences, which touch upon central questions such as the evolution of morality, the role of human agency in social evolution, the existence (or not) of directionality in undesigned processes, and the presence (nor not) of a providential element in evolutionary accounts. In this article, I explore these themes and probe the relationship between the notion of a spontaneous order and the theory of evolution by natural selection. The reflections of Nobel laureate in economics, F.A. von Hayek, provide the beginning and endpoint in this voyage, for they constitute the most pronounced effort to develop a full-fledged theory combining evolution and economics in recent times. But along the way, I also investigate the influence of classical political economy on Darwin's thought, primarily that of Adam Smith, and consider the reasons for which Darwin did not refer to Smith when discussing the principle of natural selection in The Origin of Species. I conclude that the spontaneous order, as understood by Hayek, and evolution by natural selection constitute two disparate concepts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Small Schools.

    Science.gov (United States)

    Talbot, Walter

    Recommendations from the first annual Utah Small Schools Conference resulted in several specific actions. After studying certification requirements to determine if greater flexibility could be attained to remedy some of the restrictive rules that burdened small schools, the Utah State Board made it possible to move administrators and supervisors…

  3. Small game

    Science.gov (United States)

    John C. Kilgo

    2005-01-01

    Although small game currently is not harvested on the Savannah river Site(SRS) soutside of the Crackerneck Wildlife Management area and logical Reserve (CWMA), several species of small game occur on SRS. these include snipe (Gallinago gallinago), American woodcock (Scolopax minor), morning dove (Zenaida macroura...

  4.  Spontaneous Rupture of Umbilical Hernia in Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Yahaya Ukwenya

    2011-07-01

    Full Text Available  A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to end anastomosis done. The hernia sac was excised and the 12 cm defect repaired. Six weeks later, she had spontaneous vaginal delivery of a live baby. We advocate that large umbilical hernias should be routinely repaired when seen in women of child bearing age.

  5. Innexin gap junctions in nerve cells coordinate spontaneous contractile behavior in Hydra polyps

    Science.gov (United States)

    Takaku, Yasuharu; Hwang, Jung Shan; Wolf, Alexander; Böttger, Angelika; Shimizu, Hiroshi; David, Charles N.; Gojobori, Takashi

    2014-01-01

    Nerve cells and spontaneous coordinated behavior first appeared near the base of animal evolution in the common ancestor of cnidarians and bilaterians. Experiments on the cnidarian Hydra have demonstrated that nerve cells are essential for this behavior, although nerve cells in Hydra are organized in a diffuse network and do not form ganglia. Here we show that the gap junction protein innexin-2 is expressed in a small group of nerve cells in the lower body column of Hydra and that an anti-innexin-2 antibody binds to gap junctions in the same region. Treatment of live animals with innexin-2 antibody eliminates gap junction staining and reduces spontaneous body column contractions. We conclude that a small subset of nerve cells, connected by gap junctions and capable of synchronous firing, act as a pacemaker to coordinate the contraction of the body column in the absence of ganglia.

  6. Innexin gap junctions in nerve cells coordinate spontaneous contractile behavior in Hydra polyps

    KAUST Repository

    Takaku, Yasuharu

    2014-01-07

    Nerve cells and spontaneous coordinated behavior first appeared near the base of animal evolution in the common ancestor of cnidarians and bilaterians. Experiments on the cnidarian Hydra have demonstrated that nerve cells are essential for this behavior, although nerve cells in Hydra are organized in a diffuse network and do not form ganglia. Here we show that the gap junction protein innexin-2 is expressed in a small group of nerve cells in the lower body column of Hydra and that an anti-innexin-2 antibody binds to gap junctions in the same region. Treatment of live animals with innexin-2 antibody eliminates gap junction staining and reduces spontaneous body column contractions. We conclude that a small subset of nerve cells, connected by gap junctions and capable of synchronous firing, act as a pacemaker to coordinate the contraction of the body column in the absence of ganglia.

  7. Innexin gap junctions in nerve cells coordinate spontaneous contractile behavior in Hydra polyps.

    Science.gov (United States)

    Takaku, Yasuharu; Hwang, Jung Shan; Wolf, Alexander; Böttger, Angelika; Shimizu, Hiroshi; David, Charles N; Gojobori, Takashi

    2014-01-07

    Nerve cells and spontaneous coordinated behavior first appeared near the base of animal evolution in the common ancestor of cnidarians and bilaterians. Experiments on the cnidarian Hydra have demonstrated that nerve cells are essential for this behavior, although nerve cells in Hydra are organized in a diffuse network and do not form ganglia. Here we show that the gap junction protein innexin-2 is expressed in a small group of nerve cells in the lower body column of Hydra and that an anti-innexin-2 antibody binds to gap junctions in the same region. Treatment of live animals with innexin-2 antibody eliminates gap junction staining and reduces spontaneous body column contractions. We conclude that a small subset of nerve cells, connected by gap junctions and capable of synchronous firing, act as a pacemaker to coordinate the contraction of the body column in the absence of ganglia.

  8. Acurácia da histerossonografia versus ultrassonografia transvaginal em mulheres inférteis candidatas às técnicas de reprodução assistida Sonohysterography accuracy versus transvaginal ultrasound in infertile women candidate to assisted reproduction techniques

    Directory of Open Access Journals (Sweden)

    João Rocha Vilela

    2012-03-01

    Full Text Available OBJETIVO: Comparar a acurácia diagnóstica da histerossonografia (HSN com a da ultrassonografia transvaginal convencional (USG na avaliação da cavidade uterina de mulheres inférteis candidatas às técnicas de reprodução assistida (TRA. MÉTODOS: Realizou-se estudo transversal comparativo com 120 mulheres inférteis candidatas à TRA, acompanhadas no Centro de Reprodução Assistida (CRA do Hospital Regional da Asa Sul (HRAS, Brasília - DF, no período compreendido entre agosto de 2009 e novembro de 2010. A HSN foi realizada com infusão de soro fisiológico em sistema fechado. Comparou-se o achado da HSN com o resultado da USG prévia. A cavidade uterina foi considerada anormal quando se visualizava: endométrio com espessura superior à esperada para a fase do ciclo; pólipo endometrial; mioma submucoso e alteração do formato da cavidade do útero. A análise estatística foi feita utilizando-se frequências absolutas, valores percentuais e o teste χ² com nível de significância de 5%. RESULTADOS: Observamos que 92 (76,7% mulheres inférteis, candidatas à TRA, apresentavam cavidade uterina normal pela HSN e em 28 (23,3% foram detectadas as seguintes alterações: 15 pólipos (12,5%, nove alterações no formato da cavidade uterina (7,5%, 6 miomas submucosos (5%, 4 espessura endometrial anormal (3,3% para a fase do ciclo menstrual e 2 septos uterinos (1,7%; 5 mulheres apresentavam mais de uma alteração (4,2%. Enquanto a USG observou alterações da cavidade uterina apenas em 5 (4,2% mulheres, a HSN confirmou 4 das 5 alterações detectadas pela USG e detectou alterações na cavidade uterina em outras 24 mulheres que não tinham sido detectadas na USG, ou seja, a HSN foi capaz de detectar mais alterações na cavidade uterina do que a USG, com diferença significativa (p=0,002. CONCLUSÃO: A HSN tem maior acurácia que a USG na avaliação da cavidade uterina, neste grupo de mulheres inférteis candidatas às TRA. A HSN poder

  9. Intrusions and provoked and spontaneous confabulations on memory tests in Korsakoff's syndrome.

    Science.gov (United States)

    Rensen, Yvonne C M; Oosterman, Joukje M; Walvoort, Serge J W; Eling, Paul A T M; Kessels, Roy P C

    2017-03-01

    Intrusions on verbal memory tests have been used as an index for clinical confabulation. Severe memory impairments in combination with executive dysfunction have been suggested to be the underlying mechanism of confabulation, but to date, this relation is unclear. The aim of this study was (a) to examine the relation between (different types of) intrusions and confabulations in a large sample of confabulating patients with Korsakoff's syndrome (KS) and (b) to investigate whether different measures of executive functioning and memory performance are related to provoked and spontaneous confabulation. The Dutch version of the California Verbal Learning Test (CVLT) and various executive function and memory tests were administered to a group of 51 confabulating patients with KS. Professional caregivers rated the severity of provoked and spontaneous confabulation behavior of the patients using the Nijmegen-Venray Confabulation List-20 (NVCL-20). The total number of intrusions on the CVLT was not related to either provoked or spontaneous confabulation scores. None of the CVLT intrusion scores correlated significantly with any of the confabulation scores, but we did find small-to-medium, positive correlations between unrelated intrusions and both provoked confabulations and spontaneous confabulation. Provoked confabulation behavior was associated with executive dysfunction and poorer memory performances. Spontaneous confabulation was not related to performance on measures of executive function and memory. The total number of intrusions on verbal memory tests and clinical confabulations appear to be different phenomena. Only unrelated intrusions produced on the CVLT might possibly be related to confabulations. The production of provoked, but not spontaneous, confabulation is associated with executive dysfunction and memory deficits.

  10. Investigation of KIT gene mutations in women with 46,XX spontaneous premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Nelson Lawrence M

    2002-08-01

    Full Text Available Abstract Background Spontaneous premature ovarian failure presents most commonly with secondary amenorrhea. Young women with the disorder are infertile and experience the symptoms and sequelae of estrogen deficiency. The mechanisms that give rise to spontaneous premature ovarian failure are largely unknown, but many reports suggest a genetic mechanism in some cases. The small family size associated with infertility makes genetic linkage analysis studies extremely difficult. Another approach that has proven successful has been to examine candidate genes based on known genetic phenotypes in other species. Studies in mice have demonstrated that c-kit, a transmembrane tyrosine kinase receptor, plays a critical role in gametogenesis. Here we test the hypothesis that human KIT mutations might be a cause of spontaneous premature ovarian failure. Methods and Results We examined 42 women with spontaneous premature ovarian failure and found partial X monosomy in two of them. In the remaining 40 women with known 46,XX spontaneous premature ovarian failure we evaluated the entire coding region of the KIT gene. We did this using polymerase chain reaction based single-stranded conformational polymorphism analysis and DNA sequencing. We did not identify a single mutation that would alter the amino acid sequence of the c-KIT protein in any of 40 patients (upper 95% confidence limit is 7.2%. We found one silent mutation at codon 798 and two intronic polymorphisms. Conclusion Mutations in the coding regions of the KIT gene appear not to be a common cause of 46,XX spontaneous premature ovarian failure in North American women.

  11. Presence of antibodies against Coxiella burnetii and risk of spontaneous abortion

    DEFF Research Database (Denmark)

    Nielsen, Stine Yde; Hjøllund, Niels Henrik Ingvar; Andersen, Anne-Marie Nybo

    2012-01-01

    Q fever is a bacterial zoonosis caused by infection with Coxiella burnetii. It is well established that Q fever causes fetal loss in small ruminants. The suspicion has been raised that pregnant women may also experience adverse pregnancy outcome when the infection is acquired or reactivated during...... pregnancy. The purpose of this study was to assess the potential association between serologic markers of infection with C. burnetii and spontaneous abortion....

