WorldWideScience

Sample records for surgery centers ascs

  1. Ambulatory Surgical Center (ASC) Payment System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains a summary of service utilization by ASC supplier and is derived from 2011 ASC line item level data, updated through June 2012, that is, line...

  2. Ambulatory Surgical Center (ASC) Payment System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains a summary of service utilization by ASC supplier and is derived from 2011 ASC line item level data, updated through June 2012, that is, line items...

  3. Cochlear implant in an ambulatory surgery center.

    Science.gov (United States)

    Joseph, Aimee M; Lassen, L Frederick

    2013-02-01

    Presbycusis, or sensorineural hearing loss in the elderly population, affects approximately 40% to 50% of people over the age of 75. A variety of devices are available to those with hearing loss. Cochlear implants, for example, are especially useful for those with severe-to-profound hearing loss. The population is aging, so the demand for cochlear implantation in ambulatory surgery centers will likely increase. Ambulatory surgery centers (ASC) can provide a more convenient and less expensive location for cochlear implant surgery than hospital-based operating facilities. Patient selection using standard ASC criteria, coupled with an understanding of the unique surgical and anesthetic needs of cochlear implant patients, are key to bringing this once exotic inpatient procedure into the ASC.

  4. Ambulatory surgery center market share and rates of outpatient surgery in the elderly.

    Science.gov (United States)

    Hollenbeck, Brent K; Hollingsworth, John M; Dunn, Rodney L; Zaojun Ye; Birkmeyer, John D

    2010-12-01

    Relative to outpatient surgery in hospital settings, ambulatory surgery centers (ASCs) are more efficient and associated with a lower cost per case. However, these facilities may also spur higher overall procedure utilization and thus lead to greater overall health care costs. The authors used the State Ambulatory Surgery Database from the State of Florida to identify Medicare-aged patients undergoing 4 common ambulatory procedures in 2006, including knee arthroscopy, cystoscopy, cataract removal, and colonoscopy. Hospital service areas (HSAs) were characterized according to ASC market share, that is, the proportion of residents undergoing outpatient surgery in these facilities. The authors then examined relationships between ASC market share and rates of each procedure. Age-adjusted rates of ambulatory surgery ranged from 190.5 cases per 1000 to 320.8 cases per 1000 in HSAs with low and high ASC market shares, respectively (P < .01). For all 4 procedures, adjusted rates of procedures were significantly higher in HSAs with the highest ASC market share. The greatest difference, both in relative and absolute terms, was observed for patients undergoing cystoscopy. In areas of high ASC market share, the age-adjusted rate of cystoscopy was nearly 3-fold higher than in areas with low ASC market share (34.5 vs 11.9 per 1000 population; P < .01). The presence of an ASC is associated with higher utilization of common outpatient procedures in the elderly. Whether ASCs are meeting unmet clinical demand or spurring overutilization is not clear.

  5. Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

    Science.gov (United States)

    Plotzke, Michael Robert; Courtemanche, Charles

    2011-07-01

    Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC.

  6. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  7. Dynamics of ambulatory surgery centers and hospitals market entry.

    Science.gov (United States)

    Housman, Michael; Al-Amin, Mona

    2013-08-01

    In this article, we investigate the diversity of healthcare delivery organizations by comparing the market determinants of hospitals entry rates with those of ambulatory surgery centers (ASCs). Unlike hospitals, ASCs is one of the growing populations of specialized healthcare delivery organizations. There are reasons to believe that firm entry patterns differ within growing organizational populations since these markets are characterized by different levels of organizational legitimacy, technological uncertainty, and information asymmetry. We compare the entry patterns of firms in a mature population of hospitals to those of firms within a growing population of ASCs. By using patient-level datasets from the state of Florida, we break down our explanatory variables by facility type (ASC vs. hospital) and utilize negative binomial regression models to evaluate the impact of niche density on ASC and hospital entry. Our results indicate that ASCs entry rates is higher in markets with overlapping ASCs while hospitals entry rates are less in markets with overlapping hospitals and ASCs. These results are consistent with the notion that firms in growing populations tend to seek out crowded markets as they compete to occupy the most desirable market segments while firms in mature populations such as general hospitals avoid direct competition.

  8. ASC-1

    DEFF Research Database (Denmark)

    Jakimoski, Goce; Khajuria, Samant

    2011-01-01

    The goal of the modes of operation for authenticated encryption is to achieve faster encryption and message authentication by performing both the encryption and the message authentication in a single pass as opposed to the traditional encrypt-then-mac approach, which requires two passes....... Unfortunately, the use of a block cipher as a building block limits the performance of the authenticated encryption schemes to at most one message block per block cipher evaluation. In this paper, we propose the authenticated encryption scheme ASC-1 (Authenticating Stream Cipher One). Similarly to LEX, ASC-1...... uses leak extraction from diÆerent AES rounds to compute the key material that is XOR-ed with the message to compute the ciphertext. Unlike LEX, the ASC-1 operates in a CFB fashion to compute an authentication tag over the encrypted message. We argue that ASC-1 is secure by reducingits (IND-CCA , INT...

  9. Scheduling of procedures and staff in an ambulatory surgery center.

    Science.gov (United States)

    Pash, Joel; Kadry, Bassam; Bugrara, Suhabe; Macario, Alex

    2014-06-01

    For ambulatory surgical centers (ASC) to succeed financially, it is critical for ASC managers to schedule surgical procedures in a manner that optimizes operating room (OR) efficiency. OR efficiency is maximized by using historical data to accurately predict future OR workload, thereby enabling OR time to be properly allocated to surgeons. Other strategies to maintain a well-functioning ASC include recruiting and retaining the right staff and ensuring patients and surgeons are satisfied with their experience. This article reviews different types of procedure scheduling systems. Characteristics of well-functioning ASCs are also discussed.

  10. ASC-1

    DEFF Research Database (Denmark)

    Jakimoski, Goce; Khajuria, Samant

    2011-01-01

    The goal of the modes of operation for authenticated encryption is to achieve faster encryption and message authentication by performing both the encryption and the message authentication in a single pass as opposed to the traditional encrypt-then-mac approach, which requires two passes. Unfortun......The goal of the modes of operation for authenticated encryption is to achieve faster encryption and message authentication by performing both the encryption and the message authentication in a single pass as opposed to the traditional encrypt-then-mac approach, which requires two passes...... uses leak extraction from diÆerent AES rounds to compute the key material that is XOR-ed with the message to compute the ciphertext. Unlike LEX, the ASC-1 operates in a CFB fashion to compute an authentication tag over the encrypted message. We argue that ASC-1 is secure by reducingits (IND-CCA , INT...

  11. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

    Science.gov (United States)

    Mudumbai, Seshadri C

    2016-01-01

    Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

  12. Saga of payment systems of ambulatory surgery centers for interventional techniques: an update.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Hirsch, Joshua A

    2012-01-01

    The health care system in the United States has been criticized for skyrocketing expenditures and quality deficits. Simultaneously, health care providers and systems are under pressure to provide better and more proficient care. The landscape of the US health care system is shaped by federal and private payers which continue to develop initiatives designed to curtail costs. These include value-based reimbursement programs; cost-shifting expenses to the consumer and reducing reimbursement of providers and facilities. Moreover, there is an underlying thought to steer provision of health care to theoretically more efficient settings. Many of these initiatives are based on affordable health care reform. The major aspects of curtailing health care costs include hospital and other facility payments as well as physician payments and reductions in the approved services. Consequently, ambulatory surgery centers (ASCs) are not immune to these changes. Until 1970, all surgery was performed in hospitals. The development of ASCs and site of service differential payments for in-office procedures have changed the dynamics of surgical trends with outpatient surgeries outpacing inpatient surgeries by as early as 1989. By 2008, approximately 65% of procedures were performed in all outpatient settings including hospital outpatient departments. ASCs claim that improved efficiency in health care delivery allows patients to spend less time in the health care setting with quicker turn over, improving the productivity of the health care team. However, since the majority of the ASCs are owned, in part, by the physicians who staff them, the financial incentives related to ownership have been alleged to potentially alter provider behavior. The number of Medicare certified ASCs and total Medicare payments from 1999 to 2010 increased significantly, but more recent year-to-year changes are far less substantial when compared to previous years. Net percent revenue growth from 2008 to 2009 was 3

  13. Advanced Stirling Convertor (ASC) Technology Maturation

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Scott; Collins, Josh; Wilson, Kyle

    2016-01-01

    The Advanced Stirling Convertor (ASC) development effort was initiated by NASA Glenn Research Center with contractor Sunpower, Inc., to develop high-efficiency thermal-to-electric power conversion technology for NASA Radioisotope Power Systems (RPSs). Early successful performance demonstrations led to the expansion of the project as well as adoption of the technology by the Department of Energy (DOE) and system integration contractor Lockheed Martin Space Systems Company as part of the Advanced Stirling Radioisotope Generator (ASRG) flight project. The ASRG integrates a pair of ASCs to convert the heat from a pair of General Purpose Heat Source (GPHS) modules into electrical power. The expanded NASA ASC effort included development of several generations of ASC prototypes or engineering units to help prepare the ASC technology and Sunpower for flight implementation. Sunpower later had two parallel contracts allowing the last of the NASA engineering units called ASC-E3 to serve as pathfinders for the ASC-F flight convertors being built for DOE. The ASC-E3 convertors utilized the ASC-F flight specifications and were built using the ASC-F design and process documentation. Shortly after the first ASC-F pair achieved initial operation, due to budget constraints, the DOE ASRG flight development contract was terminated. NASA continues to invest in the development of Stirling RPS technology including continued production of the ASC-E3 convertors, seven of which have been delivered with one additional unit in production. Starting in fiscal year 2015, Stirling Convertor Technology Maturation has been reorganized as an element of the RPS Stirling Cycle Technology Development (SCTD) Project and long-term plans for continued Stirling technology advancement are in reformulation. This paper provides a status on the ASC project, an overview of advancements made in the design and production of the ASC at Sunpower, and a summary of acceptance tests, reliability tests, and tactical

  14. Pathfinding the Flight Advanced Stirling Convertor Design with the ASC-E3

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Kyle; Smith, Eddie; Collins, Josh

    2012-01-01

    The Advanced Stirling Convertor (ASC) was initially developed by Sunpower, Inc. under contract to NASA Glenn Research Center (GRC) as a technology development project. The ASC technology fulfills NASA's need for high efficiency power convertors for future Radioisotope Power Systems (RPS). Early successful technology demonstrations between 2003 to 2005 eventually led to the expansion of the project including the decision in 2006 to use the ASC technology on the Advanced Stirling Radioisotope Generator (ASRG). Sunpower has delivered 22 ASC convertors of progressively mature designs to date to GRC. Currently, Sunpower with support from GRC, Lockheed Martin Space System Company (LMSSC), and the Department of Energy (DOE) is developing the flight ASC-F in parallel with the ASC-E3 pathfinders. Sunpower will deliver four pairs of ASC-E3 convertors to GRC which will be used for extended operation reliability assessment, independent validation and verification testing, system interaction tests, and to support LMSSC controller verification. The ASC-E3 and -F convertors are being built to the same design and processing documentation and the same product specification. The initial two pairs of ASC-E3 are built before the flight units and will validate design and processing changes prior to implementation on the ASC-F flight convertors. This paper provides a summary on development of the ASC technology and the status of the ASC-E3 build and how they serve the vital pathfinder role ahead of the flight build for ASRG. The ASRG is part of two of the three candidate missions being considered for selection for the Discovery 12 mission.

  15. ASC Champ Orbit Model

    DEFF Research Database (Denmark)

    Riis, Troels; Jørgensen, John Leif

    1999-01-01

    This documents describes a test of the implementation of the ASC orbit model for the Champ satellite.......This documents describes a test of the implementation of the ASC orbit model for the Champ satellite....

  16. Advanced Stirling Convertor (ASC) Development for NASA RPS

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Scott; Collins, Josh

    2014-01-01

    Sunpower's Advanced Stirling Convertor (ASC) initiated development under contract to the NASA Glenn Research Center (GRC) and after a series of successful demonstrations, the ASC began transitioning from a technology development project to flight development project. The ASC has very high power conversion efficiency making it attractive for future Radioisotope Power Systems (RPS) in order to make best use of the low plutonium-238 fuel inventory in the U.S. In recent years, the ASC became part of the NASA-Department of Energy Advanced Stirling Radioisotope Generator (ASRG) Integrated Project. Sunpower held two parallel contracts to produce ASC convertors, one with the Department of Energy/Lockheed Martin to produce the ASC-F flight convertors, and one with NASA GRC for the production of ASC-E3 engineering units, the initial units of which served as production pathfinders. The integrated ASC technical team successfully overcame various technical challenges that led to the completion and delivery of the first two pairs of flight-like ASC-E3 by 2013. However, in late Fall 2013, the DOE initiated termination of the Lockheed Martin ASRG flight development contract driven primarily by budget constraints. NASA continues to recognize the importance of high efficiency ASC power conversion for RPS and continues investment in the technology including the continuation of ASC-E3 production at Sunpower and the assembly of the ASRG Engineering Unit #2. This paper provides a summary of ASC technical accomplishments, overview of tests at GRC, plans for continued ASC production at Sunpower, and status of Stirling technology development.

  17. Accuracy of patient's turnover time prediction using RFID technology in an academic ambulatory surgery center.

    Science.gov (United States)

    Marchand-Maillet, Florence; Debes, Claire; Garnier, Fanny; Dufeu, Nicolas; Sciard, Didier; Beaussier, Marc

    2015-02-01

    Patients flow in outpatient surgical unit is a major issue with regards to resource utilization, overall case load and patient satisfaction. An electronic Radio Frequency Identification Device (RFID) was used to document the overall time spent by the patients between their admission and discharge from the unit. The objective of this study was to evaluate how a RFID-based data collection system could provide an accurate prediction of the actual time for the patient to be discharged from the ambulatory surgical unit after surgery. This is an observational prospective evaluation carried out in an academic ambulatory surgery center (ASC). Data on length of stay at each step of the patient care, from admission to discharge, were recorded by a RFID device and analyzed according to the type of surgical procedure, the surgeon and the anesthetic technique. Based on these initial data (n = 1520), patients were scheduled in a sequential manner according to the expected duration of the previous case. The primary endpoint was the difference between actual and predicted time of discharge from the unit. A total of 414 consecutive patients were prospectively evaluated. One hundred seventy four patients (42%) were discharged at the predicted time ± 30 min. Only 24% were discharged behind predicted schedule. Using an automatic record of patient's length of stay would allow an accurate prediction of the discharge time according to the type of surgery, the surgeon and the anesthetic procedure.

  18. Pros and cons of the ambulatory surgery center joint venture.

    Science.gov (United States)

    Giannini, Deborah

    2008-01-01

    If a physician group has determined that it has a realistic patient base to establish an ambulatory surgery center, it may be beneficial to consider a partner to share the costs and risks of this new joint venture. Joint ventures can be a benefit or liability in the establishment of an ambulatory surgery center. This article discusses the advantages and disadvantages of a hospital physician-group joint venture.

  19. Inguinal Hernia Surgery: a patient centered approach

    NARCIS (Netherlands)

    H.R. Langeveld-Benders (Hester)

    2014-01-01

    markdownabstract__Abstract__ The introduction of surgical mesh to create a tension free repair in inguinal hernia surgery in the 1990s, was quickly implemented worldwide, because recurrence rates dropped dramatically. Debate on the best surgical approach for this tension-free mesh repair is ongoing

  20. Knowledge Management in Cardiac Surgery: The Second Tehran Heart Center Adult Cardiac Surgery Database Report

    Directory of Open Access Journals (Sweden)

    Kyomars Abbasi

    2015-10-01

    Full Text Available Background: The Adult Cardiac Surgery Databank (ACSD of Tehran Heart Center was established in 2002 with a view to providing clinical prediction rules for outcomes of cardiac procedures, developing risk score systems, and devising clinical guidelines. This is a general analysis of the collected data.Methods: All the patients referred to Tehran Heart Center for any kind of heart surgery between 2002 and 2008 were included, and their demographic, medical, clinical, operative, and postoperative data were gathered. This report presents general information as well as in-hospital mortality rates regarding all the cardiac procedures performed in the above time period.Results: There were 24959 procedures performed: 19663 (78.8% isolated coronary artery bypass grafting surgeries (CABGs; 1492 (6.0% isolated valve surgeries; 1437 (5.8% CABGs concomitant with other procedures; 832 (3.3% CABGs combined with valve surgeries; 722 (2.9% valve surgeries concomitant with other procedures; 545 (2.2% surgeries other than CABG or valve surgery; and 267 (1.1% CABGs concomitant with valve and other types of surgery. The overall mortality was 205 (1.04%, with the lowest mortality rate (0.47% in the isolated CABGs and the highest (4.49% in the CABGs concomitant with valve surgeries and other types of surgery. Meanwhile, the overall mortality rate was higher in the female patients than in the males (1.90% vs. 0.74%, respectively.Conclusion: Isolated CABG was the most prevalent procedure at our center with the lowest mortality rate. However, the overall mortality was more prevalent in our female patients. This database can serve as a platform for the participation of the other countries in the region in the creation of a regional ACSD.

  1. Volume of Cataract Surgery and Surgeon Gender: The Florida Ambulatory Surgery Center Experience 2005 Through 2012.

    Science.gov (United States)

    French, Dustin D; Margo, Curtis E; Campbell, Robert R; Greenberg, Paul B

    2016-01-01

    Cataract is the most common surgically reversible cause of vision loss and the most common major surgical procedure performed in the United States. To understand how gender composition might affect differences in health services, we examined the surgeon gender-specific rates of routine cataract surgery performed in ambulatory surgical centers in Florida. Routine cataract surgeries were identified through the Florida Agency for Health Care Administration (AHCA) ambulatory surgery center dataset. The background of individual surgeons was determined by linking license numbers in the dataset to physician profiles publicly available from AHCA. From 2005 through 2012, women ophthalmologists in Florida performed roughly half the annual rate of cataract surgery as their male counterparts. This difference is not explained by greater time in clinical practice for men. Further investigation into the causes of this gender-volume disparity is warranted to determine what roles choice and barriers may play.

  2. Advanced Stirling Converter (ASC) Phase III Progress Update

    Science.gov (United States)

    Wood, J. Gary; Wilson, Kyle; Buffalino, Andrew; Frye, Patrick; Matejczyk, Dan; Penswick, L. B.

    2007-01-01

    Progress in the development of the Advanced Stirling Convertor (ASC) is presented here. The ASC is being developed under contact with the NASA Glenn Research Center and is supported by the Science Mission Directorate for potential use in future radioisotope power systems having significantly increased efficiency and higher specific power compared to the current thermoelectric systems. Phase II of the effort successfully demonstrated very high conversion efficiency and also demonstrated the low mass capability of the ASC design. The non-hermetic ASC-1 converters demonstrated during Phase II employ superalloy heater heads designed for greater than 14 years life at 850 °C operation. Phase III, which is reported on here, includes the fabrication of multiple next generation hermetic ASC-2 units. Phase III also includes the development of multiple lower-temperature (650 °C hot end) convertors based on the basic ASC design and designated as ASC-0 units. Multiple converters are being built for extended life testing at NASA GRC.

  3. [Minimally Invasive Surgery in Pediatric Oncology. Tertiary center experience].

    Science.gov (United States)

    Gómez-Chacón Villalba, J; Rodríguez Caraballo, L; Marco Macián, A; Segarra Llido, V; Vila Carbó, J J

    2015-07-20

    To describe our experience using Minimally Invasive Surgery (MIS) techniques in tertiary center with specific oncological pediatric surgery unit. Retrospective review of patients undergoing MIS techniques in pediatric oncology surgery unit between January 2011 and December 2014. MIS procedures were considered made by both techniques such as laparoscopy and thoracoscopy with both diagnostic and therapeutic intent. 4 procedures were diagnostic and the rest were therapeutic: During the study, 56 procedures were performed by MIS. By type of technique, 13 were thoracoscopic (7 metastasectomies, 6 thoracic masses) and 43 laparoscopic (3 hepatic masses, 3 pancreatic masses 7 abdominal masses, 2 ovarian masses, 2 typhlitis 1 splenic mass and 25 oophorectomy for ovarian cryopreservation). In 5 cases (2 thoracic masses 1 pancreatic mass abdominal masses) conversion to open surgery to complete the procedure (2 for caution in the absence of vascular control bleeding 1 and 2 for lack of space) was necessary. In all cases safety principles of oncological surgery were respected. Providing an adecuate selection of patiens, MIS techniques are safe, reproducible and fulfill the objectives of quality of cancer surgery.

  4. SWOT analysis in Sina Trauma and Surgery Research Center.

    Science.gov (United States)

    Salamati, Payman; ashraf Eghbali, Ali; Zarghampour, Manijeh

    2014-01-01

    The present study was conducted with the aim of identifying and evaluating the internal and external factors, affecting the Sina Trauma and Surgery Research Center, affiliated to Tehran University of Medical Sciences and propose some of related strategies to senior managers. We used a combined quantitative and qualitative methodology. Our study population consisted of personnel (18 individuals) at Sina Trauma and Surgery Research Center. Data-collection tools were the group discussions and the questionnaires. Data were analyzed with descriptive statistics and SWOT (Strength, Weakness, Opportunities and Threats) analysis. 18 individuals participated in sessions, consisting of 8 women (44.4%) and 10 men (55.6%). The final scores were 2.45 for internal factors (strength-weakness) and 2.17 for external factors (opportunities-threats). In this study, we proposed 36 strategies (10 weakness-threat strategies, 10 weakness-opportunity strategies, 7 strength-threat strategies, and 9 strength-opportunity strategies). The current status of Sina Trauma and Surgery Research Center is threatened weak. We recommend the center to implement the proposed strategies.

  5. SWOT analysis in Sina Trauma and Surgery Research Center.

    Directory of Open Access Journals (Sweden)

    Payman Salamati

    2014-02-01

    Full Text Available The present study was conducted with the aim of identifying and evaluating the internal and external factors, affecting the Sina Trauma and Surgery Research Center, affiliated to Tehran University of Medical Sciences and propose some of related strategies to senior managers. We used a combined quantitative and qualitative methodology. Our study population consisted of personnel (18 individuals at Sina Trauma and Surgery Research Center. Data-collection tools were the group discussions and the questionnaires. Data were analyzed with descriptive statistics and SWOT (Strength, Weakness, Opportunities and Threats analysis. 18 individuals participated in sessions, consisting of 8 women (44.4% and 10 men (55.6%. The final scores were 2.45 for internal factors (strength-weakness and 2.17 for external factors (opportunities-threats. In this study, we proposed 36 strategies (10 weakness-threat strategies, 10 weakness-opportunity strategies, 7 strength-threat strategies, and 9 strength-opportunity strategies. The current status of Sina Trauma and Surgery Research Center is threatened weak. We recommend the center to implement the proposed strategies.

  6. Advanced Stirling Convertor (ASC)--From Technology Development to Future Flight Product

    Science.gov (United States)

    Wong, Wayne A.; Wood, J. Gary; Wilson, Kyle

    2008-01-01

    The Advanced Stirling Convertor (ASC) is being developed by Sunpower Inc. under contract to NASA s Glenn Research Center (GRC) with critical technology support tasks led by GRC. The ASC development, funded by NASA s Science Mission Directorate, started in 2003 as one of 10 competitively awarded contracts that were intended to address the power conversion needs of future Radioisotope Power Systems (RPS). The ASC technology has since evolved through progressive convertor builds and successful testing to demonstrate high conversion efficiency (38 percent), low mass (1.3 kg), hermetic sealing, launch vibration simulation, EMI characterization, and is undergoing extended operation. The GRC and Sunpower team recently delivered two ASC-E convertors to the Department of Energy (DOE) and Lockheed Martin Space Systems Company for integration onto the Advanced Stirling Radioisotope Generator Engineering Unit (ASRG EU) plus one spare. The design of the next build, called the ASC-E2, has recently been initiated and is based on the heritage ASC-E with design refinements to increase reliability margin and offer higher temperature operation and improve performance. The ASC enables RPS system specific power of about 7 to 8 W/kg. This paper provides a chronology of ASC development to date and summarizes technical achievements including advancements toward flight implementation of the technology on ASRG by as early as 2013.

  7. 77 FR 25168 - Appraisal Subcommittee (ASC); ASC Rules of Operation; Amended

    Science.gov (United States)

    2012-04-27

    ... Federal Housing Finance Agency. The ASC Rules of Operation serve as corporate bylaws outlining the ASC's... amended numerous provisions in Title XI. The ASC Rules of Operation serve as corporate bylaws outlining...

  8. Advanced Stirling Convertor (ASC) - From Technology Development to Future Flight Product

    Science.gov (United States)

    Wong, Wayne A.; Wood, J. Gary; Wilson, Kyle

    2008-01-01

    The Advanced Stirling Convertor (ASC) is being developed by Sunpower, Inc. under contract to NASA s Glenn Research Center (GRC) with critical technology support tasks lead by GRC. The ASC development, funded by NASA s Science Mission Directorate, started in 2003 as one of 10 competitively awarded contracts that were to address future Radioisotope Power System (RPS) advanced power conversion needs. The ASC technology has since evolved through progressive convertor builds and successful testing to demonstrate high conversion efficiency (38 %), low mass (1.3 kg), hermetic sealing, launch vibration simulation, EMI characterization, and is undergoing extended operation. The GRC and Sunpower team recently delivered three ASC-E machines to the Department of Energy (DOE) and Lockheed Martin Space Systems Company, two units for integration onto the Advanced Stirling Radioisotope Generator Engineering Unit (ASRG EU) plus one spare. The design has recently been initiated for the ASC-E2, an evolution from the ASC-E that substitutes higher temperature materials enabling improved performance and higher reliability margins. This paper summarizes the history and status of the ASC project and discusses plans for this technology which enables RPS specific power of 8 W/kg for future NASA missions.

  9. 42 CFR 416.164 - Scope of ASC services.

    Science.gov (United States)

    2010-10-01

    ... surgical procedure under § 416.166 include, but are not limited to— (1) Nursing, technician, and related... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM AMBULATORY SURGICAL SERVICES Coverage, Scope of ASC Services, and...

  10. Ambulatory surgery center joint ventures involving tax-exempt entities.

    Science.gov (United States)

    Becker, S; Pristave, R J; McConnell, W

    1999-01-01

    This article provides an overview of the tax-exempt related issues for ambulatory surgery center joint ventures involving tax-exempt entities. The article analyzes the key points of analysis of the guidance released by the IRS, in particular General Counsel Memorandum 39862, Revenue Ruling 98-15, and Redlands Surgical Services v. Commissioner of the Internal Revenue Service. These key points include whether the venture results in private inurement to insiders and whether the venture furthers the charitable purposes of the tax-exempt entity. The article also provides practical guidance to analyze the documents and structure of the joint venture to ensure compliance with the IRS guidance. These practical considerations include, among other things, whether the charitable purposes of the tax-exempt entity are clearly expressed in the documents and whether the tax-exempt entity has sufficient control over the joint venture to ensure the charitable purposes are being adhered to.

  11. A Splice Variant of ASC Regulates IL-1β Release and Aggregates Differently from Intact ASC

    Directory of Open Access Journals (Sweden)

    Kazuhiko Matsushita

    2009-01-01

    Full Text Available The apoptosis-associated speck-like protein containing a caspase recruit domain (ASC is involved in apoptosis and innate immunity and is a major adaptor molecule responsible for procaspase-1 activation. ASC mRNA is encoded by three exons: exons 1 and 3 encode a pyrin domain (PYD and caspase recruit domain (CARD, respectively, and exon 2 encodes a proline and glycine-rich (PGR domain. Here, we identified a variant ASC protein (vASC lacking the PGR domain that was smaller than full length ASC (fASC derived from fully transcribed mRNA and searched for differences in biochemical and biological nature. Both fASC and vASC were found to activate procaspase-1 to a similar degree, but the efficiency of IL-1β excretion was significantly higher for vASC. There was also a marked structural difference observed in the fibrous aggregates formed by fASC and vASC. These results suggest that although the PGR domain is dispensable for procaspase-1 activation, it plays an important role in the regulation of the molecular structure and activity of ASC.

  12. ASC-PROBA Interface Control Document

    DEFF Research Database (Denmark)

    Betto, Maurizio; Jørgensen, John Leif; Jørgensen, Finn E;

    1999-01-01

    This document describes the Advanced Stellar Compass (ASC) and defines the interfaces between the instrument and the PROBA satellite. The ASC is a highly advanced and autonomous Stellar Reference Unit designed, developed and produced by the Space Instrumentation Group of the Department of Automat...

  13. 76 FR 71604 - Kamal Tiwari, M.D.; Pain Management and Surgery Center of Southern Indiana; Decision and Order

    Science.gov (United States)

    2011-11-18

    ... Enforcement Administration Kamal Tiwari, M.D.; Pain Management and Surgery Center of Southern Indiana... Pain Management and Surgery Center (Respondent PMSC), holder of DEA Certificate of Registration... to Respondent Pain Management and Surgery Center of Southern Indiana, be, and they hereby...

  14. Increasing Department of Surgery Productivity: A Study on the Effects of Adding an Ambulatory Surgery Room to Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Vaseliades, Aristotle A

    2006-01-01

    ...) to increase productivity in terms of relative value units (RVUs). Tripler Army Medical Center submitted 12 initiatives, one of which was the implementation of an ambulatory surgery room within the Department of Surgery...

  15. Stroke after Coronary Artery Surgery: A Single Center Report

    Science.gov (United States)

    AlWaqfi, Nizar R.; Ibrahim, Khalid S.

    2014-01-01

    Stroke or cerebrovascular accident (CVA) is a devastating complication of coronary surgery. In this report, the incidence, and correlates of CVA following isolated coronary artery bypass grafting (CABG) surgery were evaluated. Data were collected retrospectively. Between 2006 and 2009, 855 patients underwent isolated CABG surgery. CVA was defined as any new neurological deficit lasting more than 24 hours. Univariate and multivariate analyses were utilized as appropriate. The incidence of CVA was 1.4% (n = 12). Age, previous CVA, and emergency surgery were correlated by univariate analysis. Multivariate analysis revealed age, previous CVA, and chronic renal impairment as predictors of CVA. Ten (83.3%) of the 12 patients were diagnosed to have CVA in the first 24 hours. Length of hospital stay was 20.9 ± 20.34 days for CVA patients and 9.2 ± 5.17 days for non-CVA patients (p ≤ 0.001). There were 4 (33.3%) deaths in CVA group and 27 (3.2%) for non-CVA patients (p = 0.001). Postoperative CVA is a major contributor to mortality, prolonged hospitalization, and other adverse postoperative complications. Further studies are needed to develop better strategies to minimize the occurrence of CVA among patients undergoing CABG. PMID:25317028

  16. Influence of podiatry on orthopedic surgery at a level I trauma center.

    Science.gov (United States)

    Jakoi, Andre M; Old, Andrew B; O'Neill, Craig A; Stein, Benjamin E; Stander, Eric P; Rosenblatt, Joseph; Herman, Martin J

    2014-06-01

    Level I trauma centers frequently see trauma at or below the ankle, which requires consultation with the orthopedic surgery department. However, as podiatry programs begin to firmly establish themselves in more Level I trauma centers, their consultations increase, ultimately taking those once seen by orthopedic surgery. A review of the literature demonstrates that this paradigm shift has yet to be discussed. The purpose of this study was to determine how many, if any, lower extremity fracture consultations a newly developed podiatry program would take from the orthopedic surgery department. A retrospective review was performed of emergency department records from January 2007 to December 2011. Seventeen different emergency department diagnoses were used to search the database. Ultimately, each patient's emergency department course was researched. Several trends were noted. First, if trauma surgery was involved, only the orthopedic surgery department was consulted for any injuries at or below the ankle. Second, the emergency department tended to consult the podiatry program only between the hours of 8 am and 6 pm. Third, as the podiatry program became more established, their number of consultations increased yearly, and, coincidentally, the orthopedic surgery department's consultations decreased. Finally, high-energy traumas involved only the orthopedic surgery department. Whether the orthopedic surgery department or podiatry program is consulted regarding trauma surgery is likely hospital dependent.

  17. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  18. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  19. Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.

    Science.gov (United States)

    Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J

    2016-05-01

    In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  20. 75 FR 80813 - Appraisal Subcommittee (ASC); ASC Rules of Operation; Amended

    Science.gov (United States)

    2010-12-23

    ... and Urban Development. (See section 1.02 (4)). Section 3.02. General Powers. The affairs, business and... ASC's powers shall include those set forth in section 1106 of Title XI (12 U.S.C. 3335). The..., ] disapprove or veto. The matter shall be approved or disapproved by a majority vote of the ASC members...

  1. Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers.

    Science.gov (United States)

    Hansen, Laura S; Sloth, Erik; Hjortdal, Vibeke E; Jakobsen, Carl-Johan

    2015-08-01

    Short-term (30 days) mortality frequently is used as an outcome measure after cardiac surgery, although it has been proposed that the follow-up period should be extended to 120 days to allow for more accurate benchmarking. The authors aimed to evaluate whether mortality rates 120 days after surgery were comparable to general mortality and to compare causes of death between the cohort and the general population. A multicenter descriptive cohort study using prospectively entered registry data. University hospital. The cohort was obtained from the Western Denmark Heart Registry and matched to the Danish National Hospital Register as well as the Danish Register of Causes of Death. A weighted, age-matched general population consisting of all Danish patients who died within the study period was identified through the central authority on Danish statistics. A total of 11,988 patients (>15 years) who underwent cardiac-surgery at Aarhus, Aalborg and Odense University Hospitals from April 1, 2006 to December 31, 2012 were included. Coronary artery bypass grafting, valve surgery and combinations. Mortality after cardiac surgery matches with mortality in the general population after 140 days. Mortality curves run almost parallel from this point onwards, regardless of The European system for cardiac operative risk evaluation (EuroSCORE) and intervention. The causes of death in the cohort differed statistically significantly from the background population (pcardiac (38%); 53% of which was categorized as heart failure. A total of 54% of these patients were assessed preoperatively as having normal or mildly impaired heart function (EuroSCORE). This study supported an extended follow-up period after cardiac surgery when benchmarking cardiac surgery centers. Regardless of preoperative heart function, heart failure was the consistent leading cause of death. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Causes and outcomes of revisional bariatric surgery: initial experience at a single center

    OpenAIRE

    2014-01-01

    Purpose Bariatric surgery has become more prevalent owing to the worldwide obesity epidemic. With the growing number of bariatric procedures performed annually, the requirement for revisional and secondary operations is increasing accordingly. This study aimed to evaluate the initial experience of revisional bariatric surgery at a single specialized center. Methods A retrospective review of the prospectively established database identified all patients who underwent revisional bariatric surge...

  3. Bariatric Surgery and Liver Cancer in a Consortium of Academic Medical Centers.

    Science.gov (United States)

    Yang, Baiyu; Yang, Hannah P; Ward, Kristy K; Sahasrabuddhe, Vikrant V; McGlynn, Katherine A

    2016-03-01

    Obesity is implicated as an important factor in the rising incidence of liver cancer in the USA. Bariatric surgery is increasingly used for treating morbid obesity and comorbidities. Using administrative data from UHC, a consortium of academic medical centers in the USA, we compared the prevalence of liver cancer among admissions with and without a history of bariatric surgery within a 3-year period. Admissions with a history of bariatric surgery had a 61 % lower prevalence of liver cancer compared to those without a history of bariatric surgery (prevalence ratio 0.39, 95 % confidence interval 0.35-0.44), and these inverse associations persisted within strata of sex, race, and ethnicity. This hospital administrative record-based analysis suggests that bariatric surgery could play a role in liver cancer prevention.

  4. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool

    Science.gov (United States)

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery. PMID:26881060

  5. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool

    Directory of Open Access Journals (Sweden)

    Tomoichiro Ogawa

    2016-01-01

    Full Text Available Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC (Abbott Medical Optics Inc., a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery.

  6. Effects of different cutting centers on LASIK surgery in myopic patients

    Directory of Open Access Journals (Sweden)

    Yan-Wei Liu

    2017-07-01

    Full Text Available AIM:To investigate the effect of different cutting centers on the visual acuity, refractive diopter and visual quality of patients undergoing laser assisted in situ keratomileusis(LASIK. METHODS: A total of 80 patients(160 eyeswith myopia treated by elective LASIK were divided into two groups. Thirty-six cases(72 eyeswith visual axis corneal reflection point(VACRPas the cutting center were included into the VACRP group while 44 cases(88 eyeswith pupil center(PCas the cutting center were included into the PC group. The uncorrected visual acuity(UCVA, the best corrected visual acuity(BCVA, refractive diopter, corneal aberration \\〖total corneal and anterior corneal surface higher-order aberrations(HOA, spherical aberration(Z40, vertical coma(Z3-1, horizontal coma(totZ31and offset of cutting centers were determined before surgery and 1mo after surgery. RESULTS: There was no difference in the probability of UCVA ≥ 0.1, BCVA and refractive diopter between the two groups at 1mo after surgery(P>0.05. The astigmatism and cutting center deviation of VACRP group were lower than those of PC group(P40, totZ3-1, totZ31, froHOA, froZ3-1、froZ31 and froZ40 were lower in VACRP group than PC group at 1mo after surgery(PCONCLUSION: The UCVA of patients treated with both cutting centers for LASIK is good but VACRP has more advantages in reducing the offset of cutting center and improving postoperative visual quality.

  7. Arterial pseudoaneurysms following hepato-pancreato-biliary surgery: a single center experience.

    Science.gov (United States)

    Ielpo, Benedetto; Caruso, Riccardo; Prestera, Antonio; De Luca, Giuseppe Massimiano; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Olivares, Sergio; Quijano, Yolanda; Vicente, Emilio

    2015-01-31

    Arterial pseudoaneurysm is an uncommon lethal complication following hepato-pancreato-biliary surgery. Aim of this study is to present and discuss the experience of a high volume oncological center. Since 2007 all major surgeries performed at Sanchinarro Oncological Center have been included in a prospective database looking for postoperative arterial pseudonaurysm. Until June 2014, among 559 hepato-pancreato-biliary procedures, a total of 14 arterial pseudoaneurysms have been identified (2.5%). Sentinel bleeding was in 57% of cases. Failed arterial embolization occurred in 2 cases. Overall mortality rate was 28.5%. We also identified 3 asymptomatic pseudoaneurysms, one of them managed without embolization, developing a sudden bleeding and died after surgery. According to our experience, pseudoaneurysm incidence is higher than reported in current literature and it can be successfully managed through arterial embolization. Furthermore, we found 3 asymptomatic pseudoaneurysms, whose management is still controversial.

  8. Outcome of Cushing's disease following transsphenoidal surgery in a single center over 20 years.

    LENUS (Irish Health Repository)

    Hassan-Smith, Zaki K

    2012-04-01

    Historically, Cushing\\'s disease (CD) was associated with a 5-yr survival of just 50%. Although advances in CD management have seen mortality rates improve, outcome from transsphenoidal surgery (TSS), the current first-line treatment, varies significantly between centers.

  9. The AscSimulationMode command

    DEFF Research Database (Denmark)

    Jørgensen, John Leif

    1998-01-01

    Complex instruments like the ASC may be quite difficult to test in closed loops. This problem is augmented by the fact, that no direct stimulation of the CHU is possible that will render the full performance, noise-spectrum and real-timeliness with high fidelity. In order to circumvent this impasse...

  10. Pain after pediatric otorhinolaryngologic surgery: a prospective multi-center trial.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Volk, Gerd Fabian; Geissler, Katharina; Komann, Marcus; Meissner, Winfried

    2014-07-01

    The purpose of this study was to describe postoperative pain within the first day after pediatric otorhinolaryngologic surgery and to identify factors influencing postoperative pain. Using a prospective evaluation and a Web-based multi-center registry, children ≥4 years of age (n = 365) rated their pain using questionnaires of the project Quality Improvement in Postoperative Pain Treatment for Children including faces numeric rating scales (FNRS, 0-10) for the determination of patient's pain on ambulation and his/her maximal and minimal pain within 8 h after day case surgery or at the first postoperative day for inpatient cases. Additionally, functional interference and therapy-related side effects were assessed. Half of the children were 4 or 5 years of age. The predominant types of surgery were adenoidectomy and tonsillectomy ± ear ventilation tubes. Although analgesics were applied preoperatively, intraoperatively, in the recovery room and on ward, maximal pain within the first day after surgery reached 4.4 ± 3.3 (FNRS). Pain was highest after oral surgery, especially after tonsillectomy and nose surgery. 39% of the children reported pain interference with breathing (39%). The most frequent side effect was drowsiness (55%). Multivariate analysis revealed that maximal pain was independently associated with the non-standardized use of opioids in the recovery room, or use of non-opioid or opioids on ward. Analgesia and perioperative pain management in pediatric otorhinolaryngologic surgery seems to be highly variable. Tonsillectomy and nose surgery are very painful. After otorhinolaryngologic surgery many children seem to receive less analgesia than needed or ineffective analgesic drug regimes.

  11. Should This Patient Have Weight Loss Surgery?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

    Science.gov (United States)

    Smetana, Gerald W; Jones, Daniel B; Wee, Christina C

    2017-06-06

    Obesity is an important public health priority in the United States. One third of U.S. adults are obese and therefore can expect higher rates of diabetes mellitus, other obesity-related comorbidities, and mortality. In 2013, the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery issued a guideline that recommended weight loss (bariatric) surgery for all patients with a body mass index (BMI) of 40 kg/m2 or higher and for those with a BMI of 35 kg/m2 or greater in the presence of at least 1 obesity-related comorbidity. Among the 3 most commonly performed surgeries, the amount of excess weight reduction ranges from 49% for laparoscopic adjustable gastric banding to 76% for Roux-en-Y gastric bypass. In accredited centers, perioperative mortality averages 0.3%. In this Beyond the Guidelines, 2 experts in obesity management, a bariatric surgeon and a general internist, discuss the role of weight loss surgery versus dietary and lifestyle modification, both in general and for a specific patient who is eligible for surgery. Ethnic and age-related variability in the effects of obesity on mortality, as well as potential long-term benefits and risks of weight loss surgery for patient subgroups, are discussed.

  12. Does Certification as Bariatric Surgery Center and Volume Influence the Outcome in RYGB-Data Analysis of German Bariatric Surgery Registry.

    Science.gov (United States)

    Stroh, Christine; Köckerling, F; Lange, V; Wolff, S; Knoll, C; Bruns, C; Manger, Th

    2017-02-01

    To examine the association between the certification as bariatric surgery center and volume and patient outcome, data collected in the German Bariatric Surgery Registry were evaluated. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg. Data collection began in 2005 for all bariatric procedures in an online database. Participation in the quality assurance study is required for all certified bariatric surgery centers in Germany. Descriptive evaluation and matched pairs analysis were performed. Patients were matched via propensity score taking into account BMI, age, and incidence of comorbidities. During the period from 2005 to 2013, 3083 male and 10,639 female patients were operated on with the RYGB primary approach. In Centers of Competence (77.2 %) and non-accredited hospitals (76.3 %), the proportion of female patients was significantly lower than in Centers of Reference/Excellence (78.7 %; p = 0.002). The mean age in Centers of Reference/Excellence (41.2 years) was significantly lower than in Centers of Competence (43.2 years; p bariatric surgery centers with higher volume. The study supports the concept of certification. There are different factors which can and cannot be preoperatively modified and influence the perioperative outcome.

  13. [Medical controlling as medical economical service center. Successful concept for orthopedics and trauma surgery centers?].

    Science.gov (United States)

    Auhuber, T C; Hoffmann, R

    2015-01-01

    The management of patients from administrative admission through the orthopedic-surgical treatment to completion of the billing is complex. Additional challenges originate from the necessity to treat patients in both outpatient and inpatient departments and in more than one medical sector. A superior coordination is essential for a successful cooperation of the various procedures of controlling. The model of a medical controlling department as a service center with effective competence in the management of service and cost, functions as a successful solution to the problem. Central elements of a successful medical economical case management are a well-defined assignment of tasks and definitions of intersections, the integration of health professionals and administrative employees, the utilization of software for process control and the implementation of inlier controlling.

  14. Environmental Loss Characterization of an Advanced Stirling Convertor (ASC-E2) Insulation Package Using a Mock Heater Head

    Science.gov (United States)

    Schifer, Nicholas A.; Briggs, Maxwell H.

    2012-01-01

    The U.S. Department of Energy (DOE) and Lockheed Martin Space Systems Company (LMSSC) have been developing the Advanced Stirling Radioisotope Generator (ASRG) for use as a power system for space science missions. This generator would use two highefficiency Advanced Stirling Convertors (ASCs), developed by Sunpower Inc. and NASA Glenn Research Center (GRC). As part of ground testing of these ASCs, different operating conditions are used to simulate expected mission conditions. These conditions require achieving a specified electrical power output for a given net heat input. While electrical power output can be precisely quantified, thermal power input to the Stirling cycle cannot be directly measured. In an effort to improve net heat input predictions, the Mock Heater Head was developed with the same relative thermal paths as a convertor using a conducting rod to represent the Stirling cycle and tested to provide a direct comparison to numerical and empirical models used to predict convertor net heat input. The Mock Heater Head also served as the pathfinder for a higher fidelity version of validation test hardware, known as the Thermal Standard. This paper describes how the Mock Heater Head was tested and utilized to validate a process for the Thermal Standard.

  15. ASC Trilab L2 Codesign Milestone 2015

    Energy Technology Data Exchange (ETDEWEB)

    Trott, Christian Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hammond, Simon David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dinge, Dennis [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lin, Paul T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vaughan, Courtenay T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cook, Jeanine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Edwards, Harold C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rajan, Mahesh [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hoekstra, Robert J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    For the FY15 ASC L2 Trilab Codesign milestone Sandia National Laboratories performed two main studies. The first study investigated three topics (performance, cross-platform portability and programmer productivity) when using OpenMP directives and the RAJA and Kokkos programming models available from LLNL and SNL respectively. The focus of this first study was the LULESH mini-application developed and maintained by LLNL. In the coming sections of the report the reader will find performance comparisons (and a demonstration of portability) for a variety of mini-application implementations produced during this study with varying levels of optimization. Of note is that the implementations utilized including optimizations across a number of programming models to help ensure claims that Kokkos can provide native-class application performance are valid. The second study performed during FY15 is a performance assessment of the MiniAero mini-application developed by Sandia. This mini-application was developed by the SIERRA Thermal-Fluid team at Sandia for the purposes of learning the Kokkos programming model and so is available in only a single implementation. For this report we studied its performance and scaling on a number of machines with the intent of providing insight into potential performance issues that may be experienced when similar algorithms are deployed on the forthcoming Trinity ASC ATS platform.

  16. Applicability of Two International Risk Scores in Cardiac Surgery in a Reference Center in Brazil

    Science.gov (United States)

    Garofallo, Silvia Bueno; Machado, Daniel Pinheiro; Rodrigues, Clarissa Garcia; Bordim, Odemir; Kalil, Renato A. K.; Portal, Vera Lúcia

    2014-01-01

    Background The applicability of international risk scores in heart surgery (HS) is not well defined in centers outside of North America and Europe. Objective To evaluate the capacity of the Parsonnet Bernstein 2000 (BP) and EuroSCORE (ES) in predicting in-hospital mortality (IHM) in patients undergoing HS at a reference hospital in Brazil and to identify risk predictors (RP). Methods Retrospective cohort study of 1,065 patients, with 60.3% patients underwent coronary artery bypass grafting (CABG), 32.7%, valve surgery and 7.0%, CABG combined with valve surgery. Additive and logistic scores models, the area under the ROC (Receiver Operating Characteristic) curve (AUC) and the standardized mortality ratio (SMR) were calculated. Multivariate logistic regression was performed to identify the RP. Results Overall mortality was 7.8%. The baseline characteristics of the patients were significantly different in relation to BP and ES. AUCs of the logistic and additive BP were 0.72 (95% CI, from 0.66 to 0.78 p = 0.74), and of ES they were 0.73 (95% CI; 0.67 to 0.79 p = 0.80). The calculation of the SMR in BP was 1.59 (95% CI; 1.27 to 1.99) and in ES, 1.43 (95% CI; 1.14 to 1.79). Seven RP of IHM were identified: age, serum creatinine > 2.26 mg/dL, active endocarditis, systolic pulmonary arterial pressure > 60 mmHg, one or more previous HS, CABG combined with valve surgery and diabetes mellitus. Conclusion Local scores, based on the real situation of local populations, must be developed for better assessment of risk in cardiac surgery. PMID:25004415

  17. Applicability of Two International Risk Scores in Cardiac Surgery in a Reference Center in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Garofallo, Silvia Bueno; Machado, Daniel Pinheiro; Rodrigues, Clarissa Garcia; Bordim, Odemir Jr.; Kalil, Renato A. K.; Portal, Vera Lúcia, E-mail: veraportal.pesquisa@gmail.com [Post-Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia/Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil)

    2014-06-15

    The applicability of international risk scores in heart surgery (HS) is not well defined in centers outside of North America and Europe. To evaluate the capacity of the Parsonnet Bernstein 2000 (BP) and EuroSCORE (ES) in predicting in-hospital mortality (IHM) in patients undergoing HS at a reference hospital in Brazil and to identify risk predictors (RP). Retrospective cohort study of 1,065 patients, with 60.3% patients underwent coronary artery bypass grafting (CABG), 32.7%, valve surgery and 7.0%, CABG combined with valve surgery. Additive and logistic scores models, the area under the ROC (Receiver Operating Characteristic) curve (AUC) and the standardized mortality ratio (SMR) were calculated. Multivariate logistic regression was performed to identify the RP. Overall mortality was 7.8%. The baseline characteristics of the patients were significantly different in relation to BP and ES. AUCs of the logistic and additive BP were 0.72 (95% CI, from 0.66 to 0.78 p = 0.74), and of ES they were 0.73 (95% CI; 0.67 to 0.79 p = 0.80). The calculation of the SMR in BP was 1.59 (95% CI; 1.27 to 1.99) and in ES, 1.43 (95% CI; 1.14 to 1.79). Seven RP of IHM were identified: age, serum creatinine > 2.26 mg/dL, active endocarditis, systolic pulmonary arterial pressure > 60 mmHg, one or more previous HS, CABG combined with valve surgery and diabetes mellitus. Local scores, based on the real situation of local populations, must be developed for better assessment of risk in cardiac surgery.

  18. Pediatric Vascular Surgery Review with a 30-Year-Experience in a Tertiary Referral Center

    Science.gov (United States)

    Min, Seung-Kee; Cho, Sungsin; Kim, Hyun-Young; Kim, Sang Joon

    2017-01-01

    Pediatric vascular disease is rare, and remains a big challenge to vascular surgeons. In contrast to adults, surgery for pediatric vascular disease is complicated by issues related to small size, future growth, and availability of suitable vascular conduit. During the last 30 years, 131 major vascular operations were performed in a tertiary referral center, Seoul National University Hospital, including aortoiliac aneurysm, acute or chronic arterial occlusion, renovascular hypertension, portal venous hypertension, trauma, tumor invasion to major abdominal vessels, and others. Herein we review on the important pediatric vascular diseases and share our clinical experiences on these rare diseases. PMID:28690995

  19. Surgery for gastrointestinal malignant melanoma:Experience from surgical training center

    Institute of Scientific and Technical Information of China (English)

    Thawatchai; Akaraviputh; Satida; Arunakul; Varut; Lohsiriwat; Cherdsak; Iramaneerat; Atthaphorn; Trakarnsanga

    2010-01-01

    AIM:To characterize clinical features,surgery,outcome,and survival of malignant melanoma(MM) of the gastrointestinal(GI) tract in a surgical training center in Bangkok,Thailand. METHODS:A retrospective review was performed for all patients with MM of the GI tract treated at our institution between 1997 and 2007. RESULTS:Fourteen patients had GI involvement either in a metastatic form or as a primary melanoma. Thirteen patients with sufficient data were reviewed. The median age of the patients was 66 years(r...

  20. Multi-center evaluation of post-operative morbidity and mortality after optimal cytoreductive surgery for advanced ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Arash Rafii

    Full Text Available PURPOSE: While optimal cytoreduction is the standard of care for advanced ovarian cancer, the related post-operative morbidity has not been clearly documented outside pioneering centers. Indeed most of the studies are monocentric with inclusions over several years inducing heterogeneity in techniques and goals of surgery. We assessed the morbidity of optimal cytoreduction surgery for advanced ovarian cancer within a short inclusion period in 6 referral centers dedicated to achieve complete cytoreduction. PATIENTS AND METHODS: The 30 last optimal debulking surgeries of 6 cancer centers were included. Inclusion criteria included: stage IIIc- IV ovarian cancer and optimal surgery performed at the site of inclusion. All post-operative complications within 30 days of surgery were recorded and graded using the Memorial secondary events grading system. Student-t, Chi2 and non-parametric statistical tests were performed. RESULTS: 180 patients were included. There was no demographic differences between the centers. 63 patients underwent surgery including intestinal resections (58 recto-sigmoid resection, 24 diaphragmatic resections, 17 splenectomies. 61 patients presented complications; One patient died post-operatively. Major (grade 3-5 complications requiring subsequent surgeries occurred in 21 patients (11.5%. 76% of patients with a major complication had undergone an ultraradical surgery (P = 0.004. CONCLUSION: While ultraradical surgery may result in complete resection of peritoneal disease in advanced ovarian cancer, the associated complication rate is not negligible. Patients should be carefully evaluated and the timing of their surgery optimized in order to avoid major complications.

