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

Institute of Scientific and Technical Information of China (English)

Hongyi Cui

2011-01-01

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

Pubic apophysitis

DEFF Research Database (Denmark)

Sailly, Matthieu; Whiteley, Rod; Read, John W

2015-01-01

football players (15.6 years ± 1.3) who complained of adductor-related groin pain were reviewed. The imaging features (X-ray 26/26, US 9/26, MRI 11/26, CT 7/26) of the pubic apophyses in this symptomatic group were compared against those of a comparison group of 31 male patients (age range 9-30 years......) with no known history of groin pain or pelvic trauma, who underwent pelvic CT scans for unrelated medical reasons. RESULTS: All symptomatic subjects presented with similar history and physical findings. The CT scans of these patients demonstrated open pubic apophyses with stress-related physeal changes...

Cost assessment of instruments for single-incision laparoscopic cholecystectomy

DEFF Research Database (Denmark)

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

2012-01-01

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

Single-incision laparoscopic bariatric surgery

Directory of Open Access Journals (Sweden)

Huang Chih-Kun

2011-01-01

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

SUPRA SOFT SEPARATION AXIOMS AND SUPRA IRRESOLUTENESS BASED ON SUPRA B-SOFT SETS

OpenAIRE

Abd El-latif, Alaa Mohamed; Hosny, Rodyna Ahmed

2016-01-01

This paper introduces supra soft b-separation axioms based on the supra b-open soft sets which are more general than supra open soft sets. We investigate the relationships between these supra soft separation axioms. Furthermore, with the help of examples it is established that the converse does not hold. We show that, a supra soft topological space (X; t;E) is supra soft b-T1-space, if xE is supra b-closed soft set in for each x 2 X. Also, we prove that xE is supra b-closed soft set for each ...

Single-incision laparoscopic surgery through an ostomy site: a natural approach by an unnatural orifice.

Science.gov (United States)

Lopez, Nicole E; Peterson, Carrie Y; Ramamoorthy, Sonia L; McLemore, Elisabeth C; Sedrak, Michael F; Lowy, Andrew M; Horgan, Santiago; Talamini, Mark A; Sicklick, Jason K

2015-02-01

Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.

Pubic "Crab" Lice Prevention and Control

Science.gov (United States)

... and General Public. Contact Us Parasites Home Prevention & Control Recommend on Facebook Tweet Share Compartir Pubic ("crab") ... that can be taken to help prevent and control the spread of pubic ("crab") lice: All sexual ...

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

Science.gov (United States)

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

2017-04-01

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

Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

Directory of Open Access Journals (Sweden)

Aram Baram

2014-02-01

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

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

Directory of Open Access Journals (Sweden)

Noah J. Switzer

2012-01-01

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

Outcomes of single-stage total arch replacement via clamshell incision

Directory of Open Access Journals (Sweden)

Ishizaka Toru

2011-09-01

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

Solo Single-Incision Laparoscopic Resectional Roux-en-Y Gastric Bypass for Morbid Obesity with Metabolic Syndrome.

Science.gov (United States)

Kang, So Hyun; Lee, Yoontaek; Park, Young Suk; Ahn, Sang-Hoon; Park, Do Joong; Kim, Hyung-Ho

2017-12-01

With the advancement of laparoscopic devices and surgical technology, the era of minimal invasive surgery has progressed to reduced-port surgery, and finally to single-incision laparoscopic surgery (SILS). Several reports show successful application of SILS to various types of bariatric surgery. Oftentimes, this requires a skilled and experienced scopist to perform the procedure. To overcome the technical difficulties of single-incision Roux-en-Y gastric bypass, a manual scope holder was used instead of an assistant scopist, greatly stabilizing the field of view. This allows the surgery to be performed at any time without being influenced by the need of a highly experienced scopist. In this report, we describe in detail the world's first solo single-incision laparoscopic resectional Roux-en-Y gastric bypass.

Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision.

Science.gov (United States)

Lee, Yung Ki; Lee, Jun Hee; Kang, Sang Yoon

2018-04-01

Gynecomastia is characterized by the benign proliferation of breast tissue in men. Herein, we present a new method for the treatment of gynecomastia, using ultrasound-assisted liposuction with both conventional and reverse-cutting edge tip cannulas in combination with a pull-through lipectomy technique with pituitary forceps through a single transaxillary incision. Thirty patients were treated with this technique at the author's institution from January 2010 to January 2015. Ten patients were treated with conventional surgical excision of the glandular/fibrous breast tissue combined with liposuction through a periareolar incision before January 2010. Medical records, clinical photographs and linear analog scale scores were analyzed to compare the surgical results and complications. The patients were required to rate their cosmetic outcomes based on the linear analog scale with which they rated their own surgical results; the mean overall average score indicated a good or high level of satisfaction. There were no incidences of skin necrosis, hematoma, infection and scar contracture; however, one case each of seroma and nipple inversion did occur. Operative time was reduced overall using the new technique since it is relatively simple and straightforward. According to the evaluation by the four independent researchers, the patients treated with this new technique showed statistically significant improvements in scar and nipple-areolar complex (NAC) deformity compared to those who were treated using the conventional method. Glandular liposculpture through a single transaxillary incision is an efficient and safe technique that can provide aesthetically satisfying and consistent results.

On Supra-Additive and Supra-Multiplicative Maps

OpenAIRE

Jin Xi Chen; Zi Li Chen

2013-01-01

Let A and B be ordered algebras over ℝ, where A has a generating positive cone and B satisfies the property that b2>0 if 0≠b∈B. We give some conditions for a map T:A→B which is supra-additive and supra-multiplicative for all positive and negative elements to be linear and multiplicative; that is, T is a homomorphism of algebras. Our results generalize some known results on supra-additive and supra-multiplicative maps between spaces of real functions.

Pubic insufficiency fracture: MRI findings

International Nuclear Information System (INIS)

Min, Tae Kyu; Lee, Yeon Soo; Park, Jeong Mi; Kim, Jee Young; Chung, Hong Jun; Lee, Eun Hee; Lee, Eun Ja; Kang, So Won; Han Tae Il

2000-01-01

To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium

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

Science.gov (United States)

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

2015-01-01

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

Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

Science.gov (United States)

Galvez, Carlos; Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

2016-08-01

Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy.

Single perineal incision placement of artificial urinary sphincter with cadaveric correlation of sub-dartos pump placement

Directory of Open Access Journals (Sweden)

Cooper R. Benson

Full Text Available ABSTRACT Purpose We present a novel AUS implantation technique using a single perineal incision for single device placement or in combination with an inflatable penile prosthesis (IPP. Urinary and sexual dysfunction following the management of prostate cancer has a significant impact on the quality of life of our patients. While there are marginal changes in the prosthetic devices, we strive to reduce post-operative morbidity while maximizing efficacy. Materials and Methods We retrospectively reviewed the outcomes of 6 patients who underwent single perineal incision placement of a virgin AUS in 2014, 3 with simultaneous IPP placement. In all cases, the pressure regulating balloons (PRB were placed in a high sub-muscular ectopic position and the pumps were placed into a sub-dartos pouch through the perineal incision, which was also validated using a cadaveric model. Results The mean patient age was 61 (SD, 7.5 years with mean body mass index of 31 (SD, 5.9. The average pre-operative pad usage was 7.7 (SD 1.63 pads per day. The mean follow-up was 13.9 months (SD 9.45. Four out of the six patients reported utilizing ≤1 pad daily at follow-up. The one patient who was not initially dry required downsizing of his cuff to 3.5cm; the remaining patient was lost to follow-up. There were no identifiable perioperative or post-operative complications. Conclusions We present our initial report of using a single perineal incision for AUS implantation with a validated sub-dartos pump location, which is safe and effective for implantation of an AUS as a single or double implantation in well-selected patients.

Long-term pubic dermatitis diagnosed as white piedra.

Science.gov (United States)

Landero, James

2017-12-01

The case of a 58-year-old man with a pruritic rash involving the pubic area that had been undiagnosed for 30 years is presented. At least 15 different primary care physicians and dermatologists evaluated the patient during this time period. Multiple treatments were unsuccessful and a definitive diagnosis was not rendered. Wood lamp evaluation of the pubic area revealed hair shaft concretions that were confirmed on histologic evaluation to be white piedra (WP). The patient was successfully treated with topical ketoconazole and the eruption completely resolved. Our case raises awareness of the use of Wood lamp and dermoscopy to evaluate for parasitic infections of the pubic hair shafts when nonspecific dermatitis presents in this area.

LSD in pubic hair in a fatality.

Science.gov (United States)

Gaulier, Jean-michel; Maublanc, Julie; Lamballais, Florence; Bargel, Sophie; Lachâtre, Gérard

2012-05-10

Lysergic acid diethylamide (LSD) is a potent hallucinogen, active at very low dosage and its determination in body fluids in a forensic context may present some difficulties, even more so in hair. A dedicated liquid chromatography-electrospray-tandem mass spectrometry (LC-ES-MS/MS) assay in hair was used to document the case of a 24-year-old man found dead after a party. Briefly, after a decontamination step, a 50mg sample of the victim's pubic hair was cut into small pieces (LSD. A LSD concentration of 0.66pg/mg of pubic hair was observed. However, this result remains difficult to interpret owing to the concomitant LSD presence in the victim's post mortem blood and urine, the lack of previously reported LSD concentrations in hair, and the absence of data about LSD incorporation and stability in pubic hair. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Risk factors for an additional port in single-incision laparoscopic cholecystectomy in patients with cholecystitis.

Science.gov (United States)

Araki, Kenichiro; Shirabe, Ken; Watanabe, Akira; Kubo, Norio; Sasaki, Shigeru; Suzuki, Hideki; Asao, Takayuki; Kuwano, Hiroyuki

2017-01-01

Although single-incision laparoscopic cholecystectomy is now widely performed in patients with cholecystitis, some cases require an additional port to complete the procedure. In this study, we focused on risk factor of additional port in this surgery. We performed single-incision cholecystectomy in 75 patients with acute cholecystitis or after cholecystitis between 2010 and 2014 at Gunma University Hospital. Surgical indications followed the TG13 guidelines. Our standard procedure for single-incision cholecystectomy routinely uses two needlescopic devices. We used logistic regression analysis to identify the risk factors associated with use of an additional full-size port (5 or 10 mm). Surgical outcome was acceptable without biliary injury. Nine patients (12.0%) required an additional port, and one patient (1.3%) required conversion to open cholecystectomy because of severe adhesions around the cystic duct and common bile duct. In multivariate analysis, high C-reactive protein (CRP) values (>7.0 mg/dl) during cholecystitis attacks were significantly correlated with the need for an additional port (P = 0.009), with a sensitivity of 55.6%, specificity of 98.5%, and accuracy of 93.3%. This study indicated that the severe inflammation indicated by high CRP values during cholecystitis attacks predicts the need for an additional port. J. Med. Invest. 64: 245-249, August, 2017.

Single-incision laparoscopic cecectomy for low-grade appendiceal mucinous neoplasm after laparoscopic rectectomy

Science.gov (United States)

Fujino, Shiki; Miyoshi, Norikatsu; Noura, Shingo; Shingai, Tatsushi; Tomita, Yasuhiko; Ohue, Masayuki; Yano, Masahiko

2014-01-01

In this case report, we discuss single-incision laparoscopic cecectomy for low-grade appendiceal neoplasm after laparoscopic anterior resection for rectal cancer. The optimal surgical therapy for low-grade appendiceal neoplasm is controversial; currently, the options include appendectomy, cecectomy, right hemicolectomy, and open or laparoscopic surgery. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We have encountered 5 cases of low-grade appendiceal neoplasm and all 5 patients had no lymph node metastasis. We chose the appendectomy or cecectomy without lymph node dissection if preoperative imaging studies did not suspect malignancy. In the present case, we performed cecectomy without lymph node dissection by single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms. PMID:24868331

Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis.

Science.gov (United States)

Matsuda, Dean K; Sehgal, Bantoo; Matsuda, Nicole A

2015-06-01

Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments. Endoscopic pubic symphysectomy is a minimally invasive bone-conserving surgery that retains stability and may be useful in the treatment of recalcitrant osteitis pubis or osteoarthritis. It nicely complements arthroscopic surgery for femoroacetabular impingement and may find broader application in this group of co-affected athletes.

64-year-old male with septic arthritis of the pubic symphysis

Directory of Open Access Journals (Sweden)

Mark Lee

2011-09-01

Full Text Available Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.

64-year-old male with septic arthritis of the pubic symphysis

Directory of Open Access Journals (Sweden)

Ewa Konik

2011-10-01

Full Text Available Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.

Intuitionistic supra fuzzy topological spaces

International Nuclear Information System (INIS)

Abbas, S.E.

2004-01-01

In this paper, We introduce an intuitionistic supra fuzzy closure space and investigate the relationship between intuitionistic supra fuzzy topological spaces and intuitionistic supra fuzzy closure spaces. Moreover, we can obtain intuitionistic supra fuzzy topological space induced by an intuitionistic fuzzy bitopological space. We study the relationship between intuitionistic supra fuzzy closure space and the intuitionistic supra fuzzy topological space induced by an intuitionistic fuzzy bitopological space

AGE DETERMINATION FROM PUBIC SYMPHYSEAL CHANGES- AN AUTOPSY STUDY

Directory of Open Access Journals (Sweden)

Jinesh Parambathettu Sasidharan

2017-02-01

Full Text Available BACKGROUND Biological identity is one of the first things to be established when analysing skeletal, badly decomposed or otherwise unidentified human remains. The determination of age at death is an important component of identity establishment. Pubic symphysis examination is one of the reliable methods of age estimation. We attempt to determine the age of deceased from pubic symphysis using Suchey-Brooks method and to find the accuracy of Suchey-Brooks method in our population. From among the cases brought for autopsy at Department of Forensic Medicine, Government Medical College, Kottayam, Kerala, from 01/03/2012 to 28/02/2013, 316 cases were included in the study. Their pubic symphysis were harvested. Age determined using SucheyBrooks method and compared with their chronological age. The aim of the study is to- 1. Determine the age of deceased from pubic symphysis using Suchey-Brooks method. 2. Compare the age determined by Suchey-Brooks method and chronological age and find the accuracy of Suchey-Brooks method in our population. MATERIALS AND METHODS Study Design- Descriptive study- Cross-sectional study, Centre of Study- Department of Forensic Medicine, Government Medical College, Kottayam, Study Sample- From the cases brought for medicolegal postmortem examination in the Department of Forensic Medicine, Government Medical College, Kottayam, Kerala, a sample of 316 cases were selected. To make the distribution among various age groups, even the total sample divided for the age group, which resulted in having 60 samples per age group. Age groups were considered as Group 1- Age between 18-25 years; Group 2- Age between 25-35 years; Group 3- Age between 35-45 years; Group 4- Age between 45-55 years; Group 5- Age between 55-65 years. Inclusion Criteria- 1. Cases with known age; 2. Cases whose age between 18 and 65 years. Exclusion Criteria- 1. Unknown cases; 2. Known cases with doubtful age; 3. Individuals having pubic bone trauma involving the

Effects of pelvic rotation and needle angle on pubic arch interference during transperineal prostate implants

International Nuclear Information System (INIS)

Tincher, Sandra A.; Kim, Robert Y.; Ezekiel, Mark P.; Zinsli, Tom; Fiveash, John B.; Raben, David A.; Bueschen, Anton J.; Urban, Donald A.

2000-01-01

Purpose: Pubic arch interference due to an enlarged prostate gland or a narrow pubic arch is often a limiting factor in adequate prostate coverage during transperineal brachytherapy. The purpose of this study was to evaluate the effects of both pelvic rotation and needle angles on pubic arch interference using CT-based 3-D information. Methods and Materials: Seven patients had CT imaging in both supine and lithotomy positions and 3-D treatment planning was performed with three needle angles (20 downward, 0, 20 upward). The pubic arch interference was then measured and comparisons were made for each needle trajectory and pelvic position. Results: Increasing pelvic rotation from supine to lithotomy position shows less pubic arch interference. Directing the needle tip upward shows less pubic arch interference in both supine and lithotomy positions when compared to needle tips directed downward. Conclusions: Both pelvic position and needle angles are important factors influencing pubic arch interference. Preplanning CT-based 3-D information may assist for individualized treatment planning in patients with a significant bony interference, thus avoiding pubic arch interference during implantation

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

Science.gov (United States)

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

2001-11-01

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

Post-traumatic Perineal Pubic Rami Protrusion: A Simple Surgical Management

Directory of Open Access Journals (Sweden)

Voon Victor

2014-06-01

Full Text Available Although pubic ramus fractures are common, they usually heal without surgical intervention and result in little long-term disability. We herein present two cases of symptomatic malunion of pubic rami fracture, which was successfully treated with a simple and safe surgical technique. The patients' local symptoms resolved afterwards.

Black piedra of the pubic hairs - a sexually transmitted disease ?

Directory of Open Access Journals (Sweden)

Pavithran K

1990-01-01

Full Text Available Block piedra affecting only the hairs of the pubic region is reported in a recently married young male. His wife was found to have similar disease on the hairs of the scalp and pubic region. A sexual mode of transmission of the disease to the patient from his wife is suggested.

Novel technique and simple approach for supra-alar region and supra-alar crease correction by supra-alar cinching.

Science.gov (United States)

Selvaraj, Loganathan

2016-01-01

This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach.

Novel technique and simple approach for supra-alar region and supra-alar crease correction by supra-alar cinching

OpenAIRE

Selvaraj, Loganathan

2016-01-01

This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach.

A feasibility of single-incision laparoscopic percutaneous extraperitoneal closure for treatment of incarcerated inguinal hernia in children: our preliminary outcome and review of the literature.

Science.gov (United States)

Murase, Naruhiko; Uchida, Hiroo; Seki, Takashi; Hiramatsu, Kiyoshi

2016-02-01

The purpose of this study is to examine the feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (LPEC) for incarcerated inguinal hernia (IIH) repair. 6 single-incision LPEC procedures were performed for IIH repair and 60 procedures were performed for reducible inguinal hernia (RIH) in the same period of time in one hospital. The laparoscope and one pair of grasping forceps were placed through the same umbilical incision. In IIH repair, the herniated organ was gently pulled using the grasping forceps with external manual pressure. If it was difficult to reduce the herniated organ with one pair of forceps, another pair of forceps were inserted through a multi-channel port without extending the umbilical incidion. Using the LPEC needle, the hernia orifice was closed extraperitoneally. We performed a retrospective analysis to compare the outcomes of single-incision LPEC for IIH repair or reducible inguinal hernia. All procedures were completed by single-incision without open conversion. A multi-channel port with another pair of forceps was needed in three cases. The operation time and the length of stay were significantly longer with IIH repair than with RIH repair. There were no major complications and there was no evidence of early recurrence in any patient. In conclusion, single-incision LPEC with a multi-channel port is feasible and safe for IIH repair.

A Novel Supra-Brow Combined with Infra-Brow Lift Approach for Asian Women.

Science.gov (United States)

Shu, Maoguo; He, Lin; Su, Yingjun; Shi, Junli; Zhang, Xi; Liu, Xiangyu; Yu, Xueyuan

2016-06-01

Direct brow lift surgery remains popular among Asian women despite its disadvantages. The traditional direct brow lift by a supra-brow incision is not suitable for Asian women because of their unique facial features, such as higher eyebrows, wider upper eyelids, and more orbital fat. Therefore, we designed a novel brow lift technique via a supra-brow combined with an infra-brow approach for Asian women. An area of skin above and below the eyebrow was measured, demarcated, and surgically removed. The redundant orbicularis oculi muscle (OOM) was excised while keeping the frontalis muscle intact. The OOM in the inferior flap was elevated and sutured to the frontalis muscle. In cases of puffy eyelids, orbital fat was partially removed through an infra-brow incision. Finally, a series of modifications were performed to reduce post-operative scarring. A total of 496 patients underwent this surgery from July 2009 to December 2013 and 432 patients were followed up for at least 6 months after surgery. Post-operative scars, in most patients (428/432), were inconspicuous. There were no facial nerve injuries documented and eight patients reported transient forehead numbness. The height of the palpebral fissure was increased but there was no marked increase observed of the distance between the upper eyelid edge and the eyebrow. In follow-up visits, 409 out of 432 patients (94.7 %) were satisfied with their surgical results. This new brow lift technique via a supra-brow combined with an infra-brow approach provided a simple and safe surgical repair of lateral brow ptosis, upper eyelids hooding, and crows' feet in Asian women. The surgical outcomes were predictable and the scars were inconspicuous. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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

Science.gov (United States)

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

2016-08-01

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

Five years' experience of transverse groin incision for femoral artery access in arterial reconstructive surgery: parallel observational longitudinal group comparison study.

LENUS (Irish Health Repository)

Beirne, Christopher

2008-07-01

Vertical groin incisions (VGIs) have been used to access femoral vessels, but reports allude to wound complications. Our aim was to compare VGI with transverse groin incision (TGI) for femoral artery exposure. Over a 5-year interval, 196 patients with 284 femoral artery exposures for supra- and infrainguinal procedures were studied. Primary endpoints were surgical skin site wound infection, seroma, haematoma formation, and major lower limb amputation. Secondary endpoints were graft patency, wound paresthesias, and length of hospital stay. There were 160 TGIs and 124 VGIs. The demographics and risk factor profile were not statistically different between groups. Seroma developed in 4.4% of TGIs and 13.7% of VGIs (p= .005). The complicated skin and soft tissue infection rate was five times greater with VGI (p= .001). The VGI group had a significantly higher rate of major amputation (p= .0005). Significantly higher graft failure rates were observed in the VGI group (p= .011). No paresthesia was reported in any TGI wound. The mean hospital stay was also significantly shorter in the TGI group (p= .006). The study data support and expound on the theory that an alternative incision to VGI offers lower short- and long-term morbidity. Our findings sustain the selection of the TGI in femoral artery surgery for both supra- and infrainguinal procedures without compromise of vessel exposure.

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2013-06-01

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

Supra-transumbilical laparotomy (STL approach for small bowel atresia repair: Our experience and review of the literature

Directory of Open Access Journals (Sweden)

Ernesto Leva

2013-01-01

Full Text Available Background: Supra-Transumbilical Laparotomy (STL has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. Patients and Methods: Fourteen patients with small bowel atresia were treated via STL approach at our Institution over a 5-year period and their charts were retrospectively reviewed. Results: STL procedure was performed at mean age of 3.1 day. No malrotation disorders were detected with pre-operative contrast enema. Eight patients (54.1% presented jejunal atresia, five (35.7% ileal atresia, and one (7.1% multiple ileal and jejunal atresias. Standard repair with primary end-to-back anastomosis was performed in all but one patient. In the newborn with multiple atresia, STL incision was converted in supra-umbilical transverse incision due to difficulty of exposition. After surgery, one patient developed anastomotic stricture, and another developed occlusion due to adhesions: Both infants required second laparotomy. No infections of the umbilical site were recorded, and cosmetic results were excellent in all patients. Conclusions: Increasing evidence suggests that STL approach for small bowel atresia is feasible, safe and provides adequate exposure for small bowel atresia surgery. When malrotation and colonic/multiple atresia are pre-operatively ruled out, STL procedure can be choosen as first approach.

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

Directory of Open Access Journals (Sweden)

Praveenraj Palanivelu

2015-01-01

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

On Bitopological Supra B-Open Sets

OpenAIRE

M.Lellis Thivagar; B.Meera Devi

2012-01-01

In this paper, we introduce and investigate a new class of sets and maps be- tween bitopological spaces called supra(1,2) b-open, and supra (1,2) b-continuous maps, respectively. Furthermore, we introduce the concepts of supra(1,2) locally-closed, supra(1,2) locally b-closed sets. We also introduce supra(1,2) extremely disconnected. Finally, additional properties of these sets are investigated.

Tore Supra

International Nuclear Information System (INIS)

Supra, E.T.

1989-01-01

Tore Supra is a tokamak implemented on the site of CEN Cadarache by the EURATOM-CEA Association. The machine technology integrates all problems related to the fabrication and the operation of large cyrogenic superconducting coils and of the associated cryogenic system. Tore Supra will provide a significant experience to prepare the next generation of machines for controlled design. Tore Supra has been designed to implement a lage physics program that takes advantage of the capability of operation with plasma pulses in excess of 30 seconds. Operation started in April, with a toroidal field of 2 teslas. Discharges of 500 kA with a 3 second current flat top were obtained after a few days. Machine parameters will be raised to their nominal values ( B -- 4.5 Teslas and Ip -- 1.7 MA) during summer

Radiographic findings after pubic symphysiotomy: mean time to follow-up of 41.6 years.

LENUS (Irish Health Repository)

Galbraith, John G

2014-01-01

Pubic symphysiotomy is a rarely performed procedure in which the pubic symphysis is divided to facilitate vaginal delivery in cases of obstructed labor. Recently, many obstetricians have shown renewed interest in this procedure. The purpose of this paper is to report the long-term radiographic findings for patients who had undergone pubic symphysiotomy compared with the radiographic appearance of a group of age-matched and parity-matched controls.

On Neutrosophic Semi-Supra Open Set and Neutrosophic Semi-Supra Continuous Functions

OpenAIRE

R. Dhavaseelan; M. Parimala; S. Jafari; F. Smarandache

2017-01-01

In this paper, we introduce and investigate a new class of sets and functions between topological space called neutrosophic semi-supra open set and neutrosophic semi-supra open continuous functions respectively.

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

Science.gov (United States)

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

2015-01-01

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

Laparoscopic completion cholecystectomy and common bile duct exploration for retained gallbladder after single-incision cholecystectomy.

Science.gov (United States)

Kroh, Matthew; Chalikonda, Sricharan; Chand, Bipan; Walsh, R Matthew

2013-01-01

Recent enthusiasm in the surgical community for less invasive surgical approaches has resulted in widespread application of single-incision techniques. This has been most commonly applied in laparoscopic cholecystectomy in general surgery. Cosmesis appears to be improved, but other advantages remain to be seen. Feasibility has been demonstrated, but there is little description in the current literature regarding complications. We report the case of a patient who previously underwent single-incision laparoscopic cholecystectomy for symptomatic gallstone disease. After a brief symptom-free interval, she developed acute pancreatitis. At evaluation, imaging results of ultrasonography and magnetic resonance cholangiopancreatography demonstrated a retained gallbladder with cholelithiasis. The patient was subsequently referred to our hospital, where she underwent further evaluation and surgical intervention. Our patient underwent 4-port laparoscopic remnant cholecystectomy with transcystic common bile duct exploration. Operative exploration demonstrated a large remnant gallbladder and a partially obstructed cystic duct with many stones. Transcystic exploration with balloon extraction resulted in duct clearance. The procedure took 75 minutes, with minimal blood loss. The patient's postoperative course was uneventful. Final pathology results demonstrated a remnant gallbladder with cholelithiasis and cholecystitis. This report is the first in the literature to describe successful laparoscopic remnant cholecystectomy and transcystic common bile duct exploration after previous single-port cholecystectomy. Although inadvertent partial cholecystectomy is not unique to this technique, single-port laparoscopic procedures may result in different and significant complications.

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

Science.gov (United States)

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

2013-12-01

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

Buried penis: classification surgical approach.

Science.gov (United States)

Hadidi, Ahmed T

2014-02-01

The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.

Pain and Mean Absorbed Dose to the Pubic Bone After Radiotherapy Among Gynecological Cancer Survivors

International Nuclear Information System (INIS)

Waldenstroem, Ann-Charlotte; Olsson, Caroline; Wilderaeng, Ulrica; Dunberger, Gail; Lind, Helena; Al-Abany, Massoud; Palm, Asa; Avall-Lundqvist, Elisabeth; Johansson, Karl-Axel; Steineck, Gunnar

2011-01-01

Purpose: To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. Methods and Materials: In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. Results: We analyzed data from 650 survivors (participation rate 79%) with median follow-up of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses <52.5 Gy to the pubic bone and 5/12 (42%) to mean absorbed external beam doses ≥52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increased prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Conclusions: Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer.

Two cases of pyogenic osteomyelitis of pubic bone after irradiation for cervical carcinoma of the uterine

International Nuclear Information System (INIS)

Moriyama, Ichiro; Matsumoto, Morio; Yamauchi, Kenji; Horiuchi, Kiwamu; Morisue, Hikaru; Yamagishi, Masaaki; Tanaka, Mamoru

1999-01-01

Two cases of pyogenic osteomyelitis of pubic bone occurred after irradiation of cervical carcinoma were reported. Case 1: A 69-year-old female received external irradiation of 50 Gy from November 1993 to April 1994 after supravaginal uterine amputation. The left melosalgia and pain at left pubic region appeared from July 1994. On the MRI, bone marrow of the left pubic region showed low brightness by T1 weighted image and equal brightness by T2 weighted image, and the image was enhanced by gadolinium. An abscess in external obturator muscle was suspected. High accumulation was recognized by bone scintigram at the left pubic region. No bacterial infection was recognized. Focus was removed in May 1995. Case 2: A 80-year-old female received external irradiation of 50 Gy and intracavitary irradiation of 30 Gy in May 1992. Pain at left pubic region appeared from June 1993. Dilation of pubic symphysis and osteoclasia of the left pubic bone were detected on the plain radiograph in March 1995. On the MRI, the left pubic bone marrow showed low brightness by T1 weighted image and equal brightness by T2 weighted image, and image was enhanced by gadolinium. An abscess in small pelvic cavity was suspected. Streptococcus agalactae was detected in abscess, and PIPC was administered by drip infusion for five weeks. They are currently alive and doing well about three years later. (K.H.)

Single incision laparoscopic surgery (SILS) inguinal hernia repair - recent clinical experiences of this novel technique.

Science.gov (United States)

Yussra, Y; Sutton, P A; Kosai, N R; Razman, J; Mishra, R K; Harunarashid, H; Das, S

2013-01-01

Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.

When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study.

Science.gov (United States)

Mcdonald, E; Theologis, A A; Horst, P; Kandemir, U; Pekmezci, M

2015-12-01

This study aimed at evaluating the additional stability that is provided by anterior external and internal fixators in an unstable pelvic fracture model (OTA 61-C). An unstable pelvic fracture (OTA 61-C) was created in 27 synthetic pelves by making a 5-mm gap through the sacral foramina (posterior injury) and an ipsilateral pubic rami fracture (anterior injury). The posterior injury was fixed with either a single iliosacral (IS) screw, a single trans-iliac, trans-sacral (TS) screw, or two iliosacral screws (S1S2). Two anterior fixation techniques were utilized: external fixation (Ex-Fix) and supra-acetabular external fixation and internal fixation (In-Fix); supra-acetabular pedicle screws connected with a single subcutaneous spinal rod. The specimens were tested using a nondestructive single-leg stance model. Peak-to-peak (P2P) displacement and rotation and conditioning displacement (CD) were calculated. The Ex-Fix group failed in 83.3 % of specimens with concomitant single-level posterior fixation (Total: 15/18-7 of 9 IS fixation, 8 of 9 TS fixation), and 0 % (0/9) of specimens with concomitant two-level (S1S2) posterior fixation. All specimens with the In-Fix survived testing except for two specimens treated with In-Fix combined with IS fixation. Trans-sacral fixation had higher pubic rotation and greater sacral and pubic displacement than S1S2 (p < 0.05). Rotation of the pubis and sacrum was not different between In-Fix constructs combined with single-level IS and TS fixation. In this model of an unstable pelvic fracture (OTA 61-C), anterior fixation with an In-Fix was biomechanically superior to an anterior Ex-Fix in the setting of single-level posterior fixation. There was no biomechanical difference between the In-Fix and Ex-Fix when each was combined with two levels of posterior sacral fixation.

Patient-specific surgical simulator for the pre-operative planning of single-incision laparoscopic surgery with bimanual robots.

Science.gov (United States)

Turini, Giuseppe; Moglia, Andrea; Ferrari, Vincenzo; Ferrari, Mauro; Mosca, Franco

2012-01-01

The trend of surgical robotics is to follow the evolution of laparoscopy, which is now moving towards single-incision laparoscopic surgery. The main drawback of this approach is the limited maneuverability of the surgical tools. Promising solutions to improve the surgeon's dexterity are based on bimanual robots. However, since both robot arms are completely inserted into the patient's body, issues related to possible unwanted collisions with structures adjacent to the target organ may arise. This paper presents a simulator based on patient-specific data for the positioning and workspace evaluation of bimanual surgical robots in the pre-operative planning of single-incision laparoscopic surgery. The simulator, designed for the pre-operative planning of robotic laparoscopic interventions, was tested by five expert surgeons who evaluated its main functionalities and provided an overall rating for the system. The proposed system demonstrated good performance and usability, and was designed to integrate both present and future bimanual surgical robots.

A randomized, nonblinded extension study of single-incision versus transobturator midurethral sling in women with stress urinary incontinence

NARCIS (Netherlands)

Schellart, René P.; Zwolsman, Sandra E.; Lucot, Jean-Philippe; de Ridder, Dirk J. M. K.; Dijkgraaf, Marcel G. W.; Roovers, Jan-Paul W. R.

2018-01-01

Midurethral sling procedures are the first surgical option in women undergoing surgery for stress urinary incontinence (SUI). Single-incision midurethral-slings (SIMS) were designed to provide similar efficacy to traditional midurethral slings but with reduced morbidity. In this international trial

Single incision laparoscopic liver resection (SILL – a systematic review

Directory of Open Access Journals (Sweden)

Benzing, Christian

2015-12-01

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

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

Science.gov (United States)

Case, J Brad; Ellison, Gary

2013-06-01

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

Pain and mean absorbed dose to the pubic bone after radiotherapy among gynecological cancer survivors.

Science.gov (United States)

Waldenström, Ann-Charlotte; Olsson, Caroline; Wilderäng, Ulrica; Dunberger, Gail; Lind, Helena; al-Abany, Massoud; Palm, Åsa; Avall-Lundqvist, Elisabeth; Johansson, Karl-Axel; Steineck, Gunnar

2011-07-15

To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. We analyzed data from 650 survivors (participation rate 79%) with median follow-up of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses beam doses ≥ 52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increased prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

On Some Maps in Supra Topological Ordered Spaces

OpenAIRE

Al-shami, Tareq Mohammed

2018-01-01

In [6] the notion of supra semi open sets was presented and some of its properties were discussed. In this study, we introduce and investigate four main concepts namely supra continuous (supra open, supra closed, supra homeomorphism) maps via supra topological ordered spaces. Our findings in this work generalize some previous results in ([1], [13]). Many examples are considered to show the concepts introduced and main results obtained herein.

The pyramidalis-anterior pubic ligament-adductor longus complex (PLAC) and its role with adductor injuries

DEFF Research Database (Denmark)

Schilders, Ernest; Bharam, Srino; Golan, Elan

2017-01-01

cadavers. The dimensions of the pyramidalis muscle were measured and anatomical connections with adductor longus, rectus abdominis and aponeuroses examined. RESULTS: The pyramidalis is the only abdominal muscle anterior to the pubic bone and was found bilaterally in all specimens. It arises from the pubic...... is to systematically investigate the pyramidalis muscle and its anatomical connections with adductor longus and rectus abdominis, to elucidate injury patterns occurring with adductor avulsions. METHODS: A layered dissection of the soft tissues of the anterior symphyseal area was performed on seven fresh-frozen male...... the pyramidalis muscle and adductor longus tendon via the anterior pubic ligament, and it introduces the new anatomical concept of the pyramidalis-anterior pubic ligament-adductor longus complex (PLAC). Knowledge of these anatomical relationships should be employed to aid in image interpretation and treatment...

Tore Supra: technical description

International Nuclear Information System (INIS)

1985-08-01

This report is aimed, after a brief recall of physics and technologic perspectives of Tore Supra, at giving a detailed description of the basic machine; details of each component are defined. Volume 1 is specifically concerned with the general aspects of Tore Supra and the toroidal field system [fr

A comparison of single-suture and double-suture incision closures in seaward-migrating juvenile Chinook salmon implanted with acoustic transmitters: implications for research in river basins containing hydropower structures

Energy Technology Data Exchange (ETDEWEB)

Brown, Richard S.; Deters, Katherine A.; Cook, Katrina V.; Eppard, M. B.

2013-07-15

Reductions in the size of acoustic transmitters implanted in migrating juvenile salmonids have resulted in the ability to make shorter incisions that may warrant using only a single suture for closure. However, it is not known if one suture will sufficiently hold the incision closed, particularly when outward pressure is placed on the surgical site such as when migrating fish experience pressure changes associated with passage at hydroelectric dams. The objective of this research was to evaluate the effectiveness of single-suture incision closures on juvenile Chinook salmon (Oncorhynchus tshawytscha). Juvenile Chinook salmon were surgically implanted with a 2012 Juvenile Salmon Acoustic Telemetry System (JSATS) transmitter (0.30 g) and a passive integrated transponder tag (0.10 g) and incisions were closed with either one suture or two sutures. Mortality and tag retention were monitored and fish were examined after 7 and 14 days to evaluate tissue responses. In a separate experiment, surgically implanted fish were exposed to simulated turbine passage and then examined for expulsion of transmitters, expulsion of viscera through the incision, and mortal injury. With incisions closed using a single suture, there was no mortality or tag loss and similar or reduced tissue reaction compared to incisions closed with two sutures. Further, surgery time was significantly reduced when one suture was used, which leads to less handling and reduced stress. No tags were expelled during pressure scenarios and expulsion of viscera only occurred in two non-mortally injured fish (5%) with single sutures that were also exposed to very high pressure changes. No viscera expulsion was present in fish exposed to pressure scenarios likely representative of hydroturbine passage at many Columbia River dams (e.g. <2.7 ratio of pressure change; an acclimation pressure of 146.2 absolute kpa and a lowest exposure pressure of ~ 53.3 absolute kpa). Based on these results, we recommend the use of a

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

Science.gov (United States)

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

2018-02-01

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

The fourth incision: a cosmetic autopsy incision technique.

Science.gov (United States)

Patowary, Amarjyoti

2010-03-01

Autopsy procedure includes thorough external examination as well as internal examination including opening of all the body cavities for proper visualization of all the visceral organs. As such, there remains incision marks with stitches which harts the sentiment of the already traumatized relatives of the deceased. Moreover, it looks odd especially in cases of otherwise healthy dead bodies. So, autopsy incisions should be such that, we can get maximum possible visualization of the body cavities, particularly the thorax and abdomen, and at the same time the incision as well as the stitch marks are also hidden. This article is aimed to describe few modifications in the autopsy incisions for opening the thorax and abdomen and also proper visualization of the neck structures during autopsy where the incisions and the stitches are kept hidden.

Synostosis Between Pubic Bones due to Neurogenic, Heterotopic Ossification

Directory of Open Access Journals (Sweden)

Subramanian Vaidyanathan

2006-01-01

Full Text Available Neurogenic, heterotopic ossification is characterised by the formation of new, extraosseous (ectopic bone in soft tissue in patients with neurological disorders. A 33-year-old female, who was born with spina bifida, paraplegia, and diastasis of symphysis pubis, had indwelling urethral catheter drainage and was using oxybutynin bladder instillations. She was prescribed diuretic for swelling of feet, which aggravated bypassing of catheter. Hence, suprapubic cystostomy was performed. Despite anticholinergic therapy, there was chronic urine leak around the suprapubic catheter and per urethra. Therefore, the urethra was mobilised and closed. After closure of the urethra, there was no urine leak from the urethra, but urine leak persisted around the suprapubic catheter. Cystogram confirmed the presence of a Foley balloon inside the bladder; there was no urinary fistula. The Foley balloon ruptured frequently, leading to extrusion of the Foley catheter. X-ray of abdomen showed heterotopic bone formation bridging the gap across diastasis of symphysis pubis. CT of pelvis revealed heterotopic bone lying in close proximity to the balloon of the Foley catheter; the sharp edge of heterotopic bone probably acted like a saw and led to frequent rupture of the balloon of the Foley catheter. Unique features of this case are: (1 temporal relationship of heterotopic bone formation to suprapubic cystostomy and chronic urine leak; (2 occurrence of heterotopic ossification in pubic region; (3 complications of heterotopic bone formation viz. frequent rupture of the balloon of the Foley catheter by the irregular margin of heterotopic bone and difficulty in insertion of suprapubic catheter because the heterotopic bone encroached on the suprapubic track; (4 synostosis between pubic bones as a result of heterotopic ossification..Common aetiological factors for neurogenic, heterotopic ossification, such as forceful manipulation, trauma, or spasticity, were absent in this

Clear corneal incision leakage after phacoemulsification--detection using povidone iodine 5%.

Science.gov (United States)

Chee, Soon-Phaik

2005-01-01

The purpose of this work was to study the incidence of clear corneal wound leakage at the conclusion of standard co-axial phacoemulsification in a prospective observational series of 100 consecutive cataract cases in a single surgeon's institutional practice. At the conclusion of standard co-axial phacoemulsification using a 2.75 mm temporal single plane clear corneal incision with a 1 mm clear corneal side-port incision, the wounds were hydrated and checked for water-tightness. Povidone iodine 5% (P-I) was then evenly dripped over the cornea and the wounds were inspected visually. Any leakage of aqueous observed was recorded. The amount of leakage was graded as small or large from each wound. Leaky wounds were further hydrated and retested with P-I until sealed. Wound integrity was reassessed on the first postoperative day by use of fluorescein. Of the 100 cases, wound leakage was observed for 31 eyes (31%)-ten main incisions, nineteen side-port incisions, and both incisions in two cases. Wound leakage was easily detected as a ribbon of clear fluid streaming from the incision amid a pool of brown solution. Povidone iodine was not observed within the tract in any incision. All wound leakage was small except for one from the main incision and two from the side-port incision. None of the eyes developed wound leakage the day after surgery and none developed endophthalmitis. In conclusion, leakage from clear corneal incisions at the conclusion of phacoemulsification occurs in almost a third of cases, predominantly from the side incision. It is easily detected by use of the P-I test.

Intra-operative pubic arch interference during prostate seed brachytherapy in patients with CT-based pubic arch interference of ≤1 cm

International Nuclear Information System (INIS)

Sejpal, Samir V.; Sathiaseelan, Vythialingam; Helenowski, Irene B.; Kozlowski, James M.; Carter, Michael F.; Nadler, Robert B.; Dalton, Daniel P.; McVary, Kevin T.; Lin, William W.; Garnett, John E.; Kalapurakal, John A.

2009-01-01

Purpose: There are only a few reports on the frequency of intra-operative pubic arch interference (I-PAI) during prostate seed brachytherapy (PB). Materials and methods: Two hundred and forty-three patients with a CT-based pubic arch interference (PAI) of ≤1 cm and a prostate volume of ≤50-60 cc underwent PB. Those patients requiring needle repositioning by ≥0.5 cm on the template were scored as having I-PAI. The incidence of I-PAI and its impact on biochemical control were analyzed. Results: Intra-operative PAI was encountered in 47 (19.3%) patients. Forty two patients (17.3%) had I-PAI in 1-2 needles, two (0.8%) had I-PAI in four needles and three patients (1.2%) had I-PAI in six needles. Overall, 1.4% of needles required repositioning due to I-PAI. BMI > 27 kg/m 2 and wider (>75 mm) pubic bone separation at mid ramus (PS-ML) were associated with a lower incidence of I-PAI. At a median follow-up of 50.1 months, the 3- and 5-year bPFS was 97.3% and 95.2%, respectively. The 5-year bPFS rates for patients with and without I-PAI were 95.6% and 95%, respectively (p = 0.28). Conclusions: The use of CT-based PAI of ≤1 cm as a selection criterion for PB is a simple and reliable method for minimizing the incidence of I-PAI and maintaining excellent biochemical control rates.

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

Directory of Open Access Journals (Sweden)

Omer Bayrak

2015-08-01

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

Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor with RENAL nephrometry score ≥10: an innovation of traditional open surgery.

Science.gov (United States)

Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin

2015-04-01

The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score ≥10). Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score ≥10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded. MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5-8.1). Mean warm ischemia time was 28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150) and mean estimated blood loss was 68 mL (range: 10-400). Mean postoperative hospital stay was 6.5 days (range: 5-12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47-132) and 87.1 μmol/L (range: 61-189) with significant difference (P = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5), respectively with significant difference (P = 0.024). In an average follow-up of 19.9 months (range: 8-50), no local recurrence or systemic progression occurred. In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open

First experience with single incision laparoscopic surgery in Slovakia: concomitant cholecystectomy and splenectomy in an 11-year-old girl with hereditary spherocytosis.

Science.gov (United States)

Cingel, Vladimir; Zabojnikova, Lenka; Kurucova, Patricia; Varga, Ivan

2014-09-01

Hereditary spherocytosis is an autosomal dominant inheritance disorder of the red blood cell membrane characterized by the presence of spherical-shaped erythrocytes (spherocytes) in the peripheral blood. The main clinical features include haemolytic anemia, variable jaundice, splenomegaly and cholelithiasis caused by hyperbilirubinemia from erythrocyte hemolysis. Splenectomy does not solve the congenital genetic defect but it stops pathological hemolysis in the enlarged spleen. If gallstones are present, it is appropriate to perform cholecystectomy at the time of splenectomy, although the patient has symptoms of gall bladder disease. We present the case of single incision laparoscopic surgical (SILS) concomitant splenectomy and cholecystectomy performed with conventional laparoscopic instruments in an 11-year-old girl with the diagnosis of hereditary spherocytosis. A 2-3 cm umbilical incision was used for the placement of two 5 mm trocars and one 10 mm flexible videoscope. Conventional laparoscopic dissector, grasper, Ligasure, Harmonic Ace and hemoclips were the main tools during surgical procedure. We prefer Single Incision Laparoscopic Surgery Foam Port (Covidien) as the single umbilical device for introduction into the abdominal cavity. First, we performed cholecystectomy, then the gallbladder was put aside over the liver and after that we peformed splenectomy. To remove the detached spleen and gallbladder, a nylon extraction bag is introduced through one of the port sites. The spleen is than morcellated in the bag with forceps and removed in fragments. After that we removed them and the umbilical fascial incision was closed. Splenectomy is the only effective therapy for this disorder and often it is performed in combination with cholecystectomy. Conventional surgery requires a wide upper abdominal incision for correct exposure of the gallbladder and spleen. Our experience shows that SILS splenectomy and cholecystectomy is feasible even in young children and

Transconjunctival incision for total maxillectomy--an alternative for subciliary incision.

Science.gov (United States)

Goyal, Amit; Tyagi, Isha; Jain, Shilpa; Syal, Rajan; Singh, Alok Pratap; Kapila, Rajeev

2011-09-01

A subciliary incision may be associated with various complications of the lower eyelid when it is used during a total maxillectomy. The use of the transconjunctival incision instead is an alternative in suitable patients. The records of 17 patients were reviewed in whom a transconjunctival incision was used during total maxillectomy. These included 13 in whom the Weber-Ferguson incision was used, and 4 who had a sublabial incision. There was mild conjunctival oedema in all the cases during the immediate postoperative period but it did not last for more than two days. Four patients had mild to moderate oedema of the lid that resolved within two days. One had mild ectropion with transient epiphora, which was caused by early removal of the medial canthal sutures. We found the approach to be cosmetically acceptable as it avoids a scar in the subciliary region. The transconjunctival incision can be used in place of the subciliary incision for lateral exposure during total maxillectomy. There are few complications associated with the lower lid, and it has good cosmetic results; if it is combined with a sublabial incision in suitable patients, the maxillectomy is virtually scar-free. Copyright © 2010 British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Using an Elastic Band Device After a Severe Obstetric Pubic Symphyseal Separation: Clinical and Imaging Evaluation.

Science.gov (United States)

Lasbleiz, Jeremy; Sevestre, François-Xavier; Moquet, Pierre-Yves

2017-09-01

Severe separation of the pubic symphysis is a rare delivery complication. Facing this pathology, we decided to study a new elastic band device. To evaluate the elastic band device, clinical (pain-rated) and imaging (magnetic resonance imaging and radiography) evaluations with and without the device were performed. The elastic band device is a European Conformity-certified medical device, which is made of neoprene straps, that reduces the mobility of the pelvis and the use of the internal rotator muscles. Once the elastic band device was in place, on postpartum day 1, radiography showed a decrease of the pubic width from 41 to 12 mm. Furthermore, pain decreased from 10 of 10 to 2 of 10 in 2 days, allowing the patient to ambulate and avoid surgery. After 1 month, the pubic width (6 mm) and anatomy were recovered but minor pain was still present with hip rotatory movements. The elastic band device was worn 24 hours a day from postpartum days 1-90 and 12 hours a day from postpartum days 90 to 150; afterward, the patient returned to normal life without the elastic band device. Use of an elastic band device was associated with a reduction of the pubic width and pain associated after obstetric pubic symphysis separation.

The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study.

Science.gov (United States)

Birmingham, Patrick M; Kelly, Bryan T; Jacobs, Robert; McGrady, Linda; Wang, Mei

2012-05-01

A link between femoroacetabular impingement and athletic pubalgia has been reported clinically. One proposed origin of athletic pubalgia is secondary to repetitive loading of the pubic symphysis, leading to instability and parasymphyseal tendon and ligament injury. Hypothesis/ The purpose of this study was to investigate the effect of simulated femoral-based femoroacetabular impingement on rotational motion at the pubic symphysis. The authors hypothesize that the presence of a cam lesion leads to increased relative symphyseal motion. Controlled laboratory study. Twelve hips from 6 fresh-frozen human cadaveric pelvises were used to simulate cam-type femoroacetabular impingement. The hips were held in a custom jig and maximally internally rotated at 90° of flexion and neutral adduction. Three-dimensional motion of the pubic symphysis was measured by a motion-tracking system for 2 states: native and simulated cam. Load-displacement plots were generated between the internal rotational torque applied to the hip and the responding motion in 3 anatomic planes of the pubic symphysis. As the hip was internally rotated, the motion at the pubic symphysis increased proportionally with the degrees of the rotation as well as the applied torque measured at the distal femur for both states. The primary rotation of the symphysis was in the transverse plane and on average accounted for more than 60% of the total rotation. This primary motion caused the anterior aspect of the symphyseal joint to open or widen, whereas the posterior aspect narrowed. At the torque level of 18.0 N·m, the mean transverse rotation in degrees was 0.89° ± 0.35° for the native state and 1.20° ± 0.41° for cam state. The difference between cam and the native groups was statistically significant (P pubalgia.

supraHex: An R/Bioconductor package for tabular omics data analysis using a supra-hexagonal map☆

Science.gov (United States)

Fang, Hai; Gough, Julian

2014-01-01

Biologists are increasingly confronted with the challenge of quickly understanding genome-wide biological data, which usually involve a large number of genomic coordinates (e.g. genes) but a much smaller number of samples. To meet the need for data of this shape, we present an open-source package called ‘supraHex’ for training, analysing and visualising omics data. This package devises a supra-hexagonal map to self-organise the input data, offers scalable functionalities for post-analysing the map, and more importantly, allows for overlaying additional data for multilayer omics data comparisons. Via applying to DNA replication timing data of mouse embryogenesis, we demonstrate that supraHex is capable of simultaneously carrying out gene clustering and sample correlation, providing intuitive visualisation at each step of the analysis. By overlaying CpG and expression data onto the trained replication-timing map, we also show that supraHex is able to intuitively capture an inherent relationship between late replication, low CpG density promoters and low expression levels. As part of the Bioconductor project, supraHex makes accessible to a wide community in a simple way, what would otherwise be a complex framework for the ultrafast understanding of any tabular omics data, both scientifically and artistically. This package can run on Windows, Mac and Linux, and is freely available together with many tutorials on featuring real examples at http://supfam.org/supraHex. PMID:24309102

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

Directory of Open Access Journals (Sweden)

Chee Wei Tay

2013-01-01

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

Modified tubularized incised plate urethroplasty

Directory of Open Access Journals (Sweden)

Shivaji Mane

2013-01-01

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

Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury.

Science.gov (United States)

Yu, Xiaowei; Tang, Mingjie; Zhou, Zubin; Peng, Xiaochun; Wu, Tianyi; Sun, Yuqiang

2013-08-01

Fractures of the pubic rami due to low energy trauma are common in the elderly, with an incidence of 26 per 100,000 people per year in those aged more than 60 years. The purpose of this study was to evaluate the clinical application of this minimally invasive technique in patients with pubic ramus fractures combined with a sacroiliac joint complex injury, including its feasibility, merits, and limitations. Fifteen patients with pubic ramus fractures combined with sacroiliac joint injury were treated with the minimally invasive technique from June 2008 until April 2012. The quality of fracture reduction was evaluated according to the Matta standard. Fourteen cases were excellent (93.3 %), and one case was good (6.7 %). The fracture lines were healed 12 weeks after the surgery. The 15 patients had follow-up visits between four to 50 months (mean, 22.47 months). All patients returned to their pre-injury jobs and lifestyles. One patient suffered a deep vein thrombosis during the peri-operative period. A filter was placed in the patient before the surgery and was removed six weeks later. There was no thrombus found at the follow-up visits of this patient. The minimally invasive technique in patients with pubic ramus fractures combined with a sacroiliac joint complex injury provided satisfactory efficacy.

Three-dimensional finite element models of the human pubic symphysis with viscohyperelastic soft tissues.

Science.gov (United States)

Li, Zuoping; Alonso, Jorge E; Kim, Jong-Eun; Davidson, James S; Etheridge, Brandon S; Eberhardt, Alan W

2006-09-01

Three-dimensional finite element (FE) models of human pubic symphyses were constructed from computed tomography image data of one male and one female cadaver pelvis. The pubic bones, interpubic fibrocartilaginous disc and four pubic ligaments were segmented semi-automatically and meshed with hexahedral elements using automatic mesh generation schemes. A two-term viscoelastic Prony series, determined by curve fitting results of compressive creep experiments, was used to model the rate-dependent effects of the interpubic disc and the pubic ligaments. Three-parameter Mooney-Rivlin material coefficients were calculated for the discs using a heuristic FE approach based on average experimental joint compression data. Similarly, a transversely isotropic hyperelastic material model was applied to the ligaments to capture average tensile responses. Linear elastic isotropic properties were assigned to bone. The applicability of the resulting models was tested in bending simulations in four directions and in tensile tests of varying load rates. The model-predicted results correlated reasonably with the joint bending stiffnesses and rate-dependent tensile responses measured in experiments, supporting the validity of the estimated material coefficients and overall modeling approach. This study represents an important and necessary step in the eventual development of biofidelic pelvis models to investigate symphysis response under high-energy impact conditions, such as motor vehicle collisions.

An Amylase-Responsive Bolaform Supra-Amphiphile.

Science.gov (United States)

Kang, Yuetong; Cai, Zhengguo; Tang, Xiaoyan; Liu, Kai; Wang, Guangtong; Zhang, Xi

2016-02-01

An amylase-responsive bolaform supra-amphiphile was constructed by the complexation between β-cyclodextrin and a bolaform covalent amphiphile on the basis of host-guest interaction. The bolaform covalent amphiphile could self-assemble in solution, forming sheet-like aggregates and displaying weak fluorescence because of aggregation-induced quenching. The addition of β-cyclodextrin led to the formation of the bolaform supra-amphiphile, prohibiting the aggregation of the bolaform covalent amphiphile and accompanying with the significant recovery of fluorescence. Upon the addition of α-amylase, with the degradation β-cyclodextrin, the fluorescence of the supra-amphiphile would quench gradually and significantly, and the quenching rate linearly correlated to the concentration of α-amylase. This study enriches the field of supra-amphiphiles on the basis of noncovalent interactions, and moreover, it may provide a facile way to estimate the activity of α-amylase.

Two-Step Incision for Periarterial Sympathectomy of the Hand

Directory of Open Access Journals (Sweden)

Seung Bae Jeon

2015-11-01

Full Text Available BackgroundSurgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire.MethodsA total of 40 patients (17 men and 23 women with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS and the Wake Forest University rating scale.ResultsThe total patient score was 8.59 (range, 6-15 in the two-step incision group and 9.62 (range, 7-18 in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034 but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03.ConclusionsCompared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

Supra-ballistic phonons

International Nuclear Information System (INIS)

Russell, F.M.