  12. Spontaneous functional network dynamics and associated structural substrates in the human brain

    Science.gov (United States)

    Liao, Xuhong; Yuan, Lin; Zhao, Tengda; Dai, Zhengjia; Shu, Ni; Xia, Mingrui; Yang, Yihong; Evans, Alan; He, Yong

    2015-01-01

    Recent imaging connectomics studies have demonstrated that the spontaneous human brain functional networks derived from resting-state functional MRI (R-fMRI) include many non-trivial topological properties, such as highly efficient small-world architecture and densely connected hub regions. However, very little is known about dynamic functional connectivity (D-FC) patterns of spontaneous human brain networks during rest and about how these spontaneous brain dynamics are constrained by the underlying structural connectivity. Here, we combined sub-second multiband R-fMRI data with graph-theoretical approaches to comprehensively investigate the dynamic characteristics of the topological organization of human whole-brain functional networks, and then employed diffusion imaging data in the same participants to further explore the associated structural substrates. At the connection level, we found that human whole-brain D-FC patterns spontaneously fluctuated over time, while homotopic D-FC exhibited high connectivity strength and low temporal variability. At the network level, dynamic functional networks exhibited time-varying but evident small-world and assortativity architecture, with several regions (e.g., insula, sensorimotor cortex and medial prefrontal cortex) emerging as functionally persistent hubs (i.e., highly connected regions) while possessing large temporal variability in their degree centrality. Finally, the temporal characteristics (i.e., strength and variability) of the connectional and nodal properties of the dynamic brain networks were significantly associated with their structural counterparts. Collectively, we demonstrate the economical, efficient, and flexible characteristics of dynamic functional coordination in large-scale human brain networks during rest, and highlight their relationship with underlying structural connectivity, which deepens our understandings of spontaneous brain network dynamics in humans. PMID:26388757

  13. Spontaneous Functional Network Dynamics and Associated Structural Substrates in the Human Brain

    Directory of Open Access Journals (Sweden)

    Xuhong eLiao

    2015-09-01

    Full Text Available Recent imaging connectomics studies have demonstrated that the spontaneous human brain functional networks derived from resting-state functional MRI (R-fMRI include many non-trivial topological properties, such as highly efficient small-world architecture and densely connected hub regions. However, very little is known about dynamic functional connectivity (D-FC patterns of spontaneous human brain networks during rest and about how these spontaneous brain dynamics are constrained by the underlying structural connectivity. Here, we combined sub-second multiband R-fMRI data with graph-theoretical approaches to comprehensively investigate the dynamic characteristics of the topological organization of human whole-brain functional networks, and then employed diffusion imaging data in the same participants to further explore the associated structural substrates. At the connection level, we found that human whole-brain D-FC patterns spontaneously fluctuated over time, while homotopic D-FC exhibited high connectivity strength and low temporal variability. At the network level, dynamic functional networks exhibited time-varying but evident small-world and assortativity architecture, with several regions (e.g., insula, sensorimotor cortex and medial prefrontal cortex emerging as functionally persistent hubs (i.e., highly connected regions while possessing large temporal variability in their degree centrality. Finally, the temporal characteristics (i.e., strength and variability of the connectional and nodal properties of the dynamic brain networks were significantly associated with their structural counterparts. Collectively, we demonstrate the economical, efficient and flexible characteristics of dynamic functional coordination in large-scale human brain networks during rest, and highlight their relationship with underlying structural connectivity, which deepens our understandings of spontaneous brain network dynamics in humans.

  14. Differential triggering of spontaneous glutamate release by P/Q-, N- and R-type Ca2+ channels.

    Science.gov (United States)

    Ermolyuk, Yaroslav S; Alder, Felicity G; Surges, Rainer; Pavlov, Ivan Y; Timofeeva, Yulia; Kullmann, Dimitri M; Volynski, Kirill E

    2013-12-01

    The role of voltage-gated Ca2+ channels (VGCCs) in spontaneous miniature neurotransmitter release is incompletely understood. We found that stochastic opening of P/Q-, N- and R-type VGCCs accounts for ∼50% of all spontaneous glutamate release at rat cultured hippocampal synapses, and that R-type channels have a far greater role in spontaneous than in action potential-evoked exocytosis. VGCC-dependent miniature neurotransmitter release (minis) showed similar sensitivity to presynaptic Ca2+ chelation as evoked release, arguing for direct triggering of spontaneous release by transient spatially localized Ca(2+) domains. Experimentally constrained three-dimensional diffusion modeling of Ca2+ influx-exocytosis coupling was consistent with clustered distribution of VGCCs in the active zone of small hippocampal synapses and revealed that spontaneous VGCCs openings can account for the experimentally observed VGCC-dependent minis, although single channel openings triggered release with low probability. Uncorrelated stochastic VGCC opening is therefore a major trigger for spontaneous glutamate release, with differential roles for distinct channel subtypes.

  15. Spontaneous poisoning by Ricinus communis (Euphorbiaceae in cattle

    Directory of Open Access Journals (Sweden)

    Samuel S.C. Albuquerque

    2014-09-01

    Full Text Available The aim of this study is to report cases of spontaneous poisoning of cattle by Ricinus communis (castor beans in Paraíba, a semiarid region of northeastern Brazil. The cases were observed in 2 herds on neighboring properties in 2013. Clinical signs developed within 6-24 h and consisted of weakness, tachycardia, dyspnea, profuse watery diarrhea, dehydration, depression, instability, cramps, permanent lateral recumbency and death within 48-72 h. Of the 60 cattle at risk, 19 were affected and 14 died. Five fully recovered after the course of 12 days. Three animals were necropsied. The main gross lesions were hemopericardium, hemothorax, pulmonary edema, petechial hemorrhages in the epicardium and endocardium, ecchymoses at the papillary muscles and suffusions on the intercostal muscles. Hemorrhages were also observed in the abdominal cavity, spleen and mucosa of the abomasum and small intestine. The rumen content was liquid with a large amount of castor bean seeds. There were circular, whitish and focally diffuse areas in the liver parenchyma. The main microscopic lesions consisted of multifocal coagulative myocardial necrosis with the presence of mononuclear cell infiltration and varying degrees of bleeding between cardiac muscle fibers. The abomasum and small intestine mucosae and submucosa had mild edema and mononuclear and polymorphonuclear inflammatory cell infiltration. The diagnosis of R. communis was based on the history of plant consumption, clinical signs, pathology of the disease and the presence of large amounts of castor bean seeds in the forestomachs.

  16. Unexpected, spontaneous and selective formation of colloidal Pt 3Sn nanoparticles using organometallic Pt and Sn complexes

    KAUST Repository

    Boualleg, Malika

    2010-01-01

    The facile and selective synthesis of small crystalline Pt3Sn alloy nanoparticles was performed at room temperature under H2, using a colloidal approach without the use of extra-stabilizing ligands. The Pt 3Sn alloy was found to be obtained spontaneously as the unique phase regardless of the number of tin equivalents introduced. © 2010 The Royal Society of Chemistry.

  17. Zero curvature-surface driven small objects

    Science.gov (United States)

    Dou, Xiaoxiao; Li, Shanpeng; Liu, Jianlin

    2017-08-01

    In this study, we investigate the spontaneous migration of small objects driven by surface tension on a catenoid, formed by a layer of soap constrained by two rings. Although the average curvature of the catenoid is zero at each point, the small objects always migrate to the position near the ring. The force and energy analyses have been performed to uncover the mechanism, and it is found that the small objects distort the local shape of the liquid film, thus making the whole system energetically favorable. These findings provide some inspiration to design microfluidics, aquatic robotics, and miniature boats.

  18. Amplified spontaneous emission of glass forming DCM derivatives in PMMA films

    Science.gov (United States)

    Vembris, Aivars; Zarinsh, Elmars; Kokars, Valdis

    2014-05-01

    4-(dicyanomethylene)-2-methyl- 6-(p-dimethylaminostyryl)-4H-pyran (DCM) is well known red laser dye which can be used also in solid state organic lasers. The lowest threshold value of amplified spontaneous emission was achieved by doping 2wt% of DCM molecule in tris-(8-hydroxy quinoline) aluminium (Alq3) matrix. Further increase of dye concentration also increases threshold value. It is due to large intermolecular interaction which reduce photoluminescence quantum yield. Compounds with small intermolecular interaction and which exhibit similar amplified spontaneous properties as DCM could be useful for solid state organic lasers. In the work photoluminescence and amplified spontaneous emission properties of two DCM derivatives in poly (methyl methacrylate) (PMMA) matrix were investigated. Bulky trityloxyethyl groups are attached to the donor part of investigated molecules. These groups reduce intermolecular distance wherewith reduce photoluminescence quenching. More than one order of magnitude lower excitation threshold energy of the amplified spontaneous emission was achieved in doped polymer films with investigated compound in comparison to doped polymer with DCM. It means that the investigated compound is more perspective as a laser material compared to previously study.

  19. Use of bandage contact lenses for treatment of spontaneous chronic corneal epithelial defects in dogs.

    Science.gov (United States)

    Grinninger, P; Verbruggen, A M J; Kraijer-Huver, I M G; Djajadiningrat-Laanen, S C; Teske, E; Boevé, M H

    2015-07-01

    To determine whether polyxylon bandage contact lenses influence healing time and ocular comfort in the management of spontaneous chronic corneal epithelial defects in dogs. Twenty dogs with spontaneous chronic corneal epithelial defects were included. All dogs were treated by debridement under topical anaesthesia at the first presentation. Ten dogs were assigned to the study group (application of a polyxylon bandage contact lens), and the remaining ten served as a control group. The healing time and ocular (dis)comfort were evaluated by assessment of the clinical findings and an owner-based questionnaire. All dogs received the same topical and systemic medication. Healing time for dogs in the study population was significantly shorter (mean 14±0 days) than for dogs in the control group (mean 36±17 days; P=0·005). The spontaneous chronic corneal epithelial defects had completely healed at the first recheck in all dogs with a polyxylon bandage contact lens. The duration of blepharospasm following debridement was significantly shorter in the study population (mean 4±4 days) than in the control group (mean 30±20 days; P=0·001). The use of polyxylon bandage contact lenses is beneficial in the management of spontaneous chronic corneal epithelial defects. © 2015 British Small Animal Veterinary Association.