  1. Bariatric surgery outcomes: a single-center study in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Abusnana S

    2015-09-01

    Full Text Available Salah Abusnana,1 Sarah Abdi,1 Brigette Tagure,1 Murtada Elbagir,1 Almantas Maleckas2 1Rashid Center for Diabetes and Research, Ministry of Health, Ajman, United Arab Emirates; 2Kaunas University of Medicine, Kaunas, LithuaniaBackground: Bariatric surgery has become an attractive treatment for severe obesity over the last decade, due to its impacts on weight loss and remission of type 2 diabetes and metabolic syndrome. In the United Arab Emirates, a country where the rate of obesity is dramatically increasing bariatric surgery has gained popularity in recent years; however, published data on its outcomes in the Emirati population are lacking.Methods: We retrospectively reviewed the medical records of 95 patients who underwent bariatric surgery (ie, laparoscopic Roux-en-Y gastric bypass [RYGB] or laparoscopic sleeve gastrectomy at the Rashid Center for Diabetes and Research in Ajman, United Arab Emirates. Weight outcomes and metabolic marker data were abstracted at baseline and at 3, 6, and 12 months postoperatively.Results: Laparoscopic RYGB was the main procedure performed by our bariatric unit. All variables demonstrated postoperative improvement. An average excess weight loss of 68% was observed at 12 months. Fat mass was the body component that decreased the most, with an average reduction of 46%. Additionally, lipid profiles were significantly different (P<0.01 at 12 months, with triglyceride levels improving by 27% and low-density lipoprotein levels improving by 21%. Similarly, glycated hemoglobin (HbA1c levels decreased significantly (P<0.001 in patients with type 2 diabetes, with an average reduction of 73%.Conclusion: Our results show that a substantial short-term reduction in weight and significant improvements in metabolic markers followed bariatric surgery in severely obese Emirati patients. Our results are consistent with the outcomes of other internationally published studies. Additional studies are warranted to determine whether

  2. Current standards of neuropsychological assessment in epilepsy surgery centers across Europe.

    Science.gov (United States)

    Vogt, Viola Lara; Äikiä, Marja; Del Barrio, Antonio; Boon, Paul; Borbély, Csaba; Bran, Ema; Braun, Kees; Carette, Evelien; Clark, Maria; Cross, Judith Helen; Dimova, Petia; Fabo, Daniel; Foroglou, Nikolaos; Francione, Stefano; Gersamia, Anna; Gil-Nagel, Antonio; Guekht, Alla; Harrison, Sue; Hecimovic, Hrvoje; Heminghyt, Einar; Hirsch, Edouard; Javurkova, Alena; Kälviäinen, Reetta; Kavan, Nicole; Kelemen, Anna; Kimiskidis, Vasilios K; Kirschner, Margarita; Kleitz, Catherine; Kobulashvili, Teia; Kosmidis, Mary H; Kurtish, Selin Yagci; Lesourd, Mathieu; Ljunggren, Sofia; Lossius, Morten Ingvar; Malmgren, Kristina; Mameniskiené, Ruta; Martin-Sanfilippo, Patricia; Marusic, Petr; Miatton, Marijke; Özkara, Çiğdem; Pelle, Federica; Rubboli, Guido; Rudebeck, Sarah; Ryvlin, Philippe; van Schooneveld, Monique; Schmid, Elisabeth; Schmidt, Pia-Magdalena; Seeck, Margitta; Steinhoff, Bernhard J; Shavel-Jessop, Sara; Tarta-Arsene, Oana; Trinka, Eugen; Viggedal, Gerd; Wendling, Anne-Sophie; Witt, Juri-Alexander; Helmstaedter, Christoph

    2017-03-01

    We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe. Wiley Periodicals, Inc. © 2017 International League

  3. Hepatobilio-pancreatic robotic surgery: initial experience from a single center institute.

    Science.gov (United States)

    Quijano, Yolanda; Vicente, Emilio; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Malave, Luis; Ferri, Valentina; Plaza, Carlos; Lindemann, Jan Lammel; D'Andrea, Vito; Caruso, Riccardo

    2016-12-30

    The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy. There were two left hepatectomies, one right hepatectomy, one associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), three bisegmentectomies and three segmentectomies, eight wedge resections, and three pericystectomies. The mean operating time was 282 min. The overall conversion rate and postoperative complication rate were 4.7 and 19%, respectively. The mean length of hospital stay was 13.4 days (range 4-64 days). Of the 45 patients subjected to pancreatic resection, 22 were male and 23 female. The average age of all patients was 62 years (range 31-82 years). The mean operating room (OR) time was 370 min (120-780 min). Among the procedures performed were 15 pancreatico-duodenectomies, 19 distal pancreatectomies, and 11 enucleations. All procedures in the HBP area were R0. Our early experience shows that robotic surgery is a safe and feasible procedure in the HBP area. The complication and mortality rates are comparable to those of open surgery, but with the advantages of minimally invasive surgery.

  4. An excellent navigation system and experience in craniomaxillofacial navigation surgery: a double-center study.

    Science.gov (United States)

    Dai, Jiewen; Wu, Jinyang; Wang, Xudong; Yang, Xudong; Wu, Yunong; Xu, Bing; Shi, Jun; Yu, Hongbo; Cai, Min; Zhang, Wenbin; Zhang, Lei; Sun, Hao; Shen, Guofang; Zhang, Shilei

    2016-06-16

    Numerous problems regarding craniomaxillofacial navigation surgery are not well understood. In this study, we performed a double-center clinical study to quantitatively evaluate the characteristics of our navigation system and experience in craniomaxillofacial navigation surgery. Fifty-six patients with craniomaxillofacial disease were included and randomly divided into experimental (using our AccuNavi-A system) and control (using Strker system) groups to compare the surgical effects. The results revealed that the average pre-operative planning time was 32.32 mins vs 29.74 mins between the experimental and control group, respectively (p > 0.05). The average operative time was 295.61 mins vs 233.56 mins (p > 0.05). The point registration orientation accuracy was 0.83 mm vs 0.92 mm. The maximal average preoperative navigation orientation accuracy was 1.03 mm vs 1.17 mm. The maximal average persistent navigation orientation accuracy was 1.15 mm vs 0.09 mm. The maximal average navigation orientation accuracy after registration recovery was 1.15 mm vs 1.39 mm between the experimental and control group. All patients healed, and their function and profile improved. These findings demonstrate that although surgeons should consider the patients' time and monetary costs, our qualified navigation surgery system and experience could offer an accurate guide during a variety of craniomaxillofacial surgeries.

  5. Behaviour of the disease resistance gene Asc in protoplasts of Lycopersicon esculentum mill

    NARCIS (Netherlands)

    Moussatos, V.; Witsenboer, H.; Hille, J.; Gilchrist, D.

    1993-01-01

    Action of Asc, a single dominant Mendelian gene controlling disease response at the whole plant level, was detected at the level of individual cells. Protoplasts, freshly isolated from resistant (Asc/Asc) and susceptible (asc/asc) tomato isolines, were differentially sensitive to AAL toxin as observ

  6. Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC.

    Directory of Open Access Journals (Sweden)

    Haotian Lin

    Full Text Available Congenital cataract (CC is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22% of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47% of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93% of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%, nystagmus (6.16%, and refractive error (3.65%. In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

  7. Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC).

    Science.gov (United States)

    Lin, Haotian; Yang, Ye; Chen, Jingjing; Zhong, Xiaojian; Liu, Zhaochuan; Lin, Zhuoling; Chen, Wan; Luo, Lixia; Qu, Bo; Zhang, Xinyu; Zheng, Danying; Zhan, Jiao; Wu, Hanfu; Wang, Zhirong; Geng, Yu; Xiang, Wu; Chen, Weirong; Liu, Yizhi

    2014-01-01

    Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22%) of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47%) of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old) became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93%) of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%), nystagmus (6.16%), and refractive error (3.65%). In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

  8. Trends in refractive surgery at an academic center: 2007-2009

    Directory of Open Access Journals (Sweden)

    Kuo Irene C

    2011-05-01

    Full Text Available Abstract Background The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Methods Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK vs. laser-assisted in-situ keratomileusis (LASIK, and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Results Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10. The

  9. Microbial air monitoring in the operating theatres of Salam Center for Cardiac Surgery in Khartoum (Sudan

    Directory of Open Access Journals (Sweden)

    Margherita Scapaticci

    2012-06-01

    Full Text Available The seriousness of postoperative infections and the increased susceptibility of patients undergoing cardiac surgery increase the demand for the operating theatre (OT asepsis to prevent bacterial infections. In fact, the organisms carried by the air reach the wound after having sedimented onto sterile field. The air represents a critical point for quality control of air filtration systems, for sanitization procedures and for the evolution of hygienic features of the OT environment.Aim of the study is to evaluate the prevalence of microorganisms found in the operating rooms (OR air monitoring in the Salam Center for Cardiac Surgery of Khartoum (Sudan between July 2008 and March 2009.The specimens were collected every month in two different times: “OR at rest” (after sanitization and “OR operational”, using sedimentation method (Fisher 1972. Results showed that each sample collected at rest had IMA (index of microbial air contamination < 5CFU/plt, whereas the bacterial growth was between 25 and 50 CFU/plt when the samples had been collected in the same places during operating activities.This indicate the effectiveness of sanitization procedures and confirm that people working in OT are an important source of bacteria causing postoperative infections. Coagulase negative Staphylococci, Gram negative bacillus and Staphylococcus aureus spp. were the predominant organisms isolated.

  10. Outcome of noncardiac surgery in children with congenital heart disease performed outside a cardiac center.

    Science.gov (United States)

    Ng, Shermayne M; Jin, Xi; Yates, Robert; Kelsall, Anthony W R

    2016-02-01

    The objective of this study was to review the outcome of children with congenital heart disease (CHD) undergoing noncardiac surgery requiring general anesthesia (GA) in a tertiary pediatric center between January 2010 and December 2012. A retrospective case note review of children <16years of age with confirmed CHD undergoing a surgical or interventional procedure requiring GA was performed. Patients were categorized into three risk groups according to White and Peyton's anesthetic risk classification of children with CHD undergoing noncardiac surgery [Critical Care and Pain 2012;12:17-22]. 117 children with CHD were identified with a total of 240 procedures conducted. 36 procedures were conducted in the high-risk group, 135 in the intermediate-risk group, and 69 in the low-risk group. 40% of these were major operations such as small bowel and colonic procedures. Overall mortality rate at 7days and 30days was 0% and 0.4%, respectively, with a 1% mortality rate in minor procedures and 0% mortality rate in major procedures. There were no unexpected deaths. 17% of procedures resulted in complications. A higher rate of complications was recorded in emergency procedures. 17% of these procedures required admission to the intensive care unit, with the highest admissions rate in the high-risk group. The median duration of hospital stay for the whole cohort was 1day (range of 0-71days). Our study shows that procedures requiring GA can be safely conducted on children from any of the three risk groups in a nonspecialist cardiac center provided that there is close liaison and careful planning between the different specialties. Copyright © 2016. Published by Elsevier Inc.

  11. [The burnout syndrome among nurses working in Lithuanian cardiac surgery centers].

    Science.gov (United States)

    Vimantaite, Renata; Seskevicius, Arvydas

    2006-01-01

    The burnout syndrome may be defined as a complex phenomenon which is characterized by three components: emotional burnout (physical and psychical exhaustion, incapability to carry on requirements), depersonalization (cynical attitude towards performed work, duties, cold or negative reaction to the patients), and lowered efficiency (reflected by the sense of incompetence, the lack of efficiency and achievements). This process is progressing slowly for a long time and is characterized individually by various psychical and physical symptoms of different intensity. The aim of this study was to examine the manifestation of burnout syndrome and to estimate the influence of the syndrome on the behavior and practice of the nurses in cardiac surgery units of Lithuania (to evaluate physiological and psychological symptoms of the burnout). The study was performed using a questionnaire. A total of 180 questionnaires completed by nurses in Lithuanian cardiac surgical centers (Vilnius, Kaunas, and Klaipeda) were analyzed. The study revealed that 72.8% of nurses had an excess of workload (exceeding full-time job). Most of the respondents (84.4%) pointed out the emotional stress, unevaluated work and underpayment. Three-fourths of the nurses (75%) indicated that they felt physical fatigue after their work. More than half of nurses (67.2%) felt general fatigue, 63.3% reported the leg pains after the work, and 32.2% feel splitting headaches. Psychological fatigue was stressed by 86.1% of specialists. The main causes of psychological stress are as follows: the communication with the doctors in 57% of the cases, communication with the patient's relatives in 52% of cases, communication with the nursing administration in 49% of cases, and communication with the patients in 40% of cases. The majority of the nurses working in the centers of cardiac surgery experience physical and psychological fatigue, emotional stress. All this determinates the dissatisfaction in the work, conflicts

  12. Anterior cervical discectomy and fusion in the outpatient ambulatory surgery setting compared with the inpatient hospital setting: analysis of 1000 consecutive cases.

    Science.gov (United States)

    Adamson, Tim; Godil, Saniya S; Mehrlich, Melissa; Mendenhall, Stephen; Asher, Anthony L; McGirt, Matthew J

    2016-06-01

    OBJECTIVE In an era of escalating health care costs and pressure to improve efficiency and cost of care, ambulatory surgery centers (ASCs) have emerged as lower-cost options for many surgical therapies. Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries performed, and the frequency of its performance is rapidly increasing as the aging population grows. Although ASCs offer significant cost advantages over hospital-based surgical centers, concern over the safety of outpatient ACDF has slowed its adoption. The authors intended to 1) determine the safety of the first 1000 consecutive ACDF surgeries performed in their outpatient ASC, and 2) compare the safety of these outpatient ACDFs with that of consecutive ACDFs performed during the same time period in the hospital setting. METHODS A total of 1000 consecutive patients who underwent ACDF in an ACS (outpatient ACDF) and 484 consecutive patients who underwent ACDF at Vanderbilt University Hospital (inpatient ACDF) from 2006 to 2013 were included in this retrospective study of patients' medical records. Data were collected on patient demographics, comorbidities, operative details, and perioperative and 90-day morbidity. Perioperative morbidity and hospital readmission were compared between the outpatient and inpatient ACDF groups. RESULTS Of the first 1000 outpatient ACDF cases performed in the authors' ASC, 629 (62.9%) were 1-level and 365 (36.5%) were 2-level ACDFs. Mean patient age was 49.5 ± 8.6, and 484 (48.4%) were males. All patients were observed postoperatively at the ASC postanesthesia care unit (PACU) for 4 hours before being discharged home. Eight patients (0.8%) were transferred from the surgery center to the hospital postoperatively (for pain control [n = 3], chest pain and electrocardiogram changes [n = 2], intraoperative CSF leak [n = 1], postoperative hematoma [n = 1], and profound postoperative weakness and surgical reexploration [n = 1]). No perioperative

  13. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs §...

  14. The Astrobiology in Secondary Classrooms (ASC) curriculum: focusing upon diverse students and teachers.

    Science.gov (United States)

    Arino de la Rubia, Leigh S

    2012-09-01

    The Minority Institution Astrobiology Collaborative (MIAC) began working with the NASA Goddard Center for Astrobiology in 2003 to develop curriculum materials for high school chemistry and Earth science classes based on astrobiology concepts. The Astrobiology in Secondary Classrooms (ASC) modules emphasize interdisciplinary connections in astronomy, biology, chemistry, geoscience, physics, mathematics, and ethics through hands-on activities that address national educational standards. Field-testing of the Astrobiology in Secondary Classrooms materials occurred over three years in eight U.S. locations, each with populations that are underrepresented in the career fields of science, technology, engineering, and mathematics. Analysis of the educational research upon the high school students participating in the ASC project showed statistically significant increases in students' perceived knowledge and science reasoning. The curriculum is in its final stages, preparing for review to become a NASA educational product.

  15. ASC Predictive Science Academic Alliance Program Verification and Validation Whitepaper

    Energy Technology Data Exchange (ETDEWEB)

    Klein, R; Graziani, F; Trucano, T

    2006-03-31

    The purpose of this whitepaper is to provide a framework for understanding the role that verification and validation (V&V) are expected to play in successful ASC Predictive Science Academic Alliance (PSAA) Centers and projects. V&V have been emphasized in the recent specification of the PSAA (NNSA, 2006): (1) The resulting simulation models lend themselves to practical verification and validation methodologies and strategies that should include the integrated use of experimental and/or observational data as a key part of model and sub-model validation, as well as demonstrations of numerical convergence and accuracy for code verification. (2) Verification, validation and prediction methodologies and results must be much more strongly emphasized as research topics and demonstrated via the proposed simulations. (3) It is mandatory that proposals address the following two topics: (a) Predictability in science & engineering; and (b) Verification & validation strategies for large-scale simulations, including quantification of uncertainty and numerical convergence. We especially call attention to the explicit coupling of computational predictability and V&V in the third bullet above. In this whitepaper we emphasize this coupling, and provide concentrated guidance for addressing item 2. The whitepaper has two main components. First, we provide a brief and high-level tutorial on V&V that emphasizes critical elements of the program. Second, we state a set of V&V-related requirements that successful PSAA proposals must address.

  16. USDA-ASCS 1936-1939 Air Photos

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data set is a digital version of aerial photographs taken during the 1936-1939 time frame for the USDA-ASCS. These photos were originally recorded at a scale of...

  17. Artificial Loading of ASC Specks with Cytosolic Antigens.

    Directory of Open Access Journals (Sweden)

    Ali Can Sahillioğlu

    Full Text Available Inflammasome complexes form upon interaction of Nod Like Receptor (NLR proteins with pathogen associated molecular patterns (PAPMS inside the cytosol. Stimulation of a subset of inflammasome receptors including NLRP3, NLRC4 and AIM2 triggers formation of the micrometer-sized spherical supramolecular complex called the ASC speck. The ASC speck is thought to be the platform of inflammasome activity, but the reason why a supramolecular complex is preferred against oligomeric platforms remains elusive. We observed that a set of cytosolic proteins, including the model antigen ovalbumin, tend to co-aggregate on the ASC speck. We suggest that co-aggregation of antigenic proteins on the ASC speck during intracellular infection might be instrumental in antigen presentation.

  18. Aquaculture Stewardship Council (ASC) ontwikkeltraject meerval : een inventarisatie

    NARCIS (Netherlands)

    Poelman, M.; Rothuis, A.J.; Bosma, R.H.

    2012-01-01

    Om een Aquaculture Stewardship Council (ASC) gecertificeerd product te krijgen is een standaard nodig, waaraan getoetst kan worden. Deze standaard geeft certificeerders een referentiekader. Pas als een standaard aanwezig is, kunnen producten gecertificeerd worden.

  19. CVC related infections reported from Salam Center for Cardiac Surgery of Khartoum

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    Margherita Scapaticci

    2010-06-01

    Full Text Available Introduction: Central venous catheter (CVC plays an essential part in clinical management of patients admitted in Intensive Care Unit (ICU, even though catheterization is an invasive procedure that may facilitate bacterial migration from the skin surrounding the catheter insertion site to the catheter tip, representing a risk factor for the arise of bacteraemia and sepsis. Aim of our study was to assess the prevalence of micro-organisms found as responsibles of CVC-related infections and check their correspondence with those found in blood cultures collected from the same patients. Methods: The study was conduced from April 2008 to March 2009. In this period were analysed 29 CVC samples sent from ICU to the laboratory of the Salam Center for Cardiac Surgery of Khartoum (Sudan. CVC was removed after pericatheter skin disinfection and its tip was cut, put in a sterile container and finally sent to the laboratory, where it was immersed in Brain Heart Infusion (BHI and incubated at 37°C.A first culture of the sample on Blood Agar plate was done after an incubation period of 1 hour, the second one after 24 hours. In case of bacterial growth were practiced identification and sensitivity test of the isolated bacteria. Results: Of the 29 analysed samples 38% showed bacterial growth of which 27% caused by gram positive and 73% by gram negative bacteria. The identification tests showed also that among gram positive-related infection predominated those caused by Methicillin-Resistent Staphylococcus aureus (MRSA (67%, while among the gram negative infections predominated those caused by Pseudomonas spp (57%, followed by Enterobacter spp and Serratia spp. Conclusion: All the above mentioned infections were confirmed by examination of blood cultures collected simultaneously from the same patients. Furthermore the study showed that 73% of infections affected post-operative patients rather than those waiting for surgery.

  20. Children Thyroid Cancer treatment in Saint-Petersburg Endocrine SurgeryCenter and Mayo Clinic

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    Aleksandr Filippovich Romanchishen

    2015-02-01

    Full Text Available IntroductionThyroid cancer (TC is the most often malignant tumor in childhood and made 1.5 – 3.0% of all children population or 45.3% of pediatric endocrine epithelial cancers. A lot of questions concerning to volume of thyroid surgery, postoperative radio iodine therapy (RIT needs to be discussed.AimEstimation of childhood sporadic thyroid cancer specificity and comparison of children and adolescents treatment in Saint-Petersburg Endocrine Surgery Center (Russia and Mayo Clinic (USA.Material and methodsDuring 1970 –2011 in the Saint-Petersburg Center (1 group were operated 105 TC children and adolescent (up to 20 yeas and in Mayo Clinic – 188 (2 group in  1940 – 2000 period. Since of 80-s in those clinics were used the same perioperative examinations, like TSH, T4, T3 blood levels, USG, fine needles aspiration biopsy, CT and morphological examinations.Results and discussionAverage age of the Saint-Petersburg Center and Rochester patients was the same and achieve 16.3±0.3 and 16.0±0.5, accordingly. In both groups has prevailed girls: in the 1 group they made 73.3% (M:F 1:2.7 and in the 2 – 70.7% (M:F 1:2.4. Childhood differentiated TC were associated with aggressive behavior: regional metastases were found in 53.0% and 81.4%, extrathyroid TC spreading – in 9.6 and 19.7%, distant metastases - in 9.6 and 4.8%, accordingly. In our Center (1 group we have performed hemithyroidectomies and subtotal Thyroidectomies in 58.1% with ipsilateral central neck dissection (CND. In Mayo Clinic in all TC cases were performed thyroidectomy (TE since 1950. TC relapses we have no   observed in 1 group and they have place in 6.9% 2 group patients, recurring lymphatic metastases – in 8.4% and 20.7%, accordingly. Radioiodine therapy (RIT has performed in 21.1% and 25.5% operated children.In 1 group 95 (96.0 % of 99 operated were alive during 5 – 36 years, in the 2– only in two cases reason of death was TC, but in 14 – other malignant tumor

  1. The evolution of epilepsy surgery between 1991 and 2011 in nine major epilepsy centers across the United States, Germany, and Australia

    Science.gov (United States)

    Jehi, Lara; Friedman, Daniel; Carlson, Chad; Cascino, Gregory; Dewar, Sandra; Elger, Christian; Engel, Jerome; Knowlton, Robert; Kuzniecky, Ruben; McIntosh, Anne; O’Brien, Terence J.; Spencer, Dennis; Sperling, Michael R.; Worrell, Gregory; Bingaman, Bill; Gonzalez-Martinez, Jorge; Doyle, Werner; French, Jacqueline

    2016-01-01

    Summary Objective Epilepsy surgery is the most effective treatment for select patients with drug-resistant epilepsy. In this article, we aim to provide an accurate understanding of the current epidemiologic characteristics of this intervention, as this knowledge is critical for guiding educational, academic, and resource priorities. Methods We profile the practice of epilepsy surgery between 1991 and 2011 in nine major epilepsy surgery centers in the United States, Germany, and Australia. Clinical, imaging, surgical, and histopathologic data were derived from the surgical databases at various centers. Results Although five of the centers performed their highest number of surgeries for mesial temporal sclerosis (MTS) in 1991, and three had their highest number of MTS surgeries in 2001, only one center achieved its peak number of MTS surgeries in 2011. The most productive year for MTS surgeries varied then by center; overall, the nine centers surveyed performed 48% (95% confidence interval [CI] −27.3% to −67.4%) fewer such surgeries in 2011 compared to either 1991 or 2001, whichever was higher. There was a parallel increase in the performance of surgery for nonlesional epilepsy. Further analysis of 5/9 centers showed a yearly increase of 0.6 ± 0.07% in the performance of invasive electroencephalography (EEG) without subsequent resections. Overall, although MTS was the main surgical substrate in 1991 and 2001 (proportion of total surgeries in study centers ranging from 33.3% to 70.2%); it occupied only 33.6% of all resections in 2011 in the context of an overall stable total surgical volume. Significance These findings highlight the major aspects of the evolution of epilepsy surgery across the past two decades in a sample of well-established epilepsy surgery centers, and the critical current challenges of this treatment option in addressing complex epilepsy cases requiring detailed evaluations. Possible causes and implications of these findings are discussed

  2. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

    Science.gov (United States)

    Liu, Wei-Cheng; Wan, Song-Lin; Yaseen, SM; Ren, Xiang-Hai; Tian, Cui-Ping; Ding, Zhao; Zheng, Ken-Yan; Wu, Yun-Hua; Jiang, Cong-Qing; Qian, Qun

    2016-01-01

    Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented. PMID:27672293

  3. Dionis: A Novel Remote-Center-of-Motion Parallel Manipulator for Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    R. Beira

    2011-01-01

    Full Text Available The large volume and reduced dexterity of current surgical robotic systems are factors that restrict their effective performance. To improve the usefulness of surgical robots in minimally invasive surgery (MIS, a compact and accurate positioning mechanism, named Dionis, is proposed in this paper. This spatial hybrid mechanism based on a novel parallel kinematics is able to provide three rotations and one translation for single port procedures. The corresponding axes intersect at a remote center of rotation (RCM that is the MIS entry port. Another important feature of the proposed positioning manipulator is that it can be placed below the operating table plane, allowing a quick and direct access to the patient, without removing the robotic system. This, besides saving precious space in the operating room, may improve safety over existing solutions. The conceptual design of Dionis is presented in this paper. Solutions for the inverse and direct kinematics are developed, as well as the analytical workspace and singularity analysis. Due to its unique design and kinematics, the proposed mechanism is highly compact, stiff and its dexterity fullfils the workspace specifications for MIS procedures.

  4. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

    Energy Technology Data Exchange (ETDEWEB)

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia; Pilch, Martin M.

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.

  5. Validation of four different risk stratification models in patients undergoing heart valve surgery in a single center in China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-xiao; XU Jian-ping; GE Yi-peng; WEI Yu; YANG Yan; LIU Feng; SHI Yi

    2011-01-01

    Background Several risk stratification models have been developed for cardiac surgery. This study aimed to evaluate the accuracy of four existing risk stratification models, the Fuwai System for Cardiac Operative Risk Evaluation (FuwaiSCORE), the Society of Thoracic Surgeons 2008 cardiac surgery risk model for isolated valve surgery (the STS model), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the initial Parsonnet's score (the Parsonnet model) in predicting prolonged intensive care unit (ICU) stay in Chinese patients undergoing heart valve surgery. Methods Data were collected retrospectively from records of 1333 consecutive patients who received heart valve surgery in a single center between November 2006 and December 2007. Prolonged ICU stay was defined as not less than 124 hours. Calibration was assessed using the Hosmer-Lemeshow (H-L) goodness of fit test. Discrimination was assessed using the receiver-operating-characteristic (ROC) curve area. Results The FuwaiSCORE showed good calibration and discrimination compared with other risk models. According to the H-L statistics, the value of the FuwaiSCORE was 12.82, P>0.1. The area under ROC curve of the FuwaiSCORE was 0.81 (95%C/0.78-0.84). Conclusions Our study suggests that the FuwaiSCORE is superior to the other three risk models in predicting prolonged length of ICU stay in Chinese patients with heart valve surgery. Having fewer variables, the system is much easier for bedside use than other systems.

  6. Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

    Directory of Open Access Journals (Sweden)

    Dankuc Dragan

    2014-01-01

    Full Text Available Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9% and in 15 (15.1%, respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4% children, whereas in four (4.6% children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75% manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%, hereditary factor in six (6.06%, and bacterial meningitis in four (4.04% patients. Somewhat less common causes were perinatal hypoxia in three (3.03%, premature birth in three (3.03%, Down syndrome in one (1.01%, and chronic otitis media in one (1.01% patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5% were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative

  7. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  8. [Video-assisted thoracic sympathectomy - the results from a center outpatient surgery program].

    Science.gov (United States)

    R Velho, Tiago; Junqueira, Nádia; Sena, André; Guerra, Nuno; Caldeira, João; Gallego, Javier; Nobre, Ângelo

    2016-01-01

    The outpatient surgery program from our department has started in 2014 to improve patient access to surgery and to reduce the surgical waitlist. Focused on the thoracic surgery, the most common intervention is the surgical treatment of primary hyperhidrosis by thoracic sympathectomy by video-assisted thoracoscopic surgery (VATS). It is performed according to the patient's symptoms, with section or application of surgical clips between R2-R5. Retrospective study including all the patients submitted to thoracic sympathectomy by video- -assisted thoracoscopy surgery from our department's outpatient surgery program from January 2014 to January 2016. In our outpatient program we performed 198 thoracic sympathectomy by VATS. The mean age of the patients was 32,8 years old. 63,6% of the patients were females and 36.4% were males. From the 198 endoscopic thoracic sympathectomy performed, 181 (91,4%) were performed bilatellary with section between R3-R5, 12 (6,1%) were performed with the application of surgical clips in R2-R4 and 3 (1.5%) could not be performed due to the presence of pleuropulmonary adhesions. One of the patients was re-operated due to recurrent symptoms and another patients had surgery to remove the surgical clips (bilaterally in R2) due to exaggerated abdominal compensatory hyperhidrosis. Three patients had pneumothorax. The surgical treatment of primary hyperhidrosis was the most frequent procedure in our outpatient surgery program. The procedure without the use of a thoracic drainage allowed its inclusion in the outpatient surgery program. Excluding 3 patients, all the patients were discharged within 12 hours after the surgery. The good results and the reduction of the surgical waitlist encourage the cardiothoracic outpatient surgery program.

  9. Outcomes following Pediatric Auditory Brainstem Implant Surgery: Early Experiences in a North American Center.

    Science.gov (United States)

    Puram, Sidharth V; Barber, Samuel R; Kozin, Elliott D; Shah, Parth; Remenschneider, Aaron; Herrmann, Barbara S; Duhaime, Ann-Christine; Barker, Fred G; Lee, Daniel J

    2016-07-01

    There are no approved Food and Drug Administration indications for pediatric auditory brainstem implant (ABI) surgery in the United States. Our prospective case series aims to determine the safety and feasibility of ABI surgery in pediatric patients age, 2.52 ± 0.39 years). Four patients underwent ABI surgery (age, 19.2 ± 3.43 months), including 4 primary procedures and 1 revision for device failure. Spontaneous device failure occurred in another subject postoperatively. No major/minor complications occurred, including cerebrospinal fluid leak, facial nerve injury, hematoma, and nonauditory stimulation. All subjects detected sound with environmental awareness, and several demonstrated babbling and mimicry. Poor durability of older implants underscores need for updated technology. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  10. Custodiol versus blood cardioplegia in pediatric cardiac surgery, two-center study

    Directory of Open Access Journals (Sweden)

    Ebtehal A. Qulisy

    2016-05-01

    Conclusions: Custodial cardioplegia is associated with less optimal myocardial protection and higher adverse outcomes compared to cold blood cardioplegia in children undergoing cardiac surgery. A randomized comparison is warranted.

  11. Overview of ASC Capability Computing System Governance Model

    Energy Technology Data Exchange (ETDEWEB)

    Doebling, Scott W. [Los Alamos National Laboratory

    2012-07-11

    This document contains a description of the Advanced Simulation and Computing Program's Capability Computing System Governance Model. Objectives of the Governance Model are to ensure that the capability system resources are allocated on a priority-driven basis according to the Program requirements; and to utilize ASC Capability Systems for the large capability jobs for which they were designed and procured.

  12. Evaluating the Performance of Albanian Savings and Credit (ASC Union

    Directory of Open Access Journals (Sweden)

    Jonida Bou Dib (Lekocaj

    2013-04-01

    Full Text Available This research paper aimed to evaluate the role of ASC Union through three main poles:its performance in relation to outreach, its financial sustainability, and its welfare impact.It was based mainly on a descriptive study and focused on an accurate event, trying toanswer questions such as: what, where, how, who and when, through the use of differentinformation and already existing theories. Moreover, a triangulated methodologycombining interviews, questionnaires and observations was applied in order to analyze themicrocredit impacts.From the outreach angle, it was found that ASC Union's outreach has shown anincrement over the period of study with different rates of growth from 2003 to 2010 onaverage by 14.7%. On the other hand, the operational sustainability measured by returnon assets and return on equity showed instability over the period of the study, making theASC Union financial sustainability doubtful. In summary, the members confirmed thatASC Union helped them to improve their activities and income, where 87 out of 100farmers confirmed that their income increased in the last 3 years, while 31 farmers out of100, respectively 8, 9 and 10 year-old-members, proclaimed that using the micro-loanhelped them to expand their activities, while 56 farmers confirmed that microcredithelped them not only in improving their income and activity, but also their productionincrement and activity expansion.

  13. Impact of surgical delay on outcomes in elderly patients undergoing emergency surgery: A single center experience

    Institute of Scientific and Technical Information of China (English)

    Marc; Ong; Tan; Yu; Guang; Tan; Kok; Yang

    2015-01-01

    AIM: To determine predisposing factors leading to surgical delay in elderly patients with acute abdominal conditions and its impact on surgical outcomes.METHODS: A retrospective review of a total of 144 patients aged 60 years and older who had undergone emergency abdominal surgery between 2010 and 2013 at a regional general hospital was analysed. The operations analysed were limited to perforated or gangrenous viscus and strangulated hernia. Patient demographic features, time taken to obtain a computed tomography scan, time taken to surgery and the impact on postoperative morbidity and mortality were analysed.RESULTS: The mean age was 70.5 ± 9.1 years and median time taken to surgery was 9 h. The overall mortality and complication rates(Clavien Dindo 3 and above) were 9% and 13.1% respectively. Diabetes mellitus was a significant predisposing factor which had an impact on surgical delays. Delays in surgery more than 24 h led to higher complication rates at 38.9%(P = 0.003), with multivariate analysis confirming it as an independent factor. Delays in obtaining a computed tomography(CT) scan was also shown to result in higher complication rates(Clavien Dindo 3 and above).CONCLUSION: Delays in performing emergency surgery in elderly lead to higher complication rates. Obtaining CT scans early also may facilitate prompt diagnosis of certain abdominal emergencies where presentation is more equivocal and this may lead to improved surgical outcomes.

  14. Robot-assisted cardiac surgery using the da vinci surgical system: a single center experience.

    Science.gov (United States)

    Kim, Eung Re; Lim, Cheong; Kim, Dong Jin; Kim, Jun Sung; Park, Kay Hyun

    2015-04-01

    We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were 194.8±48.6 minutes and 126.1±22.6 minutes in mitral valve repair operations and 132.0±32.0 minutes and 76.1±23.1 minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was 128.3±43.1 minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

  15. What is a certified hernia center? – The example of the German Hernia Society and German Society of General and Visceral Surgery

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2014-07-01

    Full Text Available To date the scientific definition Hernia Center does not exist and this term is beeing used by hospitals and private institutions as a marketing instrument. Hernia surgery has become increasingly more complex over the pass 25 years. Differenciated use of the various techniques in hernia surgery has been adopted as a taillord approach program and requires intensive engagement with, and extensive experience of, the entire field of hernia surgery. Therefore there is a need for hernia centers. A basic requirement for a credible certification process for hernia centers involves definition of requirements and there verification by hernia societies and/or non-profit organizations that are interested in assuring the best possible quality of hernia surgery. At present there are two processes for certification of hernia centers by hernia societies or non-profit organizations.

  16. Incidence of and Risk Factors for Delirium After Cardiac Surgery at a Quaternary Care Center: A Retrospective Cohort Study.

    Science.gov (United States)

    Tse, Lurdes; Schwarz, Stephan K W; Bowering, John B; Moore, Randell L; Barr, Alasdair M

    2015-12-01

    Delirium after cardiac surgery is associated with persistent cognitive deficits and increased mortality. The authors' objective was to determine the incidence of and risk factors for delirium in a mixed cohort of patients undergoing on-pump and off-pump cardiac surgery and transcatheter aortic valve implantations (TAVI) in a Canadian quaternary care center. This study followed a pilot from the same center on patients treated in 2007. A retrospective cohort study. A quaternary care center in Vancouver, B.C., Canada. Patients undergoing cardiopulmonary bypass grafts (CABG), conventional valve replacements, combined CABG-valve replacements, transfemoral TAVI, or transapical TAVI in 2008. Data from 679 charts on demographics, medical history, medications, laboratory results, surgical procedure, and anesthesia were abstracted and analyzed using univariate and multivariate analyses. Nurses screened for delirium using the Confusion Assessment Method, and the final diagnoses were made clinically by physicians. Risk factors were identified using logistic regression and bootstrapping. Delirium occurred in 28% of patients. Delirium was most common in transapical TAVI (47%), and least common in transfemoral TAVI (17%). Delirious patients were older and had greater preoperative cardiac and neurologic burdens than nondelirious patients. Age≥64 years, history of delirium, history of stroke/transient ischemic attack, cognitive impairment, depression, and preoperative use of beta-blocker(s) were associated independently with delirium. The incidence of delirium varied greatly with the type of procedure. The authors' logistic regression model showed that age and certain pre-existing neurologic conditions could predict delirium after cardiac surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Towards patient-centered colorectal cancer surgery : focus on risks, decisions and clinical auditing

    NARCIS (Netherlands)

    Snijders, Heleen Simone

    2014-01-01

    The aim of this thesis was to explore several aspects of both clinical decision making and quality assessment in colorectal cancer surgery. Part one focusses on benefits and risks of treatment options, preoperative information provision and Shared Decision Making (SDM); part two investigates changes

  18. Clinical and pathological investigation of adnexal masses in adolescents who underwent surgery in a tertiary center

    Directory of Open Access Journals (Sweden)

    Hediye Dağdeviren

    2015-06-01

    Full Text Available Objective: Adnexal masses are the most common reason for gynecologic surgery in adolescent patients. Early detection and adequate management of adnexal lesions are very important for saving lives and preserving fertility. In this study, we analyzed the clinical characteristics of 106 Turkish adolescent women who underwent surgery for adnexal masses. Methods: The study included 106 patients aged ≤20 years that underwent surgery for adnexal masses at our hospital between January 2008 and December 2013. Clinical profiles were retrospectively collected from the hospital medical records. The records were analyzed for demographic profiles, initial symptoms, preoperative radiologic findings, operative approach, surgical procedure, pathology findings, and the maximum diameter of the adnexal mass. Results: The age of the patients ranged from 12 to 20 years (median, 18.8 years. The most common initial symptom in these patients was abdominal pain (56.6%. Non-neoplastic ovarian lesions in the patients included 7 (6.6% corpora hemorrhagica, 10 (9.4% corpus luteal cysts, 4 (3.8% paratubal cysts, and 7 (6.6% simple cysts. Benign neoplastic tumors included 20 (18.9% mature cystic teratomas (i.e., dermoid tumors, 10 (9.4% serous cystadenomas, 1 (0.9% mucinous cystadenomas, and 7 (6.6% endometriomas. The most common surgical approach and procedure were laparoscopy (67.0% and cystectomy (60.4%, respectively. Conclusion: Laparoscopy can be performed in many adolescent patients and conservative, adnexal-sparing surgery should be encouraged for all patients. Ovarian-preserving techniques should be a priority when surgery is performed for benign masses in order to optimize future fertility potential. J Clin Exp Invest 2015; 6 (2: 96-101

  19. 76 FR 27668 - ASC Machine Tools, Inc., Spokane Valley, WA; Notice of Negative Determination on Reconsideration

    Science.gov (United States)

    2011-05-12

    ... Employment and Training Administration ASC Machine Tools, Inc., Spokane Valley, WA; Notice of Negative... Regarding Application for Reconsideration for the workers and former workers of ASC Machine Tools, Inc... adjustment assistance for workers and former workers of ASC Machine Tools, Inc., Spokane Valley,...

  20. Wireless Monitoring Program of Patient-Centered Outcomes and Recovery Before and After Major Abdominal Cancer Surgery.

    Science.gov (United States)

    Sun, Virginia; Dumitra, Sinziana; Ruel, Nora; Lee, Byrne; Melstrom, Laleh; Melstrom, Kurt; Woo, Yanghee; Sentovich, Stephen; Singh, Gagandeep; Fong, Yuman

    2017-06-07

    A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge. Reminders via email were generated for all moderate to severe scores for symptoms and quality of life. Surgery-related data were collected via electronic medical records, and complications were calculated using the Clavien-Dindo classification. The study was carried out in the inpatient and outpatient surgical oncology unit of one National Cancer Institute-designated comprehensive cancer center. Eligible patients were scheduled to undergo curative resection for hepatobiliary and gastrointestinal cancers, were English speaking, and were 18 years or older. Twenty participants were enrolled over 4 months. The study dates were April 1, 2015, to July 31, 2016. Outcomes included adherence to wearing the pedometer, adherence to completing the surveys (MD Anderson Symptom Inventory and EuroQol 5-dimensional descriptive system), and satisfaction with the monitoring program. This study included a final sample of 20 patients (median age, 55.5 years [range, 22-74 years]; 15 [75%] female) with evaluable data. Pedometer adherence (88% [17 of 20] before surgery vs 83% [16 of 20] after discharge) was higher than survey adherence (65% to 75% [13 of 20 and 15 of 20] completed). The median number of daily steps at day 7 was 1689 (19% of daily steps at baseline), which correlated with the Comprehensive Complication Index, for which the median was 15 of 100 (r = -0.64, P < .05). Postdischarge overall symptom severity (2

  1. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Directory of Open Access Journals (Sweden)

    Haliti NR

    2015-10-01

    Full Text Available Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery, University Dentistry Clinical Center of Kosovo, 5Institute of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo Background: Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK.Methods: The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription.Results: Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics.Conclusion: Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. Keywords: antibiotic, analgesics

  2. Applications of neuronavigation system in cranial surgery: experience of a single center

    Science.gov (United States)

    Nouri, Mohsen; Pahlavani, Mehrdad; Amirjamshidi, Abbas; Shirani-Bidabadi, Mohammad; Ketabchi, Ebrahim; Karimi-Yarandi, Kourosh

    2012-01-01

    Abstract: Background: Since the advent of navigational systems in neurosurgery, various implications have been introduced for them in spine and brain practices. Although, the range of surgeries in which these systems are being used is getting wider over time, their application is becoming more specific in certain situations. Methods: This means that defining specific indications for their usage is not as easy as it was previously thought. Brief reviewing of the available literature showed various navigation systems proposed and used in neurosurgery. Results: In this study, we review case selection criteria, techniques, and the results of neuronavigation applications in the patients underwent neurosurgical operations in the Sina hospital (Tehran, Iran) during 2011. Conclusions: The findings of our survey and experiences prove the efficacy and advantages of this technique that reduces the risk of neurovascular damage, neural tissue manipulation, operation time, and bleeding. Keywords: Neuronavigation, Cranial surgery, Navigational system

  3. Dionis: A Novel Remote-Center-of-Motion Parallel Manipulator for Minimally Invasive Surgery

    OpenAIRE

    Beira, R.; L. Santos-Carreras; Rognini, G.; H. Bleuler; Clavel, R.

    2011-01-01

    The large volume and reduced dexterity of current surgical robotic systems are factors that restrict their effective performance. To improve the usefulness of surgical robots in minimally invasive surgery (MIS), a compact and accurate positioning mechanism, named Dionis, is proposed in this paper. This spatial hybrid mechanism based on a novel parallel kinematics is able to provide three rotations and one translation for single port procedures. The corresponding axes intersect at a remote cen...

  4. Applications of neuronavigation system in cranial surgery: experience of a single center

    OpenAIRE

    Nouri, Mohsen; Pahlavani, Mehrdad; Amirjamshidi, Abbas; Shirani-Bidabadi, Mohammad; Ketabchi, Ebrahim; Karimi-Yarandi, Kourosh

    2012-01-01

    Abstract: Background: Since the advent of navigational systems in neurosurgery, various implications have been introduced for them in spine and brain practices. Although, the range of surgeries in which these systems are being used is getting wider over time, their application is becoming more specific in certain situations. Methods: This means that defining specific indications for their usage is not as easy as it was previously thought. Brief reviewing of the available literature showed var...

  5. Hepatic Steatosis Following Pancreatic Surgery: A Swedish Centers Experience with Demographics, Risks and Outcome

    OpenAIRE

    Tommy Ivanics; Srinivas Sanjeevi; Christoph Ansorge; Åke Andrén-Sandberg

    2015-01-01

    Objective Non-alcoholic fatty liver disease encompasses a spectrum of fatty changes in the liver ranging from simple steatosis to nonalcoholic steatohepatitis. Certain patients may develop hepatic steatosis following pancreatic resections. The aim of our study was to investigate factors possibly associated with steatosis after pancreatic resection and to see if the survival of patients was influenced by its development. Methods 182 consecutive patients that underwent pancreatic surgery (betwe...

  6. Pleural Effusion in Spinal Deformity Correction Surgery- A Report of 28 Cases in a Single Center.

    Directory of Open Access Journals (Sweden)

    Weiqiang Liang

    Full Text Available To analyze the occurrence, risk factors, treatment and prognosis of postoperative pleural effusion after spinal deformity correction surgery.The clinical and imaging data of 3325 patients undergoing spinal deformity correction were collected from the database of our hospital. We analyzed the therapeutic process of the 28 patients who had postoperative pleural effusion, and we identified the potential risk factors using logistic regression.Among the 28 patients with postoperative pleural effusion, 24 (85.7% suffered from hemothorax, 2 (7.1% from chylothorax, and 2 (7.1% from subarachnoid-pleural fistula. The pleural effusion occurred on the convex side in 19 patients (67.9%, on the concave side in 4 patients (14.3%, and on both sides in 4 patients (14.3%. One patient with left hemothorax was diagnosed with kyphosis. The treatment included conservative clinical observation for 5 patients and chest tube drainage for 23 patients. One patient also underwent thoracic duct ligation and pleurodesis. All of these treatments were successful. Logistic regression analysis showed that adult patients(≥18 years old, congenital scoliosis, osteotomy and thoracoplasty were risk factors for postoperative pleural effusion in spinal deformity correction surgery.The incidence of postoperative pleural effusion in spinal deformity correction surgery was approximately 0.84% (28/3325, and hemothorax was the most common type. Chest tube drainage treatment was usually successful, and the prognosis was good. Adult patients(≥18 years old, congenital scoliosis, and had undergone osteotomy or surgery with thoracoplasty were more likely to suffer from postoperative pleural effusion.

  7. Nineteen Years of Adult Congenital Heart Surgery in a Single Center

    DEFF Research Database (Denmark)

    Perinpanayagam, Madurra; Larsen, Signe H; Emmertsen, Kristian

    2017-01-01

    who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. RESULTS: Four...... hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor...... interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI...

  8. Solidification of Spent Ion Exchange Resin Using ASC Cement

    Institute of Scientific and Technical Information of China (English)

    周耀中; 云桂春; 叶裕才

    2002-01-01

    Ion exchange resins (IERs) have been widely used in nuclear facilities. However, the spent radioactive IERs result in major quantities of low and intermediate level radioactive wastes. This article describes a laboratory experimental study on solidification processing of IERs using a new type of cement named ASC cement. The strength of the cementation matrix is in the range of 18-20 MPa (28 d); the loading of the spent IER in the cement-resin matrix is over 45% and leaching rates of 137Cs, 90Sr and 60Co are 7.92×10-5, 5.7×10-6, and 1.19×10-8 cm/d. The results show that ASC cement can be a preferable cementation material for immobilization of radioactive spent IER.

  9. Extended Operation of Stirling Convertors at NASA Glenn Research Center

    Science.gov (United States)

    Oriti, Salvatore, M.

    2012-01-01

    NASA Glenn Research Center (GRC) has been supporting development of free-piston Stirling conversion technology for spaceflight electrical power generation since 1999. GRC has also been supporting the development of the Advanced Stirling Radioisotope Generator (ASRG) since 2006. A key element of the ASRG project is providing life, reliability, and performance data for the Advanced Stirling Convertor (ASC). The Thermal Energy Conversion branch at GRC is conducting extended operation of several free-piston Stirling convertors. The goal of this effort is to generate long-term performance data (tens of thousands of hours) on multiple units to build a life and reliability database. Currently, GRC is operating 18 convertors. This hardware set includes Technology Demonstration Convertors (TDCs) from Infinia Corporation, of which one pair (TDCs #13 and #14) has accumulated over 60,000 hr (6.8 years) of operation. Also under test are various Sunpower, Inc. convertors that were fabricated during the ASC development activity, including ASC-0, ASC-E (including those in the ASRG engineering unit), and ASC-E2. The ASC-E2s also completed, or are in progress of completing workmanship vibration testing, performance mapping, and extended operation. Two ASC-E2 units will also be used for durability testing, during which components will be stressed to levels above nominal mission usage. Extended operation data analyses from these tests are covered in this paper.

  10. Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan. Part 2, Mappings for the ASC software quality engineering practices. Version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, Molly A.; Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, 'ASCI Software Quality Engineering: Goals, Principles, and Guidelines'. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  11. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  12. Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan. Part 2, Mappings for the ASC software quality engineering practices. Version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, Molly A.; Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, 'ASCI Software Quality Engineering: Goals, Principles, and Guidelines'. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  13. ASC-ATDM Performance Portability Requirements for 2015-2019

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Harold C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Computing Research Center; Trott, Christian Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Computing Research Center

    2015-03-01

    This report outlines the research, development, and support requirements for the Advanced Simulation and Computing (ASC ) Advanced Technology, Development, and Mitigation (ATDM) Performance Portability (a.k.a., Kokkos) project for 2015 - 2019 . The research and development (R&D) goal for Kokkos (v2) has been to create and demonstrate a thread - parallel programming model a nd standard C++ library - based implementation that enables performance portability across diverse manycore architectures such as multicore CPU, Intel Xeon Phi, and NVIDIA Kepler GPU. This R&D goal has been achieved for algorithms that use data parallel pat terns including parallel - for, parallel - reduce, and parallel - scan. Current R&D is focusing on hierarchical parallel patterns such as a directed acyclic graph (DAG) of asynchronous tasks where each task contain s nested data parallel algorithms. This five y ear plan includes R&D required to f ully and performance portably exploit thread parallelism across current and anticipated next generation platforms (NGP). The Kokkos library is being evaluated by many projects exploring algorithm s and code design for NGP. Some production libraries and applications such as Trilinos and LAMMPS have already committed to Kokkos as their foundation for manycore parallelism an d performance portability. These five year requirements includes support required for current and antic ipated ASC projects to be effective and productive in their use of Kokkos on NGP. The greatest risk to the success of Kokkos and ASC projects relying upon Kokkos is a lack of staffing resources to support Kokkos to the degree needed by these ASC projects. This support includes up - to - date tutorials, documentation, multi - platform (hardware and software stack) testing, minor feature enhancements, thread - scalable algorithm consulting, and managing collaborative R&D.

  14. University of Utah ASC site review. August 24-25, 2006

    Energy Technology Data Exchange (ETDEWEB)

    Hertel, Eugene S., Jr. (.,; .)

    2007-02-01

    This report is a review of progress made by the Center for the Simulation of Accidental Fires and Explosions (C-SAFE) at the University of Utah, during the ninth year (Fiscal 2006) of its existence as an activity funded by the Department of Energy's Advanced Simulation and Computing Program (ASC). The ten-member Review Team composed of the TST and AST spent two days (August 24-25, 2006) at the University, reviewing formal presentations and demonstrations by the C-SAFE researchers and conferring privately. The Review Team found that the C-SAFE project administrators and staff had prepared well for the review. C-SAFE management and staff openly shared extensive answers to unexpected questions and the advance materials were well prepared and very informative. We believe that the time devoted to the review was used effectively and hope that the recommendations included in this 2006 report will provide helpful guidance to C-SAFE personnel and ASC managers.

  15. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by restricting the ... Online Education Directory Search Patient Learning Center Bariatric Surgery ... Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  16. Improving Communication Skills: A Course for Academic Medical Center Surgery Residents and Faculty.

    Science.gov (United States)

    Raper, Steven E; Gupta, Meera; Okusanya, Olugbenga; Morris, Jon B

    2015-01-01

    To improve physician/patient communication and familiarize surgeons with contemporary skills for and metrics assessing communication, courses were developed to provide academic general surgery residents and faculty with a toolkit of information, behaviors, and specific techniques. If academic faculty are expected to mentor residents in communication and residents are expected to learn good communication skills, then both should have the necessary education to accomplish such a goal. Didactic lectures introduced current concepts of physician-patient communication including information on better patient care, fewer malpractice suits, and the move toward transparency of communication metrics. Next, course participants viewed and critiqued "Surgi-Drama" videos, with actors simulating "before" and "after" physician-patient communication scenarios. Finally, participants were provided with a "toolkit" of techniques for improving physician-patient communication including "2-3-4"-a semiscripted short communication tool residents and other physicians can use in patient encounters-and a number of other acronymic approaches. Each participant was asked to complete an anonymous evaluation to assess course content satisfaction. Overall, 86% of residents participated (68/79), with a 52% response rate (35/68) for the evaluation tool. Overall, 88% of faculty participated (84/96), with an 84% response rate (71/84). Residents voiced satisfaction with all domains. For faculty, satisfaction was quantitatively confirmed (Likert score 4 or 5) in 4 of 7 domains, with the highest satisfaction in "communication of goals" and "understanding of the HCAHPS metric." The percentage of "top box" Doctor Communication Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and national percentile ranking showed a sustained increase more than 1 and 2 years from the dates of the courses. The assessment of communication skills is increasing in importance in the practice of

  17. Evolution of cerebral perfusion techniques in type a aortic dissection surgery: a single center experience.

    Science.gov (United States)

    Salah, K; van Straten, A H M; Soliman Hamad, M A; ter Woorst, J F; Tan, M E S H

    2012-09-01

    The purpose of this study was to investigate the effect of using antegrade selective cerebral perfusion (ASCP) with moderate hypothermia on hospital mortality after surgery for acute type A aortic dissection (AAAD). Between January 1998 and December 2008, 142 consecutive patients were operated on for AAAD. Patients were divided into two subgroups: the cohort of patients operated on from January 1998 until December 2003 (without ASCP) (P1998-2003, n=64) and the cohort operated on from January 2004 until December 2008 (with ASCP)(P2004-2008, n=78). The difference in hospital mortality was statistically significant (P1998-2003: 42.2%; P2004-2008: 14.1%, pperfusion with moderate hypothermia is a significant factor in decreasing hospital mortality.