1989-05-01

Energetic particles moving with a solid, either from nuclear reactions or externally injected, deposit energy by inelastic scattering processes which eventually appears as thermal energy. If the transfer of energy occurs in a crystalline solid then it is possible to couple some of the energy directly to the nuclei forming the lattice by generating phonons. In this paper the transfer of energy from a compound excited nucleus to the lattice is examined by introducing a virtual particle Π. It is shown that by including a Π in the nuclear reaction a substantial amount of energy can be coupled directly to the lattice. In the lattice this particle behaves as a spatially localized phonon of high energy, the so-called supra-ballistic phonon. By multiple inelastic scattering the supra-ballistic phonon eventually thermalizes. Because both the virtual particle Π and the equivalent supra-ballistic phonon have no charge or spin and can only exist within a lattice it is difficult to detect other than by its decay into thermal phonons. The possibility of a Π removing excess energy from a compound nucleus formed by the cold fusion of deuterium is examined. (Author)

TORE SUPRA fast reciprocating radio frequency probe

International Nuclear Information System (INIS)

Thomas, C.E. Jr.; Harris, J.H.; Haste, G.R.; Kwon, M.; Goulding, R.H.; Hoffman, D.J.; Saoutic, B.; Becoulet, A.; Fraboulet, D.; Beaumont, B.; Kuus, H.; Ladurelle, L.; Pascal, J.Y.

1995-01-01

A fast reciprocating ion cyclotron range of frequencies (ICRF) probe was installed and operated on TORE SUPRA during 1992/1993. The body of the probe was originally used on the ATF experiment at Oak Ridge National Laboratory. The probe was adapted for use on TORE SUPRA, and mounted on one of the two fast reciprocating probe mounts. The probe consists of two orthogonal single-turn wire loops, mounted so that one loop senses toroidal rf magnetic fields and the other senses poloidal rf magnetic fields. The probe began operation in June, 1993. The probe active area is approximately 5 cm long by 2 cm, and the reciprocating mount has a slow stroke (5 cm/s) of 30 cm and a fast stroke (1.5 m/s) of about 10 cm. The probe was operated at distances from the plasma edge ranging from 30 to -5 cm (i.e., inside the last closed flux surface). The probe design, electronics, calibration, data acquisition, and data processing are discussed. First data from the probe are presented as a function of ICRF power, distance from the plasma, loop orientation, and other plasma parameters. Initial data show parametric instabilities do not play an important role for ICRF in the TORE SUPRA edge and scrape-off-layer (SOL) plasmas. Additionally it is observed that the probe signal has little or no dependence on position in the SOL/plasma edge

Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes.

Science.gov (United States)

Sailly, Matthieu; Whiteley, Rod; Read, John W; Giuffre, Bruno; Johnson, Amanda; Hölmich, Per

2015-06-01

Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress. We report pubic apophysitis as a clinically relevant entity in adolescent athletes. The clinical and imaging findings in 26 highly trained adolescent football players (15.6 years ± 1.3) who complained of adductor-related groin pain were reviewed. The imaging features (X-ray 26/26, US 9/26, MRI 11/26, CT 7/26) of the pubic apophyses in this symptomatic group were compared against those of a comparison group of 31 male patients (age range 9-30 years) with no known history of groin pain or pelvic trauma, who underwent pelvic CT scans for unrelated medical reasons. All symptomatic subjects presented with similar history and physical findings. The CT scans of these patients demonstrated open pubic apophyses with stress-related physeal changes (widening, asymmetry and small rounded cyst-like expansions) that were not observed in the comparison group. No comparison subject demonstrated apophyseal maturity before 21 years of age, and immaturity was seen up to the age of 26 years. This retrospective case series identifies pubic apophyseal stress (or 'apophysitis') as an important differential consideration in the adolescent athlete who presents with groin pain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pubic contouring after massive weight loss in men and women: correction of hidden penis, mons ptosis, and labia majora enlargement.

Science.gov (United States)

Alter, Gary J

2012-10-01

Weight gain and subsequent weight loss usually result in unsightly large fat deposition in the pubic areas along with ptosis of the fat pad and skin. Men also complain of burying of the penis and the woman complains of labia majora enlargement, both causing secondary sexual dysfunction, hygiene issues, discomfort, and aesthetic concerns. Even with weight loss, most of these deformities persist. The hidden (buried) penis is characterized by a lack of firm attachments between the Buck fascia surrounding the tunica albuginea of the corpora and the dartos fascia and skin. Successful treatment requires the penile skin and dartos fascia to be stabilized to the penile corporal bodies to make the penis one integrated unit. The method of surgery is usually to excise and lift excess pubic skin, eliminate the pubic fat without creating a significant pubic concavity, and stabilize the penile skin to the corporal bodies with tacking sutures dorsally and ventrally. If inadequate penile skin is present, scrotal flaps or skin grafts are used to cover the penis. Treatment of the mons pubis requires similar pubic lifting, fat excision, and pubic tacking. Labia majora reduction requires skin and usually fat excision. Results are excellent with the use of these techniques. Pubic contouring after massive weight loss in men and women is very successful and safe if performed meticulously. Treatment improves self-esteem along with the associated physical and aesthetic deformities.

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

Science.gov (United States)

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

2015-07-01

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

The role of pubic symphyseal CT arthrography in the imaging of athletic pubalgia.

Science.gov (United States)

McArthur, Tatum A; Narducci, Carl A; Lopez-Ben, Robert R

2014-11-01

The purpose of this article is to describe the results of pubic symphyseal CT arthrography compared with MRI in patients with suspected athletic pubalgia. In this study, two musculoskeletal radiologists retrospectively searched our department's PACS to identify patients who had undergone CT-guided injection with concurrent pubic symphyseal CT arthrography for evaluation and treatment of groin pain, sports hernia, or athletic pubalgia over a 5.5-year period (January 1, 2007-July 1, 2012). The MR and CT arthrography images and reports, clinical findings at presentation, pain response to injection, and operative findings were reviewed using the electronic medical record. Twelve patients underwent CT-guided injection and pubic symphyseal CT arthrography at our institution during the 5.5-year study period. Nine of the 12 patients had undergone MRI before the procedure. In two of the three patients who had not undergone MRI, CT arthrography revealed secondary clefts. Three of four patients who had secondary clefts on MRI had contrast extravasation reproducing the cleft at CT. Three patients had MRI findings suggestive of athletic pubalgia without MRI evidence of a secondary cleft; in all three of these patients, CT arthrography showed a secondary cleft. In four patients, CT arthrography revealed tendon tears at the adductor origin that were not apparent on MRI. All 12 patients reported decreased groin pain after injection. Pubic symphyseal CT arthrography is a useful technique for the diagnosis and short-term pain relief of athletic pubalgia. It can be used to identify secondary clefts and to detect tendon tears that can potentially be overlooked on MRI.

The TORE SUPRA fast reciprocating RF probe

International Nuclear Information System (INIS)

Thomas, C.E. Jr.; Harris, J.H.; Haste, G.R.

1994-01-01

A fast reciprocating ICRF (Ion Cyclotron Range of Frequencies) probe was installed and operated on TORE SUPRA during 1992/1993. The body of the probe was originally used on the ATF experiment at ORNL. The probe was adapted for use on TORE SUPRA, and mounted on one of the two fast reciprocating probe mounts. The probe consists of two orthogonal single-turn wire loops, mounted so that one loop senses toroidal RF magnetic fields and the other senses poloidal RF magnetic fields. The probe began operation in June, 1993. The probe active area is approximately 5 cm long by 2 cm, and the reciprocating mount has a slow stroke (5 cm/sec) of 30 cm by 2 cm, and the reciprocating mount has a slow stroke (5 cm/sec) of 30 cm and a fast stroke (1.5 m/sec) of about 10 cm. The probe was operated at distances from the plasma edge ranging from 30 cm to -5 cm (i.e., inside the last closed flux surface). The probe design, electronics, calibration, data acquisition and data processing are discussed. First data from the probe are presented as a function of ICRF power, distance from the plasma, loop orientation, and other plasma parameters. Initial data shows parametric instabilities do not play an important role for ICRF in the TORE SUPRA edge and scrape-off-layer (SOL) plasmas. Additionally it is observed that the probe signal has little or no dependence on position in the SOL/plasma edge

Ripple losses during ICRF heating in Tore Supra

International Nuclear Information System (INIS)

Basiuk, V.; Eriksson, L.-G.; Bergeaud, V.; Chantant, M.; Martin, G.; Nguyen, F.; Reichle, R.; Vallet, J.C.; Delpeche, L.; Surle, F.

2004-01-01

The toroidal field coils in Tore Supra are supra-conducting, and their number is restricted to 18. As a result, the ripple is fairly large, about 7% at the plasma boundary. Tore Supra has consequently been equipped with dedicated ripple loss diagnostics, which has allowed ripple loss studies. This paper reports on the measurements made with these diagnostics and provides an analysis of the experimental results, comparing them with theoretical expectations whenever possible. Furthermore, the main heating source accelerating ions in Tore Supra is ion cyclotron resonance range of frequency (ICRF) heating, and the paper provides new information on the ripple losses of ICRF accelerated ions. (author)

Supra-complete surgery via dual intraoperative visualization approach (DiVA) prolongs patient survival in glioblastoma.

Science.gov (United States)

Eyüpoglu, Ilker Y; Hore, Nirjhar; Merkel, Andreas; Buslei, Rolf; Buchfelder, Michael; Savaskan, Nicolai

2016-05-03

Safe and complete resection represents the first step in the treatment of glioblastomas and is mandatory in increasing the effectiveness of adjuvant therapy to prolong overall survival. With gross total resection currently limited in extent to MRI contrast enhancing areas, the extent to which supra-complete resection beyond obvious contrast enhancement could have impact on overall survival remains unclear. DiVA (dual intraoperative visualization approach) redefines gross total resection as currently accepted by enabling for the first time supra-complete surgery without compromising patient safety. This approach exploits the advantages of two already accepted surgical techniques combining intraoperative MRI with integrated functional neuronavigation and 5-ALA by integrating them into a single surgical approach. We investigated whether this technique has impact on overall outcome in GBM patients. 105 patients with GBM were included. We achieved complete resection with intraoperative MRI alone according to current best-practice in glioma surgery in 75 patients. 30 patients received surgery with supra-complete resection. The control arm showed a median life expectancy of 14 months, reflecting current standards-of-care and outcome. In contrast, patients receiving supra-complete surgery displayed significant increase in median survival time to 18.5 months with overall survival time correlating directly with extent of supra-complete resection. This extension of overall survival did not come at the cost of neurological deterioration. We show for the first time that supra-complete glioma surgery leads to significant prolongation of overall survival time in GBM patients.

EDXRF analysis of Marajoara pubic covers

International Nuclear Information System (INIS)

Calza, C.; Anjos, M.J.; Bueno, M.I.M.S.; Lima, T.A.; Lopes, R.T.

2007-01-01

This work evaluated the elemental composition of decorated pottery pubic covers (tangas) from the Marajoara culture of Marajo Island (at the mouth of the Amazon River, Brazil) using EDXRF technique. The XRF system used in this work consists in a Si(Li) detector from ORTEC, with resolution of 180 eV, at 5.9 keV, and a mini X-ray tube with Mo anode. The elements identified in the samples were: S, Cl, K, Ca, Ti, Mn, Fe, Cu, Zn, Ga, Rb, Sr, Y, Zr and Pb. Principal components analysis (PCA) was used to evaluated the provenance of the samples

TORE SUPRA fast reciprocating radio frequency probe (abstract)

International Nuclear Information System (INIS)

Thomas, C.E. Jr.; Harris, J.H.; Haste, G.R.; Kwon, M.; Goulding, R.H.; Hoffman, D.J.; Saoutic, B.; Becoulet, A.; Fraboulet, D.; Beaumont, B.; Kuus, H.; Ladurelle, L.; Pascal, J.Y.

1995-01-01

A fast reciprocating ion cyclotron range of frequencies (ICRF) probe was installed and operated on TORE SUPRA during 1992/1993. The body of the probe was originally used on the ATF experiment at Oak Ridge National Laboratory. The probe was adapted for use on TORE SUPRA, and mounted on one of the two fast reciprocating probe mounts. The probe consists of two orthogonal single-turn wire loops, mounted so that one loop senses toroidal rf magnetic fields and the other senses poloidal rf magnetic fields. The probe began operation in June, 1993. The probe active area is approximately 5 cm long by 2 cm, and the reciprocating mount has a slow stroke (5 cm/s) of 30 cm and a fast stroke (1.5 m/s) of about 10 cm. The probe was operated at distances from the plasma edge ranging from 30 to -5 cm (i.e., inside the last closed flux surface). The probe design, electronics, calibration, data acquisition, and data processing are discussed. First data from the probe are presented as a function of ICRF power, distance from the plasma, loop orientation, and other plasma parameters. Initial data show parametric instabilities do not play an important role for ICRF in the TORE SUPRA edge and scrape-off-layer (SOL) plasmas. Additionally it is observed that the probe signal has little or no dependence on position in the SOL/plasma edge

[Treatment of pubic osteomyelitis secondary to pressure sores].

Science.gov (United States)

Brunel, Anne-Sophie; Téot, Luc; Lamy, Brigitte; Masson, Raphaël; Morquin, David; Reynes, Jacques; Le Moing, Vincent

2014-01-01

There is no consensus regarding the diagnostic and therapeutic strategy for pubic osteomyelitis secondary to pelvic pressure sores. Diagnosis is often difficult and bone biopsies with microbiological and anatomical-pathological examination remain the gold standard. The rate of cicatrisation of pressure sores is low. Cleansing and negative pressure treatment are key elements of the treatment. Optimising the care management with medical-surgical collaboration is being studied in the Ostear protocol.

Double breasting of bladder neck and posterior urethra for continence in isolated peno-pubic epispadias.

Science.gov (United States)

Bhat, Amilal; Upadhayay, Ravi; Bhat, Mahakshit; Kumar, Rajiv; Kumar, Vinay

2015-05-01

The objectives of surgical repair of epispadias include the achievement of urinary continence, cosmetically acceptable genitalia with correction of curvature and normal genital function. To achieve all the aforementioned objectives, patients usually undergo two- or multiple-stage surgeries. Traditionally, the patients undergo epispadias repair in the first stage through modified Cantwell-Ransley or Mitchell-Bagli procedure. Subsequently, in the second stage, bladder neck repair is performed to achieve continence, the most common procedure being modified Young-Dees-Leadbetter. There is no reported single-stage technique of epispadias repair achieving both cosmesis and continence in isolated incontinent epispadias. The objectives of the study were to assess continence and cosmesis with partial penile disassemble and double breasting of bladder neck and posterior urethra in isolated peno-pubic epispadias. A retrospective analysis of surgical outcome of seven cases of primary isolated incontinent peno-pubic epispadias repair from July 2008 to July 2012 was carried out. Patients' age varied from 10 months to 16 years. Penile de-gloving is done with mobilization of urethral plate from ventrum to dorsum, distally till mid-glans and proximally up to pubic symphysis with preservation of blood supply at both ends. Partial mobilization of corporal bodies from its attachment and division of peno-pubic ligament are done to lengthen the penis. A mucosal strip of 5-7 mm is excised to denude the mucosa for double breasting. Tubularization of urethral plate with double breasting from the region of bladder neck to posterior urethra is done to increase the outlet resistance and then tubularization of distal urethral plate. Approximation of mobilized pelvic floor muscles is done to complete sphincteroplasty. Spongioplasty along the entire length and corporoplasty with medial rotation of corporeal bodies is done. Glanuloplasty with meatoplasty is done to bring the meatus ventrally and

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

Directory of Open Access Journals (Sweden)

Rodrigo Pedraza

2013-01-01

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

Outcomes of Single-Incision Laparoscopic Surgery for Colon Cancer: A Case-Matched Comparative Study

Directory of Open Access Journals (Sweden)

Atthaphorn Trakarnsanga

2016-03-01

Full Text Available Background: Single-incisionlaparoscopiccolectomy(SILC isanevolvingtechnique withpotentialadvantages by reducing number of incisions that can reduce port-related complications and improve cosmetic results. The purposeof thisstudy wastocomparetheshort-termoutcomesbetweenSILC,hand-assistedlaparoscopiccolectomy (HALC andstandard multi-port laparoscopic colectomy (MLC. Methods: Retrospectiveanalysesofatotalof90patientsbetweenMay2010and December2011, whounderwent SILC for coloncancer surgery, wereperformedin30patients. Clinicopathologicalparameters were matched1:1 withpatients whounderwent HALC (n=30andMLC (n=30.Short-term outcomes werecollectedandanalyzed. Results: Operativetime wassignificantlyshorter inSILC comparedto HALC andMLC (p<0.001,as wellasless estimatedbloodloss (p=0.02. There werenosignificantdifferences inconversionrateandnumberofharvested lymphnodes.SILChadtheadvantageofless24-hrpostoperativepainscorecomparedtoHALCandMLC(p<0.001, whereas length of stayandtime to full diet werenotdifferent. Conclusion: Inselectedpatients,SILC canbesuccessfullyandsafelyperformed withshorteroperativetime, less estimated blood loss andless postoperativepainscore.

Edge plasma diagnostics on Tore Supra tokamak

International Nuclear Information System (INIS)

Fujita, Junji

1991-01-01

From 1988 to 1991, the international scientific research 'Diagnosis of peripheral plasma in Tore Supra tokamak' was carried out as a three-year plan receiving the support of the scientific research expense of the Ministry of Education. This is to apply the method of measuring electron density distribution by neutral lithium beam probe spectroscopy to the measurement of the electron density distribution in the peripheral plasma in Tore Supra Tokamak in France. Among many tokamaks in operation doing respective characteristics researches, the Tore Supra generates the toroidal magnetic field by using superconducting coils, and aims at the long time discharge for 30 sec. for the time being, and for 300 sec. in future. In the plasma generators for long time discharge like this, the technology of particle control is a large problem. For this purpose, a divertor was added to the Tore Supra. In order to advance the research on particle control, it is necessary to examine the behavior of plasma in the peripheral part in detail. The measurement of peripheral plasma in tokamaks, beam probe spectroscopy, the Tore Supra tokamak, the progress of the joint research, the problems in the joint research and the perspective of hereafter are reported. (K.I.)

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

DEFF Research Database (Denmark)

Mynster, Tommie; Wille-Jørgensen, Peer

2013-01-01

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

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

Science.gov (United States)

Jauhari, Nidhi; Chopra, Deepak; Chaurasia, Rajan Kumar; Agarwal, Ashutosh

2014-01-01

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

Radiographic changes of the pelvis in Labrador and Golden Retrievers after juvenile pubic symphysiodesis: objective and subjective evaluation.

Science.gov (United States)

Boiocchi, S; Vezzoni, L; Vezzoni, A; Bronzo, V; Rossi, F

2013-01-01

The hypothesis of this study was that juvenile pubic symphysiodesis (JPS) results in pelvic changes that can be identified radiographically in adult dogs. The medical records at the Clinica Veterinaria Vezzoni were searched for standard ventro-dorsal views of the pelvis of adult Labrador and Golden Retrievers that had undergone JPS or had not undergone surgery. The objective assessment of radiographs included the analysis of various pelvic measurements. Subjective evaluation of radiographs was undertaken by 18 specialists and 21 general practitioners and was based on five criteria relating to 1) the acetabular fossae, 2) the pubic symphysis, 3) the margin of the cranial pubic area, 4) the pubic rami, and 5) the obturator foramen. The radiographs of 42 Labrador Retrievers and 16 Golden Retrievers were evaluated. The most useful criteria were the radiographic measurement of the shape of the obturator foramen and two different ratios of length to width of the pubic rami; these values were significantly smaller in dogs after JPS. The pelvic canal width was the same in both groups. All objective measurements were repeatable within and between evaluators. The most reliable subjective criterion was number 4, followed by number 5 in Golden Retrievers and by 2 in Labrador Retrievers. Our objective and subjective evaluations were simple and yielded useful and repeatable results. There was no significant difference between general practitioners and specialists with regard to subjective evaluation, which indicates that these evaluation criteria can be used by small animal clinicians after minimal training.

COMPARISON OF POSTOP SIA IN MSICS WITH STRAIGHT INCISION VERSUS FROWN INCISION

Directory of Open Access Journals (Sweden)

Shayana Bhumbla

2017-05-01

Full Text Available BACKGROUND Surgically-Induced Astigmatism (SIA is one of the commonest causes of poor postoperative vision even after uneventful cataract surgery. Recent advances have led to a newer concept of “refractive cataract surgery.” The aim of the study is to study the comparison of postop SIA in Manual Small Incision Cataract Surgery (MSICS with straight versus frown incision. MATERIALS AND METHODS 50 patients of cataract were divided into 2 groups (25 each - group A underwent MSICS with 6 mm straight incision, group B underwent MSICS with 6 mm frown incision. BCVA, keratometry readings were recorded with auto kerato-refractometer preop, at 1 week, 1 month, 3 months and SIA was calculated with SIA calculator version 2.1, a free software program. RESULTS Mean SIA in group A and B were - 1.14D versus 0.92D at 1 week; 1.26D versus 0.97D at 1 month; 1.29D versus 0.95D at 3 months. The difference was statistically significant at each follow up visit (p<0.05. CONCLUSION Frown incision gives lesser SIA than straight incision in MSICS.

Supra-National Organisations and Conflict Resolution during the ...

African Journals Online (AJOL)

Supra-National Organisations and Conflict Resolution during the Nigeria Civil War: ... or part of the non-state actors that impinge on the international environment. ... the importance or roles of Supra-national organisations in conflict resolution ...

Effect of heavy training in contact sports on MRI findings in the pubic region of asymptomatic competitive athletes compared with non-athlete controls

Energy Technology Data Exchange (ETDEWEB)

Paajanen, Hannu [Kuopio University Hospital, Department of Surgery, Kuopio (Finland); Hermunen, Heikki; Karonen, Jari [Central Hospital of Mikkeli, Department of Radiology, Mikkeli (Finland)

2011-01-15

Bone marrow edema (BME) at the pubic symphysis on magnetic resonance imaging (MRI) is usually associated with groin pain and stress injury of the pubic bone. Little is known of the pubic MR imaging findings of asymptomatic heavy training athletes in contact sports. Pelvic MRI of male asymptomatic soccer (n = 10), ice hockey (n = 10), bandy (n = 10) and female floor-ball players (n = 10) were compared with non-athlete controls (10 males, 10 females) without groin pain to analyse the presence of BME (on a four-point scale). To study the possible changes of BME directly following heavy physical activity, 10 bandy players underwent MRI before and immediately after a 2-h training session. Magnetic resonance imaging showed minimal BME (grade 1) at the pubic symphysis in 19 of the 40 athletes (48%). Two soccer and 2 ice hockey players (20%) had moderate grade 2 pubic edema, but severe grade 3 BME findings were not found. Also 10 out of 20 (50%) of controls had grade 1 BME. The extent of increased signal was equally distributed in the asymptomatic athletes of different contact sports and controls. A heavy 2-h training session did not cause any enhanced signal at the pubic symphysis. This study indicates that the presence of grade 1 pubic BME was a frequent finding in contact sports and comparable to that in non-athletes. Grade 2 BME was found only in asymptomatic athletes undergoing heavy training. (orig.)

Effect of heavy training in contact sports on MRI findings in the pubic region of asymptomatic competitive athletes compared with non-athlete controls

International Nuclear Information System (INIS)

Paajanen, Hannu; Hermunen, Heikki; Karonen, Jari

2011-01-01

Bone marrow edema (BME) at the pubic symphysis on magnetic resonance imaging (MRI) is usually associated with groin pain and stress injury of the pubic bone. Little is known of the pubic MR imaging findings of asymptomatic heavy training athletes in contact sports. Pelvic MRI of male asymptomatic soccer (n = 10), ice hockey (n = 10), bandy (n = 10) and female floor-ball players (n = 10) were compared with non-athlete controls (10 males, 10 females) without groin pain to analyse the presence of BME (on a four-point scale). To study the possible changes of BME directly following heavy physical activity, 10 bandy players underwent MRI before and immediately after a 2-h training session. Magnetic resonance imaging showed minimal BME (grade 1) at the pubic symphysis in 19 of the 40 athletes (48%). Two soccer and 2 ice hockey players (20%) had moderate grade 2 pubic edema, but severe grade 3 BME findings were not found. Also 10 out of 20 (50%) of controls had grade 1 BME. The extent of increased signal was equally distributed in the asymptomatic athletes of different contact sports and controls. A heavy 2-h training session did not cause any enhanced signal at the pubic symphysis. This study indicates that the presence of grade 1 pubic BME was a frequent finding in contact sports and comparable to that in non-athletes. Grade 2 BME was found only in asymptomatic athletes undergoing heavy training. (orig.)

H-shaped supra-amphiphiles based on a dynamic covalent bond.

Science.gov (United States)

Wang, Guangtong; Wang, Chao; Wang, Zhiqiang; Zhang, Xi

2012-10-16

The imine bond, a kind of dynamic covalent bond, is used to bind two bolaform amphiphiles together with spacers, yielding H-shaped supra-amphiphiles. Micellar aggregates formed by the self-assembly of the H-shaped supra-amphiphiles are observed. When pH is tuned down from basic to slightly acidic, the benzoic imine bond can be hydrolyzed, leading to the dissociation of H-shaped supra-amphiphiles. Moreover, H-shaped supra-amphiphiles have a lower critical micelle concentration than their building blocks, which is very helpful in enhancing the stability of the benzoic imine bond being hydrolyzed by acid. The surface tension isotherms of the H-shaped supra-amphiphiles with different spacers indicate their twisty conformation at a gas-water interface. The study of H-shaped supra-amphiphiles can enrich the family of amphiphiles, and moreover, the pH-responsiveness may make them apply to controlled or targetable drug delivery in a biological environment.

The early supra-additive apoptotic response of R3327-G prostate tumors to androgen ablation and radiation is not sustained with multiple fractions

International Nuclear Information System (INIS)

Pollack, Alan; Ashoori, Faramarz; Sikes, Charles; Lim Joon, Daryl; Eschenbach, Andrew C. von; Zagars, Gunar K.; Meistrich, Marvin L.

2000-01-01

Purpose: The treatment of R3327-G tumor-bearing rats with androgen ablation (AA) via castration results in a supra-additive increase in apoptosis when 2-8 Gy γ-irradiation (RT) is given as a single dose 3-14 days afterwards. We report here the dose response and effect of multiple fractions on this supra-additive apoptotic response. Materials and Methods: Dunning R3327-G tumors were grown in the flanks of Copenhagen rats and the experiments were initiated at a tumor volume of 1.0-1.5 cc. Androgen ablation was achieved by castration 3 days prior to γ-irradiation. Apoptosis was measured with a terminal deoxynucleotidyl transferase dUTP-biotin nick end-labeling assay 6-h after RT, unless otherwise specified. Results: The dose response of the supra-additive apoptotic response was assessed by irradiating castrated animals with single doses of 2, 4, 8, or 16 Gy (n = 5 per group); tumor cell apoptosis at 6-h following irradiation was 2.4% ± 0.7% (± SEM), 4.2% ± 0.8%, 6.5% ± 1.4%, and 1.6% ± 0.3%, respectively. The RT only and AA only controls had < 1% apoptosis. The effect of fractionated RT on apoptosis was investigated to determine if the supra-additive apoptotic response was sustained with repeated 2-8 Gy fractions. When tumor-bearing animals were treated with repeated daily 2-Gy fractions, there was a reduction in the level of the supra-additive apoptotic response. After five 2-Gy fractions at 24-h intervals, apoptosis in the combined treated tumors was at levels seen in the AA controls. This raised the possibility that more than 24 h are required for recovery of the high supra-additive apoptotic levels seen after one fraction. When the interfraction interval was extended to 96 h, there was no significant increase in apoptosis over the additive effect of AA and RT. Although there was a decline in supra-additive apoptosis with repeated fractions, a dose response for tumor growth delay was evident for RT alone using 2.5-Gy fractions. Moreover, the combination of

Study of plasma-wall interactions in Tore-supra; Etude des phenomenes d'interaction plasma/paroi dans Tore Supra

Energy Technology Data Exchange (ETDEWEB)

Ruggieri, R

2000-01-01

In tokamaks the interaction between wall and plasma generates impurities that affect the thermonuclear fusion. This thesis is divided into 2 parts. The first part describes the physico-chemical processes that are involved in chemical erosion, the second part deals with the study of the wear of Tore-supra's walls due to chemical erosion. Chapter 1 presents the wall-plasma interaction and reviews the different processes between plasma and carbon that occur in Tore-supra. Chapter 2 considers the various crystallographic and electronic structures of the carbon that interferes with Tore-supra plasma, the evolution of these structures during irradiation and their temperature dependence are studied. Chapter 3 presents a crystallo-chemical study of graphite samples that have undergone different surface treatments: ionic bombardment, annealing and air exposure. This experimental study has been performed by using energy-loss spectroscopy. It is shown that air exposure modifies the crystallo-chemical structure of surfaces, so it is necessary to prevent air from contaminating wall samples from Tore-supra. Chapter 4 presents a parametric study of chemical erosion rate of plasma facing components (LPM) of Tore-supra. A relation such as Y{sub cd4}{alpha}{gamma}{sup -0.1} gives a good agreement for chemical erosion rate between measurements and the numerical values of the simulation. (A.C.)

Comparison of electrocautery incision with scalpel incision in midline abdominal surgery - A double blind randomized controlled trial.

Science.gov (United States)

Prakash, Lalgudi Dorairajan; Balaji, Nitesh; Kumar, Sathasivam Suresh; Kate, Vikram

2015-07-01

To compare the electrocautery incision with scalpel incision in patients undergoing abdominal surgery using a midline incision with respect to incision time, blood loss during incision, postoperative incision site pain and wound infection. Patients undergoing midline abdominal surgery were randomized into electrocautery and scalpel groups. The incision dimensions, incision time and blood loss during incision were noted intraoperatively. Postoperative pain and wound infection were recorded on every postoperative day for one week. 41 patients in each of the two groups were analyzed. Gender and age distribution was similar in both the groups. The mean incision time per unit wound area in the electrocautery group and scalpel group was 9.40 ± 3.37 s/cm(2) and 9.07 ± 3.40 s/cm(2) (p = 0.87) respectively. The mean blood loss per unit wound area was significantly lower in the electrocautery group at 6.46 ± 3.94 ml when compared to that of 23.40 ± 15.28 ml in the scalpel group (p= electrocautery and scalpel groups (14.63% vs. 12.19%; p = 0.347). With a comparable Postoperative incision site pain, wound infection rate and significantly lower blood loss with the equal time taken for the incision, electrocautery can be considered safe and effective in making skin incision in midline laparotomy compared to scalpel incision. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Measurements of earplug attenuation under supra-aural and circumaural headphones.

Science.gov (United States)

Tufts, Jennifer B; Palmer, Jillian V; Marshall, Lynne

2012-10-01

Supra-aural audiometric headphones are generally not recommended for use in measuring the attenuation of earplugs, because contact between the headphone and pinna and/or earplug could alter the attenuation obtained, and because of concerns of non-comparability between modes of excitation from supra-aural headphones and the sound-field procedure required by the standardized method. In this study, we compared measurements of earplug attenuation obtained under Telephonics TDH-50P supra-aural headphones with measurements obtained under circumaural headphones designed expressly for such testing. The attenuation of three types of earplugs (foam, premolded quadruple-flange, and custom-molded) was measured in a repeated-measures design. The study sample comprised 42 normal-hearing adults (21 females, 21 males). With the foam earplugs, nearly all of the attenuation measurements under the supra-aural headphones fell within 10 dB of the measurements under the circumaural headphones. With the flange and custom earplugs, approximately 10% of individuals obtained spuriously high attenuation under the supra-aural headphones. We conclude that standard supra-aural audiometric headphones are suitable for measuring the attenuation provided by foam earplugs. However, supra-aural headphones should not be used to measure the attenuation of flange or custom-molded earplugs. The potential exists for substantial over-estimation of attenuation, especially of custom plugs.

Duration Adaptation Occurs Across the Sub- and Supra-Second Systems.

Science.gov (United States)

Shima, Shuhei; Murai, Yuki; Hashimoto, Yuki; Yotsumoto, Yuko

2016-01-01

After repetitive exposure to a stimulus of relatively short duration, a subsequent stimulus of long duration is perceived as being even longer, and after repetitive exposure to a stimulus of relatively long duration, a subsequent stimulus of short duration is perceived as being even shorter. This phenomenon is called duration adaptation, and has been reported only for sub-second durations. We examined whether duration adaptation also occurs for supra-second durations (Experiment 1) and whether duration adaptation occurs across sub- and supra-second durations (Experiment 2). Duration adaptation occurred not only for sub-second durations, but also for supra-second durations and across sub- and supra-second durations. These results suggest that duration adaptation involves an interval-independent system or two functionally related systems that are associated with both the sub- and supra-second durations.

Tore Supra. Basic design Tokamak system

International Nuclear Information System (INIS)

Aymar, R.; Bareyt, B.; Bon Mardion, G.

1980-10-01

This document describes the basic design for the main components of the Tokamak system of Tora Supra. As such, it focuses on the engineering problems, and refers to last year report on Tora Supra (EUR-CEA-1021) for objectives and experimental programme of the apparatus on one hand, and for qualifying tests of the main technical solutions on the other hand. Superconducting toroidal field coil system, vacuum vessels and radiation shields, poloidal field system and cryogenic system are described

Fast imaging system on Tore Supra

International Nuclear Information System (INIS)

Geraud, A.; Salasca, S.; Verger, J. M.; Alarcon, T.; Agarici, G.; Bremond, S.; Chenevois, J. P.; Geynet, M.; Migozzi, J. B.; Reux, C.

2009-01-01

A new endoscope aiming at transferring the image of a poloidal section of the Tore Supra plasma to a fast camera able to record frames at a speed up to 4800 frames per second at full resolution, or much faster for a limited number of pixel, has been installed on Tore Supra. First movies showing the light emission associated to fast phenomena such as plasma start up, disruptions or gas and pellet injections have been produced.

Craniosynostosis incision: scalpel or cautery?

Science.gov (United States)

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

2014-07-01

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

Asymmetric and symmetric bolaform supra-amphiphiles: formation of imine bond influenced by aggregation.

Science.gov (United States)

Wang, Guangtong; Wu, Guanglu; Wang, Zhiqiang; Zhang, Xi

2014-02-18

A series of bolaform supra-amphilphiles with different symmetries were fabricated through dynamic benzoic imine bond formation. The pH dependence of imine formations of these supra-amphiphiles were characterazied. We found that the extent of the imine formation of these supra-amphiphies were different. The supra-amphiphiles with a poorer symmetry always exhibited a lower imine formation at a given pH. Therefore, the varied extent of imine bond formation indicate the different aggregations of these supra-amphilphiles, which are controlled by the molecular symmetry of the supra-amphiphiles.

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

Science.gov (United States)

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

2017-01-01

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

[Testis volume, pubic hair development and spermarcheal age in urban Chinese boys].

Science.gov (United States)

Hua-mei, M A

2010-06-01

There is a trend that puberty is starting earlier in the 21st century, which is primarily based on studies of girls. The assessment of pubertal stages in the individual child is useful only if recent and reliable reference data from the same population are available for comparison. However, nationally representative pubertal data for Chinese boys in China are lacking. The aim of this study was to investigate the current pubertal development in healthy urban Chinese boys. A cross-sectional study of the pubertal development of a sample of 19,054 urban Chinese boys aged 3 - 19.83 years was conducted between 2003 and 2005. Testicular volume was determined with a Prader orchidometer. Pubic hair development was assessed according to the Tanner method. Data on spermarche were collected by the status quo method. Probit analysis was used to calculate the median age and 95% CI for onset of testicular and pubic hair development and spermarche. A testicular volume greater than or equal to 4 ml was taken as a definite sign of the onset of puberty. Mean ages for sexual development in boys were compared with other published series, while the spermarcheal age was compared to those in the similar population of the five National Surveys on Students Constitution and Health undertaken since 1979 in China. At the age of 9 years, 12.99% of the boys had a testicular volume 4 ml or more. The median age of onset of puberty as indicated by a testicular volume of 4 ml or more was 10.55 (95% CI 10.27 - 10.79) years. The median age for onset of pubic hair development (PH(2)) and spermarche was 12.78 (95% CI 12.67 - 12.89) years and 14.05 (95%CI 13.80 - 14.32) years, respectively. There was a highly significant downward secular trend for spermarcheal age of Chinese boys since 1979. Pubertal onset as indicated by testicular development in urban Chinese boys is earlier than currently used norms. Age of testicular development is among the earliest medians recorded in the world population, while

Supra-auricular versus Sinusectomy Approaches for Preauricular Sinuses.

Science.gov (United States)

El-Anwar, Mohammad Waheed; ElAassar, Ahmed Shaker

2016-10-01

Introduction  Several surgical techniques and modifications have been described to reduce the high recurrence rate after excision of preauricular sinus. Objectives  The aim of this study is to review the literature regarding surgical approaches for preauricular sinus. Data Synthesis  We performed searches in the LILACS, MEDLINE, SciELO, PubMed databases and Cochrane Library in September, 2015, and the key words used in the search were "preauricular sinus," "sinusectomy," "supra-auricular approach," "methylene blue," and/or "recurrence." We revised the results of 17 studies, including 1270 preauricular sinuses that were surgically excised by sinusectomy in 937 ears and by supra-auricular approach in 333 ears. Recurrence with supra-auricular was 4 (1.3%) while sinusectomy was 76 (8.1%) with significant difference ( p  Supra-auricular approach had significantly less recurrence rate than tract sinusectomy approaches. Thus, it could be regularly chosen as the standard procedure for preauricular sinus excision. As such, it would be helpful for surgeons to be familiar with this approach.

Effect of pubic bone marrow edema on recovery from endoscopic surgery for athletic pubalgia.

Science.gov (United States)

Kuikka, L; Hermunen, H; Paajanen, H

2015-02-01

Athletic pubalgia (sportsman's hernia) is often repaired by surgery. The presence of pubic bone marrow edema (BME) in magnetic resonance imaging (MRI) may effect on the outcome of surgery. Surgical treatment of 30 patients with athletic pubalgia was performed by placement of totally extraperitoneal endoscopic mesh behind the painful groin area. The presence of pre-operative BME was graded from 0 to 3 using MRI and correlated to post-operative pain scores and recovery to sports activity 2 years after operation. The operated athletes participated in our previous prospective randomized study. The athletes with (n = 21) or without (n = 9) pubic BME had similar patients' characteristics and pain scores before surgery. Periostic and intraosseous edema at symphysis pubis was related to increase of post-operative pain scores only at 3 months after surgery (P = 0.03) but not to long-term recovery. Two years after surgery, three athletes in the BME group and three in the normal MRI group needed occasionally pain medication for chronic groin pain, and 87% were playing at the same level as before surgery. This study indicates that the presence of pubic BME had no remarkable long-term effect on recovery from endoscopic surgical treatment of athletic pubalgia. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2 incision-dependent systems.

Science.gov (United States)

Vasavada, Vaishali; Vasavada, Abhay R; Vasavada, Viraj A; Srivastava, Samaresh; Gajjar, Devarshi U; Mehta, Siddharth

2013-04-01

To compare incision integrity and clinical outcomes of 2 microcoaxial phacoemulsification systems. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Prospective randomized clinical trial. Eyes were randomized to have phacoemulsification using a 1.8 mm clear corneal incision (CCI) system (Group 1, Stellaris system) or a 2.2 mm CCI system (Group 2, Intrepid Infiniti system). Incision enlargement at end of surgery was measured. At the conclusion of surgery, trypan blue was applied over the conjunctival surface, anterior chamber aspirate withdrawn, and ingress into anterior chamber measured. Postoperative observations included evaluation of the CCI using anterior segment optical coherence tomography (AS-OCT), change in central corneal thickness (CCT), and anterior segment inflammation at 1 day, 1 week, and 1 month and endothelial cell loss and surgically induced astigmatism (SIA) at 3 months. Incision enlargement (P.05). At the end of surgery, it is not the initial incision size alone but also the distortion of the incision during subsequent stages of surgery that determine the integrity of the CCI. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Snake studies on Tore Supra

International Nuclear Information System (INIS)

Cristofani, P.; Desgranges, C.; Garbet, X.; Geraud, A.; Gil, C.; Hoang, G.T.; Joffrin, E.; Pecquet, A.L.

1995-01-01

Snakes have been achieved after pellet injection in Tore Supra during ohmic as well as ICRH discharges as it has already been observed in other machines. On Tore Supra, high speed H 2 pellets were injected into D 2 plasmas under the specified experimental conditions, the matter is deposited in the centre and snakes are produced in 50% of the cases, but they are created on a second much more internal q=1 surface leading probably to a non monotonic current profile. The properties of the snake, induced current modification and the important role of the bootstrap current in the snake formation are described. (K.A.) 5 refs.; 7 figs

Runaway electrons dynamics and confinement in Tore-Supra

International Nuclear Information System (INIS)

Chatelier, M.; Geraud, A.; Joyer, P.; Martin, G.; Rax, J.M.

1989-01-01

The lack of energy of runaway electrons, confined in Tore Supra tokamak, is studied. Ohmic discharges, obtained with helium gas, exhibit a small amount of runaway electrons on both hard X-ray monitors and neutron sensors. The observations show an important lack of energy for runaway electrons confined in Tore Supra. It is assumed to be dued to a small pitch-angle scattering (a few degrees), and many candidates for this are compared: the strongest known one collisions seems not to be enough by an order of magnitude. Density and magnetic scans on Tore Supra are needed to discriminate between enhanced collisional scattering processes and purely magnetic phenomena

Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects.

Science.gov (United States)

Mota Filho, Francisco Hidelbrando Alves; Sávio, Luis Felipe; Sakata, Rafael Eiji; Ivanovic, Renato Fidelis; da Silva, Marco Antonio Nunes; Maia, Ronaldo; Passerotti, Carlo

2018-01-01

Robot-Assisted Single Site Radical Nephrectomy (RASS-RN) has been reported by surgeons in Europe and United States (1-3). To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America. A 66 year-old renal transplant male due to chronic renal failure presented with an incidental 1.3cm nodule in the upper pole of the right kidney. In addition, symptomatic gallbladder stones were detected. Patient was placed in modified flank position. Multichannel single port device was placed using Hassan's technique through a 3cm supra-umbilical incision. Standard radical nephrectomy and cholecystectomy were made using na 8.5mm camera, two 5mm robotic arms and an assistant 5mm access. Surgery time and estimated blood loss were 208 minutes and 100mL, respectively. Patient did well and was discharged within less than 48 hours, without complications. Pathology report showed benign renomedullary tumor of interstitial cells and chronic cholecystitis. Robotic technology improves ergonomics, gives better precision and enhances ability to approach complex surgeries. Robot-assisted Single Port aims to reduce the morbidity of multiple trocar placements while maintaining the advantages of robotic surgery (2). Limitations include the use of semi-rigid instruments providing less degree of motion and limited space leading to crash between instruments. On the other hand, it is possible to perform complex and concomitant surgeries with just one incision. RASS-RN seems to be safe and feasible option for selected cases. Studies should be performed to better understand the results using single port technique in Urology. Copyright® by the International Brazilian Journal of Urology.

Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects

Directory of Open Access Journals (Sweden)

Francisco Hidelbrando Alves Mota Filho

Full Text Available ABSTRACT Introduction Robot-Assisted Single Site Radical Nephrectomy (RASS-RN has been reported by surgeons in Europe and United States (1–3. To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America. Case A 66 year-old renal transplant male due to chronic renal failure presented with an incidental 1.3cm nodule in the upper pole of the right kidney. In addition, symptomatic gallbladder stones were detected. Results Patient was placed in modified flank position. Multichannel single port device was placed using Hassan's technique through a 3 cm supra-umbilical incision. Standard radical nephrectomy and cholecystectomy were made using an 8.5mm camera, two 5mm robotic arms and an assistant 5mm access. Surgery time and estimated blood loss were 208 minutes and 100mL, respectively. Patient did well and was discharged within less than 48 hours, without complications. Pathology report showed benign renomedullary tumor of interstitial cells and chronic cholecystitis. Discussion Robotic technology improves ergonomics, gives better precision and enhances ability to approach complex surgeries. Robot-assisted Single Port aims to reduce the morbidity of multiple trocar placements while maintaining the advantages of robotic surgery (2. Limitations include the use of semi-rigid instruments providing less degree of motion and limited space leading to crash between instruments. On the other hand, it is possible to perform complex and concomitant surgeries with just one incision. Conclusion RASS-RN seems to be safe and feasible option for selected cases. Studies should be performed to better understand the results using single port technique in Urology.

Ischio-pubic-patellar hypoplasia: is it a new syndrome?

International Nuclear Information System (INIS)

Habboub, H.K.; Thneibat, W.A.

1997-01-01

Aplasia/hypoplasia of the patella has been described as an isolated finding or, more commonly, as a part of congenital syndromes. We describe here bilateral absence of the patella in an 11-year-old girl with absence of the ischial and inferior pubic rami bilaterally. Other associated skeletal and soft-tissue deformities are also reported. To our knowledge, the constellation of these findings has not been described previously and represents a unique syndrome. (orig.). With 1 fig

Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures

Energy Technology Data Exchange (ETDEWEB)

Beall, Douglas P. [University of Oklahoma, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); D' Souza, Sharon L. [University of Oklahoma, Oklahoma City, OK (United States); Costello, Richard F.; Stapp, Annette M. [Clinical Radiology of Oklahoma, Edmond, OK (United States); Prater, Scott D. [University of Oklahoma College of Medicine, Edmond, OK (United States); Van Zandt, Bryan L. [University of Oklahoma College of Medicine, Oklahoma City, OK (United States); Martin, Hal D. [Oklahoma Sports Science and Orthopaedics, Oklahoma City, OK (United States)

2007-10-15

The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. (orig.)

Time-dependent regulation of morphological changes and cartilage differentiation markers in the mouse pubic symphysis during pregnancy and postpartum recovery.

Science.gov (United States)

Castelucci, Bianca Gazieri; Consonni, Sílvio Roberto; Rosa, Viviane Souza; Sensiate, Lucimara Aparecida; Delatti, Paula Cristina Rugno; Alvares, Lúcia Elvira; Joazeiro, Paulo Pinto

2018-01-01

Animal models commonly serve as a bridge between in vitro experiments and clinical applications; however, few physiological processes in adult animals are sufficient to serve as proof-of-concept models for cartilage regeneration. Intriguingly, some rodents, such as young adult mice, undergo physiological connective tissue modifications to birth canal elements such as the pubic symphysis during pregnancy; therefore, we investigated whether the differential expression of cartilage differentiation markers is associated with cartilaginous tissue morphological modifications during these changes. Our results showed that osteochondral progenitor cells expressing Runx2, Sox9, Col2a1 and Dcx at the non-pregnant pubic symphysis proliferated and differentiated throughout pregnancy, giving rise to a complex osteoligamentous junction that attached the interpubic ligament to the pubic bones until labour occurred. After delivery, the recovery of pubic symphysis cartilaginous tissues was improved by the time-dependent expression of these chondrocytic lineage markers at the osteoligamentous junction. This process potentially recapitulates embryologic chondrocytic differentiation to successfully recover hyaline cartilaginous pads at 10 days postpartum. Therefore, we propose that this physiological phenomenon represents a proof-of-concept model for investigating the mechanisms involved in cartilage restoration in adult animals.

Femtosecond laser effect on the self-sealing properties of the corneal incision of various lengths and profile (experimental trial

Directory of Open Access Journals (Sweden)

Yulduz Shavkatovna Nizametdinova

2015-06-01

Full Text Available An experimental investigation was carried out to study self-sealing properties of corneal incisions of different profile and length carried out with femtosecond laser Victus (Technolas Perfect Vision/Bausch&Lomb. Using femtosecond laser for this purpose allows creating corneal incisions of high precision and predictability. Reproducibility and standardization of the incision profile and length are an advantage of this technology. Obtained results showed that single-profile incisions are less stable and safe when compared to multi-profile ones. It was noted that incision length increase promotes its self-sealing properties.

Ciel, a new breath for Tore Supra

International Nuclear Information System (INIS)

Garin, P.

1998-01-01

In view of preparing next generation of tokamaks, a new goal has been given to Tore Supra, initially designed for 30 second operation. In order to fulfill this target, with the ultimate aim of injecting in the plasma 25 MW for 1000 s shots: all existing components (including the 6 ergodic divertor modules) present inside the inner vessel of Tore Supra will be removed by the end of 1999, they will be replaced in 2000 by a set of up to date technology components, designed to withstand an overall power of 25 MW for shots up to 1000 s constituting the so-called 'CIEL' project (French acronym for 'Composants Internes Et Limiteur'). It is planned to stop present Tore Supra's operation in autumn 1999, and start again with CIEL environment at the end of 2000. Full capacity (pumping and cooling) will be available in 2002. (author)

Remote experiment participation on Tore-Supra

International Nuclear Information System (INIS)

Theis, J.-M.; Larsen, J.-M.

2004-01-01

The DRFC has traditionally had a very large external collaboration involvement. In particular, 15% of the DRFC work is directed towards the JET programme. As a consequence substantial telecommunications facilities have been installed [F.E.D. 60/3 (2002) 449; F.E.D. 60/3 (2002) 459]. A specific station for remote communication has been set up in the Tore-Supra control room, closely coupled to a collaborating team at INRS Que., Canada. This paper describes our pilot experience with the Canadian participation, which gives details of the communication and data sharing tools used to fully work on Tore-Supra

Postoperative Granulomas at Liposuction Incision Sites.

Science.gov (United States)

Weniger, Frederick G; White, Peter F; Barrero Castedo, Carlos E

2016-02-01

Since most liposuction incisions heal uneventfully, difficult healing in such incisions must be investigated. In the cases of two gynecomastia liposuction patients in which a water-based lubricating gel was used on the liposuction incisions, the incisions failed to heal. For both patients, workup uncovered palisading granulomas at the lateral inframammary fold incision sites several months after otherwise successful surgeries. These two cases are presented and the previous literature is reviewed, with consideration given to the etiology and prevention of such granulomas. LEVEL OF EVIDENCE 5: Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

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

Directory of Open Access Journals (Sweden)

S O Agodirin

2017-01-01

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

Supra-amphiphiles: a new bridge between colloidal science and supramolecular chemistry.

Science.gov (United States)

Kang, Yuetong; Liu, Kai; Zhang, Xi

2014-06-03

In addition to conventional amphiphiles, an emerging research area is supra-amphiphiles, which are constructed on the basis of noncovalent interactions and dynamic covalent bonds. In this feature article, we have provided a general introduction to the concept, design principles, and topologies of supra-amphiphiles, starting from some rationally tailored building blocks. In addition, we highlight some progress in the functional assembly of supra-amphiphiles, such as responsive nanoscale carriers, antibacterial and antitumor agents, fluorescent-based chemical sensors, and enzyme mimics. The supra-amphiphile is a new bridge between colloidal science and supramolecular chemistry, and it is a field where we can make full use of our imaginative power.

Lateral Erosion Encourages Vertical Incision in a Bimodal Alluvial River

Science.gov (United States)

Gran, K. B.

2015-12-01

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

Atypical initial presentation of Takayasu arteritis as isolated supra-valvular aortic stenosis.

Science.gov (United States)

Kim, Do Yeon; Kim, Hwan Wook

2016-01-19

Among the vascular involvements of Takayasu arteritis, a supra-valvular aortic stenosis has been reported very rarely. We report a case of surgically corrected, supra-valvular aortic stenosis caused by Takayasu arteritis. A 32-year-old female was diagnosed with supra-valvular aortic stenosis by transthoracic echocardiography for the evaluation of cardiac murmur with constitutional symptoms. Under the impression of non-familial sporadic type of supra-valvular aortic stenosis, surgical correction was performed. However, after 1 year from the operation, we could know the cause of her disease through the findings of computed tomographic aortography that Takayasu arteritis was suspected. Takayasu arteritis should be considered in adult female patients presenting supra-valvular aortic stenosis with constitutional symptoms, even if no typical features of vascular involvement.

Runaway electrons dynamics and confinement in TORE-SUPRA

International Nuclear Information System (INIS)

Chatelier, M.; Geraud, A.; Joyer, P.; Martin, G.; Rax, J.M.

1989-01-01

Ohmic discharges in TORE-SUPRA are sufficiently long (∼ 6 s) for runaway electrons (R.E.) to reach a steady energy state: their energy limit is determined by the balance between parallel electric field acceleration (20 MeV/V.s in TORE-SUPRA) and radiation losses due to the curvature of the trajectories. When R.E. energy is supposed to be only parallel, this provides estimate of order of 70 MeV (value usually called 'synchrotron limit') reached in less than 2 seconds. Experimental observations on TORE-SUPRA of photoneutron emission together with residual induced radioactivity in the first wall components tend to prove that the actual value is much lower than 70 MeV (i.e. 15-35 MeV). Earlier observations in ORMAK, PLT and TFR already showed R.E. energy a slightly less than expected from standard loop voltage acceleration calculations. Explanations given for this lack of energy (as skin-effect lowering the electric field during the ramp-up phase or balance between continuous creation and losses) seems not to hold on TORE-SUPRA and therefore another mechanism must be considered to explain the R.E. energy limitation. 4 refs., 2 figs

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

Directory of Open Access Journals (Sweden)

Amedo AO

2016-04-01

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

Impact of adding a second-layer to a single unlocked closure of Cesarean uterine incision: a randomized controlled trial

DEFF Research Database (Denmark)

Rudnicki, Martin; Bennich, G; Wilken-Jensen, C

2016-01-01

the criteria and accepted participation. Thirty-eight women were assigned to single-layer and 38 to double-layer unlocked closure technique. Groups were comparable regarding gestational age at delivery, duration of surgery and peroperative blood loss. RMT was without difference between the two groups, both......The purpose of the present study was to investigate short- and long term effects on residual myometrial thickness (RMT) by adding a second-layer to a single unlocked closure of caesarean uterine incision. METHOD: he study was a randomized double-blind controlled trial. Healthy nulliparous scheduled...... for first-time elective Caesarean delivery were operated using a modified version of the Misgav-Ladach surgical technique. The women were examined by abdominal ultrasound before discharge from the maternity ward and by hysterosonography five months post partum. RESULTS: Seventy-six nulliparous met...

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

Directory of Open Access Journals (Sweden)

Md Shafiqul Alam

2014-01-01

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

Small incision guarded hydroaspiration of iris lesions.

Science.gov (United States)

Singh, Arun D

2017-11-01

To describe the technique and results of a minimally invasive surgical technique for resection of small iris lesions. Consecutive case series of 22 patients with localised, small iris lesions that were resected using the described surgical technique that composed of multiple, small corneal incisions created to allow for internal iris resection with 23-gauge horizontal vitrectomy scissors, followed by guarded tumour aspiration through a clear plastic tubing (diameter 3.5 mm) primed with viscoelastic agent. The mean largest basal diameter was 3.0 mm (range 1.5-5.0 mm; median 3.0 mm) and mean thickness was 1.3 mm (range 0.5-2.5 mm; median 1.0 mm). Use of multiple (2-4) small corneal incisions (range 2.0-3.0 mm; mean 2.8 mm) allowed reduced postoperative morbidity (significant hyphema (0%), hypotony (0%), wound leak (0%), >2 line change in best corrected visual acuity at postoperative 1 week (4.5%) and mean corneal astigmatism of 1.0 D (range 0.14-2.99 D; median 0.8 D) at postoperative 4-12 weeks. The tumour could be resected with clear surgical margins in all neoplastic cases (benign (2), borderline (1) and malignant (16)). Local recurrence or metastases were not observed in any melanoma case over a mean follow-up of 33.0 months (range 1.0-90.0 months; median 33.5 months). Small incision guarded hydroaspiration is a minimally invasive surgical technique for resection of select small iris lesions. Use of multiple small corneal incisions avoids morbidity associated with a single large corneoscleral incision, and use of guarded aspiration may eliminate the risk of wound contamination by the malignant tumour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Towards high-power long-pulse operation on Tore Supra

International Nuclear Information System (INIS)

2000-01-01

The Tore Supra tokamak was given the main mission to investigate the route towards long pulse plasma discharges. This includes the problem of heat exhaust and particle control (via the development of high-performance plasma facing components), and in parallel the physics of fully non inductive discharges and its optimization with respect to the confinement. Tore Supra is thus equipped with a superconducting toroidal magnet (maximum magnetic field on axis 4.5T), a full set of actively cooled plasma facing components (PFC), and a heating and current drive capability based on high power RIF systems connected to actively cooled antennas. The encouraging results already obtained, as well as recent progress in PFC, allowed us to envisage a significant improvement in the heat exhaust capability of Tore Supra. The so-called CIEL-project consists in a complete upgrade of the inner chamber of Tore Supra, planned to be installed during the year 2000. The present paper deals with the experimental and modeling activity linked to the preparation of the long-pulse high-power discharges using the present Tore Supra equipment: heating and current drive scenarios, power coupling, confinement and transport studies, discharge control... An overview of the results obtained in that field is presented, as well as the progress required in the coming years, and the expected performance, for the CIEL phase, in terms of current drive and confinement. (author)

Massive Intrapelvic Hematoma after a Pubic Ramus Fracture in an Osteoporotic Patient

Energy Technology Data Exchange (ETDEWEB)

Haruki, Funao, E-mail: hfunao@yahoo.co.jp; Takahiro, Koyanagi [Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013 (Japan)

2016-03-24

An 88-year-old female presented with a left thigh pain and dysuria. She visited our hospital 2 week after she noticed her symptoms. She stated that she might have a low-energy fall, but she could not identify the exact onset. Her radiograph of the pelvis (Figure 1) showed displaced left pubic ramus fracture. Her computed tomographic scanning of the pelvis (Figure 2) showed massive intrapelvic hematoma (axial size, 11 cm by 5 cm) around the fracture site, although she did not use any anticoagulants. Because her bone mineral density was 0.357 g/cm{sup 2}, and T score was -4.8 SD, she started a bisphosphonate therapy. She received a bed-rest physical therapy for 6 weeks, and the hematoma regressed spontaneously. She started full weight bearing after 6 weeks, and walked by a walker after 8 weeks. Although it is extremely rare to develop massive chronic intra-pelvic hematoma after a lowenergy pubic ramus fracture without any use of anticoagulants, it may occur in elderly and severely osteoporotic patient.