  20. Resolution of gallstone ileus with spontaneous evacuation of gallstone: a case report.

    Science.gov (United States)

    Tandon, Anupama; Usha, Thingujam; Bhargava, Satish K; Bhatt, Shuchi; Bhargava, Sumeet; Prakash, Meenakshi; Durgadas, Aggrwal Anupkumar

    2013-06-01

    Gallstone ileus is an infrequent complication of cholelithiasis. The formation of a fistula between the gallbladder and duodenum may allow a gallstone to enter the gastrointestinal (GI) tract. Gallstone ileus generally occurs in the elderly patients and is associated with significant mortality. Spontaneous resolution of gallstone ileus after passage of gallstone per rectally, though rare, has been reported Farooq et al. (Emerg Radiol 4(6):421-423, 2007). We describe a 60-year-old woman who presented with a 3-day history of vomiting, pain, distension and constipation .Radiological investigations revealed dilatation of small bowel loops with multiple air fluid levels with a large lamellated radio-opaque density measuring 4.4 cm × 4 cm seen in the right iliac fossa. A possibility of gallstone ileus was kept. Because of co-morbid conditions (post-myocardial infarct with cardiac failure), surgery could not be done and patient was kept on conservative management. Three days later patient had sudden relief of her symptoms after passing a large calculus per rectally suggesting a spontaneous evacuation of gallstone. This case highlights the possibility of spontaneous resolution of gallstone ileus after the passage of gallstone. It has been reported in stones less than 2.5 cm. However, to the best of our knowledge, this is the first time in which a large stone measuring 4 cm × 3.8 cm passed spontaneously.

  1. Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hee Mang; Jung, Ah Young; Cho, Young Ah; Yoon, Chong Hyun; Lee, Jin Seong [Asan Medical Center Children' s Hospital, University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Songpa-gu, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Division of Neonatology, Asan Medical Center Children' s Hospital, Seoul (Korea, Republic of); Chung, Sung-Hoon [Kyung Hee University School of Medicine, Department of Pediatrics, Seoul (Korea, Republic of); Kim, Seon-Ok [Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, Seoul (Korea, Republic of)

    2017-06-15

    To describe the natural course of extralobar pulmonary sequestration (EPS) and identify factors associated with spontaneous regression of EPS. We retrospectively searched for patients diagnosed with EPS on initial contrast CT scan within 1 month after birth and had a follow-up CT scan without treatment. Spontaneous regression of EPS was assessed by percentage decrease in volume (PDV) and percentage decrease in sum of the diameter of systemic feeding arteries (PDD) by comparing initial and follow-up CT scans. Clinical and CT features were analysed to determine factors associated with PDV and PDD rates. Fifty-one neonates were included. The cumulative proportions of patients reaching PDV > 50 % and PDD > 50 % were 93.0 % and 73.3 % at 4 years, respectively. Tissue attenuation was significantly associated with PDV rate (B = -21.78, P <.001). The tissue attenuation (B = -22.62, P =.001) and diameter of the largest systemic feeding arteries (B = -48.31, P =.011) were significant factors associated with PDD rate. The volume and diameter of systemic feeding arteries of EPS spontaneously decreased within 4 years without treatment. EPSs showing a low tissue attenuation and small diameter of the largest systemic feeding arteries on initial contrast-enhanced CT scans were likely to regress spontaneously. (orig.)

  2. Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group.

    Science.gov (United States)

    Kenyon, S L; Taylor, D J; Tarnow-Mordi, W

    2001-03-31

    Preterm birth after spontaneous preterm labour is associated with death, neonatal disease, and long-term disability. Previous small trials of antibiotics for spontaneous preterm labour have reported inconclusive results. We did a randomised multicentre trial to resolve this issue. 6295 women in spontaneous preterm labour with intact membranes and without evidence of clinical infection were randomly assigned 250 mg erythromycin (n=1611), 325 mg co-amoxiclav (250 mg amoxicillin and 125 mg clavulanic acid; n=1550), both (n=1565), or placebo (n=1569) four times daily for 10 days or until delivery, whichever occurred earlier. The primary outcome measure was a composite of neonatal death, chronic lung disease, or major cerebral abnormality on ultrasonography before discharge from hospital. Analysis was by intention to treat. None of the trial antibiotics was associated with a lower rate of the composite primary outcome than placebo (erythromycin 90 [5.6%], co-amoxiclav 76 [5.0%], both antibiotics 91 [5.9%], vs placebo 78 [5.0%]). However, antibiotic prescription was associated with a lower occurrence of maternal infection. This trial provides evidence that antibiotics should not be routinely prescribed for women in spontaneous preterm labour without evidence of clinical infection.

  3. Spontaneous Neuronal Activity in Developing Neocortical Networks: From Single Cells to Large-Scale Interactions.

    Science.gov (United States)

    Luhmann, Heiko J; Sinning, Anne; Yang, Jenq-Wei; Reyes-Puerta, Vicente; Stüttgen, Maik C; Kirischuk, Sergei; Kilb, Werner

    2016-01-01

    Neuronal activity has been shown to be essential for the proper formation of neuronal circuits, affecting developmental processes like neurogenesis, migration, programmed cell death, cellular differentiation, formation of local and long-range axonal connections, synaptic plasticity or myelination. Accordingly, neocortical areas reveal distinct spontaneous and sensory-driven neuronal activity patterns already at early phases of development. At embryonic stages, when immature neurons start to develop voltage-dependent channels, spontaneous activity is highly synchronized within small neuronal networks and governed by electrical synaptic transmission. Subsequently, spontaneous activity patterns become more complex, involve larger networks and propagate over several neocortical areas. The developmental shift from local to large-scale network activity is accompanied by a gradual shift from electrical to chemical synaptic transmission with an initial excitatory action of chloride-gated channels activated by GABA, glycine and taurine. Transient neuronal populations in the subplate (SP) support temporary circuits that play an important role in tuning early neocortical activity and the formation of mature neuronal networks. Thus, early spontaneous activity patterns control the formation of developing networks in sensory cortices, and disturbances of these activity patterns may lead to long-lasting neuronal deficits.

  4. SPONTANEOUS POTENTIAL INVESTIGATIONS IN SEMENIC MOUNTAINS

    Directory of Open Access Journals (Sweden)

    P. URDEA

    2014-11-01

    Full Text Available Spontaneous Potential Investigations in Semenic Mountains. The use of geophysical methods such as that of Spontaneous Potential (SP to investigate areas where the geomorphological processes occur, has the role to identify less visible processes as for example subcutaneous erosion or piping, subsoil water drainage and finding specific spatial differences of these processes. Comparative study of these sites allows correlation between geomorphological factors, soil and climate, but also to observe the evolution of subsurface erosion or underground water infiltration over time. During this investigation a series of mesh grids have been made in areas with different characteristics (lithology, pedology, slope, exposition, etc. at different time periods in order to spot and analyse the change in data in the chosen sites, various conditions given. Values expressed in millivolts (mV obtained by the Spontaneous Potential method have been put into an algorithm for interpolation looking to yield a pattern of values of what is happening in the soil during that period of time. Thus, in the autumn, the investigation site at the nivation niche Baia Vulturilor, returned values of between -22.6 mV and 65.6 mV, while in spring in the same site, values were within the range of -14.4 mV / 30.1 mV. On the other hand, on the site of the cryopediment under the Semenic peak, in the spring, return values ranged from -40.4 mV and -1.1 mV. A particular case is that of the glacis near Piatra Goznei peak; in this area anthropogenic electricity influences on soil can be found. Based on some models a trend of water movement in the soil could be established, this depending heavily on the amount of precipitation infiltration, local lithology, depth of soil and their structure, and evapotranspiration process. Water movement in the soil may be a correlation with sediment movement in soil horizons and instability manifested on the slopes.

  5. Fetal primary hydrothorax with spontaneous resolution

    Directory of Open Access Journals (Sweden)

    Vera Trocado

    2017-07-01

    Full Text Available Fetal primary hydrothorax is a rare congenital anomaly with an estimated incidence of 1:10.000–15.000 pregnancies, with an unpredictable clinical course, ranging from spontaneous resolution to fetal death. We present a case of a unilateral fetal pleural effusion identified at 35th gestational week. A 37 year-old woman (G2P1 presented to our routine term pregnancy evaluation. The pregnancy had been otherwise uneventful. At ecographic evaluation a large anechogenic fluid collection was identified in the right fetal hemithorax, with atelectasis of right lung, displacing the heart and mediastinal structures to the contralateral hemithorax. Hydramnios was also identified. No other structural abnormalities were detected, as no signs of hydrops. Fetal biometry was compatible with gestational age. Fetal ecochardiogram was structurally and functionally normal. Doppler evaluation of the peak systolic velocity in the middle cerebral artery was normal. Screening for congenital infections was negative. Complete blood cell count, blood type and antibody screening rulled-out immune hydrops. Karyotype analysis was not performed as family decision. Serial ecographic re-evaluations showed a progressive volume decrease and at the 38th week there was total resolution of the effusion. A C-section was performed at the 39th week. A live female infant was born weighing 3205 g, with no need of ventilatory support. One year post-partum follow-up evaluation confirmed the child was healthy. Spontaneous regression has been reported to occur in 9–22% of primary fetal hydrothoraxes, but the features predicting a better prognosis remain difficult to define. Unilateral effusion, spontaneous resolution and absence of hydrops at the age of diagnosis seem to be indicators of better outcome.

  6. A neurodynamic account of spontaneous behaviour.

    Science.gov (United States)

    Namikawa, Jun; Nishimoto, Ryunosuke; Tani, Jun

    2011-10-01

    The current article suggests that deterministic chaos self-organized in cortical dynamics could be responsible for the generation of spontaneous action sequences. Recently, various psychological observations have suggested that humans and primates can learn to extract statistical structures hidden in perceptual sequences experienced during active environmental interactions. Although it has been suggested that such statistical structures involve chunking or compositional primitives, their neuronal implementations in brains have not yet been clarified. Therefore, to reconstruct the phenomena, synthetic neuro-robotics experiments were conducted by using a neural network model, which is characterized by a generative model with intentional states and its multiple timescales dynamics. The experimental results showed that the robot successfully learned to imitate tutored behavioral sequence patterns by extracting the underlying transition probability among primitive actions. An analysis revealed that a set of primitive action patterns was embedded in the fast dynamics part, and the chaotic dynamics of spontaneously sequencing these action primitive patterns was structured in the slow dynamics part, provided that the timescale was adequately set for each part. It was also shown that self-organization of this type of functional hierarchy ensured robust action generation by the robot in its interactions with a noisy environment. This article discusses the correspondence of the synthetic experiments with the known hierarchy of the prefrontal cortex, the supplementary motor area, and the primary motor cortex for action generation. We speculate that deterministic dynamical structures organized in the prefrontal cortex could be essential because they can account for the generation of both intentional behaviors of fixed action sequences and spontaneous behaviors of pseudo-stochastic action sequences by the same mechanism.