  18. A MultiCenter Pilot Randomized Controlled Trial of Remote Ischemic Preconditioning in Major Vascular Surgery.

    Science.gov (United States)

    Healy, D A; Boyle, E; McCartan, D; Bourke, M; Medani, M; Ferguson, J; Yagoub, H; Bashar, K; O'Donnell, M; Newell, J; Canning, C; McMonagle, M; Dowdall, J; Cross, S; O'Daly, S; Manning, B; Fulton, G; Kavanagh, E G; Burke, P; Grace, P A; Moloney, M Clarke; Walsh, S R

    2015-11-01

    A pilot randomized controlled trial that evaluated the effect of remote ischemic preconditioning (RIPC) on clinical outcomes following major vascular surgery was performed. Eligible patients were those scheduled to undergo open abdominal aortic aneurysm repair, endovascular aortic aneurysm repair, carotid endarterectomy, and lower limb revascularization procedures. Patients were randomized to RIPC or to control groups. The primary outcome was a composite clinical end point comprising any of cardiovascular death, myocardial infarction, new-onset arrhythmia, cardiac arrest, congestive cardiac failure, cerebrovascular accident, renal failure requiring renal replacement therapy, mesenteric ischemia, and urgent cardiac revascularization. Secondary outcomes were components of the primary outcome and myocardial injury as assessed by serum troponin values. The primary outcome occurred in 19 (19.2%) of 99 controls and 14 (14.1%) of 99 RIPC group patients (P = .446). There were no significant differences in secondary outcomes. Our trial generated data that will guide future trials. Further trials are urgently needed. © The Author(s) 2015.

  19. Sandia National Laboratories Advanced Simulation and Computing (ASC) : appraisal method for the implementation of the ASC software quality engineering practices: Version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Turgeon, Jennifer; Minana, Molly A.

    2008-02-01

    This document provides a guide to the process of conducting software appraisals under the Sandia National Laboratories (SNL) ASC Program. The goal of this document is to describe a common methodology for planning, conducting, and reporting results of software appraisals thereby enabling: development of an objective baseline on implementation of the software quality engineering (SQE) practices identified in the ASC Software Quality Plan across the ASC Program; feedback from project teams on SQE opportunities for improvement; identification of strengths and opportunities for improvement for individual project teams; guidance to the ASC Program on the focus of future SQE activities Document contents include process descriptions, templates to promote consistent conduct of appraisals, and an explanation of the relationship of this procedure to the SNL ASC software program.

  20. Market-Based Health Care in Specialty Surgery: Finding Patient-Centered Shared Value.

    Science.gov (United States)

    Smith, Timothy R; Rambachan, Aksharananda; Cote, David; Cybulski, George; Laws, Edward R

    2015-10-01

    : The US health care system is struggling with rising costs, poor outcomes, waste, and inefficiency. The Patient Protection and Affordable Care Act represents a substantial effort to improve access and emphasizes value-based care. Value in health care has been defined as health outcomes for the patient per dollar spent. However, given the opacity of health outcomes and cost, the identification and quantification of patient-centered value is problematic. These problems are magnified by highly technical, specialized care (eg, neurosurgery). This is further complicated by potentially competing interests of the 5 major stakeholders in health care: patients, doctors, payers, hospitals, and manufacturers. These stakeholders are watching with great interest as health care in the United States moves toward a value-based system. Market principles can be harnessed to drive costs down, improve outcomes, and improve overall value to patients. However, there are many caveats to a market-based, value-driven system that must be identified and addressed. Many excellent neurosurgical efforts are already underway to nudge health care toward increased efficiency, decreased costs, and improved quality. Patient-centered shared value can provide a philosophical mooring for the development of health care policies that utilize market principles without losing sight of the ultimate goals of health care, to care for patients.

  1. Improving results of surgery for fecal peritonitis due to perforated colorectal disease: A single center experience.

    Science.gov (United States)

    Mineccia, Michela; Zimmitti, Giuseppe; Ribero, Dario; Giraldi, Francesco; Bertolino, Franco; Brambilla, Romeo; Ferrero, Alessandro

    2016-01-01

    fecal peritonitis due to colorectal perforation is a dramatic event characterized by high mortality. Our study aims at determining how results of sigmoid resection (eventually extended to upper rectum) for colorectal perforation with fecal peritonitis changed in recent years and which factors affected eventual changes. Seventy-four patients were operated on at our institution (2005-2014) for colorectal perforation with fecal peritonitis and were divided into two numerically equal groups (operated on before (ERA1-group) and after (ERA2-group) May 2010). Mannheim Peritonitis Index (MPI) was calculated for each patient. Characteristics of two groups were compared. Predictors of postoperative outcomes were identified. Postoperative overall complications, major complications, and mortality occurred in 59%, 28%, and 18% of cases, respectively, and were less frequent in ERA2-group (51%, 16%, and 8%, respectively), compared to ERA1-group (68%, 41%, and 27%, respectively; p = .155, .02, and .032, respectively). Such results paralleled lower MPI values in ERA2-group, compared to ERA1-group (23(16-39) vs. 28(21-43), p = .006). Using receiver operating characteristic analysis, the best cut-off value for MPI for predicting postoperative complications and mortality was 28.5. MPI>28 was the only independent predictor of postoperative overall (p = .009, OR = 4.491) and major complications (p peritonitis longer than 24 h (p = .045, OR = 17.099). results of surgery for colorectal perforation with fecal peritonitis have improved over time, matching a concurrent decrease of MPI values and a better preoperative patient management. MPI value may help in selecting patients benefitting from surgical treatment. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  2. Strategic response by providers to specialty hospitals, ambulatory surgery centers, and retail clinics.

    Science.gov (United States)

    Burns, Lawton R; David, Guy; Helmchen, Lorens A

    2011-04-01

    Radical innovation and disruptive technologies are frequently heralded as a solution to delivering higher quality, lower cost health care. According to the literature on disruption, local hospitals and physicians (incumbent providers) may be unable to competitively respond to such "creative destruction" and alter their business models for a host of reasons, thus threatening their future survival. However, strategic management theory and research suggest that, under certain conditions, incumbent providers may be able to weather the discontinuities posed by the disrupters. This article analyzes 3 disruptive innovations in service delivery: single-specialty hospitals, ambulatory surgical centers, and retail clinics. We first discuss the features of these innovations to assess how disruptive they are. We then draw on the literature on strategic adaptation to suggest how incumbents develop competitive responses to these disruptive innovations that assure their continued survival. These arguments are then evaluated in a field study of several urban markets based on interviews with both incumbents and entrants. The interviews indicate that entrants have failed to disrupt incumbent providers primarily as a result of strategies pursued by the incumbents. The findings cast doubt on the prospects for these disruptive innovations to transform health care.

  3. Comparison of Effects of Mechanical Stretching on Osteogenic Potential of ASCs and BMSCs

    Institute of Scientific and Technical Information of China (English)

    Brian E. Grottkau; Xingmei Yang; Liang Zhang; Ling Ye; Yunfeng Lin

    2013-01-01

    Mechanical forces play critical roles in the development and remodeling processes of bone. As an alternative cell source for bone engineering, adipose-derived stem cells (ASCs) should be fully investigated for their responses to mechanical stress. Similarly, the osteogenic potential, stimulated by mechanical stress, should be compared with bone marrow stromal cells (BMSCs), which have been clinically used for bone tissue engineering. In this study, ASCs and BMSCs were osteogenic-induced for 48 hours, and then subjected to uniaxial mechanical stretching for 2 or 6 hours. Cell orientation, osteogenic regulatory genes, osteogenic genes and ALP activities were measured and compared between ASCs and BMSCs. ASCs could align in a perpendicular way to the direction of stretching stress, while BMSCs did not present a specific alignment. Both 2 and 6 hours mechanical stretching could enhance the mRNA expression of Osx and Runx2 in BMSCs and ASCs, while OCN mRNA only increased in ASCs after 6 hours mechanical loading. Mechanical stretching enhanced the BMP-2 mRNA expression in ASCs, while only after 6 hours of mechanical loading significantly increased the BMP-2 gene expression in BMSCs. Significant differences only exist between ASCs and BMSCs loaded at 2 hours of mechanical stretching. It is concluded that ASCs are more rapid responders to mechanical stress, and have greater potential than BMSCs in osteogenesis when stimulated by mechanical stretching, indicating their usefulness for bone study in a rat model.

  4. Clinical features and risk assessment for cardiac surgery in adult congenital heart disease: Three years at a single Japanese center

    Directory of Open Access Journals (Sweden)

    Satoshi Kurokawa

    2014-04-01

    Conclusion: Cardiac surgery could be safely performed in most ACHD cases. Exercise tolerance testing can be useful in identifying patients at high risk of mortality or major complications. BNP can be valuable in predicting poor outcomes after cardiac surgery.

  5. Center of Cardiac Surgery Robotic Computerized Telemanipulation as Part of a Comprehensive Approach to Advanced Heart Care

    Science.gov (United States)

    2011-10-01

    Robotic OR Appendix E: Comparison Chart of daVinci Simulator Skill Sets and Training Exercise Activities 1 INTRODUCTION Robotic surgery recently...techniques in endoscopic cardiac bypass surgery is important not only for surgeons and surgical teams just beginning to perform robotic surgery , but also...Director, Robotic Surgery Scott Keith, PhD Faculty, Division of Biostatistics Rebecca O’Shea, MBA Senior Vice President for Clinical

  6. Characterization of ASC-2 as an antiatherogenic transcriptional coactivator of liver X receptors in macrophages.

    Science.gov (United States)

    Kim, Geun Hyang; Park, Keunhee; Yeom, Seon-Yong; Lee, Kyung Jin; Kim, Gukhan; Ko, Jesang; Rhee, Dong-Kwon; Kim, Young Hoon; Lee, Hye Kyung; Kim, Hae Won; Oh, Goo Taeg; Lee, Ki-Up; Lee, Jae W; Kim, Seung-Whan

    2009-07-01

    Activating signal cointegrator-2 (ASC-2) functions as a transcriptional coactivator of many nuclear receptors and also plays important roles in the physiology of the liver and pancreas by interacting with liver X receptors (LXRs), which antagonize the development of atherosclerosis. This study was undertaken to establish the specific function of ASC-2 in macrophages and atherogenesis. Intriguingly, ASC-2 was more highly expressed in macrophages than in the liver and pancreas. To inhibit LXR-specific activity of ASC-2, we used DN2, which contains the C-terminal LXXLL motif of ASC-2 and thereby acts as an LXR-specific, dominant-negative mutant of ASC-2. In DN2-overexpressing transgenic macrophages, cellular cholesterol content was higher and cholesterol efflux lower than in control macrophages. DN2 reduced LXR ligand-dependent increases in the levels of ABCA1, ABCG1, and apolipoprotein E (apoE) transcripts as well as the activity of luciferase reporters driven by the LXR response elements (LXREs) of ABCA1, ABCG1, and apoE genes. These inhibitory effects of DN2 were reversed by overexpression of ASC-2. Chromatin immunoprecipitation analysis demonstrated that ASC-2 was recruited to the LXREs of the ABCA1, ABCG1, and apoE genes in a ligand-dependent manner and that DN2 interfered with the recruitment of ASC-2 to these LXREs. Furthermore, low-density lipoprotein receptor (LDLR)-null mice receiving bone marrow transplantation from DN2-transgenic mice showed accelerated atherogenesis when administered a high-fat diet. Taken together, these results indicate that suppression of the LXR-specific activity of ASC-2 results in both defective cholesterol metabolism in macrophages and accelerated atherogenesis, suggesting that ASC-2 is an antiatherogenic coactivator of LXRs in macrophages.

  7. Sox9 Modulates Proliferation and Expression of Osteogenic Markers of Adipose-Derived Stem Cells (ASC

    Directory of Open Access Journals (Sweden)

    Sabine Stöckl

    2013-05-01

    Full Text Available Background: Mesenchymal stem cells (MSC are promising tools for tissue-engineering and musculoskeletal regeneration. They reside within various tissues, like adipose tissue, periosteum, synovia, muscle, dermis, blood and bone marrow, latter being the most common tissue used for MSC isolation. A promising alternative source for MSC is adipose tissue due to better availability and higher yield of MSC in comparison to bone marrow. A drawback is the yet fragmentary knowledge of adipose-derived stem cell (ASC physiology in order to make them a safe tool for in vivo application. Methods/Results: Here, we identified Sox9 as a highly expressed and crucial transcription factor in undifferentiated rat ASC (rASC. In comparison to rat bone marrow-derived stem cells (rBMSC, mRNA and protein levels of Sox9 were significantly higher in rASC. To study the role of Sox9 in detail, we silenced Sox9 with shRNA in rASC and examined proliferation, apoptosis and the expression of osteogenic differentiation markers. Our results clearly point to a difference in the expression profile of osteogenic marker genes between undifferentiated rASC and rBMSC in early passages. Sox9 silencing induced the expression of osteocalcin, Vegfα and Mmp13, and decreased rASC proliferation accompanied with an induction of p21 and cyclin D1 expression and delayed S-phase entry. Conclusions: We suggest a pro-proliferative role for Sox9 in undifferentiated rASC which may explain the higher proliferation rate of rASC compared to rBMSC. Moreover, we propose an osteogenic differentiation delaying role of Sox9 in rASC which suggests that Sox9 expression is needed to maintain rASC in an undifferentiated, proliferative state.

  8. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  9. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  10. High success rate and considerable adverse events of pelvic prolapse surgery with Prolift: A single center experience

    Directory of Open Access Journals (Sweden)

    Mun-Kun Hong

    2013-09-01

    Conclusions: Prolapse surgery with Prolift yielded a good anatomical outcome and satisfactory symptom improvement at different periods of follow-up, especially in uterus-sparing prolapse surgery. However, adverse events were not uncommon, and patients should be fully informed of all possible adverse events prior to surgery.

  11. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo.

    Science.gov (United States)

    Haliti, Naim R; Haliti, Fehim R; Koçani, Ferit K; Gashi, Ali A; Mrasori, Shefqet I; Hyseni, Valon I; Bytyqi, Samir I; Krasniqi, Lumnije L; Murtezani, Ardiana F; Krasniqi, Shaip L

    2015-01-01

    Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK). The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription. Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics. Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards.

  12. Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study.

    Science.gov (United States)

    Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A

    2016-01-01

    Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (purinary tract (CAKUT) (purinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  13. Bovine pericardium for portal vein reconstruction in abdominal surgery: a surgical guide and first experiences in a single center.

    Science.gov (United States)

    Jara, Maximilian; Malinowski, Maciej; Bahra, Marcus; Stockmannn, Martin; Schulz, Antje; Pratschke, Johann; Puhl, Gero

    2015-01-01

    Resection and reconstruction of infiltrated vessels achieve resectability of extended pancreatic tumors. The aim of the present study was to assess the feasibility of bovine pericardium as graft material for the individualised portal vein reconstruction and demonstrate a surgical technique for abdominal vein repair. We performed a MEDLINE search to review the methods for complex abdominal vein reconstruction in the course of extended pancreatectomy. Moreover, clinical data of patients receiving portal vein reconstruction using a bovine pericardial patch at our institution were retrospectively analyzed. Based on the results of a review of the literature, autologous venous grafts using the internal jugular vein represent the most popular option for segmental portal vein reconstruction in case of impossible direct suture. At our center, segmental portal vein reconstruction with bovine pericardial patch in course of pancreatic surgery was performed in 4 patients. No case of vascular complications such as occlusion, segmental stenosis or thrombosis occurred. Our experience suggests a surgical procedure for an individual size-matched portal vein reconstruction using bovine pericardium. Although first results appear promising, prospective studies are required to objectively assess the patency of bovine pericardium compared with autologous and synthetic interposition grafts for portal vein reconstruction. © 2015 S. Karger AG, Basel.

  14. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  15. Specification of the ASC to be used on the PRC satellite (HITSAT)

    DEFF Research Database (Denmark)

    Jørgensen, Finn E; Thuesen, Gøsta; Kilsgaard, Søren;

    1999-01-01

    The document describes the technical specifications of the ASC Star Tracker and the requirements for the equipment onboard the satellite HITSAT .......The document describes the technical specifications of the ASC Star Tracker and the requirements for the equipment onboard the satellite HITSAT ....

  16. 75 FR 65516 - ASC Machine Tools, Inc., Spokane Valley, WA; Notice of Affirmative Determination Regarding...

    Science.gov (United States)

    2010-10-25

    ... Employment and Training Administration ASC Machine Tools, Inc., Spokane Valley, WA; Notice of Affirmative... apply for Trade Adjustment Assistance (TAA) applicable to workers and former workers of ASC Machine Tools, Inc., Spokane Valley, Washington (the subject firm). The Notice of negative determination...

  17. Treatment and outcome of intestinal perforation after liver transplant surgery in adults: a single-center experience

    Directory of Open Access Journals (Sweden)

    Lin J

    2017-05-01

    Full Text Available Jianyu Lin,1,* Jing Wang,2,* Peng Yue,3 Xingmao Zhang,4 Ren Lang,4 Yuan Wang,4 Chen Cui,4 Qiang He4 1Integrated Department, 2Patient Service Center, The Affiliated Hospital to Capital Medical University, Beijing Chaoyang Hospital, 3School of Nursing, Department of Basic Nursing, Capital Medical University, 4Department of Hepatobiliary Surgery, The Affiliated Hospital to Capital Medical University, Beijing Chaoyang Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Objective: Intestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients.Materials and methods: The clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed.Results: The mean operative time was 8.5 h (range: 6–11 h. The mean portal vein occlusion time was 66.5 min (range: 58–72 min, and the mean cold ischemia time was 7.9 h (range: 6.5–9.5 h. Four (2.7% patients developed intestinal perforation from 9 to 14 days postliver transplant. All perforations were single and repaired by interrupted silk sutures. Two patients uneventfully recovered, but intestinal perforation recurred in two other patients. Simple repair was undertaken in one patient, and terminal ileum resection and ileostomy were performed in the other patient. There were no perioperative deaths.Conclusion: The incidence of intestinal perforation after liver transplantation is low. Prompt diagnosis and treatment should be carried out to reduce comorbidities and mortality. Keywords: liver transplant, intestinal perforation, incidence, treatment, nursing

  18. Differential splicing of the apoptosis-associated speck like protein containing a caspase recruitment domain (ASC regulates inflammasomes

    Directory of Open Access Journals (Sweden)

    Rojanasakul Yon

    2010-05-01

    Full Text Available Abstract Background The apoptotic speck-like protein containing a caspase recruitment domain (ASC is the essential adaptor protein for caspase 1 mediated interleukin (IL-1β and IL-18 processing in inflammasomes. It bridges activated Nod like receptors (NLRs, which are a family of cytosolic pattern recognition receptors of the innate immune system, with caspase 1, resulting in caspase 1 activation and subsequent processing of caspase 1 substrates. Hence, macrophages from ASC deficient mice are impaired in their ability to produce bioactive IL-1β. Furthermore, we recently showed that ASC translocates from the nucleus to the cytosol in response to inflammatory stimulation in order to promote an inflammasome response, which triggers IL-1β processing and secretion. However, the precise regulation of inflammasomes at the level of ASC is still not completely understood. In this study we identified and characterized three novel ASC isoforms for their ability to function as an inflammasome adaptor. Methods To establish the ability of ASC and ASC isoforms as functional inflammasome adaptors, IL-1β processing and secretion was investigated by ELISA in inflammasome reconstitution assays, stable expression in THP-1 and J774A1 cells, and by restoring the lack of endogenous ASC in mouse RAW264.7 macrophages. In addition, the localization of ASC and ASC isoforms was determined by immunofluorescence staining. Results The three novel ASC isoforms, ASC-b, ASC-c and ASC-d display unique and distinct capabilities to each other and to full length ASC in respect to their function as an inflammasome adaptor, with one of the isoforms even showing an inhibitory effect. Consistently, only the activating isoforms of ASC, ASC and ASC-b, co-localized with NLRP3 and caspase 1, while the inhibitory isoform ASC-c, co-localized only with caspase 1, but not with NLRP3. ASC-d did not co-localize with NLRP3 or with caspase 1 and consistently lacked the ability to function as an

  19. Changing profiles of pediatric epilepsy surgery candidates over time : A nationwide single-center experience from 1990 to 2011

    NARCIS (Netherlands)

    Lamberink, Herm J.; Boshuisen, K; van Rijen, Peter C.; Gosselaar, Peter H.; Braun, Kees P. J.

    ObjectiveOver the past decades, the number of epilepsy surgeries in children has increased and indications for surgery have broadened. We studied the changes in patient characteristics between 1990 and 2011 in a nationwide cohort and related these to seizure outcome and postoperative medication

  20. Composition-dependent structural changes and antitumor activity of ASC-DP/DSPE-PEG nanoparticles.

    Science.gov (United States)

    Higashi, Kenjirou; Mibu, Fusako; Saito, Kengo; Limwikrant, Waree; Yamamoto, Keiji; Moribe, Kunikazu

    2017-03-01

    Ascorbyl 2,6-dipalmitate (ASC-DP) and distearoyl phosphatidylethanolamine polyethylene glycol 2000 (DSPE-PEG) formed stable nanoparticles at a molar ratio of less than or equal to 2:1 after dispersing the solvent-evaporated film in water. The mean particle sizes measured by dynamic light scattering were within the range of ca. 100-160nm. Composition-dependent changes of the ASC-DP and DSPE-PEG molecular states within the film were analyzed by wide-angle X-ray diffraction and infrared (IR) and solid-state nuclear magnetic resonance (NMR) spectroscopy. Transmission electron microscopy (TEM) of nanoparticles revealed that ASC-DP/DSPE-PEG changed from a micelle to a disk and tubular structure as the molar ratio increased. Quantitative solution-state (1)H NMR measurements elucidated the structure of nanoparticle in water; the core could be composed of ASC-DP and hydrophobic acyl chains of DSPE, whereas the hydrophilic PEG chains of DSPE-PEG on the surface form the hydration shell to stabilize the nanoparticle dispersion in water. Cytotoxicity of ASC-DP against cancer cell lines was observed by using ASC-DP/DSPE-PEG nanoparticles, and no cytotoxicity against normal cells was found. Thus, the ASC-DP/DSPE-PEG formulation, with tumor cell specific cytotoxicity, can be applicable for cancer monotherapy or in combination with other anticancer drugs. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Outpatient Surgery

    Science.gov (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  2. Laparoscopic Surgery

    Science.gov (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  3. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study.

    Science.gov (United States)

    Stanford, Fatima Cody; Alfaris, Nasreen; Gomez, Gricelda; Ricks, Elizabeth T; Shukla, Alpana P; Corey, Kathleen E; Pratt, Janey S; Pomp, Alfons; Rubino, Francesco; Aronne, Louis J

    2017-03-01

    Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Two academic medical centers. We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy. A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications. Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  4. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m(2) (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  5. Test Rack Development for Extended Operation of Advanced Stirling Convertors at NASA Glenn Research Center

    Science.gov (United States)

    Dugala, Gina M.

    2010-01-01

    The U.S. Department of Energy, Lockheed Martin Space Systems Company, Sunpower Inc., and NASA Glenn Research Center (GRC) have been developing an Advanced Stirling Radioisotope Generator (ASRG) for use as a power system on space science missions. This generator will make use of free-piston Stirling convertors to achieve higher conversion efficiency than with currently available alternatives. One part of NASA GRC's support of ASRG development includes extended operation testing of Advanced Stirling Convertors (ASCs) developed by Sunpower Inc. and GRC. The ASC consists of a free-piston Stirling engine integrated with a linear alternator. NASA GRC has been building test facilities to support extended operation of the ASCs for several years. Operation of the convertors in the test facility provides convertor performance data over an extended period of time. One part of the test facility is the test rack, which provides a means for data collection, convertor control, and safe operation. Over the years, the test rack requirements have changed. The initial ASC test rack utilized an alternating-current (AC) bus for convertor control; the ASRG Engineering Unit (EU) test rack can operate with AC bus control or with an ASC Control Unit (ACU). A new test rack is being developed to support extended operation of the ASC-E2s with higher standards of documentation, component selection, and assembly practices. This paper discusses the differences among the ASC, ASRG EU, and ASC-E2 test racks.

  6. Proposed maximum surgical blood ordering schedule for common orthopedic surgeries in a Tertiary Health - Care Center in Northern India

    Directory of Open Access Journals (Sweden)

    Sonam Kumari

    2017-01-01

    CONCLUSIONS: MSBOS based on the past blood utilization records for different surgeries and keeping patients variables in consideration wherever required would provide an efficient way of blood utilization and appropriate management of blood bank resources.

  7. Outcomes of resective surgery in children and adolescents with focal lesional epilepsy: The experience of a tertiary epilepsy center.

    Science.gov (United States)

    Hirfanoglu, Tugba; Serdaroglu, Ayse; Kurt, Gokhan; Erdem, Atilla; Capraz, Irem; Bilir, Erhan; Vural, Ozge; Ucar, Murat; Oner, Ali Yusuf; Onal, Baran; Akdemir, Ozgur; Atay, Ozlem; Arhan, Ebru; Aydin, Kursad

    2016-10-01

    This study aimed to investigate the efficacy of resective surgery in children with focal lesional epilepsy by evaluating the predictive value of pre- and postsurgical factors in terms of seizure freedom. This study included 61 children aged between 2 and 18years who were admitted to the pediatric video-EEG unit for presurgical workup. Each patient was evaluated with a detailed history, video-EEG, neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom. All the possible factors including history, etiology, presurgical evaluation, surgical procedures, and postsurgical results were analyzed for their predictive value for postoperative seizure freedom. Of the 61 patients, 75% were diagnosed as having temporal lobe epilepsy (TLE), and 25% were diagnosed with extra-TLE. Two years after the surgery, 78.6% were seizure-free, of which 89% had TLE, and 50% had extra-TLE (pseizure freedom if they had rare seizure frequency, focal EEG findings, and focal seizures; had a temporal epileptogenic zone; or had TLE and hippocampal sclerosis. On the other hand, patients were more likely to have unfavorable results for seizure freedom if they had younger age of seizure onset, frequent seizures before the surgery, a frontal or multilobar epileptogenic zone, secondarily generalized seizures, extra-TLE with frontal lobe surgery, or focal cortical dysplasia. Resective surgery is one of the most effective treatment methods in children with intractable epilepsy. A history of young age of seizure onset, frequent seizures before surgery, secondarily generalized seizures, a multilobar epileptogenic zone, frontal lobe surgery, and focal cortical dysplasia (FCD) are the most important predictive factors indicating that a patient would continue having seizures after surgery. On the other hand, focal seizure semiologies, temporal lobe localization, and hippocampal sclerosis indicate that a patient would have better results in terms of

  8. Employment and Professional Outcomes in 803 Patients Undergoing Bariatric Surgery in a French Reference Center for Obesity

    Directory of Open Access Journals (Sweden)

    Q Durand-Moreau

    2015-04-01

    Full Text Available Background: Very few studies have been performed on small populations about the links between employment and bariatric surgery. Objective: To determine if rates of employment are increased among patients who have undergone bariatric surgery, to assess their post-operative health consequences (post-prandial weakness, diarrhea, and patients' ability to maintain post-operative advice (ie, 30 minutes of daily physical activity, 6 small meals daily compared to non-employed post-surgical patients. Methods: This cross-sectional study was performed in the Regional Reference Centre for Obesity, which is a partnership between the University Hospital and a clinic in Angers, France during 2012 using a self-administrated questionnaire completed by patients hospitalized for post-operative follow-ups after bariatric surgery. Issues investigated were their professional situation before and after the surgery, compliancy to post-operative advice, and any postoperative side effects. Results: Employment rates were 64.4% before and 64.7% after the surgery (p=0.94. Of these, 30.6% maintained 30 minutes of daily physical activity vs. 41.0% of non-workers (p=0.02. 50.5% of employed patients and 57.3% of non-workers maintained 6 small meals a day after surgery (p=0.09. 8% of working patients reported post-prandial weaknesses and 8% reported diarrhea that caused problems at work. Conclusion: Employment rate remained stable after surgery. Having a job seemed to be an obstacle to managing 30 minutes of daily exercise, especially among women, but not maintaining 6 small meals a day. Therefore, working environment needs to be assessed to improve job quality and retention for patients who have undergone bariatric surgery.

  9. Impact of prior abdominal surgery on the outcomes after robotic - assisted laparoscopic radical prostatectomy: single center experience

    Directory of Open Access Journals (Sweden)

    Nozomu Kishimoto

    Full Text Available ABSTRACT Purpose: To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP. Materials and Methods: We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications. Results: A total of 203 patients who underwent RALP during the study period were included in this study. In all, 65 patients (32% had a prior history of abdominal surgery, whereas 138 patients (68% had no prior history. The total operating, console, and port-insertion times were 328 and 308 (P=0.06, 252 and 242 (P=0.28, and 22 and 17 minutes (P=0.01, respectively, for patients with prior and no prior surgery. The estimated blood losses, positive surgical margin rates, mean durations of catheterization, and complication rates were 197 and 170 mL (P=0.29, 26.2% and 20.2% (P=0.32, 7.1 and 6.8 days (P=0.74, and 12.3% and 8.7% (P=0.42, respectively. Furthermore, whether prior abdominal surgery was performed above or below the umbilicus or whether single or multiple surgeries were performed did not further affect the perioperative outcomes. Conclusions: Our results suggest that RALP can be performed safely in patients with prior abdominal surgery, without increasing the risk of complications.

  10. Engineering a bilayered hydrogel to control ASC differentiation.

    Science.gov (United States)

    Natesan, Shanmugasundaram; Zamora, David O; Suggs, Laura J; Christy, Robert J

    2012-05-25

    Natural polymers over the years have gained more importance because of their host biocompatibility and ability to interact with cells in vitro and in vivo. An area of research that holds promise in regenerative medicine is the combinatorial use of novel biomaterials and stem cells. A fundamental strategy in the field of tissue engineering is the use of three-dimensional scaffold (e.g., decellularized extracellular matrix, hydrogels, micro/nano particles) for directing cell function. This technology has evolved from the discovery that cells need a substrate upon which they can adhere, proliferate, and express their differentiated cellular phenotype and function. More recently, it has also been determined that cells not only use these substrates for adherence, but also interact and take cues from the matrix substrate (e.g., extracellular matrix, ECM). Therefore, the cells and scaffolds have a reciprocal connection that serves to control tissue development, organization, and ultimate function. Adipose-derived stem cells (ASCs) are mesenchymal, non-hematopoetic stem cells present in adipose tissue that can exhibit multi-lineage differentiation and serve as a readily available source of cells (i.e. pre-vascular endothelia and pericytes). Our hypothesis is that adipose-derived stem cells can be directed toward differing phenotypes simultaneously by simply co-culturing them in bilayered matrices. Our laboratory is focused on dermal wound healing. To this end, we created a single composite matrix from the natural biomaterials, fibrin, collagen, and chitosan that can mimic the characteristics and functions of a dermal-specific wound healing ECM environment.

  11. Immunomagnetic Separation of Fat Depot-Specific Sca1high Adipose-Derived Stem Cells (Ascs)

    Science.gov (United States)

    Barnes, Richard H; Chun, Tae-Hwa

    2016-01-01

    The isolation of adipose-derived stem cells (ASCs) is an important method in the field of adipose tissue biology, adipogenesis, and extracellular matrix (ECM) remodeling. In vivo, ECM-rich environment consisting of fibrillar collagens provides a structural support to adipose tissues during the progression and regression of obesity. Physiological ECM remodeling mediated by matrix metalloproteinases (MMPs) plays a major role in regulating adipose tissue size and function1, 2. The loss of physiological collagenolytic ECM remodeling may lead to excessive collagen accumulation (tissue fibrosis), macrophage infiltration, and ultimately, a loss of metabolic homeostasis including insulin resistance3, 4. When a phenotypic change of the adipose tissue is observed in gene-targeted mouse models, isolating primary ASCs from fat depots for in vitro studies is an effective approach to define the role of the specific gene in regulating the function of ASCs. In the following, we define an immunomagnetic separation of Sca1high ASCs. PMID:27583550

  12. Evaluation of replacement protocols and modifications to TCP to enhance ASC Wide Area Network performance.

    Energy Technology Data Exchange (ETDEWEB)

    Romero, Randy L. Jr.

    2004-09-01

    Historically, TCP/IP has been the protocol suite used to transfer data throughout the Advanced Simulation and Computing (ASC) community. However, TCP was developed many years ago for an environment very different from the ASC Wide Area Network (WAN) of today. There have been numerous publications that hint of better performance if modifications were made to the TCP algorithms or a different protocol was used to transfer data across a high bandwidth, high delay WAN. Since Sandia National Laboratories wants to maximize the ASC WAN performance to support the Thor's Hammer supercomputer, there is strong interest in evaluating modifications to the TCP protocol and in evaluating alternatives to TCP, such as SCTP, to determine if they provide improved performance. Therefore, the goal of this project is to test, evaluate, compare, and report protocol technologies that enhance the performance of the ASC WAN.

  13. Methylation mediated silencing of TMS1/ASC gene in prostate cancer

    Directory of Open Access Journals (Sweden)

    Gopisetty Gopal

    2006-07-01

    Full Text Available Abstract Background Transcriptional silencing associated with aberrant promoter methylation has been established as an alternate pathway for the development of cancer by inactivating tumor suppressor genes. TMS1 (Target of Methylation induced Silencing, also known as ASC (Apoptosis Speck like protein containing a CARD is a tumor suppressor gene which encodes for a CARD (caspase recruitment domain containing regulatory protein and has been shown to promote apoptosis directly and by activation of downstream caspases. This study describes the methylation induced silencing of TMS1/ASC gene in prostate cancer cell lines. We also examined the prevalence of TMS1/ASC gene methylation in prostate cancer tissue samples in an effort to correlate race and clinico-pathological features with TMS1/ASC gene methylation. Results Loss of TMS1/ASC gene expression associated with complete methylation of the promoter region was observed in LNCaP cells. Gene expression was restored by a demethylating agent, 5-aza-2'deoxycytidine, but not by a histone deacetylase inhibitor, Trichostatin A. Chromatin Immunoprecipitation (ChIP assay showed enrichment of MBD3 (methyl binding domain protein 3 to a higher degree than commonly associated MBDs and MeCP2. We evaluated the methylation pattern in 66 prostate cancer and 34 benign prostatic hyperplasia tissue samples. TMS1/ASC gene methylation was more prevalent in prostate cancer cases than controls in White patients (OR 7.6, p 0.002 while no difference between the cases and controls was seen in Black patients (OR 1.1, p 0.91. Conclusion Our study demonstrates that methylation-mediated silencing of TMS1/ASC is a frequent event in prostate cancer, thus identifying a new potential diagnostic and prognostic marker for the treatment of the disease. Racial differences in TMS1/ASC methylation patterns implicate the probable role of molecular markers in determining in susceptibility to prostate cancer in different ethnic groups.

  14. Overall accuracy of cervical cytology and clinicopathological significance of LSIL cells in ASC-H cytology.

    Science.gov (United States)

    Kim, S H; Lee, J M; Yun, H G; Park, U S; Hwang, S U; Pyo, J-S; Sohn, J H

    2017-02-01

    The aims of this study were (i) to investigate the diagnostic accuracy of Papanicolaou (Pap) smears and (ii) to evaluate the clinicopathological significance of the presence of low-grade squamous intraepithelial lesion (LSIL) cells in atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H) cytology. We retrospectively reviewed paired cytological and histological findings from 3141 patients. ASC-H cytology was classified as either ASC-H or LSIL with some features suggestive of the presence of a concurrent HSIL (LSIL-H). Clinicopathological characteristics were evaluated through a retrospective study and meta-analysis. The accuracy of the cytological diagnosis was 93.7% (2942 of 3141 cases). The positive predictive value (PPV) of ASC-H for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+ ) was 51.4%. In cases of LSIL-H, CIN 2+ histology was more prevalent in the pre-menopausal period (19-44 years) than in peri- and postmenopausal periods (older than 45 years) (P = 0.024). There was no difference in the ability of LSIL-H and ASC-H to predict CIN 2+. The Pap smear is a good cervical cancer screening method. Although there was no difference in the predictive value for CIN 2+ between LSIL-H and ASC-H, the presence of definite LSIL cells was more predictive of CIN 2+ in younger patients than in older patients. © 2016 John Wiley & Sons Ltd.

  15. Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma

    Directory of Open Access Journals (Sweden)

    Hwang Tsann-Long

    2008-09-01

    Full Text Available Abstract Background Pancreatic adenosquamous carcinoma (ASC is a rare pancreatic malignancy subtype. We investigated the clinicopathological features and outcome of pancreatic ASC patients after surgery. Methods The medical records of 12 patients with pancreatic ASC undergoing surgical treatment (1993 to 2006 were retrospectively reviewed. Survival data of patients with stage IIB pancreatic adenocarcinoma and ASC undergoing surgical resection were compared. Results Symptoms included abdominal pain (91.7%, body weight loss (83.3%, anorexia (41.7% and jaundice (25.0%. Tumors were located at pancreatic head in 5 (41.7% patients, tail in 5 (41.7%, and body in 4 (33.3%. Median tumor size was 6.3 cm. Surgical resection was performed on 7 patients, bypass surgery on 3, and exploratory laparotomy with biopsy on 2. No surgical mortality was identified. Seven (58.3% and 11 (91.7% patients died within 6 and 12 months of operation, respectively. Median survival of 12 patients was 4.41 months. Seven patients receiving surgical resection had median survival of 6.51 months. Patients with stage IIB pancreatic ASC had shorter median survival compared to those with adenocarcinoma. Conclusion Aggressive surgical management does not appear effective in treating pancreatic ASC patients. Strategies involving non-surgical treatment such as chemotherapy, radiotherapy or target agents should be tested.

  16. Load Calculation of the American Criterion ASCE74%浅析美国规范ASCE74中的荷载计算

    Institute of Scientific and Technical Information of China (English)

    薛英

    2012-01-01

      在国际工程标书中,美国输电线路结构荷载导则《Guidelines for Electrical Transmission Line Structural Loading》(ASCE74-2009)经常是被业主青睐和采用的标准。本文结合工程实际介绍了ASCE74中,线路在大风工况、覆冰工况、安装维护以及断线等工况下的荷载计算,可供国际工程投标及设计使用。%  The requirements of(ASCE 74-2009) have been adopted in many international transmission line projects. The article introduced the basic requirements for extreme wind, ice and wind loading, construction&maintenance and for longitudinal load in ASCE74, which may be taken as the reference for the tender documents and design.

  17. Immunocytoexpression profile of ProExC in smears interpreted as ASC-US, ASC-H, and cervical intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Zeynep Tosuner

    2017-01-01

    Full Text Available Aims: We aimed to investigate the immunocytoexpression profiles of a novel assay ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 in abnormal interpreted smears. Settings and Design: Screening programs with Papanicolaou smear and high risk group human papilloma virus testing have yielded a dramatic reduction of cervical cancer incidence. However, both of these tests have limited specificity for the detection of clinically significant cervical high grade lesions. ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 has been considered to have tight association with high grade intraepithelial lesions. Materials and Methods: A total number of 54 SurePath cervical cytology specimens of patients previously interpreted as atypical squamous cells-undetermined significance (ASC-US, atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H, low grade squamous intraepithelial lesion (LSIL, and high grade squamous intraepithelial lesion (HSIL were included in our study. Results and Conclusions: ProEx C was positive in 14 of HSILs (100%, 3 of 19 LSILs (16%, 2 of 4 ASC-Hs, and none of ASC-USs (0%. The ProEx C test showed very intense nuclear staining in all cytologically abnormal cells. Further studies are indicated to evaluate the diagnostic role of ProEx C.

  18. Developing the Storyline for an Advance Care Planning Video for Surgery Patients: Patient-Centered Outcomes Research Engagement from Stakeholder Summit to State Fair.

    Science.gov (United States)

    Aslakson, Rebecca A; Schuster, Anne L R; Lynch, Thomas J; Weiss, Matthew J; Gregg, Lydia; Miller, Judith; Isenberg, Sarina R; Crossnohere, Norah L; Conca-Cheng, Alison M; Volandes, Angelo E; Smith, Thomas J; Bridges, John F P

    2017-08-17

    Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. The objective is to develop and test acceptability of an ACP video storyline. The design is a stakeholder-guided development of the ACP video storyline. Design-thinking methods explored and prioritized stakeholder perspectives. Patients and family members evaluated storyboards containing the proposed storyline. The study was conducted at hospital outpatient surgical clinics, in-person stakeholder summit, and the 2014 Maryland State Fair. Measurements are done through stakeholder engagement and deidentified survey. Stakeholders evaluated and prioritized evidence from an environmental scan. A surgeon, family member, and palliative care physician team iteratively developed a script featuring 12 core themes and worked with a medical graphic designer to translate the script into storyboards. For 10 days, 359 attendees of the 2014 Maryland State Fair evaluated the storyboards and 87% noted that they would be "very comfortable" or "comfortable" seeing the storyboard before major surgery, 89% considered the storyboards "very helpful" or "helpful," and 89% would "definitely recommend" or "recommend" this story to others preparing for major surgery. Through an iterative process utilizing diverse PCOR engagement methods and informed by SLT, storyboards were developed for an ACP video. Field testing revealed the storyline to be highly meaningful for surgery patients and family members.

  19. Comparison of Biodegradable and Titanium Fixation Systems in Maxillofacial Surgery : A Two-year Multi-center Randomized Controlled Trial

    NARCIS (Netherlands)

    van Bakelen, N. B.; Buijs, G. J.; Jansma, J.; de Visscher, J. G. A. M.; Hoppenreijs, Th. J. M.; Bergsma, J. E.; Stegenga, B.; Bos, R. R. M.

    2013-01-01

    Biodegradable osteosynthesis could reduce/delete the problems associated with titanium plate removal. The aim of the present study was to compare the clinical performance in the first 2 post-operative years between a biodegradable and a titanium system in oral and maxillofacial surgery. The multicen

  20. 77 FR 61411 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Science.gov (United States)

    2012-10-09

    ... ambulatory surgery locations (ASLs); and freestanding ambulatory surgery centers (ASCs). The National Center... surgery locations, and in 2010 began collection of data from free-standing ambulatory surgery centers... ASL). FREESTANDING AMBULATORY SURGERY CENTERS (FSASC) FSASC Chief Executive Officer.......

  1. A study on visual outcomes after cataract surgery with intraocular lens implants at the rural health training center, Paithan, Maharashtra

    Directory of Open Access Journals (Sweden)

    Vijay K Domple

    2011-01-01

    Full Text Available A study was conducted to assess the visual outcomes of patients after cataract surgery with intraocular lens implants with reference to visual acuity (VA and visual function (VF and to assess patient satisfaction with surgical outcome. The retrospective study was carried out using operation theatre records at the Rural Health Training Centre (RHTC, Paithan, during 2007. Out of 819 cataract surgery patients operated in 2007 a total of 50 were selected randomly. Door-to-door visits were paid by investigator and multipurpose worker to previously operated patients for VA examination and to fill predesigned questionnaire. Statistical analysis was done by using SPSS 17.0 Version; 50% patients had VA in fair vision range of <6/18-6/60 and 52% showed the VF in the range of 76-100. Of the 32 satisfied patients, majority were in the age group 70-79 years. The patients with good visual outcomes achieved after surgery would act as pamphlets for the community.

  2. Factors Affecting Innovation Within Aeronautical Systems Center (ASC) Organizations - An inductive Study

    Science.gov (United States)

    2003-03-01

    Innovation A Top Value Driver B2B 1. Innovation 2. Customer 3. Brand 4. Globalization 5. Quality B2C 1. Innovation 2. Brand 3. Customer 4. Quality...included in the appendix. The data was collected primarily via the Internet and all participants’ 18 anonymity was ensured through the use of...free to suggest new and better ways of doing things . 55.) My unit encourages appropriate risk taking. 56.) My unit challenges old ways of doing

  3. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  4. How to select elderly colorectal cancer patients for surgery: a pilot study in an Italian academic medical center

    Science.gov (United States)

    Ugolini, Giampaolo; Pasini, Francesco; Ghignone, Federico; Zattoni, Davide; Bacchi Reggiani, Maria Letizia; Parlanti, Daniele; Montroni, Isacco

    2015-01-01

    Objective Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer (CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or under-treatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC. Methods Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk factors. Results Forty-six patients were studied. The median follow-up time after surgery was 4.6 years (range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived (4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go (TUG), Eastern Cooperative Group Performance Status (ECOG PS), Instrumental Activities of Daily Living (IADLs), Vulnerable Elders Survey (VES-13) scoring systems were significantly associated with increased long term mortality risk. Conclusion Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients. PMID:26779367

  5. Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

    Directory of Open Access Journals (Sweden)

    Moslemi MK

    2011-05-01

    Full Text Available Mohammad Kazem Moslemi1, Mehdi Abedinzadeh2, Mohammad Aghaali11Department of Urology, Kamkar Hospital, School of Medicine, Qom University of Medical Sciences, Qom, Iran; 2Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranBackground: Circumcision can be performed for a variety of techniques, including conventional dissection surgery or a Plastibell device, and has religious, ritual, or medical roots. In countries like Iran, circumcision is done purely on religious grounds. In this study, we outline 390 cases in our practice and describe the epidemiology, indications, surgical technique used, and the early complications.Materials and methods: In this retrospective study, the charts for 390 circumcision cases were analyzed for the period March 2005 to August 2010. We reviewed all cases, noting age, indication, type of anesthesia used, technique, cosmetic appearance, and any potential early complications. All cases were followed up 1–4 weeks postoperatively and their notes were evaluated.Results: The age of children who underwent circumcision ranged from 3 weeks to 14 years, with a mean age of 4.25 years. The most common age for circumcision was 4–5 years (14.6%, and the least common age was 11–12 years (1.5%. In 372 cases (95%, the parents had opted for the procedure for religious reasons, and in 18 cases (5%, there was a medical indication, including phimosis (11 cases, 3%, urinary tract infection (5 cases, 1.2%, and balanoposthitis (2 cases, 0.8%. No major early complications were found in our series. Cosmetic appearance was satisfactory in all cases by 4 weeks after the operation.Conclusion: Circumcision was performed for religious reasons in our cases, although medical indications sometimes modified the timing of the procedure. Conventional dissection surgery for circumcision was safe, effective, and without any major complications.Keywords: male circumcision, conventional

  6. Aggressive clinical approach to obesity improves metabolic and clinical outcomes and can prevent bariatric surgery: a single center experience.

    Science.gov (United States)

    Cadegiani, Flavio A; Diniz, Gustavo C; Alves, Gabriella

    2017-01-01

    The number of bariatric procedures has exponentially increased in the past decade, as a result of the lack of successful clinical weight-loss interventions. The main reasons for the failure of clinical obesity management are: (1) anti-obesity medications are administered as monotherapies (or pre-combined drugs); (2) lack of combination between pharmacotherapy and non-pharmacological modalities; (3) short duration of pharmacotherapy for obesity; (4) lack of weight-loss maintenance strategies; (5) misunderstanding of the complex pathophysiology of obesity; and (6) underprescription of anti-obesity medications. We developed a protocol that can potentially overcome the drawbacks that may lead to the failure of clinical therapy for obesity. The aim of this study is therefore to report the clinical and metabolic effects of our proposed obesity-management protocol over a 2-year period, and to determine whether this more intensive approach to obesity management is feasible and a possible alternative to bariatric surgery in patients with moderate-to-severe obesity. This retrospective study involved 43 patients in whom bariatric surgery was indicated. Patients underwent an intensive anti-obesity protocol that included pharmacotherapy with multiple drugs; intense surveillance with monthly body analysis by air-displacement plethysmography, electrical bioimpedance, and 3D body scans; weekly psychotherapy; diet planning with a dietician every 2 months; and exercises at least 3 times a week with exercises prescribed by a personal trainer at least once a month. Body weight (BW), total weight excess (TWE), obesity class, body mass index, fat weight, muscle weight, waist circumference, and visceral fat were analyzed. Markers of lipid and glucose metabolism, liver function, and inflammation were also evaluated. Therapeutic success was defined as >20% BW loss or >50% decrease in TWE after 1 year. Significant improvements were observed in all clinical and metabolic parameters. Thirty

  7. Comparison of Simulated Microgravity and Hydrostatic Pressure for Chondrogenesis of hASC.

    Science.gov (United States)

    Mellor, Liliana F; Steward, Andrew J; Nordberg, Rachel C; Taylor, Michael A; Loboa, Elizabeth G

    2017-04-01

    Cartilage tissue engineering is a growing field due to the lack of regenerative capacity of native tissue. The use of bioreactors for cartilage tissue engineering is common, but the results are controversial. Some studies suggest that microgravity bioreactors are ideal for chondrogenesis, while others show that mimicking hydrostatic pressure is crucial for cartilage formation. A parallel study comparing the effects of loading and unloading on chondrogenesis has not been performed. The goal of this study was to evaluate chondrogenesis of human adipose-derived stem cells (hASC) under two different mechanical stimuli relative to static culture: microgravity and cyclic hydrostatic pressure (CHP). Pellets of hASC were cultured for 14 d under simulated microgravity using a rotating wall vessel bioreactor or under CHP (7.5 MPa, 1 Hz, 4 h · d-1) using a hydrostatic pressure vessel. We found that CHP increased mRNA expression of Aggrecan, Sox9, and Collagen II, caused a threefold increase in sulfated glycosaminoglycan production, and resulted in stronger vimentin staining intensity and organization relative to microgravity. In addition, Wnt-signaling patterns were altered in a manner that suggests that simulated microgravity decreases chondrogenic differentiation when compared to CHP. Our goal was to compare chondrogenic differentiation of hASC using a microgravity bioreactor and a hydrostatic pressure vessel, two commonly used bioreactors in cartilage tissue engineering. Our results indicate that CHP promotes hASC chondrogenesis and that microgravity may inhibit hASC chondrogenesis. Our findings further suggest that cartilage formation and regeneration might be compromised in space due to the lack of mechanical loading.Mellor LF, Steward AJ, Nordberg RC, Taylor MA, Loboa EG. Comparison of simulated microgravity and hydrostatic pressure for chondrogenesis of hASC. Aerosp Med Hum Perform. 2017; 88(4):377-384.

  8. ASC-H in Pap test- definitive categorization of cytomorphological spectrum

    Directory of Open Access Journals (Sweden)

    Chivukula Mamatha

    2006-05-01

    Full Text Available Abstract Objective The American Society for Colposcopy and Cervical Pathology (ASCCP guidelines for management of ASC-H is colposcopic examination followed by biopsy. HPV testing (HPVT is recommended after a negative biopsy result. More definitive interpretation of ASC-H could prevent discomfort and minimize the cost. The purpose of this study was to evaluate association of various cytomorphological patterns of ASC-H with various clinical scenarios. Methods We reviewed SurePath™ (TriPath Imaging, Inc. Burlington, NC, USA cervical smears interpreted as ASC-H in 161 women (mean age, 37 {15 to 78} years, over 24 months (2002 to 2003. HPVT (Digene, Hybrid Capture® II HPV test, Digene Corporation, Gaithersburg, MD, USA was performed in 20% of cases (33/161 and biopsy results were available in 54 cases (19 with and 35 without HPVT. Results HPVT was positive in 64% (21/33 cases, and negative in 36% (12/33 cases. In the follow-up biopsies of 71% (15/21 of cases with positive HPVT, 27% showed HPV changes or CIN1, 27% showed CIN2-3, and 46% were negative for epithelial abnormality. Follow-up biopsies from cases with negative HPVT (33%, 4/12 cases, 8% showed CIN1 and 25% were negative for any epithelial abnormality. Six cytomorphological patterns of ASC-H correlated with different clinical categories in relation to HPVT and biopsy results. 35% (19 out of 54 ASC-H cases in which biopsy results were available could be interpreted definitively as HSIL by cytopathology, 11% (6/54 cases as LSIL with cyanophilic atypical parakeratotic pattern, and 31% (17/54 cases as reactive, with HPV status. The interpretation had to be continued as ASC-H in 22% (12/54 cases. Conclusion ASC-H demonstrated a spectrum of cytomorphological patterns. Some of these patterns in liquid-based cervical smears may be more specifically interpreted as LSIL, HSIL, or benign if HPV status is known.

  9. Fundamentals of civil engineering an introduction to the ASCE body of knowledge

    CERN Document Server

    McCuen, Richard H; Wong, Melanie K

    2011-01-01

    While the ASCE Body of Knowledge (BOK2) is the codified source for all technical and non-technical information necessary for those seeking to attain licensure in civil engineering, recent graduates have notoriously been lacking in the non-technical aspects even as they excel in the technical. Fundamentals of Civil Engineering: An Introduction to the ASCE Body of Knowledge addresses this shortfall and helps budding engineers develop the knowledge, skills, and attitudes suggested and implied by the BOK2. Written as a resource for all of the non-technical outcomes not specifically covered in the

  10. MicroASC instrument onboard Juno spacecraft utilizing inertially controlled imaging

    DEFF Research Database (Denmark)

    Pedersen, David Arge Klevang; Jørgensen, Andreas Härstedt; Benn, Mathias

    2016-01-01

    This contribution describes the post-processing of the raw image data acquired by the microASC instrument during the Earth-fly-by of the Juno spacecraft. The images show a unique view of the Earth and Moon system as seen from afar. The procedure utilizes attitude measurements and inter......-calibration of the Camera Head Units of the microASC system to trigger the image capturing. The triggering is synchronized with the inertial attitude and rotational phase of the sensor acquiring the images. This is essentially works as inertially controlled imaging facilitating image acquisition from unexplored...