Single-Incision Transumbilical Surgery (SITUS) versus Single-Port Laparoscopic Surgery and conventional laparoscopic surgery: a prospective randomized comparative study of performance with novices in a dry laboratory.

Science.gov (United States)

Schoenthaler, Martin; Avcil, Tuba; Sevcenco, Sabina; Nagele, Udo; Hermann, Thomas E W; Kuehhas, Franklin E; Shariat, Shahrokh F; Frankenschmidt, Alexander; Wetterauer, Ulrich; Miernik, Arkadiusz

2015-01-01

To evaluate the Single-Incision Transumbilical Surgery (SITUS) technique as compared to an established laparoendoscopic single-site surgery (LESS) technique (Single-Port Laparoscopic Surgery, SPLS) and conventional laparoscopy (CLS) in a surgical simulator model. Sixty-three medical students without previous laparoscopic experience were randomly assigned to one of the three groups (SITUS, SPLS and CLS). Subjects were asked to perform five standardized tasks of increasing difficulty adopted from the Fundamentals of Laparoscopic Surgery curriculum. Statistical evaluation included task completion times and accuracy. Overall performances of all tasks (except precision cutting) were significantly faster and of higher accuracy in the CLS and SITUS groups than in the SPLS group (p = 0.004 to p port-assisted LESS technique such as SPLS. The demonstrated advantages of SITUS may be attributed to a preservation of the basic principles of conventional laparoscopy, such as the use of straight instruments and an adequate degree of triangulation.

Fatigue stress fractures of the pubic ramus in the army: imaging features with radiographic, scintigraphic and MR imaging findings

Energy Technology Data Exchange (ETDEWEB)

Lee, Sang Woo; Lee, Chang Hyun [The Armed Forces Capital Hospital, Seongnam (Korea, Republic of)

2005-03-15

Although fatigue fractures are not unusual in athletes and military personnel those of the pubic ramus are rare. We report three cases of fatigue fractures of the inferior pubic rami in two male recruits and one female military cadet. On the initial radiograph, most of the lesions were subtle and easy to overlook. However, bone scintigraphy provided more distinct images that allowed easy and early detection of lesion, and MR imaging presented more diagnostic information, which allowed a precise diagnosis.

MHD limits in non-inductive tokamak plasmas: simulations and comparison to experiments on Tore Supra

International Nuclear Information System (INIS)

Maget, P.; Huysmans, G.; Ottaviani, M.; Garbet, X.; Moreau, Ph.; Segui, J.-L.; Luetjens, H.

2008-01-01

Non-inductive tokamak discharges with a flat or hollow current profile are prone to the triggering of large tearing modes when the minimum of the safety factor is just below a low order rational. This issue is of particular importance for discussing the optimal safety factor for MHD modes avoidance in Steady-State reactor plasmas. Different non-linear regimes of such magnetic configurations in Tore Supra are studied using the full MHD code XTOR. Numerical simulations show that the non-linear stage of the Double-Tearing Mode (DTM) is governed by the full reconnection model, but a single tearing mode in a low magnetic shear configuration can have a similar impact on the confinement. The different regimes observed experimentally are recovered in the simulations: a small amplitude (2,1) DTM for close resonant surfaces as seen in Tore Supra, a sawtooth-like behaviour of the (2,1) Double-Tearing Mode as first seen in TFTR, or a large amplitude (2,1) tearing mode that severely degrades the energy confinement, as reported in Tore Supra, JET or DIII-D. Situations where q min ≅1.5 with a stable n = 1 mode, as seen in Tore Supra longest discharges, seem to put specific constraints on the MHD model that is used. Indeed, curvature stabilisation without transport terms as could explain linear stability, but such effect vanishes in presence of heat transport. Electron diamagnetic rotation effect is investigated as a possible mechanism for n = 1 mode stabilization.

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

Directory of Open Access Journals (Sweden)

Sanoop Koshy Zachariah

2014-09-01

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

Nuclear fusion TORE SUPRA, a new stage

International Nuclear Information System (INIS)

Gregoire, M.; Laurent, L.

1995-01-01

Since almost forty years, the scientists try and neutralize in a pacific aim thermonuclear fusion energy and therefore they use the magnetic confinement of hot plasmas.In France, since 1960 the achieved studies permitted in 1988 to bring into service the TORE SUPRA TOKAMAK, which used, for the first time a superconducting magnet to generate the confinement magnetic field. TORE SUPRA, which didn't still explore its maximal potentialities, will be one of the apparatuses which will be used as basis of the international project ITER development. 5 figs

New developments on Tore Supra data acquisition units

International Nuclear Information System (INIS)

Leroux, F.; Caulier, G.; Ducobu, L.; Goniche, M.; Antar, G.

2012-01-01

The Tore Supra data acquisition system (DAS) was designed in the early eighties and has considerably evolved since then. Three generations of data acquisition units still coexist. As cost and maintenance of different operating systems is expensive, it was decided to explore an alternative solution based on an open source operating system (OS) with a disk-less system for the fourth generation. In 2010, Linux distributions for VME bus and PCI bus systems have been evaluated and compared to Lynx OS TM real time OS. The results obtained allowed to choose a version of Linux for VME and PC platform for DAS on Tore Supra. In 2011, the Tore Supra DAS dedicated software was ported on a Linux disk-less PCI platform. The new generation was successfully tested during real plasma experiments on one diagnostic, called DCEDRE. (authors)

The acquisition system for Tore Supra 1000 s discharges

International Nuclear Information System (INIS)

Guillerminet, B.; How, J.

2000-01-01

Long duration discharges are planned for Tore Supra in the near future. A study has been made to detect and correct all the possible limitations of the data acquisition system. Results and analysis of a few 1000 s 'dry-run' test pulses are presented in this paper as well as the solutions foreseen for Tore Supra

A Comparison of Sacroiliac and Pubic Rami Fracture Occurrences in Oblique Side Impact Tests on Nine Post Mortem Human Subjects.

Science.gov (United States)

Petit, Philippe; Trosseille, Xavier; Lebarbé, Mathieu; Baudrit, Pascal; Potier, Pascal; Compigne, Sabine; Masuda, Mitsutoshi; Yamaoka, Akira; Yasuki, Tsuyoshi; Douard, Richard

2015-11-01

The WorldSID dummy can be equipped with both a pubic and a sacroiliac joint (S-I joint) loadcell. Although a pubic force criterion and the associated injury risk curve are currently available and used in regulation (ECE95, FMVSS214), as of today injury mechanisms, injury criteria, and injury assessment reference values are not available for the sacroiliac joint itself. The aim of this study was to investigate the sacroiliac joint injury mechanism. Three configurations were identified from full-scale car crashes conducted with the WorldSID 50th percentile male where the force passing through the pubis in all three tests was approximately 1500 N while the sacroiliac Fy/Mx peak values were 4500 N/50 Nm, 2400 N/130 Nm, and 5300 N/150 Nm, respectively. These tests were reproduced using a 150 kg guided probe impacting Post Mortem Human Subjects (PMHS) at 8 m/s, 5.4 m/s and 7.5 m/s. The shape and the orientation of the impacting face of the probe were selected to match the WorldSID pubic Fy and sacroiliac Fy/Mx loads of the three vehicle test configurations. Three PMHS were tested in each of the three configurations (nine PMHS in total). In the first PMHS configuration, one specimen sustained an AIS 3 injury and one sustained an AIS 4 injury (an unstable pelvis with complete disruption of the posterior arch, a sacroiliac joint disruption associated with an iliac fracture, and a pubic symphysis separation). In the second configuration, all specimens sustained a fracture of the superior lateral iliac wing (AIS 2). In the third configuration, one specimen sustained a partial disruption of the anterior arch (AIS 2). Based on the data from strain gauges located on the pubic rami and near the sacroiliac joint, the pubic rami fractures were identified as occurring prior to the sacroiliac fractures. Out of nine impactor tests performed, the PMHS S-I joint injuries were observed to consistently be associated with pelvic anterior arch fractures. In addition, from the injury

Cerebellar Roles in Self-Timing for Sub- and Supra-Second Intervals.

Science.gov (United States)

Ohmae, Shogo; Kunimatsu, Jun; Tanaka, Masaki

2017-03-29

Previous studies suggest that the cerebellum and basal ganglia are involved in sub-second and supra-second timing, respectively. To test this hypothesis at the cellular level, we examined the activity of single neurons in the cerebellar dentate nucleus in monkeys performing the oculomotor version of the self-timing task. Animals were trained to report the passage of time of 400, 600, 1200, or 2400 ms following a visual cue by making self-initiated memory-guided saccades. We found a sizeable preparatory neuronal activity before self-timed saccades across delay intervals, while the time course of activity correlated with the trial-by-trial variation of saccade latency in different ways depending on the length of the delay intervals. For the shorter delay intervals, the ramping up of neuronal firing rate started just after the visual cue and the rate of rise of neuronal activity correlated with saccade timing. In contrast, for the longest delay (2400 ms), the preparatory activity started late during the delay period, and its onset time correlated with self-timed saccade latency. Because electrical microstimulation applied to the recording sites during saccade preparation advanced self-timed but not reactive saccades, regardless of their directions, the signals in the cerebellum may have a causal role in self-timing. We suggest that the cerebellum may regulate timing in both sub-second and supra-second ranges, although its relative contribution might be greater for sub-second than for supra-second time intervals. SIGNIFICANCE STATEMENT How we decide the timing of self-initiated movement is a fundamental question. According to the prevailing hypothesis, the cerebellum plays a role in monitoring sub-second timing, whereas the basal ganglia are important for supra-second timing. To verify this, we explored neuronal signals in the monkey cerebellum while animals reported the passage of time in the range 400-2400 ms by making eye movements. Contrary to our expectations, we

European Hernia Society guidelines on the closure of abdominal wall incisions

DEFF Research Database (Denmark)

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

2015-01-01

using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II...... of rapidly absorbable sutures. It is suggested using a slowly absorbable monofilament suture in a single layer aponeurotic closure technique without separate closure of the peritoneum. A small bites technique with a suture to wound length (SL/WL) ratio at least 4/1 is the current recommended method......, it is suggested using the smallest trocar size adequate for the procedure and closure of the fascial defect if trocars larger or equal to 10 mm are used. For single incision laparoscopic surgery, we suggest meticulous closure of the fascial incision to avoid an increased risk of incisional hernias....

Identification of individual adult female Javan lutungs (Trachypithecus auratus sondaicus) by using patterns of dark pigmentation in the pubic area.

Science.gov (United States)

Tsuji, Yamato; Widayati, Kanthi Arum; Hadi, Islamul; Suryobroto, Bambang; Watanabe, Kunio

2013-01-01

In a series of field surveys of wild Javan lutungs (Trachypithecus auratus sondaicus) conducted at Pangandaran Nature Reserve in West Java, Indonesia, from 2011 to 2012, we tried to use a method of individual identification by using individual-specific patterns of dark pigmentation in the pubic area. During the 2011 dry season, we used a digital SLR camera with a 400-mm telephoto lens to photograph the pubic area of each individual of a habituated group. These photographs were the basis for identifying 14 different adult females. During the rainy season of 2011 and the dry season of 2012, we checked the presence/absence of each of the identified individuals and found that these patterns were stable, at least during our study period. We found that two adult females and one adult female disappeared from the subject group between the first and second and between the second and third surveys, respectively, and that one adult female gave birth between the first and second surveys, but the infant had disappeared from the group between the second and third surveys. We could not confirm the validity of the method for juvenile females because of the dense white hair in their pubic areas and the fact that few individuals had clear patterns. Furthermore, we could not use this method for males because of the lack of pigmentation in the pubic area. As patterns of pigmentation in the pubic area are known to be present in other Trachypithecus species, our method can be useful for identification of individual adult females of these species, on which few individual-based behavioral studies have been conducted. Collecting individual-based behavioral data would enable us to track the presence of individuals in groups or movements between groups; determine the effects of social rank and age on within-group competition and copulation; and examine population data.

Modified incision for maxillectomy: our experience.

Science.gov (United States)

Bhavana, Kranti; Tyagi, Isha; Ramani, Mukesh Kumar

2012-06-01

Radical maxillectomy has usually been done by the classical Weber Ferguson incision since age old times and still is being used widely due to its advantage of excellent exposure and minimal scarring as the incision follows the natural skin crease. In our modification of radical maxillectomy incision we avoid a scar on the midface by performing a midface degloving and combining it with a subconjunctival eye incision thus avoiding any cosmetic deformity and associated eye complication. It also avoids the late complication of cutaneous fistula following radiotherapy to these areas and due to early healing of the wound, early radiotherapy can be started.

Real chimney technique for total debranching of supra-aortic trunks.

Science.gov (United States)

Kato, Masaaki; Kagaya, Hideo; Kubo, Yoji; Banno, Hiroshi; Ohkubo, Nobukazu

2015-02-01

Side-clamping of the ascending aorta is an indispensable technique for proximal anastomosis in total debranching of supra-aortic trunks and in endovascular aneurysm repair for arch aneurysm. However, this procedure may lead to the dislodging of multiple plaques and to clamp injury of the ascending aorta. We developed a clampless technique to achieve proximal anastomosis between the ascending aorta and an artificial graft used for total debranching of supra-aortic trunks. We applied this method in six patients with arch aneurysm and a plaque-rich ascending aorta and were able to achieve total debranching of the supra-aortic trunks in all of the patients without side-clamping the ascending aorta and no procedurally related complications. This clampless anastomosis technique ("real chimney technique") in the ascending aorta is a valuable option for total debranching of supra-aortic trunks in the hybrid repair of arch aneurysms. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Penetrating and Intrastromal Corneal Arcuate Incisions in Rabbit and Human Cadaver Eyes: Manual Diamond Blade and Femtosecond Laser-Created Incisions.

Science.gov (United States)

Gray, Brad; Binder, Perry S; Huang, Ling C; Hill, Jim; Salvador-Silva, Mercedes; Gwon, Arlene

2016-07-01

To compare morphologic differences between freehand diamond or femtosecond laser-assisted penetrating and intrastromal arcuate incisions. Freehand diamond blade, corneal arcuate incisions (180° apart, 60° arc lengths) and 150 kHz femtosecond laser (80% scheimpflug pachymetry depth corneal thickness) arcuate incisions were performed in rabbits. Intrastromal arcuate incisions (100 μm above Descemet's membrane, 100 μm below epithelium) were performed in rabbit corneas (energy 1.2 μJ, spot line separation 3 × 3 μm, 90° side cut angle). Eyes were examined by slit lamp and light microscopy up to 47 days post-procedure. Freehand diamond blade penetrating incisions, and femtosecond laser penetrating and intrastromal arcuate incisions (energy 1.8 μJ, spot line separation 2 × 2 μm) were performed in cadaver eyes. Optical coherence tomography was performed immediately after surgery and the corneas were fixed for light scanning and transmission electron microscopy. The rabbit model showed anterior stromal inflammation with epithelial hyperplasia in penetrating blade and laser penetrating wounds. The laser intrastromal and penetrating incisions showed localized constriction of the stromal layers of the cornea near the wound. In cadaver eyes, penetrating wound morphology was similar between blade and laser whereas intrastromal wounds did not affect the cornea above or below incisions. Penetrating femtosecond laser arcuate incisions have more predictable and controlled outcomes shown by less post-operative scarring than incisions performed with a diamond blade. Intrastromal incisions do not affect uncut corneal layers as demonstrated by histopathology. The femtosecond laser has significant advantages in its ability to make intrastromal incisions which are not achievable by traditional freehand or mechanical diamond blades.

Can the nuclear symmetry potential at supra-saturation densities be negative?

International Nuclear Information System (INIS)

Yong Gaochan

2010-01-01

In the framework of an isospin-dependent Boltzmann-Uehling-Uhlenbeck (IBUU) transport model, for the central 197 Au+ 197 Au reaction at an incident beam energy of 400 MeV/nucleon, the effect of nuclear symmetry potential at supra-saturation densities on the preequilibrium clusters emission is studied. It is found that for the positive symmetry potential at supra-saturation densities the neutron-to-proton ratio of lighter clusters with mass number A≤3[(n/p) A≤3 ] is larger than that of the heavier clusters with mass number A>3[(n/p) A>3 ], whereas for the negative symmetry potential at supra-saturation densities the (n/p) A≤3 is smaller than the (n/p) A>3 . This may be considered as a probe of the negative symmetry potential at supra-saturation densities.

Water leak localization and recovery in Tore Supra

International Nuclear Information System (INIS)

Martinez, A.; Samaille, F.; Chantant, M.; Hatchressian, J.C.

2007-01-01

For almost 20 years at Tore Supra, plasma facing components (PFCs) are actively cooled by a pressurized water primary loop. Tore Supra can be considered as ITER relevant on this particular aspect. During plasma operation, it happened, that unexpected localized power deposits damaged a PFC leading to more or less large water leaks in the vacuum vessel. The improvement of the procedure to localize the leaky circuits, the investigation of technical solutions for minimizing the amount of water from steam condensation in the vacuum vessel and the optimisation of the quality of the draining and the drying of Tore Supra cooling loop circuits are the result of the experience gained during several years by the analysis of the water leak from plasma facing components (PFCs) and their consequences. Different new specific systems designed and installed during this year to fulfil these objectives are described in this paper

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-05-11

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

Tore Supra: technical description

International Nuclear Information System (INIS)

1985-08-01

Cryogenic system of Tore Supra is described with its principal functions and operation modes. Data control and acquisition with on line data processing is presented. Radiation dose and induced radioactivity evaluation is studied. Cooling system is detailed together with characteristics of facilities and circuits to cool. Then machine assembly and buildings are presented [fr

Controlled thermonuclear reactions and Tora Supra program

International Nuclear Information System (INIS)

1988-01-01

The research programs for the nuclear energy production by means of thermonuclear fusion are shown. TORA SUPRA, Joint European Torus, Next European Torus and those developed at the Atomic Energy Center are described. The controlled fusion necessary conditions, the energy and confinement balance, and the research of a better tokamak configuration are discussed. A description of TORA SUPRA, the ways of achieving the project and the expected delays are shown. The Controlled Fusion Research Department functions, concerning these programs, are described. The importance of international cooperation and the perspectives about the use of controlled fusion are underlined [fr

Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures.

Science.gov (United States)

Vigdorchik, Jonathan M; Esquivel, Amanda O; Jin, Xin; Yang, King H; Onwudiwe, Ndidi A; Vaidya, Rahul

2012-09-27

We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX). This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX) and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation). Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01) at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017) at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used.

Pellet injection requirements for TORE SUPRA

International Nuclear Information System (INIS)

Lafferranderie, J.

1986-01-01

The main parameters of TORE SUPRA are outlined and pellet injection requirements to meet plasma density goals are discussed. Topics considered include plasma buildup, plasma refueling and penetration depth

Risky business: is pubic hair removal by women associated with body image and sexual health?

Science.gov (United States)

Grossman, Stephanie L; Annunziato, Rachel A

2018-04-30

Background: Body hair removal is a behaviour that has become normative among women in Westernised cultures, and is presented by the media as the feminine ideal, despite being painful and a potential cause of infection. Of concern, removal may be part of a more global pattern of appearance dissatisfaction and risky sexual behaviour. The aim of the present study was to examine the relationships among pubic hair removal, body image and sexual health indicators. Methods: Women (n=264; Mage=33.82, s.d.=11.13, range=18-66) completed self-report questionnaires assessing these constructs, including an assessment of body hair removal practices. Results: Greater appearance concerns (as measured by thin-ideal internalisation, appearance investment and self-objectification) and sexual health indicators (i.e. less condom use self-efficacy when a partner disapproves of condom use) all predicted greater importance of reasons for pubic hair removal (R2=0.315, F(8184)=9.97, Pwomen who removed a greater amount of hair reported more thin-ideal internalisation and appearance investment than those who removed less hair. Conclusions: Women who express stronger reasoning for pubic hair removal, and remove a larger amount of it, may endorse problematic beliefs and behaviours particularly related to appearance concerns. It is important for practitioners to consider this practice as distinct from grooming and to be aware of its association with a broader array of risky beliefs and behaviours that can compromise women's well-being.

A rare case of primary clear cell sarcoma of the pubic bone resembling small round cell tumor: an unusual morphological variant

International Nuclear Information System (INIS)

Nakayama, Shoko; Tsuji, Motomu; Hanafusa, Toshiaki; Yokote, Taiji; Iwaki, Kazuki; Akioka, Toshikazu; Miyoshi, Takuji; Hirata, Yuji; Takayama, Ayami; Nishiwaki, Uta; Masuda, Yuki

2012-01-01

Clear cell sarcoma (CCS) and malignant melanoma share overlapping immunohistochemistry with regard to the melanocytic markers HMB45, S100, and Melan-A. However, the translocation t(12; 22)(q13; q12) is specific to CCS. Therefore, although these neoplasms are closely related, they are now considered to be distinct entities. However, the translocation is apparently detectable only in 50%–70% of CCS cases. Therefore, the absence of a detectable EWS/AFT1 rearrangement may occasionally lead to erroneous exclusion of a translocation-negative CCS. Therefore, histological assessment is essential for the correct diagnosis of CCS. Primary CCS of the bone is exceedingly rare. Only a few cases of primary CCS arising in the ulna, metatarsals, ribs, radius, sacrum, and humerus have been reported, and primary CCS arising in the pubic bone has not been reported till date. We present the case of an 81-year-old man with primary CCS of the pubic bone. Histological examination of the pubic bone revealed monomorphic small-sized cells arranged predominantly as a diffuse sheet with round, hyperchromatic nuclei and inconspicuous nucleoli. The cells had scant cytoplasm, and the biopsy findings indicated small round cell tumor (SRCT). Immunohistochemical staining revealed the tumor cells to be positive for HMB45, S100, and Melan-A but negative for cytokeratin (AE1/AE3) and epithelial membrane antigen. To the best of our knowledge, this is the first case report of primary CCS of the pubic bone resembling SRCT. This ambiguous appearance underscores the difficulties encountered during the histological diagnosis of this rare variant of CCS. Awareness of primary CCS of the bone is clinically important for accurate diagnosis and management when the tumor is located in unusual locations such as the pubic bone and when the translocation t(12; 22)(q13; q12) is absent

Iatrogenic Bowel Injury at Exchange of Supra-Pubic Catheter

LENUS (Irish Health Repository)

Foran, AT

2018-04-01

Suprapubic catheter insertion and exchange is a common urological procedure, but it is not without risks and complications. While bowel perforation is a recognised complication at suprapubic catheter insertion, it is not commonly reported at suprapubic catheter exchange. We report our experience of recognition, diagnosis and subsequent successful management of the most important complication related to suprapubic catheters.

SUPRA - Enhanced upset recovery simulation

NARCIS (Netherlands)

Groen, E.; Ledegang, W.; Field, J.; Smaili, H.; Roza, M.; Fucke, L.; Nooij, S.; Goman, M.; Mayrhofer, M.; Zaichik, L.E.; Grigoryev, M.; Biryukov, V.

2012-01-01

The SUPRA research project - Simulation of Upset Recovery in Aviation - has been funded by the European Union 7th Framework Program to enhance the flight simulation envelope for upset recovery simulation. Within the project an extended aerodynamic model, capturing the key aerodynamics during and

Electrocautery skin incision for neurosurgery procedures--technical note.

Science.gov (United States)

Nitta, Naoki; Fukami, Tadateru; Nozaki, Kazuhiko

2011-01-01

The reluctance to incise skin with electrocautery is partly attributable to concerns about excessive scarring and poor wound healing. However, recently no difference was reported in wound complications between the cold scalpel and electrocautery scalpel. We assessed the safety and efficacy of electrocautery skin incision in 22 scalp incisions, including 4 cases of reoperation. Electrocautery skin incisions were created using a sharp needle electrode. The generator unit was set on cutting mode, with power of 6 W and 330 kHz sinusoid waveform. Subcutaneous dissections also used the sharp needle electrode, set on coagulating mode, with power of 10 W and 1 MHz pulse-modulated waveform. Galea incisions used a standard blade tip, set on coagulating mode, with power of 20 W and 1 MHz pulse-modulated waveform. Skin incision with the sharp needle electrode caused no charring of the wound. Little bleeding or oozing were observed and skin clips were not necessary. No wound complication such as necrosis or infection occurred. Electrocautery skin incisions for re-operations were also performed safely without complications. Electrocautery skin incision is sufficiently safe procedure not only for first operation but also for re-operation. Electrocautery skin incision is efficacious, especially for extended operation times, because of little blood loss from the edges of skin incision and possible avoidance of skin edge necrosis or alopecia caused by skin clips.

Particle control studies on Tore Supra

International Nuclear Information System (INIS)

Mioduszewski, P.

1987-01-01

The report consists of viewgraphs. The goal of the particle control program at Tore Supra is to study plasma performance with strong pellet fueling and corresponding particle exhaust in a limiter tokamak

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

Directory of Open Access Journals (Sweden)

Yongqi He

2009-01-01

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

Characterisation of Supra- and Infratentorial ICP Profiles.

Science.gov (United States)

Moyse, Emmanuel; Ros, Maxime; Marhar, Fouad; Swider, Pascal; Schmidt, Eric Albert

2016-01-01

In pathophysiology and clinical practice, the intracranial pressure (ICP) profiles in the supratentorial and infratentorial compartments are unclear. We know that the pressure within the skull is unevenly distributed, with demonstrated ICP gradients. We recorded and characterised the supra- and infratentorial ICP patterns to understand what drives the transtentorial ICP gradient.A 70-year-old man was operated on for acute cerebellar infarction. One supratentorial probe and one cerebellar probe were implanted. Both signals were recorded concurrently and analysed off-line. We calculated mean ICP, ICP pulse amplitude, respiratory waves, slow waves and the RAP index of supra- and infratentorial ICP signals. Then, we measured transtentorial difference and performed correlation analysis for every index.Supratentorial ICP mean was 8.5 mmHg lower than infratentorial ICP, but the difference lessens for higher values. Both signals across the tentorium showed close correlation. Supra- and infratentorial pulse amplitude, respiratory waves and slow waves also showed a high degree of correlation. The compensatory reserve (RAP) showed good correlation. In this case report, we demonstrate that the mean value of ICP is higher in the posterior fossa, with a strong correlation across the tentorium. All other ICP-derived parameters display a symmetrical profile.

Thermal Structure of Supra-Arcade Plasma in Two Solar Flares

Science.gov (United States)

Reeves, Katharine K.; Savage, Sabrina; McKenzie, David E.; Weber, Mark A.

2012-01-01

In this work, we use Hinode/XRT and SDO/AIA data to determine the thermal structure of supra-arcade plasma in two solar flares. The first flare is a Ml.2 flare that occurred on November 5, 2010 on the east limb. This flare was one of a series of flares from AR 11121, published in Reeves & Golub (2011). The second flare is an XI.7 flare that occurred on January 27, 2012 on the west limb. This flare exhibits visible supra-arcade downflows (SADs), where the November 2010 flare does not. For these two flares we combine XRT and AlA data to calculate DEMs of each pixel in the supra-arcade plasma, giving insight into the temperature and density structures in the fan of plasma above the post-flare arcade. We find in each case that the supra-arcade plasma is around 10 MK, and there is a marked decrease in the emission measure in the SADs. We also compare the DEMs calculated with the combined AIA/XRT dataset to those calculated using AIA alone.

Delayed Bleeding and Pelvic Haematoma after Low-Energy Osteoporotic Pubic Rami Fracture in a Warfarin Patient: An Unusual Cause of Abdominal Pain

Directory of Open Access Journals (Sweden)

Andrea Sandri

2014-01-01

Full Text Available Introduction. Acute abdominal pain may be the presenting symptom in a wide range of diseases in the elderly. Acute abdominal pain related to a delayed bleeding and pelvic haematoma after a low-energy pubic rami fracture is rare and can have important consequences; to the best of our knowledge, only one case has been previously described. Case Report. We present an unusual case of an 83-year-old woman taking warfarin for atrial fibrillation, admitted to the Emergency Department (ED with acute abdominal pain and progressive anemia related to a delayed bleeding and pelvic haematoma 72 hours after a low-energy osteoporotic pubic rami fracture. Warfarin was withheld, anticoagulation was reversed by using fresh frozen plasma and vitamin K, and concentrated red blood cells were given. Haemoglobin level gradually returned to normal with a progressive resorption of the haematoma. Conclusion. Delayed bleeding and pelvic haematoma after osteoporotic pubic rami fracture should be considered in the differential diagnosis of acute abdominal pain in the elderly. This case indicates the need for hospital admission, careful haemodynamic monitoring, and early identification of bleeding in patients with “benign” osteoporotic pubic rami fracture, especially those receiving anticoagulants, to provide an adequate management and prevent severe complications.

Human FAN1 promotes strand incision in 5'-flapped DNA complexed with RPA.

Science.gov (United States)

Takahashi, Daisuke; Sato, Koichi; Hirayama, Emiko; Takata, Minoru; Kurumizaka, Hitoshi

2015-09-01

Fanconi anaemia (FA) is a human infantile recessive disorder. Seventeen FA causal proteins cooperatively function in the DNA interstrand crosslink (ICL) repair pathway. Dual DNA strand incisions around the crosslink are critical steps in ICL repair. FA-associated nuclease 1 (FAN1) is a DNA structure-specific endonuclease that is considered to be involved in DNA incision at the stalled replication fork. Replication protein A (RPA) rapidly assembles on the single-stranded DNA region of the stalled fork. However, the effect of RPA on the FAN1-mediated DNA incision has not been determined. In this study, we purified human FAN1, as a bacterially expressed recombinant protein. FAN1 exhibited robust endonuclease activity with 5'-flapped DNA, which is formed at the stalled replication fork. We found that FAN1 efficiently promoted DNA incision at the proper site of RPA-coated 5'-flapped DNA. Therefore, FAN1 possesses the ability to promote the ICL repair of 5'-flapped DNA covered by RPA. © The Authors 2015. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

Single-incision laparoscopic appendectomy using homemade glove port at low cost

Directory of Open Access Journals (Sweden)

Sang Myoung Lee

2016-01-01

Full Text Available Purpose: The aim of this study was to report homemade glove port technique for single-incision laparoscopic appendectomy (SILA. Materials and Methods: Our homemade glove port was composed of a size 6 latex sterile surgical glove, a sterilized plastic bangle, and three pieces of silicon tube (5 cm in length that were used as the suction tube. Clinical data were retrospectively collected from those patients who underwent SILA at Bucheon St. Mary's Hospital, Bucheon, Gyeonggi-do, South Korea between February 2014 and June 2014, including patient demographics, and operative and postoperative outcomes. To compare the outcomes, a retrospective review was performed for those patients who underwent conventional laparoscopic appendectomy (CLA between October 2013 and January 2014. Both SILA and CLA were performed by the same surgical team. Results: The SILA and CLA groups included 37 and 57 patients, respectively. The mean age, weight, body mass index (BMI, operation time, and pathologic diagnosis of gangrenous appendicitis were not significantly different between the two groups. However, the mean hospital stay in the CLA group was significantly (P = 0.018 longer than that in the SILA group (4.2 days vs 3.5 days. There was no conversion to open surgery in both the groups. Of the cases who underwent SILA, 10 (27.0% needed insertion of additional port and drain. There was one (3.2% complication of umbilical surgical site infection. Conclusion: In this study, SILA, with homemade glove port, was technically feasible and safe at low cost.

Amphiphilic building blocks for self-assembly: from amphiphiles to supra-amphiphiles.

Science.gov (United States)

Wang, Chao; Wang, Zhiqiang; Zhang, Xi

2012-04-17

The process of self-assembly spontaneously creates well-defined structures from various chemical building blocks. Self-assembly can include different levels of complexity: it can be as simple as the dimerization of two small building blocks driven by hydrogen bonding or as complicated as a cell membrane, a remarkable supramolecular architecture created by a bilayer of phospholipids embedded with functional proteins. The study of self-assembly in simple systems provides a fundamental understanding of the driving forces and cooperativity behind these processes. Once the rules are understood, these guidelines can facilitate the research of highly complex self-assembly processes. Among the various components for self-assembly, an amphiphilic molecule, which contains both hydrophilic and hydrophobic parts, forms one of the most powerful building blocks. When amphiphiles are dispersed in water, the hydrophilic component of the amphiphile preferentially interacts with the aqueous phase while the hydrophobic portion tends to reside in the air or in the nonpolar solvent. Therefore, the amphiphiles aggregate to form different molecular assemblies based on the repelling and coordinating forces between the hydrophilic and hydrophobic parts of the component molecules and the surrounding medium. In contrast to conventional amphiphiles, supra-amphiphiles are constructed on the basis of noncovalent interactions or dynamic covalent bonds. In supra-amphiphiles, the functional groups can be attached to the amphiphiles by noncovalent synthesis, greatly speeding their construction. The building blocks for supra-amphiphiles can be either small organic molecules or polymers. Advances in the development of supra-amphiphiles will not only enrich the family of conventional amphiphiles that are based on covalent bonds but will also provide a new kind of building block for the preparation of complex self-assemblies. When polymers are used to construct supra-amphiphiles, the resulting

Charge-Transfer Supra-Amphiphiles Built by Water-Soluble Tetrathiafulvalenes and Viologen-Containing Amphiphiles: Supramolecular Nanoassemblies with Modifiable Dimensions.

Science.gov (United States)

Lv, Zhong-Peng; Chen, Bin; Wang, Hai-Ying; Wu, Yue; Zuo, Jing-Lin

2015-08-05

In this study, multidimensional nanoassemblies with various morphologies such as nanosheets, nanorods, and nanofibers are developed via charge-transfer interaction and supra-amphiphile self-assembling in aqueous phase. The charge-transfer interactions between tetrathiafulvalene derivatives (TTFs) and methyl viologen derivatives (MVs) have been confirmed by the characteristic charger-transfer absorption. (1) H NMR and electrospray ionizsation mass spectrometry (ESI-MS) analyses also indicate supra-amphiphiles are formed by the combination of TTFs and MVs head group through charge-transfer interaction and Coulombic force. X-ray single crystal structural studies, transmission electron microscopy (TEM), and scanning electron microscopy (SEM) reveal that both linkage pattern of TTFs in hydrophilic part and alkane chain structure in hydrophobic part have significant influence on nanoassemblies morphology and microstructure. Moreover, gold nanoparticles (AuNPs) are introduced in the above supramolecular nanoassemblies to construct a supra-amphiphile-driven organic-AuNPs assembly system. AuNPs could be assembled into 1D-3D structures by adding different amount of MVs. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Tore-Supra: a Tokamak with superconducting toroidal field coils

International Nuclear Information System (INIS)

Turck, B.

1987-07-01

Tore Supra is a tokamak under construction on the site of Cen Cadarache by the Euratom-CEA Association. The machine technology integrates all problems related to the fabrication and the operation of large superconducting coils and of the associated cryogenic system. Tore Supra will provide a significant experience to prepare the next generation of machines for plasma physics and controlled fusion. Tore Supra is specially designed to implement a large physics program. The superconducting coils make possible the study of plasma confinement in long pulses (more than 60s), the impurities and the stability, and the efficiency of additional heating sources (neutral particle beams and radio frequency heating). The opportunity is taken to recall the particular features and requirements of the superconducting coils of the large future tokamaks in order to point out the problems that have to be faced by any new material (superconducting or not)

Heat loads on Tore Supra ICRF Launchers Plasma Facing Components

International Nuclear Information System (INIS)

Bremond, S.; Colas, L.; Beaumont, B.; Chantant, M.; Goniche, M.; Mitteau, R.

2005-01-01

Understanding the heat loads on Ion Cyclotron Range of Frequency (ICRF) launchers plasma-facing components is a crucial task both for operating present tokamaks and for designing ITER ICRF launchers as these loads may limit the RF power coupling capability. Tore Supra facility is particularly well suited to take this issue. Parametric studies have been performed which enables to get an overall detailed picture of the different heat loads on several areas, pointing to different mechanisms at the origin of the heat power fluxes. It is found that the most critical items for Tore-Supra operation are localized heat loads on the Faraday screen top left corner and vertical edges. Warming up close to maximum temperature limit originally set for protection of the plasma-facing components is found of high power pulses, but no erosion was observed after detailed inspection of the launcher in Tore-Supra vessel. Yet, the associated heat loads could be limiting for Tore-Supra operation in the future, and some dedicated work is under progress to improve the understanding of these power fluxes, pointing out the importance of getting a better knowledge of particle flows in the scrape of layer

Maximizing prosthetic valve size with the Top Hat supra-annular aortic valve

DEFF Research Database (Denmark)

Aagaard, Jan; Geha, Alexander S.

2007-01-01

BACKGROUND AND AIM OF THE STUDY: The CarboMedics Top Hat supra-annular aortic valve allows a one-size (and often two-size) increase over the standard intra-annular valve. This advantage should minimize the risk of patient-prosthesis mismatch, where the effective prosthetic valve orifice area....... This study evaluates the authors' clinical experience with Top Hat supra-annular aortic valve size selection, and the technical aspects of implantation. METHODS: Between January 1999 and October 2005, a total of 251 consecutive patients underwent 252 aortic valve replacements with Top Hat supra...... required unplanned coronary bypass, and 30-day mortality was 2.0% (5/251), indicating a good safety profile for the valves implanted in this series. CONCLUSION: The general distribution of implant sizes in the US indicates that cardiac surgeons may be under-sizing the Top Hat supra-annular aortic valve...

Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone

Directory of Open Access Journals (Sweden)

Damian Ziaja

2015-01-01

Full Text Available Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia. Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.

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

Science.gov (United States)

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

2015-06-01

The aim of the present study is to evaluate mental workload and fatigue in fingers, hand, arm, shoulder in single-incision laparoscopic surgery (SILS) and multiport laparoscopy. Volunteers performed chosen tasks by standard laparoscopy and SILS. Time to complete tasks and finger and hand strength were evaluated. Lateral, tripod, and pulp pinch strengths were measured. Hand dexterity was determined by pegboard. Electromyography recordings were taken from biceps and deltoid muscles of both extremities. The main outcome measurement was median frequency (MF) slope. NASA-TLX was used for mental workload. Time to complete laparoscopic tasks were longer in the SILS group (P NASA-TLX score was 73 ± 13.3 and 42 ± 19.5 in SILS and multiport laparoscopy, respectively (P < .01). Mental demand, physical demand, temporal demand, performance, effort, and frustration were, respectively, scored 10.7 ± 3.8, 11.7 ± 3.5, 12.2 ± 2.7, 11 ± 3, 13.6 ± 2.7, and 13.5 ± 2.8 in SILS and 6.3 ± 3.1, 6.6 ± 3.3, 7.3 ± 3.3, 7.1 ± 4.1, 7.9 ± 3.9, and 6.6 ± 3.8 in standard laparoscopy (P < .01). SILS is mentally and physically demanding, particularly on arms and shoulders. Fatigue of big muscles, effort, and frustration were major challenges of SILS. Ergonomic intervention of instruments are needed to decrease mental and physical workload. © The Author(s) 2014.

Regional Themes and Global Means in Supra-National Higher Education Policy

Science.gov (United States)

Watson, Pam

2009-01-01

The supra-national level has become increasingly important in educational policy formulation. This paper describes and compares two settings in which growth in these supra-national policies is evident--in Europe and in Africa. Key themes arising in policy documents in each context are examined. A distinction is drawn in analysis between themes…

EDXRF analysis of Marajoara pubic covers

Energy Technology Data Exchange (ETDEWEB)

Calza, Cristiane; Lopes, Ricardo Tadeu [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia. Lab. de Instrumentacao Nuclear]. E-mail: ccalza@lin.ufrj.br; ricardo@lin.ufrj.br; Anjos, Marcelino Jose dos [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Inst. de Fisica]. E-mail: marcelin@lin.ufrj.br; Lima, Tania Andrade [Museu Nacional, Rio de Janeiro, RJ (Brazil)]. E-mail: talima@montreal.com.br

2005-07-01

This work evaluated the elemental composition of decorated pottery pubic covers (tangas) from the Marajoara culture of Marajo Island (located at the mouth of the Amazon River, Brazil). The tangas were used by Marajoara girls probably as part of puberty rites and were anatomically adjustable to the body, containing holes on its corners for string attachment. The samples included two tangas and four fragments from the National Museum collection. One fragment (sample 22245) presented a different design pattern that seemed to indicate a different provenance. EDXRF was performed at the Nuclear Instrumentation Laboratory (COPPE/UFRJ), using a Si(Li) detector from ORTEC with resolution of 180 eV at 5.9 keV and a mini x-ray tube with Mo anode. The angle of the incident x-ray beam was 16 deg and the detector was placed at 90 deg to the sample surface. The elements identified in the samples were: S, Cl, K, Ca, Ti, Mn, Fe, Cu, Zn, Ga, Rb, Sr, Y, Zr and Pb. Principal Component Analysis (PCA) was used to evaluate the provenance of the samples. (author)

Steady state operation and control experiments on Tore Supra

International Nuclear Information System (INIS)

Saint-Laurent, F.

2000-01-01

The main programme of the Tore Supra tokamak is to investigate the route towards long pulse plasma discharges. Tore Supra is thus equipped with a superconducting toroidal magnet, a full set of actively cooled plasma facing components, and a heating and current drive capability based on high power RF systems connected to actively cooled antennas. After pioneering investigations using the LHCD system alone (2 min and zero loop voltage discharges), recent efforts have concentrated on finding scenarios to couple the two RF heating systems in order to perform high power, long duration discharges. To this aim, 6.5 MW, 25 s as well as 4 MW, 60 s discharges have been successfully achieved. At these high power levels, the plasma-wall interaction becomes a critical issue, and recycling fluxes must be controlled to maintain density and to avoid plasma contamination. All these results contributed to the validation of the upgrade of the Tore Supra first wall components (CIEL project) scheduled for 2000. (author)

Major progress on tore supra toward steady state operation of tokamaks

International Nuclear Information System (INIS)

Saoutic, Y.

2003-01-01

During winter 2000-2001, a major upgrade of the internal components of Tore Supra has been completed that increased the heat extraction capability to 25 MW in steady state. Operating Tore Supra in this new configuration has produced a wealth of new results. The highlights of the 2002 long duration discharges campaign are: 4 minutes 25 seconds long discharges with an integrated energy of 0.75 GJ, which is three time higher than the old Tore Supra world record; recharge of the primary transformer by Lower Hybrid Current Drive (LHCD) for about 1 minute; 4 minutes long LHCD pulses; 1 minute long Ion Cyclotron Resonant Heating (ICRH) pulse (0.11 GJ of ICRH injected energy). Beyond the quantitative step, significant qualitative progress in the steady state nature of the discharge has been accomplished: contrary to the situation in the old Tore Supra configuration, the plasma density is perfectly controlled by active pumping over the overall shot duration. The duration of Tore Supra discharges is sufficient to allow the complete diffusion of the resistive current. Surprising new physics is revealed in such discharges when approaching zero loop voltage. Slow central electron temperature oscillations have been observed in a variety of situations. Such oscillations are not likely to be linked to any MHD instabilities and probably results from an interplay between current profile shape, LHCD power deposition and transport. Analysis of the temperature gradient in the core region shows a very interesting behaviour and the normalised temperature gradient length is compared to the critical thresholds. Finally, the performance of heating and current drive systems and the observations made of the interior of Tore Supra after the long duration discharges campaign are reported. (author)

Vertical compared with transverse incisions in abdominal surgery

DEFF Research Database (Denmark)

Grantcharov, T P; Rosenberg, J

2001-01-01

, and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less......OBJECTIVE: To reach an evidence-based consensus on the relative merits of vertical and transverse laparotomy incisions. DESIGN: Review of all published randomised controlled trials that compared the postoperative complications after the two main types of abdominal incisions, vertical and transverse....... SETTING: Teaching hospital, Denmark. SUBJECTS: Patients undergoing open abdominal operations. INTERVENTIONS: For some of the variables (burst abdomen and incisional hernia) it was considered adequate to include retrospective studies. Studies were identified through Medline, Cochrane library, Embase...

Prostate Brachytherapy With Oblique Needles to Treat Large Glands and Overcome Pubic Arch Interference

International Nuclear Information System (INIS)

Ryu, Bon; Bax, Jeff; Edirisinge, Chandima; Lewis, Craig; Chen, Jeff; D’Souza, David; Fenster, Aaron; Wong, Eugene

2012-01-01

Purpose: First, to show that low-dose-rate prostate brachytherapy plans using oblique needle trajectories are more successful than parallel trajectories for large prostates with pubic arch interference (PAI); second, to test the accuracy of delivering an oblique plan by using a three-dimensional (3D) transrectal ultrasonography (TRUS)-guided mechatronic system. Methods and Materials: Prostates were contoured for 5 subjects’ 3D TRUS images showing a maximum PAI of ≤1 cm and a prostate volume of <50 cc. Two planning studies were done. First, prostate contours were artificially enlarged to 45 to 80 cc in 5- to 10-cc increments for a single subject. Second, all subject prostate contours were enlarged to 60 cc. For each study, three types of plans were manually created for comparison: a parallel needle template (PT) plan, a parallel needle no-template (PNT) plan, and an oblique needle no-template (OBL) plan. Needle positions and angles were not discretized for nontemplate plans. European Society for Therapeutic Radiology and Oncology dose-volume histogram guidelines, iodine-125 (145-Gy prescription, 0.43 U), and needle angles of <15° were used. An OBL plan was delivered to a pubic arch containing a 60-cc prostate phantom that mimicked the anatomy of the subject with the greatest PAI (23% by volume). Results: In the increasing-prostate volume study, OBL plans were successful for prostates of ≤80 cc, and PT plans were successful for prostates of <65 cc. In paired, one-sided t tests for the 60-cc volume study, OBL plans showed dosimetric improvements for all organs compared to both of the parallel type plans (p < 0.05); PNT plans showed a benefit only in planning target volumes receiving more than 100 Gy compared to PT plans. A computed tomography scan of the phantom showed submillimeter seed placement accuracy in all directions. Conclusion: OBL plans were significantly better than parallel plans, and an OBL plan was accurately delivered to a 60-cc prostate phantom

Incision of the Jezero Crater Outflow Channel by Fluvial Sediment Transport

Science.gov (United States)

Holo, S.; Kite, E. S.

2017-12-01

Jezero crater, the top candidate landing site for the Mars 2020 rover, once possessed a lake that over-spilled and eroded a large outflow channel into the Eastern rim. The Western deltaic sediments that would be the primary science target of the rover record a history of lake level, which is modulated by the inflow and outflow channels. While formative discharges for the Western delta exist ( 500 m3/s), little work has been done to see if these flows are the same responsible for outflow channel incision. Other models of the Jezero outflow channel incision assume that a single rapid flood (incision timescales of weeks), with unknown initial hydraulic head and no discharge into the lake (e.g. from the inflow channels or the subsurface), incised an open channel with discharge modulated by flow over a weir. We present an alternate model where, due to an instability at the threshold of sediment motion, the incision of the outflow channel occurs in concert with lake filling. In particular, we assume a simplified lake-channel-valley system geometry and that the channel is hydraulically connected to the filling/draining crater lake. Bed load sediment transport and water discharge through the channel are quantified using the Meyer-Peter and Mueller relation and Manning's law respectively. Mass is conserved for both water and sediment as the lake level rises/falls and the channel incises. This model does not resolve backwater effects or concavity in the alluvial system, but it does capture the non-linear feedbacks between lake draining, erosion rate, channel flow rate, and slope relaxation. We identify controls on incision of the outflow channel and estimate the time scale of outflow channel formation through a simple dynamical model. We find that the observed 300m of channel erosion can be reproduced in decades to centuries of progressive bed load as the delta forming flows fill the lake. This corresponds to time scales on the order of or smaller than the time scale

Supra-thermal charged particle energies in a low pressure radio-frequency electrical discharge in air

International Nuclear Information System (INIS)

Littlefield, R.G.

1976-01-01

Velocity spectra of supra-thermal electrons escaping from a low-pressure radio-frequency discharge in air have been measured by a time-of-flight method of original design. In addition, the energy spectra of the supra-thermal electrons and positive ions escaping from the rf discharge have been measured by a retarding potential method. Various parameters affecting the energy of the supra-thermal charged particles are experimentally investigated. A model accounting for the supra-thermal charged particle energies is developed and is shown to be consistent with experimental observations

Oncologic outcomes of single-incision versus conventional laparoscopic anterior resection for sigmoid colon cancer: a propensity-score matching analysis.

Science.gov (United States)

Kim, Chang Woo; Cho, Min Soo; Baek, Se Jin; Hur, Hyuk; Min, Byung Soh; Kang, Jeonghyun; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu

2015-03-01

The aim of this study was to investigate oncologic outcomes, as well as perioperative and pathologic outcomes, of single-incision laparoscopic anterior resection (SILAR) compared with conventional laparoscopic anterior resection (CLAR) for sigmoid colon cancer using propensity-score matching analysis. From July 2009 through April 2012, a total of 407 patients underwent laparoscopic anterior resection for sigmoid colon cancer. Data on short- and long-term outcomes were collected prospectively and reviewed. Propensity-score matching was applied at a ratio of 1:2 comparing the SILAR (n = 60) and CLAR (n = 120) groups. There was no difference in operation time, estimated blood loss, time to soft diet, and length of hospital stay; however, the SILAR group showed less pain on postoperative day 2 (mean 2.6 vs. 3.6; p = 0.000) and shorter length of incision (3.3 vs. 7.7 cm; p = 0.000) compared with the CLAR group. Morbidity, mortality, and pathologic outcomes were similar in both groups. The 3-year overall survival rates were 94.5 versus 97.1% (p = 0.223), and disease-free survival rates were 89.5 versus 87.4% (p = 0.751) in the SILAR and CLAR groups, respectively. The long-term oncologic outcomes, as well as short-term outcomes, of SILAR are comparable with those of CLAR. Although SILAR might have some technical difficulties, it appears to be a safe and feasible option, with better cosmetic results.

Steady-State Operation in Tore Supra

Science.gov (United States)

Hoang, G. T.; Tore Supra, Equipe

1999-11-01

The Tore Supra superconducting tokamak is devoted to steady-state operation. The CIEL (French acronym for internal component and limiter) project( LIPA, M., et al., Proc. of the 17th IEEE/NPSS Symp. on Fus. Engineering, San Diego, USA, 1997.) consists of a complete upgrade of the inner chamber of Tore Supra, planned to be installed during the year 2000. This project will allow physics scenarios with up to 24 MW of radio frequency heating and current drive (typically 8 - 10 MW of ICRF, 10 - 12 MW of LHCD and 2 MW of ECRF) in stationary plasmas up to 1000 s, with active particle control. This paper presents an overview of the experiments planned to explore the properties, such as the confinement and MHD stability, of various heating and current drive scenarios for long duration discharges. The expected performance for the CIEL phase is also reported.

Liquid in the major incision

International Nuclear Information System (INIS)

Herrera Jaramillo, Diego Alberto; Ortega Jaramillo, Hector

2003-01-01

We present the case of a patient with spill pleural extending in the left major incision. In the chest thorax PA, we could observe one of the complex radiographic appearances that take the reconfiguration of fluid in this localization, being this appearance dependent of the patient's position. Some points are also discussed on the anatomy of the major incisions and some of their radiographic characteristics

Behaviour of UV-sensitive mutants of Proteus mirabilis to repair incision breaks

International Nuclear Information System (INIS)

Stoerl, K.; Mund, C.

1977-01-01

In U.V.-sensitive mutants of P. mirabilis with the phenotype HCR, REC and EXR single-strand breaks appeared immediately after UV-irradiation. The behaviour of REC- and EXR-mutants was similar to the wildtype. The number of incision breaks observed by sedimentation analysis in these strains was very low. They could be joined during the excision repair process. From the ability of REC- and EXR-strains to rejoin most of the induced single-strand breaks it can be concluded that these strains have approximately the same capacity for excision repair as the wildtype. HCR-mutants of P. mirabilis produced single-strand breaks after UV-irradiation in contrast to HCR-mutants of E. coli. Therefore we suggest that HCR-mutants of P. mirabilis are not completely inhibited in the incision step. The single-strand breaks introduced in the DNA at the beginning of the repair process were not rejoined during further incubation. Experiments with toluenized cells led to the same results. The newly synthesized daughter DNA-strands of UV-irradiated HCR-mutants were of low molecular weight in comparison with those from unirradiated control cells during the repair period. This result is in agreement with the incapability of HCR-mutants to remove the pyrimidine dimers from the parental template strand. (author)

Effects of post-treatment incubation on recombinogenesis in incision-proficient and incision-deficient strains of saccharomyces cerevisiae, 2

International Nuclear Information System (INIS)

Saeki, Tetsuya; Machida, Isamu

1991-01-01

After the photoaddition of mono- and bifunctional furocoumarins to G1 phase cells, most gene conversion and crossing-over occurred without post-irradiation incubation of these cells in incision-proficient strains. In contrast, incision-deficient cells showed marked induction of both recombinational events only after treated cells had been incubated for several hours before selection. These results indicate that when furocoumarins are photoadded to G1 cells, initiation of recombinational events occurs during the same G1 phase in the incision-proficient cells; whereas, it occurs only after post-irradiation DNA replication in incision-deficient cells. The action of the PSO2 gene product specific for the repair of DNA crosslinks in recombination induction is discussed and compared to the actions of the excision repair genes RAD1 and RAD2. (author)

Lower hybrid current drive in Tore Supra and JET

International Nuclear Information System (INIS)

Moreau, D.; Gormezano, C.

1991-01-01

Recent Lower Hybrid Current Drive (LHCD) experiments in TORE SUPRA and JET are reported. Large multijunction launchers have allowed the coupling of 5MW to the plasma for several seconds with a maximum of 3.8 kW/cm 2 . Measurements of the scattering matrices of the antennae show good agreement with theory. The current drive efficiency in TORE SUPRA is about 0.2 x 10 20 Am -2 /W with LH power alone and reaches 0.4 x 10 20 Am -2 /W in JET thanks to a high volume-averaged electron temperature (1.9 keV) and also to a synergy between Lower Hybrid and Fast Magnetosonic Waves. At n e = 1.5 x 10 19 m -3 in TORE SUPRA, sawteeth are suppressed and m = 1MHD oscillations the frequency of which clearly depends on the amount of LH power are observed on soft X-rays, and also on non-thermal ECE. In Jet ICRH produced sawtooth free periods are extended by the application of LHCD and current profile broadening has been clearly observed consistent with off-axis fast electron populations. LH power modulation experiments performed in TORE SUPRA at n e = 4 x 10 19 m -3 show a delayed central electron heating despite the off-axis creation of suprathermal electrons, thus ruling out the possibility of a direct heating through central wave absorption. A possible explanation in terms of anomalous fast electron transport and classical slowing down would yield a diffusion coefficient of the order of 10 m 2 /s for the fast electrons. Finally, successful pellet fuelling of a partially LH driven plasma was obtained in TORE SUPRA, 28 successive pellets allowing the density to rise to n e = 4 x 10 19 m -3 . This could be achieved by switching the LH power off for 90 ms before each pellet injection, i.e. without modifying significantly the current density profile

Lower hybrid current drive in Tore Supra and jet

International Nuclear Information System (INIS)

Moreau, D.; Gormezano, C.