  7. A neurodynamic account of spontaneous behaviour.

    Directory of Open Access Journals (Sweden)

    Jun Namikawa

    2011-10-01

    Full Text Available The current article suggests that deterministic chaos self-organized in cortical dynamics could be responsible for the generation of spontaneous action sequences. Recently, various psychological observations have suggested that humans and primates can learn to extract statistical structures hidden in perceptual sequences experienced during active environmental interactions. Although it has been suggested that such statistical structures involve chunking or compositional primitives, their neuronal implementations in brains have not yet been clarified. Therefore, to reconstruct the phenomena, synthetic neuro-robotics experiments were conducted by using a neural network model, which is characterized by a generative model with intentional states and its multiple timescales dynamics. The experimental results showed that the robot successfully learned to imitate tutored behavioral sequence patterns by extracting the underlying transition probability among primitive actions. An analysis revealed that a set of primitive action patterns was embedded in the fast dynamics part, and the chaotic dynamics of spontaneously sequencing these action primitive patterns was structured in the slow dynamics part, provided that the timescale was adequately set for each part. It was also shown that self-organization of this type of functional hierarchy ensured robust action generation by the robot in its interactions with a noisy environment. This article discusses the correspondence of the synthetic experiments with the known hierarchy of the prefrontal cortex, the supplementary motor area, and the primary motor cortex for action generation. We speculate that deterministic dynamical structures organized in the prefrontal cortex could be essential because they can account for the generation of both intentional behaviors of fixed action sequences and spontaneous behaviors of pseudo-stochastic action sequences by the same mechanism.

  8. Being Spontaneous: The Future of Telehealth Implementation?

    Science.gov (United States)

    Mars, Maurice; Scott, Richard E

    2017-09-01

    The smartphone simplifies interprofessional communication, and smartphone applications can facilitate telemedicine activity. Much has been written about the steps that need to be followed to implement and establish a successful telemedicine service that is integrated into everyday clinical practice. A traditional and systematic approach has evolved incorporating activities such as strategy development, needs assessment, business cases and plans, readiness assessment, implementation plans, change management interventions, and ongoing monitoring and evaluation. This "best practice" has been promoted in the telehealth literature for many years. In contrast, several recent initiatives have arisen without any such formal undertakings. This article describes the strengths and weaknesses of two "spontaneous" telemedicine services in dermatology and burn management that have evolved in South Africa. Two spontaneous services were identified and reviewed. In one unsolicited service, doctors at rural referring hospitals have been taking photographs of skin lesions and sending them with a brief text message history to dermatologists using the instant messaging smartphone app, WhatsApp. In the other, burns service, admissions to the burns unit or the clinic were triaged by telephonic description of the case and completion of a preadmission questionnaire. More recently, management and referral decisions are made only after completion of the questionnaire and subsequent submission of photographs of the burn sent by WhatsApp, with the decision transmitted by text message. Although efficient and effective, potential legal and ethical shortcomings have been identified. These "spontaneous" telehealth services challenge traditional best practice, yet appear to lead to truly integrated practice and, therefore, are successful and warrant further study.

  9. [The cell number in spontaneous uncentrifuged urine].

    Science.gov (United States)

    Rebentisch, G; Braun, H; Muche, J

    1982-08-01

    The leucocytes and erythrocytes in spontaneous urines were determined in the counting chamber at native and experimentally reduced pH values after standing for various periods. The pH value remained constant for up 6 h, whereby the disintegration of cells increases with rising pH values. The investigations do not rule out a circadian rhythm of cell excretion referring to the quantity of cells/time. Depending on the absolute number of cells the methodic variation coefficient lies between 4 and 25%.

  10. Angyomatous vocal polypus: a complete spontaneous regression

    Directory of Open Access Journals (Sweden)

    Edmir Américo Lourenço

    Full Text Available The authors describe a male patient who had malignant lymphoma seven years ago which remitted with chemotherapy.Two years ago he developed dysphonia. An unilateral, pediculate smooth red lesion on the right vocal fold was later discovered. Even without benefit of medicamentosus treatment, the patient refused surgery. In a reevaluation using rigid telescopy of the larynx two years later, the lesion had disappeared, completely and spontaneously. As there are no existing publications on this topic, this case report is an alert that surgery should be recommended with extreme caution in this type of vocal disease.

  11. Recurring spontaneous pneumothorax concomitant with menstruation

    Science.gov (United States)

    Davies, Rosemary

    1968-01-01

    Details are given of nine cases of recurrent spontaneous pneumothorax concomitant with menstruation; of these, four are culled from the literature. In every case the time interval between the onset of menstruation and the development of a pneumothorax has been very close, and from the evidence presented some causal relationship is envisaged. Endometriosis is considered as a possible cause. Two of the patients had proven endometriosis of the diaphragm and this condition was almost certainly present in a third patient. Three patients had pelvic endometriosis. The pneumothorax always occurred on the right side, and the possible significance of this is discussed. PMID:5664697

  12. Spontaneous Brillouin scattering in a microdroplet

    Science.gov (United States)

    Ching, S. C.; Leung, P. T.; Young, K.

    1990-05-01

    Spontaneous Brillouin scattering in a micrometer-sized liquid droplet is analyzed from first principles, using the spherical-wave normal-mode basis. Instead of the conservation of linear momentum, this interaction is governed by a selection rule due to the conservation of angular momentum. The Brillouin spectrum is then calculated, both for observation at a given angle and for the sum over all angles, and compared with scattering in a bulk medium. Special attention is paid to the case where the incident and scattered radiation fall on an electromagnetic resonance of the droplet. The analysis lays the foundation for formulating stimulated Brillouin scattering in the same system.

  13. Promoting Spontaneous Second Harmonic Generation through Organogelation.

    Science.gov (United States)

    Marco, A Belén; Aparicio, Fátima; Faour, Lara; Iliopoulos, Konstantinos; Morille, Yohann; Allain, Magali; Franco, Santiago; Andreu, Raquel; Sahraoui, Bouchta; Gindre, Denis; Canevet, David; Sallé, Marc

    2016-07-27

    An organogelator based on the Disperse Red nonlinear optical chromophore was synthesized according to a simple and efficient three-step procedure. The supramolecular gel organization leads to xerogels which display a spontaneous second harmonic generation (SHG) response without any need for preprocessing, and this SHG activity appears to be stable over several months. These findings, based on an intrinsic structural approach, are supported by favorable intermolecular supramolecular interactions, which promote a locally non-centrosymmetric NLO-active organization. This is in sharp contrast with most materials designed for SHG purposes, which generally require the use of expensive or heavy-to-handle external techniques for managing the dipoles' alignment.

  14. Spontaneous Achilles tendon rupture in alkaptonuria

    Science.gov (United States)

    Alajoulin, Omar A.; Alsbou, Mohammed S.; Ja’afreh, Somayya O.; Kalbouneh, Heba M.

    2015-01-01

    Alkaptonuria (AKU) is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA). Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis), early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations. PMID:26620992

  15. Spontaneous electric fields in solid films: spontelectrics

    DEFF Research Database (Denmark)

    Field, David; Plekan, Oksana; Cassidy, Andrew

    2013-01-01

    When dipolar gases are condensed at sufficiently low temperature onto a solid surface, they form films that may spontaneously exhibit electric fields in excess of 108V/m. This effect, called the ‘spontelectric effect’, was recently revealed using an instrument designed to measure scattering...... and capture of low energy electrons by molecular films. In this review it is described how this discovery was made and the properties of materials that display the spontelectric effect, so-called ‘spontelectrics’, are set out. A discussion is included of properties that differentiate spontelectrics from...

  16. Spontaneous hygroma in intracranial arachnoid cyst

    Energy Technology Data Exchange (ETDEWEB)

    Agnoli, A.L.

    1984-06-01

    Anamnesis and treatment of two cases of arachnoid cysts extending into the subarachnoid space are described. No traumatic incident was discovered in the previous history of these two patients. The causal genesis of neurological signs of deficiency in patients with arachnoid and acquired cysts is discussed. However, the cause of the development of a subdural hygroma in arachnoid cysts remains unclarified. CT findings of arachnoid cysts with a hypodense zone between brain surface and the vault of the cranium always require an investigation into the possibility of a spontaneous emptying of the cyst or of a congenital and not only localised extension of the cyst itself.

  17. NSAIDs and spontaneous abortions - true effect or an indication bias?

    Science.gov (United States)

    Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Levy, Amalia

    2015-10-01

    The aim of the study was to characterize the extent of indication bias resulting from the excessive use of NSAIDs on the days preceding a spontaneous abortion to relieve pain. We used data from a retrospective cohort study assessing the risk for spontaneous abortions following exposure to NSAIDs. Three definitions of exposure for cases of spontaneous abortions were compared, from the first day of pregnancy until the day of spontaneous abortion and until 3 and 2 days before a spontaneous abortion. Statistical analysis was performed using multivariate time programmed Cox regression. A sharp increase was observed in the dispensation of indomethacin, diclofenac and naproxen, and a milder increase was found in the use of ibuprofen during the week before a spontaneous abortion. Non- selective COX inhibitors in general and specifically diclofenac and indomethacin were found to be associated with spontaneous abortions when the exposure period was defined until the day of spontaneous abortion (hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.04, 1.28; HR 1.31, 95% CI 1.08, 1.59 and HR 3.33, 95% CI 2.09, 5.29, respectively). The effect disappears by excluding exposures occurring on the day before the spontaneous abortion for non-selective COX inhibitors and on the last week before the spontaneous abortion for indomethacin. In general, decreasing HRs were found with the exclusion of exposures occurring on the days immediately before the spontaneous abortion. The increased use of NSAIDs during the last few days that preceded a spontaneous abortion to relieve pain associated with the miscarriage could bias studies assessing the association between exposure to NSAIDs and spontaneous abortions. © 2015 The British Pharmacological Society.

  18. Small vacuum energy from small equivalence violation in scalar gravity

    Science.gov (United States)

    Agrawal, Prateek; Sundrum, Raman

    2017-05-01

    The theory of scalar gravity proposed by Nordström, and refined by Einstein and Fokker, provides a striking analogy to general relativity. In its modern form, scalar gravity appears as the low-energy effective field theory of the spontaneous breaking of conformal symmetry within a CFT, and is AdS/CFT dual to the original Randall-Sundrum I model, but without a UV brane. Scalar gravity faithfully exhibits several qualitative features of the cosmological constant problem of standard gravity coupled to quantum matter, and the Weinberg no-go theorem can be extended to this case as well. Remarkably, a solution to the scalar gravity cosmological constant problem has been proposed, where the key is a very small violation of the scalar equivalence principle, which can be elegantly formulated as a particular type of deformation of the CFT. In the dual AdS picture this involves implementing Goldberger-Wise radion stabilization where the Goldberger-Wise field is a pseudo-Nambu Goldstone boson. In quantum gravity however, global symmetries protecting pNGBs are not expected to be fundamental. We provide a natural six-dimensional gauge theory origin for this global symmetry and show that the violation of the equivalence principle and the size of the vacuum energy seen by scalar gravity can naturally be exponentially small. Our solution may be of interest for study of non-supersymmetric CFTs in the spontaneously broken phase.