  11. Dual role of apoptosis-associated speck-like protein containing a CARD (ASC) in tumorigenesis of human melanoma

    NARCIS (Netherlands)

    Liu, W.; Luo, Y.; Dunn, J.H.; Norris, D.A.; Dinarello, C.A.; Fujita, M.

    2013-01-01

    Apoptosis-associated Speck-like protein containing a CARD (caspase recruitment domain) (ASC) was originally named because it triggered apoptosis in certain tumors. More recently, however, ASC was found to be a central adaptor protein of inflammasome, which mediates the secretion of protumorigenic

  12. Quercetin Inhibits Inflammasome Activation by Interfering with ASC Oligomerization and Prevents Interleukin-1 Mediated Mouse Vasculitis

    Science.gov (United States)

    Domiciano, Talita P.; Wakita, Daiko; Jones, Heather D.; Crother, Timothy R.; Verri, Waldiceu A.; Arditi, Moshe; Shimada, Kenichi

    2017-01-01

    Interleukin-1β (IL-1β) is a highly inflammatory cytokine that significantly contributes to both acute and chronic inflammatory diseases. The secretion of IL-1β requires a unique protease, caspase-1, which is activated by various protein platforms called inflammasomes. Data suggests a key role for mitochondrial reactive oxygen species for inflammasome activation. Flavonoids constitute a group of naturally occurring polyphenolic molecules with many biological activities, including antioxidant effects. In this study, we investigated the effect of three flavonoids, quercetin (QUC), naringenin, and silymarim on inflammasome activation. We found that QUC inhibits IL-1β secretion by both the NLRP3 and AIM2 inflammasome in a dose dependent manner, but not the NLRC4 inflammasome. QUC inhibition of the inflammasome was still observed in Atg16l1 knockout macrophages, indicating that QUC’s effect was autophagy independent. Since QUC inhibited both NLRP3 and AIM2 inflammasomes but not NLRC4, we assessed ASC speck formation. QUC reduced ASC speck formation and ASC oligomerization compared with controls. Additionally, QUC inhibited IL-1β in Cryopyrin-Associated Periodic Syndromes (CAPS) macrophages, where NLRP3 inflammasome is constitutively activated. In conclusion, QUC inhibits both the NLRP3 and AIM2 inflammasome by preventing ASC oligomerization and may be a potential therapeutic candidate for Kawasaki disease vasculitis and other IL-1 mediated inflammatory diseases. PMID:28148962

  13. Quercetin Inhibits Inflammasome Activation by Interfering with ASC Oligomerization and Prevents Interleukin-1 Mediated Mouse Vasculitis.

    Science.gov (United States)

    Domiciano, Talita P; Wakita, Daiko; Jones, Heather D; Crother, Timothy R; Verri, Waldiceu A; Arditi, Moshe; Shimada, Kenichi

    2017-02-02

    Interleukin-1β (IL-1β) is a highly inflammatory cytokine that significantly contributes to both acute and chronic inflammatory diseases. The secretion of IL-1β requires a unique protease, caspase-1, which is activated by various protein platforms called inflammasomes. Data suggests a key role for mitochondrial reactive oxygen species for inflammasome activation. Flavonoids constitute a group of naturally occurring polyphenolic molecules with many biological activities, including antioxidant effects. In this study, we investigated the effect of three flavonoids, quercetin (QUC), naringenin, and silymarim on inflammasome activation. We found that QUC inhibits IL-1β secretion by both the NLRP3 and AIM2 inflammasome in a dose dependent manner, but not the NLRC4 inflammasome. QUC inhibition of the inflammasome was still observed in Atg16l1 knockout macrophages, indicating that QUC's effect was autophagy independent. Since QUC inhibited both NLRP3 and AIM2 inflammasomes but not NLRC4, we assessed ASC speck formation. QUC reduced ASC speck formation and ASC oligomerization compared with controls. Additionally, QUC inhibited IL-1β in Cryopyrin-Associated Periodic Syndromes (CAPS) macrophages, where NLRP3 inflammasome is constitutively activated. In conclusion, QUC inhibits both the NLRP3 and AIM2 inflammasome by preventing ASC oligomerization and may be a potential therapeutic candidate for Kawasaki disease vasculitis and other IL-1 mediated inflammatory diseases.

  14. The standardized psychometric assessment of altered states of consciousness (ASCs) in humans.

    Science.gov (United States)

    Dittrich, A

    1998-07-01

    The APZ questionnaire was developed in order to explore hypotheses on ASCs. First -- in a series of 11 experiments using different induction methods on N = 393 healthy subjects -- the hypothesis was tested that ASCs have major dimensions in common irrespective of the mode of their induction. In the International Study on Altered States of Consciousness (ISASC) the external validity of the experimental results was assessed. The ISASC was carried out on a total of N = 1133 subjects in six countries. The main results of the experimental studies were corroborated in the field studies. The results can be summarized as follows: the common denominator of ASCs is described by three oblique dimensions, designated as "Oceanic Boundlessness (OSE)", "Dread of Ego Dissolution (AIA)" and "Visionary Restructuralization (VUS)". The reliability and validity of the scales are satisfactory. Tested versions of the APZ scales are available in English (UK, USA), German, Italian and Portuguese. Psychometrically as yet untested versions exist in Dutch, Finnish, French, Greek, Spanish and Russian. The APZ questionnaire has become the international standard for the assessment of ASCs, thus helping to integrate research. A psychometrically improved version exists in German (OAV questionnaire). The BETA questionnaire, which measures the dimensions "Vigilance Reduction (VIR)" and "Auditive Alteration (AVE)" is also available in German. These dimensions are most likely etiology-dependent.

  15. 18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM...

  16. ASC Computational Environment (ACE) requirements version 8.0 final report.

    Energy Technology Data Exchange (ETDEWEB)

    Larzelere, Alex R. (Exagrid Engineering, Alexandria, VA); Sturtevant, Judith E.

    2006-11-01

    A decision was made early in the Tri-Lab Usage Model process, that the collection of the user requirements be separated from the document describing capabilities of the user environment. The purpose in developing the requirements as a separate document was to allow the requirements to take on a higher-level view of user requirements for ASC platforms in general. In other words, a separate ASC user requirement document could capture requirements in a way that was not focused on ''how'' the requirements would be fulfilled. The intent of doing this was to create a set of user requirements that were not linked to any particular computational platform. The idea was that user requirements would endure from one ASC platform user environment to another. The hope was that capturing the requirements in this way would assist in creating stable user environments even though the particular platforms would be evolving and changing. In order to clearly make the separation, the Tri-lab S&CS program decided to create a new title for the requirements. The user requirements became known as the ASC Computational Environment (ACE) Requirements.

  17. Voluntary autonomous simulator based training in minimally invasive surgery, residents' compliance and reflection

    NARCIS (Netherlands)

    van Empel, P.J.; Verdam, M.G.E.; Strypet, M.; van Rijssen, L.B.; Huirne, J. A.; Scheele, F.; Bonjer, H.J.; Meijerink, W.J.

    2012-01-01

    Background: Knot tying and suturing skills in minimally invasive surgery (MIS) differ markedly from those in open surgery. Appropriate MIS training is mandatory before implementation into practice. The Advanced Suturing Course (ASC) is a structured simulator based training course that includes a 6-w

  18. Composite PLGA/AgNpPGA/AscH nanospheres with combined osteoinductive, antioxidative, and antimicrobial activities.

    Science.gov (United States)

    Stevanović, Magdalena; Uskoković, Vuk; Filipović, Miloš; Škapin, Srečo D; Uskoković, Dragan

    2013-09-25

    The global rise in the resistance of pathogens to conventional antibiotics has created an intensive search for alternative materials with antimicrobial properties. This study is performed with an intention to investigate the combined effects of poly(l-glutamic acid)-capped silver nanoparticles (AgNpPGA) and ascorbic acid (AscH) encapsulated within freeze-dried poly(lactide-co-glycolide) (PLGA) nanospheres to obtain a nanomaterial with simultaneous osteoinductive, antioxidative, and prolonged antimicrobial properties. The influence of PLGA/AgNpPGA/AscH particles on (i) viability and superoxide production of human umbilical vein endothelial cells in vitro, (ii) morphology and expression of osteogenic markers in osteoblastic MC3T3-E1 cells in vitro, and (iii) antimicrobial activity against a Gram-positive bacterium, methicillin-resistant Staphylococcus aureus, and a Gram-negative bacterium, Escherichia coli, was investigated. PLGA/AgNpPGA/AscH nanoparticles showed a superior and extended antibacterial activity against both types of bacteria. The nanoparticles appeared to be capable of delivering ascorbate to the cells, which was evidenced by the significant decrease in the level of superoxides in human umbilical vein endothelial cells and which could have a therapeutic potential in preventing oxidative stress. PLGA/AgNpPGA/AscH nanoparticles had a positive effect on MC3T3-E1 osteoblastic cells in vitro, promoting: (i) an intimate contact with the cells and preservation of their healthy morphologies; (ii) unreduced cell viability; and (iii) multiple-fold upregulation of two osteogenic markers: osteocalcin and type I procollagen. It is concluded that PLGA/AgNpPGA/AscH nanospheres present a promising new material for the treatment of infections and use in wound dressings and other prophylactic applications.

  19. Small Radioisotope Power System Testing at NASA Glenn Research Center

    Science.gov (United States)

    Dugala, Gina; Bell, Mark; Oriti, Salvatore; Fraeman, Martin; Frankford, David; Duven, Dennis

    2013-01-01

    In April 2009, NASA Glenn Research Center (GRC) formed an integrated product team (IPT) to develop a Small Radioisotope Power System (SRPS) utilizing a single Advanced Stirling Convertor (ASC) with passive balancer. A single ASC produces approximately 80 We making this system advantageous for small distributed lunar science stations. The IPT consists of Sunpower, Inc., to provide the single ASC with a passive balancer, The Johns Hopkins University Applied Physics Laboratory (JHUAPL) to design an engineering model Single Convertor Controller (SCC) for an ASC with a passive balancer, and NASA GRC to provide technical support to these tasks and to develop a simulated lunar lander test stand. The single ASC with a passive balancer, simulated lunar lander test stand, and SCC were delivered to GRC and were tested as a system. The testing sequence at GRC included SCC fault tolerance, integration, electromagnetic interference (EMI), vibration, and extended operation testing. The SCC fault tolerance test characterized the SCCs ability to handle various fault conditions, including high or low bus power consumption, total open load or short circuit, and replacing a failed SCC card while the backup maintains control of the ASC. The integrated test characterized the behavior of the system across a range of operating conditions, including variations in cold-end temperature and piston amplitude, including the emitted vibration to both the sensors on the lunar lander and the lunar surface. The EMI test characterized the AC and DC magnetic and electric fields emitted by the SCC and single ASC. The vibration test confirms the SCCs ability to control the single ASC during launch. The extended operation test allows data to be collected over a period of thousands of hours to obtain long term performance data of the ASC with a passive balancer and the SCC. This paper will discuss the results of each of these tests.

  20. EFFICACY OF ADDING FENTANYL TO LIGNOCAINE – ADRENALINE COMBINATION IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB ORTHOPEDIC SURGERIES A MULTI - CENTER STUDY

    Directory of Open Access Journals (Sweden)

    Anish M

    2015-06-01

    Full Text Available BACKGROUND: Brachial plexus block is a suitable alternative to general anesthesia for surgeries of upper limb and it can be performed even in patients who are not adequately fit for general anesthesia. The significance of brachial plexus block has increased in recent years due to renewed interest in day care surgery. Lignocaine hydrochloride has been used extensively for brachial plexus block and it has the disadvantage of having short duration of action. Opioids when added to anesthetic mixtures may improve and prolo ng the action of local anesthetics during peripheral nerve blocks. Such postoperative pain control can reduce both narcotic requirements and narcotic induced side effects. Studies have shown the efficacy of opioids as analgesic adjuvants in prolonging the duration of brachial plexus block. With this background in mind, this study was conducted to compare the onset and duration of sensory and motor block produced by a mixture of lignocaine and adrenaline with that produced by a mixture of fentanyl, lignocain e and adrenaline. Aims: To assess the effectiveness of addition of fentanyl to a mixture of lignocaine and adrenaline in prolonging the duration of analgesia and motor block for upper limb orthopedic surgeries. MATERIALS AND METHODS: This multi - center rand omized control study was conducted in two tertiary care centers in 80 patients underwent elective upper limb orthopedic surgeries and they were allocated into two groups of 40 each group L and group F. the classical approach of supraclavicular brachial ple xus block. Drug used were 30 ml of lignocaine 1.5%+adrenaline 5mcg/ml + 0.5ml normal saline in group L and 30ml of lignocaine 1.5% + adrenaline 5mcg/ml + fentanyl 50 mcg in group F. Adequacy of block was assessed by the pin prick test and temperature test. Motor power was assessed by the modified Lowett scale. Sedation was monitored using the modified Ramsay scale. An assessment was made for onset of analgesia, onset of

  1. Study of ASC in Cervical Exfoliated Cytology%宫颈脱落细胞学中 ASC 的研究与分析

    Institute of Scientific and Technical Information of China (English)

    张志兴

    2015-01-01

    Objective To investigate the significance of thinprep cytoligic test (TCT) in the diagnosis of atypical squamous cells.Methods A retrospective analysis was conducted among TCT samples from which those with atypical squamous cells were diag-nosed from July 2012 till July 2014.Results Of all 349 cases, 152 were HPV-positive, and 44.7% were diagnosed with cervical intraepithelial neoplasia or cervical cancer; among 197 cases of HPV-negative patients, 8 cases of patients were with cervical intraepi-thelial neoplasia or cervical cancer.since atypical squamous cells were correlated with age, women older than 40 years old composed the main part of ASC.Conclusion TCT was meaningful for an early detection of cervical lesions and cervical cancer.Increasing awareness of ASC and attention to patients may avoid delay in diagnosis and treatment of cervical lesions.%目的:探讨薄层液基细胞学检测(Thinprep cytoligic test, TCT)在诊断非典型鳞状细胞的意义。方法回顾性分析某医院2012年7月至2014年7月期间 TCT 标本中诊断为非典型鳞状细胞患者的结局。结果349例宫颈非典型鳞状细胞中,152例患者 HPV 阳性,44.7%存在宫颈上皮内瘤变或宫颈癌;197例 HPV 阴性患者中,8例患者存在宫颈上皮内瘤变或宫颈癌。同时非典型鳞状细胞的诊断与年龄存在相关性,年龄在40岁以上的妇女被诊断为 ASC 的人数较多。结论宫颈 TCT 及 HPV 筛查对于宫颈癌前病变及宫颈癌的早期发现有重要价值。应提高对 ASC 认识及对患者重视,以免耽误宫颈病变的诊断和治疗。

  2. NASA Glenn Research Center Support of the Advanced Stirling Radioisotope Generator Project

    Science.gov (United States)

    Wilson, Scott D.; Wong, Wayne A.

    2015-01-01

    A high-efficiency radioisotope power system was being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center. DOE initiated termination of that contract in late 2013, primarily due to budget constraints. Sunpower, Inc., held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with Lockheed Martin to produce ASC-F flight units, and one with Glenn for the production of ASC-E3 engineering unit "pathfinders" that are built to the flight design. In support of those contracts, Glenn provided testing, materials expertise, Government-furnished equipment, inspection capabilities, and related data products to Lockheed Martin and Sunpower. The technical support included material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests were performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests were conducted to characterize performance under operating conditions that are representative of various mission conditions. Despite termination of the ASRG flight development contract, NASA continues to recognize the importance of high-efficiency ASC power conversion for Radioisotope Power Systems (RPS) and continues investment in the technology, including the continuation of the ASC-E3 contract. This paper describes key Government support for the ASRG project and future tests to be used to provide data for ongoing reliability assessments.

  3. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival for patients with peritoneal carcinomatosis from colorectal cancer: a phase II study from a Chinese center.

    Directory of Open Access Journals (Sweden)

    Chao-Qun Huang

    Full Text Available Peritoneal carcinomatosis (PC is a difficult clinical challenge in colorectal cancer (CRC because conventional treatment modalities could not produce significant survival benefit, which highlights the acute need for new treatment strategies. Our previous case-control study demonstrated the potential survival advantage of cytoreductive surgery (CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC over CRS alone. This phase II study was to further investigate the efficacy and adverse events of CRS+HIPEC for Chinese patients with CRC PC.A total of 60 consecutive CRC PC patients underwent 63 procedures consisting of CRS+HIPEC and postoperative chemotherapy, all by a designated team focusing on this combined treatment modality. All the clinico-pathological information was systematically integrated into a prospective database. The primary end point was disease-specific overall survival (OS, and the secondary end points were perioperative safety profiles.By the most recent database update, the median follow-up was 29.9 (range 3.5-108.9 months. The peritoneal cancer index (PCI ≤20 was in 47.0% of patients, complete cytoreductive surgery (CC0-1 was performed in 53.0% of patients. The median OS was 16.0 (95% confidence interval [CI] 12.2-19.8 months, and the 1-, 2-, 3-, and 5-year survival rates were 70.5%, 34.2%, 22.0% and 22.0%, respectively. Mortality and grades 3 to 5 morbidity rates in postoperative 30 days were 0.0% and 30.2%, respectively. Univariate analysis identified 3 parameters with significant effects on OS: PCI ≤20, CC0-1 and adjuvant chemotherapy over 6 cycles. On multivariate analysis, however, only CC0-1 and adjuvant chemotherapy ≥6 cycles were found to be independent factors for OS benefit.CRS+HIPEC at a specialized treatment center could improve OS for selected CRC PC patients from China, with acceptable perioperative safety.

  4. Infections in outpatient surgery.

    Science.gov (United States)

    Nazarian Mobin, Sheila S; Keyes, Geoffrey R; Singer, Robert; Yates, James; Thompson, Dennis

    2013-07-01

    In the plastic surgery patient population, outpatient surgery is cost effective and will continue to grow as the preferred arena for performing surgery in healthy patients. Although there is a widespread myth that outpatient surgery centers may suffer from increased infection rates due to lax infection control, the data presented from American Association for Accreditation of Ambulatory Surgery Facilities-accredited facilities prove the contrary. There is a lack of data investigating infection prevention in the perioperative period in plastic surgery patients. As data collection becomes more refined, tracking the postoperative care environment should offer additional opportunities to lower the incidence of postoperative infections.

  5. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kenji [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Narita, Yoshitaka, E-mail: yonarita@ncc.go.jp [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Miyakita, Yasuji; Ohno, Makoto [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Mayahara, Hiroshi [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Kayama, Takamasa; Shibui, Soichiro [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan)

    2011-11-15

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  6. Ascídias (Tnicata, Ascidiacea) do Espírito Santo, Brasil

    OpenAIRE

    Gamba, Gustavo Antunes

    2013-01-01

    Resumo: De acordo com o banco de dados The World Register of Marine Species existem em torno de 2900 espécies de ascídias descritas. No Brasil, o conhecimento sobre a fauna desses animais é ainda insuficiente, com muitas espécies de ascídias ainda não conhecidas. Acredita-se que existam aproximadamente 130 espécies válidas no país, mas aproximadamente 100 estão atualmente registradas. O Espírito Santo é um dos vários estados brasileiros para o qual pouco se conhece a fauna desse táxon, pois o...

  7. Checklist das ascídias (Tunicata, Ascidiacea) do Estado de São Paulo, Brasil

    OpenAIRE

    Rocha,Rosana Moreira da; Dias,Gustavo Muniz; Lotufo,Tito Monteiro da Cruz

    2011-01-01

    Ascídias são organismos marinhos que, em sua maioria, vivem fixados a substratos consolidados desde as regiões costeiras até às grandes profundidades. Apesar de serem cordados, apresentam um plano corporal adulto muito modificado em função de seu hábito de vida. O Estado de São Paulo é o que apresenta o melhor conhecimento da fauna de ascídias, tanto em termos de sua biodiversidade como em aspectos ecológicos. No estado, a região do município de São Sebastião foi a mais estudada em função da ...

  8. ASC Tri-lab Co-design Level 2 Milestone Report 2015

    Energy Technology Data Exchange (ETDEWEB)

    Hornung, Rich [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Jones, Holger [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Keasler, Jeff [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Neely, Rob [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pearce, Olga [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hammond, Si [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Trott, Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lin, Paul [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vaughan, Courtenay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cook, Jeanine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hoekstra, Rob [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bergen, Ben [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Payne, Josh [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Womeldorff, Geoff [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-09-23

    In 2015, the three Department of Energy (DOE) National Laboratories that make up the Advanced Sci- enti c Computing (ASC) Program (Sandia, Lawrence Livermore, and Los Alamos) collaboratively explored performance portability programming environments in the context of several ASC co-design proxy applica- tions as part of a tri-lab L2 milestone executed by the co-design teams at each laboratory. The programming environments that were studied included Kokkos (developed at Sandia), RAJA (LLNL), and Legion (Stan- ford University). The proxy apps studied included: miniAero, LULESH, CoMD, Kripke, and SNAP. These programming models and proxy-apps are described herein. Each lab focused on a particular combination of abstractions and proxy apps, with the goal of assessing performance portability using those. Performance portability was determined by: a) the ability to run a single application source code on multiple advanced architectures, b) comparing runtime performance between \

  9. ASC-H诊断的临床指导意义

    Institute of Scientific and Technical Information of China (English)

    白合尼莎·阿不都热西提; 迪丽努尔·吐尔逊

    2007-01-01

    目的 分析不除外高度上皮内病变的不典型鳞状上皮细胞(ASC-H)在宫颈病变中的诊断意义.方法 ASC-H病例行阴道镜检查并取活检,结果作对照分析.结果 细胞学诊断的40例ASCH病例中,33例有病理对照,其中有20例病理结果显示慢性宫颈炎,3例LSIL(低度鳞状上皮内病变)、8例HSIL(高度鳞状上皮内病变)、1例鳞状细胞癌(SCC)、1例息肉(polyp).结论 ASC-H有预示CIN2和CIN3的阳性价值.

  10. Intracellular invasion of Orientia tsutsugamushi activates inflammasome in asc-dependent manner.

    Directory of Open Access Journals (Sweden)

    Jung-Eun Koo

    Full Text Available Orientia tsutsugamushi, a causative agent of scrub typhus, is an obligate intracellular bacterium, which escapes from the endo/phagosome and replicates in the host cytoplasm. O. tsutsugamushi infection induces production of pro-inflammatory mediators including interleukin-1β (IL-1β, which is secreted mainly from macrophages upon cytosolic stimuli by activating cysteine protease caspase-1 within a complex called the inflammasome, and is a key player in initiating and maintaining the inflammatory response. However, the mechanism for IL-1β maturation upon O. tsutsugamushi infection has not been identified. In this study, we show that IL-1 receptor signaling is required for efficient host protection from O. tsutsugamushi infection. Live Orientia, but not heat- or UV-inactivated Orientia, activates the inflammasome through active bacterial uptake and endo/phagosomal maturation. Furthermore, Orientia-stimulated secretion of IL-1β and activation of caspase-1 are ASC- and caspase-1- dependent since IL-1β production was impaired in Asc- and caspase-1-deficient macrophages but not in Nlrp3-, Nlrc4- and Aim2-deficient macrophages. Therefore, live O. tsutsugamushi triggers ASC inflammasome activation leading to IL-1β production, which is a critical innate immune response for effective host defense.

  11. A Comparison of ASCE and FAO56 Reference Evapotranspiration at Different Subdaily Timescales: a Numerical Study

    Directory of Open Access Journals (Sweden)

    Farzin Parchami-Araghi

    2017-01-01

    Full Text Available Introduction: Subdaily estimates of reference evapotranspiration (ETo are needed in many applications such as dynamic agro-hydrological modeling. The ASCE and FAO56 Penman–Monteith models (ASCE-PM and FAO56-PM, respectively has received favorable acceptance and application over much of the world, including the United States, for establishing a reference evapotranspiration (ETo index as a function of weather parameters. In the past several years various studies have evaluated ASCE-PM and FAO56-PM models for calculating the commonest hourly or 15-min ETo either by comparing them with lysimetric measurements or by comparison with one another (2, 3, 5, 9, 10, 11, 16, 17, 19. In this study, sub-daily ET o estimates made by the ASCE-PM and FAO56-PM models at different timescales (1-360 min were compared through conduction of a computational experiment, using a daily to sub-daily disaggregation framework developed by Parchami-Araghi et al. (14. Materials and Methods: Daily and sub-daily weather data at different timescales (1-360 min were generated via a daily-to-sub-daily weather data disaggregation framework developed by Parchami-Araghi et al. (14, using long-term (59 years daily weather data obtained from Abadan synoptic weather station. Daily/sub-daily net long wave radiation (Rnl was estimated through 6 different approaches, including using two different criteria for identifying the daytime/nighttime periods : 1 the standard criteria implemented in both ASCE-PM and FAO56-PM models and 2 criterion of actual time of sunset and sunrise in combination with 1 estimation of clear-sky radiation (Rso based on the standard approach implemented in both ASCE-PM and FAO56-PM models (1st and 2nd Rnl estimation approaches, respectively, 2 integral of the Rso estimates derived via a physically based solar radiation model developed by Yang et al. (25, YNG model, for one-second time-steps (3rd and 4th Rnl estimation approaches, respectively, and 3 integral of

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

    Science.gov (United States)

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

    2012-11-01

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

  13. The Astrobiology in Secondary Classroom (ASC) Curriculum Development Project: Focusing Upon Diverse Students and Teachers in the Pilot Testing Process

    Science.gov (United States)

    Butler, J.; Arino de La Rubia, L.; Gary, T.; Kuner, S.; Ceballos, R. M.; Pfiffner, S.; Brown, S.

    2010-04-01

    The ASC curriculum guide is designed to address the learning styles present in diverse classrooms by incorporating research-based teaching strategies that increase participation of underrepresented groups in STEM fields.

  14. New therapy with ASC-J9® to suppress the prostatitis via altering the cytokine CCL2 signals.

    Science.gov (United States)

    Lin, Shin-Jen; Chou, Fu-Ju; Lin, Chang-Yi; Chang, Hong-Chiang; Yeh, Shuyuan; Chang, Chawnshang

    2016-10-11

    Prostatitis is a common disease contributing to 8% of all urologist visits. Yet the etiology and effective treatment remain to be further elucidated. Using a non-obese diabetes mouse model that can be induced by autoimmune response for the spontaneous development of prostatitis, we found that injection of the ASC-J9® at 75 mg/Kg body weight/48 hours led to significantly suppressed prostatitis that was accompanied with reduction of lymphocyte infiltration with reduced CD4+ T cells in prostate. In vitro studies with a co-culture system also confirmed that ASC-J9® treatment could suppress the CD4+ T cell migration to prostate stromal cells. Mechanisms dissection indicated that ASC-J9® can suppress CD4+ T cell migration via decreasing the cytokine CCL2 in vitro and in vivo, and restoring CCL2 could interrupt the ASC-J9® suppressed CD4+ T cell migration. Together, results from in vivo and in vitro studies suggest that ASC-J9® can suppress prostatitis by altering the autoimmune response induced by CD4+ T cell recruitment, and using ASC-J9® may help us to develop a potential new therapy to battle the prostatitis with little side effects.

  15. Establishment of wound care center and development of burns and plastic surgery discipline%伤口治疗中心建立与烧伤整形学科发展

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2011-01-01

    @@ 伴随着我国社会经济的高速发展,人民生活水平日益提高,生活习惯和饮食习惯逐渐发生变化,由此也导致疾病谱出现相应改变.以糖尿病为例,我国糖尿病发病率呈逐年增高的趋势.%To study the interaction between establishment of wound care center and development of discipline of burns and plastic surgery. The changes in number of outpatient,time for dressing change per patient, outpatient service income,number of inpatients and operations in our hospital were summarized and retrospectively analyzed before and after establishment of wound care center. The proportion of patients with chronic wounds and skin and soft tissue defects after trauma among all inpatients in the same term were investigated. Meanwhile, the development of discipline of burns and plastic surgery before and after establishment of wound care center was analyzed. Compared with those in the year before establishment of wound care center, outpatient number, time for dressing change per patient,outpatient service income, inpatient number, and amount of operations were all increased(with increase rate of 330% , 569%,325%, 161% , and 173%, respectively) in the year after establishment of wound care center. The ratio of patients with chronic wounds and skin and soft tissue defects after trauma among all inpatients was respectively increased from 4.3% and 4.5% in the year before establishment of wound care center to 9.2% and 12.4% in the year after establishment of wound care center. Patient satisfaction, bed utilization rate, levels of wound treatment and repair were all improved after establishment of wound care center. So we come to conclusions as follows. Establishment of wound care center can promote development of the standard of burns and plastic surgery. Comprehensive use of multidisciplinary theories and techniques concerning burns, plastic and aesthetic surgery, medical aesthetics, etc. can be beneficial for improvement of quality of wound

  16. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooij, Peter van [Department of Biostatistics, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Verduijn, Gerda M. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Meeuwis, Cees A. [Department of Otorhinolaryngology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-09-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  17. Efficacy of stereotactic gamma knife surgery and microvascular decompression in the treatment of primary trigeminal neuralgia: a retrospective study of 220 cases from a single center

    Directory of Open Access Journals (Sweden)

    Dai ZF

    2016-07-01

    Full Text Available Zi-Feng Dai, Qi-Lin Huang, Hai-Peng Liu, Wei Zhang Department of Neurosurgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, People’s Republic of China Objectives: A retrospective study was undertaken to compare the efficacy of stereotactic gamma knife surgery (GKS and microvascular decompression (MVD in the treatment of primary trigeminal neuralgia (TN at a single center. The study included the evaluation of clinical outcomes of pain relief and pain recurrence and complications associated with GKS and MVD.Methods: The study included 202 patients with primary TN and was conducted between January 2013 and December 2014; about 115 patients were treated with GKS and 87 patients were treated with MVD. TN pain was evaluated using the Barrow Neurological Institute and the visual analog scale scoring systems. Preoperative magnetic resonance tomographic angiography was performed for all patients. Microscope-assisted MVD used the suboccipital retrosigmoid sinus approach. GKS targeted the trigeminal nerve root entry zone with a margin radiation dose of 59.5 Gy, and brainstem dose <12 Gy. Posttreatment follow-up was for 2 years.Results: Postoperative Barrow Neurological Institute scores for patients treated with GKS and MVD were significantly improved compared with preoperative scores (P<0.01. Reduction in postoperative pain following MVD (95.4% patients was significantly greater than that following GKS (88.7% patients (P<0.01. Postoperative visual analog scale scores of the MVD group were significantly reduced compared with those of patients treated with GKS at the same postoperative time points (P<0.01. Patients treated with GKS had a significantly increased rate of loss of corneal reflex compared with patients treated with MVD (P=0.002.Conclusion: Both GKS and MVD are safe and effective first-line and adjunctive treatment options for patients with TN. The clinical outcomes of pain relief and reduction of pain recurrence were

  18. Bariatric Surgery

    Science.gov (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  19. Antiproliferative effect of ASC-J9 delivered by PLGA nanoparticles against estrogen-dependent breast cancer cells.

    Science.gov (United States)

    Verderio, Paolo; Pandolfi, Laura; Mazzucchelli, Serena; Marinozzi, Maria Rosaria; Vanna, Renzo; Gramatica, Furio; Corsi, Fabio; Colombo, Miriam; Morasso, Carlo; Prosperi, Davide

    2014-08-04

    Among polymeric nanoparticles designed for cancer therapy, PLGA nanoparticles have become one of the most popular polymeric devices for chemotherapeutic-based nanoformulations against several kinds of malignant diseases. Promising properties, including long-circulation time, enhanced tumor localization, interference with "multidrug" resistance effects, and environmental biodegradability, often result in an improvement of the drug bioavailability and effectiveness. In the present work, we have synthesized 1,7-bis(3,4-dimethoxyphenyl)-5-hydroxyhepta-1,4,6-trien-3-one (ASC-J9) and developed uniform ASC-J9-loaded PLGA nanoparticles of about 120 nm, which have been prepared by a single-emulsion process. Structural and morphological features of the nanoformulation were analyzed, followed by an accurate evaluation of the in vitro drug release kinetics, which exhibited Fickian law diffusion over 10 days. The intracellular degradation of ASC-J9-bearing nanoparticles within estrogen-dependent MCF-7 breast cancer cells was correlated to a time- and dose-dependent activity of the released drug. A cellular growth inhibition associated with a specific cell cycle G2/M blocking effect caused by ASC-J9 release inside the cytosol allowed us to put forward a hypothesis on the action mechanism of this nanosystem, which led to the final cell apoptosis. Our study was accomplished using Annexin V-based cell death analysis, MTT assessment of proliferation, radical scavenging activity, and intracellular ROS evaluation. Moreover, the intracellular localization of nanoformulated ASC-J9 was confirmed by a Raman optical imaging experiment designed ad hoc. PLGA nanoparticles and ASC-J9 proved also to be safe for a healthy embryo fibroblast cell line (3T3-L1), suggesting a possible clinical translation of this potential nanochemotherapeutic to expand the inherently poor bioavailability of hydrophobic ASC-J9 that could be proposed for the treatment of malignant breast cancer.

  20. Length of stay and cost for surgical site infection after abdominal and cardiac surgery in Japanese hospitals: multi-center surveillance.

    Science.gov (United States)

    Kusachi, Shinya; Kashimura, Nobuichi; Konishi, Toshiro; Shimizu, Junzo; Kusunoki, Masato; Oka, Masaaki; Wakatsuki, Toshiro; Kobayashi, Junjiro; Sawa, Yoshiki; Imoto, Hiroshi; Motomura, Noboru; Makuuchi, Haruo; Tanemoto, Kazuo; Sumiyama, Yoshinobu

    2012-08-01

    This study evaluated the influence of surgical site infections (SSIs) after abdominal or cardiac surgery on the post-operative duration of hospitalization and cost. A retrospective 1:1 matched case-control study of length of stay and healthcare expenditures for patients who were discharged from nine hospitals, between April 1, 2006 and March 31, 2008, after undergoing abdominal or cardiac surgery and who did and did not have a SSI. Information was obtained from 246 pairs of patients who had undergone abdominal surgery and 27 pairs of patients who had undergone cardiac surgery. Overall, the mean post-operative hospitalization was 20.7 days longer and the mean post-operative healthcare expenditure was $8,791 higher in the SSI group than for the SSI-free group. Among the patients who had undergone abdominal surgery, development of SSI extended the average hospitalization by 17.6 days and increased the average healthcare expenditure by $6,624. Among the patients who had undergone cardiac surgery, SSI extended the post-operative hospitalization by an average of 48.9 days and increased the post-operative healthcare expenditure by an average of $28,534. Under the current healthcare system in Japan, the development of SSI after abdominal surgery necessitates extension of hospitalization two-fold and increases the post-operative healthcare expenditure 2.5-fold. Development of SSI after cardiac surgery necessitates extension of hospitalization fourfold and increases the healthcare expenditure six-fold.

  1. Optimizing the ASC WAN: evaluating network performance tools for comparing transport protocols.

    Energy Technology Data Exchange (ETDEWEB)

    Lydick, Christopher L.

    2007-07-01

    The Advanced Simulation & Computing Wide Area Network (ASC WAN), which is a high delay-bandwidth network connection between US Department of Energy National Laboratories, is constantly being examined and evaluated for efficiency. One of the current transport-layer protocols which is used, TCP, was developed for traffic demands which are different from that on the ASC WAN. The Stream Control Transport Protocol (SCTP), on the other hand, has shown characteristics which make it more appealing to networks such as these. Most important, before considering a replacement for TCP on any network, a testing tool that performs well against certain criteria needs to be found. In order to try to find such a tool, two popular networking tools (Netperf v.2.4.3 & v.2.4.6 (OpenSS7 STREAMS), and Iperf v.2.0.6) were tested. These tools implement both TCP and SCTP and were evaluated using four metrics: (1) How effectively can the tool reach a throughput near the bandwidth? (2) How much of the CPU does the tool utilize during operation? (3) Is the tool freely and widely available? And, (4) Is the tool actively developed? Following the analysis of those tools, this paper goes further into explaining some recommendations and ideas for future work.

  2. Aeroacoustics research in Europe: The CEAS-ASC report on 2014 highlights

    Science.gov (United States)

    Detandt, Yves

    2015-11-01

    The Council of European Aerospace Societies (CEAS) Aeroacoustics Specialists Committee (ASC) supports and promotes the interests of the scientific and industrial aeroacoustics community on an European scale and European aeronautics activities internationally. Each year the committee highlights some of the research and development projects in Europe. This paper is the 2014 issue of this collection of Aeroacoustic Highlights, compiled from informations submitted to the CEAS-ASC. The contributions are classified in different topics; the first categories being related to specific aeroacoustic challenges (airframe noise, fan and jet noise, helicopter noise, aircraft interior noise) and two last sections are respectively devoted to recent improvements and emerging techniques and to general advances in aeroacoustics. For each section, the present paper focus on accomplished projects, providing the state of the art in each research category in 2014. A number of research programmes involving aeroacoustics were funded by the European Commission. Some of the highlights from these programmes are summarised in this paper, as well as highlights funded by national programmes or by industry.

  3. Comparison of lysimeter based and calculated ASCE reference evapotranspiration in a subhumid climate

    Science.gov (United States)

    Nolz, Reinhard; Cepuder, Peter; Eitzinger, Josef

    2016-04-01

    The standardized form of the well-known FAO Penman-Monteith equation, published by the Environmental and Water Resources Institute of the American Society of Civil Engineers (ASCE-EWRI), is recommended as a standard procedure for calculating reference evapotranspiration (ET ref) and subsequently plant water requirements. Applied and validated under different climatic conditions it generally achieved good results compared to other methods. However, several studies documented deviations between measured and calculated reference evapotranspiration depending on environmental and weather conditions. Therefore, it seems generally advisable to evaluate the model under local environmental conditions. In this study, reference evapotranspiration was determined at a subhumid site in northeastern Austria from 2005 to 2010 using a large weighing lysimeter (ET lys). The measured data were compared with ET ref calculations. Daily values differed slightly during a year, at which ET ref was generally overestimated at small values, whereas it was rather underestimated when ET was large, which is supported also by other studies. In our case, advection of sensible heat proved to have an impact, but it could not explain the differences exclusively. Obviously, there were also other influences, such as seasonal varying surface resistance or albedo. Generally, the ASCE-EWRI equation for daily time steps performed best at average weather conditions. The outcomes should help to correctly interpret ET ref data in the region and in similar environments and improve knowledge on the dynamics of influencing factors causing deviations.

  4. Safety and feasibility of laparoscopic colo-rectal surgery for cancer at a tertiary center in a developing country: Egypt as an

    Directory of Open Access Journals (Sweden)

    Anwar Tawfik Amin

    2015-06-01

    Conclusion: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.

  5. Primary transoral robotic surgery with concurrent neck dissection for early stage oropharyngeal squamous cell carcinoma implemented at a Danish head and neck cancer center

    DEFF Research Database (Denmark)

    Rubek, Niclas; Channir, Hani Ibrahim; Charabi, Birgitte Wittenborg

    2017-01-01

    (RT) with or without concomitant chemotherapy. This is the first study in Scandinavia from a head and neck cancer centre that aims to demonstrate the feasibility of performing primary transoral robotic surgery (TORS) and concurrent neck dissection for patients with early stage OPSCC. Between September...... bilateral neck dissection. Due to an upstaging following surgery, 13 patients were referred to adjuvant therapy. Four of these patients received RT and two patients received concomitant chemo-radiation (CCR) therapy. Seven patients declined the recommended adjuvant therapy one of whom later developed an N......-site recurrence and received salvage surgery with postoperative RT. In summary, 43% of the patients were referred to adjuvant therapy following primary surgery which was mainly due to N-site stage migration and ECE. Primary TORS and concurrent neck dissection is a safe and feasible procedure that may...

  6. The role of colposcopy and typization of human papillomavirus in further diagnostic proceedings in patients with ASC-US cytological finding of the uterine cervix

    Directory of Open Access Journals (Sweden)

    Živadinović Radomir

    2009-01-01

    Full Text Available Background/Aim. Bethesda system of classification of cytological findings was introduced in 2001 two subcategories in the category of atypical squamous cells (ASC findings: ASC of undetermined significance (ASC-US and ASC which cannot exclude high-grade intraepithelial lesions (ASC-H. The aim of our study was to assess a possible association of these two subcategories with pathologic biopsy finding and to find out the best further diagnostic proceedings. Methods. At the Clinic of Gynecology and Obstetrics, Niš 130 patients with ASC findings were analyzed. Colposcopy was performed in all study participants. Patients with pathological colposcopic findings underwent cervical biopsy. In 10 patients with pathologic histologic and 15 with benign findings human papilloma virus (HPV typization was done using the Hybrid Capture method. Results. Patients with ASC-H finding had significantly more pathologic biopsies compared with patients with ASC-US finding (57.84: 20.72. Conclusion. Colposcopy was exhibited somewhat higher sensitivity compared to HPV typization (94.7 : 90, but lower sensitivity (79.27 : 86.6. The usage of HPV typization in the triage of patients with ASC cytologic smear induces statistically significant reduction of unnecessary percentage of cervical biopsies.

  7. Thyroid Surgery

    Science.gov (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  8. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  9. Atypical squamous cells, cannot exclude high grade squamous intraepithelial (ASC-H in HIV-positive women

    Directory of Open Access Journals (Sweden)

    Michelow Pam

    2010-01-01

    Full Text Available Objective: South Africa has very high rates of both HIV infection and cervical pathology. The management of ASC-H is colposcopy and directed biopsy, but with so many women diagnosed with HSIL and a dearth of colposcopy centres in South Africa, women with cytologic diagnosis of ASC-H may not be prioritized for colposcopy. The aim of this study was to determine if HIV-positive women with a cytologic diagnosis of ASC-H should undergo immediate colposcopy or whether colposcopy can be delayed, within the context of an underfunded health care setting with so many competing health needs. Materials and Methods: A computer database search was performed from the archives of an NGO-administered clinic that offers comprehensive HIV care. All women with a cytologic diagnosis of ASC-H on cervical smears from September 2005 until August 2009 were identified. Histologic follow up was sought in all patients. Results: A total of 2111 cervical smears were performed and 41 diagnosed as ASC-H (1.94%. No histologic follow up data was available in 15 cases. Follow up histologic results were as follows: three negative (11.5%, five koilocytosis and/ or CIN1 (19.2%, ten CIN2 (38.5% and eight CIN3 (30.8%. There were no cases of invasive carcinoma on follow up. Conclusion: The current appropriate management of HIV-positive women in low-resource settings with a diagnosis of ASC-H on cervical smear is colposcopy, despite the costs involved. In the future and if cost-effective in developing nations, use of novel markers may help select which HIV-positive women can be managed conservatively and which ones referred for more active treatment. More research in this regard is warranted.

  10. Visualization on supercomputing platform level II ASC milestone (3537-1B) results from Sandia.

    Energy Technology Data Exchange (ETDEWEB)

    Geveci, Berk (Kitware, Inc., Clifton Park, NY); Fabian, Nathan; Marion, Patrick (Kitware, Inc., Clifton Park, NY); Moreland, Kenneth D.

    2010-09-01

    This report provides documentation for the completion of the Sandia portion of the ASC Level II Visualization on the platform milestone. This ASC Level II milestone is a joint milestone between Sandia National Laboratories and Los Alamos National Laboratories. This milestone contains functionality required for performing visualization directly on a supercomputing platform, which is necessary for peta-scale visualization. Sandia's contribution concerns in-situ visualization, running a visualization in tandem with a solver. Visualization and analysis of petascale data is limited by several factors which must be addressed as ACES delivers the Cielo platform. Two primary difficulties are: (1) Performance of interactive rendering, which is most computationally intensive portion of the visualization process. For terascale platforms, commodity clusters with graphics processors(GPUs) have been used for interactive rendering. For petascale platforms, visualization and rendering may be able to run efficiently on the supercomputer platform itself. (2) I/O bandwidth, which limits how much information can be written to disk. If we simply analyze the sparse information that is saved to disk we miss the opportunity to analyze the rich information produced every timestep by the simulation. For the first issue, we are pursuing in-situ analysis, in which simulations are coupled directly with analysis libraries at runtime. This milestone will evaluate the visualization and rendering performance of current and next generation supercomputers in contrast to GPU-based visualization clusters, and evaluate the performance of common analysis libraries coupled with the simulation that analyze and write data to disk during a running simulation. This milestone will explore, evaluate and advance the maturity level of these technologies and their applicability to problems of interest to the ASC program. Scientific simulation on parallel supercomputers is traditionally performed in four

  11. Post-processing V&V level II ASC milestone (2360) results.

    Energy Technology Data Exchange (ETDEWEB)

    Chavez, Elmer; Karelitz, David B.; Brunner, Thomas A.; Trucano, Timothy Guy; Moreland, Kenneth D.; Weirs, V. Gregory; Shead, Timothy M.

    2007-09-01

    The 9/30/2007 ASC Level 2 Post-Processing V&V Milestone (Milestone 2360) contains functionality required by the user community for certain verification and validation tasks. These capabilities include loading of edge and face data on an Exodus mesh, run-time computation of an exact solution to a verification problem, delivery of results data from the server to the client, computation of an integral-based error metric, simultaneous loading of simulation and test data, and comparison of that data using visual and quantitative methods. The capabilities were tested extensively by performing a typical ALEGRA HEDP verification task. In addition, a number of stretch criteria were met including completion of a verification task on a 13 million element mesh.

  12. Sliding and Rocking of Unanchored Components and Structures: Chapter 7.6 ASCE 4 Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    S. R. Jensen

    2011-04-01

    Chapter 7.6 of ASCE 4-Rev 2, Seismic Analysis of Safety-Related Nuclear Structures: Standard and Commentary, provides updated guidance for analysis of rocking and sliding of unanchored structures and components subjected to seismic load. This guidance includes provisions both for simplified approximate energy-based approaches, and for detailed probabilistic time history analysis using nonlinear methods. Factors to be applied to the analytical results are also provided with the intent of ensuring achievement of the 80% non-exceedence probability target of the standard. The present paper surveys the published literature supporting these provisions. The results of available testing and analysis are compared to results produced by both simplified and probabilistic approaches. In addition, adequacy of the standard's provisions for analysis methods and factors is assessed. A comparison is made between the achieved level of conservatism and the standard's non-exceedence probability target.

  13. Evaluation and Validation of Organic Materials for Advanced Stirling Convertors (ASCs): Overview

    Science.gov (United States)

    Shin, Euy-Sik Eugene

    2015-01-01

    Various organic materials are used as essential parts in Stirling Convertors for their unique properties and functionalities such as bonding, potting, sealing, thread locking, insulation, and lubrication. More efficient Advanced Stirling Convertors (ASC) are being developed for future space applications especially with a long mission cycle, sometimes up to 17 years, such as deep space exploration or lunar surface power or Mars rovers, and others. Thus, performance, durability, and reliability of those organics should be critically evaluated in every possible material-process-fabrication-service environment relations based on their mission specifications. In general, thermal stability, radiation hardness, outgassing, and material compatibility of the selected organics have been systematically evaluated while their process and fabrication conditions and procedures were being optimized. Service environment-simulated long term aging tests up to 4 years were performed as a function of temperature for durability assessment of the most critical organic material systems.

  14. Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: a single center experience in a developing economy.

    Science.gov (United States)

    Balachandran, Rakhi; Kappanayil, Mahesh; Sen, Amitabh Chanchal; Sudhakar, Abhish; Nair, Suresh G; Sunil, G S; Raj, R Benedict; Kumar, Raman Krishna

    2015-01-01

    The International Quality Improvement Collaborative (IQIC) for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world. We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution. The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms. We evaluated 1702 consecutive patients ≤18 years undergoing congenital heart surgery in our institute from January 2010-December 2012 using the IQIC database. Preoperative variables included age, gender, weight at surgery and surgical complexity as per the RACHS-1 model. The outcome variables included, in- hospital mortality, duration of ventilation, intensive care unit (ICU) stay, bacterial sepsis and surgical site infection. The 1702 patients included 771(45.3%) females. The median age was 8 months (0.03-216) and the median weight was 6.1Kg (1-100). The overall in-hospital mortality was 3.1%, Over the three years there was a significant decline in bacterial sepsis (from 15.1%, to 9.6%, P < 0.001), surgical site infection (11.1% to 2.4%, P < 0.001) and duration of ICU stay from 114(8-999) hours to 72 (18-999) hours (P < 0.001) The decline in mortality from (4.3% to 2.2%) did not reach statistical significance. The inclusion of our institution in the IQIC program was associated with improvement in key outcome measures following congenital heart surgery over a three year period.

  15. Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: A single center experience in a developing economy

    Directory of Open Access Journals (Sweden)

    Rakhi Balachandran

    2015-01-01

    Full Text Available Background: The International Quality Improvement Collaborative (IQIC for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world. Objective: We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution. Methods: The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms. We evaluated 1702 consecutive patients ≤18 years undergoing congenital heart surgery in our institute from January 2010-December 2012 using the IQIC database. Preoperative variables included age, gender, weight at surgery and surgical complexity as per the RACHS-1 model. The outcome variables included, in- hospital mortality, duration of ventilation, intensive care unit (ICU stay, bacterial sepsis and surgical site infection. Results: The 1702 patients included 771(45.3% females. The median age was 8 months (0.03-216 and the median weight was 6.1Kg (1-100. The overall in-hospital mortality was 3.1%, Over the three years there was a significant decline in bacterial sepsis (from 15.1%, to 9.6%, P < 0.001, surgical site infection (11.1% to 2.4%, P < 0.001 and duration of ICU stay from 114(8-999 hours to 72 (18-999 hours (P < 0.001 The decline in mortality from (4.3% to 2.2% did not reach statistical significance. Conclusions: The inclusion of our institution in the IQIC program was associated with improvement in key outcome measures following congenital heart surgery over a three year period.

  16. Implications of the center of rotation concept for the reconstruction of anterior column lordosis and axial preloads in spinal deformity surgery.

    Science.gov (United States)

    Koller, Heiko; Mayer, Michael; Zenner, Juliane; Resch, Herbert; Niederberger, Alfred; Fierlbeck, Johann; Hitzl, Wolfgang; Acosta, Frank L

    2012-07-01

    In thoracolumbar deformity surgery, anterior-only approaches are used for reconstruction of anterior column failures. It is generally advised that vertebral body replacements (VBRs) should be preloaded by compression. However, little is known regarding the impact of different techniques for generation of preloads and which surgical principle is best for restoration of lordosis. Therefore, the authors analyzed the effect of different surgical techniques to restore spinal alignment and lordosis as well as the ability to generate axial preloads on VBRs in anterior column reconstructions. The authors performed a laboratory study using 7 fresh-frozen specimens (from T-3 to S-1) to assess the ability for lordosis reconstruction of 5 techniques and their potential for increasing preloads on a modified distractable VBR in a 1-level thoracolumbar corpectomy. The testing protocol was as follows: 1) Radiographs of specimens were obtained. 2) A 1-level corpectomy was performed. 3) In alternating order, lordosis was applied using 1 of the 5 techniques. Then, preloads during insertion and after relaxation using the modified distractable VBR were assessed using a miniature load-cell incorporated in the modified distractable VBR. The modified distractable VBR was inserted into the corpectomy defect after lordosis was applied using 1) a lamina spreader; 2) the modified distractable VBR only; 3) the ArcoFix System (an angular stable plate system enabling in situ reduction); 4) a lordosizer (a customized instrument enabling reduction while replicating the intervertebral center of rotation [COR] according to the COR method); and 5) a lordosizer and top-loading screws ([LZ+TLS], distraction with the lordosizer applied on a 5.5-mm rod linked to 2 top-loading pedicle screws inserted laterally into the vertebra). Changes in the regional kyphosis angle were assessed radiographically using the Cobb method. The bone mineral density of specimens was 0.72 ± 22.6 g/cm(2). The maximum regional

  17. [Short- and long-term results in operable pancreatic ductal adenocarcinomas from a cooperation between two departments gastroenterology-visceral surgery at non-university hospitals benchmarked to results of expert-centers].

    Science.gov (United States)

    Dippold, Wolfgang; Sivanathan, Visvakanth; Statt, Katharina; Roitman, Marc; Link, Karl Heinrich

    2017-02-01

    The only curative approach in pancreatic ductal adenocarcinoma (PDAC) is resection, which is possible only in 15 - 30 % of patients. Local tumor spread or distant metastases are contraindications for resection in the majority of patients. Surgical-oncological quality with short- and long-term results are varying tremendously, so that "expertise/quality" are associated to hospital- or surgeon's volume and/or center formation. The treatment results also depend, to a great extent, on the medical diagnostic quality. With our retrospective study, we aim to compare the results-quality of cooperative pancreatic cancer treatment based on an extensive preoperative diagnostic procedure for staging and risk estimation in a specialized GI-medical department and visceral surgical-oncological expertise in pancreatic cancer surgery at a general hospital with the results-quality of expert centers. Fifty-three patients with PDAC had diagnosis and resection of their cancer between 1/2002 and 12/2009. The 30 day hospital-mortality was 3.8 % and the median survival time after demission from the hospital was 23.1 months. The 5-year-survival rate of R0-resected patients, all of whom had received adjuvant chemotherapy, was high with 31 %. The survival data and the extraordinarily high resection rate of 98.1 % in the patient group, whose primary tumor stage was pT3 in 81 %, reflects the excellent cooperation of high standards in medical diagnostic processes, visceral pancreatic surgery, and adjuvant medical chemotherapy. The results are well comparable to those of "high volume centers". The responsible heads of the two departments have been trained at university expert centers. Expertise in the treatment of pancreatic cancer patients may be successfully transferred from an expert center to a general hospital, if the team has high expertise. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Targeting ASC in NLRP3 inflammasome by caffeic acid phenethyl ester: a novel strategy to treat acute gout

    Science.gov (United States)

    Lee, Hye Eun; Yang, Gabsik; Kim, Nam Doo; Jeong, Seongkeun; Jung, Yunjin; Choi, Jae Young; Park, Hyun Ho; Lee, Joo Young

    2016-01-01

    Gouty arthritis is caused by the deposition of uric acid crystals, which induce the activation of NOD-like receptor family, pyrin domain containing 3(NLRP3) inflammasome. The NLRP3 inflammasome, composed of NLRP3, the adaptor protein ASC, and caspase-1, is closely linked to the pathogenesis of various metabolic diseases including gouty arthritis. We investigated whether an orally administrable inhibitor of NLRP3 inflammasome was effective for alleviating the pathological symptoms of gouty arthritis and what was the underlying mechanism. In primary mouse macrophages, caffeic acid phenethyl ester(CAPE) blocked caspase-1 activation and IL-1β production induced by MSU crystals, showing that CAPE suppresses NLRP3 inflammasome activation. In mouse gouty arthritis models, oral administration of CAPE suppressed MSU crystals-induced caspase-1 activation and IL-1β production in the air pouch exudates and the foot tissues, correlating with attenuation of inflammatory symptoms. CAPE directly associated with ASC as shown by SPR analysis and co-precipitation, resulting in blockade of NLRP3-ASC interaction induced by MSU crystals. Our findings provide a novel regulatory mechanism by which small molecules harness the activation of NLRP3 inflammasome by presenting ASC as a new target. Furthermore, the results suggest the preventive or therapeutic strategy for NLRP3-related inflammatory diseases such as gouty arthritis using orally available small molecules. PMID:27934918

  19. To treat or not to treat; the clinical dilemma of atypical squamous cells of undetermined significance (ASC-US)

    NARCIS (Netherlands)

    Bie, R.P. de; Massuger, L.F.A.G.; Dongen, R.A. van; Snijders, M.P.; Bulten, J.; Melchers, W.J.G.; Bekkers, R.L.M.