1991-07-01

Recent Lower Hybrid Current Drive (LHCD) experiments in TORE SUPRA and JET are reported. Large multijunction launchers have allowed the coupling of 5 MW to the plasma for several seconds with a maximum of 3.8 kW/cm 2 . Measurements of the scattering matrices of the antennae show good agreement with theory. The current drive efficiency in TORE SUPRA is about 0.2 x 10 20 Am -2 /W with LH power alone and reaches 0.4 x 10 20 Am -2 /W in JET thanks to a high volume-averaged electron temperature (1.9 keV) and also to a synergy between Lower Hybrid and Fast Magnetosonic Waves. At average n e = 1.5 x 10 19 m -3 in TORE SUPRA, sawteeth are suppressed and m = 1 MHD oscillations the frequency of which clearly depends on the amount of LH power are observed on soft X-rays, and also on non-thermal ECE. In JET ICRH produced sawtooth-free periods are extended by the application of LHCD (2.9 s. with 4 MW ICRH) and current profile broadening has been clearly observed consistent with off-axis fast electron populations. LH power modulation experiments performed in TORE SUPRA at average n e = 4 x 10 19 m -3 show a delayed central electron heating despite the off-axis creation of suprathermal electrons, thus ruling out the possibility of a direct heating through central wave absorption. A possible explanation in terms of anomalous fast electron transport and classical slowing down would yield a diffusion coefficient of the order of 10 m 2 /s for the fast electrons. Other interpretations such as an anomalous heat pinch or a central confinement enhancement cannot be excluded. Finally, successful pellet fuelling of a partially LH driven plasma was obtained in TORE SUPRA, 28 successive pellets allowing the density to rise to average n e = 4 x 10 19 m -3 . This could be achieved by switching the LH power off for 90 ms before each pellet injection, i.e. without modifying significantly the current density profile

The "Propeller" incision for transpalatal advancement pharyngoplasty: a new approach to reduce post-operative oronasal fistulae.

Science.gov (United States)

Shine, Neville Patrick; Lewis, Richard Hamilton

2008-09-01

To present a new soft tissue approach for transpalatal advancement pharyngoplasty (TPA), the propeller incision, and to compare the rates of post-operative oronasal fistula in those undergoing TPA with the traditional "Gothic Arch" incision described by Woodson and those with the propeller incision. A prospectively maintained adult sleep apnoea surgery database was used to identify those patients undergoing TPA, either alone or in combination with other procedures, for obstructive sleep apnoea syndrome (OSAS) between February 2001 and September 2006 in a tertiary referral centre by a single surgeon (RHL). In addition to the incision used during TPA, patient demographic data, previous surgery of the upper airways, smoking history, pre-operative body mass index, respiratory disturbance index, oxygen saturation index and the occurrence of oronasal fistula post-operatively, were recorded. The propeller incision technique is described. A total of 89 patients who underwent TPA were identified. A total of 49 patients had a "Gothic Arch" incision and 40 had a "Propeller" incision. The two groups of patients were comparable in age, sex, previous tonsillar and uvulopalatopharyngoplasty surgery, smoking histories and pre-operative disease severity. In the "Gothic Arch" group, eight patients (16%) developed oronasal fistulae in the post-operative period versus only one patient (2.5%) in the "Propeller" group. The difference between the two groups was statistically significant (P=0.038, Fisher's exact test). Of the total cases with post-operative oronasal fistula (n=9), only one patient (from the Gothic Arch incision group) required operative closure which was performed under local anesthesia and healed without complication. The propeller incision provides an anatomically sensible axial-based flap that provides adequate access to perform TPA. It is associated with a lower incidence of oronasal fistula and is recommended by the authors.

Single minimum incision endoscopic radical nephrectomy for renal tumors with preoperative virtual navigation using 3D-CT volume-rendering

Directory of Open Access Journals (Sweden)

Shioyama Yasukazu

2010-04-01

Full Text Available Abstract Background Single minimum incision endoscopic surgery (MIES involves the use of a flexible high-definition laparoscope to facilitate open surgery. We reviewed our method of radical nephrectomy for renal tumors, which is single MIES combined with preoperative virtual surgery employing three-dimensional CT images reconstructed by the volume rendering method (3D-CT images in order to safely and appropriately approach the renal hilar vessels. We also assessed the usefulness of 3D-CT images. Methods Radical nephrectomy was done by single MIES via the translumbar approach in 80 consecutive patients. We performed the initial 20 MIES nephrectomies without preoperative 3D-CT images and the subsequent 60 MIES nephrectomies with preoperative 3D-CT images for evaluation of the renal hilar vessels and the relation of each tumor to the surrounding structures. On the basis of the 3D information, preoperative virtual surgery was performed with a computer. Results Single MIES nephrectomy was successful in all patients. In the 60 patients who underwent 3D-CT, the number of renal arteries and veins corresponded exactly with the preoperative 3D-CT data (100% sensitivity and 100% specificity. These 60 nephrectomies were completed with a shorter operating time and smaller blood loss than the initial 20 nephrectomies. Conclusions Single MIES radical nephrectomy combined with 3D-CT and virtual surgery achieved a shorter operating time and less blood loss, possibly due to safer and easier handling of the renal hilar vessels.

Replica sizing strategy for aortic valve replacement improves haemodynamic outcome of the epic supra valve.

Science.gov (United States)

Gonzalez-Lopez, David; Faerber, Gloria; Diab, Mahmoud; Amorim, Paulo; Zeynalov, Natig; Doenst, Torsten

2017-10-01

Current sizing strategies suggest valve selection based on annulus diameter despite supra-annular placement of biological prostheses potentially allowing placement of a larger size. We assessed the frequency of selecting a larger prosthesis if prosthesis size was selected using a replica (upsizing) and evaluated its impact on haemodynamics. We analysed all discharge echocardiograms between June 2012 and June 2014, where a replica sizer was used for isolated aortic valve replacement (Epic Supra: 266 patients, Trifecta: 49 patients). Upsizing was possible in 71% of the Epic Supra valves (by 1 size: 168, by 2 sizes: 20) and in 59% of the Trifectas (by 1 size: 26, by 2 sizes: 3). Patients for whom upsizing was possible had the lowest pressure gradients within their annulus size groups. The difference was significant in annulus diameters of 21-22 or 25-26 mm (Epic Supra) and 23-24 mm (Trifecta). Trifecta gradients were the lowest. However, the ability to upsize the Epic Supra by 2 sizes eliminated the differences between Epic Supra and Trifecta. Upsizing did not cause intraoperative complications. Using replica sizers for aortic prosthesis size selection allows the implantation of bigger prostheses than recommended in most cases and reduces postoperative gradients, specifically for Epic Supra. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

A step towards controlled fusion reactors: Tore Supra tokamak with superconducting magnets

International Nuclear Information System (INIS)

Turck, B.

1988-01-01

Tore Supra technology has to solve all the problems related to the development and the installaion of superconducting coils and associated cryogenic devices. Tore Supra will allow to get a significative experience to prepare next machines. Specifications and needs of tokamaks concerning the superconducting coils of future machines are recalled [fr

DNA Methylation Modulates Nociceptive Sensitization after Incision.

Directory of Open Access Journals (Sweden)

Yuan Sun

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

Morphodynamic Model of Submarine Canyon Incision by Sandblasting

Science.gov (United States)

Zhang, L.; Parker, G.; Izumi, N.; Cartigny, M.; Li, T.; Wang, G.

2017-12-01

Submarine canyons are carved by turbidity currents under the deep sea. As opposed to subaerial canyons, the relevant processes are not easy to observe directly. Turbidity currents are bottom-hugging sediment gravity flows of that can incise or deposit on the seafloor to create submarine canyons or fans. The triggers of turbidity currents can be storms, edge waves, internal waves, canyon wall sapping, delta failure, breaching and hyperpycnal flows. The formation and evolution mechanisms of submarine canyons are similar to those of subaerial canyons, but have substantial differences. For example, sandblasting, rather than wear due to colliding gravel clasts is more likely to be the mechanism of bedrock incision. Submarine canyons incise downward, and often develop meander bends and levees within the canyon, so defining "fairways". Here we propose a simple model for canyon incision. The starting point of our model is the Macro Roughness Saltation Abrasion Alluviation model of Zhang et al. [2015], designed for bedrock incision by gravel clasts in mixed bedrock-alluvial rivers. We adapt this formulation to consider sandblasting as a means of wear. We use a layer-averaged model for turbidity current dynamics. The current contains a mixture of mud, which helps drive the flow but which does not cause incision, and sand, which is the agent of incision. We show that the model can successfully model channel downcutting, and indeed illustrate the early formation of net incisional cyclic steps, i.e. upstream-migrating undulations on the bed associated with transcritical (in the Froude sense) flow. These steps can be expected to abet the process of incision.

Single incision vs conventional laparoscopic anterior resection for sigmoid colon cancer: a case-matched study.

Science.gov (United States)

Kwag, Seung-Jin; Kim, Jun-Gi; Oh, Seong-Taek; Kang, Won-Kyung

2013-09-01

The purpose of the study was to evaluate the safety and effects of single-incision laparoscopic anterior resection (SILAR) for sigmoid colon cancer by comparing it with conventional laparoscopic anterior resection (CLAR). Twenty-four patients who underwent SILAR between April 2010 and July 2011 were case matched 1:2 with patients who underwent CLAR, with respect to age, sex, body mass index, tumor location, and history of abdominal surgery. Two patients in the SILAR group and 1 patient in the CLAR group experienced anastomotic leakage. The operative time was longer in the SILAR group than in the CLAR group (251 ± 50 vs 237 ± 49 minutes; P = .253). The number of harvested lymph nodes (19.6 ± 10.7 vs 20.8 ± 7.7; P = .630) was not different. The postoperative hospital stay was shorter in the SILAR group (7.1 ± 3.4 days) than in the CLAR group (8.1 ± 3.5 days) (P = .234). On the basis of the early outcomes, we conclude that SILAR is feasible and safe. Moreover, the adequate lymph node harvest and free margins support the use of this procedure. Copyright © 2013 Elsevier Inc. All rights reserved.

Matching of Tore Supra ICRH antennas

International Nuclear Information System (INIS)

Ladurelle, L.; Beaumont, B.; Kuus, H.; Lombard, G.

1994-01-01

An automatic matching method is described for Tore Supra ICRH antennas based on impedance variations seen at their feed points. Error signals derived from directional voltage and phase measurements in the feeder allow to control the matching capacitors values for optimal power transmission. (author) 5 refs.; 9 figs

Cochlear neuropathy and the coding of supra-threshold sound.

Science.gov (United States)

Bharadwaj, Hari M; Verhulst, Sarah; Shaheen, Luke; Liberman, M Charles; Shinn-Cunningham, Barbara G

2014-01-01

Many listeners with hearing thresholds within the clinically normal range nonetheless complain of difficulty hearing in everyday settings and understanding speech in noise. Converging evidence from human and animal studies points to one potential source of such difficulties: differences in the fidelity with which supra-threshold sound is encoded in the early portions of the auditory pathway. Measures of auditory subcortical steady-state responses (SSSRs) in humans and animals support the idea that the temporal precision of the early auditory representation can be poor even when hearing thresholds are normal. In humans with normal hearing thresholds (NHTs), paradigms that require listeners to make use of the detailed spectro-temporal structure of supra-threshold sound, such as selective attention and discrimination of frequency modulation (FM), reveal individual differences that correlate with subcortical temporal coding precision. Animal studies show that noise exposure and aging can cause a loss of a large percentage of auditory nerve fibers (ANFs) without any significant change in measured audiograms. Here, we argue that cochlear neuropathy may reduce encoding precision of supra-threshold sound, and that this manifests both behaviorally and in SSSRs in humans. Furthermore, recent studies suggest that noise-induced neuropathy may be selective for higher-threshold, lower-spontaneous-rate nerve fibers. Based on our hypothesis, we suggest some approaches that may yield particularly sensitive, objective measures of supra-threshold coding deficits that arise due to neuropathy. Finally, we comment on the potential clinical significance of these ideas and identify areas for future investigation.

Cochlear Neuropathy and the Coding of Supra-threshold Sound

Directory of Open Access Journals (Sweden)

Hari M Bharadwaj

2014-02-01

Full Text Available Many listeners with hearing thresholds within the clinically normal range nonetheless complain of difficulty hearing in everyday settings and understanding speech in noise. Converging evidence from human and animal studies points to one potential source of such difficulties: differences in the fidelity with which supra-threshold sound is encoded in the early portions of the auditory pathway. Measures of auditory subcortical steady-state responses in humans and animals support the idea that the temporal precision of the early auditory representation can be poor even when hearing thresholds are normal. In humans with normal hearing thresholds, behavioral ability in paradigms that require listeners to make use of the detailed spectro-temporal structure of supra-threshold sound, such as selective attention and discrimination of frequency modulation, correlate with subcortical temporal coding precision. Animal studies show that noise exposure and aging can cause a loss of a large percentage of auditory nerve fibers without any significant change in measured audiograms. Here, we argue that cochlear neuropathy may reduce encoding precision of supra-threshold sound, and that this manifests both behaviorally and in subcortical steady-state responses in humans. Furthermore, recent studies suggest that noise-induced neuropathy may be selective for higher-threshold, lower-spontaneous-rate nerve fibers. Based on our hypothesis, we suggest some approaches that may yield particularly sensitive, objective measures of supra-threshold coding deficits that arise due to neuropathy. Finally, we comment on the potential clinical significance of these ideas and identify areas for future investigation.

A novel supra-temporal approach to retrobulbar anaesthesia in dogs: Preliminary study in cadavers.

Science.gov (United States)

Chiavaccini, Ludovica; Micieli, Fabiana; Meomartino, Leonardo; Duffee, Lauren R; Vesce, Giancarlo

2017-05-01

A novel supra-temporal technique for retrobulbar anaesthesia in dogs is described and compared to the inferior temporal palpebral approach. Supra-temporal and inferior temporal palpebral retrobulbar injections were performed in 20 orbits of canine cadavers. Distribution of injected contrast medium within the intraconal space and around the optic nerve was analysed using computed tomography. There was adequate distribution of contrast medium within the intraconal space with both techniques. Concurrent intraconal and extraconal distribution was observed using the inferior temporal palpebral approach in 3/10 orbits and using the supra-temporal approach in 5/10 orbits. In 3/10 supra-temporal injections, the injected vehicle was distributed preferentially in the caudal aspect of the retrobulbar cone, closer to the orbital fissure. Accidental intraocular injection was never observed. The supra-temporal approach appears to be a valid alternative to the inferior temporal palpebral approach for retrobulbar anaesthesia in dogs, being less technically challenging. Further studies are required to confirm the clinical efficacy of this approach in dogs. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-04-01

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

Minimally invasive treatment of female stress urinary incontinence with the adjustable single-incision sling system (AJUST ™ in an elderly and overweight population

Directory of Open Access Journals (Sweden)

Ralf Anding

Full Text Available ABSTRACT Introduction The prevalence of urinary incontinence is increasing. Two major risk factors are overweight and age. We present objective and subjective cure rates of elderly and overweight patients treated with an adjustable single-incision sling system (AJUST™, C.R. BARD, Inc.. Materials and Methods Between 04/2009 and 02/2012 we treated 100 female patients with the single incision sling. Patients were retrospectively evaluated by Stamey degree of incontinence, cough test, pad use, and overall satisfaction. The primary outcomes of the study were objective and subjective cure rates, secondary outcomes were the safety profile of the sling and complications. Results The overall success rate in this population was 84.6% with a mean follow-up of 9.3 months. The average usage of pads per day decreased from 4.9 to 1.6 and was significantly lower in patients with a BMI <30 (p=0.004. Postoperative residual SUI was also lower in patients with a BMI <30 (p=0.006. Postoperative satisfaction was better in patients with a lower BMI, but this difference did not reach a level of significance (p=0.055. There were no complications such as bleeding, bladder injury, or tape infection. Conclusions In elderly and obese patients a considerable success rate is achievable with this quick and minimal invasive procedure. However, the success rate shows a clear trend in favor of a lower body-mass-index. The cut-off point has been identified at a BMI of 30. The AJUST™ system can be regarded as safe and beneficial for elderly and obese patients.

Primary closure of equine laryngotomy incisions

DEFF Research Database (Denmark)

Lindegaard, C.; Karlsson, L.; Ekstrøm, Claus Thorn

2016-01-01

incision between January 1995 and June 2012 were reviewed. Horses with a laryngotomy incision closed in three layers for primary healing were included. Descriptive data on healing characteristics and complications of laryngotomy wounds were collected from the medical records and via follow......The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

Manufacture and mechanical test of a TORE SUPRA model coil

International Nuclear Information System (INIS)

Aymar, R.; Claudet, G.; Disdier, F.; Hamelin, J.; Libeyre, P.; Mayaux, G.; Meuris, C.; Parain, J.; Torossian, A.

1980-09-01

Inside the qualifying test programme, supporting the Tore Supra Design, a reduced scale model of a Bsub(T) coil was fabricated by a large industrial firm. This model coil is provided with the same features as those retained for the complete magnet. Tests of this model coil have been carried out in such a way that most of stresses which will arise in Tore Supra windings are simulated; simultaneously its cryogenic supply is fully representative of the system retained for the complete machine. Operation of the model coil has been found highly stable; under the conditions of applied field and forces a coil transition could be triggered, by an electrical heater located inside the coil, only when the temperature of the superfluid helium bath was close to Tsub(lambda). Thus, design and manufacturing techniques have been qualified satisfactorily to proceed to the next step: fabrication of the superconducting Bsub(T) coils of Tore Supra

Contribution of supra-permafrost discharge to thermokarst lake water balances on the northeastern Qinghai-Tibet Plateau

Science.gov (United States)

Pan, Xicai; Yu, Qihao; You, Yanhui; Chun, Kwok Pan; Shi, Xiaogang; Li, Yanping

2017-12-01

The seasonal hydrological mechanisms of two thermokarst lakes on the northeastern Qinghai-Tibet Plateau (QTP) were characterized by three-year intensive field observations and a water balance model. In three ice-free seasons, the supra-permafrost discharge contributed a mean ratio of over 170% of the precipitation. In the ice-cover seasons, the supra-permafrost discharge contribution varied between -20% and 22% of the water storage change. Results show that a large portion of the lake water storage change is because of the supra-permafrost discharge resulting from precipitation. Furthermore, a precipitation-subsurface runoff function is preliminarily identified in which the supra-permafrost discharge nonlinearly increased with more precipitation. Our results show that the recent lake expansion is linked with increasing supra-permafrost discharge dominated by precipitation. This study also suggests that we need to pay attention to the nonlinear increase of precipitation-controlled supra-permafrost discharge on the large lake expansion at the catchment scale in the QTP region, instead of only looking at the inputs (e.g., precipitation and river discharge) as shown in the previous studies.

Mini transverse versus longitudinal incision in carpal tunnel syndrome

International Nuclear Information System (INIS)

Korkmaz, M.; Cepoglu, M.C.

2013-01-01

Objective: To evaluate the effectiveness of mini-transverse compared with mini-longitudinal incision for carpal tunnel release (CTR) with reference to postoperative functional capacity, symptom severity and complication rate. Study Design: Analytical study. Place and Duration of Study: Cumhuriyet University Medical Faculty, Department of Orthopaedics, Tokat State Hospital, Department of Orthopaedics and Medical Park Tokat Hospital, Department of Neurosurgery, from January 2007 to January 2009. Methodology: This study included 93 hands of 79 patients with carpal tunnel syndrome (CTS), which were operated between 2007 and 2009. Patients were divided according to incision types into Group-1 (undergoing mini-longitudinal incision) and Group-2 (undergoing mini-transverse incision). Patients were evaluated initially and at 3 weeks after treatment according to symptom severity and functional status of Boston Questionnaire (BQ). Demographic and clinical data were analyzed and compared statistically between two groups. Results: Statistically significant differences were observed in BQ symptom and functional scores between the pre- and postoperative period (p < 0.0001). BQ symptom and functional scores at postoperative period were better in Group-1 than Group-2 (p = 0.044 and p = 0.023 respectively). The scar hypersensitivity (p = 0.258) and tenderness (p = 1.00) associated with the incision sites were not statistically different. Conclusion: Longitudinal incision is more effective on symptom and functional conditions than transverse incision. However, there was less scar formation with transverse incision. (author)

Plantar Fascia Release Through a Single Lateral Incision in the Operative Management of a Cavovarus Foot: A Cadaver Model Analysis of the Operative Technique.

Science.gov (United States)

Kiskaddon, Eric M; Meeks, Brett D; Roberts, Joseph G; Laughlin, Richard T

2018-04-04

Plantar fascia release and calcaneal slide osteotomy are often components of the surgical management for cavovarus deformities of the foot. In this setting, plantar fascia release has traditionally been performed through an incision over the medial calcaneal tuberosity, and the calcaneal osteotomy through a lateral incision. Two separate incisions can potentially increase the operative time and morbidity. The purpose of the present study was threefold: to describe the operative technique, use cadaveric dissection to analyze whether a full release of the plantar fascia was possible through the lateral incision, and examine the proximity of the medial neurovascular structures to both the plantar fascia release and calcaneal slide osteotomy when performed together. In our cadaveric dissections, we found that full release of the plantar fascia is possible through the lateral incision with no obvious damage to the medial neurovascular structures. We also found that the calcaneal branch of the tibial nerve reliably crossed the osteotomy in all specimens. We have concluded that both the plantar fascia release and the calcaneal osteotomy can be safely performed through a lateral incision, if care is taken when completing the calcaneal osteotomy to ensure that the medial neurovascular structures remain uninjured. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Acquisition and retention of laparoscopic skills is different comparing conventional laparoscopic and single-incision laparoscopic surgery: a single-centre, prospective randomized study.

Science.gov (United States)

Ellis, Scott Michael; Varley, Martin; Howell, Stuart; Trochsler, Markus; Maddern, Guy; Hewett, Peter; Runge, Tina; Mees, Soeren Torge

2016-08-01

Training in laparoscopic surgery is important not only to acquire and improve skills but also avoid the loss of acquired abilities. The aim of this single-centre, prospective randomized study was to assess skill acquisition of different laparoscopic techniques and identify the point in time when acquired skills deteriorate and training is needed to maintain these skills. Sixty surgical novices underwent laparoscopic surgery (LS) and single-incision laparoscopic surgery (SILS) baseline training (BT) performing two validated tasks (peg transfer, precision cutting). The novices were randomized into three groups and skills retention testing (RT) followed after 8 (group A), 10 (group B) or 12 (group C) weeks accordingly. Task performance was measured in time with time penalties for insufficient task completion. 92 % of the participants completed the BT and managed to complete the task in the required time frame of proficiency. Univariate and multivariate analyses revealed that SILS (P skills (comparison of BT vs RT) was not identified; however, for SILS a significant deterioration of skills (adjustment of BT and RT values) was demonstrated for all groups (A-C) (P skills more difficult to maintain. Acquired LS skills were maintained for the whole observation period of 12 weeks but SILS skills had begun to deteriorate at 8 weeks. These data show that maintenance of LS and SILS skills is divergent and training curricula need to take these specifics into account.

Towards operations on Tore Supra of an ITER relevant inspection robot and associated processes

International Nuclear Information System (INIS)

Gargiulo, L.; Cordier, J.J.; Friconneau, J.P.; Grisolia, C.; Palmer, J.D.; Perrot, Y.; Samaille, F.

2007-01-01

The aim of the project is to demonstrate on Tore Supra the reliability of a multi-purpose in-vessel remote handling inspection system using a long reach, limited payload carrier. The robot prototype is fully representative of the deployment carrier system that could be required on ITER. The demonstration on Tore Supra will help in the understanding of operation issues that could occur in the tokamak vacuum vessel equipped of actively cooled components. The viewing process that is currently under development will allow close inspection of the Tore Supra plasma facing components that are representative of the ITER divertor targets in terms of confined environment and identification of possible tiles failure of CFC carbon tiles. One of the other potential inspection processes that is foreseen to be tested using the AIA carrier in Tore Supra is the laser ablation system of the CFC armour. It could be fully relevant for the ITER wall detritiation issues. Such process can be simulated on Tore Supra through the deuterium inventory under long-time plasma discharges. The in situ leakage localisation of a damaged plasma facing component is also one of the major ITER maintenance challenges that could use remote handling inspection tools

Towards operations on Tore Supra of an ITER relevant inspection robot and associated processes

Energy Technology Data Exchange (ETDEWEB)

Gargiulo, L. [Association Euratom-CEA, DSM/Departement de Recherche sur la Fusion Controlee, CEA/Cadarache, F-13108 Saint Paul Lez Durance Cedex (France)], E-mail: laurent.gargiulo@cea.fr; Cordier, J.J. [Association Euratom-CEA, DSM/Departement de Recherche sur la Fusion Controlee, CEA/Cadarache, F-13108 Saint Paul Lez Durance Cedex (France); Friconneau, J.P. [CEA-LIST Robotics and Interactive Systems Unit, BP6 F-92265 Fontenay aux Roses Cedex (France); Grisolia, C. [Association Euratom-CEA, DSM/Departement de Recherche sur la Fusion Controlee, CEA/Cadarache, F-13108 Saint Paul Lez Durance Cedex (France); Palmer, J.D. [EFDA CSU, Max-Planck-Institut fuer Plasma Physik Boltzmannstr. 2, D-85748 Garching (Germany); Perrot, Y. [CEA-LIST Robotics and Interactive Systems Unit, BP6 F-92265 Fontenay aux Roses Cedex (France); Samaille, F. [Association Euratom-CEA, DSM/Departement de Recherche sur la Fusion Controlee, CEA/Cadarache, F-13108 Saint Paul Lez Durance Cedex (France)

2007-10-15

The aim of the project is to demonstrate on Tore Supra the reliability of a multi-purpose in-vessel remote handling inspection system using a long reach, limited payload carrier. The robot prototype is fully representative of the deployment carrier system that could be required on ITER. The demonstration on Tore Supra will help in the understanding of operation issues that could occur in the tokamak vacuum vessel equipped of actively cooled components. The viewing process that is currently under development will allow close inspection of the Tore Supra plasma facing components that are representative of the ITER divertor targets in terms of confined environment and identification of possible tiles failure of CFC carbon tiles. One of the other potential inspection processes that is foreseen to be tested using the AIA carrier in Tore Supra is the laser ablation system of the CFC armour. It could be fully relevant for the ITER wall detritiation issues. Such process can be simulated on Tore Supra through the deuterium inventory under long-time plasma discharges. The in situ leakage localisation of a damaged plasma facing component is also one of the major ITER maintenance challenges that could use remote handling inspection tools.

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

Science.gov (United States)

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

2016-10-01

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

Ohmic discharges in Tore Supra - Marfes and detached plasmas

International Nuclear Information System (INIS)

Vallet, J.C.

1990-01-01

The Tore Supra plasma characteristics are given. The observed discharges are either leaning on the graphite inner first wall or limited by movable pump limiters located outboard and at the bottom of the vacuum chamber. The particular plasma conditions which lead to marfes and detached plasmas in ohmically heated He and D2 discharges limited by the inner wall are investigated. The results show that the ratio of radiated power to ohmic power increase linearly with M.g. As M.g rises, attached plasma, marfe and detached plasma are sequentially observed. Detached plasma with an effective radius as small as. 7 times the limiter radius was observed on Tore Supra

Artritis séptica del pubis en dos deportistas Septic arthritis of the pubic symphysis in two athletes

Directory of Open Access Journals (Sweden)

José A. Andrews

2012-06-01

Full Text Available La artritis séptica de pubis u osteomielitis púbica es la infección que compromete la sínfisis pubiana y su articulación. Es poco frecuente, representando menos del 1% de las osteomielitis. Afecta más a menudo a atletas jóvenes y a mujeres que se someten a cirugía ginecológica o urológica. Se presenta con fiebre y dolor púbico, irradiado a genitales, que aumenta con la movilización de la cadera lo que produce claudicación de la marcha. Debe hacerse el diagnóstico diferencial con la osteítis del pubis que es una condición inflamatoria estéril. La punción guiada por imagen suele ser necesaria para el diagnóstico diferencial con la osteítis del pubis. El diagnóstico se basa en la clínica apoyada en el aislamiento microbiológico, métodos por imágenes e incremento de las proteínas de fase aguda. Los agentes etiológicos más comúnmente encontrados son Staphylococcus aureus, seguidos de bacilos gram negativos, o pueden ser polimicrobianos en posquirúrgicos. El tratamiento antibiótico se ajusta al germen aislado por cultivo, además de antiinflamatorios y reposo. El desbridamiento quirúrgico se requiere hasta en el 55% de los casos. Se recomiendan antibióticos por 6 semanas. Se presentan dos casos de osteomielitis del pubis por S. aureus, con buena respuesta al tratamiento. Ambos pacientes eran jóvenes y deportistas.Septic arthritis of the pubic symphysis, so called osteomyelitis pubis is the infection which involves pubic symphysis and its joint. It is a rare condition, representing less than one percent of all cases of osteomyelitis. It affects most frequently young athletes and women undergoing gynecologic or urologic surgery. It presents itself with fever and pubic pain which irradiates to the genitals and increases when hip is mobilized, and this fact produces gait claudication. Differential diagnosis should be made with pubic osteitis, which is a sterile inflammatory condition. Diagnosis is based on clinic

Pyrosequencing of supra- and subgingival biofilms from inflamed peri-implant and periodontal sites.

Science.gov (United States)

Schaumann, Simone; Staufenbiel, Ingmar; Scherer, Ralph; Schilhabel, Markus; Winkel, Andreas; Stumpp, Sascha Nico; Eberhard, Jörg; Stiesch, Meike

2014-12-17

To investigate the microbial composition of biofilms at inflamed peri-implant and periodontal tissues in the same subject, using 16S rRNA sequencing. Supra- and submucosal, and supra- and subgingival plaque samples were collected from 7 subjects suffering from diseased peri-implant and periodontal tissues. Bacterial DNA was isolated and 16S rRNA genes were amplified, sequenced and aligned for the identification of bacterial genera. 43734 chimera-depleted, denoised sequences were identified, corresponding to 1 phylum, 8 classes, 10 orders, 44 families and 150 genera. The most abundant families or genera found in supramucosal or supragingival plaque were Streptoccocaceae, Rothia and Porphyromonas. In submucosal plaque, the most abundant family or genera found were Rothia, Streptococcaceae and Porphyromonas on implants. The most abundant subgingival bacteria on teeth were Prevotella, Streptococcaceae, and TG5. The number of sequences found for the genera Tannerella and Aggregatibacter on implants differed significantly between supra- and submucosal locations before multiple testing. The analyses demonstrated no significant differences between microbiomes on implants and teeth in supra- or submucosal and supra- or subgingival biofilms. Diseased peri-implant and periodontal tissues in the same subject share similiar bacterial genera and based on the analysis of taxa on a genus level biofilm compositions may not account for the potentially distinct pathologies at implants or teeth.

Excitation of beta Alfven eigenmodes in Tore-Supra

International Nuclear Information System (INIS)

Nguyen, C; Garbet, X; Sabot, R; Goniche, M; Maget, P; Basiuk, V; Decker, J; Elbeze, D; Huysmans, G T A; Macor, A; Segui, J-L; Schneider, M; Eriksson, L-G

2009-01-01

Modes oscillating at the acoustic frequency and identified as beta Alfven eigenmodes (BAEs) have been observed in Tore-Supra under ion cyclotron resonant heating. In this paper, the linear excitation threshold of these modes, thought to be driven by suprathermal ions, is calculated and compared with Tore-Supra observations. Similar studies of the linear excitation threshold of energetic particles driven modes were carried out previously for toroidal Alfven eigenmodes or fishbones. In the case of BAEs, the main point is to understand whether the energetic particle drive is able to exceed ion Landau damping, which is expected to be important in the acoustic frequency range. For this, the BAE dispersion relation is computed and simplified in order to derive a tractable excitation criterion suitable for comparison with experiments. The observation of BAEs in Tore-Supra is found to be in agreement with the calculated criterion and confirms the possibility to trigger these modes in the presence of ion Landau damping. Moreover, the conducted analysis clearly puts forward the role of the global tunable parameters which play a role in the BAE excitation (the magnetic field, the density etc), as well as the role of some plasma profiles. In particular, the outcome of a modification of the shear or of the heating localization is found to be non-negligible and it is discussed in the paper.

Disruption mitigation on Tore Supra

International Nuclear Information System (INIS)

Martin, G.; Sourd, F.; Saint-Laurent, F.; Bucalossi, J.; Eriksson, L.G.

2004-01-01

During disruptions, the plasma energy is lost on the first wall within 1 ms, forces up to hundred tons are applied to the structures and kA of electrons are accelerated up to 50 MeV (runaway electrons). Already sources of concern in present day tokamaks, extrapolation to ITER shows the necessity of mitigation procedures, to avoid serious damages to in-vessel components. Massive gas injection was proposed, and encouraging tests have been done on Textor and DIII-D. Similar experiments where performed on Tore Supra, with the goal to validate their effect on runaway electrons, observed during the majority of disruptions. 0.1 mole of helium was injected within 5 ms in ohmic plasmas, up to 1.2 MA, either stable, or in a pre-disruptive phase (argon puffing). Beneficial effects where obtained: reduction of the current fall rate and eddy currents, total disappearance of runaway electrons and easy recovery for the next pulse, without noticeable helium pollution of following plasmas. Analysis of the 4 ms period between injection and disruption indicates that to reach these goals, one need to inject enough helium to keep it only partially ionised. It corresponds to 0.1 g for Tore Supra, and extrapolate to hundreds of grams for ITER. (authors)

Disruption mitigation on Tore Supra

International Nuclear Information System (INIS)

Martin, G.; Sourd, F.; Saint-Laurent, F.; Bucalossi, J.; Eriksson, L.G.

2005-01-01

During disruptions, the plasma energy is lost on the first wall within 1 ms, forces up to hundred tons are applied to the structures and kA of electrons are accelerated up to 50 MeV (runaway electrons). Already sources of concern in present day tokamaks, extrapolation to ITER shows the necessity of mitigation procedures, to avoid serious damages to in-vessel components. Massive gas injection was proposed, and encouraging tests have been done on Textor and DIII-D. Similar experiments where performed on Tore Supra, with the goal to validate their effect on runaway electrons, observed during the majority of disruptions. 0.1 mole of helium was injected within 5 ms in ohmic plasmas, up to 1.2 MA, either stable, or in a pre-disruptive phase (argon puffing). Beneficial effects where obtained: reduction of the current fall rate and eddy currents, total disappearance of runaway electrons and easy recovery for the next pulse, without noticeable helium pollution of following plasmas. Analysis of the 4 ms period between injection and disruption indicates that to reach these goals, one need to inject enough helium to keep it only partially ionised. It correspond to 0.1 g for Tore Supra, and extrapolate to hundred's of grams for ITER. (author)

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

DEFF Research Database (Denmark)

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

2015-01-01

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

Tore Supra: technical aspects and early results after one year of operation

International Nuclear Information System (INIS)

Gravier, R.

1989-01-01

After one year operation (1988 to 1989), technical aspects of component systems and equipment of Tore Supra are summarized. Particular attention is given to the operation with: supraconducting toroidal field coil system, cryogenic system, poloidal field system, in vessel equipment, first wall conditioning, pump limiter. The ergodic divertor experiments and the current drive experiment are reported. The plasma heating methods adopted in Tore Supra are presented

A test of Hartnett's revisions to the pubic symphysis and fourth rib methods on a modern sample.

Science.gov (United States)

Merritt, Catherine E

2014-05-01

Estimating age at death is one of the most important aspects of creating a biological profile. Most adult age estimation methods were developed on North American skeletal collections from the early to mid-20th century, and their applicability to modern populations has been questioned. In 2010, Hartnett used a modern skeletal collection from the Maricopia County Forensic Science Centre to revise the Suchey-Brooks pubic symphysis method and the İşcan et al. fourth rib methods. The current study tests Hartnett's revised methods as well as the original Suchey-Brooks and İşcan et al. methods on a modern sample from the William Bass Skeletal Collection (N = 313, mean age = 58.5, range 19-92). Results show that the Suchey-Brooks and İşcan et al. methods assign individuals to the correct phase 70.8% and 57.5% of the time compared with Hartnett's revised methods at 58.1% and 29.7%, respectively, with correctness scores based on one standard deviation of the mean rather than the entire age range. Accuracy and bias scores are significantly improved for Hartnett's revised pubic symphysis method and marginally better for Hartnett's revised fourth rib method, suggesting that the revised mean ages at death of Hartnett's phases better reflect this modern population. Overall, both Hartnett's revised methods are reliable age estimation methods. For the pubic symphysis, there are significant improvements in accuracy and bias scores, especially for older individuals; however, for the fourth rib, the results are comparable to the original İşcan et al. methods, with some improvement for older individuals. © 2014 American Academy of Forensic Sciences.

Supra-acetabular line is better than supra-iliac line for coronal balance referencing-a study of perioperative whole spine X-rays in degenerative lumbar scoliosis and ankylosing spondylitis patients.

Science.gov (United States)

Hey, Hwee Weng Dennis; Kim, Cheung-Kue; Lee, Won-Gyu; Juh, Hyung-Suk; Kim, Ki-Tack

2017-12-01

The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. We conducted a single-center, radiographic comparative study between 2011 and 2015. A total of 199 patients with a mean age of 55.1 years were studied. Ninety patients with degenerative lumbar scoliosis (DLS) and 109 ankylosing spondylitis (AS) were treated with posterior surgery during this period. Baseline clinical and radiographic parameters (sagittal and coronal) were recorded. Comparison was performed between the new supra-acetabular line (central sacral vertical line [CSVL1]) and conventional supra-iliac line (CSVL2) perpendicular methods of coronal balance assessment. These methods were also compared with the gold standard standing C7 plumb line. Each patient underwent standardized operative procedures and had perioperative spine X-rays obtained for assessment of spinal balance. Adjusted multivariate analysis was used to determine predictors of coronal balance. Significant differences in baseline characteristics (age, gender, and radiographic parameters) were found between patients with DLS and AS. CSVL1, CSVL2, and C7 plumb line differed in all the perioperative measurements. These three radiological methods showed a mean right coronal imbalance for both diagnoses in all pre-, intra-, and postoperative radiographs. The magnitude of imbalance was the greatest for CSVL2 followed by CSVL1 and subsequently the C7 plumb line. A larger discrepancy between CSVL and C7 plumb line measurements intraoperatively than those postoperatively suggests a postural effect on these parameters, which is greater for CSVL2. Multivariate analysis identified that in DLS, the preoperative C7 plumb line was predictive of its

Experience from Tore Supra acquisition system and evolutions

International Nuclear Information System (INIS)

Guillerminet, B.; Buravand, Y.; Chatelier, E.; Leroux, F.

2004-01-01

The Tore Supra tokamak has been upgraded to explore long duration plasma discharges up to 1000s. Since summer 2001, the acquisition system operates in continuous mode apart of the data processing which is still done after the pulse. In the first part, we explore a few solutions to process continuously the data during the pulse, based on parallel processing on a Linux farm and then on a CONDOR system. The second part is devoted to the Web service exposing the Tore Supra operation. In the last part, the VME acquisition system has been redesigned to keep up with the high data rates required by a few diagnostics. The workflow is now distributed among a few computers. At the end, we give the current status of the realisation and the future planning

First lower hybrid current drive experiments at 3.7 GHz in Tore Supra

International Nuclear Information System (INIS)

Tonon, G.; Goniche, M.; Moreau, D.

1989-01-01

The results of electromagnetic waves injection in the Tore Supra plasma, at a frequency of 3.7 GHz, are reported. The process is applied for current generation and plasma heating, through Landau damping on the electron population. The experimental set-up is described. The lower hybrid current drive experiments in Tore Supra are carried out under the following conditions: major and minor radii of the plasma are respectively 2.37 m and 0.77 m and the toroidal magnetic field is 1.8 Teslas. A multijunction-grill composed of 128 waveguides is applied. Up to 1.25 MW of rf power is injected in Tore Supra, after less than 30 plasma shots. The results lead to the conclusion that the coupling, not yet optimized, is good enough for safe klystron operation with no circulator. The measured value RIp P RF -1 (δV L /V L ) obtained on Tore Supra (Bt = 1.8 T) is closed to one observed on PETULA-B (Bt = 2.75 T) at the same frequency and density

Fabrication of Propeller-Shaped Supra-amphiphile for Construction of Enzyme-Responsive Fluorescent Vesicles.

Science.gov (United States)

Li, Jie; Liu, Kaerdun; Han, Yuchun; Tang, Ben Zhong; Huang, Jianbin; Yan, Yun

2016-10-04

Propeller-shaped molecules have been recognized to display fantastic AIE (aggregation induced emission), but they can hardly self-assemble into nanostructures. Herein, we for the first time report that ionic complexation between a water-soluble tetrapheneyl derivative and an enzyme substrate in aqueous media produces a propeller-shaped supra-amphiphile that self-assembles into enzyme responsive fluorescent vesicles. The supra-amphiphile was fabricated upon complexation between a water-soluble propeller-shaped AIE luminogen TPE-BPA and myristoylcholine chloride (MChCl) in aqueous media. MChCl filled in the intramolecular voids of propeller-shaped TPE-BPA upon supra-amphiphile formation, which endows the supra-amphiphile superior self-assembling ability to the component molecules thus leading to the formation of fluorescent vesicles. Because MChCl is the substrate of cholinesterases, the vesicles dissemble in the presence of cholinesterases, and the fluorescent intensity can be correlated to the level of enzymes. The resulting fluorescent vesicles may be used to recognize the site of Alzheimer's disease, to encapsulate the enzyme inhibitor, and to release the inhibitor at the disease site.

Balancing sub- and supra-salt strain in salt-influenced rifts: Implications for extension estimates

Science.gov (United States)

Coleman, Alexander J.; Jackson, Christopher A.-L.; Duffy, Oliver B.

2017-09-01

The structural style of salt-influenced rifts may differ from those formed in predominantly brittle crust. Salt can decouple sub- and supra-salt strain, causing sub-salt faults to be geometrically decoupled from, but kinematically coupled to and responsible for, supra-salt forced folding. Salt-influenced rifts thus contain more folds than their brittle counterparts, an observation often ignored in extension estimates. Fundamental to determining whether sub- and supra-salt structures are kinematically coherent, and the relative contributions of thin- (i.e. gravity-driven) and thick-skinned (i.e. whole-plate stretching) deformation to accommodating rift-related strain, is our ability to measure extension at both structural levels. We here use published physical models of salt-influenced extension to show that line-length estimates yield more accurate values of sub- and supra-salt extension compared to fault-heave, before applying these methods to seismic data from the Halten Terrace, offshore Norway. We show that, given the abundance of ductile deformation in salt-influenced rifts, significant amounts of extension may be ignored, leading to the erroneous interpretations of thin-skinned, gravity-gliding. If a system is kinematically coherent, supra-salt structures can help predict the occurrence and kinematics of sub-salt faults that may be poorly imaged and otherwise poorly constrained.

300 W - 1.75 K TORE SUPRA refrigerator cold centrifugal compressors report

International Nuclear Information System (INIS)

Gistau, G.M.; Pecoud, Y.; Ravex, A.E.

1988-01-01

The centrifugal helium compressors for the TORE SUPRA tokamak refrigerator were designed and manufactured by L'Air Liquide and tested at nominal conditions on a custom test rig. The refrigerator is now installed and all acceptance tests have been completed. Other tests were carried out off design conditions with the machines installed in the TORE SUPRA refrigerator. The results of these tests, including compression ratio, efficiency, and heat losses, are discussed

Heat Loads On Tore Supra ICRF Launchers Plasma Facing Components

International Nuclear Information System (INIS)

Bremond, S.; Colas, L.; Chantant, M.; Beaumont, B.; Ekedahl, A.; Goniche, M.; Moreau, P.; Mitteau, R.

2005-01-01

Understanding the heat loads on Ion Cyclotron Range of Frequency launchers plasma facing components is a crucial task both for operating present tokamaks and for designing ITER ICRF launchers as these loads may limit the RF power coupling capability. Tore Supra facility is particularly well suited to take this issue. Parametric studies have been performed which enables to get an overall detailed picture of the different heat loads on several areas, pointing to different mechanisms at the origin of the heat power fluxes. Lessons are drawned both with regards to Tore Supra possible operational limits and to ITER ICRF launcher design

The data acquisition and interlock system for Tore Supra infrared imaging

International Nuclear Information System (INIS)

Moulin, D.; Balorin, C.; Buravand, Y.; Caulier, G.; Ducobu, L.; Guilhem, D.; Jouve, M.; Roche, H.

2003-01-01

The data acquisition for the infrared measurement system on Tore-Supra is a key element in ensuring the supervision of the new actively-cooled plasma facing components of the CIEL project. It will allow us to follow the thermal evolution of components of Tore-Supra, in particular the toroidal pumped limiter (LPT) (360 deg.-15 m long) and the five additional heating launchers. When fully installed, the infrared measurement system will be composed of 12 digital 16-bit infrared cameras. They cover a 100-1200 deg.C temperature range and each picture has a definition of 320x240 pixels with a 20 ms time resolution. The objectives of the data acquisition system is real-time recording and analysis of each view element for further post-pulse analysis in order to understand the physics phenomenon and ensure the supervision of the plasma facing components and also to be part of the global feedback control system of Tore Supra

Attachment of composite porous supra-particles to air-water and oil-water interfaces: theory and experiment.

Science.gov (United States)

Paunov, Vesselin N; Al-Shehri, Hamza; Horozov, Tommy S

2016-09-29

We developed and tested a theoretical model for the attachment of fluid-infused porous supra-particles to a fluid-liquid interface. We considered the wetting behaviour of agglomerated clusters of particles, typical of powdered materials dispersed in a liquid, as well as of the adsorption of liquid-infused colloidosomes at the liquid-fluid interface. The free energy of attachment of a composite spherical porous supra-particle made from much smaller aggregated spherical particles to the oil-water interface was calculated. Two cases were considered: (i) a water-filled porous supra-particle adsorbed at the oil-water interface from the water phase, and, (ii) an oil-filled porous supra-particle adsorbed at the oil-water interface from the oil-phase. We derived equations relating the three-phase contact angle of the smaller "building block" particles and the contact angle of the liquid-infused porous supra-particles. The theory predicts that the porous supra-particle contact angle attached at the liquid interface strongly depends on the type of fluid infused in the particle pores and the fluid phase from which it approaches the liquid interface. We tested the theory by using millimetre-sized porous supra-particles fabricated by evaporation of droplets of polystyrene latex suspension on a pre-heated super-hydrophobic surface, followed by thermal annealing at the glass transition temperature. Such porous particles were initially infused with water or oil and approached to the oil-water interface from the infusing phase. The experiment showed that when attaching at the hexadecane-water interface, the porous supra-particles behaved as hydrophilic when they were pre-filled with water and hydrophobic when they were pre-filled with hexadecane. The results agree with the theoretically predicted contact angles for the porous composite supra-particles based on the values of the contact angles of their building block latex particles measured with the Gel Trapping Technique. The

Sequencing at the syllabic and supra-syllabic levels during speech perception: an fMRI study.

Science.gov (United States)

Deschamps, Isabelle; Tremblay, Pascale

2014-01-01

The processing of fluent speech involves complex computational steps that begin with the segmentation of the continuous flow of speech sounds into syllables and words. One question that naturally arises pertains to the type of syllabic information that speech processes act upon. Here, we used functional magnetic resonance imaging to profile regions, using a combination of whole-brain and exploratory anatomical region-of-interest (ROI) approaches, that were sensitive to syllabic information during speech perception by parametrically manipulating syllabic complexity along two dimensions: (1) individual syllable complexity, and (2) sequence complexity (supra-syllabic). We manipulated the complexity of the syllable by using the simplest syllable template-a consonant and vowel (CV)-and inserting an additional consonant to create a complex onset (CCV). The supra-syllabic complexity was manipulated by creating sequences composed of the same syllable repeated six times (e.g., /pa-pa-pa-pa-pa-pa/) and sequences of three different syllables each repeated twice (e.g., /pa-ta-ka-pa-ta-ka/). This parametrical design allowed us to identify brain regions sensitive to (1) syllabic complexity independent of supra-syllabic complexity, (2) supra-syllabic complexity independent of syllabic complexity and, (3) both syllabic and supra-syllabic complexity. High-resolution scans were acquired for 15 healthy adults. An exploratory anatomical ROI analysis of the supratemporal plane (STP) identified bilateral regions within the anterior two-third of the planum temporale, the primary auditory cortices as well as the anterior two-third of the superior temporal gyrus that showed different patterns of sensitivity to syllabic and supra-syllabic information. These findings demonstrate that during passive listening of syllable sequences, sublexical information is processed automatically, and sensitivity to syllabic and supra-syllabic information is localized almost exclusively within the STP.

Incisive canal deflation for correct implant placement: case report.

Science.gov (United States)

Spin-Neto, Rubens; Bedran, Telma Blanca Lombardo; de Paula, Wagner Nunes; de Freitas, Rubens Moreno; de Oliveira Ramalho, Lizeti Toledo; Marcantonio, Elcio

2009-12-01

This article is a case report of a patient in whom the prosthetic planning indicated the necessity of an incisive canal deflation for the correct installation of an implant that is to be osseointegrated. In the reopening phase after the bone graft installation, the incisive canal deflation (biopsy of its content) was done and titanium implants were installed with one of them invading the anatomical space occupied previously by the incisive canal. The biopsy analysis showed fragments of the incisive artery and nerve, which are responsible for the anterior upper-tooth pulp, the periodontium vascularization and the innervation. From the anastomosis present along with other structures allied with the absence of teeth in the region, there was no detriment to the patient caused by the deflation. Incisive canal deflation is a viable technique in implantology. It can permit ideal prosthetic planning with no detriment to the patient.

Supra-molecular Association and Polymorphic Behaviour In Systems Containing Bile Acid Salts

Directory of Open Access Journals (Sweden)

Camillo La Mesa

2007-08-01

Full Text Available A wide number of supra-molecular association modes are observed in mixtures containing water and bile salts, BS, (with, eventually, other components. Molecular or micellar solutions transform into hydrated solids, fibres, lyotropic liquid crystals and/or gels by raising the concentration, the temperature, adding electrolytes, surfactants, lipids and proteins. Amorphous or ordered phases may be formed accordingly. The forces responsible for this very rich polymorphism presumably arise from the unusual combination of electrostatic, hydrophobic and hydrogen-bond contributions to the system stability, with subsequent control of the supra-molecular organisation modes. The stabilising effect due to hydrogen bonds does not occur in almost all surfactants or lipids and is peculiar to bile acids and salts. Some supra-molecular organisation modes, supposed to be related to malfunctions and dis-metabolic diseases in vivo, are briefly reported and discussed.

Grading Scale of Radiographic Findings in the Pubic Bone and Symphysis in Athletes

International Nuclear Information System (INIS)

Besjakov, J.; Scheele, C. von; Ekberg, O.; Gentz, C. F.; Westlin, N.E.

2003-01-01

Purpose: Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes. Material and Methods: Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19-35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance. Results and Conclusion: The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely (p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women

Towards operations on Tore Supra of an ITER relevant inspection robot and associated processes

International Nuclear Information System (INIS)

Laurent Gargiulo, L.; Cordier, J.-J.; Samaille, F.; Grisolia, Ch.; Perrot, Y.; Olivier, D.; Friconneau, J.-P.; Palmer, J.

2006-01-01

The aim of the project is to demonstrate on Tore Supra the reliability of a multi-purpose in-vessel Remote Handling inspection system using a long reach, limited payload carrier. This project called AIA (Articulated Inspection Arm) is currently being developed at CEA under a European EFDA work program. The paper describes the detailed design, the manufacturing processes and the results of the first module test campaign in the CEA Tore Supra ME60 facility, at representative vacuum, temperature and nominal loading conditions. The second part of this work that is reported in the paper, concerns the description of the whole integration of the device on the Tore Supra tokamak that is foreseen to be operated on Tore Supra early 2007. The deployer system and the 10 m long storage vacuum vessel are presented. The robot prototype is fully representative of the deployment carrier system that could be required on ITER. The demonstration on Tore Supra will help in the understanding of operation issues that could occur in the tokamak vacuum vessel equipped of actively cooled components. The viewing process that is currently under development is presented in the paper. It will allow close inspection of the Tore Supra Plasma Facing Components that are representative of the ITER divertor targets in terms of confined environment and identification of possible tiles failure of CFC carbon tiles. Such viewing process could be used on ITER during the early stage of operation under a limited radiation level. The AIA technology is also showing promising potential for generic application in alternative systems for ITER. The feasibility study for viewing inspection of the beam line components in the neutral beam test facility is presented. One of the other potential inspection processes that is foreseen to be tested using the AIA carrier in Tore Supra is the laser ablation system of the CFC armour. It could be fully relevant for the ITER wall detritiation issues. Such process can be

Higher Incision at Upper Part of Lower Segment Caesarean Section

Directory of Open Access Journals (Sweden)

Yong Shao

2014-06-01

Conclusions: An incision at the upper part of the lower segment reduces blood loss, enhances uterine retraction, predisposes to fewer complications, is easier to repair, precludes bladder adhesion to the suture line and reduces operation time. Keywords: caesarean section; higher incision technique; traditional uterine incision technique.

Snake studies on TORE-SUPRA

International Nuclear Information System (INIS)

Cristofani, P.; Desgranges, C.; Garbet, X.; Geraud, A.; Gil, C.; Hoang, G.T.; Joffrin, E.; Pecquet, A.L.

1994-01-01

Snakes have been achieved after pellet injection in TORE-SUPRA during ohmic as well as ICRH discharges as it has already been observed in other machines. They are usually localized on a region around the q=1 surface, and correspond mainly to a perturbation of the density profile. The formation of the snake depends on the penetration depth L p of the pellet: the maximum of ablation must be well inside the q=1 surface, this condition is necessary but not sufficient to produce snakes. For example on TORE-SUPRA high speed H 2 pellets (1500 m/s and approximately 10 21 atoms) were injected into D 2 plasmas with following parameters: I p =1.4 MA, B Φ =3 T, T e =1.7 KeV, e >=2-3 10 19 m -3 , a=0.78 m, R=2.4 m, and q a =3.3. In such experimental conditions, the matter is deposited in the centre and snakes are produced in 50% of the cases, but they are created on a second much more internal q=1 surface leading probably to a non monotonic current profile. The first two paragraphs describe the properties of the snake and the induced current modification. The latter paragraph discusses the important role of the bootstrap current in the snake formation. (author) 5 refs., 7 figs

Activation/Inhibition of mast cells by supra-optimal antigen concentrations.

Science.gov (United States)

Huber, Michael

2013-01-22

Mast cells (MCs) are tissue resident cells of hemopoietic origin and are critically involved in allergic diseases. MCs bind IgE by means of their high-affinity receptor for IgE (FcεRI). The FcεRI belongs to a family of multi-chain immune recognition receptors and is activated by cross-linking in response to multivalent antigens (Ags)/allergens. Activation of the FcεRI results in immediate release of preformed granular substances (e.g. histamine, heparin, and proteases), generation of arachidonic acid metabolites, and production of pro-inflammatory cytokines. The FcεRI shows a remarkable, bell-shaped dose-response behavior with weak induction of effector responses at both low and high (so-called supra-optimal) Ag concentrations. This is significantly different from many other receptors, which reach a plateau phase in response to high ligand concentrations. To explain this unusual dose-response behavior of the FcεRI, scientists in the past have drawn parallels to so-called precipitin curves resulting from titration of Ag against a fixed concentration of antibody (Ab) in solution (a.k.a. Heidelberger curves). Thus, for high, supra-optimal Ag concentrations one could assume that every IgE-bound FcεRI formed a monovalent complex with "its own Ag", thus resulting in marginal induction of effector functions due to absence of receptor cross-linking. However, this was never proven to be the case. More recently, careful studies of FcεRI activation and signaling events in MCs in response to supra-optimal Ag concentrations have suggested a molecular explanation for the descending part of this bell-shaped curve. It is obvious now that extensive FcεRI/IgE/Ag clusters are formed and inhibitory molecules and signalosomes are engaged in response to supra-optimal cross-linking (amongst them the Src family kinase Lyn and the inositol-5'-phosphatase SHIP1) and they actively down-regulate MC effector responses. Thus, the analysis of MC signaling triggered by supra

Effects of two different incision phacoemulsification on corneal astigmatism

Directory of Open Access Journals (Sweden)

Lu Huo

2014-12-01

Full Text Available AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. METHODS: Totally 88 cases(122 eyeswith pure cataract were randomly divided into two groups. Forty cases(60 eyeswere clarity corneal incision in group A, and 48 cases(62 eyeswere sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA, uncorrected visual acuity(UCVAand best correct vision acuity(BCVAwere observed in pre- and post-operation at 1d; 1wk; 1mo.RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(PPP>0.05. UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(PP>0.05.CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOLimplantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

Diathermy versus scalpel incisions for open cholecystectomy comparative study

International Nuclear Information System (INIS)

Ali, M.A.; Niazi, W.A.K.