  19. Progesterone to prevent spontaneous preterm birth

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Hassan, Sonia

    2014-01-01

    Summary Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important healthcare priority. Preterm parturition is one of the ‘great obstetrical syndromes’ and is caused by multiple etiologies. One of the mechanisms of disease is the untimely decline in progesterone action, which can be manifested by a sonographic short cervix in the midtrimester. The detection of a short cervix in the midtrimester is a powerful risk factor for preterm delivery. Vaginal progesterone can reduce the rate of preterm delivery by 45%, and the rate of neonatal morbidity (admission to neonatal intensive care unit, respiratory distress syndrome, need for mechanical ventilation, etc.). To prevent one case of spontaneous preterm birth preterm birth in women with a short cervix both with and without a prior history of preterm birth. In patients with a prior history of preterm birth, vaginal progesterone is as effective as cervical cerclage to prevent preterm delivery. 17α-Hydroxyprogesterone caproate has not been shown to be effective in reducing the rate of spontaneous preterm birth in women with a short cervix. PMID:24315687

  20. Spontaneous ad hoc mobile cloud computing network.

    Science.gov (United States)

    Lacuesta, Raquel; Lloret, Jaime; Sendra, Sandra; Peñalver, Lourdes

    2014-01-01

    Cloud computing helps users and companies to share computing resources instead of having local servers or personal devices to handle the applications. Smart devices are becoming one of the main information processing devices. Their computing features are reaching levels that let them create a mobile cloud computing network. But sometimes they are not able to create it and collaborate actively in the cloud because it is difficult for them to build easily a spontaneous network and configure its parameters. For this reason, in this paper, we are going to present the design and deployment of a spontaneous ad hoc mobile cloud computing network. In order to perform it, we have developed a trusted algorithm that is able to manage the activity of the nodes when they join and leave the network. The paper shows the network procedures and classes that have been designed. Our simulation results using Castalia show that our proposal presents a good efficiency and network performance even by using high number of nodes.

  1. [Spontaneous achilles tendon rupture in granulomatous vasculitis].

    Science.gov (United States)

    Benthien, Jan Philipp; Delling, G; Rüther, W

    2003-08-01

    A 66-year old patient sustained a non-traumatic rupture of her left achilles tendon. She suffered from Sjögren's syndrome which occurred in conjunction with a systemic vasculitis, and recurrent episcleritis. The combination of Sjögren's syndrome and systemic vasculitis is well known. Subsequently, she was treated with high-dose systemic steroids over a period of 2 years. In order to reduce the amount of steroids due to preexisting severe osteoporosis and thoracic vertebral fractures, her medication was changed to cyclophosphamide shortly before her injury. Intraoperatively, a granuloma was discovered at the site of the rupture. This granuloma had infiltrated most of the achilles tendon at this site and virtually replaced viable tendon tissue. Originally, the rupture was supposedly due to the high dose steroids. This theory had to be revised according to the intraoperative findings. Following excision of the granuloma and operative treatment of the achilles tendon rupture, the continuity of the tendon could be completely restored. A MRI scan 3 months after the procedure demonstrated a completely healed Achilles tendon. Spontaneous achilles tendon rupture due to a granuloma in patients with vasculitis seems to be a rare event. However, tendon ruptures in combination with systemic lupus erythematodes have been described. Mostly, these events are attributed to long term application of steroids. Spontaneous rupture in combination with high dose treatment of steroids seems to be an underestimated problem.

  2. Body Mass Index and spontaneous miscarriage.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: We compared the incidence of spontaneous miscarriage in women categorised as obese, based on a Body Mass Index (BMI) >29.9 kg\\/m(2), with women in other BMI categories. STUDY DESIGN: In a prospective observational study conducted in a university teaching hospital, women were enrolled at their convenience in the first trimester after a sonogram confirmed an ongoing singleton pregnancy with fetal heart activity present. Maternal height and weight were measured digitally and BMI calculated. Maternal body composition was measured by advanced bioelectrical impedance analysis. RESULTS: In 1200 women, the overall miscarriage rate was 2.8% (n=33). The mean gestational age at enrolment was 9.9 weeks. In the obese category (n=217), the miscarriage rate was 2.3% compared with 3.3% in the overweight category (n=329), and 2.3% in the normal BMI group (n=621). There was no difference in the mean body composition parameters, particularly fat mass parameters, between those women who miscarried and those who did not. CONCLUSIONS: In women with sonographic evidence of fetal heart activity in the first trimester, the rate of spontaneous miscarriage is low and is not increased in women with BMI>29.9 kg\\/m(2) compared to women in the normal BMI category.

  3. Spontaneous delivery is related to barometric pressure.

    Science.gov (United States)

    Akutagawa, Osamu; Nishi, Hirotaka; Isaka, Keiichi

    2007-04-01

    Many studies have shown that changes in the weather affect health. In the field of obstetrics and gynecology, several events have been empirically shown to be related to the weather. Labor pain is controlled by the autonomic nervous system and various hormones, and is expected to be influenced by the weather and environmental changes. Several studies have been conducted on the relationship between delivery and barometric pressure, which shows constant changes with changes in weather, but there is no generally accepted view on this. We conducted a retrospective study in our patients who had a spontaneous cephalic delivery in this hospital between January 1997 and December 2003, in order to determine whether low barometric pressure induces labor pains, premature rupture of the membranes, and delivery, and whether changes in barometric pressure affect delivery. There was a significant increase in the number of deliveries and rupture of the membranes at low barometric pressure (P barometric pressure. This tendency was noted in both women with spontaneous rupture of the fetal membranes and those with premature rupture of the membranes (P barometric pressure, regardless of whether it was increasing or decreasing, the number of deliveries increased and the relationship was statistically significant (P barometric pressure, suggesting that low barometric pressure induces rupture of the fetal membranes and delivery.

  4. Spontaneous Ad Hoc Mobile Cloud Computing Network

    Directory of Open Access Journals (Sweden)

    Raquel Lacuesta

    2014-01-01

    Full Text Available Cloud computing helps users and companies to share computing resources instead of having local servers or personal devices to handle the applications. Smart devices are becoming one of the main information processing devices. Their computing features are reaching levels that let them create a mobile cloud computing network. But sometimes they are not able to create it and collaborate actively in the cloud because it is difficult for them to build easily a spontaneous network and configure its parameters. For this reason, in this paper, we are going to present the design and deployment of a spontaneous ad hoc mobile cloud computing network. In order to perform it, we have developed a trusted algorithm that is able to manage the activity of the nodes when they join and leave the network. The paper shows the network procedures and classes that have been designed. Our simulation results using Castalia show that our proposal presents a good efficiency and network performance even by using high number of nodes.

  5. [Spontaneous remission of congenital leukemia cutis].

    Science.gov (United States)

    Eberst, E; Michel, B; Stoebner, P; Dandurand, M; Meunier, L

    2011-01-01

    Aleukaemic leukaemia--without blasts in the blood or the bone marrow--with isolated cutaneous manifestations has been very rarely reported since only seven patients have been described to date. The prognosis is variable, and the indications for an aggressive treatment such as polychemotherapy are currently unclear. We report a case of spontaneously remitting aleukaemic leukaemia in a newborn child and compare it with other cases in the literature. A male newborn presented diffuse, violaceous skin nodules reminiscent of the so-called "blueberry muffin syndrome" present since birth. Blood and marrow examinations did not show any blasts and karyotype was normal. Biopsy of a nodule established the diagnosis of acute myeloid leukaemia type 5. The course was spontaneously favourable despite the absence of specific therapy and the boy was asymptomatic after one year of follow-up. Of the eight reported infants (including ours), three died, including two through acute transformation of the leukaemia. The prognosis seems to be highly dependent on cytogenetic features with the 11q23 rearrangement being at higher risk of acute transformation, prompting recourse to aggressive chemotherapy. Our case further illustrates the favourable prognostic value of a normal karyotype, a situation in which therapeutic abstention seems possible, and is even recommended. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Controlling collective spontaneous emission with plasmonic waveguides.

    Science.gov (United States)

    Li, Ying; Argyropoulos, Christos

    2016-11-14

    We demonstrate a plasmonic route to control the collective spontaneous emission of two-level quantum emitters. Superradiance and subradiance effects are observed over distances comparable to the operating wavelength inside plasmonic nanochannels. These plasmonic waveguides can provide an effective epsilon-near-zero operation in their cut-off frequency and Fabry-Pérot resonances at higher frequencies. The related plasmonic resonant modes are found to efficiently enhance the constructive (superradiance) or destructive (subradiance) interference between different quantum emitters located inside the waveguides. By increasing the number of emitters located in the elongated plasmonic channel, the superradiance effect is enhanced at the epsilon-near-zero operation, leading to a strong coherent increase in the collective spontaneous emission rate. In addition, the separation distance between neighboring emitters and their emission wavelengths can be changed to dynamically control the collective emission properties of the plasmonic system. It is envisioned that the dynamic modification between quantum superradiant and subradiant modes will find applications in quantum entanglement of qubits, low-threshold nanolasers and efficient sensors.

  7. Spontaneous avalanche dephasing in large Rydberg ensembles

    Science.gov (United States)

    Boulier, T.; Magnan, E.; Bracamontes, C.; Maslek, J.; Goldschmidt, E. A.; Young, J. T.; Gorshkov, A. V.; Rolston, S. L.; Porto, J. V.

    2017-11-01

    Strong dipole-exchange interactions due to spontaneously produced contaminant states can trigger rapid dephasing in many-body Rydberg ensembles [E. A. Goldschmidt et al., Phys. Rev. Lett. 116, 113001 (2016), 10.1103/PhysRevLett.116.113001]. Such broadening has serious implications for many proposals to coherently use Rydberg interactions, particularly Rydberg dressing proposals. The dephasing arises as a runaway process where the production of the first contaminant atoms facilitates the creation of more contaminant atoms. Here we study the time dependence of this process with stroboscopic approaches. Using a pump-probe technique, we create an excess "pump" Rydberg population and probe its effect with a different "probe" Rydberg transition. We observe a reduced resonant pumping rate and an enhancement of the excitation on both sides of the transition as atoms are added to the pump state. We also observe a time scale for population growth that is significantly shorter than predicted by homogeneous mean-field models, as expected from a clustered growth mechanism where high-order correlations dominate the dynamics. These results support earlier works and confirm that the time scale for the onset of dephasing is reduced by a factor which scales as the inverse of the atom number. In addition, we discuss several approaches to minimize these effects of spontaneous broadening, including stroboscopic techniques and operating at cryogenic temperatures. It is challenging to avoid the unwanted broadening effects, but under some conditions they can be mitigated.