    2011-01-01

    OBJECTIVE: Management of patients diagnosed on cervical smears with twice consecutively atypical squamous cells of undetermined significance (ASC-US) remains a clinical dilemma. We describe a follow-up of aggressive vs. less aggressive colposcopic treatment in order to determine which treatment is p

  20. The Asc locus for resistance to Alternaria stem canker in tomato does not encode the enzyme aspartate carbamoyltransferase

    NARCIS (Netherlands)

    Overduin, Bert; Hogenhout, Saskia A.; Biezen, Erik A. van der; Haring, Michel A.; Nijkamp, H. John J.; Hille, Jacques

    1993-01-01

    The fungal disease resistance locus Alternaria stem canker (Asc) in tomato has been suggested to encode the enzyme aspartate carbamoyltransferase (ACTase). To test this hypothesis a segment of the tomato ACTase gene was amplified by the polymerase chain reaction (PCR) using degenerate primers. The P

  1. Molecular genetic characterisation of the Asc locus of tomato conferring resistance to the fungal pathogen Alternaria alternata f. sp. lycopersici

    NARCIS (Netherlands)

    Biezen, E.A. van der; Overduin, B.; Kneppers, T.J.A.; Mesbah, L.A.; Nijkamp, H.J.J.; Hille, J.

    1994-01-01

    The Alternaria stem canker disease of tomato is caused by the fungal pathogen Alternaria alternata f. sp. lycopersici and its host-selective AAL-toxins. Resistance to the pathogen and insensitivity to the toxins are conferred by the Asc locus on chromosome 3L. Sensitivity to AAL-toxins is a relative

  2. Human adipose stromal cells (ASC for the regeneration of injured cartilage display genetic stability after in vitro culture expansion.

    Directory of Open Access Journals (Sweden)

    Simona Neri

    Full Text Available Mesenchymal stromal cells are emerging as an extremely promising therapeutic agent for tissue regeneration due to their multi-potency, immune-modulation and secretome activities, but safety remains one of the main concerns, particularly when in vitro manipulation, such as cell expansion, is performed before clinical application. Indeed, it is well documented that in vitro expansion reduces replicative potential and some multi-potency and promotes cell senescence. Furthermore, during in vitro aging there is a decrease in DNA synthesis and repair efficiency thus leading to DNA damage accumulation and possibly inducing genomic instability. The European Research Project ADIPOA aims at validating an innovative cell-based therapy where autologous adipose stromal cells (ASCs are injected in the diseased articulation to activate regeneration of the cartilage. The primary objective of this paper was to assess the safety of cultured ASCs. The maintenance of genetic integrity was evaluated during in vitro culture by karyotype and microsatellite instability analysis. In addition, RT-PCR array-based evaluation of the expression of genes related to DNA damage signaling pathways was performed. Finally, the senescence and replicative potential of cultured cells was evaluated by telomere length and telomerase activity assessment, whereas anchorage-independent clone development was tested in vitro by soft agar growth. We found that cultured ASCs do not show genetic alterations and replicative senescence during the period of observation, nor anchorage-independent growth, supporting an argument for the safety of ASCs for clinical use.

  3. Expressions of ASC and caspase-1 but not AIM2 are disrupted in chronic HBV infected patients

    Directory of Open Access Journals (Sweden)

    Gholamhossein Hassanshahi

    2014-08-01

    Full Text Available Objective: To determine the mRNA levels of absent in melanoma 2 (AIM2, apoptosis-associated speck like protein containing a caspase recruitment domain (ASC and caspase-1 in the peripheral blood mononuclear cells of chronic hepatitis B virus (CHB infected patients. Methods: This study was conducted on 60 CHB patients and 60 healthy controls and the mRNA levels of AIM2, ASC and caspase-1 were examined in parallel with beta-actin (as housekeeping gene using real-time polymerase chain reaction technique. Results: Our results indicated that expression of ASC and caspase-1 but not AIM2 were significantly decreased in peripheral blood mononuclear cells isolated from CHB patients compared to healthy controls. Conclusions: According to our results, it is likely that CHB patients are unable to firmly express ASC and caspase-1 genes and in turn properly activate IL1β and IL-18 subsequent to hepatitis B virus infection. Thus, these results propose a mechanism which almost partially may describe a reasonable fact that why the infection is sustained in the CHB patients.

  4. Targeting ASC in NLRP3 inflammasome by caffeic acid phenethyl ester: a novel strategy to treat acute gout.

    Science.gov (United States)

    Lee, Hye Eun; Yang, Gabsik; Kim, Nam Doo; Jeong, Seongkeun; Jung, Yunjin; Choi, Jae Young; Park, Hyun Ho; Lee, Joo Young

    2016-12-09

    Gouty arthritis is caused by the deposition of uric acid crystals, which induce the activation of NOD-like receptor family, pyrin domain containing 3(NLRP3) inflammasome. The NLRP3 inflammasome, composed of NLRP3, the adaptor protein ASC, and caspase-1, is closely linked to the pathogenesis of various metabolic diseases including gouty arthritis. We investigated whether an orally administrable inhibitor of NLRP3 inflammasome was effective for alleviating the pathological symptoms of gouty arthritis and what was the underlying mechanism. In primary mouse macrophages, caffeic acid phenethyl ester(CAPE) blocked caspase-1 activation and IL-1β production induced by MSU crystals, showing that CAPE suppresses NLRP3 inflammasome activation. In mouse gouty arthritis models, oral administration of CAPE suppressed MSU crystals-induced caspase-1 activation and IL-1β production in the air pouch exudates and the foot tissues, correlating with attenuation of inflammatory symptoms. CAPE directly associated with ASC as shown by SPR analysis and co-precipitation, resulting in blockade of NLRP3-ASC interaction induced by MSU crystals. Our findings provide a novel regulatory mechanism by which small molecules harness the activation of NLRP3 inflammasome by presenting ASC as a new target. Furthermore, the results suggest the preventive or therapeutic strategy for NLRP3-related inflammatory diseases such as gouty arthritis using orally available small molecules.

  5. Genetic and physical analysis of a YAC contig spanning the fungal disease resistance locus Asc of tomato (Lycopersicon esculentum)

    NARCIS (Netherlands)

    Mesbah, L.A.; Kneppers, T.J.A.; Takken, F.L.W.; Laurent, P.; Hille, J.; Nijkamp, H.J.J.

    1998-01-01

    The Alternaria stem canker disease of tomato is caused by the necrotrophic fungal pathogen Alternaria alternata f. sp. lycopersici (AAL). The fungus produces AAL toxins that kill the plant tissue. Resistance to the fungus segregates as a single locus, called Asc, and has been genetically mapped on c

  6. To treat or not to treat; the clinical dilemma of atypical squamous cells of undetermined significance (ASC-US)

    NARCIS (Netherlands)

    Bie, R.P. de; Massuger, L.F.A.G.; Dongen, R.A. van; Snijders, M.P.; Bulten, J.; Melchers, W.J.G.; Bekkers, R.L.M.

    2011-01-01

    OBJECTIVE: Management of patients diagnosed on cervical smears with twice consecutively atypical squamous cells of undetermined significance (ASC-US) remains a clinical dilemma. We describe a follow-up of aggressive vs. less aggressive colposcopic treatment in order to determine which treatment is p

  7. The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden

    Directory of Open Access Journals (Sweden)

    Andersson Annette Erichsen

    2012-06-01

    Full Text Available Abstract Background Current knowledge suggests that, by applying evidence-based measures relating to the correct use of prophylactic antibiotics, perioperative normothermia, urinary tract catheterization and hand hygiene, important contributions can be made to reducing the risk of postoperative infections and device-related infections. The aim of this study was to explore and describe the application of intraoperative evidence-based measures, designed to reduce the risk of infection. In addition, we aimed to investigate whether the type of surgery, i.e. total joint arthroplasty compared with tibia and femur/hip fracture surgery, affected the use of protective measures. Method Data on the clinical application of evidence-based measures were collected structurally on site during 69 consecutively included operations involving fracture surgery (n = 35 and total joint arthroplasties (n = 34 using a pre-tested observation form. For observations in relation to hand disinfection, a modified version of the World Health Organization hand hygiene observation method was used. Results In all, only 29 patients (49% of 59 received prophylaxis within the recommended time span. The differences in the timing of prophylactic antibiotics between total joint arthroplasty and fracture surgery were significant, i.e. a more accurate timing was implemented in patients undergoing total joint arthroplasty (p = 0.02. Eighteen (53% of the patients undergoing total joint arthroplasty were actively treated with a forced-air warming system. The corresponding number for fracture surgery was 12 (34% (p = 0.04. Observations of 254 opportunities for hand hygiene revealed an overall adherence rate of 10.3% to hand disinfection guidelines. Conclusions The results showed that the utilization of evidence-based measures to reduce infections in clinical practice is not sufficient and there are unjustifiable differences in care depending on the type of surgery. The poor

  8. Status of Department of Defense Architecture Framework (DoDAF) Implementation within the Aeronautical Systems Center (ASC)

    Science.gov (United States)

    2007-11-02

    characterizes these complex, unprecedented systems” (26:6). Further, Howard Eisner offers the following in his book, Essentials of Project and Systems...definitions deal with architectures role in the design of the system. Howard Eisner, author of Essentials of Project and Systems Engineering Management...prescribed several views as beneficial to the program manager in acquisition strategy development. Further, as Zinn noted, with the Clinger-Cohen Act

  9. ASC provides a potential link between depression and inflammatory disorders: A clinical study of depressed Iranian medical students.

    Science.gov (United States)

    Momeni, Mohammad; Ghorban, Khodayar; Dadmanesh, Maryam; Khodadadi, Hassan; Bidaki, Reza; Kazemi Arababadi, Mohammad; Kennedy, Derek

    2016-01-01

    Background and aims AIM2 is a component of inflammasomes which can activate caspase-1 via an adaptor protein (ASC) after pathogen-associated molecular pattern (PAMP) or danger-associated molecular pattern (DAMP) recognition. Activation of caspase-1 is a trigger for the induction of IL-1 and IL-18 which are important pro-inflammatory cytokines. Furthermore, IL-1β, which can regulate inflammatory responses, has also been associated with depression. Previous studies revealed that patients suffering from depression may also have altered immune responses, but the mechanisms underlying this correlation are unclear. Thus, the aim of this study was to determine the mRNA levels of AIM2 and ASC in the peripheral blood mononuclear cells (PBMCs) isolated from Iranian medical students suffering from depression. Materials and methods The participants used for the study included 38 Iranian medical students diagnosed with depression and 43 non-depressed students as a control group. The mRNA levels of AIM2 and ASC were evaluated by quantitative real-time polymerase chain reaction (PCR) using β-actin as a housekeeping gene for the normalization of expression. Results The results showed that mRNA levels of AIM2 were similar in both groups. However, ASC levels were significantly increased in PBMCs isolated from individuals with elevated depressive symptoms when compared to non-depressed participants. Conclusions Based on the current results, it appears that ASC transcript expression may be a surrogate marker for depression and may represent a link between depression and the altered immune responses observed in these categories of individuals with elevated depressive symptoms.

  10. Glycolic Acid Silences Inflammasome Complex Genes, NLRC4 and ASC, by Inducing DNA Methylation in HaCaT Cells.

    Science.gov (United States)

    Tang, Sheau-Chung; Yeh, Jih-I; Hung, Sung-Jen; Hsiao, Yu-Ping; Liu, Fu-Tong; Yang, Jen-Hung

    2016-03-01

    AHAs (α-hydroxy acids), including glycolic acid (GA), have been widely used in cosmetic products and superficial chemical peels. Inflammasome complex has been shown to play critical roles in inflammatory pathways in human keratinocytes. However, the anti-inflammatory mechanism of GA is still unknown. The aim of this study is to investigate the relationship between the expression of the inflammasome complex and epigenetic modification to elucidate the molecular mechanism of the anti-inflammatory effect of GA in HaCaT cells. We evaluated NLRP3, NLRC4, AIM2, and ASC inflammasome complex gene expression on real-time polymerase chain reaction (PCR). Methylation changes were detected in these genes following treatment with DNA methyltransferase (DNMT) inhibitor 5-aza-2'-deoxycytidine (5-Aza) with or without the addition of GA using methylation-specific PCR (MSP). GA inhibited the expressions of these inflammasome complex genes, and the decreases in the expressions of mRNA were reversed by 5-Aza treatment. Methylation was detected in NLRC4 and ASC on MSP, but not in NLRP3 or AIM2. GA decreased NLRC4 and ASC gene expression by increasing not only DNA methyltransferase 3B (DNMT-3B) protein level, but also total DNMT activity. Furthermore, silencing of DNMT-3B (shDNMT-3B) increased the expressions of NLRC4 and ASC. Our data demonstrated that GA treatment induces hypermethylation of promoters of NLRC4 and ASC genes, which may subsequently lead to the hindering of the assembly of the inflammasome complex in HaCaT cells. These results highlight the anti-inflammatory potential of GA-containing cosmetic agents in human skin cells and demonstrate for the first time the role of aberrant hypermethylation in this process.

  11. Apoptosis-associated speck-like protein containing a CARD (ASC) expression profiles in familial Mediterranean fever (FMF) patients with different MEFV mutation patterns.

    Science.gov (United States)

    Nalbantoglu, S; Tanyolac, B; Berdeli, A

    2013-01-01

    The inflammasome complex and the inflammatory pathway have been implicated in the pathogenesis of the most common autoinflammatory disorder, familial Mediterranean fever (FMF). Pyrin, the protein product of the FMF gene MEFV, interacts with the inflammasome complex adaptor protein ASC/PYCARD (apoptosis-associated speck-like protein with a CARD). Pyrin and ASC can both function as either inducers or suppressors of the cellular inflammatory response. We aimed to characterize ASC-induced gene expression profiles in FMF patients with different MEFV mutation patterns. A total of 165 Caucasian patients with clinical and molecular FMF diagnoses were enrolled in the study. ASC gene expression was quantified by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). ASC mRNA expression was increased in the MEFV mutation-positive group compared to the mutation-negative group (p = 0.001). The fold changes of ASC expression in the M694V homozygous (p = 0.02), M694V heterozygous (p = 0.012), compound heterozygous (p = 0.002), and R202Q/P369S/R408Q (p = 0.00) groups relative to the MEFV mutation-negative group were +2.4, +2.7, +3, and +3.4, respectively. qRT-PCR did not reveal a significant difference in ASC mRNA expression levels among the MEFV mutation-positive groups (p > 0.05). ASC mRNA expression was up-regulated in patients carrying MEFV mutations independent of mutation type. There was no significant relationship between specific MEFV genotypes and the level of ASC expression in the patient group analysed. Thus, the findings of this work may suggest a crucial relationship between mutant MEFV/pyrin and remarkable ASC up-regulation in FMF inflammation.

  12. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  13. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  14. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written By: Kierstan Boyd Reviewed By: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  15. Predicting mortality after congenital heart surgeries: Evaluation of the Aristotle and Risk Adjustement in Congenital Heart surgery-1 risk prediction scoring systems: A retrospective single center analysis of 1150 patients

    Directory of Open Access Journals (Sweden)

    Shreedhar S Joshi

    2014-01-01

    Full Text Available Aims and Objectives: To validate Aristotle basic complexity and Aristotle comprehensive complexity (ABC and ACC and risk adjustment in congenital heart surgery-1 (RACHS-1 prediction models for in hospital mortality after surgery for congenital heart disease in a single surgical unit. Materials and Methods: Patients younger than 18 years, who had undergone surgery for congenital heart diseases from July 2007 to July 2013 were enrolled. Scoring for ABC and ACC scoring and assigning to RACHS-1 categories were done retrospectively from retrieved case files. Discriminative power of scoring systems was assessed with area under curve (AUC of receiver operating curves (ROC. Calibration (test for goodness of fit of the model was measured with Hosmer-Lemeshow modification of χ2 test. Net reclassification improvement (NRI and integrated discrimination improvement (IDI were applied to assess reclassification. Results: A total of 1150 cases were assessed with an all-cause in-hospital mortality rate of 7.91%. When modeled for multivariate regression analysis, the ABC (χ2 = 8.24, P = 0.08, ACC (χ2 = 4.17 , P = 0.57 and RACHS-1 (χ2 = 2.13 , P = 0.14 scores showed good overall performance. The AUC was 0.677 with 95% confidence interval (CI of 0.61-0.73 for ABC score, 0.704 (95% CI: 0.64-0.76 for ACC score and for RACHS-1 it was 0.607 (95%CI: 0.55-0.66. ACC had an improved predictability in comparison to RACHS-1 and ABC on analysis with NRI and IDI. Conclusions: ACC predicted mortality better than ABC and RCAHS-1 models. A national database will help in developing predictive models unique to our populations, till then, ACC scoring model can be used to analyze individual performances and compare with other institutes.

  16. Factors Influencing Selection of Vaginal, Open Abdominal, or Robotic Surgery to Treat Apical Vaginal Vault Prolapse

    Science.gov (United States)

    Anand, Mallika; Weaver, Amy L.; Fruth, Kristin M.; Gebhart, John B.

    2016-01-01

    Objectives To determine factors influencing selection of Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), or robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery between January 1, 2000, and June 30, 2012, at our institution. Baseline characteristics and explicit selection factors were abstracted from the electronic medical records. Factors were compared between groups using χ2 tests for categorical variables, ANOVA for continuous variables, and Kruskal-Wallis tests for ordinal variables. Results Among the 512 patients identified who met inclusion criteria, the MMC group (n=174) had more patients who were older, American Society of Anesthesiologists class 3+ or greater, had anterior vaginal prolapse grade 3+, desired to avoid abdominal surgery, and did not desire a functional vagina. Patients in the ASC (n=237) and RSC (n=101) groups had more failed prolapse surgeries, suspected abdominopelvic pathologic processes, and chronic pain. Advanced prolapse was more frequently cited as an explicit selection factor for ASC than for either MMC or RSC. Conclusions The most common factors that influenced the type of apical vaginal vault prolapse surgery overlapped with characteristics that differed at baseline. In general, MMC was chosen for advanced anterior vaginal prolapse and baseline characteristics that increased surgical risks, ASC for advanced apical prolapse, and ASC or RSC for recurrent prolapse, suspected abdominal pathology, and patients with chronic pain or lifestyles including heavy lifting. Thus, efforts should be made to attempt to control for selection bias when comparing these procedures. PMID:26945273

  17. [The performance of coronary angioplasties at centers without cardiac surgery. The recommendations of the Sociedad Española de Cardiología].

    Science.gov (United States)

    Esplugas Oliveras, E; Hernández Antolín, R A; López Bescós, L; Moreu Burgos, J; Pomar Moya-Prats, J L

    1999-01-01

    During the early years of coronary interventions a rigorous on-site surgical stand-by was mandatory. The increased experience in coronary angioplasty both on total number of procedures and the experience gained by each operator, together with the technical improvements, namely since the introduction of stents has induced an evolution in the stand-by strategy, with new concepts such as "next available operating room" or coronary interventions "without on site" surgical facilities, are gaining widespread acceptance. With the aim of defining the requirements to perform coronary interventions at hospitals without coronary surgery, the following aspects are reviewed: a) complications following coronary angioplasty that require coronary surgery; b) the current status of coronary angioplasty without surgical stand-by in different countries. All this information allows us to advance some recommendations concerning the performance of coronary interventions at hospitals without on-site cardiac surgery. Different issues including hospital characteristics, operator and cardiac catheterization laboratory requirements, as well as lesion characteristics and the type of informed consent, should be taken into account.

  18. Data Processing Center of Radioastron Project: 3 years of operation.

    Science.gov (United States)

    Shatskaya, Marina

    ASC DATA PROCESSING CENTER (DPC) of Radioastron Project is a fail-safe complex centralized system of interconnected software/ hardware components along with organizational procedures. Tasks facing of the scientific data processing center are organization of service information exchange, collection of scientific data, storage of all of scientific data, data science oriented processing. DPC takes part in the informational exchange with two tracking stations in Pushchino (Russia) and Green Bank (USA), about 30 ground telescopes, ballistic center, tracking headquarters and session scheduling center. Enormous flows of information go to Astro Space Center. For the inquiring of enormous data volumes we develop specialized network infrastructure, Internet channels and storage. The computer complex has been designed at the Astro Space Center (ASC) of Lebedev Physical Institute and includes: - 800 TB on-line storage, - 2000 TB hard drive archive, - backup system on magnetic tapes (2000 TB); - 24 TB redundant storage at Pushchino Radio Astronomy Observatory; - Web and FTP servers, - DPC management and data transmission networks. The structure and functions of ASC Data Processing Center are fully adequate to the data processing requirements of the Radioastron Mission and has been successfully confirmed during Fringe Search, Early Science Program and first year of Key Science Program.

  19. BATHY_2M_ASC.ASC: Bathymetric data collected by the U.S. Geological Survey off the southern shore of Martha's Vineyard, MA, 2007 (ASCII RASTER)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Woods Hole Science Center conducted a nearshore geophysical survey offshore of the southern coast of Martha's Vineyard, in the vicinity of the Martha's...

  20. BATHY_2M_ASC.ASC: Bathymetric data collected by the U.S. Geological Survey off the southern shore of Martha's Vineyard, MA, 2007 (ASCII RASTER)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Woods Hole Science Center conducted a nearshore geophysical survey offshore of the southern coast of Martha's Vineyard, in the vicinity of the Martha's...

  1. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  2. Syntheses, structure and intercalation properties of low-dimensional phenylarsonates, A(HO3AsC6H5)(H2O3AsC6H5) (A = Tl, Na, K and Rb)

    Indian Academy of Sciences (India)

    Bonthu Krishna Kishore Reddy; K Prabhakara Rao; K Vidyasagar

    2006-01-01

    Four new low-dimensional phenylarsonates, A(HO3AsC6H5)(H2O3AsC6H5) (A = Tl(1), Na(2), K(3) and Rb(4)), have been synthesized and characterized by X-ray diffraction, spectroscopic and thermal studies. They crystallize in triclinic unit cells and have approximately planar arrangement of A+ ions, coordinated to oxygen atoms of phenylarsonates, on both sides. Structure of thallium phenylarsonate as determined by single crystal X-ray diffraction, is one-dimensional, whereas those of alkalimetal analogues are two-dimensional. Successful intercalation reactions of compounds 1 and 2 with primary -alkyl amines have been demonstrated.

  3. Weight-loss surgery and children

    Science.gov (United States)

    ... more likely to have problems such as: Low self-esteem Poor grades in school Depression ... weight-loss surgery should receive care at an adolescent bariatric surgery center. There, a team of experts ...

  4. The Role of Wellbeing and Wellness: A Positive Psychological Model in Supporting Young People With ASCs

    Directory of Open Access Journals (Sweden)

    Irina Roncaglia

    2017-04-01

    Full Text Available In the last 10 years sport psychology expanded its applicability in a variety of fields which have helped to address some of the challenges related to high level performance and sport competition. When we talk about performance in its wider sense, sport psychology is able to help develop a better understanding on how strategies can be adopted in improving general human performance levels. This includes increasing the knowledge of key concepts such as motivation, self-confidence and resilience. Furthermore performance in its wider sense helps in the understanding of the impact of stress and arousal and how these can affect both positively and negatively performance levels including appreciating individual differences as well as dynamics between groups of individuals. In this paper performance rather than solely be related to the field of competitive or professional sport has been discussed in people with ASCs and aims to explore how by adopting a positive psychological model in the formulation of individual assessments and subsequent interventions have led to improvement in individual skills, participation, engagement and ultimately quality of life. Positive psychological principles, such as the role of wellbeing and wellness, the PERMA Model has increased our understanding of human potentials, performance and wellbeing. The aim of this paper is to present and reflect on the applicability and benefits of adopting sport psychology models, the PERMA model and positive psychological principles in special education and care settings with the presentation and discussion of their theoretical and some practical implementation in two case studies.

  5. Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial.

    Directory of Open Access Journals (Sweden)

    Lijian Pei

    Full Text Available The contribution of ultrasound-assisted thoracic paravertebral block to postoperative analgesia remains unclear. We compared the effect of a combination of ultrasound assisted-thoracic paravertebral block and propofol general anesthesia with opioid and sevoflurane general anesthesia on volatile anesthetic, propofol and opioid consumption, and postoperative pain in patients having breast cancer surgery.Patients undergoing breast cancer surgery were randomly assigned to ultrasound-assisted paravertebral block with propofol general anesthesia (PPA group, n = 121 or fentanyl with sevoflurane general anesthesia (GA group, n = 126. Volatile anesthetic, propofol and opioid consumption, and postoperative pain intensity were compared between the groups using noninferiority and superiority tests.Patients in the PPA group required less sevoflurane than those in the GA group (median [interquartile range] of 0 [0, 0] vs. 0.4 [0.3, 0.6] minimum alveolar concentration [MAC]-hours, less intraoperative fentanyl requirements (100 [50, 100] vs. 250 [200, 300]μg,, less intense postoperative pain (median visual analog scale score 2 [1, 3.5] vs. 3 [2, 4.5], but more propofol (median 529 [424, 672] vs. 100 [100, 130] mg. Noninferiority was detected for all four outcomes; one-tailed superiority tests for each outcome were highly significant at P<0.001 in the expected directions.The combination of propofol anesthesia with ultrasound-assisted paravertebral block reduces intraoperative volatile anesthetic and opioid requirements, and results in less post operative pain in patients undergoing breast cancer surgery.ClinicalTrial.gov NCT00418457.

  6. Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery.

    Science.gov (United States)

    Sorenson, Rebecca; Scott, Ingrid U; Tucker, Steven H; Chinchilli, Vernon M; Papachristou, George C

    2016-02-01

    To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Cross-sectional study of anonymous survey results. An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Sixty-seven (57.2%) of 117 confirmed survey recipients participated. Thirty-six (62.1%) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6% would place a primary anterior chamber IOL (AC IOL), 29.3% would place a primary scleral-fixated PC IOL, and 5.3% would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3%). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2%) and scleral-fixated PC IOLs (41.7%). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7% cited a decreased risk for long-term complications as their reason for IOL choice; 50.0% of surgeons who favored primary AC IOLs cited avoidance of a second surgery. In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Physical Therapy and Surgery

    Science.gov (United States)

    Valle-Onate, Rafael; Ward, Michael M.; Kerr, Gail S.

    2012-01-01

    Physical therapy and orthopedic surgery are important components in the treatment of ankylosing spondylitis (AS). Supervised physical therapy is more effective that individual or unsupervised exercise in improving symptoms, but controlled trials suggest than combined inpatient and outpatient therapy provides the greatest improvement. Recommendations for exercise are universal, but the best types and sequence of therapies are not known. Total hip replacement is the surgery most commonly performed for AS, with good long-term implant survival. Heterotopic ossification may occur no more frequently after hip replacement in patients with AS than in patients with other diseases. Corrective spinal surgery is rarely performed and requires specialized centers and experienced surgeons. PMID:22543536

  8. Estimate of Bariatric Surgery Numbers, 2011-2015

    Science.gov (United States)

    ... to Care Toolkit EHB Access Toolkit Estimate of Bariatric Surgery Numbers, 2011-2015 Published July 2016 2011 2012 ... Online Education Directory Search Patient Learning Center Bariatric Surgery FAQs Bariatric Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  9. Inflammasome adaptor protein Apoptosis-associated speck-like protein containing CARD (ASC) is critical for the immune response and survival in west Nile virus encephalitis.

    Science.gov (United States)

    Kumar, Mukesh; Roe, Kelsey; Orillo, Beverly; Muruve, Daniel A; Nerurkar, Vivek R; Gale, Michael; Verma, Saguna

    2013-04-01

    West Nile virus (WNV) is a neurotropic flavivirus that has emerged globally as a significant cause of viral encephalitis in humans. The WNV-induced innate immune response, including production of antiviral cytokines, is critical for controlling virus infection. The adaptor protein ASC mediates a critical step in innate immune signaling by bridging the interaction between the pathogen recognition receptors and caspase 1 in inflammasome complexes, but its role in WNV immunopathogenesis is not defined. Here, we demonstrate that ASC is essential for interleukin-1β (IL-1β) production and development of effective host immunity against WNV. ASC-deficient mice exhibited increased susceptibility to WNV infection, and reduced survival was associated with enhanced virus replication in the peripheral tissues and central nervous system (CNS). Infection of cultured bone marrow-derived dendritic cells showed that ASC was essential for the activation of caspase 1, a key component of inflammasome assembly. ASC(-/-) mice exhibited attenuated levels of proinflammatory cytokines in the serum. Intriguingly, infected ASC(-/-) mice also displayed reduced levels of alpha interferon (IFN-α) and IgM in the serum, indicating the overall protective role of ASC in restricting WNV infection. However, brains from ASC(-/-) mice displayed unrestrained inflammation, including elevated levels of proinflammatory cytokines and chemokines, such as IFN-γ, CCL2, and CCL5, which correlated with more pronounced activation of the astrocytes, enhanced infiltration of peripheral immune cells in the CNS, and increased neuronal cell death. Collectively, our data provide new insights into the role of ASC as an essential modulator of inflammasome-dependent and -independent immune responses to effectively control WNV infection.

  10. 77 FR 37678 - Medicare and Medicaid Programs; Application From American Association for Accreditation of...

    Science.gov (United States)

    2012-06-22

    ... Ambulatory Surgery Facilities Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS... continued recognition as a national accrediting organization for ambulatory surgery centers (ASCs) wish to..., eligible beneficiaries may receive covered services in an ambulatory surgery center (ASC) that meet...

  11. Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

    Energy Technology Data Exchange (ETDEWEB)

    East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

    2008-09-22

    This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.

  12. Multifunctional nanocrystalline calcium phosphates loaded with Tetracycline antibiotic combined with human adipose derived mesenchymal stromal stem cells (hASCs).

    Science.gov (United States)

    Marycz, K; Pazik, R; Zawisza, K; Wiglusz, K; Maredziak, M; Sobierajska, P; Wiglusz, R J

    2016-12-01

    Osteoconductive drug delivery system composed of nanocrystalline calcium phosphates (Ca10(PO4)6(OH)2/β-Ca3(PO4)2) co-doped with Yb(3+)/Er(3+) ions loaded with Tetracycline antibiotic (TC) was developed. Their effect on human adipose derived mesenchymal stromal stem cells (hASCs) as a potential reconstructive biomaterial for bone tissue regeneration was studied. The XRD and TEM measurements were used in order to determine the crystal structure and morphology of the final products. The characteristics of nanocomposites with the TC and hASCs as potential regenerative materials as well as the antimicrobial activity of the nanoparticles against: Staphylococcus aureus ATCC 25923 as a model of the Gram-positive bacteria, Escherichia coli ATCC 8739 of the Gram-negative bacteria, were shown. These combinations can be a promising material for theranostic due to its regenerative, antimicrobial and fluorescent properties.

  13. Asc-1, PAT2 and P2RX5 are novel cell surface markers for white, beige and brown adipocytes

    OpenAIRE

    Ussar, Siegfried; Lee, Kevin Y.; Dankel, Simon N.; Boucher, Jeremie; Haering, Max-Felix; Kleinridders, Andre; Thomou, Thomas; Xue, Ruidan; Macotela, Yazmin; Cypess, Aaron M.; Tseng, Yu-Hua; Mellgren, Gunnar; Kahn, C. Ronald

    2014-01-01

    White, beige and brown adipocytes are developmentally and functionally distinct but often occur mixed together within individual depots. To target white, beige and brown adipocytes for diagnostic or therapeutic purposes, a better understanding of the cell surface properties of these cell types is essential. Using a combination of in silico, in vitro and in vivo methods, we have identified three new cell surface markers of adipose cell types. The amino acid transporter Asc-1 is a white adipocy...

  14. Fluorescent immortalized human adipose derived stromal cells (hASCs-TS/GFP+) for studying cell drug delivery mediated by microvesicles.

    Science.gov (United States)

    Coccè, Valentina; Balducci, Luigi; Falchetti, Maria Laura; Pascucci, Luisa; Ciusani, Emilio; Brini, Anna Teresa; Sisto, Francesca; Piovani, Giovanna; Alessandri, Giulio; Parati, Eugenio; Cabeza, Laura; Pessina, Augusto

    2017-03-27

    A new tool for the drug delivery is based on the use of Mesenchymal Stromal Cells (MSCs) loaded in vitro with anti-cancer drugs. Unfortunately, the restricted lifespan of MSCs represents a significant limitation to produce them in high amounts and for long time studies. Immortalized MSCs from adipose tissue (hASC) have been generated as good source of cells with stable features. These cells could improve the development of standardized procedures for both in vitro and preclinical studies. Furthermore they facilitate procedures for preparing large amounts of secretome containing microvesicles (MVs). We used human adipose tissue derived MSCs immortalized with hTERT+SV40 (TS) genes and transfected with GFP (hASCs-TS/GFP+). This line was investigate for its ability to uptake and release anticancer drugs. Microvesicles associated to paclitaxel (MVs/PTX) were isolated, quantified, and tested on pancreatic cancer cells. The line hASCs-TS/GFP+ maintained the main mesenchymal characters and was able to uptake and release, in active form, both paclitaxel and gemcitabine. From paclitaxel loaded hASCs-TS/GFP+ cells were isolated microvesicles in sufficient amount to inhibit "in vitro" the proliferation of pancreatic tumor cells. Our study suggests that human immortalized MSCs could be used for a large scale production of cells for mediated drug delivery. Moreover, the secretion of drug-associated MVs could represent a new way for producing new drug formulation by "biogenesis". In the context of the "advanced cell therapy procedure", the MVs/PTX production would be less resource and time consuming and it could possibly contribute to simplification of GMP procedures. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  16. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  17. Analysis of margin index as a method for predicting residual disease after breast-conserving surgery in a European cancer center.

    LENUS (Irish Health Repository)

    Bolger, Jarlath C

    2012-02-01

    INTRODUCTION: Breast-conserving surgery (BCS), followed by appropriate adjuvant therapies is established as a standard treatment option for women with early-stage invasive breast cancers. A number of factors have been shown to correlate with local and regional disease recurrence. Although margin status is a strong predictor of disease recurrence, consensus is yet to be established on the optimum margin necessary. Margenthaler et al. recently proposed the use of a "margin index," combining tumor size and margin status as a predictor of residual disease after BCS. We applied this new predictive tool to a population of patients with primary breast cancer who presented to a symptomatic breast unit to determine its suitability in predicting those who require reexcision surgery. METHODS: Retrospective analysis of our breast cancer database from January 1, 2000 to June 30, 2010 was performed, including all patients who underwent BCS. Of 531 patients who underwent BCS, 27.1% (144\\/531) required further reexcision procedures, and 55 were eligible for inclusion in the study. Margin index was calculated as: margin index = closest margin (mm)\\/tumor size (mm) x 100, with index >5 considered optimum. RESULTS: Of the 55 patients included, 31% (17\\/55) had residual disease. Fisher\\'s exact test showed margin index not to be a significant predictor of residual disease on reexcision specimen (P = 0.57). Of note, a significantly higher proportion of our patients presented with T2\\/3 tumors (60% vs. 38%). CONCLUSIONS: Although an apparently elegant tool for predicting residual disease after BCS, we have shown that it is not applicable to a symptomatic breast unit in Ireland.

  18. Analysis of Margin Index as a Method for Predicting Residual Disease After Breast-Conserving Surgery in a European Cancer Center.

    LENUS (Irish Health Repository)

    Bolger, Jarlath C

    2011-06-03

    INTRODUCTION: Breast-conserving surgery (BCS), followed by appropriate adjuvant therapies is established as a standard treatment option for women with early-stage invasive breast cancers. A number of factors have been shown to correlate with local and regional disease recurrence. Although margin status is a strong predictor of disease recurrence, consensus is yet to be established on the optimum margin necessary. Margenthaler et al. recently proposed the use of a "margin index," combining tumor size and margin status as a predictor of residual disease after BCS. We applied this new predictive tool to a population of patients with primary breast cancer who presented to a symptomatic breast unit to determine its suitability in predicting those who require reexcision surgery. METHODS: Retrospective analysis of our breast cancer database from January 1, 2000 to June 30, 2010 was performed, including all patients who underwent BCS. Of 531 patients who underwent BCS, 27.1% (144\\/531) required further reexcision procedures, and 55 were eligible for inclusion in the study. Margin index was calculated as: margin index = closest margin (mm)\\/tumor size (mm) × 100, with index >5 considered optimum. RESULTS: Of the 55 patients included, 31% (17\\/55) had residual disease. Fisher\\'s exact test showed margin index not to be a significant predictor of residual disease on reexcision specimen (P = 0.57). Of note, a significantly higher proportion of our patients presented with T2\\/3 tumors (60% vs. 38%). CONCLUSIONS: Although an apparently elegant tool for predicting residual disease after BCS, we have shown that it is not applicable to a symptomatic breast unit in Ireland.

  19. Having faith in each other: not-for-profit giant Ascension Health hooks up with United Surgical Partners for ASC joint venture.

    Science.gov (United States)

    Romano, Michael

    2004-09-13

    In the biggest deal of its kind, not-for-profit giant Ascension is going to build ambulatory surgery centers with for-profit United Surgical Partners, which already has a deal with Baylor, left. "Hospitals are realizing that outpatient services are the future. This strategy is sound," one healthcare consultant said.

  20. ASCS online fault detection and isolation based on an improved MPCA

    Science.gov (United States)

    Peng, Jianxin; Liu, Haiou; Hu, Yuhui; Xi, Junqiang; Chen, Huiyan

    2014-09-01

    Multi-way principal component analysis (MPCA) has received considerable attention and been widely used in process monitoring. A traditional MPCA algorithm unfolds multiple batches of historical data into a two-dimensional matrix and cut the matrix along the time axis to form subspaces. However, low efficiency of subspaces and difficult fault isolation are the common disadvantages for the principal component model. This paper presents a new subspace construction method based on kernel density estimation function that can effectively reduce the storage amount of the subspace information. The MPCA model and the knowledge base are built based on the new subspace. Then, fault detection and isolation with the squared prediction error (SPE) statistic and the Hotelling ( T 2) statistic are also realized in process monitoring. When a fault occurs, fault isolation based on the SPE statistic is achieved by residual contribution analysis of different variables. For fault isolation of subspace based on the T 2 statistic, the relationship between the statistic indicator and state variables is constructed, and the constraint conditions are presented to check the validity of fault isolation. Then, to improve the robustness of fault isolation to unexpected disturbances, the statistic method is adopted to set the relation between single subspace and multiple subspaces to increase the corrective rate of fault isolation. Finally fault detection and isolation based on the improved MPCA is used to monitor the automatic shift control system (ASCS) to prove the correctness and effectiveness of the algorithm. The research proposes a new subspace construction method to reduce the required storage capacity and to prove the robustness of the principal component model, and sets the relationship between the state variables and fault detection indicators for fault isolation.

  1. ASCS Online Fault Detection and Isolation Based on an Improved MPCA

    Institute of Scientific and Technical Information of China (English)

    PENG Jianxin; LIU Haiou; HU Yuhui; XI Junqiang; CHEN Huiyan

    2014-01-01

    Multi-way principal component analysis (MPCA) has received considerable attention and been widely used in process monitoring. A traditional MPCA algorithm unfolds multiple batches of historical data into a two-dimensional matrix and cut the matrix along the time axis to form subspaces. However, low efficiency of subspaces and difficult fault isolation are the common disadvantages for the principal component model. This paper presents a new subspace construction method based on kernel density estimation function that can effectively reduce the storage amount of the subspace information. The MPCA model and the knowledge base are built based on the new subspace. Then, fault detection and isolation with the squared prediction error (SPE) statistic and the Hotelling (T2) statistic are also realized in process monitoring. When a fault occurs, fault isolation based on the SPE statistic is achieved by residual contribution analysis of different variables. For fault isolation of subspace based on the T2 statistic, the relationship between the statistic indicator and state variables is constructed, and the constraint conditions are presented to check the validity of fault isolation. Then, to improve the robustness of fault isolation to unexpected disturbances, the statistic method is adopted to set the relation between single subspace and multiple subspaces to increase the corrective rate of fault isolation. Finally fault detection and isolation based on the improved MPCA is used to monitor the automatic shift control system (ASCS) to prove the correctness and effectiveness of the algorithm. The research proposes a new subspace construction method to reduce the required storage capacity and to prove the robustness of the principal component model, and sets the relationship between the state variables and fault detection indicators for fault isolation.

  2. Land Cover Information for the Upper Colorado River Basin in Maurer et al. (2002) Climate Data resolution (nlcd_UCRB_Maurer_resolution.asc)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — nlcd_UCRB_Maurer_resolution.asc is an Esri ASCII grid representing land cover information for the Upper Colorado River Basin. The 2011 National Land Cover Database...

  3. Hydrologic Soil Group for the Upper Colorado River Basin in Maurer et al. (2002) Climate Data resolution (hsg_UCRB_Maurer_resolution.asc)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — hsg_UCRB_Maurer_resolution.asc is an Esri ASCII grid representing the hydrologic soil group (HSG) for the Upper Colorado River Basin. The HSG for an area is...

  4. Available Water Capacity for the Upper Colorado River Basin in Maurer et al. (2002) Climate Data resolution (awc_UCRB_Maurer_resolution.asc)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — awc_UCRB_Maurer_resolution.asc is an Esri ASCII grid representing the available water capacity (AWC) for the Upper Colorado River Basin. AWC is the amount of water...

  5. Overland Flow Direction Information for the Upper Colorado River Basin in Maurer et al. (2002) Climate Data resolution (overland_flow_direction_UCRB_Maurer_resolution.asc)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — overland_flow_direction_UCRB_Maurer_resolution.asc is an Esri ASCII grid representing overland flow direction in the Upper Colorado River Basin using the D8...

  6. Preventing Blood Clots After Orthopaedic Surgery

    Medline Plus

    Full Text Available ... Centers Broken Bones & Injuries Diseases & Conditions Arthritis Tumors Sports Injuries & Prevention Children Bone Health Health & Safety Treatment Treatments & Surgeries Joint Replacement Rehabilitation ...

  7. Preventing Blood Clots After Orthopaedic Surgery

    Medline Plus

    Full Text Available ... Ankle Neck & Back Health Centers Broken Bones & Injuries Diseases & Conditions Arthritis Tumors Sports Injuries & Prevention Children Bone Health Health & Safety Treatment Treatments & Surgeries ...

  8. Comparison of incidence of postoperative nausea and vomiting (PONV between children of smoker parent and children of non-smoker parents after surgery in Imam Khomeini and Children Medical Center Hospitals

    Directory of Open Access Journals (Sweden)

    Ghazi Saeidi K

    2001-10-01

    Full Text Available Postoperative nausea and vomiting is a common complication that all anesthesiologist are familiar with the problems of its consequences. Although continued research on the recognition of factors affecting the incidence of PONV is being done but they are not sufficient and the need for research along with advances in anesthesiology and newer drugs are considered. In this prospective cohort study 400 children of 3 to 12 age who has been operated for general surgery (other than eye, thorax and upper abdomen and orthopedic surgery in the Imam Khomeini and Children Medical Center Hospital has been evaluated. Of these, 200 children who had smoking parent and according to definition were passive smokers and the other 200 children had no smoking parents. Both the groups were matched for sex, age, and type of operation. With the analysis of data we noted that the incidence of PONV in both groups was 19.5 and there was no significant difference between the two groups. (Passive smoker 19 percent and non-passive smoker 20 percent. We also noted a relation between the duration and the incidence of PONV. So operation with more than 2 hours had higher incidence of PONV. There was also positive relation between PONV and controlled ventilation. However, there was no significant difference as the sex and type of operation was concerned. In conclusion, children of smoker parents suffer more PONV than children of non-smoker parents if operation takes longer than two hours or the patient is mechanically ventilated during operation.

  9. A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center.

    Science.gov (United States)

    Nurok, Michael; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan

    2010-05-01

    To create and test a reproducible method for measuring emotional climate, surgical team skills, and threats to patient outcome by conducting an observational study to assess the impact of a surgical team skills and communication improvement intervention on these measurements. Observational study. Operating rooms in a high-volume thoracic surgery center from September 5, 2007, through June 30, 2008. Thoracic surgery operating room teams. Two 90-minute team skills training sessions focused on findings from a standardized safety culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication, and leadership. The sessions created an interactive forum to educate team members on the importance of communication and to role-play optimal interactive and communication strategies. Calculated indices of emotional climate, team skills, and threat to patient outcome. The calculated communication and team skills score improved from the preintervention to postintervention periods, but the improvement extinguished during the 3 months after the intervention (P skills and communication and decrease a calculated score of threats to patient outcome. However, the effect is only durable for threats to patient outcome.

  10. Draft Genome Sequence of Heavy Metal-Resistant Cupriavidus alkaliphilus ASC-732T, Isolated from Agave Rhizosphere in the Northeast of Mexico

    Science.gov (United States)

    Rojas-Rojas, Fernando Uriel; Huntemann, Marcel; Clum, Alicia; Pillay, Manoj; Palaniappan, Krishnaveni; Varghese, Neha; Mikhailova, Natalia; Stamatis, Dimitrios; Reddy, T. B. K.; Markowitz, Victor; Ivanova, Natalia; Kyrpides, Nikos; Woyke, Tanja; Shapiro, Nicole

    2016-01-01

    Cupriavidus alkaliphilus ASC-732T was isolated from the rhizosphere of agave plant growing in alkaline soils in San Carlos, Tamaulipas, Mexico. The species is able to grow in the presence of arsenic, zinc, and copper. The genome sequence of strain ASC-732T is 6,125,055 bp with 5,586 genes and an average G+C content of 67.81%. PMID:27660789

  11. Draft Genome Sequence of Heavy Metal-Resistant Cupriavidus alkaliphilus ASC-732T, Isolated from Agave Rhizosphere in the Northeast of Mexico.

    Science.gov (United States)

    Rojas-Rojas, Fernando Uriel; Huntemann, Marcel; Clum, Alicia; Pillay, Manoj; Palaniappan, Krishnaveni; Varghese, Neha; Mikhailova, Natalia; Stamatis, Dimitrios; Reddy, T B K; Markowitz, Victor; Ivanova, Natalia; Kyrpides, Nikos; Woyke, Tanja; Shapiro, Nicole; Ibarra, J Antonio; Estrada-de Los Santos, Paulina

    2016-09-22

    Cupriavidus alkaliphilus ASC-732(T) was isolated from the rhizosphere of agave plant growing in alkaline soils in San Carlos, Tamaulipas, Mexico. The species is able to grow in the presence of arsenic, zinc, and copper. The genome sequence of strain ASC-732(T) is 6,125,055 bp with 5,586 genes and an average G+C content of 67.81%.

  12. Engineering Foundation Conference: Advances in optics for biotechnology, medicine, and surgery, Kona Surf Resort and Conference Center, Kailua-Kona, Hawaii, August 1-6, 1999. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Yodh, Arjun; Sevick-Muraca, Eva; Benaron, David

    2001-09-01

    The intent of the conference was to gather a group of cross-disciplinary investigators from universities, medical schools, national laboratories, industry, and government in order to highlight future applications and technology of the optical sciences in biotechnology, medicine, and surgery. The session chairs brought new participants and speakers to the conference who were not regular attendees of the OSA and SPIE conferences. Attendees included a good number of graduate and post-doctoral students who tended to join the more senior members in organized and spontaneous afternoon activities. A critique of the conference is given which discusses things that worked well and things that could have been better, focusing on costs, funding, and speaker cancellations. Sessions were held on the following topics: Photodynamic therapy: fundamental and clinical studies; Frontiers in spectroscopy; Photon migration; Advances in tissue microscopy, dyes and reporters; Advances in cell microscopy: spectroscopy and micromanipulation; Laser-tissue interactions: therapeutic interventions; and Optics for biotechnology. Along with the program and participant lists, nearly 50 poster presentations are included.

  13. Does laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors preserve residual gastric motility? Results of a retrospective single-center study.

    Directory of Open Access Journals (Sweden)

    Yohei Waseda

    Full Text Available Laparoscopic and endoscopic cooperative surgery (LECS is a minimally invasive surgical technique used to resect gastric submucosal tumors with intraluminal growth. Endoscopic submucosal dissection is used to determine the appropriate resection line from within the stomach lumen as it minimizes the stomach wall resection area and prevents postoperative stomach deformity. Although LECS is intended to preserve gastric function, few reports have evaluated postoperative residual gastric motility. Therefore, we conducted a retrospective analysis of patients who underwent LECS to determine the effects of LECS on residual gastric motility.Twenty-two patients underwent endoscopy 3 to 12 months after LECS. Patients were evaluated for endoscopic evidence of gastric motility disorder, namely food residue and occurrence/exacerbation of reflux esophagitis. We considered patients with new onset of gastric symptoms and endoscopic evidence of gastric motility disorder to have clinically relevant gastric motility disorder. We described patient characteristics, tumor location, and surgical findings.Two of 22 patients developed clinically relevant gastric motility disorder after LECS. In one of these patients, the symptoms were not severe; only one had reduced dietary intake and had lost weight. We identified clinically relevant gastric motility disorder in two patients with gastrointestinal stromal tumors located in the lesser curvature of the stomach. The major axis of these two tumors was 34 mm and 38 mm.Many patients did not have clinically relevant gastric motility disorder after LECS. Further investigation is required to identify predisposing factors for gastric motility disorder.

  14. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  15. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  16. 人本位整体护理在乳腺癌保乳术围手术期中的应用%Application of people - centered holistic nursing in perioperative period of breast conserving surgery for breast cancer

    Institute of Scientific and Technical Information of China (English)

    武丹; 史秋莲; 李敏; 王水娇; 刘莉萍

    2016-01-01

    Objective:To explore the effect of people - centered holistic nursing in perioperative period of breast conserving surgery for breast cancer. Meth-ods:Selected 30 patients who underwent breast conserving surgery in our hospital from January 2015 to December 2015 as the observation group. Selected 30 patients who underwent breast conserving surgery in our hospital from January 2014 to December 2014 as control group. The control group was treated with routine nursing while the observation group was treated with people - centered holistic nursing care. Postoperative incision recovery,postoperative com-plications and postoperative mammographic appearance were observed and compared between the two groups. Results:The degree of wound healing in obser-vation group was significantly higher than that in control group,the difference was of statistical significance(P < 0. 05). The incidence of postoperative com-plications of the observation group was lower than that of the control group,the difference was statistically significant(P < 0. 05). The mammary gland ap-pearance evaluation grade of the observation group was significantly higher than that of the control group,the difference was statistically significant(P <0. 05). Conclusion:The holistic nursing care conducted for patients during perioperative period of breast conserving surgery can effectively solve the female patients’anxiety about the esthetic appearance. Its surgical incision recovery is better than traditional nursing in the breast conserving surgery. What’s more,the incidence of complications is significantly reduced. Therefore this method is worthy of clinical application.%目的:探讨人本位整体护理在乳腺癌保乳术围手术期中的应用效果。方法:选取2015年1~12月在我院进行乳腺癌保乳手术治疗的患者30例作为观察组,选取2014年1~12月在我院进行乳腺癌保乳手术治疗的患者30例作为对照组,对照组执行常规护理;观察组实施人本

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws and ... Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by ...