2014-01-01

The aim of the study was to make a comparison between skin incisions made with electrocautery versus scalpel in terms of their safety, efficacy and post-operative complications. Design: A randomized controlled study. Setting: The study was conducted in Combined Military Hospital (CMH) Kharian, Pakistan airforce (PAF) Hospital Sargodha. Duration of Study: May 2008 to August 2011. Patients and Methods: Ninety seven patients who underwent open cholecystectomy were randomly divided into two groups on the basis of the use of electrocautery versus steel scalpel for making skin incision and sub-cutaneous tissue dissection. Parameters recorded were, time taken from skin incision to full incising of the peritoneum, length of the wound, amount of blood loss during this step of surgery in each group. Post-operative pain scoring using visual analogue scale was done. Wound complications such as infection, haematoma/seroma and dehiscence were noted too. One month of follow up was recorded in each group. Subsequently a comparison of these findings was done. Results: Incision time (sec/cm/sub 2/) was longer in scalpel group than in diathermy group (p = 0.001), whereas, incision blood loss (ml/cm/sub 2/) was significantly less in diathermy group than in scalpel group (p = 0.03). There was no difference in post-operative pain perception as delineated by visual pain analogue scoring system between the two groups (p = 0.57). Post-operative wound complications and the final healing of wound at 01 month of follow-up were almost similar in both groups. Conclusion: Electrocautery may be used safely without any untoward complication in making skin incision and sub-cutaneous tissue dissection with an advantage of reduced incision time and and less blood loss. (author)

ORNL compact loop antenna design for TFTR and Tore Supra

International Nuclear Information System (INIS)

Taylor, D.J.; Baity, F.W.; Bryan, W.E.; Hoffman, D.J.; McIlwain, R.L.; Ray, J.M.

1987-01-01

The goal supplemental ion cyclotron resonance heating (ICRH) of fusion plasma is to deliver power at high efficiencies deep within the plasma. The technology for fast-wave ICRH has reached the point of requiring ''proof-of-performance'' demonstration of specific antenna configurations of specific antenna configurations and their mechanical adequacy for operating in a fusion environment. Oak Ridge National Laboratory (ORNL) has developed the compact loop antenna concept based on a resonant double loop (RDL) configuration for use in both Tokamak Fusion Test Reactor (TFTR) and the Tore Supra ICRH programs. A description and a comparison of the technologies developed in the two designs are presented. The electrical circuit and the mechanical philosophy employed are the same for both antennas, but different operating environments result in substantial differences in the design of specific components. The ORNL TFTR antenna is designed to deliver 4 MW over a 2-s pulse, and the ORNL Tore Supra antenna is designed for 4 MW and essentially steady-state conditions. The TFTR design embodies the first operations compact RDL antenna, and the Tore Supra antenna extends the technology to an operational duty cycle consistent with reactor-relevant applications. 7 refs., 5 figs

Collection and Characterization of Particulate from the Tore Supra Tokamak (Dec. 1999 Vent)

International Nuclear Information System (INIS)

Sharpe, John Phillip

2002-01-01

Particulate generated during the operation of a fusion device contributes to the radiological source term associated with accident scenarios in the device. Understanding the mechanisms generating the particulate and correctly describing its physical and chemical behavior is essential for safety analyses of future fusion devices. Knowledge of these mechanisms is gained by collecting and characterizing particulate matter from operating fusion facilities. Tokamak dust, the particulate matter generated during the operation of a tokamak fusion device, was collected from Tore Supra in December 1999, during the initial phase of the scheduled shutdown for installation of advanced plasma facing components. Tore Supra, located at CEA Cadarache, France, is presently the third largest operating tokamak with the capability of long-pulse operation. Eighteen super-conducting coils produce the 4.5 T magnetic field inside a vessel 2.4 m in major radius and 1.2 m in minor radius. Limiter and divertor regimes of operation are possible. In the divertor regime, the circular magnetic configuration is ergodized by six outboard resonant divertor modules that are covered with 12 m2 of carbon fiber composite (CFC) tiles. In addition, some field lines are diverted to actively cooled neutralizing plates made of CuCrZr bars covered with B4C. In the limiter regime, the plasma leans on the actively cooled inboard first wall or on a set of inertially cooled pumped limiters. The first wall area of 12 m2 is covered with both polycrystalline graphite tiles (83%) and CFC tiles (17%). The single outboard limiter is constructed of pyrolitic graphite, and the four toroidally symmetric bottom limiters are constructed of CFC. Figure 1.1 displays the relative location of plasma facing components within the plasma chamber of Tore Supra. In this report, we present in Section 2 the methods used to collect and analyze this dust and describe the selection of sampling locations. Section 3 includes a discussion

Laser beam welding of new ultra-high strength and supra-ductile steels

OpenAIRE

Dahmen, M.

2015-01-01

Ultra-high strength and supra-ductile are entering fields of new applications. Those materials are excellent candidates for modern light-weight construction and functional integration. As ultra-high strength steels the stainless martensitic grade 1.4034 and the bainitic steel UNS 53835 are investigated. For the supra-ductile steels stand two high austenitic steels with 18 and 28 % manganese. As there are no processing windows an approach from the metallurgical base on is required. Adjusting t...

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

Science.gov (United States)

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

2011-12-01

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

Implementation of FCI heating system to the control system of Tore-Supra

International Nuclear Information System (INIS)

Wisniewski, S.

2001-11-01

This report presents the implementation of the ion cyclotron resonance heating system (FCI) to the instrumentation and control system of the Tore-Supra tokamak. The new plasma heating system involves 3 antennas delivering 12 MW that are required to maintain fusion reactions. This paper is divided into 8 chapters: 1) thermonuclear fusion and Tore-Supra tokamak; 2) hardware system around Tore-Supra, in this chapter the control system and the data acquisition and processing systems are presented; 3) functional analysis, this analysis defines the different needs concerning timing and pilot-controlling, a preliminary proposition of hardware equipment is made; 4) operating modes of FCI; 5) communication within the control system network; 6) communication with the supervisory system of the power stations; 7) management of data exchange with SMX generators; and 8) control of the rate of stationary waves during the injection of power into the plasma

Laser beam welding of new ultra-high strength and supra-ductile steels

Science.gov (United States)

Dahmen, Martin

2015-03-01

Ultra-high strength and supra-ductile are entering fields of new applications. Those materials are excellent candidates for modern light-weight construction and functional integration. As ultra-high strength steels the stainless martensitic grade 1.4034 and the bainitic steel UNS 53835 are investigated. For the supra-ductile steels stand two high austenitic steels with 18 and 28 % manganese. As there are no processing windows an approach from the metallurgical base on is required. Adjusting the weld microstructure the Q+P and the QT steels require weld heat treatment. The HSD steel is weldable without. Due to their applications the ultra-high strength steels are welded in as-rolled and strengthened condition. Also the reaction of the weld on hot stamping is reflected for the martensitic grades. The supra-ductile steels are welded as solution annealed and work hardened by 50%. The results show the general suitability for laser beam welding.

Implementation of FCI heating system to the control system of Tore-Supra; Integration du systeme de chauffage FCI au sein du reseau de controle commande du Tokamak Tore Supra

Energy Technology Data Exchange (ETDEWEB)

Wisniewski, S

2001-11-01

This report presents the implementation of the ion cyclotron resonance heating system (FCI) to the instrumentation and control system of the Tore-Supra tokamak. The new plasma heating system involves 3 antennas delivering 12 MW that are required to maintain fusion reactions. This paper is divided into 8 chapters: 1) thermonuclear fusion and Tore-Supra tokamak; 2) hardware system around Tore-Supra, in this chapter the control system and the data acquisition and processing systems are presented; 3) functional analysis, this analysis defines the different needs concerning timing and pilot-controlling, a preliminary proposition of hardware equipment is made; 4) operating modes of FCI; 5) communication within the control system network; 6) communication with the supervisory system of the power stations; 7) management of data exchange with SMX generators; and 8) control of the rate of stationary waves during the injection of power into the plasma.

3400 m/s deuterium pellet injector for Tore Supra

International Nuclear Information System (INIS)

Perin, J.P.; Geraud, A.

1995-01-01

This paper reports on the Tore Supra high velocity pellet injector which was built in Grenoble and after qualification tests installed on Tore Supra Tokomak where it is used for plasma and ablation studies. By using a two stage light gas gun (TSG) and two cells (φ = 3 mm or 4 mm), unsupported pellets pellets (1 to 3.5 10 21 atoms) made directly in the gun by > [1] have been launched into Tore Supra plasma at speeds between 2400m/s and 3400m/s with a reliability of 80%. These higher pellets velocities (> 2500 m/s) [2] are obtained by the optimization of a TSG and the search for the cryogenic conditions of freezing deuterium with good mechanical properties. In particular, the impurities concentration in deuterium during the condensation process has been studied. Several tens pellets have been injected into ohmically and ICR heated plasma and during LH current drive experiments with a good reliability in the range of 3000m/s. These experiments allowed us to extend significantly the ablation data base. Central penetrations can be reached even for high temperatures plasma (3-5 keV) and very peaked density profiles have been obtained in ohmically and ICR heated plasmas A transient improved confinement regime is then observed, which presents some features similar to the PEP regime obtained on JET. (orig.)

Effects of Reiki on Pain and Vital Signs When Applied to the Incision Area of the Body After Cesarean Section Surgery: A Single-Blinded, Randomized, Double-Controlled Study.

Science.gov (United States)

Sagkal Midilli, Tulay; Ciray Gunduzoglu, Nazmiye

This study was conducted to determine the effects of Reiki on pain and vital signs when applied for 15 minutes to the incision area of the body after cesarean section surgery. The study was single-blinded, randomized, and double-controlled (Reiki, sham Reiki, and control groups). Forty-five patients, equalized by age and number of births, were randomly assigned to the Reiki, sham Reiki, and control groups. The treatment, which was applied to the patients in these 3 groups, was applied for 15 minutes to the incision area of body in the first 24 and 48 hours after the operation within 4 to 8 hours of the application of standard analgesics. The study data were collected using a patient follow-up form and a visual analog scale. Mean visual analog scale measurement values were significantly different from each other according to groups and times (P Reiki group patients between day 1 pre-tx and after application on the second day (day 2 post-tx) measurements. Mean breathing rate and systolic blood pressure measurement values were significantly different from each other according to groups (P Reiki group was observed to use fewer analgesics throughout the study and to need them after a longer time than the sham Reiki and control groups (P Reiki applied for 15 minutes to the incision area after a cesarean operation had the expected effects on pain and the need for the use of analgesics, but it had no effect on vital signs.

Standardized technique for single port laparoscopic ileostomy and colostomy.

Science.gov (United States)

Shah, A; Moftah, M; Hadi Nahar Al-Furaji, H; Cahill, R A

2014-07-01

Single site laparoscopic techniques and technology exploit maximum usefulness from confined incisions. The formation of an ileostomy or colostomy seems very applicable for this modality as the stoma occupies the solitary incision obviating any additional wounds. Here we detail the principles of our approach to defunctioning loop stoma formation using single port laparoscopic access in a stepwise and standardized fashion along with the salient specifics of five illustrative patients. No specialized instrumentation is required and the single access platform is established table-side using the 'glove port' technique. The approach has the intra-operative advantage of excellent visualization of the correct intestinal segment for exteriorization along with direct visual control of its extraction to avoid twisting. Postoperatively, abdominal wall trauma has been minimal allowing convalescence and stoma care education with only one parietal incision. Single incision stoma siting proves a ready, robust and reliable technique for diversion ileostomy and colostomy with a minimum of operative trauma for the patient. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Electron cyclotron heating and supra-thermal electron dynamics in the TCV Tokamak

Energy Technology Data Exchange (ETDEWEB)

Gnesin, S.

2011-10-15

enhancing its potential for full spectral analysis in high-fluency scenarios. Additional flexibility is afforded by the possibility to rotate the orientation of two of the cameras, permitting the crucial comparison of radiation emitted perpendicular and parallel to the primary magnetic field. The design of the HXR system was optimized through an extensive iterative simulation process with the aid of tomographic reconstruction codes as well as quasilinear Fokker- Planck modeling of ECH-driven TCV plasmas. In parallel, the selection of the detectors for this system was performed through comprehensive laboratory testing of several candidate detectors available on the market. While the design was completed in the course of the thesis work, commissioning of the system has only commenced recently with one of the four cameras installed on TCV. The first preliminary results, discussed in the last part of this thesis, include basic parameter scans of ECH wave-plasma interaction and the investigation of the dynamic response of supra-thermal electrons to modulated ECH. In addition, the cameras possess the novel ability to discriminate against very high-energy γ-ray radiation that cannot be collimated and must thus be excluded from spatial distribution analysis. A basic study of the conditions for γ-ray suppression was conducted in preparation for future experiments. The Fokker-Planck modeling tool used in this diagnostic development was acquired through a collaboration with CEA-Cadarache, initially with the primary motivation of studying the simultaneous plasma heating by 2{sup nd} and 3{sup rd} harmonic electron cyclotron waves that is uniquely possible on TCV. This motivated a dedicated study, both theoretical and experimental, of one particular instance of this combined heating, which became a second primary subject of this thesis work. The particular scenario studied here is one in which a single ECH frequency is resonant at both harmonics in the same plasma. The primary

Electron cyclotron heating and supra-thermal electron dynamics in the TCV Tokamak

International Nuclear Information System (INIS)

Gnesin, S.

2011-10-01

enhancing its potential for full spectral analysis in high-fluency scenarios. Additional flexibility is afforded by the possibility to rotate the orientation of two of the cameras, permitting the crucial comparison of radiation emitted perpendicular and parallel to the primary magnetic field. The design of the HXR system was optimized through an extensive iterative simulation process with the aid of tomographic reconstruction codes as well as quasilinear Fokker- Planck modeling of ECH-driven TCV plasmas. In parallel, the selection of the detectors for this system was performed through comprehensive laboratory testing of several candidate detectors available on the market. While the design was completed in the course of the thesis work, commissioning of the system has only commenced recently with one of the four cameras installed on TCV. The first preliminary results, discussed in the last part of this thesis, include basic parameter scans of ECH wave-plasma interaction and the investigation of the dynamic response of supra-thermal electrons to modulated ECH. In addition, the cameras possess the novel ability to discriminate against very high-energy γ-ray radiation that cannot be collimated and must thus be excluded from spatial distribution analysis. A basic study of the conditions for γ-ray suppression was conducted in preparation for future experiments. The Fokker-Planck modeling tool used in this diagnostic development was acquired through a collaboration with CEA-Cadarache, initially with the primary motivation of studying the simultaneous plasma heating by 2 nd and 3 rd harmonic electron cyclotron waves that is uniquely possible on TCV. This motivated a dedicated study, both theoretical and experimental, of one particular instance of this combined heating, which became a second primary subject of this thesis work. The particular scenario studied here is one in which a single ECH frequency is resonant at both harmonics in the same plasma. The primary objective of this

Validation of the LH antenna code ALOHA against Tore Supra experiments

International Nuclear Information System (INIS)

Hillairet, J.; Ekedahl, A.; Kocan, M.; Gunn, J. P.; Goniche, M.

2009-01-01

Comparisons between ALOHA code predictions and experimental measurements of reflection coefficients for the two different Lower Hybrid Current Drive (LHCD) antennas (named C2 and C3) in Tore Supra are presented. A large variation of density in front of the antennas was obtained by varying the distance between the plasma and the antennas. Low power ( 2 ) was used in order to avoid non-linear effects on the wave coupling. Results obtained with ALOHA are in good agreement with the experimental measurements for both Tore Supra antennas and show that ALOHA is an efficient LH predictive tool.

Repetitive Supra-Physiological Shear Stress Impairs Red Blood Cell Deformability and Induces Hemolysis.

Science.gov (United States)

Horobin, Jarod T; Sabapathy, Surendran; Simmonds, Michael J

2017-11-01

The supra-physiological shear stress that blood is exposed to while traversing mechanical circulatory assist devices affects the physical properties of red blood cells (RBCs), impairs RBC deformability, and may induce hemolysis. Previous studies exploring RBC damage following exposure to supra-physiological shear stress have employed durations exceeding clinical instrumentation, thus we explored changes in RBC deformability following exposure to shear stress below the reported "hemolytic threshold" using shear exposure durations per minute (i.e., duty-cycles) reflective of that employed by circulatory assist devices. Blood collected from 20 male donors, aged 18-38 years, was suspended in a viscous medium and exposed to an intermittent shear stress protocol of 1 s at 100 Pa, every 60 s for 60 duty-cycles. During the remaining 59 s/min, the cells were left at stasis until the subsequent duty-cycle commenced. At discrete time points (15/30/45/60 duty-cycles), an ektacytometer measured RBC deformability immediately after shear exposure at 100 Pa. Plasma-free hemoglobin, a measurement of hemolysis, was quantified via spectrophotometry. Supra-physiological shear stress impaired RBC properties, as indicated by: (1) decreased maximal elongation of RBCs at infinite shear stress following 15 duty-cycles (P supra-physiological shear stress protocol (100 Pa) following exposure to 1 duty-cycle (F (1.891, 32.15) = 12.21, P = 0.0001); and (3) increased plasma-free hemoglobin following 60 duty-cycles (P supra-physiological shear stress, impairs RBC deformability, with the extent of impairment exacerbated with each duty-cycle, and ultimately precipitates hemolysis. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The plasma facing components of the Tore Supra ICRF antenna

International Nuclear Information System (INIS)

Beaumont, B.; Agarici, G.; Gauthier, E.; Kuus, H.; Schlosser, J.

1994-01-01

Two generations of Faraday shields for the Tore Supra ICRH antennas interacting with the edge plasma are presented. The last one, using a film of boron carbide as protective material performs well, proving the relevance of this technique for in vessel equipment submitted to low power fluxes. The different lateral protections used on Tore Supra are submitted to high power fluxes. Finite element calculations allow to assess their performances. One type, using Boron Carbide, can be used to measure the local heat flux. The estimation of this flux confirm the specificity of the edge/RF interaction, which is more than one order of magnitude above the exponential decay observed in ohmic plasmas. (author) 11 refs.; 1 fig

ERP signs of categorical and supra-categorical processing of visual information.

Science.gov (United States)

Zani, Alberto; Marsili, Giulia; Senerchia, Annapaola; Orlandi, Andrea; Citron, Francesca M M; Rizzi, Ezia; Proverbio, Alice M

2015-01-01

The aim of the present study was to investigate to what extent shared and distinct brain mechanisms are possibly subserving the processing of visual supra-categorical and categorical knowledge as observed with event-related potentials of the brain. Access time to these knowledge types was also investigated. Picture pairs of animals, objects, and mixed types were presented. Participants were asked to decide whether each pair contained pictures belonging to the same category (either animals or man-made objects) or to different categories by pressing one of two buttons. Response accuracy and reaction times (RTs) were also recorded. Both ERPs and RTs were grand-averaged separately for the same-different supra-categories and the animal-object categories. Behavioral performance was faster for more endomorphic pairs, i.e., animals vs. objects and same vs. different category pairs. For ERPs, a modulation of the earliest C1 and subsequent P1 responses to the same vs. different supra-category pairs, but not to the animal vs. object category pairs, was found. This finding supports the view that early afferent processing in the striate cortex can be boosted as a by-product of attention allocated to the processing of shapes and basic features that are mismatched, but not to their semantic quintessence, during same-different supra-categorical judgment. Most importantly, the fact that this processing accrual occurred independent of a traditional experimental condition requiring selective attention to a stimulus source out of the various sources addressed makes it conceivable that this processing accrual may arise from the attentional demand deriving from the alternate focusing of visual attention within and across stimulus categorical pairs' basic structural features. Additional posterior ERP reflections of the brain more prominently processing animal category and same-category pairs were observed at the N1 and N2 levels, respectively, as well as at a late positive complex level

Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

Energy Technology Data Exchange (ETDEWEB)

Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

1991-06-01

We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study.

Science.gov (United States)

Jaeger, Filipe; Chiavaioli, Gustavo Marques; de Toledo, Guilherme Lacerda; Freire-Maia, Belini; Amaral, Marcio Bruno Figueiredo; Mesquita, Ricardo Alves

2018-01-01

The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.

Transurethral incision of urethral diverticulum in the female

DEFF Research Database (Denmark)

Miskowiak, J; Honnens de Lichtenberg, M

1989-01-01

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

Extra-Thoracic Supra-aortic Bypass Surgery Is Safe in Thoracic Endovascular Aortic Repair and Arterial Occlusive Disease Treatment.

Science.gov (United States)

Gombert, Alexander; van Issum, Lea; Barbati, Mohammad E; Grommes, Jochen; Keszei, Andras; Kotelis, Drosos; Jalaie, Houman; Greiner, Andreas; Jacobs, Michael J; Kalder, Johannes

2018-04-20

The safety and feasibility of supra-aortic debranching as part of endovascular aortic surgery or as a treatment option for arterial occlusive disease (AOD) remains controversial. The aim of this study was to assess the clinical outcome of this surgery. This single centre, retrospective study included 107 patients (mean age 69.2 years, 38.4% women) who underwent supra-aortic bypass surgery (carotid-subclavian bypass, carotid-carotid bypass, and carotid-carotid-subclavian bypass) because of thoracic or thoraco-abdominal endovascular aortic repair (57%; 61/107) or as AOD treatment (42.9%; 46/107) between January 2006 and January 2015. Mortality, morbidity with a focus on neurological complications, and patency rate were assessed. Twenty-six of 107 (14.2%) of the debranching patients were treated under emergency conditions because of acute type B dissection or symptomatic aneurysm. Follow up, conducted by imaging interpretation and telephone interviews, continued till March 2017 (mean 42.1, 0-125, months). The in hospital mortality rate was 10.2% (11/107), all of these cases from the debranching group and related to emergency procedures (p supra-aortic bypass surgery involves low complication rates and high mid-term bypass patency rates. It is a safe and feasible treatment option in the form of debranching in combination with endovascular aortic aneurysm repair and in AOD. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Supra-transumbilical laparotomy (STL) approach for small bowel ...

African Journals Online (AJOL)

Background: Supra-Transumbilical Laparotomy (STL) has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. Patients and Methods: Fourteen patients with ...

Transport and turbulence in TORE SUPRA ohmic discharges

International Nuclear Information System (INIS)

Garbet, X.; Payan, J.; Laviron, C.; Devynck, P.; Saha, S.K.; Capes, H.; Chen, X.P.; Coulon, J.P.; Gil, C.; Harris, G.; Hutter, T.; Pecquet, A.L.

1992-01-01

The mechanisms underlying the energy confinement behaviour in ohmic tokamak discharges are not yet understood. It is well known that the confinement time increases with the average density and saturates above a critical value of the density, but several explanations exist for this saturation. The present study is an analysis of a set of ohmic discharges in Tore Supra with I p =1.6 MA, B=4 T, R=2.35 m and a=0.78 m, where the average density was increased from 0.9 to 4.2 10 19 m -3 . For these plasma parameters, the energy confinement time given by magnetic measurements saturates for e > ≥ 2.5 10 19 m -3 . It is emphasized here that the onset of ionic turbulence is unlikely in Tore Supra. This conclusion relies on a transport analysis and turbulence measurements by CO 2 laser scattering, whose results are presented in this paper

Supra-annular valve strategy for an early degenerated transcatheter balloon-expandable heart valve.

Science.gov (United States)

Kamioka, Norihiko; Caughron, Hope; Corrigan, Frank; Block, Peter; Babaliaros, Vasilis

2018-01-23

Currently, there are no recommendations regarding the selection of valve type for a transcatheter heart valve (THV)-in-THV procedure. A supra-annular valve design may be superior in that it results in a larger effective orifice area and may have a lower chance of valve thrombosis after THV-in-THV. In this report, we describe the use of a supra-annular valve strategy for an early degenerated THV. © 2018 Wiley Periodicals, Inc.

In vitro conjunctival incision repair by temperature-controlled laser soldering.

Science.gov (United States)

Norman, Galia; Rabi, Yaron; Assia, Ehud; Katzir, Abraham

2009-01-01

The common method of closing conjunctival incisions is by suturing, which is associated with several disadvantages. It requires skill to apply and does not always provide a watertight closure, which is required in some operations (e.g., glaucoma filtration). The purpose of the present study was to evaluate laser soldering as an alternative method for closing conjunctival incisions. Conjunctival incisions of 20 ex vivo porcine eyes were laser soldered using a temperature-controlled fiberoptic laser system and an albumin mixed with indocyanine green as a solder. The control group consisted of five repaired incisions by a 10-0 nylon running suture. The leak pressure of the repaired incisions was measured. The mean leak pressure in the laser-soldered group was 132 mm Hg compared to 4 mm Hg in the sutured group. There was no statistically significant difference in both the incision's length and distance from the limbus between the groups, before and after the procedure, indicating that there was no severe thermal damage. These preliminary results clearly demonstrate that laser soldering may be a useful method for achieving an immediate watertight conjunctival wound closure. This procedure is faster and easier to apply than suturing.

Tore supra first wall conditioning

International Nuclear Information System (INIS)

Gauthier, E.; Achard, M.H.; Grosman, A.; Monier, P.

1989-01-01

The procedures and the results obtained concerning impurity and isotopic control in Tore Supra tokamak are summarized. The conditioning of the vessel, mainly achieved by glow discharges, is described. The impurity control of the discharge was monitored with a VUV-X spectrometer. The in situ blasting degassing procedure applied is explained. In the sequence of the conditioning process, the hydrogen and the helium glow discharges and the carbonization method are discussed. The He glow discharges allowed to limit the H content of the He plasma shot below 20%

Fusion profile measurement on Tore-Supra

International Nuclear Information System (INIS)

Martin, G.; Gilles, P.; Joyer, P.

1990-01-01

The new diagnostic set on Tore-Supra to observe charged fusion particles is described. The detector is a multiple strip chips and equivalent to 16 small detectors placed close to one another. For given toroidal and poloidal fields, the knowledge of the pitch angle allows to calculate the particle trajectories. The proton flux on the detector is the highest for the most central trajectory. The detector efficiency, resolution and first experimental results are discussed

Minimal abdominal incisions

Directory of Open Access Journals (Sweden)

João Carlos Magi

2017-04-01

Full Text Available Minimally invasive procedures aim to resolve the disease with minimal trauma to the body, resulting in a rapid return to activities and in reductions of infection, complications, costs and pain. Minimally incised laparotomy, sometimes referred to as minilaparotomy, is an example of such minimally invasive procedures. The aim of this study is to demonstrate the feasibility and utility of laparotomy with minimal incision based on the literature and exemplifying with a case. The case in question describes reconstruction of the intestinal transit with the use of this incision. Male, young, HIV-positive patient in a late postoperative of ileotiflectomy, terminal ileostomy and closing of the ascending colon by an acute perforating abdomen, due to ileocolonic tuberculosis. The barium enema showed a proximal stump of the right colon near the ileostomy. The access to the cavity was made through the orifice resulting from the release of the stoma, with a lateral-lateral ileo-colonic anastomosis with a 25 mm circular stapler and manual closure of the ileal stump. These surgeries require their own tactics, such as rigor in the lysis of adhesions, tissue traction, and hemostasis, in addition to requiring surgeon dexterity – but without the need for investments in technology; moreover, the learning curve is reported as being lower than that for videolaparoscopy. Laparotomy with minimal incision should be considered as a valid and viable option in the treatment of surgical conditions. Resumo: Procedimentos minimamente invasivos visam resolver a doença com o mínimo de trauma ao organismo, resultando em retorno rápido às atividades, reduções nas infecções, complicações, custos e na dor. A laparotomia com incisão mínima, algumas vezes referida como minilaparotomia, é um exemplo desses procedimentos minimamente invasivos. O objetivo deste trabalho é demonstrar a viabilidade e utilidade das laparotomias com incisão mínima com base na literatura e

Retrocrural Lymph Node Metastasis Disclosed by (18)F-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer.

Science.gov (United States)

Im, Hyung-Jun; Kim, Yong-Il; Paeng, Jin Chul; Chung, June-Key; Kang, Soon-Beom; Lee, Dong Soo

2012-03-01

Retrocrural lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra-diaphragmatic extension will occur in abdomino-pelvic cancers. The authors investigated performance of (18)F-FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra-diaphragmatic lymphatic metastases of ovarian cancer. Sixty-seven patients with stage IV ovarian cancer who had undergone (18)F-FDG PET/CT were included in this retrospective study. Diagnostic performance of (18)F-FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra-diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated. Sensitivity and specificity of (18)F-FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra-diaphragmatic LN metastases. (18)F-FDG PET/CT showed 26 RCLN metastases in patients with supra-diaphragmatic LN metastases (54.5%), and only 1 in patients without supra-diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P supra-diaphragmatic LN metastasis was 17.3 (95% confidence interval = 2.1 to 140.9, P = 0.008). Performance of (18)F-FDG PET/CT to diagnose RCLN metastasis was excellent. RCLN metastasis revealed by (18)F-FDG PET/CT was strongly associated with supra-diaphragmatic LN spread of ovarian cancer. Thus, RCLN metastasis could be used as a predictor of supra-diaphragmatic lymphatic metastasis of ovarian cancer.

Reliability of the xipho-pubic angle in patients with sagittal imbalance of the spine.

Science.gov (United States)

Langella, Francesco; Villafañe, Jorge H; Ismael, Maryem; Buric, Josip; Piazzola, Andrea; Lamartina, Claudio; Berjano, Pedro

2018-04-01

Proximal junctional kyphosis (PJK) is a frequent complication that compromises the outcomes of spinal surgery, especially for adult deformity. To the date no single risk factor or cause has been identified that explains its occurrence. The purpose of this study was to investigate the test-retest reliability of the radiologic measurements using xipho-pubic angle (XPA) for subjects undergoing surgery for sagittal misalignment of the spine. Retrospective observational cross-sectional study of prospectively collected data. Full-spine standing lateral radiographs of 50 patients who underwent surgery for fixed sagittal imbalance (preoperative and postoperative) were evaluated. Internal consistency, reproducibility, concurrent validity, and discriminative ability of the XPA. Two physicians measured XPA on the 100 randomly sorted and anonymized radiographs on two occasions, one week apart (test and retest conditions), were calculated for inter and intraobserver agreement. Test-retest reliability of XPA measurement was excellent for pre- (ICC=0.98; P=0.001) and post-surgical (ICC=0.86; P=0.001) radiographs of subjects with sagittal imbalance of the spine. XPA was able to discriminate between preoperative and postoperative radiographs F=17.924, Pimbalance for both raters. There were significant differences between pre- vs. postoperative XPA, pelvic tilt, lumbar lordosis and sagittal vertical axis values (all Pimbalance.

Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair.

Science.gov (United States)

Ullery, Brant W; Suh, Ga-Young; Hirotsu, Kelsey; Zhu, David; Lee, Jason T; Dake, Michael D; Fleischmann, Dominik; Cheng, Christopher P

2018-04-01

To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair. Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed. Branch angle of the supra-aortic branch vessels and curvature metrics of the ascending aorta, aortic arch, and stented thoracic aortic lumen were calculated both at pre- and postintervention. The left common carotid artery branch angle was lower than the left subclavian artery angles preintervention ( P Supra-aortic branch vessel angulation remains relatively static when proximal landing zones are distal to the left common carotid artery.

Long-Term Incisal Relationships After Palatoplasty in Patients With Isolated Cleft Palate.

Science.gov (United States)

Odom, Elizabeth B; Woo, Albert S; Mendonca, Derick A; Huebener, Donald V; Nissen, Richard J; Skolnick, Gary B; Patel, Kamlesh B

2016-06-01

Various palatoplasty techniques have limited incisions in the hard palate due to concerns that these incisions may limit maxillary growth. There is little convincing long-term evidence to support this. Our purpose is to determine incisal relationships, an indicator for future orthognathic procedure, in patients after repair of an isolated cleft of the secondary palate. Our craniofacial database was used to identify patients aged 10 years or greater with an isolated cleft of the secondary palate who underwent palatoplasty between 1985 and 2002. Data collected included age at palatoplasty and follow-up, cleft type, associated syndrome, Robin sequence, surgeon, repair technique, number of operations, and occlusion. Incisal relationship was determined through clinical observation by a pediatric dentist and orthodontist. Seventy eligible patients operated on by 9 surgeons were identified. Class III incisal relationship was seen in 5 patients (7.1%). Palatoplasty techniques over the hard palate (63 of 70 patients) included 2-flap palatoplasty, VY-pushback, and Von Langenbeck repair. There was an association between class III incisal relationship and syndromic diagnosis (P <0.001). Other study variables were not associated with class III incisal relationships. In patients with an isolated cleft of the secondary palate, there was no association between class III incisal relationship and surgeon, age at repair, cleft type, palatoplasty technique, or number of operations. Increased likelihood of class III incisal relationship was associated primarily with syndromic diagnosis.

A STUDY ON EFFICACY OF MANUAL SMALL INCISION CATARACT SURGERY BY TEMPORAL APPROACH

Directory of Open Access Journals (Sweden)

Vinodhini Kannan

2018-01-01

Full Text Available BACKGROUND Manual Small Incision Cataract Surgery (MSICS is a well-known technique of cataract surgery owing to its advantage of a selfsealing suture less incision with least surgically induced astigmatism at a low cost. It is a safe, simple, consistent, stable and cost-effective technique with various modifications that involve site, size, type of incision and method of nucleus delivery. One such modification is Temporal Incision MSICS, where the cataract surgery is done by a temporal approach, which is equally good compared to the superior incision. This study was done retrospectively to analyse the visual outcome of patients operated by Manual SICS - Temporal Approach, using the WHO criteria and to establish its efficacy as a good surgical technique. MATERIALS AND METHODS Records of patients operated for senile cataract by a single surgeon by Temporal MSICS using a temporal sclerocorneal incision of 6-6.5 mm, during a 1-year period, were analysed retrospectively. Post-operative followup records of POD-1 and subsequent follow-ups at 1 st week and 6 th week were recorded for visual outcome. RESULTS Out of the 83 cases analysed retrospectively, majority of them were found to be between 61-70 years with a female Preponderance. Most of the cases were found to have senile immature cataract (55 patients, with Grade III nuclear sclerosis (52 cases. The pre-operative visual acuity was poor <6/60 in 72 cases (86.7% and borderline in 11 cases (14.5%. 55 cases (66.3% had a 6.5 mm scleral incision and the remaining 28 cases (33.7% had a 6 mm incision. Average duration of surgery noted was 8.35 minutes. Striate Keratopathy was the most common 1 st POD complication followed by corneal oedema. Striate keratopathy was the most common complication at the 1 st week followup followed by pigment dispersion. Majority of cases (76 cases were found to have been complication free at the end of 6 weeks. At the end of 6 weeks post-operatively as per records, 80 cases

Speech-in-Noise Tests and Supra-threshold Auditory Evoked Potentials as Metrics for Noise Damage and Clinical Trial Outcome Measures.

Science.gov (United States)

Le Prell, Colleen G; Brungart, Douglas S

2016-09-01

In humans, the accepted clinical standards for detecting hearing loss are the behavioral audiogram, based on the absolute detection threshold of pure-tones, and the threshold auditory brainstem response (ABR). The audiogram and the threshold ABR are reliable and sensitive measures of hearing thresholds in human listeners. However, recent results from noise-exposed animals demonstrate that noise exposure can cause substantial neurodegeneration in the peripheral auditory system without degrading pure-tone audiometric thresholds. It has been suggested that clinical measures of auditory performance conducted with stimuli presented above the detection threshold may be more sensitive than the behavioral audiogram in detecting early-stage noise-induced hearing loss in listeners with audiometric thresholds within normal limits. Supra-threshold speech-in-noise testing and supra-threshold ABR responses are reviewed here, given that they may be useful supplements to the behavioral audiogram for assessment of possible neurodegeneration in noise-exposed listeners. Supra-threshold tests may be useful for assessing the effects of noise on the human inner ear, and the effectiveness of interventions designed to prevent noise trauma. The current state of the science does not necessarily allow us to define a single set of best practice protocols. Nonetheless, we encourage investigators to incorporate these metrics into test batteries when feasible, with an effort to standardize procedures to the greatest extent possible as new reports emerge.

Open Treatment of Blunt Injuries of Supra-Aortic Branches: Case Series.

Science.gov (United States)

Sladojevic, Milos; Markovic, Miroslav; Ilic, Nikola; Pejkic, Sinisa; Banzic, Igor; Djoric, Predrag; Koncar, Igor; Tomic, Ivan; Davidovic, Lazar

2016-02-01

Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases. We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment. When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

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

DEFF Research Database (Denmark)

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

2014-01-01

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

Cosmetic effects of skin-crease camouflage incision versus longitudinal incision following carotid endarterectomy.

Science.gov (United States)

Kazimierczak, Arkadiusz; Rybicka, Anita; Rynio, Pawel; Gutowski, Piotr; Wiernicki, Ireneusz

2018-03-01

Despite the increasing use of carotid angioplasty and stenting (CAS), carotid endarterectomy (CEA) nonetheless remains a more medically beneficial method of treatment for carotid artery stenosis. Therefore, one possibility for progress within this procedure may be to use minimally invasive carotid surgery, especially when the scar is in plain sight: the use of the natural wrinkles (skin crease) as a camouflage of the skin incision provides significant cosmetic improvements. To compare the cosmetic effects of classic and trans-wrinkle CEA. To assess the distance between the carotid artery bifurcation (CAB) and the skin-crease incision whilst attempting CEA. It was a randomized prospective study with two groups: patients undergoing classic surgery (control group; n = 100) and skin-crease trans-wrinkle camouflaged CEA (study group; n = 100). Follow-up was at 2 months and 1 year. The medical results of the treatment were similar in both groups. The cumulative count of strokes and myocardial infarctions was 0.5% within 30 days, and after one year 3.5% (and 5.5% including cases of death). The superiority of the transverse crease being hidden compared to the conventional longitudinal technique was proven in the Patient and Observer Scar Assessment Scale (POSAS) score, respectively 11.4 ±1.0 vs. 14.1 ±3.4 (p = 0.0001) after 2 months and 13.5 ±2.8 vs. 14.1 ±3.4 (p = 0.039) after a year. Trans-wrinkle incision gives better cosmetic results, can be safely performed in most cases, and offers a comfortable approach during CEA.

In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography.

Science.gov (United States)

Dupont-Monod, Sylvère; Labbé, Antoine; Fayol, Nicolas; Chassignol, Alexis; Bourges, Jean-Louis; Baudouin, Christophe

2009-03-01

To use anterior segment optical coherence tomography (AS-OCT) to analyze the in vivo architecture of clear corneal incisions after phacoemulsification using different techniques. Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France. This prospective observational study analyzed clear corneal incisions used in phacoemulsification. All wounds were evaluated 1 day and 8 days postoperatively by AS-OCT (Visante). Incision architecture and pachymetry at the wound level were analyzed. Thirty-five clear corneal incisions were analyzed. Six eyes had 2.75 mm coaxial phacoemulsification, 19 had 2.20 mm microincision coaxial phacoemulsification, and 10 had 1.30 mm bimanual microincision phacoemulsification. The 1.30 mm incision had a straight-line configuration. The 2.20 mm and 2.75 mm incisions had an arcuate configuration. The angles of incidence of 1.30 mm incisions were greater than those of 2.20 mm incisions (P<.001). All incisions had slight corneal edema limited to the incision area. The edema was slightly greater around 1.30 mm incisions (mean pachymetry 1143 microm +/- 140 [SD]) than around 2.20 mm incisions (mean 1012 +/- 101 microm) (P = .001). Bimanual procedures had satisfactory endothelial apposition in the enlarged areas, where stromal edema was less than that surrounding the unenlarged 1.30 mm incisions. The 3 phacoemulsification techniques induced gaping of the endothelial edge, minor inadequate endothelial apposition, and mild stromal edema in the area of the clear corneal incisions. Bimanual microincision sleeveless phacoemulsification may alter the wound slightly more than coaxial 2.75 mm and microcoaxial 2.20 mm sleeved-tip phacoemulsification.

Long pulse operation on Tore Supra

International Nuclear Information System (INIS)

Monier-Garbet, P.

2004-01-01

This document gathers a series of transparencies dedicated to the long pulse operation on Tore-Supra. The structure of the document is described as follows: the first part is an introduction recalling fusion basis and presenting the different physical and technological phenomenon time scales. The second part is dedicated to the production of long pulses through non-inductive drive and some experimental scenarios illustrate it. The final part is devoted to physics issues like particle retention

Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

Science.gov (United States)

Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

2011-01-01

The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.

Single-incision laparoscopic surgery for locally advanced colorectal cancer : feasibility, short-term and oncologic outcomes.

Science.gov (United States)

Famiglietti, F; Leonard, D; Bachmann, R; Remue, C; Abbes Orabi, N; van Maanen, A; van den Eynde, M; Kartheuser, A

2018-01-01

Data about single-incision laparoscopic surgery (SILS) in locally advanced colorectal cancers are scarce. This study aimed to evaluate perioperative and shortterm oncologic outcomes of SILS in pT3-T4 colorectal cancer. From 2011 to 2015 data from 249 SILS performed in our Colorectal Unit were entered into a prospective database. Data regarding patients with a pT3-T4 colorectal adenocarcinoma were compared to those with pTis-pT2. Factors influencing conversion were assessed by multivariate analysis. There were 100 consecutive patients (T3-T4 = 70, Tis-T2 = 30). Demographics were similar. Tumor size was significantly larger in the T3-T4 group [3.9cm vs 2cm; p2) postoperative complication rate was similar between groups (8.6% vs 10% ; p = 0.999), as well as conversion rate (18.6% vs 6.7% ; p = 0.220). Finally, there were no differences in terms of hospital stay and mortality rate. On multivariate analysis, age (OR = 1.06, 95%CI: 1.012-1.113 ; p = 0.015] and stage IV (OR = 5.372, 95%CI: 1.320-21.862, p = 0.019) were independently associated with conversion. SILS for locally advanced colorectal cancer did not affect the short-term outcomes in this series and oncological clearance remained satisfactory. Age and stage IV disease are independent risk factors for conversion. © Acta Gastro-Enterologica Belgica.

Radiological findings after endoscopic incision of ureterocele

International Nuclear Information System (INIS)

Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang; Cheon, Jung Eun; Seok, Eul Hye; Cha, Joo Hee; Choi, Guk Myung

2001-01-01

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

Cervical and incisal marginal discrepancy in ceramic laminate veneering materials: A SEM analysis

Directory of Open Access Journals (Sweden)

Hemalatha Ranganathan

2017-01-01

Full Text Available Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

Measuring dynamic and kinetic information in the previously inaccessible supra-τ(c) window of nanoseconds to microseconds by solution NMR spectroscopy.

Science.gov (United States)

Ban, David; Sabo, T Michael; Griesinger, Christian; Lee, Donghan

2013-09-26

Nuclear Magnetic Resonance (NMR) spectroscopy is a powerful tool that has enabled experimentalists to characterize molecular dynamics and kinetics spanning a wide range of time-scales from picoseconds to days. This review focuses on addressing the previously inaccessible supra-tc window (defined as τ(c) supra-τ(c) supra-τ(c) window. In the second section, the current state of the art for RD is analyzed, as well as the considerable progress toward pushing the sensitivity of RD further into the supra-τ(c) scale by up to a factor of two (motion up to 25 μs). From the data obtained with these techniques and methodology, the importance of the supra-τ(c) scale for protein function and molecular recognition is becoming increasingly clearer as the connection between motion on the supra-τ(c) scale and protein functionality from the experimental side is further strengthened with results from molecular dynamics simulations.

Retrocrural Lymph Node Metastasis Disclosed by 18F-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer

International Nuclear Information System (INIS)

Im, Hyung Jun; Kim, Yong il; Paeng, Jin Chul; Chung, June Key; Kang, Soon Beom; Lee, Dong Soo

2012-01-01

Retrocrual lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra diaphragmatic extension will occur in abdomino pelvic cancers. The authors investigated performance of 18F FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra diaphragmatic lymphatic metastases of ovarian cancer. Sixty seven patients with stage IV ovarian cancer who had undergone 18F FDG PET/CT were included in this retrospective study. Diagnostic performance of 18F FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated. Sensitivity and specificity of 18F FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra diaphragmatic LN metastases. 18F FDG PET/CT showed 26 RCLN metastases in patients with supra diaphragmatic LN metastases (54.5%), and only 1 in patients without supra diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P 18F FDG PET/CT to diagnose RCLN metastasis was excellent. RCLN metastasis revealed by 18F FDG PET/CT was strongly associated with supra diaphragmatic LN spread of ovarian cancer. Thus, RCLN metastasis could be used as a predictor of supra diaphragmatic lymphatic metastasis of ovarian cancer

Edge plasma control: Particle channeling in Tore Supra pump limiter and ergodic divertor

International Nuclear Information System (INIS)

Ghendrih, P.; Samain, A.; Grosman, A.; Capes, H.; Morera, J.P.

1989-01-01

Improved pumping efficiency can be achieved on Tore Supra by channeling process for particles, i.e. channeling of neutrals in the throat of pump limiters and channeling of plasma towards neutralizer plates in the ergodic divertor. The plugging length for the pump limiter throat is computed and numerical evidence of plasma flux channeling between the conductor bars of the ergodic divertor is presented. The effect of the Tore Supra ergodic divertor on edge plasma state and edge plasma transport is discussed. (orig.)

Pellet injection and confinement in the tore supra tokamak; Injection de glacons et confinement dans le tokamak tore supra

Energy Technology Data Exchange (ETDEWEB)

Maget, P

1998-09-23

Pellet injection in the centre of tokamak plasmas can lead to an improved confinement regime called PEP (Pellet Enhanced Performance). The present work is dedicated to the mechanisms involved in the PEP regimes obtained in the tokamak Tore Supra. A neoclassical approach of transport shows that it is the anomalous transport, due to plasma turbulence, that causes the enhanced confinement. A linear model describing electrostatic instabilities has been developed in order to study the roles of density profile and current profile during the PEP, in the limit of large growth rates. The effect ofradial shear in flows is taken into account by removing the ExB shear flow rate from the linear growth rate, as suggested by non-linear numerical simulations of turbulence. A local transport coefficient is estimated from the knowledge of the linear growth rate and the mode width. We find that the peaked density profile in PEP regime lowers the diffusion coefficient, and that the velocity shear amplifies this effect. The evolution of the current profile is also stabilizing, but this parameter is not known with sufficient accuracy, so that its role in Tore Supra PEP experiments remains uncertain. (author)

Can diffusion tensor imaging predict the functional outcome of supra-tentorial stroke?

International Nuclear Information System (INIS)

Maeda, Takahiro; Ishizaki, Ken-ichi; Yura, Shigeki

2005-01-01

We used diffusion tensor imaging (DTI) to assess wallerian degeneration of the pyramidal tract after the onset of supra-tentorial stroke, and correlation of the extent of Wallerian degeneration with the motor function at 3 months after stroke. Twenty eight patients with supra-tentorial acute stroke were examined, two weeks and one month after stroke by DTI. We measured fractional anisotropy (FA) of affected side/unaffected side (FA ratio) in the cerebral peduncle. We used modified Rankin Scale (mRS) for assessment of motor function at 3 months after stroke. FA ratio was significantly reduced at 2 weeks after stroke (0.833±0.146) compared to on admission (0.979±0.0797). But no significant change of FA ratio was seen between two weeks and one month after stroke in 7 cases examined (0.758±0.183 vs. 0.754±0.183). In all patients in whom the FA ratio was under 0.8 at 2 weeks after stroke, motor function showed poor recovery (mRS 4 and 5) at 3 months after stroke. When FA ratio was over 0.8 at 2 weeks after stroke, motor function at 3 months after stroke showed good recovery (mRS 0 to 3) expect for three elderly patients. With the use of DTI, Wallerian degeneration could be detected in the corticospinal tracts at midbrain level during the early phase of supra-tentorial stroke. We conclude that DTI may be useful for early prediction of motor function prognosis in patients with supra-tentorial acute stroke. (author)

Solvent-shared pairs of densely charged ions induce intense but short-range supra-additive slowdown of water rotation.

Science.gov (United States)

Vila Verde, Ana; Santer, Mark; Lipowsky, Reinhard

2016-01-21

The question "Can ions exert supra-additive effects on water dynamics?" has had several opposing answers from both simulation and experiment. We address this ongoing controversy by investigating water reorientation in aqueous solutions of two salts with large (magnesium sulfate) and small (cesium chloride) effects on water dynamics using molecular dynamics simulations and classical, polarizable models. The salt models are reparameterized to reproduce properties of both dilute and concentrated solutions. We demonstrate that water rotation in concentrated MgSO4 solutions is unexpectedly slow, in agreement with experiment, and that the slowdown is supra-additive: the observed slowdown is larger than that predicted by assuming that the resultant of the extra forces induced by the ions on the rotating water molecules tilts the free energy landscape associated with water rotation. Supra-additive slow down is very intense but short-range, and is strongly ion-specific: in contrast to the long-range picture initially proposed based on experiment, we find that intense supra-additivity is limited to water molecules directly bridging two ions in solvent-shared ion pair configuration; in contrast to a non-ion-specific origin to supra-additive effects proposed from simulations, we find that the magnitude of supra-additive slowdown strongly depends on the identity of the cations and anions. Supra-additive slowdown of water dynamics requires long-lived solvent-shared ion pairs; long-lived ion pairs should be typical for salts of multivalent ions. We discuss the origin of the apparent disagreement between the various studies on this topic and show that the short-range cooperative slowdown scenario proposed here resolves the existing controversy.

A Possible Link between Supra-Second Open-Ended Timing Sensitivity and Obsessive-Compulsive Tendencies.

Science.gov (United States)

Gilaie-Dotan, Sharon; Ashkenazi, Hamutal; Dar, Reuven

2016-01-01

One of the main characteristics of obsessive-compulsive disorder (OCD) is the persistent feeling of uncertainty, affecting many domains of actions and feelings. It was recently hypothesized that OCD uncertainty is related to attenuated access to internal states. As supra-second timing is associated with bodily and interoceptive awareness, we examined whether supra-second timing would be associated with OC tendencies. We measured supra-second (~9 s) and sub-second (~450 ms) timing along with control non-temporal perceptual tasks in a group of 60 university students. Supra-second timing was measured either with fixed criterion tasks requiring to temporally discriminate between two predefined fixed interval durations (9 vs. 9.9 s), or with an open-ended task requiring to discriminate between 9 s and longer intervals which were of varying durations that were not a priori known to the participants. The open-ended task employed an adaptive Bayesian procedure that efficiently estimated the duration difference required to discriminate 9 s from longer intervals. We also assessed symptoms of OCD, depression, and anxiety. Open-ended supra-second temporal sensitivity was correlated with OC tendencies, as predicted (even after controlling for depression and anxiety), whereas the other tasks were not. Higher OC tendencies were associated with lower timing sensitivity to 9 s intervals such that participants with higher OC tendency scores required longer interval differences to discriminate 9 s from longer intervals. While these results need to be substantiated in future research, they suggest that open-ended timing tasks, as those encountered in real-life (e.g., estimating how long it would take to complete a task), might be adversely affected in OCD.

SupraTrans II. Test drive facility for a superconductor-based maglev train; SupraTrans II. Fahrversuchsanlage fuer eine Magnetbahn mit Supraleitern

Energy Technology Data Exchange (ETDEWEB)

Kuehn, Lars; Haas, Oliver de [evico GmbH, Dresden (Germany); Berger, Dietmar; Schultz, Ludwig [IFW Dresden (Germany); Olsen, Henning; Roehlig, Steffen [ELBAS Elektrische Bahnsysteme Ingenieur-Gesellschaft mbH, DNV company, Dresden (Germany)

2012-08-15

The SupraTrans system was further developed and a test drive facility built up in Dresden. The latter permits complex drive tests to be made as well as the testing of components. Compared to the demonstrator, the facility is characterized by a higher loadability, higher speeds and a completely contactless energy transmission. (orig.)

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

International Nuclear Information System (INIS)

Roh, Yang Gyun; Jang, Hyun Seon; Kim, Byung Ock; Kim, Jin Soo

2006-01-01

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

Watershed-scale modeling of streamflow change in incised montane meadows

Science.gov (United States)

Essaid, Hedeff I.; Hill, Barry R.

2014-01-01

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

Sub-Coronal Inflatable Penile Prosthesis Placement With Modified No-Touch Technique: A Step-by-Step Approach With Outcomes.

Science.gov (United States)

Weinberg, Aaron C; Pagano, Matthew J; Deibert, Christopher M; Valenzuela, Robert J

2016-02-01

The surgical treatment of disorders of male sexual function requires specific exposure to correct the underlying problem safely and efficiently. Currently, sub-coronal exposure is used for treatment of phimosis, Peyronie's disease plaque (PDP), and semirigid penile prosthesis insertion. Infra-pubic and scrotal incisions are used for inflatable penile prosthesis (IPP) placement. However, men who present with several disorders might require multiple procedures and surgical incisions. To report a prospective review of our surgical experience and outcomes with a single sub-coronal incision for IPP placement with a modified no-touch technique. This approach allows for access to the entire corporal body for multiple reconstructive procedures. Two hundred men had IPPs placed through a sub-coronal incision using our modified no-touch technique. The penis was degloved to the level of the penoscrotal junction and the dartos muscle was everted and secured to the drapes. This allowed exclusion of the scrotal and penile skin from the operative field. After artificial erection, the patient's corpora were inspected for PDP and other abnormalities. Penoscrotal IPP models were placed in all cases with insertion proximal to the penoscrotal junction. After placement of the IPP, the abnormalities were repaired. Feasibility of the procedure, operative times, complication rate, utilization of accessory, reconstructive procedures, and post-operative penile length. Of the 200 men who had IPP placement, 92 had PDP that was treated, 106 (53%) consented to circumcision, 24 (12%) had their reservoir placed ectopically, and 31 (16%) had a prosthesis exchanged through the sub-coronal technique. Mean operative time was 73 minutes (39-161 minutes). Specialists in the surgical treatment of disorders of male sexual function can perform multiple procedures safely and easily through a modified no-touch single sub-coronal incision. This approach allows access to the entire corporal body, providing

"Supra-Institutional Research": A Cost-Effective Contribution towards Enhancement

Science.gov (United States)

Yorke, Mantz

2010-01-01

Relatively inexpensive studies that go beyond the boundaries of individual institutions have considerable attraction, particularly at a time when resources are under significant constraint. These studies can be viewed as existing under the rather larger umbrella of "supra-institutional research". Three examples illustrate the argument…

Temporal versus Superior Limbal Incision: Any difference in visual ...

African Journals Online (AJOL)

Aim: To compare the visual outcome of a superiorly placed limbal incision with a temporal limbal incision in extracapsular cataract surgery. The main outcome measures are visual acuity and the degree of stigmatism based on refraction. Method: A retrospective non randomized comparative study. Medical records of 40 ...

A distal femoral supra-condylar plate: biomechanical comparison with condylar plate and first clinical application for treatment of supracondylar fracture.

Science.gov (United States)

Liang, Bowei; Ding, Zhenqi; Shen, Junguo; Zhai, Wenliang; Kang, Liangqi; Zhou, Liang; Sha, Mo; Liang, Dongzhu

2012-08-01

An anatomical supra-condylar plate is designed and analysed by biomechanical testing. The biomechanical properties of the supra-condylar and condylar plate were compared in six matched pairs of cadaveric femurs. A transverse osteotomy gap was created to simulate an OTA/AO type A3 supracondylar fracture. The left and right specimens were fitted with supra-condylar and condylar plate, respectively. Nondestructive axial compression, three-point bending and torsion tests were performed, and the peak load of the bone-implant construction was measured. The fracture site suitable for supra-condylar plate application and its correlation with femoral length were calculated. The gender influence on it was also discussed. The difference of stiffness between the supra-condylar and condyle groups were not significant (P > 0.05) at 363.4 and 362.5 N/mm for compression, 229.5 and 237.6 N/mm in the sagittal plane and 195.5 and 188.4 N/mm in the coronal plane for three-point bending, and 7.5 and 7.9 Nm/deg for axial torsion, respectively. The peak load was 4438 ± 136.15 N and 5215 ± 174.33 N, respectively, for the two groups. The average extent of the fracture site suitable for the application of the supra-condylar plate was 70.86 ± 4.61 mm. The femoral length and gender showed no influence on it. Despite the limited bone contact area provided by the supra-condylar plate, its construct stiffness is comparable to the condylar plate. The supra-condylar plate can be used to treat carefully-selected extra-articular supracondylar fractures.