  8. H1-antihistamines for chronic spontaneous urticaria.

    Science.gov (United States)

    Sharma, Maulina; Bennett, Cathy; Cohen, Stuart N; Carter, Ben

    2014-11-14

    Background Chronic spontaneous urticaria (CSU) is characterised by the development of crops of red, itchy, raised weals or hives with no identifiable external cause.Objectives To assess the effects of H1-antihistamines for CSU.Search methods We searched the following databases up to June 2014: Cochrane Skin Group Specialised Register, CENTRAL (2014, Issue 5), MEDLINE(from 1946), EMBASE (from 1974) and PsycINFO (from 1806). We searched five trials registers and checked articles for references to relevant randomised controlled trials.Selection criteria We included randomised controlled trials of H1-antihistamines for CSU. Interventions included single therapy or a combination of H1-antihistamines compared with no treatment (placebo) or another active pharmacological compound at any dose.Data collection and analysis We used standard methodological procedures as expected by The Cochrane Collaboration.Our primary outcome measures were proportion of participants with complete suppression of urticaria: 'good or excellent' response,50% or greater improvement in quality of life measures, and adverse events.We present risk ratios (RR) with 95% confidence intervals(CIs). Main results We identified 73 studies (9759 participants); 34 studies provided data for 23 comparisons. The duration of the intervention was up to two weeks (short-term) or longer than two weeks and up to three months (intermediate-term).Cetirizine 10mg once daily in the short term and in the intermediate term led to complete suppression of urticaria by more participants than was seen with placebo (RR 2.72, 95% CI 1.51 to 4.91). For this same outcome, comparison of desloratadine versus placebo in the intermediate term (5 mg) (RR 37.00, 95% CI 2.31 to 593.70) and in the short term (20 mg) (RR 15.97, 95% CI 1.04 to 245.04)favoured desloratadine, but no differences were seen between 5 mg and 10 mg for short-term treatment.Levocetirizine 20 mg per day (short-term) was more effective for complete suppression of

  9. Maternal smoking predicts the risk of spontaneous abortion

    DEFF Research Database (Denmark)

    Nielsen, Ann; Hannibal, Charlotte Gerd; Lindekilde, Bodil Eriksen

    2006-01-01

    BACKGROUND: Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study...... was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. METHODS: We performed a nested case-control study using prospective data from a population-based cohort comprising 11,088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n=343......) or who gave birth (n=1,578) during follow-up were selected. Associations between self-reported smoking at enrollment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. RESULTS: The risk of spontaneous abortion in relation to pre-pregnancy smoking showed a clear...

  10. Maternal underweight and the risk of spontaneous abortion

    DEFF Research Database (Denmark)

    Helgstrand, Stine; Andersen, Anne-Marie Nybo

    2005-01-01

    BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively...... spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95......% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did...

  11. Spontaneous erythrocytosis in a patient on chronic hemodialysis.

    Science.gov (United States)

    Adeniyi, Muniru; Sun, Yijuan; Servilla, Karen S; Hartshorne, Michael F; Tzamaloukas, Antonios H

    2009-10-01

    While anemia is common in patients on chronic hemodialysis (HD), spontaneous erythrocytosis is rare and can be caused by either the same conditions causing erythrocytosis in the general population or any condition specific to chronic renal failure. We present a patient illustrating this latter circumstance. A 53-year-old man with diabetic nephropathy, with no known disease causing hypoxemia started HD in April 2001. Blood hemoglobin (Hgb) level was 13.7 +/- 2.8 g/dL while his kidney function was normal (1993-1996) and after 1997, with the development of chronic kidney disease, decreased progressively to a low of 10.2 g/dL in March 2001 when erythropoietin (EPO) injections were started. Erythropoietin requirements progressively decreased because of rising Hgb. Erythropoietin was discontinued in mid-2005. Blood hemoglobin continued to rise, however, to a high value of 17.6 g/dL in February 2006. At the same time, endogenous blood EPO level was 3.6 mIU/mL, a value consistent with primary polycythemia. White blood cell and platelet counts were normal. Several small renal cysts, including 1 complex cyst, were detected by ultrasonography and computer tomography in April 2006. He refused surgical treatment. He was treated with small phlebotomies (not returning the blood in the dialyzer at the end of dialysis) and monitoring of Hgb, which decreased toward the desired range. Repeated computer tomographic scans showed a slow increase in the size of the complex cyst and several other cysts. In late 2007 Hgb started rising again, and in February 2008, while the Hgb level was 16.4 g/dL, the endogenous serum EPO level was 726 mIU/mL (upper normal limit 31.5 mIU/mL). Intermittent phlebotomies were reinstituted. He subsequently developed multiple vascular catastrophes and expired from ischemic bowel disease in September 2008. Acquired cystic disease of the kidneys should be considered in HD patients who develop spontaneous erythrocytosis. The risks of acquired cystic disease

  12. Adam Small

    African Journals Online (AJOL)

    Owner

    oudste dogter (MOOC 29304). Jan Small (vroeër: Jan Dampies) het ek as Oupa Jan geken en Fatimah was vir my Ouma Tiema. Uncle erken ruiterlik sy ma se sterk invloed op sy verbeelding en lewensbenadering, soos hy dit ietwat enigmaties gestel het: 'My skryfwerk lê iewers.' In sy huldeblyk,. “Onaf gedig”, wat hy tydens ...

  13. Spontaneous Uterine Perforation Caused by Pyometra: A Case Report

    OpenAIRE

    Yousefi, Zohreh; sharifi, Noorieh; Morshedy, Maryam

    2014-01-01

    Introduction: Pyometra is an accumulation of purulent material or pus in the uterine cavity. Spontaneous perforation of uterus by pyometra is rare. This is a clinical presentation and management of a spontaneous perforation of uterine caused by pyometra. Case Presentation: This is a case report on spontaneously perforated associated with pyometra secondary to cervical malignancy. The patient underwent exploratory laparotomy with total hysterectomy and bilateral salpingo-oophorectomy. Conclusi...

  14. Spontaneous globe luxation associated with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    M Ashok Kumar

    2012-01-01

    Full Text Available Spontaneous globe luxation is a rarely reported condition which can lead to complications like optic neuropathy. Common causes are thyroid eye disease, shallow orbit and floppy eyelid syndrome. We report a case of spontaneous globe luxation with the onset and severity associated with chronic obstructive pulmonary disease (COPD. To our knowledge, this is the first case of spontaneous globe luxation associated with COPD.

  15. Serum anti-Mullerian hormone levels after ovarian drilling for the second-line treatment of polycystic ovary syndrome: a pilot-randomized study comparing laparoscopy and transvaginal hydrolaparoscopy.

    Science.gov (United States)

    Giampaolino, Pierluigi; Morra, Ilaria; Della Corte, Luigi; Sparice, Stefania; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2017-01-01

    Aim of the study was to asses and compare serum anti-Mullerian harmone (AMH) levels after laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) ovarian drilling in clomifene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients; secondary outcome was to evaluate postoperative pain to estimate the acceptability of procedures. A total of 246 patients with CC-resistant PCOS were randomized into two groups: 123 underwent LOD and 123 underwent THL ovarian drilling. AMH serum levels were evaluated before and after the procedure; moreover, women were asked to rate pain on a visual analog scale (VAS) from 0 (no pain, perfectly acceptable) to 10 (unbearable pain, completely unacceptable). In both groups, postoperative serum AMH levels were significantly reduced compared to preoperative levels (6.06 ± 1.18 and 5.84 ± 1.16 versus 5.00 ± 1.29 and 4.83 ± 1.10; p drilling in comparison to THL (3.26 ± 1.1 versus 1.11 ± 0.5; p drilling is comparable to the LOD in terms of reduction in AMH, but it is preferred by patients in terms of acceptability. These results could support to use of THL ovarian drilling in the treatment of patients with CC- resistant PCOS.

  16. Spontaneous regression of a lumbar disc herniation: case report

    Directory of Open Access Journals (Sweden)

    Mostarchid Brahim El

    2016-12-01

    Full Text Available Lumbar disc herniation is a common disease that induces back pain and radicular pain. Some cases require conservative treatment or at times relived spontaneously. Spontaneous regression of disc herniation is an atypical clinical presentation, and it has been recognized with the advancement of recent advances in imaging techniques. We present a 35-year-old woman presented a spontaneous regression of a lumbar disc herniation with good outcome after intensive physical therapy program. Spontaneous regression of disc herniation is thought to occur via an inflammatory reaction with molecular mechanisms of phagocytic processes.

  17. Dorsomedial prefontal cortex supports spontaneous thinking per se.

    Science.gov (United States)

    Raij, T T; Riekki, T J J

    2017-06-01

    Spontaneous thinking, an action to produce, consider, integrate, and reason through mental representations, is central to our daily experience and has been suggested to serve crucial adaptive purposes. Such thinking occurs among other experiences during mind wandering that is associated with activation of the default mode network among other brain circuitries. Whether and how such brain activation is linked to the experience of spontaneous thinking per se remains poorly known. We studied 51 healthy subjects using a comprehensive experience-sampling paradigm during 3T functional magnetic resonance imaging. In comparison with fixation, the experiences of spontaneous thinking and spontaneous perception were related to activation of wide-spread brain circuitries, including the cortical midline structures, the anterior cingulate cortex and the visual cortex. In direct comparison of the spontaneous thinking versus spontaneous perception, activation was observed in the anterior dorsomedial prefrontal cortex. Modality congruence of spontaneous-experience-related brain activation was suggested by several findings, including association of the lingual gyrus with visual in comparison with non-verbal-non-visual thinking. In the context of current literature, these findings suggest that the cortical midline structures are involved in the integrative core substrate of spontaneous thinking that is coupled with other brain systems depending on the characteristics of thinking. Furthermore, involvement of the anterior dorsomedial prefrontal cortex suggests the control of high-order abstract functions to characterize spontaneous thinking per se. Hum Brain Mapp 38:3277-3288, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Visually evoked spiking evolves while spontaneous ongoing dynamics persist

    Directory of Open Access Journals (Sweden)

    Raoul eHuys

    2016-01-01

    Full Text Available Neurons in the primary visual cortex spontaneously spike even when there are no visual stimuli. It is unknown whether the spiking evoked by visual stimuli is just a modification of the spontaneous ongoing cortical spiking dynamics or whether the spontaneous spiking state disappears and is replaced by evoked spiking. This study of laminar recordings of spontaneous spiking and visually evoked spiking of neurons in the ferret primary visual cortex shows that the spiking dynamics does not change: the spontaneous spiking as well as evoked spiking is controlled by a stable and persisting fixed point attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix. The functional advantage of this organization is that it avoids the need for a system reorganization following visual stimulation, and impedes the transition of spontaneous spiking to evoked spiking and the propagation of spontaneous spiking from layer 4 to layers 2-3.

  19. Spontaneous closure of an ileostomy: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Ashish Saxena

    2015-01-01

    CONCLUSION: Further research is warranted to understand the mechanism behind spontaneous regression of a stoma. Relationship between this event and intestinal tuberculosis or ATT needs to be analysed.