  18. Clinical significance of detection of HPV feedback on patients with cervical cytology ASC-H%对宫颈细胞学ASC-H患者进行反馈性HPV检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    林文毅; 陈颖; 王世凤; 胡志敏; 赖娜; 王敏

    2015-01-01

    Objective: To discuss the clinical significance of HPV (human papilloma virus)-detection in women with cervical ASC-H (atypical squamous cell cannotexclude high-grade squamous intraepithelial lesion). Methods: Retrospective analysis of the HPV-feedback test and histopathological findings in 197 cases of patients with ASC-H from June 2012 to June 2014. Results: Collected 197 cases of ASC-H patients diagnosed through cervical cytology in our hospital from June 2012 to June 2014. 124 cases gave the feedback tests of HPV and cervical tissue examination results, who were female, aged 25-63 years, with an average age of about 46 years old;clinical manifestations include cervical erosion,the real bleeding,physical examinations and others. 92 cases with the HPV positive, including histopathological findings as inflammation and 22 normal cases,accounting for about 23.91%, 15 cases with the low level of cervical intraepithelial neoplasia (CINI) ,accounting for about 16.3% , 45 cases with advanced differentiation of cervical intraepithelial neoplasia (cervical intraepithelial neopsia. CINII/CINIII), 10 cases with carcinoma, accounted for 59.78%, 32 cases of HPV negative, including histopathological findings as inflammation and 23 cases of normal, accounting for about 71.88%,8 cases with the low level of cervical intraepithelial neoplasia (CINI),accounting for about 25%,1 case with advanced differentiation of cervical intraepithelial neoplasia (CINII), accounting for about 3.12%, CINIII and squamous cell carcinoma were detected negatively. Thus the HPV detection has higher predictive value for lesions in high grade cervical intraepithelial cancer , risk of high-grade cervical intraepithelial lesion in HPV positive ASC-H patients were higher than the negative group (P< 0.05). Conclusion HPV feedback inspection in all ASC-H patients is very useful. Treatments could be provided more reasonable and personalized, while excessive examinations and treatments could be avoided and the

  19. Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H cannot be ruled out

    Directory of Open Access Journals (Sweden)

    Andréa Cytryn

    Full Text Available CONTEXT AND OBJECTIVE: The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS into ASC-US (undetermined significance and ASC-H (high-grade intraepithelial lesion cannot be ruled out. The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF with ASC-H cytology, and compare them with ASC-US cases. DESIGN AND SETTING: Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. METHODS: ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis was taken as the gold standard. RESULTS: The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55% and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764. Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83; P = 0.2786998. There were no uterine cervical cancer cases. CONCLUSION: The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

  20. Economics of pelvic organ prolapse surgery.

    Science.gov (United States)

    Cheon, Cecilia; Maher, Christopher

    2013-11-01

    The aim was to review the economic costs associated with pelvic organ prolapse surgery. Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs. Grade C recommendation usually depends on level 4 studies or "majority evidence" from level 2/3 studies or Delphi processed expert opinion. Grade D "no recommendation possible" would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi. The annual economic costs of pelvic organ prolapse surgeries are significant and over the next decades will grow at twice the rate of population growth because of our aging population. In a single institution study vaginal reconstructive surgery and pessary use were more cost-effective than expectant management, traditional abdominal sacral colpopexy (ASC) or robot-assisted sacral colpopexy (RSC; grade C). Two studies have demonstrated that ASC incurs lower inpatient costs than LSC or RSC (grade C). Data from a single RCT demonstrated the LSC to incur lower inpatient costs than RSC specifically relating to shorter operating times in the LSC group (grade B). Data from a single RCT demonstrated LSC to be a more effective cost-minimising surgery

  1. Some Opinion on the Term of ASC-US in Cervical Cytological Test%关于子宫颈细胞学检查ASC-US术语的几点认识

    Institute of Scientific and Technical Information of China (English)

    李晴; 黄美娥; 古晓红; 麦凤珍; 刘植华

    2007-01-01

    子宫颈脱落细胞学检查被认为是医学史上最成功的早期癌症筛查方法之一。1988年美国阴道镜和细胞病理协会(ASCCP)修改了宫颈/阴道细胞病理学诊断方式,废除“巴氏五级分类法”,推出描述性诊断报告方式(Thebe—thesda system,TBS),由此,报告中出现了一种“不能明确诊断意义的不典型鳞状上皮细胞(ASC-US)”的术语。目前对ASC—US的临床意义有多种释义,在临床工作中可能出现一些认识误区。现对我院2005年子宫颈脱落细胞学检查筛查出的ASC-US病例资料进行分析,

  2. Clay hydration and crystal growth in expansive anhydritic claystone. The Ascó Power Plant case

    Science.gov (United States)

    Alonso, Eduardo; Ramon, Anna

    2015-04-01

    A large power plant directly founded on a hard claystone experienced, soon after the construction of the foundation slabs, a continuous heave developing at decreasing rate, which has been active for the last 35 years. When undisturbed (i.e., at some depth, in the range of several meters) Ascó claystone exhibits high unconfined compressive strengths (30-40 MPa). In high quality cores the rock has a massive aspect and discontinuities are difficult to observe. The rock has a Tertiary origin and horizontal layers at spacing of 1-4 m could be identified. Whitish seams of gypsum, bassanite or anhydrite are also observed within the reddish rock matrix. Minerals identified in deep cores are quartz (10%), calcite and dolomite (50-70%), clay minerals (10-20%) and gypsum and anhydrite (2-20%). Among the clay minerals, illite dominates (10%). Smectite or smectite-interbedded minerals do not amount in general to more than 5%. The undisturbed rock has a low porosity (6-11%) and low water content (2-5%). Because of the presence of hydrated sulphates, water content and degree of saturation (Sr=0.8-0.9 was found) are somewhat uncertain. However, high suctions were found in recovered cores. This rock changes into a weathered material at shallow depths. Mineralogy is not much affected but porosity increases to 22-29% and water content increases to 10-19%. Strength drops to small values (soil like) and a lower "in situ" suction has been measured (0.4-7.1 MPa). The added pore volume of the weathered material, if compared with the deep rock, is filled with water. The heave of the station was attributed to the hydration of undisturbed rock under the building slabs of the power plant. In fact, large excavations preceded the layout of foundations. As a result, atmospheric water had an easy access to the intact rock. The installation of a compacted soil fill around the buildings allowed the presence of a permanent water table which could infiltrate into the rock. Piezometric data provided

  3. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Rooma Sinha

    2015-01-01

    Full Text Available FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.

  4. Endodontic surgery.

    Science.gov (United States)

    Chong, B S; Rhodes, J S

    2014-03-01

    A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.

  5. Analysis of the Mammotome minimally invasive operation in ambulatory surgery center%乳腺Mammotome微创旋切系统在日间手术中心的应用分析

    Institute of Scientific and Technical Information of China (English)

    陈荣恒; 甄作均; 谭家驹; 杨胜利; 黄伟俊

    2014-01-01

    目的探讨乳腺微创手术旋切系统在日间手术中心的应用。方法回顾性分析2012年1月至2013年6月600例在日间手术中心用麦默通(Mammotome)微创活检乳腺病变组织,同时在超声引导下对一些良性肿瘤完整切除患者(研究组)的临床资料。选取同期500例常规住院患者作为对照组。结果研究组患者住院费用[(3204.5±215.6)元v s (7352.6±541.7)元]、在院时间[(13.7±3.4)h v s(86.7±12.3)h]明显优于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率与对照组比较差异无统计学意义(2%v s 1.8%)。结论应用乳腺微创手术旋切系统可在日间手术中心完成乳腺病变组织快速活检及乳腺良性实性肿块切除术,具有损伤极小、疼痛轻、方便快捷等特点。%Objective To explore the efficacy of application of Mammotome minimally invasive operation in the ambulatory surgery center. Methods The clinical data of 600 cases (research group) of inpatients admitted to our hospital from January 2012 to June 2013 with breast benign mass was retrospectively reviewed. 500 cases of normal hospitalized patients were selected as control group during the same period. Results The hospitalization costs and length of hospital stay between the two groups had statistically significant difference. There was no statistically significant difference between the two groups at the complication rates. Conclusion The application of minimally invasive breast operation cutting system of breast lesions were successfully used for rapid biopsy of breast lesions and breast benign tumor resection in the ambulatory surgery center with many advantages, especially of minimal damage, less pain, and convenience.

  6. Low-frequency, low-magnitude vibrations (LFLM enhances chondrogenic differentiation potential of human adipose derived mesenchymal stromal stem cells (hASCs

    Directory of Open Access Journals (Sweden)

    Krzysztof Marycz

    2016-02-01

    Full Text Available The aim of this study was to evaluate if low-frequency, low-magnitude vibrations (LFLM could enhance chondrogenic differentiation potential of human adipose derived mesenchymal stem cells (hASCs with simultaneous inhibition of their adipogenic properties for biomedical purposes. We developed a prototype device that induces low-magnitude (0.3 g low-frequency vibrations with the following frequencies: 25, 35 and 45 Hz. Afterwards, we used human adipose derived mesenchymal stem cell (hASCS, to investigate their cellular response to the mechanical signals. We have also evaluated hASCs morphological and proliferative activity changes in response to each frequency. Induction of chondrogenesis in hASCs, under the influence of a 35 Hz signal leads to most effective and stable cartilaginous tissue formation through highest secretion of Bone Morphogenetic Protein 2 (BMP-2, and Collagen type II, with low concentration of Collagen type I. These results correlated well with appropriate gene expression level. Simultaneously, we observed significant up-regulation of α3, α4, β1 and β3 integrins in chondroblast progenitor cells treated with 35 Hz vibrations, as well as Sox-9. Interestingly, we noticed that application of 35 Hz frequencies significantly inhibited adipogenesis of hASCs. The obtained results suggest that application of LFLM vibrations together with stem cell therapy might be a promising tool in cartilage regeneration.

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ...

  8. Thyroid Surgery

    Science.gov (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  9. [Antimicrobial prophylaxis in surgery].

    Science.gov (United States)

    Cisneros, José Miguel; Rodríguez-Baño, Jesús; Mensa, José; Trilla, Antoni; Cainzos, Miguel

    2002-01-01

    Antimicrobial prophylaxis in surgery refers to a very brief course of an antimicrobial agent initiated just before the start of the procedure. The efficacy of antimicrobials to prevent postoperative infection at the site of surgery (incisional superficial, incisional deep, or organ/space infection) has been demonstrated for many surgical procedures. Nevertheless, the majority of studies centering on the quality of preoperative prophylaxis have found that a high percentage of the antimicrobials used are inappropriate for this purpose. This work discusses the scientific basis for antimicrobial prophylaxis, provides general recommendations for its correct use and specific recommendations for various types of surgery. The guidelines for surgical antimicrobial prophylaxis are based on results from well-designed studies, whenever possible. These guidelines are focussed on reducing the incidence of infection at the surgical site while minimizing the contribution of preoperative administration of antimicrobials to the development of bacterial resistance.

  10. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  11. Application of da Vinci surgical system in hepatobiliary and pancreatic surgery: a single center experience%“达芬奇”机器人在肝胆胰手术中的应用(单中心报道)

    Institute of Scientific and Technical Information of China (English)

    顾磊; 詹茜; 邓侠兴; 彭承宏; 沈柏用

    2013-01-01

    目的:总结“达芬奇”机器人手术系统在我中心进行肝胆胰手术的临床经验.方法:回顾性分析我科2010年3月至2013年3月间机器人肝胆胰手术124例临床资料和手术并发症的发生率.结果:肝脏手术组15例,中转开腹1例,中转腹腔镜手术1例,该组所有病人围手术期无并发症,无死亡病例.手术时间(199.6±110.5)min,术中出血(703.3±1 260.7)mL,术后住院(11.0±3.6)d.胆囊手术组7例,无中转开腹病人,并发症发生率14.3%,无死亡病例.手术时间(212.9±64.2) min,术中出血(257.1±127.2)mL,术后住院(6.8±2.5)d.胰腺手术组102例,其中良性病人中1例中转开腹,并发症发生率50.0%,无死亡病例;恶性病人中2例中转开腹,并发症发生率55.9%,1例死亡.胰十二指肠切除术31例,手术时间(450.4±102.1)min,术中出血(506.5±266.5)mL,术后住院(34.4±7.8)d;胰体尾切除术42例,手术时间(161.0±68.7)min,术中出血(278.0±331.5) mL,术后住院(20.9±10.9)d;胰腺中段切除术16例,手术时间(215.6±45.7) min,术中出血(145.6±118.4)mL,术后住院(22.7±8.0)d;Beger术7例,手术时间(284.2±35.8) min,术中出血(321.7±244.2)mL,术后住院(26.3±7.7)d;局部切除术6例,手术时间(116.7±37.2)min,术中出血(61.7±69.1)mL,术后住院(27.8±11.8)d.结论:“达芬奇”机器人系统可独立完成各类肝胆胰手术,安全可行,推动了微创外科领域的发展进程,尤其在复杂的肝胆胰手术方面,有效地补充传统的腹腔镜手术.但在机器人手术开展初期,应慎重选择胰腺手术病人.%Objective To summarize the clinical experience of robotic hepatobiliary and pancreatic surgery in our center.Methods da Vinci surgical system was applied to perform robotic hepatobiliary and pancreatic operations for 124 patients from Mar 2010 to Mar 2013.The intra-and post-operative data including morbidity were analyzed.Results The robotic hepatectomy was performed in 15 cases.One case was

  12. 美国输电线路风荷载计算介绍%Introduction of Wind Load Computation of Transmission Line in ASCE74-2009

    Institute of Scientific and Technical Information of China (English)

    王振华

    2012-01-01

    了解《美国输电线路结构荷载指南》( ASCE74-2009)对从事涉外工程和提高工程师设计水平都有着重要意义.风荷载是输电线路设计的控制荷载,了解ASCE74-2009风荷载计算方法非常有必要.本文介绍了ASCE74-2009输电线路风荷载的计算方法,并对基本风速、风压高度变化系数、体型系数、风荷载调整系数、地形影响因子和斜向风荷载计算方法及其计算参数进行了说明.%It is very important to comprehend 《 Guidelines for electrical transmission line structural loading》 (ASCE74-2009) for overseas projects and improve the design level of engineer. Wind load is the control load for transmission line, so it is necessary to master wind load computation method of ASCE74-2009. Wind load computation formulas for transmission line of ASCE74-2009 are introduced in this paper. The computation parameters of basic wind speed, height variation factor of wind pressure, shape factor, wind load factor, topographic factor and yawed wind load computation method are illustrated in detail.

  13. Differential expression of specific FGF ligands and receptor isoforms during osteogenic differentiation of mouse Adipose-derived Stem Cells (mASCs) recapitulates the in vivo osteogenic pattern.

    Science.gov (United States)

    Quarto, Natalina; Longaker, Michael T

    2008-11-15

    The ability of Adipose-derived Stem Cells (ASCs) to differentiate into various tissues in vitro and in vivo, a function known as "stem cell plasticity", makes them an appealing cell source for tissue engineering. Our laboratory is particularly focused on the potential role of adipose tissue as a readily available postnatal source of osteoprogenitor. Fibroblast growth factors (FGF) and their receptors (FGFR) are important regulators of osteogenesis. The goal of this study was to elucidate how changes in temporal expression patterns of individual components of the fibroblast growth factor (FGF) signaling axis correlate with osteogenic differentiation of mASCs. Our results indicate that FGF ligand genes, such as Fgf-2, -4, -8, and -18, displayed a differential and dynamic profile during mouse ASC (mASC) osteogenesis. Fgf-2 transcript was down-regulated, while Fgf-18 transcript level was strongly up-regulated. Interestingly, a drift in the ratio of different FGF-2 protein forms, with translation favoring the HMWFGF-2 forms, occurred during osteogenic differentiation, whereas, the expression of LMWFGF-2 form was down-regulated. This finding shares similarity with a previous study suggesting that preferential expression of the HMWFGF-2 forms is associated with a more osteogenic differentiated state of calvarial osteoblast. Moreover, a differential expression of Fgf Receptor 1 and 2 resembling that previously found in in vivo osteogenic study was observed. Thus, mASCs undergoing osteogenesis recapitulate the in vivo osteogenic differentiation expression pattern of FGF ligands and receptors of calvarial mesenchymal cells during their own osteogenic differentiation. Indeed, this observation further validates ASCs as a suitable resource for skeletal tissue engineering.

  14. Gaia16asc, Gaia16ase, Gaia16asj and Gaia16ask candidate supernovae near galaxies confirmed by Mercator/Maia imaging

    Science.gov (United States)

    Blanco-Cuaresma, S.; Semaan, T.; Roelens, M.; Palaversa, L.; Mowlavi, N.; Eyer, L.

    2016-07-01

    We report confirmation of Gaia Science Alerts transients Gaia16asc, Gaia16ase, Gaia16asj and Gaia16ask. Images were obtained in G and R bands of the Maia instrument mounted to the Flemish 1.2m Mercator telescope at Roque de los Muchachos observatory, La Palma, Canary Islands, Spain, on 2016 July 02 - 04. These new sources are supernovae candidates near galaxies and they are not visible in archival 2MASS and DSS images: Gaia16asc, Gaia16ase, Gaia16asj and Gaia16ask.

  15. Ambulatory spine surgery: a survey study.

    Science.gov (United States)

    Baird, Evan O; Brietzke, Sasha C; Weinberg, Alan D; McAnany, Steven J; Qureshi, Sheeraz A; Cho, Samuel K; Hecht, Andrew C

    2014-08-01

    Study Design Cross-sectional study. Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039). Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety.

  16. CARDIOTHORACIC SURGERY

    African Journals Online (AJOL)

    lbadan, Nigeria. Reprint requests to: Dr. V. O. Adegboye, Department Of Surgery, University College Hospital, Iberian,. Nigeria. ... been shown to be related to the rate of bleeding. .... patients after an interval of conservative/medical treatment.

  17. General Surgery

    African Journals Online (AJOL)

    bbshehu

    underwent major colonic restorative resection between July 1997 and September 199 in order to ... factors, the level of anastomosis and the experience of the surgeon are perhaps the ... indications for surgery and cancer stage were similar.

  18. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  19. Hemorrhoid surgery

    Science.gov (United States)

    ... and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches . Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...

  20. GENERAL SURGERY

    African Journals Online (AJOL)

    The traditional operative approach is an open surgical one to drain the cysts and ... early outcomes of laparoscopic treatment of liver hydatid cysts at our institution. .... O. Radical vs. conservative surgery for hydatid liver cysts: Experience from ...

  1. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  2. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  3. [Aesthetic surgery].

    Science.gov (United States)

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  4. Outcomes in Endoscopic Ear Surgery.

    Science.gov (United States)

    Kiringoda, Ruwan; Kozin, Elliott D; Lee, Daniel J

    2016-10-01

    Endoscopic ear surgery (EES) provides several advantages compared with traditional binocular microscopy, including a wide-field view, improved resolution with high magnification, and visual access to hidden corridors of the middle ear. Although binocular microscopic-assisted surgical techniques remain the gold standard for most otologists, EES is slowly emerging as a viable alternative for performing otologic surgery at several centers in the United States and abroad. In this review, we evaluate the current body of literature regarding EES outcomes, summarize our EES outcomes at the Massachusetts Eye and Ear Infirmary, and compare these results with data for microscopic-assisted otologic surgery.

  5. Overexpression of the tomato asc-1 gene mediates high insensitivity to AAL toxins and fumonisin B-1 in tomato hairy roots and confers resistance to Alternaria alternata f. sp lycopersici in Nicotiana umbratica plants

    NARCIS (Netherlands)

    Brandwagt, BF; Kneppers, TJA; Nijkamp, HJJ; Hille, J

    2002-01-01

    The sphinganine-analog mycotoxins (SAMs) fumonisin B-1 and AAL toxins are inhibitors of eukaryotic sphinganine N-acyltransferase in vitro. Treatment of eukaryotes with SAMs generally results in an accumulation of sphingoid base precursors and a depletion of complex sphingolipids. The asc,asc genotyp

  6. Overexpression of the Tomato Asc-1 Gene Mediates High Insensitivity to AAL Toxins and Fumonisin B1 in Tomato Hairy Roots and Confers Resistance to Alternaria alternata f. sp. lycopersici in Nicotiana umbratica Plants

    NARCIS (Netherlands)

    Brandwagt, Bas F.; Kneppers, Tarcies J.A.; Nijkamp, H. John J.; Hille, Jacques

    2002-01-01

    The sphinganine-analog mycotoxins (SAMs) fumonisin B1 and AAL toxins are inhibitors of eukaryotic sphinganine N-acyltransferase in vitro. Treatment of eukaryotes with SAMs generally results in an accumulation of sphingoid base precursors and a depletion of complex sphingolipids. The asc,asc genotype

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... find out more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ...

  8. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  10. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  11. Corrective Jaw Surgery

    Science.gov (United States)

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  12. Ambulatory Surgical Center Payment Rates Archive Page

    Data.gov (United States)

    U.S. Department of Health & Human Services — These files contain the procedure codes which may be performed in an ASC under the Medicare program as well as the ASC payment group assigned to each of the...

  13. Role of adipose-derived stem cells in fat grafting and reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Shaun S Tan

    2016-01-01

    Full Text Available Autologous fat grafting is commonly utilised to reconstruct soft tissue defects caused by ageing, trauma, chronic wounds and cancer resection. The benefits of fat grafting are minimal donor site morbidity and ease of availability through liposuction or lipectomy. Nonetheless, survival and longevity of fat grafts remain poor post-engraftment. Various methods to enhance fat graft survival are currently under investigation and its stem cell constituents are of particular interest. Cell-assisted lipotransfer refers to the addition of adipose-derived stem cell (ASC rich component of stromal vascular fraction to lipoaspirate, the results of which have proven promising. This article aims to review the role of ASCs in fat grafting and reconstructive surgery.

  14. Role of Adipose-derived Stem Cells in Fat Grafting and Reconstructive Surgery

    Science.gov (United States)

    Tan, Shaun S; Ng, Zhi Yang; Zhan, Weiqing; Rozen, Warren

    2016-01-01

    Autologous fat grafting is commonly utilised to reconstruct soft tissue defects caused by ageing, trauma, chronic wounds and cancer resection. The benefits of fat grafting are minimal donor site morbidity and ease of availability through liposuction or lipectomy. Nonetheless, survival and longevity of fat grafts remain poor post-engraftment. Various methods to enhance fat graft survival are currently under investigation and its stem cell constituents are of particular interest. Cell-assisted lipotransfer refers to the addition of adipose-derived stem cell (ASC) rich component of stromal vascular fraction to lipoaspirate, the results of which have proven promising. This article aims to review the role of ASCs in fat grafting and reconstructive surgery.

  15. Robotic surgery.

    Science.gov (United States)

    Diana, M; Marescaux, J

    2015-01-01

    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  16. The effect of magnetic stimulation on the osteogenic and chondrogenic differentiation of human stem cells derived from the adipose tissue (hASCs)

    Energy Technology Data Exchange (ETDEWEB)

    Lima, João; Gonçalves, Ana I.; Rodrigues, Márcia T.; Reis, Rui L. [3Bs Research Group–Biomaterials, Biodegradables and Biomimetics, University of Minho, Guimarães (Portugal); ICVS/3Bs–PT Government Associate Laboratory, Braga/Guimarães (Portugal); Gomes, Manuela E., E-mail: megomes@dep.uminho.pt [3Bs Research Group–Biomaterials, Biodegradables and Biomimetics, University of Minho, Guimarães (Portugal); ICVS/3Bs–PT Government Associate Laboratory, Braga/Guimarães (Portugal)

    2015-11-01

    The use of magnetic nanoparticles (MNPs) towards the musculoskeletal tissues has been the focus of many studies, regarding MNPs ability to promote and direct cellular stimulation and orient tissue responses. This is thought to be mainly achieved by mechano-responsive pathways, which can induce changes in cell behavior, including the processes of proliferation and differentiation, in response to external mechanical stimuli. Thus, the application of MNP-based strategies in tissue engineering may hold potential to propose novel solutions for cell therapy on bone and cartilage strategies to accomplish tissue regeneration. The present work aims at studying the influence of MNPs on the osteogenic and chondrogenic differentiation of human adipose derived stem cells (hASCs). MNPs were incorporated in hASCs and cultured in medium supplemented for osteogenic and chondrogenic differentiation. Cultures were maintained up to 28 days with/without an external magnetic stimulus provided by a magnetic bioreactor, to determine if the MNPs alone could affect the osteogenic or chondrogenic phenotype of the hASCs. Results indicate that the incorporation of MNPs does not negatively affect the viability nor the proliferation of hASCs. Furthermore, Alizarin Red staining evidences an enhancement in extracellular (ECM) mineralization under the influence of an external magnetic field. Although not as evident as for osteogenic differentiation, Toluidine blue and Safranin-O stainings also suggest the presence of a cartilage-like ECM with glycosaminoglycans and proteoglycans under the magnetic stimulus provided. Thus, MNPs incorporated in hASCs under the influence of an external magnetic field have the potential to induce differentiation towards the osteogenic and chondrogenic lineages. - Highlights: • Cellular viability was not negatively influenced by the nanoparticles. • Chondrogenic medium influences more the synthesis of cartilage-like ECM than MNPs. • Synergetic effect among

  17. The effect of magnetic stimulation on the osteogenic and chondrogenic differentiation of human stem cells derived from the adipose tissue (hASCs)

    Science.gov (United States)

    Lima, João; Gonçalves, Ana I.; Rodrigues, Márcia T.; Reis, Rui L.; Gomes, Manuela E.

    2015-11-01

    The use of magnetic nanoparticles (MNPs) towards the musculoskeletal tissues has been the focus of many studies, regarding MNPs ability to promote and direct cellular stimulation and orient tissue responses. This is thought to be mainly achieved by mechano-responsive pathways, which can induce changes in cell behavior, including the processes of proliferation and differentiation, in response to external mechanical stimuli. Thus, the application of MNP-based strategies in tissue engineering may hold potential to propose novel solutions for cell therapy on bone and cartilage strategies to accomplish tissue regeneration. The present work aims at studying the influence of MNPs on the osteogenic and chondrogenic differentiation of human adipose derived stem cells (hASCs). MNPs were incorporated in hASCs and cultured in medium supplemented for osteogenic and chondrogenic differentiation. Cultures were maintained up to 28 days with/without an external magnetic stimulus provided by a magnetic bioreactor, to determine if the MNPs alone could affect the osteogenic or chondrogenic phenotype of the hASCs. Results indicate that the incorporation of MNPs does not negatively affect the viability nor the proliferation of hASCs. Furthermore, Alizarin Red staining evidences an enhancement in extracellular (ECM) mineralization under the influence of an external magnetic field. Although not as evident as for osteogenic differentiation, Toluidine blue and Safranin-O stainings also suggest the presence of a cartilage-like ECM with glycosaminoglycans and proteoglycans under the magnetic stimulus provided. Thus, MNPs incorporated in hASCs under the influence of an external magnetic field have the potential to induce differentiation towards the osteogenic and chondrogenic lineages.

  18. Environmental impact of non-certified versus certified (ASC) intensive Pangasius aquaculture in Vietnam, a comparison based on a statistically supported LCA.

    Science.gov (United States)

    Nhu, Trang T; Schaubroeck, Thomas; Henriksson, Patrik J G; Bosma, Roel; Sorgeloos, Patrick; Dewulf, Jo

    2016-12-01

    Pangasius production in Vietnam is widely known as a success story in aquaculture, the fastest growing global food system because of its tremendous expansion by volume, value and the number of international markets to which Pangasius has been exported in recent years. While certification schemes are becoming significant features of international fish trade and marketing, an increasing number of Pangasius producers have followed at least one of the certification schemes recognised by international markets to incorporate environmental and social sustainability practices in aquaculture, typically the Pangasius Aquaculture Dialogue (PAD) scheme certified by the Aquaculture Stewardship Council (ASC). An assessment of the environmental benefit of applying certification schemes on Pangasius production, however, is still needed. This article compared the environmental impact of ASC-certified versus non-ASC certified intensive Pangasius aquaculture, using a statistically supported LCA. We focused on both resource-related (water, land and total resources) and emissions-related (global warming, acidification, freshwater and marine eutrophication) categories. The ASC certification scheme was shown to be a good approach for determining adequate environmental sustainability, especially concerning emissions-related categories, in Pangasius production. However, the non-ASC certified farms, due to the large spread, the impact (e.g., water resources and freshwater eutrophication) was possibly lower for a certain farm. However, this result was not generally prominent. Further improvements in intensive Pangasius production to inspire certification schemes are proposed, e.g., making the implementation of certification schemes more affordable, well-oriented and facilitated; reducing consumed feed amounts and of the incorporated share in fishmeal, especially domestic fishmeal, etc. However, their implementation should be vetted with key stakeholders to assess their feasibility. Copyright

  19. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep

    2009-01-01

    Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

  20. Epilepsy surgery: Recommendations for India

    Directory of Open Access Journals (Sweden)

    Chandra P

    2010-01-01

    Full Text Available The following article recommends guidelines for epilepsy surgery for India. This article reviews the indications, the various surgical options available and the outcome of surgery for drug resistant epilepsy based on current evidence. Epilepsy surgery is a well-established option for patients who have been diagnosed to have drug resistant epilepsy (DRE (on at least two appropriate, adequate anti-epileptic drugs (AEDs (either in monotherapy or in combination with continuing seizures, where the presurgical work-up has shown concordance of structural imaging (magnetic resonance imaging and electrical mapping data (electroencephalography (EEG, video EEG. There may be a requirement of functional imaging techniques in a certain number of DRE like positron emission tomography (PET, single photon emission tomography, (SPECT. Invasive monitoring should be restricted to a few when all noninvasive investigations are inconclusive, there is a dual pathology or there is a discordance of noninvasive data. The types of surgery could be curative (resective surgeries: amygdalo hippocampectomy, lesionectomy and multilobar resections; functional surgeries: hemispherotomy and palliative (multiple subpial transaction, corpus callosotomy, vagal nerve stimulation. Epilepsy surgery in indicated cases has a success range from 50 to 86% in achieving seizure freedom as compared with < 5% success rate with AEDs only in persons with DRE. Centers performing surgery should be categorized into Level I and Level II.

  1. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  2. [Geriatric surgery].

    Science.gov (United States)

    Paulino-Netto, Augusto

    2005-10-01

    Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous.

  3. CLASSIFICATION OF GROUND BEETLES (COLEOPTERA, CARABIDAE IN SPECIES AND GENERA USING ASC-ANALYSIS OF THEIR IMAGES

    Directory of Open Access Journals (Sweden)

    Lutsenko Y. V.

    2016-09-01

    considered the further possibility of using the method of ASC- analysis to classify insects, not only in species but also in genera, orders, thereby increasing the reliability of determination of ground beetles, which will be done in this article. A numerical example is given. We also have gained a successful experience of solving such problems in other subject areas. This article can be considered as a continuation of the series of works dedicated to governmental use of the automated system-cognitive analysis (ASC-analysis and its software tools – the system of "Eidos"

  4. GENERAL SURGERY

    African Journals Online (AJOL)

    Globally, the entry of female students into medical schools has ... how female registrars perceived the impact of gender on their training and practice of surgery. ... male-dominated specialty, their choice of mentors and the challenges that they encountered ..... Social Determinants of Health2007 (Accessed on 23 Sep 2016).

  5. Preventing Blood Clots After Orthopaedic Surgery

    Medline Plus

    Full Text Available ... Thigh Knee & Lower Leg Foot & Ankle Neck & Back Health Centers Broken Bones & Injuries Diseases & Conditions Arthritis Tumors Sports Injuries & Prevention Children Bone Health Health & Safety Treatment Treatments & Surgeries Joint Replacement Rehabilitation ...

  6. Preventing Blood Clots After Orthopaedic Surgery

    Medline Plus

    Full Text Available ... Thigh Knee & Lower Leg Foot & Ankle Neck & Back Health Centers Broken Bones & Injuries Diseases & Conditions Arthritis Tumors Sports Injuries & Prevention Children Bone Health Health & Safety Treatment Treatments & Surgeries Joint Replacement Rehabilitation ...

  7. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  8. Impacto da estocagem sobre atividade antioxidante e teor de ácido ascórbico em sucos e refrescos de tangerina

    Directory of Open Access Journals (Sweden)

    Carolina Ferraz Figueiredo Moreira

    2012-12-01

    Full Text Available OBJETIVO: Objetivou-se avaliar a estabilidade do ácido ascórbico em suco in natura de tangerina cultivar Ponkan sob diferentes condições de armazenamento, e em 13 amostras de bebidas industrializadas de tangerina, bem como a estabilidade da atividade antioxidante no suco in natura. MÉTODOS: O suco in natura de tangerina foi armazenado em três temperaturas: ambiente, refrigeração e congelamento. Amostras de tangerinas foram armazenadas sob refrigeração. Treze marcas de bebidas industrializadas de tangerina foram adquiridas e mantidas sob refrigeração. Foram determinados o teor de ácido ascórbico pelo método titulométrico de Tillmans (Association of Official Analytical Chemists e a atividade antioxidante por meio da capacidade sequestradora do radical 2,2-difenil-1-picril-hidrazila. RESULTADOS: O suco in natura apresentou teor médio de ácido ascórbico de 32,40mg/100mL; a taxa de redução deste nutriente foi maior em temperatura de estocagem mais elevada. A atividade antioxidante média foi de 89,74% de inibição do radical 2,2-difenil-1-picril-hidrazila, apresentando variações de até 4,26% durante o armazenamento. Nas bebidas industrializadas, o teor médio de ácido ascórbico variou entre 1,01 e 10,72mg/100mL, com perdas de até 82,76%. Com base na legislação brasileira, seis marcas de bebidas industrializadas apresentaram não conformidades em relação à declaração do teor de ácido ascórbico nos rótulos. CONCLUSÃO: O suco de tangerina cultivar Ponkan apresenta elevada atividade antioxidante, inclusive durante o armazenamento. Observou-se superioridade nutricional do suco fresco em comparação às bebidas industrializadas, considerando o teor de ácido ascórbico e sua estabilidade. Adicionalmente, os dados obtidos apontam para a necessidade de maior fiscalização em relação à rotulagem nutricional.

  9. The deoxyhypusine synthase mutant dys1-1 reveals the association of eIF5A and Asc1 with cell wall integrity.

    Directory of Open Access Journals (Sweden)

    Fabio Carrilho Galvão

    Full Text Available The putative eukaryotic translation initiation factor 5A (eIF5A is a highly conserved protein among archaea and eukaryotes that has recently been implicated in the elongation step of translation. eIF5A undergoes an essential and conserved posttranslational modification at a specific lysine to generate the residue hypusine. The enzymes deoxyhypusine synthase (Dys1 and deoxyhypusine hydroxylase (Lia1 catalyze this two-step modification process. Although several Saccharomyces cerevisiae eIF5A mutants have importantly contributed to the study of eIF5A function, no conditional mutant of Dys1 has been described so far. In this study, we generated and characterized the dys1-1 mutant, which showed a strong depletion of mutated Dys1 protein, resulting in more than 2-fold decrease in hypusine levels relative to the wild type. The dys1-1 mutant demonstrated a defect in total protein synthesis, a defect in polysome profile indicative of a translation elongation defect and a reduced association of eIF5A with polysomes. The growth phenotype of dys1-1 mutant is severe, growing only in the presence of 1 M sorbitol, an osmotic stabilizer. Although this phenotype is characteristic of Pkc1 cell wall integrity mutants, the sorbitol requirement from dys1-1 is not associated with cell lysis. We observed that the dys1-1 genetically interacts with the sole yeast protein kinase C (Pkc1 and Asc1, a component of the 40S ribosomal subunit. The dys1-1 mutant was synthetically lethal in combination with asc1Δ and overexpression of TIF51A (eIF5A or DYS1 is toxic for an asc1Δ strain. Moreover, eIF5A is more associated with translating ribosomes in the absence of Asc1 in the cell. Finally, analysis of the sensitivity to cell wall-perturbing compounds revealed a more similar behavior of the dys1-1 and asc1Δ mutants in comparison with the pkc1Δ mutant. These data suggest a correlated role for eIF5A and Asc1 in coordinating the translational control of a subset of m

  10. The deoxyhypusine synthase mutant dys1-1 reveals the association of eIF5A and Asc1 with cell wall integrity.

    Science.gov (United States)

    Galvão, Fabio Carrilho; Rossi, Danuza; Silveira, Wagner da Silva; Valentini, Sandro Roberto; Zanelli, Cleslei Fernando

    2013-01-01

    The putative eukaryotic translation initiation factor 5A (eIF5A) is a highly conserved protein among archaea and eukaryotes that has recently been implicated in the elongation step of translation. eIF5A undergoes an essential and conserved posttranslational modification at a specific lysine to generate the residue hypusine. The enzymes deoxyhypusine synthase (Dys1) and deoxyhypusine hydroxylase (Lia1) catalyze this two-step modification process. Although several Saccharomyces cerevisiae eIF5A mutants have importantly contributed to the study of eIF5A function, no conditional mutant of Dys1 has been described so far. In this study, we generated and characterized the dys1-1 mutant, which showed a strong depletion of mutated Dys1 protein, resulting in more than 2-fold decrease in hypusine levels relative to the wild type. The dys1-1 mutant demonstrated a defect in total protein synthesis, a defect in polysome profile indicative of a translation elongation defect and a reduced association of eIF5A with polysomes. The growth phenotype of dys1-1 mutant is severe, growing only in the presence of 1 M sorbitol, an osmotic stabilizer. Although this phenotype is characteristic of Pkc1 cell wall integrity mutants, the sorbitol requirement from dys1-1 is not associated with cell lysis. We observed that the dys1-1 genetically interacts with the sole yeast protein kinase C (Pkc1) and Asc1, a component of the 40S ribosomal subunit. The dys1-1 mutant was synthetically lethal in combination with asc1Δ and overexpression of TIF51A (eIF5A) or DYS1 is toxic for an asc1Δ strain. Moreover, eIF5A is more associated with translating ribosomes in the absence of Asc1 in the cell. Finally, analysis of the sensitivity to cell wall-perturbing compounds revealed a more similar behavior of the dys1-1 and asc1Δ mutants in comparison with the pkc1Δ mutant. These data suggest a correlated role for eIF5A and Asc1 in coordinating the translational control of a subset of mRNAs associated with cell

  11. ADAPTIVE SYNTHESIS OF INTELLIGENT MEASUREMENT SYSTEMS WITH THE USE OF ASC-ANALYSIS AND "EIDOS" SYSTEM. SYSTEM IDENTIFICATION IN ECONOMETRICS, BIOMETRICS, ECOLOGY, PEDAGOGY, PSYCHOLOGY AND MEDICINE

    Directory of Open Access Journals (Sweden)

    Lutsenko Y. V.

    2016-02-01

    Full Text Available The article proposes using the automated system-cognitive analysis (ASC-analysis and its software tool, which is the system called "Eidos" for synthesis and application of adaptive intelligent measuring systems to measure values of parameters of objects, and for system state identification of complex multivariable nonlinear dynamic systems. The article briefly describes the mathematical method of ASC-analysis, implemented in the software tool – universal cognitive analytical system named "Eidos-X++". The mathematical method of ASC-analysis is based on system theory of information (STI which was created in the conditions of implementation of program ideas of generalizations of all the concepts of mathematics, in particularly, the information theory based on the set theory, through a total replacement of the concept of “many” with the more general concept of system and detailed tracking of all the consequences of this replacement. Due to the mathematical method, which is the basis of ASC-analysis, this method is nonparametric and allows you to process comparably tens and hundreds of thousands of gradations of factors and future conditions of the control object (class in incomplete (fragmented, noisy data numeric and non-numeric nature which are measured in different units of measurement. We provide a detailed numerical example of the application of ASC-analysis and the system of "Eidos-X++" as a synthesis of systemic-cognitive model, providing a multiparameter typization of the states of complex systems, and system identification of their states, as well as for making decisions about managing the impact of changing the composition of the control object to get its quality (level of consistency maximally increased at minimum cost. For a numerical example of a complex system we have selected the team of the company, and its component – employees and applicants (staff. However, it must be noted that this example should be considered even wider

  12. The astrocytic transporter SLC7A10 (Asc-1) mediates glycinergic inhibition of spinal cord motor neurons

    Science.gov (United States)

    Ehmsen, Jeffrey T.; Liu, Yong; Wang, Yue; Paladugu, Nikhil; Johnson, Anna E.; Rothstein, Jeffrey D.; du Lac, Sascha; Mattson, Mark P.; Höke, Ahmet

    2016-01-01

    SLC7A10 (Asc-1) is a sodium-independent amino acid transporter known to facilitate transport of a number of amino acids including glycine, L-serine, L-alanine, and L-cysteine, as well as their D-enantiomers. It has been described as a neuronal transporter with a primary role related to modulation of excitatory glutamatergic neurotransmission. We find that SLC7A10 is substantially enriched in a subset of astrocytes of the caudal brain and spinal cord in a distribution corresponding with high densities of glycinergic inhibitory synapses. Accordingly, we find that spinal cord glycine levels are significantly reduced in Slc7a10-null mice and spontaneous glycinergic postsynaptic currents in motor neurons show substantially diminished amplitudes, demonstrating an essential role for SLC7A10 in glycinergic inhibitory function in the central nervous system. These observations establish the etiology of sustained myoclonus (sudden involuntary muscle movements) and early postnatal lethality characteristic of Slc7a10-null mice, and implicate SLC7A10 as a candidate gene and auto-antibody target in human hyperekplexia and stiff person syndrome, respectively. PMID:27759100

  13. Transcriptional signature of human adipose tissue-derived stem cells (hASCs) preconditioned for chondrogenesis in hypoxic conditions

    Energy Technology Data Exchange (ETDEWEB)

    Pilgaard, L.; Lund, P.; Duroux, M. [Laboratory for Stem Cell Research, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg (Denmark); Lockstone, H.; Taylor, J. [Bioinformatics and Statistical Genetics, Wellcome Trust Centre for Human Genetics, Oxford University, Roosevelt Drive, Oxford, OX3 7BN (United Kingdom); Emmersen, J.; Fink, T. [Laboratory for Stem Cell Research, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg (Denmark); Ragoussis, J. [Genomics, Wellcome Trust Centre for Human Genetics, Oxford University, Roosevelt Drive, Oxford, OX3 7BN (United Kingdom); Zachar, V., E-mail: vlaz@hst.aau.dk [Laboratory for Stem Cell Research, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg (Denmark)

    2009-07-01

    Hypoxia is an important factor involved in the control of stem cells. To obtain a better insight into the phenotypical changes brought about by hypoxic preconditioning prior to chondrogenic differentiation; we have investigated growth, colony-forming and chondrogenic capacity, and global transcriptional responses of six adipose tissue-derived stem cell lines expanded at oxygen concentrations ranging from ambient to 1%. The assessment of cell proliferation and colony-forming potential revealed that the hypoxic conditions corresponding to 1% oxygen played a major role. The chondrogenic inducibility, examined by high-density pellet model, however, did not improve on hypoxic preconditioning. While the microarray analysis revealed a distinctive inter-donor variability, the exposure to 1% hypoxia superseded the biological variability and produced a specific expression profile with 2581 significantly regulated genes and substantial functional enrichment in the pathways of cell proliferation and apoptosis. Additionally, exposure to 1% oxygen resulted in upregulation of factors related to angiogenesis and cell growth. In particular, leptin (LEP), the key regulator of body weight and food intake was found to be highly upregulated. In conclusion, the results of this investigation demonstrate the significance of donor demographics and the importance of further studies into the use of regulated oxygen tension as a tool for preparation of ASCs in order to exploit their full potential.

  14. Engineering anatomically shaped vascularized bone grafts with hASCs and 3D-printed PCL scaffolds.

    Science.gov (United States)

    Temple, Joshua P; Hutton, Daphne L; Hung, Ben P; Huri, Pinar Yilgor; Cook, Colin A; Kondragunta, Renu; Jia, Xiaofeng; Grayson, Warren L

    2014-12-01

    The treatment of large craniomaxillofacial bone defects is clinically challenging due to the limited availability of transplantable autologous bone grafts and the complex geometry of the bones. The ability to regenerate new bone tissues that faithfully replicate the anatomy would revolutionize treatment options. Advances in the field of bone tissue engineering over the past few decades offer promising new treatment alternatives using biocompatible scaffold materials and autologous cells. This approach combined with recent advances in three-dimensional (3D) printing technologies may soon allow the generation of large, bioartificial bone grafts with custom, patient-specific architecture. In this study, we use a custom-built 3D printer to develop anatomically shaped polycaprolactone (PCL) scaffolds with varying internal porosities. These scaffolds are assessed for their ability to support induction of human adipose-derived stem cells (hASCs) to form vasculature and bone, two essential components of functional bone tissue. The development of functional tissues is assessed in vitro and in vivo. Finally, we demonstrate the ability to print large mandibular and maxillary bone scaffolds that replicate fine details extracted from patient's computed tomography scans. The findings of this study illustrate the capabilities and potential of 3D printed scaffolds to be used for engineering autologous, anatomically shaped, vascularized bone grafts.

  15. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...

  17. Surgery for Breast Cancer

    Science.gov (United States)

    ... Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment for breast cancer, ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  19. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  20. Refractive corneal surgery - discharge

    Science.gov (United States)

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  1. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  2. Corrective Jaw Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  3. Dental Implant Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  4. Facial Cosmetic Surgery

    Science.gov (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  5. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  6. Network protocol changes can improve DisCom WAN performance : evaluating TCP modifications and SCTP in the ASC tri-lab environment.

    Energy Technology Data Exchange (ETDEWEB)

    Tolendino, Lawrence F.; Hu, Tan Chang

    2005-06-01

    The Advanced Simulation and Computing (ASC) Distance Computing (DisCom) Wide Area Network (WAN) is a high performance, long distance network environment that is based on the ubiquitous TCP/IP protocol set. However, the Transmission Control Protocol (TCP) and the algorithms that govern its operation were defined almost two decades ago for a network environment vastly different from the DisCom WAN. In this paper we explore and evaluate possible modifications to TCP that purport to improve TCP performance in environments like the DisCom WAN. We also examine a much newer protocol, SCTP (Stream Control Transmission Protocol) that claims to provide reliable network transport while also implementing multi-streaming, multi-homing capabilities that are appealing in the DisCom high performance network environment. We provide performance comparisons and recommendations for continued development that will lead to network communications protocol implementations capable of supporting the coming ASC Petaflop computing environments.

  7. Efecto de la densidad de siembra y la adición de ácido ascórbico en el cultivo de Osteoglossum bicirrhosum

    Directory of Open Access Journals (Sweden)

    Carolina Cuaical T.

    2013-11-01

    Full Text Available Objetivo. Evaluar el efecto de la densidad de siembra y la adición de ácido ascórbico en la alimentación de alevinos de O. bicirrhosum, cultivados en jaulas. Materiales y métodos. Se incluyeron 396 alevinos y se distribuyeron en nueve tratamientos, resultado de la combinación de los niveles del factor densidad de siembra: 1pez/5 L; 1pez/10 L y 1pez/15 L y los niveles de ácido ascórbico: 0; 500 y 1000 mg/kg. Los datos obtenidos se evaluaron mediante el análisis de varianza del diseño factorial 32. Resultados. La densidad de siembra presentó diferencias estadísticas significativas en el incremento de peso. Las variables incremento de longitud y tasa de crecimiento específico no presentaron diferencias estadísticas. En cuanto a la conversión alimenticia aparente, se demostraron diferencias significativas en los dos factores: La densidad de 1pez/10 L indicó la mejor conversión con un valor de 1.50, asimismo, la inclusión de 1000 mg de ácido ascórbico por Kg de alimento mostró los mejores promedios con 1.55. En la sobrevivencia se precisaron diferencias estadísticas entre los tratamientos de la densidad de 1pez/5 L, siendo mejores aquellos que incluyeron ácido ascórbico en la dieta. Conclusiones. La densidad de 1pez/10 L registró el mayor incremento de peso con 31.83 g en 87 días. La sobrevivencia general fue del 96%, lo que demuestra la eficiencia del sistema de cultivo utilizado, al tiempo que actúa de manera positiva en el desarrollo de esta especie.

  8. ASC-J9 Suppresses Castration-Resistant Prostate Cancer Growth through Degradation of Full-length and Splice Variant Androgen Receptors

    Directory of Open Access Journals (Sweden)

    Shinichi Yamashita

    2012-01-01

    Full Text Available Early studies suggested androgen receptor (AR splice variants might contribute to the progression of prostate cancer (PCa into castration resistance. However, the therapeutic strategy to target these AR splice variants still remains unresolved. Through tissue survey of tumors from the same patients before and after castration resistance, we found that the expression of AR3, a major AR splice variant that lacks the AR ligand-binding domain, was substantially increased after castration resistance development. The currently used antiandrogen, Casodex, showed little growth suppression in CWR22Rv1 cells. Importantly, we found that AR degradation enhancer ASC-J9 could degrade both full-length (fAR and AR3 in CWR22Rv1 cells as well as in C4-2 and C81 cells with addition of AR3. The consequences of such degradation of both fAR and AR3 might then result in the inhibition of AR transcriptional activity and cell growth in vitro. More importantly, suppression of AR3 specifically by short-hairpin AR3 or degradation of AR3 by ASC-J9 resulted in suppression of AR transcriptional activity and cell growth in CWR22Rv1-fARKD (fAR knockdown cells in which DHT failed to induce, suggesting the importance of targeting AR3. Finally, we demonstrated the in vivo therapeutic effects of ASC-J9 by showing the inhibition of PCa growth using the xenografted model of CWR22Rv1 cells orthotopically implanted into castrated nude mice with undetectable serum testosterone. These results suggested that targeting both fAR- and AR3-mediated PCa growth by ASC-J9 may represent the novel therapeutic approach to suppress castration-resistant PCa. Successful clinical trials targeting both fAR and AR3 may help us to battle castration-resistant PCa in the future.

  9. Jet Formation Mechanism Contrast Between ASC and LSC%环型与线型聚能装药射流成型机理对比

    Institute of Scientific and Technical Information of China (English)

    傅磊; 王伟力; 吕进; 李永胜

    2014-01-01

    Asymmetry exists during the process of jet formation of Annular shaped charge (ASC) liner, and the existing theo-ry on the linear shaped charge (LSC) jet formation cannot be used directly. DNYA 3D software was used to simulate the jet formation process of ASC and LSC with the structure of same section. Through contrast, the slug and jet parameter charac-teristics of ASC were analyzed, and it might provide reference to the theoretical research and engineering application.%环型聚能装药药型罩2侧在挤压汇聚形成射流过程中存在不对称性,不能完全套用线型聚能装药射流成型的现有理论。利用DYNA3D软件对相同剖面结构的环型、线型聚能装药射流成型过程进行数值模拟,通过比较分析得出了环型聚能装药形成杵体及射流参数的分布特性,为进一步理论研究及工程应用提供参考。

  10. 术前放化疗并手术治疗局部晚期食管鳞癌的多中心随机对照临床研究%A multi-centered randomized controlled study of neo-adjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of esophagus:an interim analysis

    Institute of Scientific and Technical Information of China (English)

    杨弘; 毛伟敏; 郑晓; 朱成楚; 孔敏; 韩泳涛; 李涛; 傅剑华; 刘孟忠; 方文涛; 王家明; 陈于平; 陈志坚; 相加庆; 杨焕军

    2012-01-01

    Objective To evaluate the safety and validity of neo-adjuvant chemoradiotherapy followed by surgery for locally advanced esophageal carcinoma.Methods Patients with Ⅱ B,Ⅲ staged squamous cell carcinoma of thoracic esophagus were randomly allocated to either preoperative chemoradiotherapy followed by surgery ( arm A ) or surgery alone ( arm B ).In arm A,chemotherapy and radiotherapy were performed concurrently.Patients received two cycles of vinorelbine and cisplatin.Vinorelbine at 25 mg/m2 per day was administered as a bolus infusion at dl,d8,d22 and d29.Cisplatin at 75 mg/m2 was administered by an intravenous infusion at dl and d22( or 25 mg/m2 days 1 - 4 and 22 - 25 ).A total radiotherapeutic dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (5 d/wk for 4 weeks ).Three-incisioned esophagectomy was performed at Weeks 4 - 6 after chemoradiotherapy.Primary outcome was overall survival time.An interim analysis was performed in June 2011.Results From July 2007 to June 2011,123 eligible patients were randomly assigned at 7 cooperative cancer centers (54 cases in arm A vs 69 cases in arm B).In arm A,the clinical response rate of chemoradiotherapy was 90.7%.All patients finished the preoperative chemoradiotherapy. Forty-nine cases continued to receive esophagectomy.The pathological complete response rate was 29.6%.The rate of RO resection in arm A was significant higher than that in arm B (96.0% vs 85.5%,P =0.015 ).The most common grade 3/4 toxicity of chemoradiotherapy was leukopenia occurring in 33 cases (61.l% ).Vomiting and esophagitis were usually of Grade 1/2.No patient died or abandoned surgery because of chemoradiation toxicity.Between arms A and B,operative duration,blood loss,duration of chest tube drainage and length of postsurgical hospital stay were similar.The incidences of postoperative heart failure (2.0% vs 1.4%,P =1.000),anastomotic leakage(8.2% vs 11.6%,P =0.759)and hoarseness(6.1% vs 4.3%,P =0.691 )were not

  11. ASC Predictive Science Academic Alliance Program (PSAAP) II Review of the Carbon Capture Multidisciplinary Science Center (CCMSC) at the University of Utah

    Energy Technology Data Exchange (ETDEWEB)

    Still, C. H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ferencz, R. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hoekstra, R. J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Hungerford, A. L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Kuhl, A. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Montoya, D. R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wagner, J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2015-06-08

    The review was conducted on March 31 – April 1, 2015 at the University of Utah. Overall the review team was impressed with the work presented and found that the CCMSC had met or exceeded all of their Year 1 milestones. Specific details, comments and recommendations are included in this document.

  12. The Accuracy of p16/Ki-67 and HPV Test in the Detection of CIN2/3 in Women Diagnosed with ASC-US or LSIL.

    Directory of Open Access Journals (Sweden)

    Júlio C Possati-Resende

    Full Text Available The objective of this study was to compare the accuracies of double staining for p16/Ki-67 and the molecular test for high-risk HPV (hr-HPV to identify high-grade cervical intraepithelial neoplasia (CIN2/CIN3 in women with cervical cytology of atypical squamous cells of undetermined significance (ASC-US and low-grade squamous intraepithelial lesion (LSIL. Data were collected from 201 women who underwent cervical cytology screening in the Barretos Cancer Hospital and their results were categorized as ASC-US (n=96 or LSIL (n=105. All patients underwent colposcopy with or without cervical biopsy for diagnosis of CIN2/CIN3. The hr-HPV test (Cobas 4800 test and immunocytochemistry were performed to detect biomarkers p16/Ki-67 (CINtec PLUS test. Two samples (1 ASC-US/1 LSIL were excluded from the analysis due to inconclusive results of the histologic examination. There were 8 cases of CIN2/CIN3 among 95 women with ASC-US (8.4%, and 23 cases of CIN2/CIN3 among 104 women with LSIL (22.1%. In the group of women with ASC-US, the sensitivity and specificity in diagnosing CIN2/CIN3 were 87.5% and 79.5% for the HPV test and 62.5% and 93.1% for p16/Ki-67. Among women with LSIL, the sensitivity and specificity in the diagnosis of CIN2/CIN3 were 87% and 34.7% for the HPV test and 69.6% and 75.3% for immunocytochemistry. Superior performance was observed for p16/Ki-67 double staining, especially among women under 30 for whom the test had an area under the ROC curve of 0.762 (p30 years. In younger women (≤30 years with LSIL, p16/Ki-67 had greater accuracy in identifying precursor lesions. Among women >30 years diagnosed with LSIL, the two methods showed similar performance.