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

LENUS (Irish Health Repository)

Ahmad, Nasir Zaheer

2012-02-01

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

TORE SUPRA vacuum vessel and shield manufacturing

International Nuclear Information System (INIS)

Blateyron, J.; Lepez, R.

1984-01-01

TORE SUPRA vacuum vessel and vacuum chamber shield manufacturing in progress at Jeumont-Schneider consists of three main phases: - Detail engineering and manufacturing fixture construction; - Prototype section manufacturing and process preparation; - Construction of the 6 production modules. The welding techniques adopted, call for three special automatic processes: TIG, MIG and PLASMA welding which guarantee mechanical strength, vacuum tightness and absence of distortion. Production of the modules began July 1984. (author)

Electron cyclotron emission measurement in Tore Supra

International Nuclear Information System (INIS)

Javon, C.

1991-06-01

Electron cyclotron radiation from Tore-Supra is measured with Michelson and Fabry-Perot interferometers. Calibration methods, essential for this diagnostic, are developed allowing the determination of electron temperature in the plasma. In particular the feasibility of Fabry-Perot interferometer calibration by an original method is demonstrated. A simulation code is developed for modelling non-thermal electron population in these discharges using measurements in non-inductive current generation regime [fr

Test model of the fast thyristor circuit breaker, for TORE SUPRA

International Nuclear Information System (INIS)

Bareyt, B.; Leloup, C.; Rijnoudt, E.

1984-01-01

The tokamak TORE SUPRA, permits, owing to the toroidal superconducting coils and to the poloidal field system performances, long discharges (30 s and more), for a plasma current of typically 2 MA. The poloidal field system uses the magnetic energy initially stored, for the ignition and the fast rise of the plasma current, by forcing the primary current to flow through a resistor after breaking the main rectifier current by a fast thyristor circuit breaker. In order to test the technical capabilities of such a breaker system made of fast thyristors, in series and in parallel, after a single thyristor test model T1 the series arrangement was studied on a 24 thyristor test model T2 and the parallel arrangement problems, led the manufacturer CGEE Alsthom, to build a new test model T3. (author)

Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

Science.gov (United States)

Chana-Rodríguez, Francisco; Cuervas-Mons, Manuel; Rojo-Manaute, José; Mora, Félix; Arnal, Juan; Vaquero-Martín, Javier

2017-11-01

Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. Cross-sectional study with cadaveric specimens. Ultrasound-guided pin placement assessed by fluoroscopy and dissection. Fourteen ultrasound-guided supra-acetabular pins were placed in seven cadaveric specimens. Excellent placement in all cases, evaluated with radiological control. Good qualitative bone fixation after dissection. One femoral cutaneous nerve was not found during anatomic dissection and was assumed injured. Ultrasound-guided supra-acetabular pin placement is a feasible and effective technique. Our study indicates that pin placement without intraoperative fluoroscopy is feasible without compromising the reliability of its placement. © 2017 Elsevier Ltd. All rights reserved.

Cherenkov-type diamond detectors for measurements of fast electrons in the TORE-SUPRA tokamak

International Nuclear Information System (INIS)

Jakubowski, L.; Sadowski, M. J.; Zebrowski, J.; Rabinski, M.; Malinowski, K.; Mirowski, R.; Lotte, Ph.; Gunn, J.; Pascal, J-Y.; Colledani, G.; Basiuk, V.; Goniche, M.; Lipa, M.

2010-01-01

The paper presents a schematic design and tests of a system applicable for measurements of fast electron pulses emitted from high-temperature plasma generated inside magnetic confinement fusion machines, and particularly in the TORE-SUPRA facility. The diagnostic system based on the registration of the Cherenkov radiation induced by fast electrons within selected solid radiators is considered, and electron low-energy thresholds for different radiators are given. There are some estimates of high thermal loads, which might be deposited by intense electron beams upon parts of the diagnostic equipment within the TORE-SUPRA device. There are some proposed measures to overcome this difficulty by the selection of appropriate absorption filters and Cherenkov radiators, and particularly by the application of a fast-moving reciprocating probe. The paper describes the measuring system, its tests, as well as some results of the preliminary measurements of fast electrons within TORE-SUPRA facility.

Cherenkov-type diamond detectors for measurements of fast electrons in the TORE-SUPRA tokamak

Energy Technology Data Exchange (ETDEWEB)

Jakubowski, L.; Sadowski, M. J.; Zebrowski, J.; Rabinski, M.; Malinowski, K.; Mirowski, R. [Andrzej Soltan Institute for Nuclear Studies (IPJ), Otwock-Swierk 05-400 (Poland); Lotte, Ph.; Gunn, J.; Pascal, J-Y.; Colledani, G.; Basiuk, V.; Goniche, M.; Lipa, M. [CEA, IRFM, St Paul-lez-Durance F-13108 (France)

2010-01-15

The paper presents a schematic design and tests of a system applicable for measurements of fast electron pulses emitted from high-temperature plasma generated inside magnetic confinement fusion machines, and particularly in the TORE-SUPRA facility. The diagnostic system based on the registration of the Cherenkov radiation induced by fast electrons within selected solid radiators is considered, and electron low-energy thresholds for different radiators are given. There are some estimates of high thermal loads, which might be deposited by intense electron beams upon parts of the diagnostic equipment within the TORE-SUPRA device. There are some proposed measures to overcome this difficulty by the selection of appropriate absorption filters and Cherenkov radiators, and particularly by the application of a fast-moving reciprocating probe. The paper describes the measuring system, its tests, as well as some results of the preliminary measurements of fast electrons within TORE-SUPRA facility.

Circularly Polarized Luminescence from a Pyrene-Cyclodextrin Supra-Dendron.

Science.gov (United States)

Zhang, Yuening; Yang, Dong; Han, Jianlei; Zhou, Jin; Jin, Qingxian; Liu, Minghua; Duan, Pengfei

2018-05-22

Soft nanomaterials with circularly polarized luminescence (CPL) have been currently attracting great interest. Here, we report a pyrene-containing π-peptide dendron hydrogel, which shows 1D and 2D nanostructures with varied CPL activities. It was found that the individual dendrons formed hydrogels in a wide pH range (3-12) and self-assembled into helices with pH-tuned pitches. Through chirality transfer, the pyrene unit could show CPL originated from both the monomer and excimer bands. When cyclodextrin was introduced, different supra-dendrons were obtained with β-cyclodextrin (PGAc@β-CD) and γ-cyclodextrin (PGAc@γ-CD) through host-guest interactions, respectively. Interestingly, the PGAc@β-CD and PGAc@γ-CD supra-dendrons self-assembled into 2D nanosheet and entangled nanofibers, respectively, showing cyclodextrin induced circularly polarized emission from both the monomer and excimer bands of the pyrene moiety. Thus, through a simple host-guest interaction, both the nanostructures and the chiroptical activities could be modulated.

U.S. EPA, Pesticide Product Label, BIO-GUARD OBQ-SUPRA 100 ORANGE BOUQUET, 09/03/1975

Science.gov (United States)

2011-04-14

... I I j i ' i) :1 I '~F t r: I t \\ N rlll'( \\' I}f' ll," cI t h I () II q I d II t () 111,j I Ie f I () ( ) I ,I,,:d,lflil "qIJlp'l\\i':'~ • OBa-SUPRA 100 ~~~ ... DBQ-SUPRA 100 tJ~~ -. / I ...

Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

Directory of Open Access Journals (Sweden)

Manoel Antonio de Paiva-Neto

2010-06-01

Full Text Available The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%. All tumors were histologically benign. Two patients (8% experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%. One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months, with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%. Todos os tumores eram histologicamente benignos. Dois pacientes (8% apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%. Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (m

Supra choroidal buckling in managing myopic vitreoretinal interface disorders: 1-year data.

Science.gov (United States)

El Rayes, Ehab N

2014-01-01

To evaluate the efficacy of supra choroidal buckling procedure using a supra choroidal catheter, as a new approach in treating myopic vitreomacular interface disorders specially in difficult cases of myopic traction maculopathy with or without macular hole retinal detachment in posterior staphyloma depending on the concept of indenting the choroid only, from a 1-year data study. A newly developed supra choroidal catheter was used to deliver stabilized, cross-linked, long-acting hyaluronic acid as a filler in the supra choroidal space in the area of the staphyloma forming a choroidal indenting effect. Before the injection, pars plana vitrectomy was performed without internal limiting membrane peeling to avoid the risk of break of the roof of foveal detachment in case of foveoschisis. This indentation was used to treat 11 patients with myopic foveoschisis and 12 patients with myopic macular hole retinal detachment, 5 of whom had failed primary repair by vitrectomy before inclusion in this trial. Clinical and optical coherence tomographic evaluations of these patients were performed over 1-year follow-up. Retinal layer restoration was achieved in all 11 eyes with myopic foveoschisis. This was gradual over a period of 2 to 6 weeks postoperatively. No recurrence over the 12-month follow-up was observed. Visual acuity improved by 1 line or more in 9 eyes (81.8%). Of the 12 eyes, 10 with macular hole detachment (83%) showed closure of the holes in association with the resolution of the detachment; 2 eyes showed resolution of the detachment and flatting of the edge of the holes but with incomplete closure on optical coherence tomography. Eight eyes (66.6%) showed improvement in visual acuity by 1 or more lines with no recurrence of retinal detachment over the 12-month follow-up period. The indentation effect was sufficient over the 12-month follow-up period. The indentation effect achieved by supra choroidal approach can be used as a method of managing myopic foveoschisis

Particles pumping in Tore Supra

International Nuclear Information System (INIS)

Bonnel, P.; Chappuis, P.; Lipa, M.

1989-01-01

TORE SUPRA and its peripheral equipments are provided with routine clean high vacuum by turbomolecular pumping. During plasma discharges large quantity of very hot gases activating at plasma edge and plasma density in scrape off layer has to be controlled before they strike violently solid wall provoking increase in impurities content and make density up to disruptive level. A Magnetic Ergodic Divertor made of six winding structures - MED - six Vertical Pumped Limiters - VPL - and one Horizontal Pumped Limiter - HPL - are set in the vacuum chamber in order to cope with plasma-wall interactions and neutral gas recycling. Each apparatus is equipped at front side with thermal shield respectively made of polycristallin and pyrolitic graphite bolted on stainless steel support for MED and HPL whereas for VPL it is made of CFC Aerolor 05 brazed on hardened copper. The total heat removal capacity of these plasma facing components is 12 MW. Design of particles collection openings and ducts conductance allow 10% of capture efficiency, that means for TORE SUPRA a flux of 3 x 10 21 particles/second has to be sorbed by water cooled titanium getter pumps, settled at rear side. All those facilities were put into plasma operation at the beginning of 1989 for a short time. Preliminary observations go along with theoretical predictions, that actions in scrappe-off layer may provoke effects in bulk plasma. Very first results drawn out, show that particle collection and heat removal were effective by MED, VPL and HPL and that plasma behaviour was not disturbed by their presence and actions but instead tendency to improvement was observed

Observations of supra-arcade fans: instabilities at the head of reconnection jets

International Nuclear Information System (INIS)

Innes, D. E.; Guo, L.-J.; Schmit, D.; Bhattacharjee, A.; Huang, Y.-M.

2014-01-01

Supra-arcade fans are bright, irregular regions of emission that develop during eruptive flares above flare arcades. The underlying flare arcades are thought to be a consequence of magnetic reconnection along a current sheet in the corona. At the same time, theory predicts plasma jets from the reconnection sites which are extremely difficult to observe directly because of their low densities. It has been suggested that the dark supra-arcade downflows (SADs) seen falling through supra-arcade fans may be low-density jet plasma. The head of a low-density jet directed toward higher-density plasma would be Rayleigh-Taylor unstable, and lead to the development of rapidly growing low- and high-density fingers along the interface. Using Solar Dynamics Observatory/Atmospheric Imaging Assembly 131 Å images, we show details of SADs seen from three different orientations with respect to the flare arcade and current sheet, and highlight features that have been previously unexplained, such as the splitting of SADs at their heads, but are a natural consequence of instabilities above the arcade. Comparison with three-dimensional magnetohydrodynamic simulations suggests that SADs are the result of secondary instabilities of the Rayleigh-Taylor type in the exhaust of reconnection jets.

Observations of Supra-arcade Fans: Instabilities at the Head of Reconnection Jets

Science.gov (United States)

Innes, D. E.; Guo, L.-J.; Bhattacharjee, A.; Huang, Y.-M.; Schmit, D.

2014-11-01

Supra-arcade fans are bright, irregular regions of emission that develop during eruptive flares above flare arcades. The underlying flare arcades are thought to be a consequence of magnetic reconnection along a current sheet in the corona. At the same time, theory predicts plasma jets from the reconnection sites which are extremely difficult to observe directly because of their low densities. It has been suggested that the dark supra-arcade downflows (SADs) seen falling through supra-arcade fans may be low-density jet plasma. The head of a low-density jet directed toward higher-density plasma would be Rayleigh-Taylor unstable, and lead to the development of rapidly growing low- and high-density fingers along the interface. Using Solar Dynamics Observatory/Atmospheric Imaging Assembly 131 Å images, we show details of SADs seen from three different orientations with respect to the flare arcade and current sheet, and highlight features that have been previously unexplained, such as the splitting of SADs at their heads, but are a natural consequence of instabilities above the arcade. Comparison with three-dimensional magnetohydrodynamic simulations suggests that SADs are the result of secondary instabilities of the Rayleigh-Taylor type in the exhaust of reconnection jets.

Numerical modelling of pump limiter biasing on TEXTOR-94 and Tore Supra

International Nuclear Information System (INIS)

Gerhauser, H.; Claassen, H.A.; Mank, G.; Zagorski, R.; Loarer, T.; Gunn, J.; Boucher, C.

2002-01-01

The two-dimensional multifluid code TECXY has been used to model the biasing (with respect to the first wall) of the toroidal belt limiter ALT-II on the tokamak TEXTOR-94 and of the new toroidal pump limiter being installed on Tore Supra tokamak in the framework of the CIEL project. It is well known that the edge flow pattern can be influenced by the poloidal electric drifts from imposing radial electric fields. The modelling with TECXY introduces imprinted bias currents in the scrape-off layer (SOL) for the case of negative (limiter) biasing, and imprinted bias potentials for the case of positive biasing. This allowed us to simulate sufficiently well the experimental I-V characteristics for either biasing of ALT-II and also reproduced the essential features and trends of the observed plasma profiles in the SOL of TEXTOR-94. For negative biasing a moderate improvement of the pumping exhaust efficiency can be achieved in the case of TEXTOR. For Tore Supra, however, only a negligible improvement of the limiter performance with biasing can be predicted, which is explained by the relatively weak drift flows in Tore Supra. (author)

Tore-Supra infrared thermography system, a real steady-state diagnostic

International Nuclear Information System (INIS)

Guilhem, D.; Bondil, J.L.; Bertrand, B.; Desgranges, C.; Lipa, M.; Messina, P.; Missirlian, M.; Portafaix, C.; Reichle, R.; Roche, H.; Saille, A.

2005-01-01

Tore-Supra Tokamak (I p = 1.5 MA, B t = 4 T) has been constructed with a steady-state magnetic field using super-conducting magnets and water-cooled plasma facing components (PFCs) for high-performance long pulse plasma discharges. When not actively cooled, plasma facing components can only accumulate a limited amount of energy since the temperature increases continuously during the discharge until radiation cooling equals the incoming heat flux. Such an environment is found in the JET Tokamak [JET Team, IAEA-CN-60/A1-3, Seville, 1994] and on TRIAM [M. Sakamoto, H. Nakashima, S. Kawasaki, A. Iyomasa, S.V. Kulkarni, M. Hasegawa, E. Jotaki, H. Zushi, K. Nakamura, K. Hanada, S. Itoh, Static and dynamic properties of wall recycling in TRIAM-1M, J. Nucl. Mater. 313-316 (2003) 519-523] [Y. Kamada, et al., Nucl. Fusion 3 (1999) 1845]. In Tore-Supra, the surface temperature of the actively cooled plasma facing components reach steady state within a second. We present here the Tore-Supra thermographic system, made of seven endoscope bodies equipped so far with eight infrared (IR) cameras. It has to be noted that this diagnostic is the first diagnostic to be actively cooled, as required for steady state. The main purpose of such a diagnostic is to prevent the plasma to damage the actively cooled plasma facing components (ACPFCs), which consist of the toroidal pumped limiter (TPL), 7 m 2 , and of five radio-frequency antennae, 1.5 m 2 each

Hybrid aortic repair with antegrade supra-aortic and renovisceral debranching from ascending aorta.

Science.gov (United States)

Del Castro-Madrazo, José Antonio; Rivas-Domínguez, Margarita; Fernández-Prendes, Carlota; Zanabili Al-Sibbai, Amer; Llaneza-Coto, José Manuel; Alonso-Pérez, Manuel

2017-05-01

Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR. At three-year follow up, the patient is free of intervention-related complications.

MHD activity triggered by monster sawtooth crashes on Tore Supra

International Nuclear Information System (INIS)

Maget, P; Artaud, J-F; Eriksson, L-G; Huysmans, G; Lazaros, A; Moreau, P; Ottaviani, M; Segui, J-L; Zwingmann, W

2005-01-01

The crash of monster sawteeth in Tore Supra ion cyclotron resonance heated plasmas is observed to trigger long-lived magneto hydrodynamic (MHD) activity, dominated by a (m = 3, n = 2) magnetic perturbation at the edge. This phenomenon is reminiscent of the triggering of neoclassical tearing modes, although in Tore Supra the MHD activity decays and eventually vanishes. It can be explained by the linear destabilization of the (3, 2) mode as the current sheet developed in the non-linear stage of the internal kink relaxation gets closer to q = 3/2. However, the lifetime of the (3, 2) island is longer than the period of linear instability. We find that the neoclassical drive is essential for explaining the observed lifetime and width of the island, although the overall dynamics is controlled by the relaxation of the current profile on a resistive time scale

The Tore Supra HeII cryogenic system

International Nuclear Information System (INIS)

Claudet, G.

1991-01-01

The tokamak TORE SUPRA built by the association EURATOM-CEA is routinely operated with a toroidal magnet made of Niobium Titanium cooled at 1.8 K by pressurized HeII. The paper will remind the reasons for such a choice and will describe the corresponding technical solutions. After several years of operation, the validity of the HeII cooling solution will be discussed on the basis of the actual and long term behaviour

First results of the Tore Supra ITER like ICRF antenna prototype

International Nuclear Information System (INIS)

Vulliez, K.; Bosia, G.; Bremond, S.; Agarici, G.; Beaumont, B.; Lombard, G.; Millon, L.; Mollard, P.; Volpe, D.

2005-01-01

The project of an ITER-like (IL) ion cyclotron (IC) prototype antenna was initiated in mid 2002 in Cadarache, to assess the operational characteristics of the IL scheme in a Tore Supra (TS)-sized array. The prototype was developed by modifying an existing Tore Supra resonant double loop (RDL) antenna. This strategy, chosen to reduce cost and manufacturing time, allowed the completion of the array construction at the end of 2003. The array was installed on TS in January 2004, at the beginning of the new experimental campaign. After a few comments on the design, the paper reports results on low-power characterisation, high-power commissioning and preliminary tests on TS plasmas, prior to the array dis-assembly for inspection

Laser incising of wood: Impregnation of columns with water-soluble dye

International Nuclear Information System (INIS)

Hattori, N.; Ando, K.; Kitayama, S.; Nakamura, Y.

1994-01-01

To know whether or not laser incising is a useful pre-treatment technique in impregnating a chemical fluid into lumber, pin holes were made in columns of hinoki (Chamaecyparis obtusa Endl.), sugi (Cryptomeria japonica D. Don), karamatsu (Larix leptolepis Gordon) and douglas-fir (Pseudo-tsuga menziesii Franco) with 1.7 kW CO2 laser, and a water-soluble dye was impregnated into these columns with a local pressure impregnation device. Retentions, and lengths and widths of penetrations from each hole were measured quantitatively. Referring to the results of the preparatory experiment mentioned above, incising patterns for sugi and douglas-fir were designed, and the same water-soluble dye was impregnated into the laser-incised columns as well as into non-incised ones with the vacuum-pressure method to obtain penetrated layers with the target depths completely. As a result, a retention of 200 kg/m3 of dye could be achieved for a column of douglas-fir even if it is a species difficult to impregnate. The penetrated layer also could be formed completely at the depth of the laser incision. Therefore, it is concluded that laser incising can be used for the pre-treatment before impregnation of wood columns. (author)

Diathermy vs. scalpel skin incisions in general surgery: double-blind, randomized, clinical trial.

Science.gov (United States)

Shamim, Muhammad

2009-08-01

This prospective, double-blind, randomized, controlled trial was designed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery. A total of 369 patients who underwent diathermy incision (group A: 185 patients) or scalpel incision (group B: 184 patients) were analyzed. Variables analyzed were: surgical wound classification, length and depth of incision, incision time, duration of operation, incisional blood loss, postoperative pain, duration of hospital stay, duration of healing, and postoperative complications. The inclusion criteria were all patients who underwent elective or emergency general surgery. The exclusion criteria were only cases with incomplete patients' data and patients who were lost to follow-up. This study was conducted at Fatima Hospital-Baqai Medical University and Shamsi Hospital (Karachi), from January 2006 to December 2007. Incision time was significantly longer for patients in group B (p = 0.001). Incisional blood loss also was more for patients in group B (p = 0.000). Pain perception was found to be markedly reduced during the first 48 h in group A (p = 0.000). Total period of hospital stay (p = 0.129) and time for complete wound healing (p = 0.683) were almost the same for both groups. Postoperative complication rate by wound classification did not differ markedly between the two groups (p = 0.002 vs. p = 0.000). Diathermy incision has significant advantages compared with the scalpel because of reduced incision time, less blood loss, & reduced early postoperative pain.

Perineal Ectopic Testis in an Adult

African Journals Online (AJOL)

in an ectopic site outside the scrotum; such as the perineum, pubic region, dorsum of the penis, femoral region, anterior abdominal wall and the contralateral scrotum. Management is orchidopexy through an inguinal crease incision as the length of the spermatic cord is normal. We report a 26 year old man with a left perineal ...

Two Late Pleistocene climate-driven incision/aggradation rhythms in the middle Dnieper River basin, west-central Russian Plain

Science.gov (United States)

Panin, Andrei; Adamiec, Grzegorz; Buylaert, Jan-Pieter; Matlakhova, Ekaterina; Moska, Piotr; Novenko, Elena

2017-06-01

In valleys of the River Seim and its tributaries in the middle Dnieper basin (west-central Russian Plain), two low terraces (T1, 10-16 m, and T0, 5-7 m above the river) and a floodplain (2-4 m) with characteristic large and small palaeochannels exist. A range of field and laboratory techniques was applied and ∼30 new numerical ages (OSL and 14C dates) were obtained to establish a chronology of incision and aggradation events that resulted in the current valley morphology. Two full incision/aggradation rhythms and one additional aggradation phase from the previous rhythm were recognized in the Late Pleistocene - Holocene climate cycle. The following events were detected. (1) Late MIS 5 - early MIS 4: aggradation of Terrace T1 following the deep incision at the end of MIS 6. (2) Late MIS 4 (40-30 ka): incision into Terrace T1 below the present-day river, formation of the main scarp in the bottom of the valley between Terrace T1 and Terrace T0/Floodplain levels. (3) MIS 2: aggradation of Terrace T0, lateral migrations of a shallow braided channel located few meters above the present-day river since ∼25 ka through the LGM. (4) 18-13 ka: incision into Terrace T0 below the modern river. Multiple-thread channels concentrated in a single flow that at some places formed large meanders. In the period 15-13 ka, high floods that rose above the present-day floods left large levees and overbank loams on Terrace T0. (5) Younger Dryas - Holocene transition: aggradation up to the modern channel level, transformation of large Late Glacial to small Holocene meanders. The established incision/aggradation rhythms are believed to be manifested over the Central Russian Plain outside the influence of ice sheets in the north and base level changes in the south. The two-phase deepening of the valley occurred in the last quarter of the last glacial epoch but can not be attributed directly to the glacial-interglacial transition. Both the detected incision events correspond to relatively

Channel incision and suspended sediment delivery at Caspar Creek, Mendocino County, California

Science.gov (United States)

Nicholas J. Dewey; Thomas E. Lisle; Leslie M. Reid

2003-01-01

Tributary and headwater valleys in the Caspar Creek watershed,in coastal Mendocino County, California,show signs of incision along much of their lengths.An episode of incision followed initial-entry logging which took place between 1860 and 1906. Another episode of incision cut into skid-trails created for second-entry logging in the 1970's.

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

Science.gov (United States)

Vellei, Samatha; Borri, Alessandro

2017-08-01

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

A study of incisive canal using a cone beam computed tomography

International Nuclear Information System (INIS)

Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae

2004-01-01

To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm ± 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm ± 0.76 and 3.89 mm ± 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 ± 6.96 and 117.45 ± 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

A study of incisive canal using a cone beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

2004-03-15

To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm {+-} 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm {+-} 0.76 and 3.89 mm {+-} 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 {+-} 6.96 and 117.45 {+-} 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

Detecting atheromatous plaques in the aortic arch or supra-aortic arteries for more accurate stroke subtype classification.

Science.gov (United States)

Cui, Xiaoyang; Wu, Simiao; Zeng, Quantao; Xiao, Jiahe; Liu, Ming

2015-02-01

To investigate the correlations of atheromatous plaques in the aortic arch or supra-aortic arteries with intracranial arterial stenosis and carotid plaques in stroke patients, and to determine whether taking these plaques into account will reduce the proportion of patients in the undetermined etiology group. We prospectively enrolled 308 ischemic stroke patients, whose clinical characteristics and A-S-C-O classifications were compared with analyses of intracranial arteries, carotid arteries, aortic arch, and supra-aortic arteries. 125(40.6%) patients had plaques in the aortic arch or supra-aortic arteries, of which 106 (84.8%) had complex plaques. No correlations were observed between these plaques and carotid plaques ( p = 0.283) or intracranial arterial stenosis ( p = 0.097). After detecting the mobile thrombi in the aortic arch and supra-aortic arteries, the proportion of patients in the atherothrombosis group was increased from 33.8% to 55.5% ( p = 0.00), whereas the proportion of patients in stroke of undetermined etiology group was decreased from 19.2% to 11.0% ( p = 0.00). Examining only the carotid and intracranial arteries may not provide adequate information about large arteries in stroke patients. Therefore, it would be better to include a search for relevant plaques in the aortic arch or supra-aortic arteries in modern stroke workup, for it may lead to more accurate stroke subtype classification and guide secondary prevention.

Sialylglycan-Assembled Supra-Dots for Ratiometric Probing and Blocking of Human-Infecting Influenza Viruses.

Science.gov (United States)

Wang, Chang-Zheng; Han, Hai-Hao; Tang, Xin-Ying; Zhou, Dong-Ming; Wu, Changfeng; Chen, Guo-Rong; He, Xiao-Peng; Tian, He

2017-08-02

The seasonal outbreak of influenza causes significant morbidity and mortality worldwide because a number of influenza virus (IV) strains have been shown to infect and circulate in humans. Development of effective means to timely monitor as well as block IVs is still a challenging task. Whereas conventional fluorescence probes rely on a fluorimetric change upon recognizing IVs, here we developed simple "Supra-dots" that are formed through the aqueous supramolecular assembly between a blue-emitting polymer dot and red-emitting sialylglycan probes for the ratiometric detection of IVs. Tuning the Förster resonance energy transfer from polymer dots to glycan probes by selective sialylglycan-virus recognition enables the fluorescence ratiometric determination of IVs, whereas the presence of unselective, control viruses quenched the fluorescence of the Supra-dots. Meanwhile, we show that the Supra-dots can effectively inhibit the invasion of a human-infecting IV toward a human cell line, thereby making possible a unique bifunctional, supramolecular probe for influenza theranostics.

A skin abscess model for teaching incision and drainage procedures.

Science.gov (United States)

Fitch, Michael T; Manthey, David E; McGinnis, Henderson D; Nicks, Bret A; Pariyadath, Manoj

2008-07-03

Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure. We developed a realistic model of skin abscess formation to demonstrate the technique of incision and drainage for educational purposes. The creation of this model is described in detail in this report. This model has been successfully used to develop and disseminate a multimedia video production for teaching this medical procedure. Clinical faculty and resident physicians find this model to be a realistic method for demonstrating abscess incision and drainage. This manuscript provides a detailed description of our model of abscess incision and drainage for medical education. Clinical educators can incorporate this model into skills labs or demonstrations for teaching this basic procedure.

Plasma upflows and microwave emission in hot supra-arcade structure associated with AN M1.6 limb flare

International Nuclear Information System (INIS)

Kim, S.; Shibasaki, K.; Bain, H.-M.; Cho, K.-S.

2014-01-01

We have investigated a supra-arcade structure associated with an M1.6 flare, which occurred on the south-east limb on 2010 November 4. It is observed in EUV with the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamics Observatory, microwaves at 17 and 34 GHz with the Nobeyama Radioheliograph (NoRH), and soft X-rays of 8-20 keV with RHESSI. Interestingly, we found exceptional properties of the supra-arcade thermal plasma from the AIA 131 Å and the NoRH: (1) plasma upflows along large coronal loops and (2) enhancing microwave emission. RHESSI detected two soft X-ray sources, a broad one in the middle of the supra-arcade structure and a bright one just above the flare-arcade. We estimated the number density and thermal energy for these two source regions during the decay phase of the flare. In the supra-arcade source, we found that there were increases of the thermal energy and the density at the early and last stages, respectively. On the contrary, the density and thermal energy of the source on the top of the flare-arcade decreases throughout. The observed upflows imply that there is continuous energy supply into the supra-arcade structure from below during the decay phase of the flare. It is hard to explain by the standard flare model in which the energy release site is located high in the corona. Thus, we suggest that a potential candidate of the energy source for the hot supra-arcade structure is the flare-arcade, which has exhibited a predominant emission throughout.

Clinical, Biomechanical, and Anatomic Investigation of Colles Fascia and Pubic Ramus Periosteum for Use During Medial Thighplasty.

Science.gov (United States)

Carney, Martin J; Matatov, Tim; Freeman, Matthew; Miller, John; Vemula, Rahul; Schuster, Jason; Dancisak, Michael; Lindsey, John; Rae, Guenevere

2017-06-01

The medial thighplasty is a procedure where patients may attain superior mobility, hygiene, and cosmesis. Most surgeons use attachment of the superficial fascial system (SFS) of the thigh flap to the Colles fascia, whereas others attach the SFS to the pubic ramus periosteum. Because of a high complication profile, we aim to elucidate the clinical, biomechanical, and anatomic qualities of the Colles fascia versus the pubic ramus periosteum. We performed a 17-year retrospective review documenting clinical complications, a biomechanical analysis of sutures placed in different tissue layers of the thigh, and a histologic analysis surrounding the ischiopubic ramus. Separate suture pull-out strength testing was conducted on cadaveric tissue using an Admet MTEST Quattro with no. 1 Vicryl suture and tissue grips at a displacement rate of 2.12 mm/s. Simultaneous displacement and force were acquired at 100 Hz and with measurements obtained at regular intervals between the pubic symphysis and the ischial tuberosity in both the Colles fascia and the deeper periosteal layers of the thigh. A histologic analysis was performed at 3 points along the ischiopubic ramus using paraffin-embedded large mount tissue sections stained with hematoxylin, eosin, and Gomori trichrome. Thirty-nine patients underwent medial thighplasty with a 46.16% complication rate. Suture pull-out force of the suspected superficial Colles fascia sites was, on average, 72.8% less than values from the deeper periosteum tissue. Anchor points in the Colles fascia elongated 17.4% further before failure than those in the periosteum. There was noticeable variability between anchor points and across samples. The histologic sections suggest that the Colles fascia from the different regions of the ischiopubic ramus varies considerably in both continuity and collagen fiber content with no discernible pattern. The periosteal and muscular fascial layers were more continuous histologically with direct attachments into the

Comparison of reconstruction plate screw fixation and percutaneous cannulated screw fixation in treatment of Tile B1 type pubic symphysis diastasis: a finite element analysis and 10-year clinical experience.

Science.gov (United States)

Yu, Ke-He; Hong, Jian-Jun; Guo, Xiao-Shan; Zhou, Dong-Sheng

2015-09-22

The objective of this study is to compare the biomechanical properties and clinical outcomes of Tile B1 type pubic symphysis diastasis (PSD) treated by percutaneous cannulated screw fixation (PCSF) and reconstruction plate screw fixation (RPSF). Finite element analysis (FEA) was used to compare the biomechanical properties between PCSF and RPSF. CT scan data of one PSD patient were used for three-dimensional reconstructions. After a validated pelvic finite element model was established, both PCSF and RPSF were simulated, and a vertical downward load of 600 N was loaded. The distance of pubic symphysis and stress were tested. Then, 51 Tile type B1 PSD patients (24 in the PCSF group; 27 in the RPSF group) were reviewed. Intra-operative blood loss, operative time, and the length of the skin scar were recorded. The distance of pubic symphysis was measured, and complications of infection, implant failure, and revision surgery were recorded. The Majeed scoring system was also evaluated. The maximum displacement of the pubic symphysis was 0.408 and 0.643 mm in the RPSF and PCSF models, respectively. The maximum stress of the plate in RPSF was 1846 MPa and that of the cannulated screw in PCSF was 30.92 MPa. All 51 patients received follow-up at least 18 months post-surgery (range 18-54 months). Intra-operative blood loss, operative time, and the length of the skin scar in the PCSF group were significantly different than those in the RPSF group. No significant differences were found in wound infection, implant failure, rate of revision surgery, distance of pubic symphysis, and Majeed score. PCSF can provide comparable biomechanical properties to RPSF in the treatment of Tile B1 type PSD. Meanwhile, PCSF and RPSF have similar clinical and radiographic outcomes. Furthermore, PCSF also has the advantages of being minimally invasive, has less blood loss, and has shorter operative time and skin scar.

Simulation of core turbulence measurement in Tore Supra ohmic regimes

NARCIS (Netherlands)

Hacquin, S.; Citrin, J.; Arnichand, H.; Sabot, R.; Bourdelle, C.; Garbet, X.; Kramer-Flecken, A.; Tore Supra team,

2016-01-01

This paper reports on a simulation of reflectometry measurement in Tore Supra ohmic discharges, for which the experimental observations as well as gyrokinetic non-linear computations predict a modification of turbulence spectrum between the linear (LOC) and the saturated ohmic confinement (SOC)

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

Directory of Open Access Journals (Sweden)

Ling-Ying Wu

2016-07-01

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

Superficial parotidectomy via facelift incision

NARCIS (Netherlands)

Lohuis, Peter J. F. M.; Tan, M. Liane; Bonte, Katrien; van den Brekel, Michiel W. M.; Balm, Alfons J. M.; Vermeersch, Hubert B.

2009-01-01

The stigma of a visually prominent facial scar following parotid surgery can be distressing to a young patient. The surgical technique of parotidectomy via a facelift incision is described and evaluated. Thirty patients with a benign lesion of the parotid gland underwent a partial superficial

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

Directory of Open Access Journals (Sweden)

Arefah Dehghani Tafti

2011-03-01

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

Effect of electroacupuncture on the cervicospinal P2X7 receptor/fractalkine/CX3CR1 signaling pathway in a rat neck-incision pain model.

Science.gov (United States)

Gao, Y H; Li, C W; Wang, J Y; Tan, L H; Duanmu, C L; Jing, X H; Chang, X R; Liu, J L

2017-06-01

Increasing evidence supports that acupuncture intervention is an effective approach for intraoperative and postoperative pain. Neuron-microglia crosstalk, mediated by the purinergic P2X7 receptor (R)/fractalkine/CX3CR1 cascade in the spinal cord dorsal horn, plays a pivotal role in pain processing. However, its involvement in the analgesic effect of electroacupuncture (EA) remains unclear. In this study, a rat neck-incision pain model was established by making a longitudinal incision along the midline of the neck and subsequent repeated mechanical stimulation. EA stimulation was applied to bilateral LI18, LI4-PC6, or ST36-GB34. The thermal pain threshold, cervicospinal ATP concentration, expression levels of purinergic P2XR and P2YR subunits mRNAs, and fractalkine, CX3CR1 and p38 MAPK proteins, were detected separately. The neck incision induced strong thermal hyperalgesia and upregulation of spinal ATP within 48 h. No significant change was found in thermal hyperalgesia after a single session of EA intervention. However, a single session of EA dramatically enhanced the neck incision-induced upregulation of ATP and upregulated the expression of P2X7R, which was reversed by two sessions of EA. Two sessions of EA at bilateral LI18 or LI4-PC6 attenuated hyperalgesia significantly, accompanied with downregulation of P2X7R/fractalkine/ CX3CR1 signaling after three sessions of EA. EA stimulation of LI18 or LI4-PC6 alleviates thermal hyperalgesia in neck-incision pain rats, which may be associated with its effects in regulating the neck incision-induced increase of ATP and P2X7R and subsequently suppressing fractalkine/CX3CR1 signaling in the cervical spinal cord.

Does pilonidal abscess heal quicker with off-midline incision and drainage?

Science.gov (United States)

Webb, P M; Wysocki, A P

2011-06-01

No clinical trials have been done to guide the surgeon in the optimal technique of draining a pilonidal abscess. The aim of our study was to investigate whether the location of the incision influences wound healing. Electronic records from the surgical database at our 200-bed district general hospital were reviewed for operative technique (midline vs. lateral) for patients who underwent incision and drainage for acute pilonidal abscess between January 2003 and February 2010. These patients were admitted from the Emergency Department with a pilonidal abscess, underwent operative drainage, and returned for follow-up. The main outcome measure was wound healing time. Two hundred and forty-three pilonidal abscesses were drained, 134 with a lateral and 74 with a midline incision. All patients underwent simple longitudinal incision. No patient underwent de-roofing, marsupialisation, or closure. Forty-eight patients with midline drainage who returned for follow-up were matched for gender, age, and microbiology culture results with patients who underwent lateral drainage. Almost all were drained under general anesthesia with a median postoperative stay of 1 day. The overall length of follow-up was the same in both groups (P = 0.13). Abscesses that did not heal were followed-up for the same period of time irrespective of incision type (P = 0.48). Abscesses that healed after midline incision took approximately 3 weeks longer than those drained via a lateral incision (P = 0.02). Our study has limitations since it was a retrospective study that did not capture patients whose abscess drained spontaneously or were drained in the emergency department. Pilonidal abscess should be drained away from the midline.

Systematic review and meta-analysis of electrocautery versus scalpel for surgical skin incisions.

Science.gov (United States)

Aird, Lisa N F; Brown, Carl J

2012-08-01

The creation of surgical skin incisions has historically been performed using a cold scalpel. The use of electrocautery for this purpose has been controversial with respect to patient safety and surgical efficacy. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to compare skin incisions made by electrocautery and a scalpel. A systematic electronic literature search was performed using 2 electronic databases (MEDLINE and PubMed), and the methodological quality of included publications was evaluated. Six RCTs were identified comparing electrocautery (n = 606) and a scalpel (n = 628) for skin incisions. No significant difference in wound infection rates or scar cosmesis was identified between the treatment groups. Electrocautery significantly reduced the incision time and postoperative wound pain. A trend toward less incisional blood loss from skin incisions made with electrocautery was noted. Electrocautery is a safe and effective method for performing surgical skin incisions. Copyright © 2012 Elsevier Inc. All rights reserved.

Thermal study of bare tips with various system parameters and incision sizes.

Science.gov (United States)

Osher, Robert H; Injev, Valentine P

2006-05-01

To identify major and minor surgeon-controlled parameters that affect incision temperature when performing microincision lens removal using the Alcon Infiniti Vision System. In vitro research and development laboratory, Alcon Research, Irvine, California, USA. Phacoemulsification was performed in eye-bank cadaver eyes and the following parameters evaluated: incision, duty cycle, ultrasound (US) power, aspiration flow rate (AFR), vacuum, pulse, bottle height and balanced salt solution temperature, and tip design/size. Each parameter was varied while the others remained constant. The resulting temperature of the incision and US tip was measured using a thermal camera. Major contributors to elevated incision temperature included incision size, US power, duty cycle, AFR, vacuum setting, tip design, and presence of an ophthalmic viscosurgical device (OVD). Minor contributors included pulse frequency, bottle height, and temperature of the infusate. Microincision lens removal can be performed at safe temperatures with the knowledgeable selection of surgeon-controlled parameters.

The Tore Supra control, computer system : six years of operation and improvements

International Nuclear Information System (INIS)

Journeaux, J.Y.; Badie, O.; Chatelier, E.; Hennion, F.; Lebourg, P.; Leveque, P.; Hernandez, M.; Moulin, D.

1995-01-01

The Tore Supra control computer system has been providing a good operation of the Tore Supra machine for six years. It controls all of the sub-systems, the continuous ones as well as the sequential ones, and the automatic operation is very efficient. The control system has been programmed by the users themselves thanks to its user-friendly qualities, in order to keep the full control and knowledge of the automatisms. Nevertheless, some improvements are now necessary. Their main principles are : to choose ergonomic and powerful tools, industrial standards, and to keep the users's participation. The whole control system will be upgraded : the automatism level as well as the display level and the communication networks. The operator's driving job is analysed as supervisory and diagnostic tasks which have an effect on the Tore Supra machine efficiency. So a very powerful driving software has been chosen and linked with an expert system, which is to be designed and implemented with the aim to give an immediate accurate and global understanding of the process and situations, in particular in case of trouble. The method is based on an artificial intelligence approach, and it exploits both the process' informations and automatisms' steps, to determine the process state, next possible states and diagnosis of the process troubles. (orig.)

Articulated inspection arm for ITER, a demonstration in the Tore Supra tokamak

Energy Technology Data Exchange (ETDEWEB)

Cordier, J.J.; Gargiulo, L.; Grisolia, C.; Samaille, F. [Association Euratom-CEA Cadarache, 13 - Saint-Paul-lez-Durance (France). Dept. de Recherches sur la Fusion Controlee; Friconneau, J.P.; Perrot, Y. [CEA Fontenay-aux-Roses, LIST Robotics and Interactive Systems Unit, 92 (France); Palmer, J.D. [Max-Planck-Institut fuer Plasmaphysik Boltzmannstr.2, Garching (Germany)

2003-07-01

The aim of this program is to demonstrate for ITER the feasibility of an in-vessel remote handling inspection using a long reach, limited payload carrier (1 to 10 kg) for penetration of the ITER chamber through the openings. This device is dedicated to close inspection of the Plasma Facing Components (PFC). An articulated demonstrator called articulated inspection arm (AIA) has been manufactured. A feasibility study of a full AIA operation in Tore Supra was performed, taking into account ITER reference requirements. A scale one demonstration of the AIA under ITER relevant condition is feasible on Tore Supra and would give significant improvement in research results for ITER remote Handling equipment. The test of the AIA demonstrator behaviour is foreseen in 2005 in real Tokamak conditions. The paper presents the full robot concept, the results of the first test campaign, the AIA new design and its integration on Tore Supra. Several potential uses of the AIA for the in vessel components inspection are being studied such as PFC visual inspection, water loop leak testing, laser ablation for wall detritiation and carbon dust and flakes removal are foreseen as utilities to be placed at the AIA head. These various systems are described in the paper.

Articulated inspection arm for ITER, a demonstration in the Tore Supra tokamak

International Nuclear Information System (INIS)

Cordier, J.J.; Gargiulo, L.; Grisolia, C.; Samaille, F.; Palmer, J.D.

2003-01-01

The aim of this program is to demonstrate for ITER the feasibility of an in-vessel remote handling inspection using a long reach, limited payload carrier (1 to 10 kg) for penetration of the ITER chamber through the openings. This device is dedicated to close inspection of the Plasma Facing Components (PFC). An articulated demonstrator called articulated inspection arm (AIA) has been manufactured. A feasibility study of a full AIA operation in Tore Supra was performed, taking into account ITER reference requirements. A scale one demonstration of the AIA under ITER relevant condition is feasible on Tore Supra and would give significant improvement in research results for ITER remote Handling equipment. The test of the AIA demonstrator behaviour is foreseen in 2005 in real Tokamak conditions. The paper presents the full robot concept, the results of the first test campaign, the AIA new design and its integration on Tore Supra. Several potential uses of the AIA for the in vessel components inspection are being studied such as PFC visual inspection, water loop leak testing, laser ablation for wall detritiation and carbon dust and flakes removal are foreseen as utilities to be placed at the AIA head. These various systems are described in the paper

Site specific mineral composition and microstructure of human supra-gingival dental calculus.

Science.gov (United States)

Hayashizaki, Junko; Ban, Seiji; Nakagaki, Haruo; Okumura, Akihiko; Yoshii, Saori; Robinson, Colin

2008-02-01

Dental calculus has been implicated in the aetiology of several periodontal conditions. Its prevention and removal are therefore desirable clinical goals. While it is known that calculus is very variable in chemical composition, crystallinity and crystallite size little is known about site specific variability within a dentition and between individuals. With this in mind, a study was undertaken to investigate the comparative site specific nature and composition of human dental supra-gingival dental calculus obtained from 66 male patients visiting for their dental check-up using fluorescent X-ray spectroscopy, X-ray diffractometry and Fourier transform infrared spectroscopy. The supra-gingival dental calculus formed on the lingual surfaces of lower anterior teeth and the buccal surfaces of upper molar teeth were classified into four types based on calcium phosphate phases present. There was significant difference in composition of the crystal phase types between lower and upper teeth (pdental calculus on anterior or molar teeth of all samples. The degree of crystallinity of dental calculus formed on the upper molar teeth was higher than that formed on the lower anterior teeth (pdental calculus formed on the lower anterior teeth were higher than on upper molar teeth (pdental supra-gingival dental calculus is related to its location in the mouth.

Age- and gender-related characteristics of the pubic symphysis and triradiate cartilage in pediatric computed tomography

International Nuclear Information System (INIS)

Bayer, Joerg; Suedkamp, Norbert P.; Reising, Kilian; Neubauer, Jakob; Saueressig, Ulrich

2016-01-01

There is little information on the pubic symphysis' normal CT appearance in children. We sought to generate age-, gender- and maturity-related symphyseal width appearances in CT scans. Pelvic CT scans performed for any reason during a 6-year period in patients younger than 18 years were retrospectively analyzed. The symphysis width was measured in the axial plane and the triradiate cartilage was classified as open or closed. Four hundred twenty-seven CT scans were evaluated and 350 remained for analysis. Age- and gender-related measurements of the symphysis width are illustrated on various centile graphs. When grouping children by age in years 0-6, 7-11, 12-15 and 16-17, mean (standard deviation) symphysis width was 5.4 mm (0.9), 5.3 mm (1.1), 4.1 mm (1.1) and 3.5 mm (1.0), respectively, in girls and 5.9 mm (1.3), 5.4 mm (1.2), 5.2 mm (1.1) and 4.0 mm (1.0), respectively, in boys. Boys and girls were significantly different in the age groups 12-15 years (P<0.001) and 16-17 years (P=0.04). In the mature pelvis, the symphyseal gap is significantly (P<0.001) shorter in both genders, and in girls compared to boys (P=0.04). The pubic symphysis width in children differs according to age, gender and maturity. The reference values published herein may help detect symphyseal injury. (orig.)

Age- and gender-related characteristics of the pubic symphysis and triradiate cartilage in pediatric computed tomography

Energy Technology Data Exchange (ETDEWEB)

Bayer, Joerg; Suedkamp, Norbert P.; Reising, Kilian [Medical Centre -University of Freiburg, Department of Orthopedics and Trauma Surgery, Freiburg (Germany); Neubauer, Jakob [Medical Centre - University of Freiburg, Department of Radiology, Freiburg (Germany); Saueressig, Ulrich [Kreiskrankenhaus Emmendingen, Department of Radiology, Emmendingen (Germany)

2016-11-15

There is little information on the pubic symphysis' normal CT appearance in children. We sought to generate age-, gender- and maturity-related symphyseal width appearances in CT scans. Pelvic CT scans performed for any reason during a 6-year period in patients younger than 18 years were retrospectively analyzed. The symphysis width was measured in the axial plane and the triradiate cartilage was classified as open or closed. Four hundred twenty-seven CT scans were evaluated and 350 remained for analysis. Age- and gender-related measurements of the symphysis width are illustrated on various centile graphs. When grouping children by age in years 0-6, 7-11, 12-15 and 16-17, mean (standard deviation) symphysis width was 5.4 mm (0.9), 5.3 mm (1.1), 4.1 mm (1.1) and 3.5 mm (1.0), respectively, in girls and 5.9 mm (1.3), 5.4 mm (1.2), 5.2 mm (1.1) and 4.0 mm (1.0), respectively, in boys. Boys and girls were significantly different in the age groups 12-15 years (P<0.001) and 16-17 years (P=0.04). In the mature pelvis, the symphyseal gap is significantly (P<0.001) shorter in both genders, and in girls compared to boys (P=0.04). The pubic symphysis width in children differs according to age, gender and maturity. The reference values published herein may help detect symphyseal injury. (orig.)

Supra-annular Valve-in-Valve implantation reduces blood stasis on the transcatheter aortic valve leaflets.

Science.gov (United States)

Vahidkhah, Koohyar; Azadani, Ali N

2017-06-14

Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and Valve-in-Valve (ViV) procedures has been increasingly recognized. This study aimed to investigate the effect of positioning of the transcatheter aortic valve (TAV) in ViV setting on the flow dynamics aspect of post-ViV thrombosis by quantifying the blood stasis in the intra-annular and supra-annular settings. To that end, two idealized computational models, representing ViV intra-annular and supra-annular positioning of a TAV were developed in a patient-specific geometry. Three-dimensional flow fields were then obtained via fluid-solid interaction modeling to study the difference in blood residence time (BRT) on the TAV leaflets in the two settings. At the end of diastole, a strip of high BRT (⩾1.2s) region was observed on the TAV leaflets in the ViV intra-annular positioning at the fixed boundary where the leaflets are attached to the frame. Such a high BRT region was absent on the TAV leaflets in the supra-annular positioning. The maximum value of BRT on the surface of non-, right, and left coronary leaflets of the TAV in the supra-annular positioning were 53%, 11%, and 27% smaller compared to the intra-annular positioning, respectively. It was concluded that the geometric confinement of TAV by the leaflets of the failed bioprosthetic valve in ViV intra-annular positioning increases the BRT on the leaflets and may act as a permissive factor in valvular thrombosis. The absence of such a geometric confinement in the ViV supra-annular positioning leads to smaller BRT and subsequently less likelihood of leaflet thrombosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Minimizing surgical skin incision scars with a latex surgical glove.

Science.gov (United States)

Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

2013-04-01

The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

First results of the ECE measurements on Tore Supra

International Nuclear Information System (INIS)

Garcin, M.; Javon, C.; Laurent, L.; Masset, R.; Rodriguez, L.; Talvard, M.

1989-01-01

Since the beginning of the Tore Supra experiments in april 1988, the ECE diagnostic has been partially operated. The main elements of the diagnostic have been tested and first results have been obtained with a Michelson interferometer and a vertical array of antennae. According to the latter arrangement, the first inverted emissivity profiles are presented

Spatially resolved charge exchange flux calculations on the Toroidal Pumped Limiter of Tore Supra

International Nuclear Information System (INIS)

Marandet, Y.; Tsitrone, E.; Boerner, P.; Reiter, D.; Beaute, A.; Delchambre, E.; Escarguel, A.; Brezinsek, S.; Genesio, P.; Gunn, J.; Monier-Garbet, P.; Mitteau, R.; Pegourie, B.

2009-01-01

A spatially resolved calculation of the charge exchange particle and energy fluxes on the Toroidal Pumped Limiter (TPL) of Tore Supra is presented, as a first step towards a better understanding and modelling of carbon erosion, migration, as well as deuterium codeposition and bulk diffusion of deuterium in Tore Supra. The results are obtained with the EIRENE code run in a 3D geometry. Physical and chemical erosion maps on the TPL are calculated, and the contribution of neutrals to erosion, especially in the self-shadowed area, is calculated.

An enhanced computational method for age-at-death estimation based on the pubic symphysis using 3D laser scans and thin plate splines.

Science.gov (United States)

Stoyanova, Detelina; Algee-Hewitt, Bridget F B; Slice, Dennis E

2015-11-01

The pubic symphysis is frequently used to estimate age-at-death from the adult skeleton. Assessment methods require the visual comparison of the bone morphology against age-informative characteristics that represent a series of phases. Age-at-death is then estimated from the age-range previously associated with the chosen phase. While easily executed, the "morphoscopic" process of feature-scoring and bone-to-phase-matching is known to be subjective. Studies of method and practitioner error demonstrate a need for alternative tools to quantify age-progressive change in the pubic symphysis. This article proposes a more objective, quantitative method that analyzes three-dimensional (3D) surface scans of the pubic symphysis using a thin plate spline algorithm (TPS). This algorithm models the bending of a flat plane to approximately match the surface of the bone and minimizes the bending energy required for this transformation. Known age-at-death and bending energy were used to construct a linear model to predict age from observed bending energy. This approach is tested with scans from 44 documented white male skeletons and 12 casts. The results of the surface analysis show a significant association (regression p-value = 0.0002 and coefficient of determination = 0.2270) between the minimum bending energy and age-at-death, with a root mean square error of ≈19 years. This TPS method yields estimates comparable to established methods but offers a fully integrated, objective and quantitative framework of analysis and has potential for use in archaeological and forensic casework. © 2015 Wiley Periodicals, Inc.

Impact of sub and supra-threshold adaptation currents in networks of spiking neurons.

Science.gov (United States)

Colliaux, David; Yger, Pierre; Kaneko, Kunihiko

2015-12-01

Neuronal adaptation is the intrinsic capacity of the brain to change, by various mechanisms, its dynamical responses as a function of the context. Such a phenomena, widely observed in vivo and in vitro, is known to be crucial in homeostatic regulation of the activity and gain control. The effects of adaptation have already been studied at the single-cell level, resulting from either voltage or calcium gated channels both activated by the spiking activity and modulating the dynamical responses of the neurons. In this study, by disentangling those effects into a linear (sub-threshold) and a non-linear (supra-threshold) part, we focus on the the functional role of those two distinct components of adaptation onto the neuronal activity at various scales, starting from single-cell responses up to recurrent networks dynamics, and under stationary or non-stationary stimulations. The effects of slow currents on collective dynamics, like modulation of population oscillation and reliability of spike patterns, is quantified for various types of adaptation in sparse recurrent networks.

Tore supra: towards the 'long time' fusion. Press journey

International Nuclear Information System (INIS)

2008-01-01

After a recall of the interest in the fusion for the development of energy sources, the document presents the fusion from the solar reaction to the nuclear fusion in laboratory. Then it discusses the great challenges of this technology and the Tore Supra installation. The last part is devoted to ITER and DEMO projects. (A.L.B.)

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

Science.gov (United States)

Cuda, D

2009-04-01

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

Radiological landmarks for the safe extra-capsular placement of supra-acetabular half pins for external fixation.

Science.gov (United States)

Lidder, Surjit; Heidari, Nima; Gänsslen, Axel; Grechenig, Wolfgang

2013-03-01

Low anterior external fixators are constructed by placing half pins in the dense bone tunnel of the supra-acetabular region in an anterior to posterior direction. Although the placement of these pins is extra-articular, they may still breach the hip capsule on the anterior inferior iliac spine and thus be intra-capsular. We aim to provide radiological markers for the most superior fibres of the capsule to allow safe extra-capsular pin placement within the supra-acetabular bone tunnel. Thirteen cadaveric pelves were used for this study. The supra-acetabular bone tunnel was visualised with an image intensifier. The proximal most fibres of the hip joint capsule were marked with a K-wire so that their relation to the bone tunnel could be clearly seen on the images. Once all images were acquired they were calibrated and analysed to estimate the dimensions of the supra-acetabular bone tunnel and the reflection of the hip capsule. The median height of the bone tunnel was 23.6 mm (18.9-33.2) and maximum width was 11.4 mm (7.6-16.3). The inferior margin of the bone tunnel was 6.7 mm (1.1-14.5) superior to the acetabular dome, and the most proximal fibres of the capsule were 9.3 mm (4.7-6.1) superior to the acetabular dome. The inferior portion of the tunnel was 3.7 mm (0.3-8.9) within the joint. Half pins for the construction of a pelvic external fixator should be placed in the upper half of the supra-acetabular bone corridor to minimise the risk of intra-capsular placement.

Treatment of bilateral mammary ptosis and pectus excavatum through the same incision in one surgical stage

Directory of Open Access Journals (Sweden)

Fernando Passos Rocha

Full Text Available CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.