  20. General Anesthesia with Preserved Spontaneous Breathing through an Intubation Tube

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to study whether spontaneous patient breathing may be preserved during elective operations under general anesthesia with tracheal intubation. Subjects and methods. One hundred and twelve patients undergoing elective surgeries under general endotracheal anesthesia were randomized into 2 groups: 1 patients who had forced mechanical ventilation in the volume-controlled mode and 2 those who received assisted ventilation as spontaneous breathing with mechanical support. Conclusion. The study shows that spontaneous breathing with mechanical support may be safely used during some surgical interventions in patients with baseline healthy lungs. Key words: Pressure Support, assisted ventilation, spontaneous breathing, general anesthesia, lung function.

  1. Enhancement by citral of glutamatergic spontaneous excitatory transmission in adult rat substantia gelatinosa neurons.

    Science.gov (United States)

    Zhu, Lan; Fujita, Tsugumi; Jiang, Chang-Yu; Kumamoto, Eiichi

    2016-02-10

    Although citral, which is abundantly present in lemongrass, has various actions including antinociception, how citral affects synaptic transmission has not been examined as yet. Citral activates in heterologous cells transient receptor potential vanilloid-1, ankyrin-1, and melastatin-8 (TRPV1, TRPA1, and TRPM8, respectively) channels, the activation of which in the spinal lamina II [substantia gelatinosa (SG)] increases the spontaneous release of L-glutamate from nerve terminals. It remains to be examined what types of transient receptor potential channel in native neurons are activated by citral. With a focus on transient receptor potential activation, we examined the effect of citral on glutamatergic spontaneous excitatory transmission using the whole-cell patch-clamp technique to SG neurons in adult rat spinal cord slices. Bath-applied citral for 3 min increased the frequency of spontaneous excitatory postsynaptic current in a concentration-dependent manner (half-maximal effective concentration=0.58 mM), with a small increase in its amplitude. The spontaneous excitatory postsynaptic current frequency increase produced by citral was repeated at a time interval of 30 min, albeit this action recovered with a slow time course after washout. The presynaptic effect of citral was inhibited by TRPA1 antagonist HC-030031, but not by voltage-gated Na-channel blocker tetrodotoxin, TRPV1 antagonist capsazepine, and TRPM8 antagonist BCTC. It is concluded that citral increases spontaneous L-glutamate release in SG neurons by activating TRPA1 channels. Considering that the SG plays a pivotal role in modulating nociceptive transmission from the periphery, the citral activity could contribute toward at least a part of the modulation.

  2. Withdrawal of voluntary inhibition unravels the off state of the spontaneous blink generator.

    Science.gov (United States)

    Moraitis, Timoleon; Ghosh, Arko

    2014-12-01

    Involuntary movements such as spontaneous eye blinks can be successfully inhibited at will. Little do we know how the voluntary motor circuits countermand spontaneous blinks. Do the voluntary inhibitory commands act to pause or to turn off the endogenous blink generator, or does inhibition intersect and counter the generator׳s excitatory outputs? In theory, the time taken for the system to generate an after-inhibition blink will reflect onto the form of inhibition. For instance, if voluntary commands were to turn the blink generator off then the after-blink latency would be fixed to the inhibition offset and reflect the time it takes for the generator to rebound and turn on. In this study we measured the after-blink latency from the offset of voluntary inhibition. Volunteers inhibited their blinks in response to sound tones of randomly varying durations. At the offset volunteers withdrew the inhibition and relaxed. Interestingly, the spontaneous after-blinks were fixed to the offset of the inhibition as if the generator rebounded from an off state. The after-blink latency was not related to the duration of the inhibition, and inhibiting even for a small fraction of the mean inter-blink interval generated an after-blink time-locked to the inhibition offset. Interestingly, the insertion of voluntary blinks after inhibition further altered the blink generator by delaying the spontaneous after-blinks. We propose that the inhibition of spontaneous blinks at the level of the generator allows for highly effective voluntary countermanding. Nevertheless, the withdrawal of such inhibition was strongly associated with motor excitation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Presumptive Spontaneous Lysosomal Storage-Like Disease in a Crl:CD1(ICR) Mouse.

    Science.gov (United States)

    Hernon, Krista M; Whitcomb, Tiffany L; Davis, Lori; Cooper, Timothy K

    2017-02-01

    A clinically unremarkable 4.5-mo-old female Crl:CD1(ICR) VAF/Elite mouse was euthanized for scheduled sentinel processing. Gross necropsy findings included significant hepatosplenomegaly and visceral lymphadenomegaly, resulting in a preliminary gross diagnosis of lymphoma. Histology revealed florid accumulations of large, 'foamy' macrophages present in the bone marrow, small intestines, and viscera including liver, spleen, lymph nodes, thymus, uterus, and ovaries. The cytoplasm of these cells was abundant, stained pale blue with Wright-Giemsa and was periodic acid-Schiff positive. Given these characteristic gross and histologic findings, a spontaneous lysosomal storage-like disease was diagnosed in this mouse. Cholesterol ester storage disease is likely, because of the visceral involvement with sparing of the CNS, but could not be diagnosed definitively. To our knowledge, this report is the first to describe a case of spontaneous lysosomal storage disease in an outbred mouse of the CD1(ICR) background.

  4. Spontaneous exfoliation of a drying gel.

    Science.gov (United States)

    Chung, Jun Young; Regev, Ido; Mahadevan, L

    2016-09-20

    Wet starch cracks when it dries inhomogeneously, while hot glass cracks when it cools non-uniformly. In both cases, differential shrinkage induced by drying/cooling from the surface causes superficial cracks to grow perpendicular to the surface in different patterns. In contrast with these observations of bulk cracking in brittle materials, when a soft and homogeneously swollen polymer gel dries, differential strains lead to the peeling of a thin layer that spontaneously tears away from the bulk. Continued drying leads to the process repeating itself, forming a peeled-layered structure. The emergent thickness of the exfoliated layer is a function of both the geometry of the original gel and the physical parameters associated with the drying rate and external temperature. We characterize the experimental conditions under which layer peeling can arise, and use simulations to corroborate these observations. Finally, a minimal theory explains the scaling of the peel thickness, consistent with our experiments.

  5. Spontaneous Heterotopic Triplet Pregnancy With Tubal Rupture

    Directory of Open Access Journals (Sweden)

    Lima Arsala MBBS, BBMedSci

    2014-04-01

    Full Text Available The recent increase in heterotopic pregnancies has been largely attributed to the increased use of assisted reproduction technologies. We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy. Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites. It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies. However, the prevalence is rising with the increased use of assisted reproduction techniques to that of 1:100 to 1:500 in these patient subgroups, highlighting the need to incorporate it into a clinician’s diagnostic algorithm.

  6. [Spontaneous rupture of the esophagus. Case report].

    Science.gov (United States)

    Pădureanu, S; Burcoveanu, C; Mârţ, Laura; Ignat, Mihaela

    2004-01-01

    We present a 50 years old man who was admitted for severe pain in the chest appeared after vomiting, dyspnoea, cardiovascular collapse. The diagnosis of spontaneous perforation of the esophagus (Boerhaave's syndrome) was confirmed by a radiopaque swallow. We performed a laparotomy, mediastinal drainage, cervical esophagostomy and jejunostomy. Postoperatively, the general state was severe--with high fever, important pleurezia, necessitating pleural drainage, mechanical ventilation for 8 days, parenteral and jejunostomy nutrition. It was possible to close the esophagostomy in the 43rd postoperative day. The patient has been dismissed on the 59th day. Five days later he presented in the ER with severe dyspnoea due to tracheal stenosis--emergency tracheotomy was performed, followed by resection of the stenotic cartilages.

  7. Spontaneous bilateral coxofemoral luxation in four dogs.

    Science.gov (United States)

    Trostel, C D; Peck, J N; deHaan, J J

    2000-01-01

    Spontaneous bilateral coxofemoral luxations and their clinical managements are described in four dogs. Luxations in each case occurred while the patient was in a controlled environment with no possibility of trauma. While all cases had bilateral luxations, the luxations occurred in a staged fashion in two of the four cases. Treatment varied with each case, but included closed reduction, triple pelvic osteotomy, prosthetic capsulorrhaphy, toggle pin, ischioilial pinning, total hip replacement, and femoral head and neck ostectomy. Other than femoral head and neck ostectomy, results were uniformly poor, with reluxation being the most common complication. Evidence of pre-existing degenerative changes was minimal, particularly considering the ages of the patients (range, three to 12 yrs). Histopathological evaluation of joint capsules, round ligaments, and femoral heads are warranted in future cases.

  8. Spontaneously abandoned settlements in Serbia: Part 2

    Directory of Open Access Journals (Sweden)

    Milošević Marko V.

    2011-01-01

    Full Text Available This is the second part of the article “Spontaneously abandoned settlements in Serbia”, the first part of which was published in No. 60-2 of this Journal. Geomorphological indicators pointing at unsustainability of the studied settlements are singled out. The indicators are classified as morphometric (quantitative and morphologic (qualitative. Geomorphometry has been used for determination of quantitative indicators. The coefficient of settlement isolation (Ki is defined, which is a product of road coefficient (Kr and real relative height (RRH. Morphological indicators refer to the position of a settlement on a certain geomorphological unit (ridge, valley, valley side, as well as to the geomorphological homogeneity of space, determined by geomorphological mapping. The defined indicators of unsustainability are presented in detail as a case study of the abandoned village Smilov Laz, in the municipality of Novi Pazar.

  9. Mapping quantum state dynamics in spontaneous emission

    Science.gov (United States)

    Naghiloo, M.; Foroozani, N.; Tan, D.; Jadbabaie, A.; Murch, K. W.

    2016-01-01

    The evolution of a quantum state undergoing radiative decay depends on how its emission is detected. If the emission is detected in the form of energy quanta, the evolution is characterized by a quantum jump to a lower energy state. In contrast, detection of the wave nature of the emitted radiation leads to different dynamics. Here, we investigate the diffusive dynamics of a superconducting artificial atom under continuous homodyne detection of its spontaneous emission. Using quantum state tomography, we characterize the correlation between the detected homodyne signal and the emitter's state, and map out the conditional back-action of homodyne measurement. By tracking the diffusive quantum trajectories of the state as it decays, we characterize selective stochastic excitation induced by the choice of measurement basis. Our results demonstrate dramatic differences from the quantum jump evolution associated with photodetection and highlight how continuous field detection can be harnessed to control quantum evolution. PMID:27167893

  10. Spontaneously electrical solids in a new light.

    Science.gov (United States)

    Lasne, Jérôme; Rosu-Finsen, Alexander; Cassidy, Andrew; McCoustra, Martin R S; Field, David

    2015-08-28

    Reflection-absorption infrared spectroscopy (RAIRS) of nitrous oxide (N2O) thin films is shown to provide an independent means of observing the spontelectric state, the first new structural phase of matter, with unique electrical properties, to have emerged in decades. The presence of a spontaneous and powerful static electric field within the film, the defining characteristic of spontelectric solids, is demonstrated through observations of longitudinal-transverse optical (LO-TO) splitting in RAIR spectra, using an analysis based on the vibrational Stark effect. In particular the dependence of the LO-TO splitting on the film deposition temperature may be wholly attributed to the known temperature dependence of the spontelectric field.