  13. Report of experiments and evidence for ASC L2 milestone 4467 : demonstration of a legacy application's path to exascale.

    Energy Technology Data Exchange (ETDEWEB)

    Curry, Matthew L.; Ferreira, Kurt Brian; Pedretti, Kevin Thomas Tauke; Leung, Vitus Joseph; Moreland, Kenneth D.; Lofstead, Gerald Fredrick, II; Gentile, Ann C. (Sandia National Laboratories, Livermore, CA); Klundt, Ruth Ann; Ward, H. Lee; Laros, James H., III; Hemmert, Karl Scott; Fabian, Nathan D.; Levenhagen, Michael J.; Barrett, Brian W.; Brightwell, Ronald Brian; Barrett, Richard; Wheeler, Kyle Bruce; Kelly, Suzanne Marie; Rodrigues, Arun F.; Brandt, James M. (Sandia National Laboratories, Livermore, CA); Thompson, David (Sandia National Laboratories, Livermore, CA); VanDyke, John P.; Oldfield, Ron A.; Tucker, Thomas (Open Grid Computing, Inc., Austin, TX); Vaughan, Courtenay Thomas

    2012-03-01

    This report documents thirteen of Sandia's contributions to the Computational Systems and Software Environment (CSSE) within the Advanced Simulation and Computing (ASC) program between fiscal years 2009 and 2012. It describes their impact on ASC applications. Most contributions are implemented in lower software levels allowing for application improvement without source code changes. Improvements are identified in such areas as reduced run time, characterizing power usage, and Input/Output (I/O). Other experiments are more forward looking, demonstrating potential bottlenecks using mini-application versions of the legacy codes and simulating their network activity on Exascale-class hardware. The purpose of this report is to prove that the team has completed milestone 4467-Demonstration of a Legacy Application's Path to Exascale. Cielo is expected to be the last capability system on which existing ASC codes can run without significant modifications. This assertion will be tested to determine where the breaking point is for an existing highly scalable application. The goal is to stretch the performance boundaries of the application by applying recent CSSE RD in areas such as resilience, power, I/O, visualization services, SMARTMAP, lightweight LWKs, virtualization, simulation, and feedback loops. Dedicated system time reservations and/or CCC allocations will be used to quantify the impact of system-level changes to extend the life and performance of the ASC code base. Finally, a simulation of anticipated exascale-class hardware will be performed using SST to supplement the calculations. Determine where the breaking point is for an existing highly scalable application: Chapter 15 presented the CSSE work that sought to identify the breaking point in two ASC legacy applications-Charon and CTH. Their mini-app versions were also employed to complete the task. There is no single breaking point as more than one issue was found with the two codes. The results were

  14. Percutaneous Surgery of the Forefoot.

    Science.gov (United States)

    Redfern, David; Vernois, Joel; Legré, Barbara Piclet

    2015-07-01

    This article describes some of the common techniques used in percutaneous surgery of the forefoot. Techniques such as minimally invasive chevron Akin osteotomy for correction of hallux valgus, first metatarsophalangeal joint cheilectomy, distal minimally invasive metatarsal osteotomies, bunionette correction, and hammertoe correction are described. This article is an introduction to this rapidly developing area of foot and ankle surgery. Less invasive techniques are continually being developed across the whole spectrum of surgical specialties. The surgical ethos of minimizing soft-tissue disruption in the process of achieving surgical objectives remains at the center of this evolution.

  15. Regional anesthesia as compared to general anesthesia for surgery in geriatric patients with hip fracture: Does it decrease morbidity, mortality and healthcare costs? Results of a single-centered study

    Science.gov (United States)

    Le-Wendling, Linda; Bihorac, Azra; Baslanti, Tezcan Ozrazgat; Lucas, Stephen; Sadasivan, Kalia; Heyman, James; Wendling, Adam; Heyman, H. James; Boezaart, Andre

    2013-01-01

    Introduction Hip fracture in geriatric patients has a substantial economic impact and represents a major cause of morbidity and mortality in this population. At our institution, a regional anesthesia program was instituted for patients undergoing surgery for hip fracture. This retrospective cohort review examines the effects of regional anesthesia (from mainly after July 2007) versus general anesthesia (mainly prior to July 2007) on morbidity, mortality and hospitalization costs. Methods This retrospective cohort study involved data collection from electronic and paper charts of 308 patients who underwent surgery for hip fracture from September 2006 to December 2008. Data on postoperative morbidity, in-patient mortality, and cost of hospitalization (as estimated from data on hospital charges) were collected and analyzed. Seventy-three patients received regional anesthesia and 235 patients received general anesthesia. During July 2007, approximately halfway through the study period, a regional anesthesia and analgesia program was introduced. Results The average cost of hospitalization in patients who receive surgery for hip fracture was no different between patients who receive regional or general anesthesia ($16,789 + 631 v. $16,815 + 643, respectively, p = 0.9557). Delay in surgery and intensive care unit admission resulted in significantly higher hospitalization costs. Age, male gender, African-American race and intensive care unit admission were associated with increased in-hospital mortality. In-hospital mortality and rates of readmission are not statistically different between the two anesthesia groups. Conclusions There is no difference in postoperative morbidity, rates of re-hospitalization, in-patient mortality or hospitalization costs in geriatric patients undergoing regional or general anesthesia for repair of hip fracture. Delay in surgery beyond 3 days and intensive care unit admission both increase cost of hospitalization. PMID:22758782

  16. ASC Weekly News Notes

    Energy Technology Data Exchange (ETDEWEB)

    Womble, David E.

    2016-05-01

    Unified collision operator demonstrated for both radiation transport and PIC-DSMC. A side-by-side comparison between the DSMC method and the radiation transport method was conducted for photon attenuation in the atmosphere over 2 kilometers in physical distance with a reduction of photon density of six orders of magnitude. Both DSMC and traditional radiation transport agreed with theory to two digits. This indicates that PIC-DSMC operators can be unified with the radiation transport collision operators into a single code base and that physics kernels can remain unique to the actual collision pairs. This simulation example provides an initial validation of the unified collision theory approach that will later be implemented into EMPIRE.

  17. Excel Center

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Citigroup,one of the World top 500 companies,has now settled in Excel Center,Financial Street. The opening ceremony of Excel Center and the entry ceremony of Citigroup in the center were held on March 31.Government leaders of Xicheng District,the Excel CEO and the heads of Asia-Pacific Region leaders of Citibank all participated in the ceremony.

  18. Efeitos do ácido ascórbico nos biomarcadores de estresse oxidativo em nadadores de elite

    Directory of Open Access Journals (Sweden)

    Monike Garlipp-Picchi

    2013-12-01

    Full Text Available OBJETIVO: O objetivo do estudo foi verificar os efeitos da oferta de vitamina C através de um suplemento alimentar e dieta rica em ácido ascórbico (AA no estresse oxidativo induzido pelo exercício. MÉTODOS: A amostra foi composta por 13 nadadores de elite (seis homens e sete mulheres com idades entre 18 e 26 anos. Os mesmos atletas foram submetidos a sessão de exercício agudo em três fases, com diferentes tratamentos: controle (C, dieta rica em AA (D e suplemento de AA (S, nas quais amostras de sangue foram colhidas antes, imediatamente após e 24 horas depois do exercício. Para comparação entre as fases e etapas foi utilizado o modelo de regressão linear com efeitos mistos. RESULTADOS: O consumo alimentar habitual de antioxidantes não foi diferente entre as fases, apenas a ingestão de AA foi maior na fase D e S em relação à fase C. O uso de dieta rica em AA favoreceu uma menor peroxidação lipídica, devido aos menores valores de hidroperóxidos lipídicos (FOX, diminuição da peroxidação após exercício, pela diminuição de substâncias reativas ao ácido tiobarbitúrico (TBARS e aumento dos níveis de vitamina C logo após o exercício. O uso de suplemento de AA também conteve a peroxidação lipídica após exercício e aumentou o poder antioxidante, devido aos maiores níveis de glutationa reduzida (GSH. Sem adição de AA os nadadores tiveram um maior dano hepático, pois apresentaram maiores níveis de transaminase-glutâmico-oxalacética (TGO, menores níveis de antioxidantes (vitamina C e GSH e aumento do ácido úrico. CONCLUSÃO: Assim, as mudanças observadas com a adição de AA à dieta de nadadores sugerem um importante papel deste micronutriente na defesa contra o estresse oxidativo induzido pelo exercício.

  19. Antocianinas, ácido ascórbico, polifenoles totales y actividad antioxidante, en la cáscara de camu-camu (Myrciaria dubia (H.B.K McVaugh Antocianinas, ácido ascórbico, polifenóis totais e atividade antioxidante na casca do camu-camu (Myrciaria dubia (H.B.K McVaugh

    Directory of Open Access Journals (Sweden)

    Juan Edson Villanueva-Tiburcio

    2010-05-01

    Full Text Available Este trabajo fue realizado en la UNAS, Tingo María, Perú. Los objetivos fueron evaluar el contenido de antocianinas, ácido ascórbico, y polifenoles totales, en la cáscara fresca y seca de camu-camu (Myrciaria dubia (H.B.K McVaugh en diferentes estados de madurez; evaluar la actividad antioxidante en la cáscara seca, usando diferentes tipos de radicales (DPPH, ABTS+ y Peroxilo y correlacionar el valor de ácido ascórbico y polifenoles totales con la actividad antioxidante. La extracción fue realizada en medio acuoso, y los resultados de las evaluaciones de cada experimento fueron analizados por un diseño completamente al azar (DCA, según la prueba de t-student (p A pesquisa foi realizada na UNAS em Tingo Maria, Peru, teve como objetivos: avaliar o teor de antocianinas, ácido ascórbico e polifenóis totais, na casca fresca e na casca seca do camu-camu (Myrciaria dubia (HBK McVaugh em diferentes tempos de maturação; avaliar a atividade antioxidante na casca seca utilizando diferentes tipos de radicais (DPPH, ABTS+ e Peroxilo e correlacionar o teor de ácido ascórbico e polifenóis totais com a atividade antioxidante. A extraç��o foi realizada em meio aquoso, os resultados das avaliações de cada experiência são analisados no delineamento inteiramente casualizado (DIC, pelo teste de t-student (p < 0,05. O extrato da casca da amostra madura fresca apresentou as concentrações mais elevadas de ácido ascórbico e de antocianinas em relação a meio madura e verde, com 21,95 mg.g-1 de casca e 46,42 mg.L-1 de cianidin-3-glucosídeo, respectivamente, enquanto que o extrato da casca seca meio madura apresentou o maior teor de ácido ascórbico em relação a madura e verde (53,49 mg.g-1 e de polifenóis totais: 7,70 mg Ác. Gálico/g. A maior atividade antioxidante foi encontrada no extrato da casca seca da amostra meio madura com IC50 = 46,20; 20,25 e 8,30 μg.mL-1, em comparação com DPPH radical, ABTS+ e Perox

  20. The Implementation of Robotic Surgery in Israel.

    Science.gov (United States)

    Matanes, Emad; Boulus, Sari; Lowenstein, Lior

    2015-09-01

    In the last decade the number of robotic devices and the medical procedures utilizing them increased significantly around the world. To evaluate the implementation of robotic surgeries in Israel in various surgical disciplines. We conducted a retrospective study accessing information about the annual purchases of robots, the number of physicians trained for their use, and the number of robotic surgeries performed each year, according to indications of surgery and the disciplines of the operating medical staff. The data were taken from the database of Intuitive Surgical Inc. Six robots were purchased by six medical centers in Israel during the years 2008-2013. There are currently 150 physicians trained to use the robot in one of the simulators of Intuitive Surgical Inc. Of them, 104 are listed as active robotic surgeons. Most of these physicians are urologists, gynecologists, or general surgeons. The number of robotic surgeries increased each year in all fields in which it was implemented. In 2013, 975 robotic surgeries were performed in Israel. Of them, 52% were performed by urologists; 89% of them were radical prostatectomy. The use of robotic surgery increased considerably in Israel over recent years, in urology, gynecology, general surgery, and otolaryngology. Despite the lack of conclusive evidence of the advantages of robotic surgery over the laparoscopic approach, the market power and the desire to be at the technological forefront drive many medical centers to purchase the robot and to train physicians in its use.

  1. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    Science.gov (United States)

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  2. Advanced laparoscopic bariatric surgery Is safe in general surgery training.

    Science.gov (United States)

    Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

    2017-05-01

    Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

  3. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  4. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  5. Plastic Surgery Statistics

    Science.gov (United States)

    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  6. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  7. Who Needs Heart Surgery?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  8. Gastric Sleeve Surgery

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Gastric Sleeve Surgery KidsHealth > For Teens > Gastric Sleeve Surgery Print A ... buying healthy food ) continue Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  9. Cavus Foot Surgery

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A ... problems. What are the goals of cavus foot surgery? The main goal of surgery is to reduce ...

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  11. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  12. Smoking and surgery

    Science.gov (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and ...

  13. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  14. Adipose-Derived Stem Cells in Aesthetic Surgery: A Mixed Methods Evaluation of the Current Clinical Trial, Intellectual Property, and Regulatory Landscape.

    Science.gov (United States)

    Arshad, Zeeshaan; Halioua-Haubold, Celine-Lea; Roberts, Mackenna; Urso-Baiarda, Fulvio; Branford, Oliver A; Brindley, David A; Davies, Benjamin M; Pettitt, David

    2017-06-07

    Adipose tissue, which can be readily harvested via a number of liposuction techniques, offers an easily accessible and abundant source of adipose-derived stem cells (ASCs). Consequently, ASCs have become an increasingly popular reconstructive option and a novel means of aesthetic soft tissue augmentation. This paper examines recent advances in the aesthetic surgery field, extending beyond traditional review formats to incorporate a comprehensive analysis of current clinical trials, adoption status, and the commercialization pathway. Keyword searches were carried out on clinical trial databases to search for trials using ASCs for aesthetic indications. An intellectual property landscape was created using commercial software (Thomson Reuters Thomson Innovation, New York, NY). Analysis of who is claiming what in respect of ASC use in aesthetic surgery for commercial purposes was analyzed by reviewing the patent landscape in relation to these techniques. Key international regulatory guidelines were also summarized. Completed clinical trials lacked robust controls, employed small sample sizes, and lacked long-term follow-up data. Ongoing clinical trials still do not address such issues. In recent years, claims to intellectual property ownership have increased in the "aesthetic stem cell" domain, reflecting commercial interest in the area. However, significant translational barriers remain including regulatory challenges and ethical considerations. Further rigorous randomized controlled trials are required to delineate long-term clinical efficacy and safety. Providers should consider the introduction of patient reported outcome metrics to facilitate clinical adoption. Robust regulatory and ethical policies concerning stem cells and aesthetic surgery should be devised to discourage further growth of "stem cell tourism."

  15. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  16. Diplopia after strabismus surgery.

    Science.gov (United States)

    Holgado, Sandra

    2012-01-01

    The presence of diplopia is an undesirable result following strabismus surgery. There are a variety of scenarios where diplopia exists prior to strabismus surgery, and, after surgery, has either been alleviated or decreased to a magnitude amenable to prism correction. In other cases, the patient does not experience diplopia prior to the strabismus surgery, but there exists a definite risk of diplopia after the surgery. In the current review, I examine the literature to help determine the incidence of diplopia after strabismus surgery.

  17. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad

    2010-01-01

    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  18. hESC expansion and stemness are independent of connexin forty-three-mediated intercellular communication between hESCs and hASC feeder cells.

    Directory of Open Access Journals (Sweden)

    Jin-Su Kim

    Full Text Available BACKGROUND: Human embryonic stem cells (hESCs are a promising and powerful source of cells for applications in regenerative medicine, tissue engineering, cell-based therapies, and drug discovery. Many researchers have employed conventional culture techniques using feeder cells to expand hESCs in significant numbers, although feeder-free culture techniques have recently been developed. In regard to stem cell expansion, gap junctional intercellular communication (GJIC is thought to play an important role in hESC survival and differentiation. Indeed, it has been reported that hESC-hESC communication through connexin 43 (Cx43, one of the major gap junctional proteins is crucial for the maintenance of hESC stemness during expansion. However, the role of GJIC between hESCs and feeder cells is unclear and has not yet been reported. METHODOLOGY/PRINCIPAL FINDINGS: This study therefore examined whether a direct Cx43-mediated interaction between hESCs and human adipose-derived stem cells (hASCs influences the maintenance of hESC stemness. Over 10 passages, hESCs cultured on a layer of Cx43-downregulated hASC feeder cells showed normal morphology, proliferation (colony growth, and stemness, as assessed by alkaline phosphatase (AP, OCT4 (POU5F1-Human gene Nomenclature Database, SOX2, and NANOG expression. CONCLUSIONS/SIGNIFICANCE: These results demonstrate that Cx43-mediated GJIC between hESCs and hASC feeder cells is not an important factor for the conservation of hESC stemness and expansion.

  19. Critical role of ASC inflammasomes and bacterial type IV secretion system in caspase-1 activation and host innate resistance to Brucella abortus infection.

    Science.gov (United States)

    Gomes, Marco Tulio R; Campos, Priscila C; Oliveira, Fernanda S; Corsetti, Patricia P; Bortoluci, Karina R; Cunha, Larissa D; Zamboni, Dario S; Oliveira, Sergio C

    2013-04-01

    Pathogens are detected by innate immune receptors that, upon activation, orchestrate an appropriate immune response. Recent studies revealed the intracellular signaling cascades involved in the TLR-initiated immune response to Brucella abortus infection. However, no report has elucidated the role of inflammasome receptors in Brucella recognition. Therefore, we decided to investigate the function of NLRC4, NLRP3, and AIM2 in sensing Brucella. In this study, we showed that NLRC4 is not required to induce caspase-1 activation and further secretion of IL-1β by B. abortus in macrophages. In contrast, we determined that AIM2, which senses Brucella DNA, and NLRP3 are partially required for caspase-1 activation and IL-1β secretion. Additionally, mitochondrial reactive oxygen species induced by Brucella were implicated in IL-1β production. Furthermore, AIM2, NLRP3, ASC, and caspase-1 knockout mice were more susceptible to B. abortus infection than were wild-type animals, suggesting that multiple ASC-dependent inflammasomes contribute to host protection against infection. This protective effect is due to the inflammatory response caused by IL-1β and IL-18 rather than pyroptosis, because we observed augmented bacterial burden in IL-1R and IL-18 knockout mice. Finally, we determined that bacterial type IV secretion system VirB and live, but not heat-killed, Brucella are required for full inflammasome activation in macrophages during infection. Taken together, our results indicate that Brucella is sensed by ASC inflammasomes that collectively orchestrate a robust caspase-1 activation and proinflammatory response.

  20. A Two-stage Damage Detection Method with Application to the Phase I ASCE SHM Benchmark Building%基于ASCE SHM Benchmark模型的两阶段结构损伤识别方法

    Institute of Scientific and Technical Information of China (English)

    刘朝; 雷鹰

    2011-01-01

    Recently,a new method has been proposed by the authors for detecting structural local damage under limited input and output measurements. This method can be extended to detect structural local damage in complex structures based on substructure approach. In this paper, based on this structural damage detection and localization method, a two-stage damage detection strategy is developed with application to the ASCE SHM benchmark building to test its efficacy and provide a systemic solution to the Phase Ⅰbenchmark problem far damage detection. In the first stage, an 8-DOF identification model is used to identify the floors and directions ( X or Y) in which damages are present. Then,the detection is focused on the floors where damage occurs. A substructure approach is utilized for damage localization in the second stage. A 12-DOF identification model is used for the substructure containing the damaged structural floors to identify the exact locations of damage. Structural parameters and the unknown inputs are identified by a recursive algorithm based on sequential application of the Kalman extended estimator for the extended state vector and the least squares estimation for the unknown inputs. Only a limited number of measured acceleration responses of the benchmark structure subject to unmeasured excitation inputs are utilized. Damage detection results indicate that the new method can detect and localize various damage patterns of the benchmark problems with good accuracy.%近年来,一种激励未知和输出部分已知条件下结构局部损伤识别的新方法得以提出,这种方法能基于子结构思想进行复杂结构的局部损伤识别,基于此方法,提出两阶段的损伤识别策略,并将其应用于第1阶段ASCESHM benchmark模型的case4的4种损伤识别,以检验此方法的有效性.在第1阶段,提出8-DOF的损伤模型以进行损伤层的定位;第2阶段,利用子结构的思想,提出12-DOF的损伤模型,在包含损伤层的

  1. Should LSIL with ASC-H (LSIL-H in cervical smears be an independent category? A study on SurePath™ specimens with review of literature

    Directory of Open Access Journals (Sweden)

    Shidham Vinod

    2007-01-01

    Full Text Available Background: Cervical smears exhibiting unequivocal features of ′low grade squamous intraepithelial lesion′ (LSIL are occasionally also admixed with some cells suspicious for, but not diagnostic of, ′high grade squamous intraepithelial lesion′ (HSIL. Only a few studies, mostly reported as abstracts, have evaluated this concurrence. In this study, we evaluate the current evidence that favors a distinct category for "LSIL, cannot exclude HSIL" (LSIL-H, and suggest a management algorithm based on combinations of current ASCCP guidelines for related interpretations. Methods: We studied SurePath™ preparations of cervical specimens from various institutions during one year period. Cytohisto correlation was performed in cases with cervical biopsies submitted to our institution. The status of HPV DNA testing was also noted in some LSIL-H cases with biopsy results. Results: Out of 77,979 cases 1,970 interpreted as LSIL (1,523, LSIL-H (146, ′atypical squamous cells, cannot exclude HSIL′ (ASC-H (109, and HSIL (192 were selected. Concurrent biopsy results were available in 40% (Total 792 cases: 557 LSIL, 88 LSIL-H, 38 ASCH, and 109 HSIL. Biopsy results were grouped into A . negative for dysplasia (ND, B . low grade (HPV, CIN1, CIN1 with HPV, and C . high grade (CIN 2 and above. The positive predictive values for various biopsy results in relation to initial cytopathologic interpretation were: a . LSIL: (557 cases: ND 32% (179, low grade- 58% (323, high grade- 10% (55; b . LSIL-H: (88 cases: ND 24% (21, low grade- 43% (38, high grade- 33% (29; c . ASCH: (38 cases: ND 32% (12, low grade- 37% (14, high grade- 31% (12; d . HSIL (109 cases: ND 5% (6, low grade 26% (28, high grade 69% (75. The patterns of cervical biopsy results in cases reported as LSIL-H were compared with that observed in cases with LSIL, ASC-H, and HSIL. 94% (32 of 34 of LSIL-H were positive for high risk (HR HPV, 1 was negative for HR HPV but positive for low risk (LR, and 1 LSIL

  2. Hepatotoxicidad por exposición a plomo y su protección con tiamina y ácido ascórbico

    OpenAIRE

    Y. Alcaraz-Contreras; A. L. Pérez-Medina; A. G. Cárdenas-Pérez; M. A. Vázquez-Guevara; E. Durán-Castro; M. A. Deveze-Álvarez; M Martínez-Alfaro; X. S. Ramírez-Gómez

    2012-01-01

    En este trabajo se determinó el efecto hepatoprotector de tiamina y ácido ascórbico en ratas intoxicadas por plomo, en un esquema de dosis administradas como terapia individual y combinada. Los parámetros evaluados fueron: 1) marcadores de daño hepático (alanina aminotransferasa, aspartato aminotransferasa, fosfatasa alcalina) y 2) análisis histológico de cortes hepáticos. La administración de antioxidantes produjo disminución de los niveles de las enzimas evaluadas. A nivel histológico, se o...

  3. Contenido de osmoprotectores, ácido ascórbico y ascorbato peroxidasa en hojas de frijol sometidas a estrés por sequía

    OpenAIRE

    Teresa Susana Herrera Flores; Joaquín Ortíz Cereceres; Adriana Delgado Alvarado; Jorge Alberto Acosta Galleros

    2014-01-01

    La acumulación de osmoprotectores en plantas que se encuentran en condiciones de estrés por sequía, le permiten contrarrestar el efecto negativo que le provoca dichas condición ambiental. En el presente trabajo se estudió la respuesta bioquímica de plantas de frijol con base en la acumulación de carbohidratos solubles, almidón, ácido ascórbico, así como la actividad de la enzima ascorbato peroxidasa, en las hojas simples y en las dos primeras hojas trifolioladas de la variedad resistente, Pin...

  4. Impacto da estocagem sobre atividade antioxidante e teor de ácido ascórbico em sucos e refrescos de tangerina

    OpenAIRE

    Carolina Ferraz Figueiredo Moreira; Maria Lúcia Mendes Lopes; Vera Lúcia Valente-Mesquita

    2012-01-01

    OBJETIVO: Objetivou-se avaliar a estabilidade do ácido ascórbico em suco in natura de tangerina cultivar Ponkan sob diferentes condições de armazenamento, e em 13 amostras de bebidas industrializadas de tangerina, bem como a estabilidade da atividade antioxidante no suco in natura. MÉTODOS: O suco in natura de tangerina foi armazenado em três temperaturas: ambiente, refrigeração e congelamento. Amostras de tangerinas foram armazenadas sob refrigeração. Treze marcas de bebidas industrializadas...

  5. Propuesta de adaptación del documento ASCE/SEI31-03 “Evaluación Sísmica De Edificaciones Existentes”

    OpenAIRE

    López Palomino, Paulo Marcelo

    2014-01-01

    En este documento se presenta una propuesta de adaptación de la norma ASCE/SEI31-03 “Seismic Evaluation of Existing Buildings” de la American Society of Civil Engineers, para proporcionar una metodología de evaluación de edificaciones existentes en Colombia. Dicha metodología contiene el procedimiento de evaluación de edificaciones de diversos sistemas estructurales con materiales como: madera, mampostería, acero y concreto reforzado; también determina y analiza progresivamente y con compleji...

  6. Should LSIL with ASC-H (LSIL-H in cervical smears be an independent category? A study on SurePath™ specimens with review of literature

    Directory of Open Access Journals (Sweden)

    Shidham Vinod B

    2007-03-01

    Full Text Available Abstract Background Cervical smears exhibiting unequivocal features of 'low grade squamous intraepithelial lesion' (LSIL are occasionally also admixed with some cells suspicious for, but not diagnostic of, 'high grade squamous intraepithelial lesion' (HSIL. Only a few studies, mostly reported as abstracts, have evaluated this concurrence. In this study, we evaluate the current evidence that favors a distinct category for "LSIL, cannot exclude HSIL" (LSIL-H, and suggest a management algorithm based on combinations of current ASCCP guidelines for related interpretations. Methods We studied SurePath™ preparations of cervical specimens from various institutions during one year period. Cytohisto correlation was performed in cases with cervical biopsies submitted to our institution. The status of HPV DNA testing was also noted in some LSIL-H cases with biopsy results. Results Out of 77,979 cases 1,970 interpreted as LSIL (1,523, LSIL-H (146, 'atypical squamous cells, cannot exclude HSIL' (ASC-H (109, and HSIL (192 were selected. Concurrent biopsy results were available in 40% (Total 792 cases: 557 LSIL, 88 LSIL-H, 38 ASCH, and 109 HSIL. Biopsy results were grouped into A. negative for dysplasia (ND, B. low grade (HPV, CIN1, CIN1 with HPV, and C. high grade (CIN 2 and above. The positive predictive values for various biopsy results in relation to initial cytopathologic interpretation were: a. LSIL: (557 cases: ND 32% (179, low grade- 58% (323, high grade- 10% (55; b. LSIL-H: (88 cases: ND 24% (21, low grade- 43% (38, high grade- 33% (29; c. ASCH: (38 cases: ND 32% (12, low grade- 37% (14, high grade- 31% (12; d. HSIL (109 cases: ND 5% (6, low grade 26% (28, high grade 69% (75. The patterns of cervical biopsy results in cases reported as LSIL-H were compared with that observed in cases with LSIL, ASC-H, and HSIL. 94% (32 of 34 of LSIL-H were positive for high risk (HR HPV, 1 was negative for HR HPV but positive for low risk (LR, and 1 LSIL-H was

  7. Evaluación comparativa del ácido ascórbico y del tocoferol sobre la fertilidad de semen de gallo

    OpenAIRE

    Cumpa G., Marcial; Universidad Nacional Agraria La Molina (Perú).; Pomahuali, Joel; ,

    2016-01-01

    El presente trabajo de investigación se realizó en el Banco Nacional de Semen y la Unidad Experimental de Avicultura de la Universidad Nacional Agraria La Molina. Los objetivos de este estudio fueron evaluar comparativamente al ácido ascórbico y tocoferol sobre la fertilidad del semen refrigerado a 5°C de gallo. Se utilizaron 28 gallinas reproductoras de postura de 25 semanas de edad de las líneas Hy Line Brown y 6 gallos cruzados adultos de 30 meses de edad. Se establecieron 4 tratamientos d...

  8. Cardiovascular benefits of bariatric surgery.

    Science.gov (United States)

    Lee, Glenn K; Cha, Yong-Mei

    2016-04-01

    The prevalence of obesity is increasing in the United States and worldwide, bringing with it an excess of morbidity and premature death. Obesity is strongly associated with both traditional cardiovascular risk factors as well as direct effects on hemodynamics and cardiovascular structure and function. In fact, cardiovascular disease is one of the major causes of morbidity and mortality in obese patients. Often, lifestyle and pharmacological weight-loss interventions are of limited efficacy in severely obese patients. Bariatric surgery has been shown to be a feasible option to achieve substantial and sustained weight loss in this group of patients. It is a safe procedure with low in-hospital and 30-day mortality rates even in groups that are considered higher risk for surgery (e.g., the elderly), especially if performed in high-volume centers. There is observational evidence that bariatric surgery in severely obese patients is associated with both a reduction of traditional cardiovascular risk factors as well as improvement in cardiac structure and function. Marked decreases in the levels of inflammatory and prothrombotic markers, as well as markers of subclinical atherosclerosis and endothelial dysfunction, are seen after bariatric surgery. This article summarizes the existing evidence regarding the cardiovascular benefits in patients following bariatric surgery.

  9. Hardware complications in scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bagchi, Kaushik; Mohaideen, Ahamed [Department of Orthopaedic Surgery and Musculoskeletal Services, Maimonides Medical Center, Brooklyn, NY (United States); Thomson, Jeffrey D. [Connecticut Children' s Medical Center, Department of Orthopaedics, Hartford, CT (United States); Foley, Christopher L. [Department of Radiology, Connecticut Children' s Medical Center, Hartford, Connecticut (United States)

    2002-07-01

    Background: Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide. As part of the evolution of scoliosis surgery, newer implants have resulted in improved outcomes with respect to deformity correction, reliability of fixation, and paucity of complications. Each technique and implant has its own set of unique complications, and the surgeon must appreciate these when planning surgery. Materials and methods: Various surgical techniques and types of instrumentation typically used in scoliosis surgery are briefly discussed. Though scoliosis surgery is associated with a wide variety of complications, only those that directly involve the hardware are discussed. The current literature is reviewed and several illustrative cases of patients treated for scoliosis at the Connecticut Children's Medical Center and the Newington Children's Hospital in Connecticut are briefly presented. Conclusion: Spine surgeons and radiologists should be familiar with the different types of instrumentation in the treatment of scoliosis. Furthermore, they should recognize the clinical and roentgenographic signs of hardware failure as part of prompt and effective treatment of such complications. (orig.)

  10. Future of robotic surgery.

    Science.gov (United States)

    Lendvay, Thomas Sean; Hannaford, Blake; Satava, Richard M

    2013-01-01

    In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade. Adoption of these new systems will be dependent on overcoming barriers to true telesurgery that range from legal to logistical. As additional surgical disciplines embrace robotics and open surgery continues to be replaced by robotic approaches, it will be imperative that adequate education and training keep pace with technology. Methods to enhance surgical performance in robotics through the use of simulation and telementoring promise to accelerate learning curves and perhaps even improve surgical readiness through brief virtual-reality warm-ups and presurgical rehearsal. All these advances will need to be carefully and rigorously validated through not only patient outcomes, but also cost efficiency.

  11. Clinical innovations in Philippine thoracic surgery

    OpenAIRE

    Jose Luis. J. Danguilan

    2016-01-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases—first at the Quezon Institute (QI) and presently at the Lung Center of the P...

  12. Anesthetic issues for robotic cardiac surgery

    OpenAIRE

    Wendy K Bernstein; Andrew Walker

    2015-01-01

    As innovative technology continues to be developed and is implemented into the realm of cardiac surgery, surgical teams, cardiothoracic anesthesiologists, and health centers are constantly looking for methods to improve patient outcomes and satisfaction. One of the more recent developments in cardiac surgical practice is minimally invasive robotic surgery. Its use has been documented in numerous publications, and its use has proliferated significantly over the past 15 years. The anesthesiolog...

  13. Anaesthetic Management of Conjoined Twins′ Separation Surgery

    Directory of Open Access Journals (Sweden)

    Kolli S Chalam

    2009-01-01

    Full Text Available Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins ′separation surgery mainly centered on the following concerns: 1.Conjoined Twins′ physiology like crossed circulation. distribution of blood volume and organ sharing with their anaesthetic implications. 2.Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3.Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties involvement and their unique requirements.We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.

  14. Distribution center

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Distribution center is a logistics link fulfill physical distribution as its main functionGenerally speaking, it's a large and hiahly automated center destined to receive goods from various plants and suppliers,take orders,fill them efficiently,and deliver goods to customers as quickly as possible.

  15. Application of enhanced recovery after hepatopancreatobiliary surgery: a single-center experience%肝胆胰外科术后加速康复实施单中心经验

    Institute of Scientific and Technical Information of China (English)

    白雪莉; 张晓雨; 卢芳燕; 高顺良; 楼健颖; 李国刚; 陈伟; 马涛; 王冀

    2016-01-01

    Objective To investigate the clinical effect of enhanced recovery after surgery (ERAS) after hepatopancreatobiliary surgery and related factors associated with failure of the program.Methods The retrospective cohort study was adopted.The clinical data of 433 patients who underwent middle-large surgery (hepatectomy or pancreatectomy) at the Second Affiliated Hospital of Zhejiang University School of Medicine between August 2013 to January 2015 were collected.Of the 433 patients, 216 patients managed with ERAS program in the middle-large hepatic or pancreatic surgery between May 2014 and January 2015 were allocated to the ERAS group, 217 patients managed with traditional perioperative treatment between August 2013 and April 2014 were allocated to the traditional group.The following indexes of patients were collected and analyzed: (1) General information: gender, age, classification according to American Society of Anesthesiologists (ASA), concomitant disease, history of liver cirrhosis, primary disease, body mass index, smoking history, alcohol drinking history, total bilirubin (TBil), alanine aminotransferase (ALT), albumin (Alb).(2) Intraoperative status: surgical type (hepatic surgery, pancreatic surgery, biliary reconstruction in hepatic surgery, hepatic excision extension, method of pancreatic surgery), laparoscopic surgery, operation time, volume of intraoperative blood loss and intraoperative blood transfusion.(3) Postoperative efficacy: stage of complication, number of unplaned reoperation and readmission, number of patients with ICU care time > 24 hours, durations of postoperative hospital stay, duration of postoperative hospital stay of patients with grade 0-Ⅱ complications and with grade Ⅲ-Ⅳ complication.Measurement data with normal distribution were presented as (x) ± s and analyzed using the Student's t test.Measurement data with skewed distribution were presented as M(range) and analyzed using the Mann-Whitney test.Count data were analyzed

  16. Ácido ascórbico como agente redutor para determinação de fósforo por colorimetria

    Directory of Open Access Journals (Sweden)

    Lenio da Silva Santos

    2014-06-01

    Full Text Available Em muitos laboratórios de análises de solos, o ácido 1-Amino-2-naftol-4-sulfônico (ANS é usado como agente redutor para determinação do P por espectrometria de UV/Visível. Porém, devido aos riscos à saúde dos laboratoristas, uma alternativa é o uso do ácido ascórbico (AA. Entretanto, modificações no protocolo de análise podem induzir a variações nos resultados, havendo a necessidade de padronizá-las e calibrá-las. O objetivo do trabalho foi avaliar o ANS e AA nos extratos de Mehlich-1 e 3 nos intervalos de 15, 30, 45, 60 e 120min de reação. Não houve diferença na concentração de P determinado com ambos redutores quando comparados dentro de cada extrator. O ácido ascórbico pode substituir a solução ANS para determinação de P e o intervalo de tempo de reação sugerido para a quantificação colorimétrica é de 30 a 60min, para ambos redutores.

  17. Endocytosis of indium-tin-oxide nanoparticles by macrophages provokes pyroptosis requiring NLRP3-ASC-Caspase1 axis that can be prevented by mesenchymal stem cells.

    Science.gov (United States)

    Naji, Abderrahim; Muzembo, Basilua André; Yagyu, Ken-Ichi; Baba, Nobuyasu; Deschaseaux, Frédéric; Sensebé, Luc; Suganuma, Narufumi

    2016-05-19

    The biological effects of indium-tin-oxide (ITO) are of considerable importance because workers exposed to indium compounds have been diagnosed with interstitial lung disease or pulmonary alveolar proteinosis; however, the pathophysiology of these diseases is undefined. Here, mice intraperitoneally inoculated with ITO-nanoparticles (ITO-NPs) resulted in peritonitis dependent in NLRP3 inflammasome, with neutrophils recruitment and interleukin-1β (IL-1β) production. Withal peritoneal macrophages exposed ex vivo to ITO-NPs caused IL-1β secretion and cytolysis. Further, alveolar macrophages exposed to ITO-NPs in vitro showed ITO-NP endocytosis and production of tumor necrosis factor-α (TNF-α) and IL-1β, ensued cell death by cytolysis. This cell death was RIPK1-independent but caspase1-dependent, and thus identified as pyroptosis. Endocytosis of ITO-NPs by activated THP-1 cells induced pyroptosis with IL-1β/TNF-α production and cytolysis, but not in activated THP-1 cells with knockdown of NLRP3, ASC, or caspase1. However, exposing activated THP-1 cells with NLRP3 or ASC knockdown to ITO-NPs resulted in cell death but without cytolysis, with deficiency in IL-1β/TNF-α, and revealing features of apoptosis. While, mesenchymal stem cells (MSCs) co-cultured with macrophages impaired both inflammation and cell death induced by ITO-NPs. Together, our findings provide crucial insights to the pathophysiology of respiratory diseases caused by ITO particles, and identify MSCs as a potent therapeutic.

  18. Evaluation of Three Devices for the Isolation of the Stromal Vascular Fraction from Adipose Tissue and for ASC Culture: A Comparative Study

    Science.gov (United States)

    Pratta, Anne-Sophie; Abbassi, Nacira; Fabre, Hugo; Rodriguez, Fanny; Debard, Cyrille; Adobati, Jacqueline; Boucher, Fabien; Mallein-Gerin, Frédéric; Auxenfans, Céline; Damour, Odile; Mojallal, Ali

    2017-01-01

    Adipose-derived stem/stromal cells (ASCs) reside in the stromal vascular fraction (SVF) of adipose tissue (AT) and can be easily isolated. However, extraction of the SVF from lipoaspirate is a critical step in generating ASC, and semiautomated devices have been developed to enhance the efficacy and reproducibility of the outcomes and to decrease manipulation and contamination. In this study, we compared the reference method used in our lab for SVF isolation from lipoaspirate, with three medical devices: GID SVF-1™, Puregraft™, and Stem.pras®. Cell yield and their viability were evaluated as well as their phenotype with flow cytometry. Further on, we determined their proliferative potential using population doublings (PD), PD time (PDT), and clonogenicity assay (CFU-F). Finally, we checked their genetic stability using RT-qPCR for TERT mRNA assay and karyotyping as well as their multilineage potential including adipogenic, chondrogenic, and osteogenic differentiation. Our results demonstrate that all the devices allow the production of SVF cells with consistent yield and viability, in less time than the reference method. Expanded cells from the four methods showed no significant differences in terms of phenotype, proliferation capabilities, differentiation abilities, and genetic stability.

  19. Evaluation of Three Devices for the Isolation of the Stromal Vascular Fraction from Adipose Tissue and for ASC Culture: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Jonathan Rodriguez

    2017-01-01

    Full Text Available Adipose-derived stem/stromal cells (ASCs reside in the stromal vascular fraction (SVF of adipose tissue (AT and can be easily isolated. However, extraction of the SVF from lipoaspirate is a critical step in generating ASC, and semiautomated devices have been developed to enhance the efficacy and reproducibility of the outcomes and to decrease manipulation and contamination. In this study, we compared the reference method used in our lab for SVF isolation from lipoaspirate, with three medical devices: GID SVF-1™, Puregraft™, and Stem.pras®. Cell yield and their viability were evaluated as well as their phenotype with flow cytometry. Further on, we determined their proliferative potential using population doublings (PD, PD time (PDT, and clonogenicity assay (CFU-F. Finally, we checked their genetic stability using RT-qPCR for TERT mRNA assay and karyotyping as well as their multilineage potential including adipogenic, chondrogenic, and osteogenic differentiation. Our results demonstrate that all the devices allow the production of SVF cells with consistent yield and viability, in less time than the reference method. Expanded cells from the four methods showed no significant differences in terms of phenotype, proliferation capabilities, differentiation abilities, and genetic stability.

  20. ASC-J9(®) suppresses castration resistant prostate cancer progression via degrading the enzalutamide-induced androgen receptor mutant AR-F876L.

    Science.gov (United States)

    Wang, Ronghao; Lin, Wanying; Lin, Changyi; Li, Lei; Sun, Yin; Chang, Chawnshang

    2016-08-28

    Androgen deprivation therapy (ADT) with the newly developed powerful anti-androgen enzalutamide (Enz, also known as MDV3100) has promising therapeutic effects to suppress castration resistant prostate cancer (CRPC) and extending patients' lives an extra 4.8 months. However, most Enz therapy eventually fails with the development of Enz resistance. The detailed mechanisms how CRPC develops Enz resistance remain unclear and may involve multiple mechanisms. Among them, the induction of the androgen receptor (AR) mutant AR-F876L in some CRPC patients may represent one driving force that confers Enz resistance. Here, we demonstrate that the AR degradation enhancer, ASC-J9(®), not only degrades wild-type AR, but also has the ability to target AR-F876L. The consequence of suppressing AR-F876L may then abrogate AR-F876L mediated CRPC cell proliferation and metastasis. Thus, developing ASC-J9(®) as a new therapeutic approach may represent a novel therapy to better suppress CRPC that has already developed Enz resistance.

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ...

  2. Gastric bypass surgery

    Science.gov (United States)

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  3. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  4. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  5. Robotic surgery in Italy national survey (2011).

    Science.gov (United States)

    Santoro, Eugenio; Pansadoro, Vito

    2013-03-01

    Robotic surgery in Italy has become a clinical reality that is gaining increasing acceptance. As of 2011 after the United States, Italy together with Germany is the country with the largest number of active Robotic centers, 46, and da Vinci Robots installed, with at least 116 operators already trained. The number of interventions performed in Italy in 2011 exceeded 6,000 and in 2010 were 4,784, with prevalence for urology, general surgery and gynecology, however these interventions have also begun to be applied in other fields such as cervicofacial, cardiothoracic and pediatric surgery. In Italy Robotic centers are mostly located in Northern Italy, while in the South there are only a few centers, and four regions are lacking altogether. Of the 46 centers which were started in 1999, the vast majority is still operational and almost half handle over 200 cases a year. The quality of the work is also especially high with large diffusion of radical prostatectomy in urology and liver resection and colic in general surgery. The method is very well accepted among operators, over 80 %, and among patients, over 95 %. From the analysis of world literature and a survey carried out in Italy, Robotic surgery, which at the moment could be better defined as telesurgery, represents a significant advantage for operators and a consistent gain for the patient. However, it still has important limits such as high cost and non-structured training of operators.

  6. First-line therapy with coagulation factor concentrates combined with point-of-care coagulation testing is associated with decreased allogeneic blood transfusion in cardiovascular surgery: a retrospective, single-center cohort study.

    Science.gov (United States)

    Görlinger, Klaus; Dirkmann, Daniel; Hanke, Alexander A; Kamler, Markus; Kottenberg, Eva; Thielmann, Matthias; Jakob, Heinz; Peters, Jürgen

    2011-12-01

    Blood transfusion is associated with increased morbidity and mortality. We developed and implemented an algorithm for coagulation management in cardiovascular surgery based on first-line administration of coagulation factor concentrates combined with point-of-care thromboelastometry/impedance aggregometry. In a retrospective cohort study including 3,865 patients, we analyzed the incidence of intraoperative allogeneic blood transfusions (primary endpoints) before and after algorithm implementation. Following algorithm implementation, the incidence of any allogeneic blood transfusion (52.5 vs. 42.2%; P administration (4.42 vs. 8.9%; P administration of coagulation factor concentrates combined with point-of-care testing was associated with decreased incidence of blood transfusion and thrombotic/thromboembolic events.

  7. 78 FR 6327 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-01-30

    ... emergency departments (ED), outpatient departments (OPD), and ambulatory surgery locations (ASLs); and freestanding ambulatory surgery centers (ASCs). The National Center for Health Statistics' (NCHS) surveys on... collection of data from free-standing ambulatory surgery centers. NHAMCS data have been extensively used...

  8. Oral surgery: part 2. Endodontic surgery.

    Science.gov (United States)

    Pop, I

    2013-09-01

    In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition.

  9. The APTIMA HPV assay versus the Hybrid Capture 2 test in triage of women with ASC-US or LSIL cervical cytology: a meta-analysis of the diagnostic accuracy.

    Science.gov (United States)

    Arbyn, Marc; Roelens, Jolien; Cuschieri, Kate; Cuzick, Jack; Szarewski, Ann; Ratnam, Sam; Reuschenbach, Miriam; Belinson, Suzanne; Belinson, Jerome L; Monsonego, Joseph

    2013-01-01

    Testing for DNA of 13 high-risk HPV types with the Hybrid Capture 2 (HC2) test has consistently been shown to perform better in triage of women with cervical cytology results showing atypical squamous cells of undetermined significance (ASC-US) but often not in triage of low-grade squamous intraepithelial lesions (LSIL) detected in cervical cancer screening. In a meta-analysis, we compared the accuracy of the APTIMA HPV test, which identifies RNA of 14 high-risk HPV types, to HC2 for the triage of women with ASC-US or LSIL. Literature search-targeted studies where the accuracy of APTIMA HPV and HC2 for detection of underlying CIN2/3+ was assessed concomitantly including verification of all cases of ASC-US and LSIL. HSROC (Hierarchical Summary ROC) curve regression was used to compute the pooled absolute and relative sensitivity and specificity. Eight studies, comprising 1,839 ASC-US and 1,887 LSIL cases, were retrieved. The pooled sensitivity and specificity of APTIMA to triage ASC-US to detect underlying CIN3 or worse was 96.2% (95% CI = 91.7-98.3%) and 54.9% (95% CI = 43.5-65.9%), respectively. APTIMA and HC2 showed similar pooled sensitivity; however, the specificity of the former was significantly higher (ratio: 1.19; 95% CI = 1.08-1.31 for CIN2+). The pooled sensitivity and specificity of APTIMA to triage LSIL were 96.7% (95% CI = 91.4-98.9%) and 38.7% (95% CI = 30.5-47.6%) for CIN3+. APTIMA was as sensitive as HC2 but more specific (ratio: 1.35; 95% CI = 1.11-1.66). Results were similar for detection of CIN2 or worse. In both triage of ASC-US and LSIL, APTIMA is as sensitive but more specific than HC2 for detecting cervical precancer.

  10. Processing and Preparation of Advanced Stirling Convertors for Extended Operation at NASA Glenn Research Center

    Science.gov (United States)

    Oriti, Salvatore M.; Cornell, Peggy A.

    2008-01-01

    The U.S. Department of Energy (DOE), Lockheed Martin Space Company (LMSC), Sunpower Inc., and NASA Glenn Research Center (GRC) have been developing an Advanced Stirling Radioisotope Generator (ASRG) for use as a power system on space science missions. This generator will make use of the free-piston Stirling convertors to achieve higher conversion efficiency than currently available alternatives. NASA GRC is supporting the development of the ASRG by providing extended operation of several Sunpower Inc. Advanced Stirling Convertors (ASCs). In the past year and a half, eight ASCs have operated in continuous, unattended mode in both air and thermal vacuum environments. Hardware, software, and procedures were developed to prepare each convertor for extended operation with intended durations on the order of tens of thousands of hours. Steps taken to prepare a convertor for long-term operation included geometry measurements, thermocouple instrumentation, evaluation of working fluid purity, evacuation with bakeout, and high purity charge. Actions were also taken to ensure the reliability of support systems, such as data acquisition and automated shutdown checkouts. Once a convertor completed these steps, it underwent short-term testing to gather baseline performance data before initiating extended operation. These tests included insulation thermal loss characterization, low-temperature checkout, and full-temperature and power demonstration. This paper discusses the facilities developed to support continuous, unattended operation, and the processing results of the eight ASCs currently on test.

  11. Time-domain compressive dictionary of attributed scattering center model for sparse representation

    Institute of Scientific and Technical Information of China (English)

    ZHONG Jin-rong; WEN Gong-jian

    2016-01-01

    Parameter estimation of the attributed scattering center (ASC) model is significant for automatic target recognition (ATR). Sparse representation based parameter estimation methods have developed rapidly. Construction of the separable dictionary is a key issue for sparse representation technology. A compressive time-domain dictionary (TD) for ASC model is presented. Two-dimensional frequency domain responses of the ASC are produced and transformed into the time domain. Then these time domain responses are cutoff and stacked into vectors. These vectored time-domain responses are amalgamated to form the TD. Compared with the traditional frequency-domain dictionary (FD), the TD is a matrix that is quite spare and can markedly reduce the data size of the dictionary. Based on the basic TD construction method, we present four extended TD construction methods, which are available for different applications. In the experiments, the performance of the TD, including the basic model and the extended models, has been firstly analyzed in comparison with the FD. Secondly, an example of parameter estimation from SAR synthetic aperture radar (SAR) measurements of a target collected in an anechoic room is exhibited. Finally, a sparse image reconstruction example is from two apart apertures. Experimental results demonstrate the effectiveness and efficiency of the proposed TD.

  12. Restricción alimentaria en pollo de engorda para la prevención del síndrome ascítico y su efecto en el ingreso neto

    OpenAIRE

    Israel Salinas; Eliseo Sosa; Arturo Pro; Carlos M. Becerril; Juan M. Cuca; Roberto García

    2004-01-01

    Se realizaron dos experimentos con pollos de engorda para evaluar el efecto de la restricción alimentaria (RA) en la prevención del síndrome ascítico y en el ingreso neto. Se determinó la ganancia de peso corporal (GP), consumo de alimento (CA), eficiencia alimentaria (EA), mortalidad total y por síndrome ascítico (MSA). En el Experimento 2 se evaluó el rendimiento de la canal y el porcentaje de grasa abdominal. El diseño experimental fue completamente al azar con mediciones repetidas de siet...

  13. Curative and organ-preserving treatment with intra-arterial carboplatin induction followed by surgery and/or radiotherapy for advanced head and neck cancer: single-center five-year results

    Directory of Open Access Journals (Sweden)

    Tinelli Carmine

    2007-04-01

    Full Text Available Abstract Background This study evaluated the feasibility, toxicity, response rate and survival of neoadjuvant superselective intra-arterial infusion of high dose carboplatin in advanced head and neck cancer. Methods Forty-six patients with primary head and neck squamous cell carcinoma received 3 cycles of intra-arterial carboplatin (300 to 350 mg/m2 per cycle every 2 weeks, followed by radiotherapy or surgery plus radiotherapy. Results No complications or severe toxicity occurred. Sixteen patients (35% were complete responders, 20 (43% partial responders while 10 (22% did not respond to treatment. After completion of the multimodality treatment, 38/46 patients (83% were complete responders. After a 5-year follow-up period, 18/46 patients (39% are alive and disease-free, 3 (6,5% have died of a second primary tumor and 25 (54,5% have died of the disease. Conclusion Intra-arterial carboplatin induction chemotherapy is a safe, well-tolerated technique that discriminates between responders and non-responders and so may have prognostic significance in planning further integrated treatments aimed to organ preservation for advanced head and neck carcinomas.

  14. Sensitivity and specificity of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium: A single-center study in Japan.

    Science.gov (United States)

    Nishimura, Katsuji; Yokoyama, Kanako; Yamauchi, Noriko; Koizumi, Masako; Harasawa, Nozomi; Yasuda, Taeko; Mimura, Chizuru; Igita, Hazuki; Suzuki, Eriko; Uchiide, Yoko; Seino, Yusuke; Nomura, Minoru; Yamazaki, Kenji; Ishigooka, Jun

    2016-01-01

    To compare the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium. These tools have not been tested in a specialized cardio-surgical ICU. Sensitivities and specificities of each tool were assessed in a cardio-surgical ICU in Japan by two trained nurses independently. Results were compared with delirium diagnosed by psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. There were 110 daily, paired assessments in 31 patients. The CAM-ICU showed 38% sensitivity and 100% specificity for both nurses. All 20 false-negative cases resulted from high scores in the auditory attention screening in CAM-ICU. The ICDSC showed 97% and 94% sensitivity, and 97% and 91% specificity for the two nurses (cutoff ≥4). In a Japanese cardio-surgical ICU, the ICDSC had a higher sensitivity than the CAM-ICU. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Pain prevalence and trajectories following pediatric spinal fusion surgery

    OpenAIRE

    Sieberg, Christine B; Simons, Laura E.; Edelstein, Mark R.; DeAngelis, Maria R.; Pielech, Melissa; Sethna, Navil; Hresko, M. Timothy

    2013-01-01

    Factors contributing to pain following surgery are poorly understood with previous research largely focused on adults. With approximately 6 million children undergoing surgery each year8, there is a need to study pediatric persistent postsurgical pain. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multi-centered registry examining post-surgical outcomes. The Scoliosis Research Society Questionnaire- Version...