Engineering studies for the installation of an axi-symmetric metallic divertor in Tore Supra

International Nuclear Information System (INIS)

Doceul, L.; Portafaix, C.; Bucalossi, J.; Saille, A.; Bertrand, B.; Lipa, M.; Missirlian, M.; Jiolat, G.; Samaille, F.; Soler, B.

2011-01-01

Tore Supra (TS) has been designed to operate using technologies that allow long plasma operation (a few minutes), by means of superconducting magnets and actively-cooled high heat flux plasma facing components (PFCs). Actively cooled tungsten PFC will be used in the baffle area of the first ITER divertor. In order to validate such a technology fully (industrial manufacturing, operation with long plasma duration), the implementation of a tungsten axi-symmetric divertor in the tokamak Tore Supra has been studied . With this second major upgrade, Tore Supra should be able to address the problematic of long plasma discharges with a metallic divertor. The proposed divertor is made up of two stainless steel casings containing a copper coil winding located at the top and bottom area of the vacuum vessel. These casings are firmly maintained by connection beams and protected by PFC. This paper describes the mechanical design of this major component and its integration in TS, the associated electromagnetic and thermomechanical analysis, the manufacturing issues and finally the integration of ITER representative PFCs.

Temperature-controlled laser-soldering system and its clinical application for bonding skin incisions

Science.gov (United States)

Simhon, David; Gabay, Ilan; Shpolyansky, Gregory; Vasilyev, Tamar; Nur, Israel; Meidler, Roberto; Hatoum, Ossama Abu; Katzir, Abraham; Hashmonai, Moshe; Kopelman, Doron

2015-12-01

Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing.

Tore supra: towards the 'long time' fusion. Press journey; Tore Supra: vers la fusion 'longue duree'. Voyage de presse

Energy Technology Data Exchange (ETDEWEB)

NONE

2008-07-01

After a recall of the interest in the fusion for the development of energy sources, the document presents the fusion from the solar reaction to the nuclear fusion in laboratory. Then it discusses the great challenges of this technology and the Tore Supra installation. The last part is devoted to ITER and DEMO projects. (A.L.B.)

Host-Guest Interaction between Corona[n]arene and Bisquaternary Ammonium Derivatives for Fabricating Supra-Amphiphile.

Science.gov (United States)

Zeng, Lingda; Guo, Qing-Hui; Feng, Yuanning; Xu, Jiang-Fei; Wei, Yuhan; Li, Zhibo; Wang, Mei-Xiang; Zhang, Xi

2017-06-13

The interactions between a host, water-soluble corona[n]arene (S6-CAP), and a series of guests, bisquaternary ammonium derivatives (CnDAs), in water, were investigated. The host and guest can form 1:1 host-guest complex. Their binding constants decrease as the alkyl length of CnDAs increases, which can be tunable ranging from 10 3 to 10 6 M -1 . The binding processes are mainly entropy-driven, while the enthalpy changes also play an important role in enhancing the host-guest interactions. In addition, a supra-amphiphile was fabricated with S6-CAP and a normal surfactant bearing bisquaternary ammonium (C4R). The S6-CAP·C4R complex forms micellar aggregates in water, and the system possesses better assembling activity and dilution stability than its building block C4R. This study enriches the families of supra-amphiphiles with a new architecture, and employing such a supra-amphiphile in biofunctional materials is highly anticipated.

Measuring Dynamic and Kinetic Information in the Previously Inaccessible Supra-tc Window of Nanoseconds to Microseconds by Solution NMR Spectroscopy

Directory of Open Access Journals (Sweden)

Donghan Lee

2013-09-01

Full Text Available Nuclear Magnetic Resonance (NMR spectroscopy is a powerful tool that has enabled experimentalists to characterize molecular dynamics and kinetics spanning a wide range of time-scales from picoseconds to days. This review focuses on addressing the previously inaccessible supra-τc window (defined as τc < supra-τc < 40 μs; in which τc is the overall tumbling time of a molecule from the perspective of local inter-nuclear vector dynamics extracted from residual dipolar couplings (RDCs and from the perspective of conformational exchange captured by relaxation dispersion measurements (RD. The goal of the first section is to present a detailed analysis of how to extract protein dynamics encoded in RDCs and how to relate this information to protein functionality within the previously inaccessible supra-τc window. In the second section, the current state of the art for RD is analyzed, as well as the considerable progress toward pushing the sensitivity of RD further into the supra-τc scale by up to a factor of two (motion up to 25 ms. From the data obtained with these techniques and methodology, the importance of the supra-τ c scale for protein function and molecular recognition is becoming increasingly clearer as the connection between motion on the supra-τc scale and protein functionality from the experimental side is further strengthened with results from molecular dynamics simulations.

Mouse preferential incising force orientation changes during jaw closing muscle hyperalgesia and is sex dependent.

Science.gov (United States)

Widmer, C G; Morris-Wiman, J

2016-12-01

Mouse incising is controlled by a central pattern generator and this activity can change in the presence of pain. The incising frequency and maximum force generation decreases with pain. In this study, we used repetitive acidic injections in the left masseter muscle of male and female mice to determine differences between baseline and jaw muscle pain conditions and the effect of sex on preferential incising direction. A within subject design was used to evaluate data previously acquired using multi-axis force data (X, Y and Z) from the 4th baseline recording day and day 7 post-injection (day of maximal pain response) for each mouse of each sex. A total of 34 female and male (age 3-9months) CD-1 mice were evaluated. After mathematically rotating the X and Y axes to align the Y axis to be parallel to the wire struts of the cage top, data were analyzed to determine incising direction preference during baseline (non-pain) and pain (day 7) conditions and between sex. Radar plots of X-Y, X-Z and Y-Z axes depicted the average direction of incising preference between baseline and pain conditions for each sex. Statistical differences among groups were tested using a mixed model ANOVA. Similar to previous findings, female mice had a more robust difference in incising direction preference when comparing male and female pain conditions and this was most evident in the X-Z axes. The incising frequencies most commonly affected were 5.3, 6.2 and 7.6Hz. Male mice varied little in their incising direction preference between the baseline and pain conditions. In addition, statistical comparison of ratios of the percent of time spent incising in the Z versus X axes for each incising frequency found that the incising preference was not different when comparing 5.3 and 7.6Hz frequencies. Finally, female mice used a novel approach to minimize pain while incising by rotating their head and body nearly 180 degrees while males did not use this strategy as frequently. The preferred incising

An Exploration of Heating Mechanisms in a Supra-arcade Plasma Sheet Formed after a Coronal Mass Ejection

Energy Technology Data Exchange (ETDEWEB)

Reeves, Katharine K. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St. MS 58, Cambridge, MA 02138 (United States); Freed, Michael S.; McKenzie, David E. [Montana State University, Bozeman, MT 59717 (United States); Savage, Sabrina L., E-mail: kreeves@cfa.harvard.edu [NASA Marshall Space Flight Center, Huntsville, AL 35812 (United States)

2017-02-10

We perform a detailed analysis of the thermal structure of the region above the post-eruption arcade for a flare that occurred on 2011 October 22. During this event, a sheet of hot plasma is visible above the flare loops in the 131 Å bandpass of the Atmospheric Imaging Assembly (AIA) on the Solar Dynamics Observatory . Supra-arcade downflows (SADs) are observed traveling sunward through the post-eruption plasma sheet. We calculate differential emission measures using the AIA data and derive an emission measure weighted average temperature in the supra-arcade region. In areas where many SADs occur, the temperature of the supra-arcade plasma tends to increase, while in areas where no SADs are observed, the temperature tends to decrease. We calculate the plane-of-sky velocities in the supra-arcade plasma and use them to determine the potential heating due to adiabatic compression and viscous heating. Of the 13 SADs studied, 10 have noticeable signatures in both the adiabatic and the viscous terms. The adiabatic heating due to compression of plasma in front of the SADs is on the order of 0.1–0.2 MK/s, which is similar in magnitude to the estimated conductive cooling rate. This result supports the notion that SADs contribute locally to the heating of plasma in the supra-arcade region. We also find that in the region without SADs, the plasma cools at a rate that is slower than the estimated conductive cooling, indicating that additional heating mechanisms may act globally to keep the plasma temperature high.

An Exploration of Heating Mechanisms in a Supra-arcade Plasma Sheet Formed after a Coronal Mass Ejection

International Nuclear Information System (INIS)

Reeves, Katharine K.; Freed, Michael S.; McKenzie, David E.; Savage, Sabrina L.

2017-01-01

We perform a detailed analysis of the thermal structure of the region above the post-eruption arcade for a flare that occurred on 2011 October 22. During this event, a sheet of hot plasma is visible above the flare loops in the 131 Å bandpass of the Atmospheric Imaging Assembly (AIA) on the Solar Dynamics Observatory . Supra-arcade downflows (SADs) are observed traveling sunward through the post-eruption plasma sheet. We calculate differential emission measures using the AIA data and derive an emission measure weighted average temperature in the supra-arcade region. In areas where many SADs occur, the temperature of the supra-arcade plasma tends to increase, while in areas where no SADs are observed, the temperature tends to decrease. We calculate the plane-of-sky velocities in the supra-arcade plasma and use them to determine the potential heating due to adiabatic compression and viscous heating. Of the 13 SADs studied, 10 have noticeable signatures in both the adiabatic and the viscous terms. The adiabatic heating due to compression of plasma in front of the SADs is on the order of 0.1–0.2 MK/s, which is similar in magnitude to the estimated conductive cooling rate. This result supports the notion that SADs contribute locally to the heating of plasma in the supra-arcade region. We also find that in the region without SADs, the plasma cools at a rate that is slower than the estimated conductive cooling, indicating that additional heating mechanisms may act globally to keep the plasma temperature high.

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

Directory of Open Access Journals (Sweden)

Sugamata A

2011-12-01

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

The Tore Supra Lower Hybrid Test Bed : improvements and applications

International Nuclear Information System (INIS)

Delpech, L.; Achard, J.; Beaumont, B.

2006-01-01

Within the CIMES project framework in Tore Supra, a klystron TH2103C (3.7 GHz) is under development at THALES ELECTRON DEVICES. It differs from the previous klystrons used in Tore Supra generator mainly in that it has no modulating anode, the RF output power will reach 700 kW CW, by raising the High Voltage value to 76 kV and a beam current up to 23 A. The Tore Supra test bed is a dedicated facility used for high power tests on RF components or on RF transmitters. It has been improved to integrate the TH2103C klystron and a specific 100 kV solide state switch which control the beam current. Since April 2005, the integration of the first tube (without modulating anode) and the 100 kV switch has been completed in the Test Bed and has allowed the modifications and tests of the interfaces and security system for the devices. Improvements were also made on the cooling loop flow to dissipate a power of 1750 kW CW. With these devices, the RF power routinely available in the Lower Hybrid Test Bed is 400 kW CW. With the development of the TH2103C, detailed studies and tests on RF components which will be used up to 750 kW CW on match load or 700 kW on VSWR = 1.4, are necessary to evaluate their performances and thermal behaviour. The test a crucial component, the recombiner, which adds the RF powers coming from the two RF outputs of the TH2103C and inject the resulted power into one WR284 waveguide to a test load or to the plasma, was completed. Two tests have been performed : a thermal study with 400 kW during 1000 s, and RF pulsed tests on short cuts to increase the value of the electric field inside the component. The experiments and calculations (ANSYS and HFSS codes) validate the use of this device with the TH2103C. A module made with two different Beryllium Oxide RF windows, has been under test. The losses on each window are measured by calorimetric measurements and evaluated by computation with HFSS and ANSYS code. The results are compared. In this paper, the

TORE SUPRA 300 W - 1.75 K refrigerator report

International Nuclear Information System (INIS)

Gistau, G.M.; Bonneton, M.; Mart, J.W.

1988-01-01

The TORE SUPRA refrigerator is now installed and the acceptance tests have been completed. All equipment has performed above design levels. The liquid ring pumps and cold centrifugal compressors have run for more than 1000 hours. Commissioning and acceptance tests, including cooldown, variable heat load, unscheduled shutdown, power outage and automatic restart, and a 400-hour shakedown run, are described and evaluated

Infrared reflection properties and modelling of in situ reflection measurements on plasma-facing materials in Tore Supra

International Nuclear Information System (INIS)

Reichle, R; Desgranges, C; Faisse, F; Pocheau, C; Lasserre, J-P; Oelhoffen, F; Eupherte, L; Todeschini, M

2009-01-01

Tore Supra has-like ITER-reflecting internal surfaces, which can perturb the machine protection systems based on infrared (IR) thermography. To ameliorate this situation, we have measured and modelled in the 3-5 μm wavelength range the bi-directional reflection distribution function (BRDF) of wall material samples from Tore Supra and conducted in situ reflection measurements and simulated them with the CEA COSMOS code. BRDF results are presented for B 4 C and carbon fibre composite (CFC) tiles. The hemispherical integrated reflection ranges from 0.12 for the B 4 C sample to 0.39 for a CFC tile from the limiter erosion zone. In situ measurements of the IR reflection of a blackbody source off an ICRH and an LHCD antenna of Tore Supra are well reproduced by the simulation.

Infrared reflection properties and modelling of in situ reflection measurements on plasma-facing materials in Tore Supra

Energy Technology Data Exchange (ETDEWEB)

Reichle, R; Desgranges, C; Faisse, F; Pocheau, C [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France); Lasserre, J-P; Oelhoffen, F; Eupherte, L; Todeschini, M [CEA, DAM, CESTA, F-33114 Le Barp (France)

2009-12-15

Tore Supra has-like ITER-reflecting internal surfaces, which can perturb the machine protection systems based on infrared (IR) thermography. To ameliorate this situation, we have measured and modelled in the 3-5 {mu}m wavelength range the bi-directional reflection distribution function (BRDF) of wall material samples from Tore Supra and conducted in situ reflection measurements and simulated them with the CEA COSMOS code. BRDF results are presented for B{sub 4}C and carbon fibre composite (CFC) tiles. The hemispherical integrated reflection ranges from 0.12 for the B{sub 4}C sample to 0.39 for a CFC tile from the limiter erosion zone. In situ measurements of the IR reflection of a blackbody source off an ICRH and an LHCD antenna of Tore Supra are well reproduced by the simulation.

Aesthetic assessment in periciliary "v-incision" versus conventional external dacryocystorhinostomy in Asians.

Science.gov (United States)

Ng, Danny Siu-Chun; Chan, Edwin; Yu, Derek Kim-Hun; Ko, Simon Tak-Chuen

2015-10-01

To determine the functional and aesthetic outcomes of periciliary "v-incision" external dacryocystorhinostomy (DCR) and to compare with conventional approach. Charts review of consecutive cases of "v-incision" (VDCR) or conventional DCR performed in a single institute, between January 2007 and March 2014. All procedures were performed or supervised by a single surgeon. Two periciliary incisions were made near the skin-mucosal junction at the upper and lower eyelid margins medial to the punctum joining at the medial canthal angle to form a "v" shape. Subcutaneous dissection was carried out inferomedially to reach the anterior lacrimal crest. DCR was then performed in the usual manner. Functional success was defined as no persistent or recurrent epiphora and patency on irrigation of the lacrimal drainage system at least 6 months post-surgery. A cross-sectional aesthetic survey was conducted by asking the patients to rate their scar appearance satisfaction on a visual analogue scale (VAS). External photographs were graded by two independent, masked physicians using VAS as well as the Stony Brook scar evaluation scale (SBSES). Sixty-one patients with median age of 64 years met the inclusion criteria, with median follow-up duration of 28 months. Thirty-eight eyes underwent VDCR, and 23 had conventional DCR. The functional success rate for VDCR was 83.3, 95 % confidence intervals (95%CI) [lower 0.68, upper 0.92] and for conventional DCR was 73.9 %, 95%CI [lower 0.54, upper 0.87]; without statistically significant difference (p = 0.38). VDCR patients rated higher aesthetic outcome on VAS (mean scores 95.5 ± 16.8 vs 82.9 ± 25.1, p = 0.03). On the SBSES, both observers gave higher aesthetic scores to the VDCR group (observer #1 4.6 ± 1.1 and #2 4.7 ± 1.2, p aesthetic outcomes as reported by surgeons and patients. However, a higher proportion of trainees under supervision performed conventional DCR, and it is uncertain whether the outcomes were

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

Directory of Open Access Journals (Sweden)

Thomas R

2000-01-01

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

Cell-Targeted Optogenetics and Electrical Microstimulation Reveal the Primate Koniocellular Projection to Supra-granular Visual Cortex.

Science.gov (United States)

Klein, Carsten; Evrard, Henry C; Shapcott, Katharine A; Haverkamp, Silke; Logothetis, Nikos K; Schmid, Michael C

2016-04-06

Electrical microstimulation and more recently optogenetics are widely used to map large-scale brain circuits. However, the neuronal specificity achieved with both methods is not well understood. Here we compare cell-targeted optogenetics and electrical microstimulation in the macaque monkey brain to functionally map the koniocellular lateral geniculate nucleus (LGN) projection to primary visual cortex (V1). Selective activation of the LGN konio neurons with CamK-specific optogenetics caused selective electrical current inflow in the supra-granular layers of V1. Electrical microstimulation targeted at LGN konio layers revealed the same supra-granular V1 activation pattern as the one elicited by optogenetics. Taken together, these findings establish a selective koniocellular LGN influence on V1 supra-granular layers, and they indicate comparable capacities of both stimulation methods to isolate thalamo-cortical circuits in the primate brain. Copyright © 2016 Elsevier Inc. All rights reserved.

Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy.

Science.gov (United States)

Bordelon, B M; Hobday, K A; Hunter, J G

1992-01-01

An unsolved problem of laparoscopic cholecystectomy is the optimal method of removing the gallbladder with thick walls and a large stone burden. Proposed solutions include fascial dilatation, stone crushing, and ultrasonic, high-speed rotary, or laser lithotripsy. Our observation was that extension of the fascial incision to remove the impacted gallbladder was time efficient and did not increase postoperative pain. We reviewed the narcotic requirements of 107 consecutive patients undergoing laparoscopic cholecystectomy. Fifty-two patients required extension of the umbilical incision, and 55 patients did not have their fascial incision enlarged. Parenteral meperidine use was 39.5 +/- 63.6 mg in the patients requiring fascial incision extension and 66.3 +/- 79.2 mg in those not requiring fascial incision extension (mean +/- standard deviation). Oral narcotic requirements were 1.1 +/- 1.5 doses vs 1.3 +/- 1.7 doses in patients with and without incision extension, respectively. The wide range of narcotic use in both groups makes these apparent differences not statistically significant. We conclude that protracted attempts at stone crushing or expensive stone fragmentation devices are unnecessary for the extraction of a difficult gallbladder during laparoscopic cholecystectomy.

Transverse versus Longitudinal Incisions for Femoral Artery Exposure in Treating Patients with Peripheral Vascular Disease.

Science.gov (United States)

Parikh, Punam P; Rubio, Gustavo A; Patel, Kunal; Gupta, Kapil; Jones, Keith; Rey, Jorge; Robinson, Handel

2018-02-01

This study evaluates differences in wound complication rate when transverse versus longitudinal incision is utilized to expose femoral vessels in managing patients with peripheral vascular disease. A retrospective review from 2013 to 2015 was conducted of 150 patients undergoing 156 lower extremity revascularizations with femoral artery exposure through a groin incision. Patients were stratified into 2 groups, transverse versus longitudinal groin incision. Data were reviewed for 3 surgeons that utilize either transverse or longitudinal groin incision in patients undergoing common or iliofemoral endarterectomies, or where femoral artery was used as inflow and/or outflow vessel for limb revascularization. Each group had a comparative outcomes analysis based on incision type. The primary outcome was wound complication, defined as any wound infection, lymphocele, hematoma, dehiscence, pseudoaneurysm, or necrosis. Other outcomes studied included unplanned return to operating room for wound complication, wound vacuum therapy, and soft-tissue flap closure. Data were analyzed using 2-tailed chi-squared test and Student's t-test. Patients in the transverse (n = 85 cases) versus longitudinal (n = 71 cases) cohorts were similar in relation to demographics and comorbidities. Overall mean follow-up was 220 days. Patients with a transverse as compared to longitudinal incision had a significantly lower overall wound complication rate, 7% vs. 42%, respectively (P transverse incisions were associated with lower incidence of unplanned return to the operating room to manage wound complications than patients with a longitudinal incision (5% vs. 23%, respectively; P Transverse versus longitudinal incisions were also associated with significantly lower need for wound vacuum therapy (6% vs. 15%, respectively; P Transverse groin incisions for femoral artery exposure may offer a lower risk of wound complications for open procedures as compared to a longitudinal incision

Plasma Edge Control in Tore Supra

International Nuclear Information System (INIS)

Evans, T.E.; Mioduszewski, P.K.; Foster, C.; Haste, G.; Horton, L.; Grosman, A.; Ghendrih, P.; Chatelier, M.; Capes, H.; Michelis, C. De; Fall, T.; Geraud, A.; Grisolia, C.; Guilhem, D.; Hutter, T.

1990-01-01

TORE SUPRA is a large superconducting tokamak designed for sustaining long inductive pulses (t∼ 30 s). In particular, all the first wall components have been designed for steady-state heat and particle exhaust, particle injection, and additional heating. In addition to these technological assets, a strict control of the plasma-wall interactions is required. This has been done at low power: experiments with ohmic heating have been mainly devoted to the pump limiter, ergodic divertor and pellet injection experiments. Some specific problems arising in large tokamaks are encountered; the pump limiter and the ergodic divertor yield the expected effects on the plasma edge. The effects on the bulk are discussed

Pump limiter studies in Tore Supra

International Nuclear Information System (INIS)

Chatelier, M.; Bonnel, P.; Bruneau, J.L.; Gil, C.; Grisolia, C.; Loarer, T.; Martin, G.; Pegourie, B.; Rodriguez, L.

1991-01-01

The aim of the Tore Supra pump limiter program is to study particle exhaust with a pump limiter system in long-pulse discharges with continuous pellet fueling and strong auxiliary heating. The pump limiter system consists of six vertical modules, located at the bottom of the machine, and one horizontal module at the outer midplane. The instrumentation of the limiter included pressure gauges, a residual gas analyser Langmuir probes, a spectrometer and water calorimeters. Initial results in low-density discharges, with the outboard limiter only, showed a modest effect on the plasma density, while large exhaust fluxes were measured in the pump limiter, without any external fueling

Ion Temperature Measurements in the Tore Supra Scrape-Off Layer Using a Retarding Field Analyzer

International Nuclear Information System (INIS)

Kocan, M.; Gunn, J.P.; Pascal, J.Y.; Gauthier, E.

2010-01-01

The retarding field analyzer (RFA) is one of the only widely accepted diagnostics for measuring the ion temperature T i )in the tokamak scrape-off layer. An overview of the outstanding RFA performance over ten years of operation in Tore Supra tokamak is given and the validation of T i measurements is addressed. The RFA measurements in Tore Supra are found to be well reproducible. The ion-to-electron temperature ratio is higher than one at low-to-moderate ion-electron collisionality regime and converges to unity at high collisionality regime. (authors)

Production and control of an edge radiating layer with the ergodic divertor on TORE SUPRA

International Nuclear Information System (INIS)

Poutchy, L.; Vallet, J.C.; Michelis, C. de; Grosman, A.; Hess, W.; Mattioli, M.; Monier-Garbet, P.

1992-01-01

We have recently defined on Tore Supra a discharge piloting strategy to prevent disruptions at the density limit, based on the property of the Ergodic Divertor to stabilize MHD activity. This strategy allows plasma studies close to the density limit without disruptions, and has been successfully used on Tore Supra ohmicly heated plasmas. The Ergodic Divertor allows also the stabilization of detached plasmas which appear spontaneously near the density limit. Edge impurities are shown to play a fundamental role in this stabilization. Detached plasmas have been thereby controlled during 10 seconds

[Supra-aortic trunks occlusive disease: three different treatment approaches].

Science.gov (United States)

Dias, P; Almeida, P; Sampaio, S; Silva, A; Leite-Moreira, A; Pinho, P; Roncon de Albuquerque, R

2010-01-01

Unlike carotid bifurcation atherosclerotic stenosis, supra-aortic trunks (SAT) occlusive disease is rare and its revascularization uncommon, accouting for less than 10% of the operations performed on the extracranial brain-irrigating arteries. There are three different treatment approaches: transthoracic, extra-anatomic cervical and endovascular. Endovascular repair is gaining popularity as first-line therapy for proximal lesions with favorable anatomy because of its low morbidity and rare mortality. Extra-anatomic bypass is a safe and durable reconstruction and should be considered in patients with single vessel disease, with cardiopulmonary high-risk or with limited life expectancy. If cardiac surgery is needed, central transthoracic reconstruction is preferable, and the two procedures should be combined. The long-term patency of bypasses with aortic origin, specially when multiple vessels are involved, is superior to other repair techniques. We present three clinical cases that illustrate each of these therapeutic strategies: central brachiocephalic revascularization and synchronous cardiac surgery in a patient with complex SAT atherosclerosis disease; subclavian-carotid transposition for disabling upper limb claudication; and subclavian artery stenting for subclavian-steal syndrome. Surgical approach selection should be based on the individual patient's anatomy and operative risk.

One minute pulse operation in TORE SUPRA

International Nuclear Information System (INIS)

van Houtte, D.

1992-01-01

Long pulse operation is the main focus of the research program on the high field superconducting Tore Supra tokamak. During the past two years, most of subsystems (Lower Hybrid Current Drive, Ion Cyclotron Radiofrequency Heating, Pellet Injector, Inner Wall, Pump Limiters) have been tested separately and time constants of associated phenomena have been investigated. In 1992, combined experiments have allowed to perform a 1MA-1mn long flat top current plasma discharge. The present paper concentrates on the main characteristics of this long pulse high energy discharge

Discussion on the Relevant Factors of General Surgery Incision Infection and Prevention Methods

Directory of Open Access Journals (Sweden)

Jin Baotao

2017-01-01

Full Text Available There are many reasons that can lead to incision infection of general surgical patients. The main reasons include weight, age, body albumin level, surgical time, observation ward, etc. This paper analyzes the clinic data of patients with incision infection after general surgery based on clinic practice and study on the reasons that have impact on general surgical incision infection and gives relevant prevention countermeasures.

Pellet injection and confinement in the tore supra tokamak

International Nuclear Information System (INIS)

Maget, P.

1998-01-01

Pellet injection in the centre of tokamak plasmas can lead to an improved confinement regime called PEP (Pellet Enhanced Performance). The present work is dedicated to the mechanisms involved in the PEP regimes obtained in the tokamak Tore Supra. A neoclassical approach of transport shows that it is the anomalous transport, due to plasma turbulence, that causes the enhanced confinement. A linear model describing electrostatic instabilities has been developed in order to study the roles of density profile and current profile during the PEP, in the limit of large growth rates. The effect of radial shear in flows is taken into account by removing the ExB shear flow rate from the linear growth rate, as suggested by non-linear numerical simulations of turbulence. A local transport coefficient is estimated from the knowledge of the linear growth rate and the mode width. We find that the peaked density profile in PEP regime lowers the diffusion coefficient, and that the velocity shear amplifies this effect. The evolution of the current profile is also stabilizing, but this parameter is not known with sufficient accuracy, so that its role in Tore Supra PEP experiments remains uncertain. (author)

Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

Directory of Open Access Journals (Sweden)

Rosaria M. Ruggeri

2010-01-01

Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

Biological dose estimation for accidental supra-high dose gamma-ray exposure

International Nuclear Information System (INIS)

Chen, Y.; Yan, X.K.; Du, J.; Wang, Z.D.; Zhang, X.Q.; Zeng, F.G.; Zhou, P.K.

2011-01-01

To correctly estimate the biological dose of victims accidentally exposed to a very high dose of 60 Co gamma-ray, a new dose-effect curve of chromosomal dicentrics/multicentrics and rings in the supra-high dose range was established. Peripheral blood from two healthy men was irradiated in vitro with doses of 60 Co gamma-rays ranging from 6 to 22 Gy at a dose rate of 2.0 Gy/min. Lymphocytes were concentrated, cultured and harvested at 52 h, 68 h and 72 h. The numbers of dic + r were counted. The dose-effect curves were established and validated using comparisons with doses from the Tokai-mura accident and were then applied to two victims of supra-high dose exposure accident. The results indicated that there were no significant differences in chromosome aberration frequency among the different culture times from 52 h to 72 h. The 6-22 Gy dose-effect curve was fitted to a linear quadratic model Y = -2.269 + 0.776D - 7.868 x l0 -3 D 2 . Using this mathematic model, the dose estimates were similar to data from Tokai-mura which were estimated by PCC ring. Whole body average doses of 9.7 Gy and 18.1 Gy for two victims in the Jining accident were satisfactorily given. We established and successfully applied a new dose-effect curve of chromosomal dicentrics plus ring (dic + r) after 6-22 Gy γ-irradiation from a supra-high dose 60 Co gamma-ray accident.

Recent, climate-driven river incision rate fluctuations in the Mercantour crystalline massif, southern French Alps

Science.gov (United States)

Petit, C.; Goren, L.; Rolland, Y.; Bourlès, D.; Braucher, R.; Saillard, M.; Cassol, D.

2017-06-01

We present a new geomorphological analysis of the Tinée River tributaries in the southern French Alps based on numerical inverse and forward modelling of their longitudinal profiles. We model their relative uplift history with respect to the main channel, hence the incision rate history of this channel. Inverse models show that all tributaries have consistent incision rate histories with alternating high and low values. A comparison with global temperature curves shows that these variations correlate with quaternary climate changes. We suggest that during warm periods, a wave of regressive erosion propagates in the Tinée River, while its tributaries deeply incise their substratum to catch up with the falling base-level. We also show that the post 140 ka history of this landscape evolution is dominated by fluvial incision. We then perform forward models of river incision and simulate the incision of the Tinée River system over a time span of 600 ka. This model allows us to extract time and space incision rate variations of the Tinée River. With a background of a few mm.yr-1, incision rate can increase up to more than 1 cm yr-1 during short periods of time due to climatic oscillations. This result is compatible with published cosmogenic nuclide based dating, which evidenced incision rates from 0.2 to 24 mm yr-1. The part of the channel located between 12 and 20 km downstream from the source has undergone several periods of rapid incision rates, which could explain the steep hillslopes and the triggering of a landslide ∼10 ka ago.

A novel option for reducing free light chains in myeloma kidney: supra-hemodiafiltration with endogenous reinfusion (HFR).

Science.gov (United States)

Pasquali, Sonia; Iannuzzella, Francesco; Corradini, Mattia; Mattei, Silvia; Bovino, Achiropita; Stefani, Alfredo; Palladino, Giuseppe; Caiazzo, Marialuisa

2015-04-01

In myeloma cast nephropathy, fast reduction of serum free light chain (FLC) levels correlates with renal recovery. Recently, extracorporeal treatments using filters with a high-molecular weight cut-off have been successfully used for FLC removal. However, using these new filters, high cost and elevated albumin leakage are common drawbacks. We studied a new and cheaper therapeutic approach with adsorbent resins to evaluate its efficacy. We treated four patients, affected by dialysis-dependent acute kidney injury (AKI) due to biopsy proven de novo FLC myeloma cast nephropathy. Each patient underwent bortezomib chemotherapy and extracorporeal treatment with the supra-hemodiafiltration with endogenous reinfusion (HFR) technique (Supra-HFR, Bellco Mirandola, Modena, Italy). Supra-HFR is a kind of hemodiafiltration that utilizes separated convection, diffusion and adsorption. The sorbent cartridge has a high affinity for FLC (both κ and λ) but is able to re-infuse albumin, avoiding the need for albumin perfusions. Supra HFR treatments (4 h each) were carried out for eight consecutive days and then every other day. All patients showed a significant reduction of serum FLC, whereas serum albumin concentration remained unchanged. Renal function recovered in three out of four patients. FLC removal with adsorbent resins represents an effective therapeutic strategy that does not require replacement with albumin .

Supra-Epiglottic Upper Airway Volume in Elderly Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

Science.gov (United States)

Boutet, Claire; Abdirahman Mohamed Moussa, Syad; Celle, Sébastien; Laurent, Bernard; Barthélémy, Jean-Claude; Barral, Fabrice-Guy; Roche, Frédéric

2016-01-01

Small upper airway measurements areas and high body mass index are recognized risk factors for obstructive sleep apnea syndrome (OSAS) in non-elderly populations; however, there is limited information regarding elderly patients. We evaluated whether upper airway volume is associated with OSAS and OSAS treated with continuous positive airway pressure (CPAP) treatment and whether BMI is correlated with upper airway volume and measurements in elderly subjects. In 60 volunteers aged 75.58±0.9 years: 20 OSAS, 20 OSAS chronically treated with CPAP, and 20 controls, semi-automatic segmentation, retropalatal distance and transverse diameter of the supra-epiglottic upper airway were evaluated using 3DT1-weighted magnetic resonance imaging. Anteroposterior to transverse diameter ratio was defined as retropalatar diameter/transverse diameter. There were no significant differences in supra-epiglottic upper airway volume between OSAS, CPAP treated patients, and controls. There were significant differences in retropalatal distance and anteroposterior to transverse diameter ratio between OSAS, CPAP treated patients, and controls (P = 0.008 and Psupra-epiglottic upper airway volume. In elderly subjects, OSAS and body mass index are not associated with changes in supra-epiglottic upper airway volume but are associated with modification of pharynx shape.

[External periareolar incision for subdermal mastectomy in men with gynecomastia].

Science.gov (United States)

Montiel-Jarquín, Alvaro; Reyes-Páramo, Pedro; Ramos-Alvarez, Gloria; López-Colombo, Aurelio; Tinajero-Esquivel, Magdalena; Ruiz-León, Betzabé

2007-01-01

Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision. A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision. There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure. Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.

Towards long pulse high performance discharges in Tore Supra: experimental knowledge and technological developments for heat exhaust

International Nuclear Information System (INIS)

1995-08-01

This document deals with fusion heat exhaust experiments in Tore Supra tokamak. The purpose of the Tore Supra tokamak is to achieve and control long pulse powerful discharges. High input power is required to generate the non inductive current, approximately 25 MW . The conception and realisation of a Plasma Facing Component (PFC) scheme able to deal with this large amount of power is the main issue. A description of the water loop used for power removal and of the calorimetric system to determine the overall heat exhaust balance is provided. The infra-red measurements used during plasma operation are also described, together with several heat exhaust devices. The behaviour of ion cyclotron and lower hybrid wave launchers is addressed. Eventually, some information is provided on technological developments of PFC in Tore Supra. (TEC). 61 refs., 34 figs

Mach probe interpretation in the presence of supra-thermal electrons

Czech Academy of Sciences Publication Activity Database

Fuchs, Vladimír; Gunn, J. P.

2007-01-01

Roč. 14, č. 3 (2007), 032501-1 ISSN 1070-664X R&D Projects: GA ČR GA202/04/0360 Institutional research plan: CEZ:AV0Z20430508 Keywords : Mach probes * supra -thermal electrons * quasi-neutral PIC codes Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 2.325, year: 2007

Single-center mid-term experience with chimney-graft technique for the preservation of flow to the supra-aortic branches.

Science.gov (United States)

Shahverdyan, Robert; Mylonas, Spyridon; Gawenda, Michael; Brunkwall, Jan

2018-04-01

Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate. Results A total of 30 patients (80% male, median age 70.0 years) were treated using the chimney-graft technique for the supra-aortic branches. The indication was a degenerative aneurysm in nine patients (32%) and a type B Stanford aortic dissection and a penetrating aortic ulcer in the descending aorta in seven patients (23%), respectively. In six patients (20.0%), the indication was an type Ia endoleak after previous endovascular thoracic repair, whereas a pseudoaneurysm after previous open repair of the descending aorta was the indication in one patient (3%). Twenty-three patients (77%) were treated electively, five (17%) emergently and two (7%) urgently because of free rupture. Technical success was achieved in 90% of patients. The 30-day/in-hospital mortality was 17% (5/30). A retrograde dissection was presented in five patients. Four patients experienced a cerebrovascular event. Eight patients had type Ia endoleak and 10 had type II. During the median follow-up of 16 months (range: 0-56), four further patients died: one in respiratory insufficiency, one due to a ruptured abdominal aortic aneurysm, one in meningitis and the last one for unknown reason. The chimney-graft patency was 100%. According to the Kaplan-Meier curve, the estimated survival at one year was 66 ± 9%. Conclusions The chimney-graft technique, despite a technically demanding strategy, is a useful tool as bailout procedure in our armamentarium for high-risk patients

Incisão periauricular para operações da glândula parótida Periauricular incision for surgical procedures on the parotid gland

Directory of Open Access Journals (Sweden)

Andy Petroianu

2010-12-01

Full Text Available RACIONAL: As incisões mais comuns para parotidectomia consistem em abertura pré ou periauricular prolongadas para a região submandibular ou cervical. Elas podem acompanhar-se de cicatrizes imperfeitas, provocando deformidades cutâneas locais. OBJETIVO: Avaliar o tratamento de afecções cirúrgicas parotídeas através de incisão periauricular apenas. MÉTODO: Foram estudados 39 pacientes consecutivos com moléstias da parótida. Adenoma pleomórfico (20 casos foi a afecção mais encontrada, seguida por outros tumores benignos (9 casos, carcinomas (5 casos, cisto parotídeo (3 casos e parotidite crônica (2 casos. Todas as parotidectomias foram realizadas através de incisão periauricular. Em presença de carcinoma, a linfadenectomia cervical foi conduzida por meio de incisão cervical transversa supra-hióidea homolateral. RESULTADO: A remoção da afecção parotídea foi possível em todos os casos sem incisão cutânea complementar. Todas as cicatrizes tiveram bom resultado estético e, após seis meses, elas estavam quase imperceptíveis. Os pacientes revelaram satisfação com o resultado da operação. Fraqueza facial temporária ocorreu em 28 operações. Desconforto auricular transitório foi registrado em 22 pacientes. Todos tiveram hipoestesia da região operada, que perdurou por até seis meses. As complicações encontradas neste trabalho estão descritas na literatura como esperadas em parotidectomia, independentemente do tipo de incisão. CONCLUSÃO: A incisão periauricular é opção boa e estética para abordagem cirúrgica da glândula parótida.BACKGROUND: The most common incisions for parotidectomy consist of opening or pre periauricular extended to the submandibular or cervical region. They can accompany themselves ragged scars, causing local skin deformities. AIM: The purpose of this study was to evaluate the treatment of parotid surgical diseases using periauricular incision. METHOD: Thirty nine patients with

Coupling of the nucleotide incision and 3' {yields} 5' exonuclease activities in Escherichia coli endonuclease IV: Structural and genetic evidences

Energy Technology Data Exchange (ETDEWEB)

Golan, Gali [Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Ishchenko, Alexander A. [Groupe Reparation de l' ADN, CNRS UMR 8126, Univ. Paris-Sud, Institut de Cancerologie Gustave Roussy, 39, rue Camille Desmoulins, F-94805 Villejuif Cedex (France); Khassenov, Bekbolat [National Center for Biotechnology, Astana (Kazakhstan); Shoham, Gil, E-mail: gil2@vms.huji.ac.il [Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Saparbaev, Murat K., E-mail: smurat@igr.fr [Groupe Reparation de l' ADN, CNRS UMR 8126, Univ. Paris-Sud, Institut de Cancerologie Gustave Roussy, 39, rue Camille Desmoulins, F-94805 Villejuif Cedex (France)

2010-03-01

Aerobic respiration generates reactive oxygen species (ROS) as a by-product of cellular metabolism which can damage DNA. The complex nature of oxidative DNA damage requires actions of several repair pathways. Oxidized DNA bases are substrates for two overlapping pathways: base excision repair (BER) and nucleotide incision repair (NIR). In the BER pathway a DNA glycosylase cleaves the N-glycosylic bond between the abnormal base and deoxyribose, leaving either an abasic site or single-stranded DNA break. Alternatively, in the NIR pathway, an apurinic/apyrimidinic (AP) endonuclease incises duplex DNA 5' next to oxidatively damaged nucleotide. The multifunctional Escherichia coli endonuclease IV (Nfo) is involved in both BER and NIR pathways. Nfo incises duplex DNA 5' of a damaged residue but also possesses an intrinsic 3' {yields} 5' exonuclease activity. Herein, we demonstrate that Nfo-catalyzed NIR and exonuclease activities can generate a single-strand gap at the 5' side of 5,6-dihydrouracil residue. Furthermore, we show that Nfo mutants carrying amino acid substitutions H69A and G149D are deficient in both NIR and exonuclease activities, suggesting that these two functions are genetically linked and governed by the same amino acid residues. The crystal structure of Nfo-H69A mutant reveals the loss of one of the active site zinc atoms (Zn1) and rearrangements of the catalytic site, but no gross changes in the overall enzyme conformation. We hypothesize that these minor changes strongly affect the DNA binding of Nfo. Decreased affinity may lead to a different kinking angle of the DNA helix and this in turn thwart nucleotide incision and exonuclease activities of Nfo mutants but to lesser extent of their AP endonuclease function. Based on the biochemical and genetic data we propose a model where nucleotide incision coupled to 3' {yields} 5' exonuclease activity prevents formation of lethal double-strand breaks when repairing bi

Controlled thermonuclear fusion: Tore Supra back bone of the EURATOM-CEA programme for the next ten years

International Nuclear Information System (INIS)

Anon.

1982-01-01

The decision to grant priority operation status to the French Tokamak Tore Supra will make it possible to start on the construction of this large machine and to bring together at the Cadarache Nuclear Study Centre all the facilities of the CEA for their research on fusion by magnetic confinement. The work is scheduled to begin in 1982 and to last until 1985. The financing is indicated and Tore Supra is briefly described [fr

Force modeling for incisions into various tissues with MRF haptic master

Science.gov (United States)

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

2016-03-01

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

Force modeling for incisions into various tissues with MRF haptic master

International Nuclear Information System (INIS)

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

2016-01-01

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

A Water-Soluble Cyclotriveratrylene-Based Supra-amphiphile: Synthesis, pH-Responsive Self-Assembly in Water, and Its Application in Controlled Drug Release.

Science.gov (United States)

Xia, Danyu; Li, Yang; Jie, Kecheng; Shi, Bingbing; Yao, Yong

2016-06-17

A new water-soluble cyclotriveratrylene (WCTV) was designed and synthesized, and benzyldimethyldodecylammonium chloride (G) was chosen as the guest molecule to construct a supra-amphiphile by the host-guest interaction between WCTV and G in water, which is pH responsive. The supra-amphiphiles self-assembled into vesicles in water. When the pH of the solution was below 7.0, the supra-amphiphile disassociated, and the vesicles collapsed. Then, the pH-responsive self-assembly system was utilized for controlled drug release.

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

Directory of Open Access Journals (Sweden)

Antonio Marte

2014-01-01

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

Supra-annular structure assessment for self-expanding transcatheter heart valve size selection in patients with bicuspid aortic valve.

Science.gov (United States)

Liu, Xianbao; He, Yuxin; Zhu, Qifeng; Gao, Feng; He, Wei; Yu, Lei; Zhou, Qijing; Kong, Minjian; Wang, Jian'an

2018-04-01

To explore assessment of supra-annular structure for self-expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS). Annulus-based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra-annular deformity, device selection for bicuspid AS has not been systemically studied. Twelve patients with bicuspid AS who underwent TAVR with self-expanding THVs were included in this study. To assess supra-annular structure, sequential balloon aortic valvuloplasty was performed in every 2 mm increments until waist sign occurred with less than mild regurgitation. Procedural results and 30 day follow-up outcomes were analyzed. Seven patients (58.3%) with 18 mm; three patients (25%) with sequential 18 mm, 20 mm; and only two patients (16.7%) with sequential 18 mm, 20 mm, and 22 mm balloon sizing were performed, respectively. According to the results of supra-annular assessment, a smaller device size (91.7%) was selected in all but one patient compared with annulus based sizing strategy, and the outcomes were satisfactory with 100% procedural success. No mortality and 1 minor stroke were observed at 30 d follow-up. The percentage of NYHA III/IV decreased from 83.3% (9/12) to 16.7% (2/12). No new permanent pacemaker implantation and no moderate or severe paravalvular leakage were found. A supra-annular structure based sizing strategy is feasible for TAVR in patients with bicuspid AS. © 2018 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

Significant intra-valvular pressure loss across EPIC SUPRA and perimount magna supra-annular designed aortic bioprostheses in patients with normal aortic size

Directory of Open Access Journals (Sweden)

Jagdish C. Mohan

2017-01-01

Full Text Available Doppler-derived trans-prosthetic gradients are higher and the estimated effective valve area is smaller than the catheter-derived and directly measured hemodynamic values, mostly due to pressure recovery phenomenon. Pressure recovery to a varying extent is common to all prosthetic heart valves including bioprostheses. Pressure recovery-related differences are usually small except in patients with bileaflet metallic prosthesis, wherein high-pressure local jets across central orifice have been documented since long back and also in patients with narrow aortic root. We describe two patients with normally functioning stented aortic bioprostheses with supra-annular design (EPIC SUPRA and PERIMOUNT MAGNA, wherein very high trans-prosthetic gradients and critically reduced estimated effective valve orifice areas in presence of normal aortic size were consistently recorded over long periods of follow-up. The valve leaflets, however had normal excursion, were thin, opened with a triangular or oblong shape and had expected geometric valve area (1.7 and 1.6 cm2 respectively measured by 3D trans-oesophageal echocardiographic planimetry. Pressure recovery upstream the valves accounted for 20% and 12% of total pressure gradients respectively. Dominant site for pressure drop was intra-valvular (75–85%. Such a phenomenon has not been reported in vivo for these two valve designs.

Significant intra-valvular pressure loss across EPIC SUPRA and perimount magna supra-annular designed aortic bioprostheses in patients with normal aortic size.

Science.gov (United States)

Mohan, Jagdish C; Mohan, Vishwas; Shukla, Madhu; Sethi, Arvind

Doppler-derived trans-prosthetic gradients are higher and the estimated effective valve area is smaller than the catheter-derived and directly measured hemodynamic values, mostly due to pressure recovery phenomenon. Pressure recovery to a varying extent is common to all prosthetic heart valves including bioprostheses. Pressure recovery-related differences are usually small except in patients with bileaflet metallic prosthesis, wherein high-pressure local jets across central orifice have been documented since long back and also in patients with narrow aortic root. We describe two patients with normally functioning stented aortic bioprostheses with supra-annular design (EPIC SUPRA and PERIMOUNT MAGNA), wherein very high trans-prosthetic gradients and critically reduced estimated effective valve orifice areas in presence of normal aortic size were consistently recorded over long periods of follow-up. The valve leaflets, however had normal excursion, were thin, opened with a triangular or oblong shape and had expected geometric valve area (1.7 and 1.6cm 2 respectively) measured by 3D trans-oesophageal echocardiographic planimetry. Pressure recovery upstream the valves accounted for 20% and 12% of total pressure gradients respectively. Dominant site for pressure drop was intra-valvular (75-85%). Such a phenomenon has not been reported in vivo for these two valve designs. Copyright © 2016. Published by Elsevier B.V.

Calibration procedures of the Tore-Supra infrared endoscopes

Science.gov (United States)

Desgranges, C.; Jouve, M.; Balorin, C.; Reichle, R.; Firdaouss, M.; Lipa, M.; Chantant, M.; Gardarein, J. L.; Saille, A.; Loarer, T.

2018-01-01

Five endoscopes equipped with infrared cameras working in the medium infrared range (3-5 μm) are installed on the controlled thermonuclear fusion research device Tore-Supra. These endoscopes aim at monitoring the plasma facing components surface temperature to prevent their overheating. Signals delivered by infrared cameras through endoscopes are analysed and used on the one hand through a real time feedback control loop acting on the heating systems of the plasma to decrease plasma facing components surface temperatures when necessary, on the other hand for physics studies such as determination of the incoming heat flux . To ensure these two roles a very accurate knowledge of the absolute surface temperatures is mandatory. Consequently the infrared endoscopes must be calibrated through a very careful procedure. This means determining their transmission coefficients which is a delicate operation. Methods to calibrate infrared endoscopes during the shutdown period of the Tore-Supra machine will be presented. As they do not allow determining the possible transmittances evolution during operation an in-situ method is presented. It permits the validation of the calibration performed in laboratory as well as the monitoring of their evolution during machine operation. This is possible by the use of the endoscope shutter and a dedicated plasma scenario developed to heat it. Possible improvements of this method are briefly evoked.

Final results of the supra project : Improved Simulation of Upset Recovery

NARCIS (Netherlands)

Fucke, L.; Groen, E.; Goman, M.; Abramov, N.; Wentink, M.; Nooij, S.; Zaichik, L.E.; Khrabrov, A.

2012-01-01

The objective of the European research project SUPRA (Simulation of Upset Recovery in Aviation) is to develop technologies that eventually contribute to a reduction of risk of Loss of control - in flight (LOC-I) accidents, today's major cause of fatal accidents in commercial aviation. To this end

Impaired Upper Esophageal Sphincter Reflexes in Patients with Supra-Esophageal Reflux Disease

Science.gov (United States)

Babaei, Arash; Venu, Mukund; Naini, Sohrab Rahimi; Gonzaga, Jason; Lang, Ivan; Massey, Benson; Jadcherla, Sudarshan; Shaker, Reza

2015-01-01

Background & Aims Normal responses of the upper esophageal sphincter (UES) and esophageal body to liquid reflux events prevent esophagopharyngeal reflux and its complications, but abnormal responses have not been characterized. We investigated whether patients with supra-esophageal reflux disease (SERD) have impaired UES and esophageal body responses to simulated reflux events. Methods We performed a prospective study of 25 patients with SERD (19–82 y old, 13 female) and complaints of regurgitation and supra-esophageal manifestations of reflux. We also included 10 patients with gastroesophageal reflux disease (GERD; 32–60 y old, 7 female) without troublesome regurgitation and supra-esophageal symptoms and 24 healthy asymptomatic individuals (controls; 19–49 y old, 13 female). UES and esophageal body pressure responses, along with luminal distribution of infusate during esophageal rapid and slow infusion of air or liquid, were monitored by concurrent high-resolution manometry and intraluminal impedance. Results A significantly smaller proportion of patients with SERD had UES contractile reflexes in response to slow esophageal infusion of acid than controls or patients with GERD. Only patients with SERD had abnormal UES relaxation responses to rapid distension with saline. Diminished esophageal peristaltic contractions resulted in esophageal stasis in patients with GERD or SERD. Conclusions Patients with SERD and complaints of regurgitation have impaired UES and esophageal responses to simulated liquid reflux events. These patterns could predispose them to esophagopharyngeal reflux. PMID:26188682

Profile measurements of localized fast electrons and ions in TORE SUPRA

International Nuclear Information System (INIS)

Basiuk, V.; Roubin, J.P.; Becoulet, A.; Carrasco, J.; Martin, G.; Moreau, D.; Saoutic, B.

1992-01-01

The strong toroidal and poloidal anisotropy of the heat flux to the first wall of Tore Supra during additional heating has been related to suprathermal particle losses induced by the TF ripple. In this paper we describe a new system of electric collectors designed to diagnose these localized particles and we analyse measurements performed during LHCD, ICRH and NBI heating. The interaction of fast particles created by additional heating with the TF ripple perturbation in Tore Supra has been analyzed by a direct measurement of the localized particles. The good confinement region has been identified thanks to a peak in the measured current profiles and is in agreement with theory. During LHCD and ICRH, the global losses are weak but strongly anisotropic leading to hot spots at the wall. During ICRH, an ejection of fast ions by the sawteeth towards peripheral zones where they get lost in the ripple has been seen. This is a possible scenario of α particle losses in a reactor

PERISTALTIC PUMPING NEAR POST-CORONAL MASS EJECTION SUPRA-ARCADE CURRENT SHEETS

Energy Technology Data Exchange (ETDEWEB)

Scott, Roger B.; Longcope, Dana W.; McKenzie, David E., E-mail: rscott@physics.montana.edu [Department of Physics, Montana State University, P.O. Box 173840, Bozeman, MT 59717 (United States)

2013-10-10

Temperature and density measurements near supra-arcade current sheets suggest that plasma on unreconnected field lines may experience some degree of 'pre-heating' and 'pre-densification' prior to reconnection. Models of patchy reconnection allow for heating and acceleration of plasma along reconnected field lines but do not offer a mechanism for transport of thermal energy across field lines. Here, we present a model in which a reconnected flux tube retracts, deforming the surrounding layer of unreconnected field. The deformation creates constrictions that act as peristaltic pumps, driving plasma flow along affected field lines. Under certain circumstances, these flows lead to shocks that can extend far out into the unreconnected field, altering the plasma properties in the affected region. These findings have direct implications for observations in the solar corona, particularly in regard to such phenomena as high temperatures near current sheets in eruptive solar flares and wakes seen in the form of descending regions of density depletion or supra-arcade downflows.

Management of water leaks on Tore Supra actively cooled fusion device

International Nuclear Information System (INIS)

Hatchressian, J.C.; Gargiulo, L.; Samaille, F.; Soler, B.

2005-01-01

Up to now, Tore Supra is the only fusion device fully equipped with actively cooled Plasma Facing Components (PFCs). In case of abnormal events during a plasma discharge, the PFCs could be submitted to a transient high power density (run away electrons) or to a continuous phenomena as local thermal flux induced by trapped suprathermal electrons or ions). It could lead to a degradation of the PFC integrity and in the worst case to a water leak occurrence. Such water leak has important consequence on the tokamak operation that concerns PFCs themselves, monitoring equipment located in the vacuum vessel or connected to the ports as RF antennas, diagnostics or pumping systems. Following successive water leak events (the most important water leak, that occurred in September 2002, is described in the paper), a large feedback experience has been gained on Tore supra since more than 15 years that could be useful to actively cooled next devices as W7X and ITER. (authors)

Collapsing supra-massive magnetars: FRBs, the repeating FRB121102 and GRBs

Science.gov (United States)

Gupta, Patrick Das; Saini, Nidhi

2018-02-01

Fast Radio Bursts (FRBs) last for ˜ few milli-seconds and, hence, are likely to arise from the gravitational collapse of supra-massive, spinning neutron stars after they lose the centrifugal support (Falcke & Rezzolla 2014). In this paper, we provide arguments to show that the repeating burst, FRB 121102, can also be modeled in the collapse framework provided the supra-massive object implodes either into a Kerr black hole surrounded by highly magnetized plasma or into a strange quark star. Since the estimated rates of FRBs and SN Ib/c are comparable, we put forward a common progenitor scenario for FRBs and long GRBs in which only those compact remnants entail prompt γ -emission whose kick velocities are almost aligned or anti-aligned with the stellar spin axes. In such a scenario, emission of detectable gravitational radiation and, possibly, of neutrinos are expected to occur during the SN Ib/c explosion as well as, later, at the time of magnetar implosion.

Manual small incision extracapsular cataract surgery in Australia.

Science.gov (United States)

van Zyl, Lourens; Kahawita, Shyalle; Goggin, Michael

2014-11-01

Examination of the results and describing the technique of manual small incision extracapsular cataract extraction on patients with advanced cataracts in urban Australia. A descriptive case series. Thirty-eight patients at three public hospitals, one tertiary and two secondary ophthalmic units in urban Australia. Forty eyes with dense mature cataracts with hand movement vision or worse underwent a planned manual small incision extracapsular cataract extraction instead of traditional phaco-emulsification. Postoperative visual aquity, surgically induced astigmatism and complications. Seventy-eight per cent of patients had an uncorrected visual acuity of 6/12 or better on the first postoperative day. Eighty-three per cent of patients had a distance corrected visual acuity of 6/9 or better 3 months postoperatively. One case was complicated by a posterior capsule rupture. No cases of endophthalmitis were reported. The summated vector mean of the surgically induced astigmatism was 0.089D at 93°. Manual small incision extracapsular cataract extraction is an efficacious cataract surgery technique with good visual outcome and is a safe alternative to phaco-emulsification in suitable cases in a first-world setting. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

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

Directory of Open Access Journals (Sweden)

Je Hwan Yoon

2013-01-01

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

Supra-aortic interventions for endovascular exclusion of the entire aortic arch.