  11. Spontaneous closure of midline diastema following frenectomy.

    Science.gov (United States)

    Koora, Kiran; Muthu, M S; Rathna, Prabhu V

    2007-03-01

    Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies) and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

  12. Spontaneous closure of midline diastema following frenectomy

    Directory of Open Access Journals (Sweden)

    Koora Kiran

    2007-03-01

    Full Text Available Maxillary midline diastema is a common aesthetic problem in mixed and early permanent dentitions. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenical factors. Many innovative therapies varying from restorative procedures such as composite build-up to surgery (frenectomies and orthodontics are available. Although literature says every frenectomy procedure should be preceded by orthodontic treatment, we opted for frenectomy technique without any orthodontic intervention. Presented herewith is a case report of a 9-year-old girl with a high frenal attachment that had caused spacing of the maxillary central incisors. A spontaneous closure of the midline diastema was noted within 2 months following frenectomy. The patient was followed up for 4 months after which the space remained closed and there was no necessity for an orthodontic treatment at a later stage.

  13. Quantum Measurement Driven by Spontaneous Symmetry Breaking

    Science.gov (United States)

    Morikawa, M.; Nakamichi, A.

    2006-10-01

    Quantum mechanics cannot be applied within a closed system. Inevitable measurement process in quantum mechanics is usually treated separately from the basic principles of the framework and requires outside observer of the system. In this paper, we propose that the quantum measurement process is actually a physical process associated with the ubiquitous mechanism of spontaneous symmetry breaking. Based on this proposal, we construct a quantum measurement model in which the mixed state evolves into a pure state as the dynamical pro-coherence process. Furthermore, the classically distinguishable pointer parameter emerges as the c-number order parameter in the formalism of closed time-path quantum field theory. We also discuss the precision of the measurement and the possible deduction of the Born probability postulate.

  14. Constrained Gauge Fields from Spontaneous Lorentz Violation

    CERN Document Server

    Chkareuli, J L; Jejelava, J G; Nielsen, H B

    2008-01-01

    Spontaneous Lorentz violation realized through a nonlinear vector field constraint of the type $A_{\\mu}^{2}=M^{2}$ ($M$ is the proposed scale for Lorentz violation) is shown to generate massless vector Goldstone bosons, gauging the starting global internal symmetries in arbitrary relativistically invariant theories. The gauge invariance appears in essence as a necessary condition for these bosons not to be superfluously restricted in degrees of freedom, apart from the constraint due to which the true vacuum in a theory is chosen by the Lorentz violation. In the Abelian symmetry case the only possible theory proves to be QED with a massless vector Goldstone boson naturally associated with the photon, while the non-Abelian symmetry case results in a conventional Yang-Mills theory. These theories, both Abelian and non-Abelian, look essentially nonlinear and contain particular Lorentz (and $CPT$) violating couplings when expressed in terms of the pure Goldstone vector modes. However, they do not lead to physical ...

  15. Spontaneous crystallization in athermal polymer packings.

    Science.gov (United States)

    Karayiannis, Nikos Ch; Foteinopoulou, Katerina; Laso, Manuel

    2012-12-24

    We review recent results from extensive simulations of the crystallization of athermal polymer packings. It is shown that above a certain packing density, and for sufficiently long simulations, all random assemblies of freely-jointed chains of tangent hard spheres of uniform size show a spontaneous transition into a crystalline phase. These polymer crystals adopt predominantly random hexagonal close packed morphologies. An analysis of the local environment around monomers based on the shape and size of the Voronoi polyhedra clearly shows that Voronoi cells become more spherical and more symmetric as the system transits to the ordered state. The change in the local environment leads to an increase in the monomer translational contribution to the entropy of the system, which acts as the driving force for the phase transition. A comparison of the crystallization of hard-sphere polymers and monomers highlights similarities and differences resulting from the constraints imposed by chain connectivity.

  16. Spontaneous Crystallization in Athermal Polymer Packings

    Directory of Open Access Journals (Sweden)

    Nikos Ch. Karayiannis

    2012-12-01

    Full Text Available We review recent results from extensive simulations of the crystallization of athermal polymer packings. It is shown that above a certain packing density, and for sufficiently long simulations, all random assemblies of freely-jointed chains of tangent hard spheres of uniform size show a spontaneous transition into a crystalline phase. These polymer crystals adopt predominantly random hexagonal close packed morphologies. An analysis of the local environment around monomers based on the shape and size of the Voronoi polyhedra clearly shows that Voronoi cells become more spherical and more symmetric as the system transits to the ordered state. The change in the local environment leads to an increase in the monomer translational contribution to the entropy of the system, which acts as the driving force for the phase transition. A comparison of the crystallization of hard-sphere polymers and monomers highlights similarities and differences resulting from the constraints imposed by chain connectivity.

  17. Constrained gauge fields from spontaneous Lorentz violation

    DEFF Research Database (Denmark)

    Chkareuli, J. L.; Froggatt, C. D.; Jejelava, J. G.

    2008-01-01

    Spontaneous Lorentz violation realized through a nonlinear vector field constraint of the type AµAµ=M2 (M is the proposed scale for Lorentz violation) is shown to generate massless vector Goldstone bosons, gauging the starting global internal symmetries in arbitrary relativistically invariant...... theories. The gauge invariance appears in essence as a necessary condition for these bosons not to be superfluously restricted in degrees of freedom, apart from the constraint due to which the true vacuum in a theory is chosen by the Lorentz violation. In the Abelian symmetry case the only possible theory...... proves to be QED with a massless vector Goldstone boson naturally associated with the photon, while the non-Abelian symmetry case results in a conventional Yang-Mills theory. These theories, both Abelian and non-Abelian, look essentially nonlinear and contain particular Lorentz (and CPT) violating...

  18. Spontaneous regression of herniated lumbar discs.

    Science.gov (United States)

    Kim, Eric S; Oladunjoye, Azeem O; Li, Jay A; Kim, Kee D

    2014-06-01

    The spontaneous regression of a lumbar herniated disc is a common occurrence. Studies using imaging techniques as well as immunohistologic analyses have attempted to explain the mechanism for regression. However, the exact mechanism remains elusive. Understanding the process by which herniated discs disappear in the absence of surgery may better guide treatment. Recent case reports, radiographic and immunohistologic studies show that the extent of extrusion of the nucleus pulposus is related to a higher likelihood of regression. To our knowledge, Patient 3 is the first report of spontaneous regression occurring within 2 months. This occurrence was discovered intraoperatively. We present three illustrative patients. Patient 1, a 53-year-old man, presented with a large L2-L3 disc herniation. His 2 year follow-up MRI revealed a complete regression of the extruded fragment. Patient 2, a 58-year-old man, presented with an L3-L4 disc herniation with cephalad migration of a free fragment. MRI 9 months later showed no free fragment but progression of a disc bulge. Intraoperative exploration during the L3-L4 microdiscectomy confirmed the absence of the free fragment. Patient 3, a 58-year-old woman, presented with a large L2-L3 disc extrusion with cephalad migration. An imaging study performed 2 months after the initial study revealed an absence of the free fragment. Our case reports demonstrate the temporal variance in disc regression. While the time course and extent of regression vary widely, the rapid time in which regression can occur should caution surgeons contemplating discectomy based on an MRI performed a significant period prior to surgery. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Spontaneous activity in peripheral diaphragmatic lymphatic loops.

    Science.gov (United States)

    Moriondo, Andrea; Solari, Eleonora; Marcozzi, Cristiana; Negrini, Daniela

    2013-10-01

    The spontaneous contractility of FITC-dextran-filled lymphatics at the periphery of the pleural diaphragm was documented for the first time "in vivo" in anesthetized Wistar rats. We found that lymphatic segments could be divided into four phenotypes: 1) active, displaying rhythmic spontaneous contractions (51.8% of 197 analyzed sites); 2) stretch-activated, whose contraction was triggered by passive distension of the vessel lumen (4.1%); 3) passive, which displayed a completely passive distension (4.5%); and 4) inert, whose diameter never changed over time (39.6%). Smooth muscle actin was detected by immunofluorescence and confocal microscopy in the vessel walls of active but also of inert sites, albeit with a very different structure within the vessel wall. Indeed, while in active segments, actin was arranged in a dense mesh completely surrounding the lumen, in inert segments actin decorated the vessels wall in sparse longitudinal strips. When located nearby along the same lymphatic loop, active, stretch-activated, and passive sites were always recruited in temporal sequence starting from the active contraction. The time delay was ∼0.35 s between active and stretch-activated and 0.54 s between stretch-activated and passive segments, promoting a uniform lymph flux of ∼150/200 pl/min. We conclude that, unlike more central diaphragmatic lymphatic vessels, loops located at the extreme diaphragmatic periphery do require an intrinsic pumping mechanism to propel lymph centripetally, and that such an active lymph propulsion is attained by means of a complex interplay among sites whose properties differ but are indeed able to organize lymph flux in an ordered fashion.

  20. Spontaneous Resolution of Optic Disc Pit Maculopathy

    Directory of Open Access Journals (Sweden)

    Koushik Tripathy

    2017-06-01

    Full Text Available I read with interest the article reporting spontaneous resolution of optic disc pit maculopathy in a boy.1 Though the presence of an optic disc pit and associated macular involvement is undoubted in the presented case, the provided optical coherence tomography (OCT does not clearly show typical intraretinal schisis (Figure 1B1 at multiple retinal levels which may communicate with the pit. Instead, it shows a sub-internal limiting membrane (sub-ILM cavity. Such cavities are known to occur following the resolution of sub-ILM bleed due to various cause including Valsalva retinopathy,2 Terson syndrome, and also in some retinitis3 cases.4 In fact, some of these cavities may simulate a neurosensory retinal detachment or central serous chorioretinopathy on cursory clinical examination.5 To confirm that the features of the current patient1 are indeed related to the optic disc pit, it is necessary for the authors to provide an OCT scan which shows a connection of the presented cavity with the optic disc pit. Also, clear OCT scans of the fovea, both at presentation and at final follow-up would help our understanding of the visual recovery of the patient. The interval between the presenting (28 June 2012 OCT and final OCT (30 Nov 2012 is 5 months and not 6 months as described in the manuscript. For an effective comparison, both the presenting and final OCT scans should have been taken using either horizontal or vertical orientation over the macula. Though the spontaneous resolution of optic disc pit maculopathy is possible, visual recovery in usually unlikely and in such cases an alternate diagnosis needs to be excluded.