Science.gov (United States)

Andrási, Terézia B; Grossmann, Marius; Zenker, Dieter; Danner, Bernhard C; Schöndube, Friedrich A

2017-07-01

Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed. From a total of 53 relevant studies including 1853 patients, only 1021 patients undergoing 35 different total aortic arch procedures were found eligible for further evaluation and included in group I, II, or III (429, 190, and 402 patients, respectively). Overall early mortality was higher in group I vs groups II and III (P = .001; 1 - β = 95.6%) but exceeded in group III (18.6%) and group II (14.0%) vs group I (8.0%; P = .044; 1 - β = 57.4%) for diseases involving zone 0. Mortality was higher in all subgroups treated for zone 0 disease compared with corresponding subgroups treated for zone I to zone III disease. The incidence of cerebral ischemic events was increased in groups I and II vs group III (7.5% and 11% vs 1.7%; P = .0001) and correlated with early mortality (R 2  = .20; P = .033). The incidence of type II endoleaks and endovascular reintervention was similar between groups and correlated with each other (R 2  = .37; P = .004). Type Ia endoleak occurred more often in groups II and III than in group I (7.1% and 12.1% vs 5.8%; P = .023) and correlated with midterm mortality (R 2  = .53; P = .005). Retrograde type A dissection was low in all groups, whereas aneurysm growth was higher in group III (2.6%, 4.2%, 10.7%; P = .002), correlating with midterm mortality (R 2  = .311; P = .009). Surgical revision slightly correlated with surgical complications (R 2  = .18; P = .044

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

Science.gov (United States)

Pérez-Flores, I

2016-07-01

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

FIRST SINGLE-PORT LAPAROSCOPIC PANCREATECTOMY IN BRAZIL

Directory of Open Access Journals (Sweden)

Marcel Autran Cesar MACHADO

2013-12-01

Full Text Available Context Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. In the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. In the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and Latin America. Methods A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results Operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons.

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

Science.gov (United States)

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

2012-10-01

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

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

Science.gov (United States)

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

2009-12-21

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

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

Science.gov (United States)

Skov, Daniel S.; Egholm, David L.

2016-04-01

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

Comparison of the effects of 23-gauge and 25-gauge microincision vitrectomy blade designs on incision architecture

Directory of Open Access Journals (Sweden)

Inoue M

2014-11-01

Full Text Available Makoto Inoue,1 Dina Joy K Abulon,2 Akito Hirakata1 1Kyorin Eye Center, School of Medicine, Kyorin University, Tokyo, Japan; 2Alcon Research, Ltd., Irvine, CA, USA Purpose: To compare the effects of different 23- and 25-gauge microincision vitrectomy trocar cannula entry systems on incision architecture.Methods: We tested one ridged microvitreoretinal (MVR, one non-ridged MVR, one pointed beveled, and one round-tipped beveled blade (n=10 per blade design per incision type. Each blade’s straight and oblique incision architecture was assessed in a silicone disc simulating the sclera. Wound leakage under pressure and endoscopic observations were conducted on sclerotomy sites of isolated porcine eyes (n=4 per blade design after simulated vitrectomy.Results: Differences in blade design created distinct incision architecture. Incisions were linear with the ridged MVR blade, flattened “M-shaped” with the non-ridged MVR blade, asymmetrical chevron-shaped with the pointed beveled blade, and curved with the round-tipped beveled blade. With the exception of oblique entry incision thickness, both MVR blade designs created thinner incisions than the beveled blades at entry and exit sites. Only the ridged MVR blade created incisions with no leakage. Vitreous incarceration was observed with all trocar cannula systems.Conclusion: Wound closure in porcine eyes was similar with all blades despite differences in incision architecture. Wound leakage occurred at low to moderate infusion pressures with most blades; no wound leakage was observed with ridged MVR blades. Keywords: entry system, incision closure, leakage, pars plana incision, sclerotomy, trocar blade 

Lower-hybrid wave coupling and impurity generation in Tore Supra

International Nuclear Information System (INIS)

Goniche, M.; Litaudon, X.; Guilhem, D.; Hutter, T.; Beaumont, B.; Froissart, P.; Rey, G.; Saoutic, B.

1995-01-01

This document deals with the high power coupling of Lower Hybrid (LH) waves in Tore Supra. The effect of the plasma shape is described, together with LH coupling in ion-cyclotron resonance experiments. It appears that plasma modifications can alter the LH coupling. Eventually, the effect of LH power on thermal load and impurity generation is presented. (TEC). 3 refs., 3 figs

On the functional integration between postural and supra-postural tasks on the basis of contextual cues and task constraint.

Science.gov (United States)

de Lima, Andrea Cristina; de Azevedo Neto, Raymundo Machado; Teixeira, Luis Augusto

2010-10-01

In order to evaluate the effects of uncertainty about direction of mechanical perturbation and supra-postural task constraint on postural control, young adults had their upright stance perturbed while holding a tray in a horizontal position. Stance was perturbed by moving forward or backward a supporting platform, contrasting situations of certainty versus uncertainty of direction of displacement. Increased constraint on postural stability was imposed by a supra-postural task of equilibrating a cylinder on the tray. Performance was assessed through EMG of anterior leg muscles, angular displacement of the main joints involved in the postural reactions and displacement of the tray. Results showed that both certainty on the direction of perturbation and increased supra-postural task constraint led to decreased angular displacement of the knee and the hip. Furthermore, combination of certainty and high supra-postural task constraint produced shorter latency of muscular activation. Such postural responses were paralleled by decreased displacement of the tray. These results suggest a functional integration between the tasks, with central set priming reactive postural responses from contextual cues and increased stability demand. Copyright © 2010 Elsevier B.V. All rights reserved.

Influence of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients

Directory of Open Access Journals (Sweden)

Zhao-Rong Zeng

2014-05-01

Full Text Available AIM: To compare the effect of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients. METHODS: The cataract patients were selected in our hospital. The patients were divided into control group(corneal limbus opposite curved scleral tunnel incision groupand observation group(above the top of cornea or temporal transparent corneal incision grouprandomly. At 1wk; 1 and 3mo after surgery, the change of corneal astigmatism and vision of the patients in two groups were compared and analyzed. RESULTS:Compared with control group, 1wk; 1 and 3mo after surgery, the average corneal astigmatism and surgically induced corneal astigmatism of the patients in observation group were decreased significantly. The visual acuity and corrected visual acuity were increased significantly. There was statistically significant(PPCONCLUSION: Center distance and small incision corneal phacoemulsification can reduce postoperative astigmatism and improve postoperative visual acuity for cataract patients. It provides guarantee for further strengthen the clinical treated effect for cataract patients.

Conceptual design of a high heat flux toroidal pumped limiter for Tore Supra

International Nuclear Information System (INIS)

Doceul, L.; Schlosser, J.; Chappuis, Ph.; Chatelier, M.; Cocat, J.P.; Deck, C.; Faisse, F.; Grosman, A.; Mitteau, R.; Tonon, G.

1994-01-01

In the frame of the Tore-Supra upgrade, where it is planned to inject up to 25 MW during a time up to 1000 s, a complete toroidal pumped limiter covered of CFC (Carbon Fiber Composite) tiles is being designed. The design is based on the important experience gained from the operation on Tore Supra of actively cooled plasma facing components and pumped limiters. This toroidal limiter covers 7.5 m 2 of the bottom part of the inner vessel and is composed of 576 elementary components. Each element is built from dispersion strengthened copper (DSCu) protected by brazed CFC flat tiles and cooled by pressurised water at 150 deg C. This limiter is designed to sustain 15 MW of convective power. (author) 7 refs.; 5 figs., 3 tabs

Components of metacognition and metacognitive properties of forecasting as determinants of supra-situational pedagogical thinking

Directory of Open Access Journals (Sweden)

Kashapov, Mergalуаs M.

2017-03-01

Full Text Available This article describes the functions of metacognition and the role of these functions in professional pedagogical thinking (PPT: the discovery of the emergence of a problemacy, the organization of cognition processes, and the management of the comprehension and resolution of the problem situation. Thinking is related to the metacognitive activity of a subject. Components and strategies of metacognition are included in the PPT process and define (by means of conscious or unconscious regulation the efficiency of discovering and solving problems in an interpersonal interaction situation that must be comprehended and transformed. One of the conditions providing for realization of the supra-situational thinking of professionals is a high level of metacognitive activity, although the level of the pronouncedness of metacognitive activity does not depend on the subject’s possessing basic professional education. We have created and tested new psychodiagnostic techniques aimed at defining the level of forecasting in problem (conflict situations and at evaluating metacognitive knowledge and activity. The sample group included about 800 people (university lecturers, school teachers, and teachers who train college students. It was proved that the metacognitive focus of forecasting stimulates the formation and development of various forecasting types: proactive, retroactive, and interactive. Forecasting is viewed as a metacognitive component of supra-situational thinking and a component of the cognitive side of communication. Situational and supra- situational types of pedagogical thinking are shown to have different properties and different orientations toward forecasting activity; these properties and orientations determine the differentiation and hierarchization of these types of thinking. It was discovered that the metacognitive properties of supra-situational thinking are achieved through a high degree of integration of all basic forecasting qualities

What can we learn from fluvial incision in high mountains?

Science.gov (United States)

Fuchs, Margret; Gloaguen, Richard; Krbetschek, Matthias

2013-04-01

High and actively deforming mountain ranges attract the attention of geoscientists as they provide natural laboratories of fast evolving process-response systems. Tectonic compressional settings, often linked to perpendicular extension, control the topographic growth and hence, erosion, transport pathways and sedimentation. High altitude differences within short horizontal distances promote material re-organisation and high rates of surface processes. Furthermore, high mountains constitute orographic barriers that affect atmospheric circulations as well as host different climate regimes similar to those of widely separated latitudinal belts. Both cause a high sensitivity of surface processes to changes in climatic conditions. However, feedbacks between climatic and tectonic forcing are complex. Additionally, the dominance of one or the other varies in space and also over time, inheriting various traces of the paleo-morphodynamic conditions to the subsequent process regimes. To unravel the forces driving the evolution of relief in active mountains, numerous studies employ the drainage network of the corresponding mountains as a proxy of landscape evolution. Especially the rates of river incision provide a powerful tool to characterize the surface response and infer causes behind it. Several parameters of river incision are available to describe the fluvial incision at individual sites (e.g. terrace incision rates), along the river course (e.g. longitudinal river profiles, Hack index) and in its perpendicular dimension (e.g. valley cross sections, valley shape ratios). But they require careful interpretation. They are sensitive to both, climatic and tectonic forcing. Therefore, the synopsis of such indices for fluvial incision is essential to evaluate the role of climatic versus tectonic forcing. Here, we use the Panj river system, the major river draining the Pamir mountains of Central Asia, as an example. The Panj experiences high altitude changes of more than 4000

Experience gained from high heat flux actively cooled PFCs in Tore Supra

International Nuclear Information System (INIS)

Grosman, A.; Bayetti, P.; Brosset, C.; Bucalossi, J.; Cordier, J.J.; Durocher, A.; Escourbiac, F.; Ghendrih, Ph.; Guilhem, D.; Gunn, J.; Loarer, T.; Lipa, M.; Mitteau, R.; Pegourie, B.; Reichle, R.; Schlosser, J.; Tsitrone, E.; Vallet, J.C.

2005-01-01

The implementation of actively cooled high heat flux plasma facing components (PFCs) is one of the major ingredients required for operating the Tore Supra tokamak with very long pulses. A pioneering activity has been developed in this field from the very beginning of the device operation that is today culminating with the routine operation of an actively cooled toroidal pumped limiter (TPL) capable to sustain up to 10 MW/m 2 of nominal convected heat flux. Technical information is drawn from the whole development up to the industrialisation and focuses on a number of critical issues, such as bonding technology analysis, manufacture processes, repair processes, destructive and non-destructive testing. The actual experience in Tore Supra allows to address the question of D retention on carbon walls. Redeposition on surfaces without plasma flux is suspected to cause the final 'burial' of about half of the injected gas during long discharges

Poloidal asymmetries of flows in the Tore Supra tokamak

Science.gov (United States)

Vermare, L.; Hennequin, P.; Gürcan, Ö. D.; Garbet, X.; Honoré, C.; Clairet, F.; Giacalone, J. C.; Morel, P.; Storelli, A.; Tore Supra Team

2018-02-01

Simultaneous measurements of binormal velocity of density fluctuations using two separate Doppler backscattering systems at the low field side and at the top of the plasma show significant poloidal asymmetry. The measurements are performed in the core region between the radii 0.7 Supra tokamak. A possible generation mechanism by the ballooned structure of the underlying turbulence, in the form of convective cells, is proposed for explaining the observation of these poloidally asymmetric mean flows.

A Precise 6 Ma Start Date for Fluvial Incision of the Northeastern Colorado Plateau Canyonlands

Science.gov (United States)

Thomson, S. N.; Soreghan, G. S.; Reiners, P. W.; Peyton, S. L.; Murray, K. E.

2015-12-01

Outstanding questions regarding late Cenozoic Colorado Plateau landscape evolution include: (1) the relative roles of isostatic rebound as result Colorado River incision versus longer-term geodynamic processes in driving overall rock uplift of the plateau; and (2) whether incision was triggered by river integration or by a change in deep-seated mantle lithosphere dynamics. A key to answering these questions is to date more precisely the onset of incision to refine previous estimates of between 6 and 10 Ma. We present new low-temperature thermochronologic results from bedrock and deep borehole samples in the northeastern Colorado Plateau to show that rapid river incision began here at 6 Ma (5.93±0.66 Ma) with incision rates increasing from 15-50 m/Myr to 160-200 m/Myr. The onset time is constrained independently by both inverse time-temperature modeling and by the break-in-slope in fission track age-elevation relationships. This new time constraint has several important implications. First, the coincidence in time with 5.97-5.3 Ma integration of the lower Colorado River through the Grand Canyon to the Gulf of California strongly favors downstream river integration triggering carving of the canyonlands of the upper Colorado River system. Second, it implies integration of the entire Colorado River system in less than 2 million years. Third, rock uplift of the plateau driven by the flexural isostatic response to river incision is restricted to just the last 6 Ma, as is associated increased sediment budget. Fourth, incision starting at 6 Ma means that previous estimates of upper Colorado River incision rates based on 10-12 Ma basalt datum levels are too low. This also changes the dependency of measured time interval on incision rate from a non-steady-state negative power-law dependence (exponent of -0.24) to a near steady-state dependence (exponent of 0.07) meaning that long-term upper Colorado river incision rates can provide a reliable proxy for rock uplift rates.

Kualitas Pengeringan Kayu Mahoni pada Berbagai Variasi Kerapatan Incising dengan Dua Skedul Pengeringan Suhu tinggi

Directory of Open Access Journals (Sweden)

Tomy Listyanto

2016-11-01

Full Text Available Tujuan dari penelitian ini adalah untuk mengetahui pengaruh interaksi variasi kerapatan incising dan dua skedul pengeringan terhadap kecepatan dan cacat-cacat pengeringan kayu mahoni, serta mengetahui pengaruh variasi kerapatan incising terhadap kekuatan lengkung statik kayu mahoni yang telah dikeringkan. Tiga pohon mahoni (Swietenia mahagony berdiameter 300-350 mm ditebang dan selanjutnya dibelah dan dibuat menjadi balok dengan ukuran 60 mm × 100 mm dengan panjang 500 mm untuk dijadikan sampel pengeringan. Di antara masing-masing bagian tersebut, dibuat sampel ukuran 20 mm × 20 mm × 25 mm, yang digunakan untuk penentu kadar air awal dan distribusinya. Sampel pengeringan selanjutnya dibagi menjadi 5 variasi kerapatan incising, yaitu 0 lubang/m2 (tanpa incising, 1000 lubang/m2, 2000 lubang/m2, 3000 lubang/m2, dan 4000 lubang/m2. Setiap variasi kerapatan incising selanjutnya akan dikeringkan dengan 2 skedul pengeringan, yaitu suhu pengeringan 100°C sampai tercapai kadar air akhir 12% dan suhu 60°C pada 8 jam pertama dan selanjutnya dilanjutkan 100°C, sampai tercapai kadar air akhir 12%. Paramater yang diamati adalah kecepatan pengeringan, cacat retak permukaan, dan distribusi kadar air akhir. Hasil analisis menunjukkan bahwa kerapatan incising 3000-4000 lubang/m2 memberikan pengaruh yang cukup nyata di dalam mempercepat proses pengeringan dan distribusi kadar air akhir. Skedul pengeringan dan variasi kerapatan incising tidak berpengaruh pada retak permukaan. Pra perlakuan incising sampai batas 4000 lubang/m2 ini dapat diterapkan untuk mempercepat proses pengeringan dengan penurunan nilai modulus elastisitas dan modulus patah yang tidak berbeda nyata. Kata kunci: incising, pengeringan suhu tinggi, mahoni, lengkung statik, skedul pengeringan   Drying Quality of Mahoni Wood in Various Incising Densities and Two High Temperature-Drying Schedules Abstract The aims of this research were to investigate the effects of interaction

Pain thresholds, supra-threshold pain and lidocaine sensitivity in patients with erythromelalgia, including the I848Tmutation in NaV 1.7.

Science.gov (United States)

Helås, T; Sagafos, D; Kleggetveit, I P; Quiding, H; Jönsson, B; Segerdahl, M; Zhang, Z; Salter, H; Schmelz, M; Jørum, E

2017-09-01

Nociceptive thresholds and supra-threshold pain ratings as well as their reduction upon local injection with lidocaine were compared between healthy subjects and patients with erythromelalgia (EM). Lidocaine (0.25, 0.50, 1.0 or 10 mg/mL) or placebo (saline) was injected intradermally in non-painful areas of the lower arm, in a randomized, double-blind manner, to test the effect on dynamic and static mechanical sensitivity, mechanical pain sensitivity, thermal thresholds and supra-threshold heat pain sensitivity. Heat pain thresholds and pain ratings to supra-threshold heat stimulation did not differ between EM-patients (n = 27) and controls (n = 25), neither did the dose-response curves for lidocaine. Only the subgroup of EM-patients with mutations in sodium channel subunits Na V 1.7, 1.8 or 1.9 (n = 8) had increased lidocaine sensitivity for supra-threshold heat stimuli, contrasting lower sensitivity to strong mechanical stimuli. This pattern was particularly clear in the two patients carrying the Na V 1.7 I848T mutations in whom lidocaine's hyperalgesic effect on mechanical pain sensitivity contrasted more effective heat analgesia. Heat pain thresholds are not sensitized in EM patients, even in those with gain-of-function mutations in Na V 1.7. Differential lidocaine sensitivity was overt only for noxious stimuli in the supra-threshold range suggesting that sensitized supra-threshold encoding is important for the clinical pain phenotype in EM in addition to lower activation threshold. Intracutaneous lidocaine dose-dependently blocked nociceptive sensations, but we did not identify EM patients with particular high lidocaine sensitivity that could have provided valuable therapeutic guidance. Acute pain thresholds and supra-threshold heat pain in controls and patients with erythromelalgia do not differ and have the same lidocaine sensitivity. Acute heat pain thresholds even in EM patients with the Na V 1.7 I848T mutation are normal and only nociceptor

Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

International Nuclear Information System (INIS)

Major, N.M.; Helms, C.A.

1996-01-01

Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab

Role of symptomatic treatment in comparison to antibiotics in uncomplicated urinary tract infections

International Nuclear Information System (INIS)

Jamil, M.N.; Khan, R.M.; Sultan, B.; Farooq, U.

2017-01-01

Uncomplicated urinary tract infections (UTIs) are the most common bacterial infections among women presenting to primary care causing rapidly increasing strains of resistant bacteria to the growing antibiotic industry. Restricting antibiotics to necessary indications is the only solution. The objectives of the study were to compare the efficacy of symptomatic treatment vs antibiotic in patients with uncomplicated UTI, in terms of individual symptom score, i.e., frequency, urgency, dysuria, supra pubic pain scores and total symptoms scores. Methods: A randomized control trial (RCT) in 100 women (15-50 years) with symptoms of urinary frequency, urgency, dysuria and pain supra pubic region, associated with uncomplicated UTI, at Urology department, AMI, Abbottabad. Two treatment strategies were compared in uncomplicated UTI patient). Patients were randomized to antibiotic or symptomatic treatment groups on consecutive non-probability basis (50 in each group) given for 05 days. Efficacy of medications was assessed by comparing pre and post treatment symptom scores along with the post treatment scores of both groups compared to see statistical significance of difference by independent samples t-test. Results: There was a statistically significant difference in symptoms improvement in both treatment arms of all scores, i.e., p-value=0.000. Whereas only dysuria score was able to show a statistically significance of difference in post Rx scores comparison of both groups, p-value=0.004. Conclusions: Symptomatic treatment is not inferior to antibiotic treatment when proper patient selection is undertaken, resulting in decreased need for unnecessary antibiotics use. (author)

Usefulness of T-Shaped Gauze for Precise Dissection of Supra-Pancreatic Lymph Nodes and for Reduced Postoperative Pancreatic Fistula in Patients Undergoing Laparoscopic Gastrectomy for Gastric Cancer.

Science.gov (United States)

Matsunaga, Tomoyuki; Saito, Hiroaki; Murakami, Yuki; Kuroda, Hirohiko; Fukumoto, Yoji; Osaki, Tomohiro

2016-09-01

Supra-pancreatic lymph node dissection is important in patients undergoing laparoscopic gastrectomy (LG) for gastric cancer. A clear view of the supra-pancreatic area is necessary for precise dissection of supra-pancreatic lymph nodes without injury to the pancreas. This retrospective study assessed the efficacy of T-shaped gauze (TSG) in retracting the pancreas during supra-pancreatic lymph node dissection. The study cohort consisted of 80 patients who underwent LG for gastric cancer. Of these, 44 patients underwent pancreatic retraction with TSG (TSG group) and 36 without TSG (non-TSG group). The efficacy of TSG for pancreatic retraction was evaluated by comparing all grade and Clavien-Dindo grade ≥ III postoperative pancreatic fistula (POPF) and the total number of dissected supra-pancreatic lymph nodes in the TSG and non-TSG groups. The rates of all grade (6.8% vs. 11%) and of Clavien-Dindo grade ≥ III (2.2% vs. 5.5%) POPF were lower in the TSG than in the non-TSG group. The total number of supra-pancreatic lymph nodes harvested by Dissection 1+ (D1+) lymph node dissection was significantly higher in TSG than in non-TSG patients ( P = 0.0078). TSG may be useful for safe and efficient performance of supra-pancreatic lymph node dissection.

Net erosion measurements on plasma facing components of Tore Supra

International Nuclear Information System (INIS)

Tsitrone, E.; Chappuis, P.; Corre, Y.; Gauthier, E.; Grosman, A.; Pascal, J.Y.

2001-01-01

Erosion of the plasma facing components is a crucial point of investigation in long pulse operation of future fusion devices. Therefore erosion measurements have been undertaken in the Tore Supra tokamak. After each experimental campaign, different plasma facing components have been monitored in situ by non-destructive means, in order to evaluate their net erosion following a long plasma exposure. This paper presents the results obtained over three experimental campaigns on the Tore Supra ergodic divertor B 4 C-coated neutralisers and CFC Langmuir probes. The erosion on the Langmuir probes after one year of plasma exposure can reach 100 μm, leading to an effective erosion coefficient of around 5x10 -3 to 10 -2 , in reasonable agreement with values found on other tokamaks. The erosion of the ergodic divertor neutraliser plates is lower (10 μm). This is coherent with the attenuated particle flux due to a lower incidence angle, and might also be due to some surface temperature effect, since the neutralisers are actively cooled while the Langmuir probes are not. Moreover, the profile along the neutraliser shows net erosion in zones wetted by the plasma and net redeposition in shadowed zones

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

Directory of Open Access Journals (Sweden)

Parvu Valentin

2009-12-01

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

Simulation of channel sandstone architecture in an incised valley

Energy Technology Data Exchange (ETDEWEB)

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

1998-12-31

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

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

Uptake of gallium-67 citrate in clean surgical incisions after colorectal surgery

International Nuclear Information System (INIS)

Lin Wanyu; Wang Shyhjen; Tsai Shihchuan; Chao Tehsin

2001-01-01

Non-specific accumulation of gallium-67 citrate (gallium) in uncomplicated surgical incisions is not uncommon. It is important to know the normal pattern of gallium uptake at surgical incision sites in order to properly interpret the gallium scan when investigating possible wound infection in patients who have undergone abdominal surgery. We studied 42 patients without wound infection after colorectal surgery and performed gallium scans within 40 days after surgery. Patients were divided into three groups according to the interval between the operation and the scan. In group A (26 patients) gallium scan was performed within 7 days after surgery, in group B (8 patients) between 8 and 14 days after surgery, and in group C (8 patients) between 15 and 40 days after surgery. Our data showed that in group A, 61.5% had gallium accumulation at the surgical incision site. In group B, 50% had accumulation of gallium at the surgical incision site, while in group C only one patient (12.5%) showed gallium uptake. It is concluded that the incidence of increased gallium uptake at clean surgical incision sites is high after colorectal surgery. Nuclear medicine physicians should bear in mind the high incidence of non-specific gallium uptake at such sites during the interpretation of possible wound infection in patients after colorectal surgery. (orig.)

Eddy current calculations for the tore supra tokamak

International Nuclear Information System (INIS)

Blum, J.; Dupas, L.; Leloup, C.; Thooris, B.

1983-01-01

This paper deals with the calculation of the eddy currents in the structures of a Tokamak, which can be assimilated to thin conductors, so that the three-dimensional problem can be reduced mathematically to a two-dimensional one, the variables being two orthogonal coordinates of the considered surface. A variational formulation of the problem in terms of the electric vector potential is then given and a finite element method has been used, which enables to treat the complicated geometry of the toroidal field magnet, the mechanical structures and the vacuum vessels of Tore Supra

Operation of an ITER relevant inspection robot on Tore Supra tokamak

Energy Technology Data Exchange (ETDEWEB)

Gargiulo, Laurent [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France)], E-mail: laurent.gargiulo@cea.fr; Bayetti, Pascal; Bruno, Vincent; Hatchressian, Jean-Claude; Hernandez, Caroline; Houry, Michael [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France); Keller, Delphine [CEA, LIST, Service de Robotique Interactive, F-92265 Fontenay aux Roses (France); Martins, Jean-Pierre [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France); Measson, Yvan; Perrot, Yann [CEA, LIST, Service de Robotique Interactive, F-92265 Fontenay aux Roses (France); Samaille, Frank [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France)

2009-06-15

Robotic operations are one of the major maintenance challenges for ITER and future fusion reactors. CEA has developed a multipurpose carrier able to realize deployments in the plasma vessel without breaking the Ultra High Vacuum (UHV) and temperature conditioning. A 6 years R and D programme was jointly conducted by CEA-LIST Interactive Robotics Unit and the Institute for Magnetic Fusion Research (IRFM) in order to demonstrate the feasibility and reliability of an in-vessel inspection robot relevant to ITER requirements. The Articulated Inspection Arm robot (AIA) is an 8-m long multilink carrier with a payload up to 10 kg operable between plasma under tokamak conditioning environment; its geometry allows a complete close inspection of Plasma Facing Components (PFCs) of the Tore Supra vessel. Different tools are being developed by CEA to be plugged at the front head of the carrier. The diagnostic presently in operation consists in a viewing system offering accurate visual inspection of PFCs. Leak detection of first wall based on helium sniffing and laser compact system for carbon co-deposited layers characterizations or treatments are also considered for demonstration. In April 2008, the AIA robot equipped with its vision diagnostic has realized a complete deployment into Tore Supra and the first closed inspection of the vessel under UHV conditions. During the upcoming experimental campaign, the same operation will be performed under relevant conditions (10{sup -6} Pa and 120 deg. C) after a conditioning phase at 200 deg. C to avoid outgassing pollution of the chamber. This paper describes the different steps of the project development, robot capabilities with the present operations conducted on Tore Supra and future requirements for making the robot a tool for tokamak routine operation.

Integration of advanced feedback control techniques on Tore Supra

International Nuclear Information System (INIS)

Barana, O.; Basiuk, V.; Bucalossi, J.

2006-01-01

Tore Supra tokamak plays an important role in development and optimisation of steady-state scenarios. Its real-time feedback control system is a key instrument to improve plasma performances. For this reason, new feedback control schemes have been recently put into operation and others are being developed. This work deals with the implementation in Tore Supra of these advanced algorithms, reports the technical details and shows the first positive results that have been achieved. For instance, encouraging results have been obtained in the field of profiles control. Controls of the full width at half maximum of the suprathermal electrons local emission profile at very low loop voltage and of the maximum of the thermal Larmor radius, normalised to the characteristic length of the electron temperature gradient, have been attained. While the first quantity can be directly associated to the current profile, the second one characterises the pressure profile. A new feedback control algorithm, employed to maximise a given quantity by means of a '' Search Optimisation '' technique, has been effectively tested too: the hard X-ray width has been maximised with simultaneous use of lower hybrid heating power and wave parallel index as actuators. These and other promising results, whose detailed description will be given in the article, have been obtained thanks to the real-time availability of several diagnostic systems. Using a shared memory network as communication layer, they send their measurements to a central computing unit that, in its turn, dispatches the necessary requirements to the actuators. A key issue is the possibility to integrate these controls in such a way as to cope with different requests at the same time. As an example, simultaneous control of the plasma current by means of the lower hybrid heating power, of the loop voltage by means of the poloidal field system and of the hard X-ray width through the lower hybrid heating phase shift has been successfully

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

Science.gov (United States)

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

2014-01-01

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

Edge density profile measurements by X-mode reflectometry on Tore Supra

International Nuclear Information System (INIS)

Clairet, F.; Bottereau, C.; Chareau, J.M.; Paume, M.; Sabot, R.

2000-10-01

A broadband reflectometer operating in the frequency range 50-75 GHz has been developed on Tore Supra to measure electron density profiles at the edge. The system uses extraordinary mode polarization and performs routine measurements in 20 μs with a heterodyne detection to ensure a high dynamic range sensitivity. It allows separate phase and amplitude information of the signal. The density profiles are fully automatically calculated from the raw phase. The initialization is done with an automatic detection of the first cut-off from the amplitude of the reflected signal with accuracy up to ±0.5 cm. The profiles are now part of the public database of Tore Supra (TS) and can provide details of density structures better than the centimeter range. High reliability of the measurements for various plasma conditions make this diagnostic an ideal tool to study specific edge plasma physics with given examples on detached plasma behaviour and RF antenna-plasma coupling processes. It also is shown how the presence of suprathermal electrons may perturb the measurements. (authors)

INFERRING THE MAGNETOHYDRODYNAMIC STRUCTURE OF SOLAR FLARE SUPRA-ARCADE PLASMAS FROM A DATA-ASSIMILATED FIELD TRANSPORT MODEL

Energy Technology Data Exchange (ETDEWEB)

Scott, Roger B.; McKenzie, David E.; Longcope, Dana W. [Montana State University, P.O. Box 173840, Bozeman, MT 59717-3840 (United States)

2016-03-01

Supra-arcade fans are highly dynamic structures that form in the region above post-reconnection flare arcades. In these features the plasma density and temperature evolve on the scale of a few seconds, despite the much slower dynamics of the underlying arcade. Further, the motion of supra-arcade plasma plumes appears to be inconsistent with the low-beta conditions that are often assumed to exist in the solar corona. In order to understand the nature of these highly debated structures, it is, therefore, important to investigate the interplay of the magnetic field with the plasma. Here we present a technique for inferring the underlying magnetohydrodynamic processes that might lead to the types of motions seen in supra-arcade structures. Taking as a case study the 2011 October 22 event, we begin with extreme-ultraviolet observations and develop a time-dependent velocity field that is consistent with both continuity and local correlation tracking. We then assimilate this velocity field into a simplified magnetohydrodynamic simulation, which deals simultaneously with regions of high and low signal-to-noise ratio, thereby allowing the magnetic field to evolve self-consistently with the fluid. Ultimately, we extract the missing contributions from the momentum equation in order to estimate the relative strength of the various forcing terms. In this way we are able to make estimates of the plasma beta, as well as predict the spectral character and total power of Alfvén waves radiated from the supra-arcade region.

Using Supra-Arcade Downflows as Probes of Particle Acceleration in Solar Flares

Science.gov (United States)

Savage, Sabrina

2012-01-01

Extracting information from coronal features above flares has become more reliable with the availability of increasingly higher spatial- and temporal-resolution data in recent decades. We are now able to sufficiently probe the region high above long-duration flaring active regions where reconnection is expected to be continually occurring. Flows in the supra-arcade region, first observed with Yohkoh/SXT, have been theorized to be associated with newly-reconnected outflowing loops. High resolution data appears to confirm these assertions. Assuming that these flows are indeed reconnection outflows, then the detection of those directed toward the solar surface (i.e. downflowing) should be associated with particle acceleration between the current sheet and the loop footpoints rooted in the chromosphere. RHESSI observations of highly energetic particles with respect to downflow detections could potentially constrain electron acceleration models. We provide measurements of these supra-arcade downflows (SADs) in relation to reconnection model parameters and present preliminary findings comparing the downflow timings with high-energy RHESSI lightcurves.

Using Supra-Arcade Downflows as Probes of Electron Acceleration During Solar Flares

Science.gov (United States)

Savage, Sabrina L.

2011-01-01

Extracting information from coronal features above flares has become more reliable with the availability of increasingly higher spatial and temporal-resolution data in recent decades. We are now able to sufficiently probe the region high above long-duration flaring active regions where reconnection is expected to be continually occurring. Flows in the supra-arcade region, first observed with Yohkoh/SXT, have been theorized to be associated with newly-reconnected outflowing loops. High resolution data appears to confirm these assertions. Assuming that these flows are indeed reconnection outflows, then the detection of those directed toward the solar surface (i.e. downflowing) should be associated with particle acceleration between the current sheet and the loop footpoints rooted in the chromosphere. RHESSI observations of highly energetic particles with respect to downflow detections could potentially constrain electron acceleration models. I will discuss measurements of these supra-arcade downflows (SADs) in relation to reconnection model parameters and present preliminary findings comparing the downflow timings with high-energy RHESSI lightcurves.

Efficiency of soft tissue incision with a novel 445-nm semiconductor laser.

Science.gov (United States)

Braun, Andreas; Kettner, Moritz; Berthold, Michael; Wenzler, Johannes-Simon; Heymann, Paul Günther Baptist; Frankenberger, Roland

2018-01-01

Using a 445-nm semiconductor laser for tissue incision, an effective cut is expected due to the special absorption properties of blue laser light in soft tissues. The aim of the present study was the histological evaluation of tissue samples after incision with a 445-nm diode laser. Forty soft tissue specimens were obtained from pork oral mucosa and mounted on a motorized linear translation stage. The handpiece of a high-frequency surgery device, a 970-nm semiconductor laser, and a 445-nm semiconductor laser were connected to the slide, allowing a constant linear movement (2 mm/s) and the same distance of the working tip to the soft tissue's surface. Four incisions were made each: (I) 970-nm laser with conditioned fiber tip, contact mode at 3-W cw; (II-III): 445-nm laser with non-conditioned fiber tip, contact mode at 2-W cw, and non-contact mode (1 mm) at 2 W; and (IV): high-frequency surgery device with straight working tip, 90° angulation, contact mode at 50 W. Histological analysis was performed after H&E staining of the embedded specimens at 35-fold magnification. The comparison of the incision depths showed a significant difference depending on the laser wavelength and the selected laser parameters. The highest incision depth was achieved with the 445-nm laser contact mode (median depth 0.61 mm, min 0.26, max 1.17, interquartile range 0.58) (p laser, a higher cutting efficiency can be expected when compared with a 970-nm diode laser and high-frequency surgery. Even the 445-nm laser application in non-contact mode shows clinically acceptable incision depths without signs of extensive soft tissue denaturation.

Clinical role of a modified seton technique for the treatment of trans-sphincteric and supra-sphincteric anal fistulas.

Science.gov (United States)

Tokunaga, Yukihiko; Sasaki, Hirokazu; Saito, Tohru

2013-03-01

We have devised a modified seton technique that resects the external fistula tract while preserving the anal sphincter muscle. This study assessed the technique when used for the management of complex anal fistulas. Between January 2006 and December 2007, 239 patients (208 males and 31 females, median age: 41 years) underwent surgery for complex anal fistulas using the technique. Of the 239 patients, 198 patients had trans-sphincteric fistula and 41 patients had supra-sphincteric fistula. The durations of the surgeries were 17 min (47, 13) [median (range, interquartile range)] for trans-sphincteric fistulas and 38 (44, 16) for supra-sphincteric fistulas. The durations of the surgeries were significantly (P trans-sphincteric fistula. The hospital stays were 4 (13, 2) days and 5 (14, 3) days, respectively, for trans- and supra-sphincteric fistulas. The durations of seton placement until the spontaneous dropping of the seton were 42 (121, 48) and 141 (171, 55) days respectively. The recurrence rate was 0 % in patients with trans-sphincteric fistulas and 4.9 % (2 of 41) in patients with supra-sphincteric fistulas (P < 0.01). Serious incontinence was not observed. The technique provided favorable results for the treatment of complex anal fistulas and could be safely applied while preserving the sphincter function and conserving fecal continence.

Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.

Science.gov (United States)

Reitz, Sarah; Kluetsch, Rosemarie; Niedtfeld, Inga; Knorz, Teresa; Lis, Stefanie; Paret, Christian; Kirsch, Peter; Meyer-Lindenberg, Andreas; Treede, Rolf-Detlef; Baumgärtner, Ulf; Bohus, Martin; Schmahl, Christian

2015-08-01

Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress. Investigation of neurobiological mechanisms of NSSI in borderline personality disorder. In total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed. We found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group. Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension. © The Royal College of Psychiatrists 2015.

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

Science.gov (United States)

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

2014-12-22

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

Radio frequency additional heating systems issues for the TORE-SUPRA WEST project

NARCIS (Netherlands)

Guilhem, D.; Argouarch, A.; Bernard, J.M.; Bouquey, F.; Colas, L.; Delpech, L.; Durodié, F.; Ekedahl, A.; Helvoirt, J.; Hillairet, J.; Joffrin, E.; Litaudon, X.; Magne, R.; Milanesio, D.; Moerel, J.; Mollard, P.; Wittebol, E.; Achard, J.; Armitano, A.; Berger-By, G.; Charabot, N.; Goniche, M.; Jacquot, J.; Lombard, G.; Prou, M.; Traisnel-Corbel, E.; Volpe, R.; Vulliez, K.

2013-01-01

This year TORE-SUPRA celebrated its 25 years of operation. During this long time a number of technologies have been developed [1]. First of all it was mandatory to develop reliable superconducting magnets at ∼ - 4 K, with superfluid helium as efficient coolant. For the production of steady state

Ultrasonographic evaluation of the healing of ventral midline abdominal incisions in the horse.

Science.gov (United States)

Wilson, D A; Badertscher, R R; Boero, M J; Baker, G J; Foreman, J H

1989-06-01

Ultrasonography was used to evaluate the ventral midline incisions of 21 ponies following exploratory laparotomy. The incisions were evaluated before surgery and at weekly intervals from one to seven weeks after surgery. Both 5.0 and 7.5 MHz linear array and 7.5 MHz sector transducers were used for the evaluations. The incisional complications observed were drainage, oedema, suture sinus formation, suture abscess, superficial dehiscence and incisional hernia. Ultrasonographic imaging of the ventral midline incision was an easy, reliable and objective method for detecting and monitoring the progression of incisional complications in a non-invasive manner.

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

International Nuclear Information System (INIS)

De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz; De Oliveira Santos, Christiano

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-09-15

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

Supra-dendron Gelator Based on Azobenzene-Cyclodextrin Host-Guest Interactions: Photoswitched Optical and Chiroptical Reversibility.

Science.gov (United States)

Xie, Fan; Ouyang, Guanghui; Qin, Long; Liu, Minghua

2016-12-12

A novel amphiphilic dendron (AZOC 8 GAc) with three l-glutamic acid units and an azobenzene moiety covalently linked by an alkyl spacer has been designed. The compound formed hydrogels with water at very low concentration and self-assembled into chiral-twist structures. The gel showed a reversible macroscopic volume phase transition in response to pH variations and photo-irradiation. During the photo-triggered changes, although the gel showed complete reversibility in its optical absorptions, only an incomplete chiroptical property change was achieved. On the other hand, the dendron could form a 1:1 inclusion complex through a host-guest interaction with α-cyclodextrin (α-CD), designated as supra-dendron gelator AZOC 8 GAc/α-CD. The supra-dendron showed similar gelation behavior to that of AZOC 8 GAc, but with enhanced photoisomerization-transition efficiency and chiroptical switching capacity, which was completely reversible in terms of both optical and chiroptical performances. The self-assembly of the supra-dendron is a hierarchical or multi-supramolecular self-assembling process. This work has clearly illustrated that the hierarchical and multi-supramolecular self-assembling system endows the supramolecular nanostructures or materials with superior reversible optical and chiroptical switching. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Chimney Technique in Supra-Aortic Branch Reconstruction in China: A Systematic and Critical Review of Chinese Published Experience.

Science.gov (United States)

Zhao, Yang; Shi, Yawei; Wang, Mian; Cui, Jin; Chen, Yitian; Zheng, Liang; Yin, Henghui; Chang, Guangqi

2017-08-01

The chimney graft (CG) technique has been proposed as a complete endovascular supra-aortic branch reconstruction for aortic pathologies. Due to the rapid growth of thoracic endovascular aortic repair (TEVAR) in China, we aimed to investigate the current data of the CG technique in this most populous country. Studies of supra-aortic branch reconstruction using the CG technique from Chinese centers were collected and analyzed. A total of 294 patients from Chinese centers who underwent TEVAR with CGs were included. There were 301 CGs performed, with a technical successful rate of 97.7%. The rate of early type I endoleaks was 7.1%, and the patency rate of the CGs was desirable. Balloon-expandable bare CGs were significantly associated with good early outcomes and a low rate of endoleaks. Current data from China revealed positive outcomes using CGs for supra-aortic branch reconstruction. Balloon-expandable bare CGs may be the first choice according to the data available but should be considered with caution.

First plasma experiments in Tore Supra with a new generation of high heat flux limiters for RF antennas

International Nuclear Information System (INIS)

Agarici, G.; Beaumont, B.; Bibet, Ph.; Bremond, S.; Bucalossi, J.; Colas, L.; Durocher, A.; Gargiulo, L.; Ladurelle, L.; Lombard, G.; Martin, G.; Mollard, P.

2000-01-01

During the 1997 and 1998 Tore Supra shutdown, a first set of new antenna guard limiters was installed on one of the three ion cyclotron resonance heating (ICRH) antennas of Tore Supra. This limiter, which was one of the main technological studies of the 1998 campaign, was widely experimented in real plasma conditions, thus allowing the validation in situ, for the first time, of the technology of active metal casting (AMC) for plasma facing components. The huge improvement in the thermal response of the new limiter generation, compared to the old one, is shown on plasma pulses made identical in terms of antenna position and injected RF power profile. By using the infrared cameras installed inside Tore Supra and viewing the antennas front, the power density fluxes received by the carbon fibre composite (CFC) surface of the limiter were evaluated by correlation with the heat load tests made on the electrons beam facility of CEA/Framatome

Deuterium Inventory in Tore Supra (DITS): 2nd post-mortem analysis campaign and fuel retention in the gaps

International Nuclear Information System (INIS)

Dittmar, T.; Tsitrone, E.; Pegourie, B.; Cadez, I.; Pelicon, P.; Gauthier, E.; Languille, P.; Likonen, J.; Litnovsky, A.; Markelj, S.; Martin, C.; Mayer, M.; Pascal, J.-Y.; Pardanaud, C.; Philipps, V.; Roth, J.; Roubin, P.; Vavpetic, P.

2011-01-01

A dedicated study on fuel retention has been launched in Tore Supra, which includes a D wall-loading campaign and the dismantling of the main limiter (Deuterium Inventory in Tore Supra, DITS project). This paper presents new results from a second post-mortem analysis campaign on 40 tiles with special emphasis on the D retention in the gaps. SIMS analysis reveals that only 1/3 of the thickness of deposits in the plasma shadowed zones are due to the DITS wall-loading campaign. As pre-DITS deposits contain less D than DITS deposits, the contribution of DITS to the D inventory is about 30-50%. The new estimate for the total amount of D retained in the Tore Supra limiter is 1.7 x 10 24 atoms, close to the previous estimate, with the gap surfaces contributing about 33%. NRA measurements show a stepped decrease of D along the gap with strong asymmetries between different gap orientations.

Topographic organization of areas V3 and V4 and its relation to supra-areal organization of the primate visual system.

Science.gov (United States)

Arcaro, M J; Kastner, S

2015-01-01

Areas V3 and V4 are commonly thought of as individual entities in the primate visual system, based on definition criteria such as their representation of visual space, connectivity, functional response properties, and relative anatomical location in cortex. Yet, large-scale functional and anatomical organization patterns not only emphasize distinctions within each area, but also links across visual cortex. Specifically, the visuotopic organization of V3 and V4 appears to be part of a larger, supra-areal organization, clustering these areas with early visual areas V1 and V2. In addition, connectivity patterns across visual cortex appear to vary within these areas as a function of their supra-areal eccentricity organization. This complicates the traditional view of these regions as individual functional "areas." Here, we will review the criteria for defining areas V3 and V4 and will discuss functional and anatomical studies in humans and monkeys that emphasize the integration of individual visual areas into broad, supra-areal clusters that work in concert for a common computational goal. Specifically, we propose that the visuotopic organization of V3 and V4, which provides the criteria for differentiating these areas, also unifies these areas into the supra-areal organization of early visual cortex. We propose that V3 and V4 play a critical role in this supra-areal organization by filtering information about the visual environment along parallel pathways across higher-order cortex.

Novel strategies in glioblastoma surgery aim at safe, supra-maximum resection in conjunction with local therapies.

Science.gov (United States)

Wolbers, John G

2014-01-01

The biggest challenge in neuro-oncology is the treatment of glioblastoma, which exhibits poor prognosis and is increasing in incidence in an increasing aging population. Diverse treatment strategies aim at maximum cytoreduction and ensuring good quality of life. We discuss multimodal neuronavigation, supra-maximum tumor resection, and the postoperative treatment gap. Multimodal neuronavigation allows the integration of preoperative anatomic and functional data with intraoperative information. This approach includes functional magnetic resonance imaging (MRI) and diffusion tensor imaging in preplanning and ultrasound, computed tomography (CT), MRI and direct (sub)cortical stimulation during surgery. The practice of awake craniotomy decreases postoperative neurologic deficits, and an extensive supra-maximum resection appears to be feasible, even in eloquent areas of the brain. Intraoperative MRI- and fluorescence-guided surgery assist in achieving this goal of supra-maximum resection and have been the subject of an increasing number of reports. Photodynamic therapy and local chemotherapy are properly positioned to bridge the gap between surgery and chemoradiotherapy. The photosensitizer used in fluorescence-guided surgery persists in the remaining peripheral tumor extensions. Additionally, blinded randomized clinical trials showed firm evidence of extra cytoreduction by local chemotherapy in the tumor cavity. The cutting-edge promise is gene therapy although both the delivery and efficacy of the numerous transgenes remain under investigation. Issues such as the choice of (cell) vector, the choice of therapeutic transgene, the optimal route of administration, and biosafety need to be addressed in a systematic way. In this selective review, we present various evidence and promises to improve survival of glioblastoma patients by supra-maximum cytoreduction via local procedures while minimizing the risk of new neurologic deficit.

Better outcome from arthroscopic partial meniscectomy than skin incisions only?

DEFF Research Database (Denmark)

Roos, Ewa M; Hare, Kristoffer Borbjerg; Nielsen, Sabrina Mai

2018-01-01

. In total, nine participants experienced 11 adverse events; six in the surgery group and three in the skin-incisions-only group. CONCLUSION: We found greater improvement from arthroscopic partial meniscectomy compared with skin incisions only at 2 years, with the statistical uncertainty of the between......-group difference including what could be considered clinically relevant. Because of the study being underpowered, nearly half in the sham group being non-blinded and one-third crossing over to surgery, the results cannot be generalised to the greater patient population. TRIAL REGISTRATION NUMBER: NCT01264991....

Near infrared thermography by CCD cameras and application to first wall components of Tore Supra tokamak; Thermographie proche infrarouge par cameras CCD et application aux composants de premiere paroi du tokamak Tore Supra

Energy Technology Data Exchange (ETDEWEB)

Moreau, F.

1996-06-07

In the Tokamak TORE-SUPRA, the plasma facing components absorbs and evacuate (active cooling) high power fluxes (up to 10 MW/m{sup 2}). Their thermal behavior study is essential for the success of controlled thermonuclear fusion line. The first part is devoted to the study of power deposition on the TORE-SUPRA actively cooled limiters. A model of power deposition on one of the limiters is developed. It takes into account the magnetic topology and a description of the plasma edge. The model is validated with experimental calorimetric data obtained during a series of shots. This will allow to compare the surface temperature measurements with the predicted ones. The main purpose of this thesis was to evaluate and develop a new temperature measurement system. It works in the near infrared range (890 nm) and is designed to complete the existing thermographic diagnostic of TORE-SUPRA. By using the radiation laws (for a blackbody and the plasma) and the laboratory calibration one can estimate the surface temperature of the observed object. We evaluate the performances and limits of such a device in the harsh conditions encountered in a Tokamak environment. On the one hand, in a quasi ideal situation, this analysis shows that the range of measurements is 600 deg. C to 2500 deg. C. On the other hand, when one takes into account of the plasma radiation (with an averaged central plasma density of 6.10{sup 19} m{sup -3}), we find that the minimum surface temperature rise to 900 deg. C instead of 700 deg. C. In the near future, according to the development of IR-CCD cameras working in the near infrared range up to 2 micrometers, we will be able to keep the good spatial resolution with an improved lower limit for the temperature down to 150 deg. C. The last section deals with a number of computer tools to process the images obtained from experiments on TORE-SUPRA. A pattern recognition application was developed to detect a complex plasma iso-intensity structure. 87 refs.

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

Science.gov (United States)

Martinez Franco, Eva; Amat Tardiu, Lluís

2015-02-01

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

Percutaneous nephroscopic management of an isolated giant renal hydatid cyst guided by single-incision laparoscopy using conventional instruments: the Santosh-PGI technique.

Science.gov (United States)

Kumar, Santosh; Choudhary, Gautam R; Pushkarna, Arawat; Najjapa, Bhuvnesh; Ht, Vatasla

2013-11-01

Isolated renal hydatid rarely presents, but when it does occur, it requires surgical treatment. We report our experience with a novel technique involving percutaneous management of a giant renal hydatid cyst with single-incision laparoscopic assistance. First we performed retrograde ureteropyelogram, which did not show any communication between the cyst and the calyceal. A Veress needle was used for pneumoperitoneum. Three conventional laparoscopic trocars used. Under laparoscopic guidance, we punctured the cyst. The scolicidal solution used was 10% povidone-iodine. The endocyst was removed under vision with grasping forceps through the nephroscope. A Portex drain was placed into the cyst cavity. Percutaneous aspiration and instillation of scolicidal agents followed by re-aspiration have been previously reported. This is an attractive procedure because of its acceptable success rates and reduced morbidity. In our case, simple aspiration of the cyst would not have been successful because the cyst was full of daughter cysts. Also, a blind percutaneous puncture of the cyst and dilatation could have perforated the colon or the mesocolon, which is often wrapped over the surface of such giant cysts thereby making laparoscopic guidance and mobilization of the colon imperative. We devised this unique treatment method for this patient involving three conventional ports at a single umbilical site. We believe this is the first reported case of its kind in the world. Not only this technique is minimally invasive, it is also cost-effective, as only conventional laparoscopic ports and instruments are used during the procedure. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Double incision iso-anatomical ACL reconstruction: the freedom to place the femoral tunnel within the anatomical attachment site without exception.

Science.gov (United States)

Arnold, Markus P; Duthon, Victoria; Neyret, Philippe; Hirschmann, Michael T

2013-02-01

The present paper describes the rationale behind the surgical technique and the clinical results of the iso-anatomical, single bundle bone patellar-tendon bone anterior cruciate ligament (ACL) reconstruction. Using a second incision on the distal lateral femur an outside-in femoral tunnel is drilled. Guided by a special aiming device it is possible to place the femoral tunnel in the centre of the ACL footprint in every single case. Since every crucial step of the procedure is under visual control, the technique is safe and reliable, which is mirrored by good clinical results.

Qureshi-5 Catheter for Complex Supra- and Abdominal-Aortic Catheterization.

Science.gov (United States)

Qureshi, Adnan I; Xiao, WeiGang; Liu, HongLiang

2015-10-01

The use of previously described catheter technique was expanded to complex supra- and abdominal- aortic catheterizations. A new (Qureshi 5) catheter with curved shape at the distal end that has two lumens was used. One of lumens can accommodate a 0.035-inch guide wire and the second lumen can accommodate a 0.018-inch guide wire and terminates at the beginning of the distal curve of the first lumen. The manipulation and engagement of the curved distal end catheter was facilitated by rotation and movement of the J-shaped 0.018-inch guide wire extended coaxial and beyond the distal end of catheter. Subsequently, either contrast was injected or a 0.035-inch guide wire advanced into the target artery. The catheters were used in one patient to perform diagnostic cerebral and abdominal angiography through a 6F introducer sheath placed in the right common femoral artery. The catheterization was complex because of severe tortuosity of arch and descending aorta secondary to kyphosis. The left and right internal carotid arteries and left and right vertebral arteries, left renal artery, and superior mesenteric artery were catheterized in patient (fluoroscopy time 19:46 min). No complications were observed in the patient. The Qureshi-5 catheter was successful in complex supra- and abdominal-aortic catheterizations.

Particle retention during long discharges in Tore Supra and JET

International Nuclear Information System (INIS)

Loarer, T.; Tsitrone, E.; Brosset, C.; Bucalossi, J.; Gunn, J.; Joffrin, E.; Monier-Garbet, P.; Pegourie, B.; Thomas, P.; Lomas, P.; Ongena, J.

2003-01-01

The particle balances and the associated particle retentions for the long discharge experiments performed in Tore-Supra and for the L and H mode discharges carried out in JET are reported in this paper. From the reported experiments, the same particle retention behaviors are observed in Tore-Supra and JET in spite of the differences between the plasma geometry and the confinement mode (respectively limiter L-mode and divertor H-mode). A particle retention up to 70-80% of Γ(puff) for the larger gas injection has been obtained in JET. The particle retention behavior observed with the gas puff appears to be strongly dominant in the particle retention process. Indeed, no influence has been noticed from the active pumping, the saturation of the recycling area (0.4 D/C), the precedent discharges history (in terms of total 'particles retained' in the vessel) and even from the disruptions (conditioning). Also, the outgassing between discharges becomes negligible in terms of particle recovering when Γ(puff) and/or the discharge duration are increased. Finally, neither the edge localized modes (ELMs type-I or III) nor the disruptions modify the reported behaviour. For ITER, the particle retention is strictly limited and from the presented results it seems that strong gas injection should be avoided. (A.C.)

Distinguishing Between Supra-Arcade Downflows and Plasmoids

Science.gov (United States)

Savage, Sabrina

2015-01-01

Supra-arcade downflows (SADs) and downflowing loops (SADLs), observed as sunward-traveling voids and thin flux tubes in the current sheet region above developing flare arcades, are considered indicators of magnetic reconnection fueling long­-duration solar eruptions. These flows are located in regions of very low signal-­to-noise in the corona where high cadence magnetic field measurements are not yet achievable, making observations difficult to fully interpret with respect to reconnection. Several models have been developed to explain their characteristics and behaviors, but most do not successfully recreate the observations. We will present a variety of downflow observations and provide comparisons to a number of the more prominent models.

Cybele: a large size ion source of module construction for Tore-Supra injector

International Nuclear Information System (INIS)

Simonin, A.; Garibaldi, P.

2005-01-01

A 70 keV 40 A hydrogen beam injector has been developed at Cadarache for plasma diagnostic purpose (MSE diagnostic and Charge exchange) on the Tore-Supra Tokamak. This injector daily operates with a large size ions source (called Pagoda) which does not completely fulfill all the requirements necessary for the present experiment. As a consequence, the development of a new ion source (called Cybele) has been underway whose objective is to meet high proton rate (>80%), current density of 160 mA/cm 2 within 5% of uniformity on the whole extraction surface for long shot operation (from 1 to 100 s). Moreover, the main particularity of Cybele is the module construction concept: it is composed of five source modules vertically juxtaposed, with a special orientation which fits the curved extraction surface of the injector; this curvature ensures a geometrical focalization of the neutral beam 7 m downstream in the Tore-Supra chamber. Cybele will be tested first in positive ion production for the Tore-Supra injector, and afterward in negative ion production mode; its modular concept could be advantageous to ensure plasma uniformity on the large extraction surface (about 1 m 2 ) of the ITER neutral beam injector. A module prototype (called the Drift Source) has already been developed in the past and optimized in the laboratory both for positive and negative ion production, where it has met the ITER ion source requirements in terms of D-current density (200 A/m 2 ), source pressure (0.3 Pa), uniformity and arc efficiency (0.015 A D-/kW). (authors)