  16. Avaliação dos efeitos da radiação gama nos teores de carotenóides, ácido ascórbico e açúcares do futo buriti do brejo (Mauritia flexuosa L. Evaluation of gamma irradiation rffects on carotenoids, ascorbic acid and sugar contents of buriti fruit (Mauritia flexuosa L.

    Directory of Open Access Journals (Sweden)

    Antonio Luís dos Santos Lima

    2009-09-01

    Full Text Available Buriti do Brejo (Mauritia flexuosa L. é um típico fruto da Amazônia, Nordeste e Centro-Oeste brasileiro, muito utilizado na culinária para produção de sucos, doces e vinhos. É considerado uma excelente fonte de carotenóides precursores da vitamina A, apresentando maior concentração de β-caroteno. Além dos carotenóides também encontramos ácido ascórbico e açúcares. O ácido ascórbico administrado em quantidades suficientes pode prevenir os sinais clínicos de deficiência conhecida como escorbuto. O emprego da radiação ionizante gama tem mostrado um potencial efeito na redução de perdas pós-colheita, mantendo a qualidade nutricional dos alimentos. O presente trabalho teve como objetivo avaliar os efeitos da radiação gama, nas doses de 0,5 kGy e 1,0 kGy, na concentração de carotenóides totais, ácido ascórbico e açúcares do buriti. A determinação dos carotenos (α, β e luteína, ácido ascórbico e açúcares foi realizada por cromatografia líquida de alta eficiência (CLAE e os carotenóides totais por espectrofotometria. Os resultados demonstraram que o Buriti é uma excelente fonte de carotenóides totais (44600μg/100g, podendo ser utilizado no combate à hipovitaminose A. A irradiação dos frutos de buriti na dose de 0,5 kGy não alterou significativamente os teores de carotenóides e açúcares. Entretanto, houve uma redução na concentração do ácido ascórbico com o aumento da dose, que pode ter sido causada pela irradiação ou por fatores intrínsecos e extrínsecos que alteram a estabilidade do ácido ascórbico nos alimentos, podendo converter o ácido ascórbico a dehidroascórbico, mantendo ainda a forma ativa da vitamina C.Buriti (Mauritia flexuosa L., a typical fruit from the Northeast and Center-West Amazon of Brazil, is used in many regional dishes. It is considered an excellent source of carotenoids that are A vitamin precursors, showing a majority of β-carotene. It also presents ascorbic

  17. 76 FR 8294 - TRICARE Program; Surgery for Morbid Obesity

    Science.gov (United States)

    2011-02-14

    ... Surgeons (ACS), Bariatric Surgery Center Network (BSCN) and American Society for Metabolic and Bariatric... principles set forth in this Executive Order. Unfunded Mandates Reform Act (Sec. 202, Pub. L. 104-4) It has...

  18. [Thymus surgery in a general surgery department].

    Science.gov (United States)

    Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

    2005-01-01

    Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

  19. Do ideal ascético ao ideal estético: a evolução histórica da Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Cybelle Weinberg

    2010-06-01

    Full Text Available O estudo da anorexia nervosa sob uma perspectiva histórica visa contribuir para a investigação daquilo que se configura como influência cultural na gênese e manutenção do quadro, além de questionar posições segundo as quais a anorexia nervosa seria um "mal da modernidade" ou decorrente de um único fator. Uma análise da vida das santas da Idade Média, por exemplo, mostra quanto o comportamento perseverante as aproxima das anoréxicas de hoje, ainda que a motivação e os ideais (ascético nas primeiras e estético nas últimas sejam diferentes.

  20. Rivaroxaban for Thromboprophylaxis After Nonelective Orthopedic Trauma Surgery in Switzerland

    DEFF Research Database (Denmark)

    Hoffmeyer, Pierre; Simmen, Hanspeter; Jakob, Marcel

    2017-01-01

    This study investigated the effectiveness and the outcomes of rivaroxaban vs the standard of care for venous thromboembolic prophylaxis in patients undergoing fracture-related surgery. A total of 413 patients undergoing fracture-related surgery from 9 Swiss orthopedic and trauma centers were enro...

  1. 以家庭为中心的护理模式在小儿外科护理中的实施效果%The effect of family-centered care model in the pediatric surgery nursing

    Institute of Scientific and Technical Information of China (English)

    陈慧

    2015-01-01

    目的:研究以家庭为中心的护理模式在小儿外科护理中的实施效果。方法选取2014年3~12月我科收治的外科手术患儿230例,按照护理方法不同分为对照组和观察组,每组115例。对照组采用常规护理方式,观察组采用以家庭为中心的护理模式,比较两组的焦虑情况及护理满意度。结果实施护理后,两组的焦虑情况均明显缓解,观察组的焦虑评分低于对照组(P<0.05);观察组的各项护理满意度高于对照组(P<0.05)。结论以家庭为中心的护理模式可带来优质的护理服务,显著缓解患儿及家属的紧张、焦虑情况,促进护患关系和谐,有利于患儿的康复。%Objective To analyze the family-centered care model in the pediatric surgical nursing. Methods 230 cases of pediatric patients with surgical operation admitted in our department from March to December 2014 were selected and divided into control group and observation group according to the different nursing method,with 115 cases in each group.Control group was treated conventional care,observation group was treated the family-centered care method.The anxiety and nursing satisfaction was compared between two groups. Results The anxiety in two groups were significant-ly alleviated,the anxiety score in observation group was lower than that of control group (P<0.05).All the nursing satis-faction in observation group was higher than that of control group (P<0.05). Conclusion Family-centered care model can bring high quality nursing service and alleviate the anxiety in children and their families,and promote the harmo-nious relationship between nurses and patients significantly,which is helpful for children health recovery.

  2. Lactobacillus rhamnosus GR-1 Ameliorates Escherichia coli-Induced Inflammation and Cell Damage via Attenuation of ASC-Independent NLRP3 Inflammasome Activation.

    Science.gov (United States)

    Wu, Qiong; Liu, Ming-Chao; Yang, Jun; Wang, Jiu-Feng; Zhu, Yao-Hong

    2015-12-11

    Escherichia coli is a major environmental pathogen causing bovine mastitis, which leads to mammary tissue damage and cell death. We explored the effects of the probiotic Lactobacillus rhamnosus GR-1 on ameliorating E. coli-induced inflammation and cell damage in primary bovine mammary epithelial cells (BMECs). Increased Toll-like receptor 4 (TLR4), NOD1, and NOD2 mRNA expression was observed following E. coli challenge, but this increase was attenuated by L. rhamnosus GR-1 pretreatment. Immunofluorescence and Western blot analyses revealed that L. rhamnosus GR-1 pretreatment decreased the E. coli-induced increases in the expression of the NOD-like receptor family member pyrin domain-containing protein 3 (NLRP3) and the serine protease caspase 1. However, expression of the adaptor protein apoptosis-associated speck-like protein (ASC, encoded by the Pycard gene) was decreased during E. coli infection, even with L. rhamnosus GR-1 pretreatment. Pretreatment with L. rhamnosus GR-1 counteracted the E. coli-induced increases in interleukin-1β (IL-1β), -6, -8, and -18 and tumor necrosis factor alpha mRNA expression but upregulated IL-10 mRNA expression. Our data indicate that L. rhamnosus GR-1 reduces the adhesion of E. coli to BMECs, subsequently ameliorating E. coli-induced disruption of cellular morphology and ultrastructure and limiting detrimental inflammatory responses, partly via promoting TLR2 and NOD1 synergism and attenuating ASC-independent NLRP3 inflammasome activation. Although the residual pathogenic activity of L. rhamnosus, the dosage regimen, and the means of probiotic supplementation in cattle remain undefined, our data enhance our understanding of the mechanism of action of this candidate probiotic, allowing for development of specific probiotic-based therapies and strategies for preventing pathogenic infection of the bovine mammary gland. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  3. Fibroblast growth factor 21 improves insulin sensitivity and synergizes with insulin in human adipose stem cell-derived (hASC adipocytes.

    Directory of Open Access Journals (Sweden)

    Darwin V Lee

    Full Text Available Fibroblast growth factor 21 (FGF21 has evolved as a major metabolic regulator, the pharmacological administration of which causes weight loss, insulin sensitivity and glucose control in rodents and humans. To understand the molecular mechanisms by which FGF21 exerts its metabolic effects, we developed a human in vitro model of adipocytes to examine crosstalk between FGF21 and insulin signaling. Human adipose stem cell-derived (hASC adipocytes were acutely treated with FGF21 alone, insulin alone, or in combination. Insulin signaling under these conditions was assessed by measuring tyrosine phosphorylation of insulin receptor (InsR, insulin receptor substrate-1 (IRS-1, and serine 473 phosphorylation of Akt, followed by a functional assay using 14C-2-deoxyglucose [14C]-2DG to measure glucose uptake in these cells. FGF21 alone caused a modest increase of glucose uptake, but treatment with FGF21 in combination with insulin had a synergistic effect on glucose uptake in these cells. The presence of FGF21 also effectively lowered the insulin concentration required to achieve the same level of glucose uptake compared to the absence of FGF21 by 10-fold. This acute effect of FGF21 on insulin signaling was not due to IR, IGF-1R, or IRS-1 activation. Moreover, we observed a substantial increase in basal S473-Akt phosphorylation by FGF21 alone, in contrast to the minimal shift in basal glucose uptake. Taken together, our data demonstrate that acute co-treatment of hASC-adipocytes with FGF21 and insulin can result in a synergistic improvement in glucose uptake. These effects were shown to occur at or downstream of Akt, or separate from the canonical insulin signaling pathway.

  4. TLR2/MyD88/NF-κB pathway, reactive oxygen species, potassium efflux activates NLRP3/ASC inflammasome during respiratory syncytial virus infection.

    Directory of Open Access Journals (Sweden)

    Jesus Segovia

    Full Text Available Human respiratory syncytial virus (RSV constitute highly pathogenic virus that cause severe respiratory diseases in newborn, children, elderly and immuno-compromised individuals. Airway inflammation is a critical regulator of disease outcome in RSV infected hosts. Although "controlled" inflammation is required for virus clearance, aberrant and exaggerated inflammation during RSV infection results in development of inflammatory diseases like pneumonia and bronchiolitis. Interleukin-1β (IL-1β plays an important role in inflammation by orchestrating the pro-inflammatory response. IL-1β is synthesized as an immature pro-IL-1β form. It is cleaved by activated caspase-1 to yield mature IL-1β that is secreted extracellularly. Activation of caspase-1 is mediated by a multi-protein complex known as the inflammasome. Although RSV infection results in IL-1β release, the mechanism is unknown. Here in, we have characterized the mechanism of IL-1β secretion following RSV infection. Our study revealed that NLRP3/ASC inflammasome activation is crucial for IL-1β production during RSV infection. Further studies illustrated that prior to inflammasome formation; the "first signal" constitutes activation of toll-like receptor-2 (TLR2/MyD88/NF-κB pathway. TLR2/MyD88/NF-κB signaling is required for pro-IL-1β and NLRP3 gene expression during RSV infection. Following expression of these genes, two "second signals" are essential for triggering inflammasome activation. Intracellular reactive oxygen species (ROS and potassium (K(+ efflux due to stimulation of ATP-sensitive ion channel promote inflammasome activation following RSV infection. Thus, our studies have underscored the requirement of TLR2/MyD88/NF-κB pathway (first signal and ROS/potassium efflux (second signal for NLRP3/ASC inflammasome formation, leading to caspase-1 activation and subsequent IL-1β release during RSV infection.

  5. 经脐单孔上尿路腹腔镜技术:单中心经验总结%Transumbilical Laparoscopic Single-site Surgery for Upper Urologic Diseases: Single-center Experience

    Institute of Scientific and Technical Information of China (English)

    张树栋; 马潞林; 肖春雷; 黄毅; 王国良; 肖博

    2013-01-01

    Objective To evaluate the feasibility of a novel homemade single-port device for transumbilical laparoendoscopic single-site surgery (LESS) on the upper urinary system. Methods The clinical data of 30 cases of LESS that were performed (24 cases on the left side, and 6 cases on the right side) from January 2010 to May 2011 in our hospital were analyzed retrospectively. The cases included 14 cases of radical nephrectomy, 12 cases of renal cyst resection, 3 cases of non-functional kidney resection and 1 case of adrenal cystectomy. With side-lying position at the healthy side (45° - 60°) , the patients received LESS by a homemade single-port device through a 4- to 6-cm umbilical incision. Laparoscope (30°) , ultrasonic scalpel, and flexible or non-flexible instruments were employed for the operation. Results The procedure was completed in all the 30 cases within 28 to 185 min, without conversion to open surgery. Intraoperative blood loss ranged from 10 to 200 ml, and the hospital stay ranged from 4 to 8 days. Postoperative pathological examination confirmed preoperative diagnosis in all the patients. No hematoma, infection, intestinal obstruction, or incisional hernia occurred in any of the patients. A follow-up for a mean of 21. 4 months was achieved in all the patients (ranged from 12 to 29 months) , no recurrence was detected during the period. Conclusions Because of its cosmetic outcomes, LESS especially suits female patients. We recommend our homemade single-port device to be widely used for its convenience, flexibility, and low cost.%目的 总结自制单孔装置应用于经脐单孔上尿路腹腔镜技术中的经验体会. 方法 2010年1月~2011年5月,应用自制单孔装置行经脐单孔上尿路腹腔镜手术30例.包括肾癌根治性切除术14例,无功能积水肾切除3例,肾囊肿去顶减压12例,肾上腺囊肿切除1例.左侧24例,右侧6例.45.~60.健侧卧位,升高腰桥,于脐旁做4~6 cm切口,依次切开至腹膜,直视下

  6. Morbidity and mortality of complex spine surgery

    DEFF Research Database (Denmark)

    Karstensen, Sven; Bari, Tanvir; Gehrchen, Martin

    2016-01-01

    adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population. STUDY DESIGN: A prospective, consecutive cohort study......BACKGROUND CONTEXT: Most literature on complications in spine surgery has been retrospective or based on national databases with few variables. The Spine AdVerse Events Severity (SAVES) system has been found reliable and valid in two Canadian centers, providing precise information regarding all...... was conducted using the SAVES version 2010 in the period from January 1, 2013 until December 31, 2013. A retrospective analysis was performed on all patients operated from November 1, 2011 until October 31, 2012 for comparison. PATIENT SAMPLE: Patients undergoing spinal surgery at a tertiary referral center...

  7. Complications of Sinus Surgery

    Science.gov (United States)

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  8. Bariatric Surgery Misconceptions

    Science.gov (United States)

    ... from depression or anxiety and to have lower self-esteem and overall quality of life than someone who ... is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery ...

  9. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  10. Breast Reduction Surgery

    Science.gov (United States)

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  11. Aids and Surgery

    African Journals Online (AJOL)

    user

    HIV/AIDS patients require surgery sometimes during their illness. ... risks to surgical equipes and analysing preventive strategies to HIV ... problems in patients presenting HIV, AIDS and ... Dentistry, Surgery of Awolowo University in Nigeria3.

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  13. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  14. Ear Plastic Surgery

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  15. Scoliosis surgery - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007383.htm Scoliosis surgery - child To use the sharing features on this page, please enable JavaScript. Scoliosis surgery repairs abnormal curving of the spine ( scoliosis ). ...

  16. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  17. LASIK Eye Surgery

    Science.gov (United States)

    ... are nearsighted. You may need another refractive surgery (enhancement surgery) within a year to remove more tissue. ... may happen due to certain conditions, such as abnormal wound healing, hormonal imbalances or pregnancy. Visual loss ...

  18. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you need ...

  19. Types of Heart Surgery

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Heart Surgery Coronary Artery Bypass Grafting Coronary artery bypass grafting ( ... TAHs) might be used to treat these patients. Surgery To Place Ventricular Assist Devices or Total Artificial ...

  20. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  1. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis - hip ... You may receive general anesthesia for this surgery. This means you ... spinal anesthesia . With this kind of anesthesia, medicine is ...

  2. Surgery for Testicular Cancer

    Science.gov (United States)

    ... Stage Testicular Cancer Treating Testicular Cancer Surgery for Testicular Cancer Surgery is typically the first treatment for all ... Testicular Cancer, by Type and Stage More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  3. Heart valve surgery

    Science.gov (United States)

    ... Tricuspid valve stenosis Risks The risks of having cardiac surgery include: Death Heart attack Heart failure Bleeding requiring ... and the A.D.A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Latest ...

  4. Otoplasty (Cosmetic Ear Surgery)

    Science.gov (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Ear-Surgery.html. Accessed June 16, 2015. ...

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  6. Tele-surgery simulation with a patient organ model for robotic surgery training.

    Science.gov (United States)

    Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

    2005-12-01

    Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance.

  7. An overview of surgery-first approach: Recent advances in orthognathic surgery.

    Science.gov (United States)

    Sharma, Vipul Kumar; Yadav, Kirti; Tandon, Pradeep

    2015-01-01

    The disadvantages of having orthodontic interventions both before and after orthognathic surgery include a long treatment time of 7-47 months and temporary worsening of facial appearance. Nowadays, the concept of surgery-first, followed by orthodontic treatment is applied to orthognathic surgery cases in different orthodontic centers in the world. This concept and technique is called "surgery-first-orthognathic-approach" or "surgery-first approach" (SFA) rigid fixation (skeletal anchorage system) of the bony segments and regional acceleratory phenomenon were keys to broad implementation of the SFA. This article is intended to provide an overview of SFA including indications, general and specific guidelines, different protocol variations, success rate and potential problems.

  8. Development and implementation of a formalized geriatric surgery curriculum for general surgery residents.

    Science.gov (United States)

    Barbas, Andrew S; Haney, John C; Henry, Brandon V; Heflin, Mitchell T; Lagoo, Sandhya A

    2014-01-01

    Despite the growth of the elderly population, most surgical training programs lack formalized geriatric education. The authors' aim was to implement a formalized geriatric surgery curriculum at an academic medical center. Surgery residents were surveyed on attitudes toward the care of elderly patients and the importance of various geriatric topics to daily practice. A curriculum consisting of 16 didactic sessions was created with faculty experts moderating. After curriculum completion, residents were surveyed to assess curriculum impact. Residents expressed increased comfort in accessing community resources. A greater percentage of residents recognized the significance of delirium and acute renal failure in elderly patients. Implementing a geriatric surgery curriculum geared toward surgery residents is feasible and can increase resident comfort with multidisciplinary care and recognition of clinical conditions pertinent to elderly surgical patients. This initiative also provided valuable experience for geriatric surgery curriculum development.

  9. Advanced Stirling Technology Development at NASA Glenn Research Center

    Science.gov (United States)

    Shaltens, Richard K.; Wong, Wayne A.

    2007-01-01

    The NASA Glenn Research Center has been developing advanced energy-conversion technologies for use with both radioisotope power systems and fission surface power systems for many decades. Under NASA's Science Mission Directorate, Planetary Science Theme, Technology Program, Glenn is developing the next generation of advanced Stirling convertors (ASCs) for use in the Department of Energy/Lockheed Martin Advanced Stirling Radioisotope Generator (ASRG). The next-generation power-conversion technologies require high efficiency and high specific power (watts electric per kilogram) to meet future mission requirements to use less of the Department of Energy's plutonium-fueled general-purpose heat source modules and reduce system mass. Important goals include long-life (greater than 14-yr) reliability and scalability so that these systems can be considered for a variety of future applications and missions including outer-planet missions and continual operation on the surface of Mars. This paper provides an update of the history and status of the ASC being developed for Glenn by Sunpower Inc. of Athens, Ohio.

  10. Studies using wind tunnel to simulate the Atmospheric Boundary Layer at the Alcântara Space Center

    Directory of Open Access Journals (Sweden)

    Luciana P. Bassi Marinho

    2009-01-01

    Full Text Available The Alcântara Space Center (ASC region has a peculiar topography due to the existence of a coastal cliff, which modifies the atmospheric boundary layer characteristic in a way that can affect rocket launching operations. Wind tunnel measurements can be an important tool for the understanding of turbulence and wind flow pattern characteristics in the ASC neighborhood, along with computational fluid dynamics and observational data. The purpose of this paper is to describe wind tunnel experiments that have been carried out by researchers from the Brazilian Institutions IAE, ITA and INPE. The technologies of Hot-Wire Anemometer and Particle Image Velocimetry (PIV have been used in these measurements, in order to obtain information about wind flow patterns as velocity fields and vorticity. The wind tunnel measurements are described and the results obtained are presented.

  11. Minimally invasive surgery for esophageal cancer.

    Science.gov (United States)

    Santillan, Alfredo A; Farma, Jeffrey M; Meredith, Kenneth L; Shah, Nilay R; Kelley, Scott T

    2008-10-01

    Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

  12. Breast Cancer Surgery

    Science.gov (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  13. Laser technologies in ophthalmic surgery

    Science.gov (United States)

    Atezhev, V. V.; Barchunov, B. V.; Vartapetov, S. K.; Zav'yalov, A. S.; Lapshin, K. E.; Movshev, V. G.; Shcherbakov, I. A.

    2016-08-01

    Excimer and femtosecond lasers are widely used in ophthalmology to correct refraction. Laser systems for vision correction are based on versatile technical solutions and include multiple hard- and software components. Laser characteristics, properties of laser beam delivery system, algorithms for cornea treatment, and methods of pre-surgical diagnostics determine the surgical outcome. Here we describe the scientific and technological basis for laser systems for refractive surgery developed at the Physics Instrumentation Center (PIC) at the Prokhorov General Physics Institute (GPI), Russian Academy of Sciences.

  14. Single center experience of 151 consecutive cases of robotic surgery for rectal tumor%单中心151例机器人直肠肿瘤手术效果与体会

    Institute of Scientific and Technical Information of China (English)

    吕赤; 张成; 李瑾; 高广荣; 李达; 蒋会勇; 单永琪; 张雪峰

    2014-01-01

    Objective To investigate the effect of resection of rectal tumor with the da Vinci robotic surgical system and summarize surgical experience.Methods Clinical data of 151 cases of rectal tumor which received robotic radical resection from Jan.2012 to Jul.2014 were reviewed.Results All patients except one case were received radical resection successfully with robotic surgical system of da Vinci.There were 106 cases performed anterior resection,39 cases performed APR operation and 6 cases performed Hartmann operation.The average operational time was 240 min,239 min and 260 min.The mean blood loss during operation was 53 ml.The average number of lymph node dissected was 13.2.The average time for gastrointestinal function recovery was 3 d,ranged 1 to 7 d.3 cases of postoperative bowel obstruction, 2 cases of anastomotic leak and 1 case of anastomotic bleeding were cured by conservative therapy.Only one conversion for intraoperative mesenteric bleeding with pneumoperitoneum machine′s mechanical failure. Conclusion The resection of rectal cancer surgery with Da Vinci robotic is safe,reliable,and exclusive.%目的:探讨达芬奇机器人手术系统应用于直肠肿瘤手术的效果,总结手术经验。方法回顾性分析我院2012年1月-2014年7月行达芬奇机器人直肠手术151例的临床资料。结果150例手术顺利完成,1例中转开腹。其中前切除术106例,APR 手术39例,Hartmann 手术6例。平均手术时间分别为240 min,239 min 和260 min,术中平均失血量53 ml,清扫淋巴结数量平均13.2枚。术后排气时间1~7 d,平均3 d。术后肠梗阻3例,吻合口瘘2例,吻合口出血1例,均行保守治疗。1例因肠系膜血管出血时气腹机故障而中转开腹止血。无死亡病例。结论达芬奇机器人行直肠肿瘤手术安全、可靠、优势明显。

  15. Effectiveness of two strategies to follow-up ASC-US and LSIL screening results in The Netherlands using repeat cytology with or without additional hrHPV testing: a retrospective cohort study

    NARCIS (Netherlands)

    Siebers, A.G.; Arbyn, M.; Melchers, W.J.; Kemenade, F.J. van; Vedder, J.E.; Linden, H. van der; Ballegooijen, M. van; Bekkers, R.L.; Bulten, J.

    2014-01-01

    PURPOSE: The purpose of the study was to assess the effectiveness of repeat cytology with and without additional high-risk human papilloma virus (hrHPV) testing after atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASC-US/LSIL) screening results.

  16. Factores asociados a displasia, en mujeres con diagnóstico citológico de atipias de células escamosas de significado indeterminado (ASC-US

    Directory of Open Access Journals (Sweden)

    Jorge Luis Monroy Díaz

    2011-01-01

    Full Text Available Objetivo: Identificar los factores asociados a displasia en mujeres que asisten al Hospital Central de la Policía Nacional o diferentes dispensarios cuya citología cervicovaginal presentaba, atipias de células escamosas de significado indeterminado (ASC-US.

  17. Surgery Videos: MedlinePlus

    Science.gov (United States)

    ... Winston-Salem, NC, 1/15/2009) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ... Boston, Boston, MA, 6/08/2010) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ...

  18. Primary study on the isolation,culture and identification of rat ASCs%大鼠脂肪干细胞的分离培养及鉴定的初步研究

    Institute of Scientific and Technical Information of China (English)

    雷蕙嘉; 孙建军; 彭本刚; 张宁; 朱思翔

    2011-01-01

    目的 探讨大鼠脂肪干细胞(adipose-derived stem cells,ASCs)分离、培养及纯化方法,并对其表面标志进行鉴定.方法 以Wistar大鼠为研究对象,取其腹股沟皮下脂肪组织,经冲洗、剪碎成浆状后,以Ⅱ型胶原酶消化.消化液经滤网过滤后,离心悬浮细胞,并接种于培养瓶内.经差速贴壁法纯化细胞.以免疫荧光方法对其表面标志CD44,CD29及CD106,CD34进行鉴定.激光共聚焦显微镜下观察评估.结果 原代培养的ASCs呈星型或多角型,经传代后的ASCs形态比较均一,呈长梭形,漩涡样生长.冻存复苏后的ASCs仍保持较好的活力,存活率较高.经差速贴壁法可获得较纯的ASCs.免疫荧光检测ASCs表面标志鉴定结果显示CD44,CD29阳性表达,CD106,CD34阴性表达.结论 本研究进一步改进的了ASCs分离培养及纯化方法,为ASCs最终应用于临床提供了有意义的实验依据.%Objective  To investigate the isolation ,cell culture and purification of adipose-derived stem cells (ASCs) from rats and to identify their surfacse markers .Methods  Wister rats were selected and adipose tissues were obtained from the inguinalregion .The tissues were washed extensively ,minced into small pieces and digested with collagenase type Ⅱ .The digested mixture was then passed through a cell strainer and was centrifuged .The pellet of ASCs was then suspended and seeded in a plastic cellculture bottle .The cells were purified by the method of differential speed of adherence .The cell surface markers of CD 44 ,CD 29 ,CD 106 and CD 34 were identified by immuno fluore scence and analyzed by a confocal laser scan microscopy system .Results  The primary cultured ASCs grew into large and stellate-shaped cells .A fter severalpassage ,confluent ASCs showed a spindle-shaped ,fibroblast-like morphology and grew as a whirlpool .ASC maintained better viability and displayed the higher survivalrate after cryopreservation .Relatively pure ASCs were

  19. Prediction of cervical intraepithelial neoplasia grade 2+ (CIN2+ using HPV DNA testing after a diagnosis of atypical squamous cell of undetermined significance (ASC-US in Catalonia, Spain

    Directory of Open Access Journals (Sweden)

    Ibáñez Raquel

    2012-01-01

    Full Text Available Abstract Background A protocol for cervical cancer screening among sexually active women 25 to 65 years of age was introduced in 2006 in Catalonia, Spain to increase coverage and to recommend a 3-year-interval between screening cytology. In addition, Human Papillomavirus (HPV was offered as a triage test for women with a diagnosis of atypical squamous cells of undetermined significance (ASC-US. HPV testing was recommended within 3 months of ASC-US diagnosis. According to protocol, HPV negative women were referred to regular screening including a cytological exam every 3 years while HPV positive women were referred to colposcopy and closer follow-up. We evaluated the implementation of the protocol and the prediction of HPV testing as a triage tool for cervical intraepithelial lesions grade two or worse (CIN2+ in women with a cytological diagnosis of ASC-US. Methods During 2007-08 a total of 611 women from five reference laboratories in Catalonia with a novel diagnosis of ASC-US were referred for high risk HPV (hrHPV triage using high risk Hybrid Capture version 2. Using routine record linkage data, women were followed for 3 years to evaluate hrHPV testing efficacy for predicting CIN2+ cases. Logistic regression analysis was used to estimate the odds ratio for CIN2 +. Results Among the 611 women diagnosed with ASC-US, 493 (80.7% had at least one follow-up visit during the study period. hrHPV was detected in 48.3% of the women at study entry (mean age 35.2 years. hrHPV positivity decreased with increasing age from 72.6% among women younger than 25 years to 31.6% in women older than 54 years (p At the end of the 3 years follow-up period, 37 women with a diagnosis of CIN2+ (18 CIN2, 16 CIN3, 2 cancers, and 1 with high squamous intraepithelial lesions -HSIL were identified and all but one had a hrHPV positive test at study entry. Sensitivity to detect CIN2+ of hrHPV was 97.2% (95%confidence interval (CI = 85.5-99.9 and specificity was 68.3% (95%CI

  20. 76 FR 66070 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-10-25

    ...' offices and hospital outpatient and emergency departments, and ambulatory surgery centers. The target... children's general, as well as visits to freestanding ambulatory surgery centers (FS-ASCs). The objectives... (EDs), and ambulatory surgery locations (ASLs) of non-Federal, short-stay hospitals (hospitals with...

  1. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  2. High-resolution global grids of revised Priestley–Taylor and Hargreaves–Samani coefficients for assessing ASCE-standardized reference crop evapotranspiration and solar radiation

    Directory of Open Access Journals (Sweden)

    V. G. Aschonitis

    2017-08-01

    Full Text Available The objective of the study is to provide global grids (0.5° of revised annual coefficients for the Priestley–Taylor (P-T and Hargreaves–Samani (H-S evapotranspiration methods after calibration based on the ASCE (American Society of Civil Engineers-standardized Penman–Monteith method (the ASCE method includes two reference crops: short-clipped grass and tall alfalfa. The analysis also includes the development of a global grid of revised annual coefficients for solar radiation (Rs estimations using the respective Rs formula of H-S. The analysis was based on global gridded climatic data of the period 1950–2000. The method for deriving annual coefficients of the P-T and H-S methods was based on partial weighted averages (PWAs of their mean monthly values. This method estimates the annual values considering the amplitude of the parameter under investigation (ETo and Rs giving more weight to the monthly coefficients of the months with higher ETo values (or Rs values for the case of the H-S radiation formula. The method also eliminates the effect of unreasonably high or low monthly coefficients that may occur during periods where ETo and Rs fall below a specific threshold. The new coefficients were validated based on data from 140 stations located in various climatic zones of the USA and Australia with expanded observations up to 2016. The validation procedure for ETo estimations of the short reference crop showed that the P-T and H-S methods with the new revised coefficients outperformed the standard methods reducing the estimated root mean square error (RMSE in ETo values by 40 and 25 %, respectively. The estimations of Rs using the H-S formula with revised coefficients reduced the RMSE by 28 % in comparison to the standard H-S formula. Finally, a raster database was built consisting of (a global maps for the mean monthly ETo values estimated by ASCE-standardized method for both reference crops, (b global maps for the revised annual

  3. Centering research

    DEFF Research Database (Denmark)

    Katan, Lina Hauge; Baarts, Charlotte

    and collected 24 portfolios in which students reflect auto-ethnographically on their educational practices. Analyzing this qualitative material, we explore how researchers and students respectively read and write to develop and advance their thinking in those learning processes that the two groups fundamentally...... share as the common aim of both research and education. Despite some similarities, we find that how the two groups engage in and benefit from reading and writing diverges significantly. Thus we have even more reason to believe that centering practice-based teaching on these aspects of research is a good...

  4. Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.Hoelscher; Ch.Gutschow

    2004-01-01

    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  5. The robotic-assisted laparoscopic surgery treating urological diseases: experiences of 600 cases in a single medical center%机器人辅助腔镜技术处理泌尿系统疾病:单中心600例报道

    Institute of Scientific and Technical Information of China (English)

    夏丹; 来翀; 王平; 景泰乐; 叶孙益; 秦杰; 孔德波; 汪朔

    2016-01-01

    目的 总结单中心机器人辅助泌尿外科手术的临床资料,提高对机器人技术在泌尿系疾病处理中的认识.方法 回顾性分析2014年9月至2015年11月本中心600例应用da Vinci手术机器人系统进行泌尿外科手术的临床资料.男473例,女127例.年龄17 ~ 82岁,平均(67.2±6.8)岁.对病例的分布、手术方式、围术期和术后情况进行总结.结果 600例机器人辅助腹腔镜手术均顺利完成,无中转开放手术.其中根治性前列腺切除术304例,肾癌手术185例(包括根治性肾切除术9例,肾部分切除术174例,根治性肾切除术+腔静脉取癌栓术2例),肾盂输尿管离断成形术27例,根治性膀胱切除术12例(包括Bricker膀胱术11例,Studer原位新膀胱术1例),其他手术共72例(包括肾上腺切除术、腹膜后肿瘤切除术、腹膜后淋巴清扫术、腔静脉后输尿管成形术、左肾静脉移位吻合术等).117例(19.5%)患者术后出现并发症,无一例死亡.对根治性前列腺切除术和肾部分切除术重点进行了经腹腔和经腹膜后两种手术入路的比较.经腹膜后途径与经腹腔途径相比并不增加住院时间和切缘阳性率(P>O.05).结论 da Vinci机器人手术系统在泌尿系疾病处理中应用广泛,尤其适用于需要腔内缝合及在狭小空间内操作的手术类型.经腹膜后途径行根治性前列腺切除术和肾部分切除术安全、可行.%Objective To analyze and summarize the clinical data of 600 robotic-assisted urological surgeries at a single center,aiming to acquire a better understanding of the robotic techniques and emphasize its role in treating urological diseases.Methods Six hundred patients with urological diseases underwent robotic-assisted laparoscopic surgeries from September 2014 to November 2015,including 473 males and 127 females with a mean age of (67.2 ± 6.8) years.The disease categary,surgical procedure selection,intraand post-operative data and short

  6. Challenging dogmas in pancreatic surgery: biliary drainage, outcome and beyond

    NARCIS (Netherlands)

    van der Gaag, N.A.

    2012-01-01

    In this thesis we have presented the results of 5 years of basic and clinical research on pancreatic surgery. Traditions have been evaluated, controversies have been settled, physician-centered and patient-centered outcomes were evaluated, and many suggestions for clinical practice and future resear

  7. Hemorrhage after transoral robotic-assisted surgery.

    Science.gov (United States)

    Asher, Scott A; White, Hilliary N; Kejner, Alexandra E; Rosenthal, Eben L; Carroll, William R; Magnuson, J Scott

    2013-07-01

    An increasing number of head and neck surgeons have begun using transoral robotic-assisted surgery. Our objective was to examine the postoperative bleeding complications we have encountered to determine risk factors and to discuss the topic of hemorrhage control. Case series with chart review. Medical records were reviewed in 147 consecutive patients undergoing transoral robotic-assisted surgery for any indication at one tertiary academic medical center between March 2007 and September 2011. Eleven of 147 (7.5%) patients undergoing transoral robotic-assisted surgery experienced some degree of postoperative hemorrhage, with 9 patients requiring reoperation for examination and/or control of bleeding. Bleeding occurred at a mean of 11.1 ± 9.2 days after initial operation. Eight of 11 (72%) patients who bled were on antithrombotic medication (anticoagulants or antiplatelet agents) for other medical comorbidities. The postoperative hemorrhage rate in patients taking antithrombotic medication (8/48 patients = 17%) was significantly higher than in those not taking antithrombotics (3/99 patients = 3%), P = .0057. While the bleeding rate in salvage surgery (3/29 = 10.3%) was slightly higher than in primary surgery (8/118 = 6.8%), this difference did not reach statistical significance. Potential for postoperative bleeding in association with antithrombotic medications in patients undergoing transoral robotic-assisted surgery should be recognized. Various effective techniques for management of these patients without robotic assistance were demonstrated.

  8. Ergonomics in Laparoscopic Surgery

    OpenAIRE

    Supe Avinash; Kulkarni Gaurav; Supe Pradnya

    2016-01-01

    Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comf...

  9. Ergonomics in laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Supe Avinash

    2010-01-01

    Full Text Available Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.

  10. General surgery career resource.

    Science.gov (United States)

    Parsee, Ana M; Ross, Sharona B; Gantt, Nancy L; Kichler, Kandace; Hollands, Celeste

    2013-11-01

    General surgery residency training can lead to a rewarding career in general surgery and serve as the foundation for careers in several surgical subspecialties. It offers broad-based training with exposure to the cognitive and technical aspects of several surgical specialties and prepares graduating residents for a wide range of career paths. This career development resource discusses the training aspects of general surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Robotic pelvic organ prolapse surgery.

    Science.gov (United States)

    Sajadi, Kamran P; Goldman, Howard B

    2015-04-01

    Robotic sacrocolpopexy (RSC) has rapidly gained popularity over the past 10 years, owing to claims that it is associated with a reduced learning curve compared with standard laparoscopic sacrocolpopexy (LSC) and that it has equal efficacy to the gold-standard treatment, abdominal sacrocolpopexy (ASC). The specifics of the surgical technique used for RSC vary widely, but the basic steps and principles are largely the same. Although complication rates are low, specific complications can be minimized by meticulous attention to surgical technique at several important points in the procedure. Multiple levels of evidence support the efficacy of RSC, and show that it is associated with a shorter hospital stay and convalescence than ASC. The learning curve for RSC usually comprises 10-20 procedures but for those with extensive experience of laparoscopy it is likely to be even shorter. RSC is more expensive than LSC but cheaper than ASC. As RSC has only been used for about a decade, we await long-term outcomes of more than a few years.

  12. [Crohn's disease surgery].

    Science.gov (United States)

    Kala, Zdeněk; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel

    2014-01-01

    Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries.

  13. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  14. Hyperoxaluria and Bariatric Surgery

    Science.gov (United States)

    Asplin, John R.

    2007-04-01

    Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.

  15. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky

    2015-01-01

    Full Text Available All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen.

  16. Integrated bariatric surgery residency

    Directory of Open Access Journals (Sweden)

    Eltorai AE

    2014-11-01

    Full Text Available Adam EM Eltorai Warren Alpert Medical School of Brown University, RI, USA Abstract: Obesity is a major public health concern. Given its lasting efficacy for improving obesity and obesity-related diseases, bariatric surgery is an increasingly common treatment option. As the implementation of the Affordable Care Act progresses, the impending physician shortage will become more severe. Thus there will be an even greater need for doctors specialized in the management and treatment of obese patients. The development of integrated bariatric surgery residency programs could be considered and is discussed herein. Keywords: obesity, bariatric surgery, integrated residency, surgery education

  17. Does the ThinPrep Imaging System increase the detection of high-risk HPV-positive ASC-US and AGUS? The Women and Infants Hospital experience with over 200,000 cervical cytology cases

    Directory of Open Access Journals (Sweden)

    Quddus M

    2009-01-01

    Full Text Available Background: Published reports have demonstrated that introduction of the ThinPrep Imaging System (Imager to the cytology screening services has increased the detection rate of high-grade squamous intraepithelial lesions (HSILs. In accordance with recent clinical treatment guidelines, patients with atypical squamous or glandular cells of undetermined significance (ASC-US or AGUS are often tested for high-risk HPV infection using the Hybrid Capture HPV DNA test. We took the opportunity to investigate whether the Imager had resulted in any significant differences in our diagnostic categories, as well as whether the Imager increased the detection of high-risk HPV-DNA-positive (HRHPV+ ASC-US or AGUS. Materials and Methods: Cytology cases with the diagnosis of ASC-US and AGUS were retrieved from the archival files of our institution during periods of 11 months prior to and 11 months after the introduction of the Imager. The total number of cases in each category was correlated with results of reflex high-risk HPV DNA testing when the latter were available. All AGUS diagnoses were correlated with subsequent biopsy follow-up. Statistical analyses were performed using the chi-Square test with Yate′s Correction and Fisher′s Exact test. Results: A total of 108,371 and 104,555 of ThinPrep ® Pap Test (TPPT cases were reviewed during 11 months pre- and post-imager introduction. The ASC-US rate was 5.4% in the pre-Imager and 5.3% in the post-Imager period. The HPV reflex test was 38% and 34% positive respectively in the pre- and post-Imager period ( P >0.124. Similarly, 0.14% and 0.12% AGUS were found in the pre- and post-Imager period. The positive HPV reflex test was 14% versus 23% ( P = 0.1690. The abnormal biopsy follow-up rate in the AGUS category was increased from 20.9% in the pre-Imager period to 31% in the post-Imager period ( P = 0.1471. The ASCUS/SIL ratios were 1.9 and 1.6 respectively. Conclusions: The ASC-US and AGUS rates did not change

  18. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun

    2014-01-01

    OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment. STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follow......-up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery. RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1...... in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (psurgery. Endometrial carcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION...

  19. 77 FR 31361 - Medicare and Medicaid Programs; Application by American Osteopathic Association/Healthcare...

    Science.gov (United States)

    2012-05-25

    ...-Approval of its Ambulatory Surgery Center (ASC) Accreditation Program AGENCY: Centers for Medicare and...--Ambulatory surgery center Insurance Program; and No. 93.774, Medicare--Supplementary Medical Insurance... Program (AOA/HFAP) for continued recognition as a national accrediting organization for ambulatory...

  20. 以学生为中心的耳鼻咽喉头颈外科学本科临床教学体系构建及意义%Construction of student-centered learning system for undergraduate clinical training in otolaryngology-head and neck surgery

    Institute of Scientific and Technical Information of China (English)

    钟诚; 张学渊; 姜振东; 魏运军; 袁伟

    2013-01-01

    对本科医学生耳鼻咽喉头颈外科学临床学习阶段的教学实践加以总结,提出以学生为中心的教学策略并应用于教学过程.构建涵盖教学理念整体化、教学手段形象化、教学目标多元化、教学方式互动化的四个框架,采用内镜、多媒体等形式教学,设定不同的教学目标,实施不同的临床教学策略,推动学生综合素质和临床能力发展.%The author proposed student-centered learning system in otolaryngology-head and neck surgery for undergraduate clinical training after exploration and intentions.Four mutual impacted frames were built including integration of teaching philosophy,visualization of training methods,diversification of educational targets and interaction of training courses.Endoscopic navigated learning and multimedia aided training were applied,respective teaching purposes were set and various clinical training courses were introduced to students in their learning of otolaryngology,which were believed to help develop more medical talents with higher comprehensive qualities and better clinical skills.

  1. ATP Induces IL-1β Secretion in Neisseria gonorrhoeae-Infected Human Macrophages by a Mechanism Not Related to the NLRP3/ASC/Caspase-1 Axis

    Directory of Open Access Journals (Sweden)

    Killen García

    2016-01-01

    Full Text Available Neisseria gonorrhoeae (Ngo has developed multiple immune evasion mechanisms involving the innate and adaptive immune responses. Recent findings have reported that Ngo reduces the IL-1β secretion of infected human monocyte-derived macrophages (MDM. Here, we investigate the role of adenosine triphosphate (ATP in production and release of IL-1β in Ngo-infected MDM. We found that the exposure of Ngo-infected MDM to ATP increases IL-1β levels about ten times compared with unexposed Ngo-infected MDM (P0.05 and caspase-1 (CASP1, P>0.05. In addition, ATP was not able to modify caspase-1 activity in Ngo-infected MDM but was able to increase pyroptosis (P>0.01. Notably ATP treatment defined an increase of positive staining for IL-1β with a distinctive intracellular pattern of distribution. Collectively, these data demonstrate that ATP induces IL-1β secretion by a mechanism not related to the NLRP3/ASC/caspase-1 axis and likely is acting at the level of vesicle trafficking or pore formation.

  2. ATP Induces IL-1β Secretion in Neisseria gonorrhoeae-Infected Human Macrophages by a Mechanism Not Related to the NLRP3/ASC/Caspase-1 Axis

    Science.gov (United States)

    García, Killen; Escobar, Gisselle; Mendoza, Pablo; Beltran, Caroll; Perez, Claudio; Vernal, Rolando; Acuña-Castillo, Claudio

    2016-01-01

    Neisseria gonorrhoeae (Ngo) has developed multiple immune evasion mechanisms involving the innate and adaptive immune responses. Recent findings have reported that Ngo reduces the IL-1β secretion of infected human monocyte-derived macrophages (MDM). Here, we investigate the role of adenosine triphosphate (ATP) in production and release of IL-1β in Ngo-infected MDM. We found that the exposure of Ngo-infected MDM to ATP increases IL-1β levels about ten times compared with unexposed Ngo-infected MDM (P 0.05) and caspase-1 (CASP1, P > 0.05). In addition, ATP was not able to modify caspase-1 activity in Ngo-infected MDM but was able to increase pyroptosis (P > 0.01). Notably ATP treatment defined an increase of positive staining for IL-1β with a distinctive intracellular pattern of distribution. Collectively, these data demonstrate that ATP induces IL-1β secretion by a mechanism not related to the NLRP3/ASC/caspase-1 axis and likely is acting at the level of vesicle trafficking or pore formation. PMID:27803513

  3. [Haemorrhage after thyroid surgery].

    Science.gov (United States)

    Swirta, Jarosław S; Barczyński, Marcin

    2014-01-01

    Haemorrhage after thyroid surgery is rare, but if it occurs it is a life-threatening condition necessitating emergency surgery. The aim of this study was to evaluate prevalence and risk factors of haemorrhage after thyroid surgery. A retrospective analysis was undertaken in a group of 8931 consecutive patients with various thyroid diseases treated in 2004-2013 at our institution. Potential risk factors for postoperative haemorrhage after thyroid surgery were analysed using logistic regression model. Haemorrhage after thyroid operation necessitating emergency surgery occurred in 40 (0.45%) of 8931 patients. None of the patients died within the perioperative period. Bleeding occurred within first 24 hours following surgery in 38 (95%) patients, and in the remaining 2 (5%) patients in more than 24 hours after initial surgery. The following risk factors for bleeding after thyroid operation were identified: male sex (OR 3.618; 1.762-7.430; p or = 70 years (OR 3.052; 1.275-7.304; p = 0.012), surgery for hyperthyroidism (OR 2.873; 1.511-5.462; p = 0.001), smoking (OR 2.855; 1.502-5.428; p = 0.001), subtotal thyroidectomy in contrast to total thyroidectomy or lobectomy (OR 2.853; 1.356-6.004; p=0.006), and thyroid operation undertaken by resident in training in general surgery (OR 2.596; 1.393-4.837; p = 0.003). Haemorrhage after thyroid operation necessitating emergency surgical intervention occurs most frequently within first 24 hour following surgery. Hence, for safety reasons a minimum of 24-hour hospital stay is recommended in all patients with risk factors for postoperative bleeding after thyroid operation. Quality monitoring of thyroid surgery should include also risk factors for postoperative bleeding.

  4. Advanced Stirling Convertor Dual Convertor Controller Testing at NASA Glenn Research Center in the Radioisotope Power Systems System Integration Laboratory

    Science.gov (United States)

    Dugala, Gina M.; Taylor, Linda M.; Bell, Mark E.; Dolce, James L.; Fraeman, Martin; Frankford, David P.

    2015-01-01

    NASA Glenn Research Center developed a nonnuclear representation of a Radioisotope Power System (RPS) consisting of a pair of Advanced Stirling Convertors (ASCs), Dual Convertor Controller (DCC) EMs (engineering models) 2 and 3, and associated support equipment, which were tested in the Radioisotope Power Systems System Integration Laboratory (RSIL). The DCC was designed by the Johns Hopkins University Applied Physics Laboratory (JHU/APL) to actively control a pair of ASCs. The first phase of testing included a Dual Advanced Stirling Convertor Simulator (DASCS), which was developed by JHU/APL and simulates the operation and electrical behavior of a pair of ASCs in real time via a combination of hardware and software. RSIL provides insight into the electrical interactions between a representative radioisotope power generator, its associated control schemes, and realistic electric system loads. The first phase of integration testing included the following spacecraft bus configurations: capacitive, battery, and super-capacitor. A load profile, created based on data from several missions, tested the RPS's and RSIL's ability to maintain operation during load demands above and below the power provided by the RPS. The integration testing also confirmed the DCC's ability to disconnect from the spacecraft when the bus voltage dipped below 22 volts or exceeded 36 volts. Once operation was verified with the DASCS, the tests were repeated with actual operating ASCs. The goal of this integration testing was to verify operation of the DCC when connected to a spacecraft and to verify the functionality of the newly designed RSIL. The results of these tests are presented in this paper.

  5. Robotic surgery for gastric cancer: a technical review.

    Science.gov (United States)

    Hyung, Woo Jin; Woo, Yanghee; Noh, Sung Hoon

    2011-12-01

    Minimally invasive gastric cancer surgery is gaining acceptance, especially in the treatment of patients with early gastric cancer. While offering patients the benefits of minimally invasive surgery, laparoscopic surgery is limited by several disadvantages such as altered operating view and lack of versatility in surgical instrumentation. Robotic surgery offers the surgeon the benefit of superior 3D visualization, the freedom of the EndoWrist function, and the tremble-filtered control of the four robotic arms. Due to the technical advantages of the robotic surgical system, robotic surgery may facilitate the expansion of minimally invasive surgery over laparoscopy. The application of robotic surgery for gastric cancer is increasing in experienced centers. Most reports of the robotic operating methods are only slightly modified from the laparoscopic technique. Robotic gastric cancer surgery including radical subtotal gastrectomy with D2 lymph node dissection is technically feasible and safe and results in similar short-term postoperative outcomes when compared to laparoscopic surgery. The role of robotic surgery in gastric cancer is promising but awaits further comparative studies of long-term results and cost-effectiveness.

  6. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

    Science.gov (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

    2015-02-01

    The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

  7. [Robotic surgery in gynecology].

    Science.gov (United States)

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  8. Contemporary endodontic surgery.

    Science.gov (United States)

    Rubinstein, Richard; Torabinejad, Mahmoud

    2004-06-01

    During the past decade, endodontics has seen a dramatic shift in the application of periradicular surgery and the role it plays in endodontic treatment. With the introduction of enhanced magnification, periradicular ultrasonics and other associative technologies, teeth that might otherwise be extracted now have a chance for retention. This article describes the role of these advances in contemporary endodontic surgery.

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... functional problems. Jaw Surgery can have a dramatic effect on many aspects of life. Following are some of the conditions that may indicate the need for corrective jaw surgery: Difficulty chewing, or biting food Difficulty swallowing Chronic jaw or jaw joint (TMJ) ...

  10. Coronary Artery Bypass Surgery

    Science.gov (United States)

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new ...

  11. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available AAOMS - Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who We Are News Videos Contact Find a Surgeon What We ... may require one or more surgeries depending on the extent of the repair needed. Click here to ...

  13. Best Practices for Robotic Surgery Programs.

    Science.gov (United States)

    Estes, Stephanie J; Goldenberg, David; Winder, Joshua S; Juza, Ryan M; Lyn-Sue, Jerome R

    2017-01-01

    Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations. Guidelines for hospitals and robotic directors that can be applied to one's own robotic surgical services are included with examples of management of all aspects of a multispecialty robotic surgery program. The use of these best practices will ensure a robotic surgery program that is successful and well positioned for a safe and productive environment for current clinical practice.

  14. Perioperative Management Center (PERIO) for Neurosurgical Patients

    Science.gov (United States)

    YASUHARA, Takao; HISHIKAWA, Tomohito; AGARI, Takashi; KUROZUMI, Kazuhiko; ICHIKAWA, Tomotsugu; KAMEDA, Masahiro; SHINKO, Aiko; ISHIDA, Joji; HIRAMATSU, Masafumi; KOBAYASHI, Motomu; MATSUOKA, Yoshikazu; SASAKI, Toshihiro; SOGA, Yoshihiko; YAMANAKA, Reiko; ASHIWA, Takako; ARIOKA, Akemi; HASHIMOTO, Yasuko; MISAKI, Ayasa; ISHIHARA, Yuriko; SATO, Machiko; MORIMATSU, Hiroshi; DATE, Isao

    2016-01-01

    Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7–14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 ± 0.3 days), compared to that in the non-PERIO group (4.7 ± 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff. PMID:27396396

  15. DOE Centers of Excellence Performance Portability Meeting

    Energy Technology Data Exchange (ETDEWEB)

    Neely, J. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-04-21

    Performance portability is a phrase often used, but not well understood. The DOE is deploying systems at all of the major facilities across ASCR and ASC that are forcing application developers to confront head-on the challenges of running applications across these diverse systems. With GPU-based systems at the OLCF and LLNL, and Phi-based systems landing at NERSC, ACES (LANL/SNL), and the ALCF – the issue of performance portability is confronting the DOE mission like never before. A new best practice in the DOE is to include “Centers of Excellence” with each major procurement, with a goal of focusing efforts on preparing key applications to be ready for the systems coming to each site, and engaging the vendors directly in a “shared fate” approach to ensuring success. While each COE is necessarily focused on a particular deployment, applications almost invariably must be able to run effectively across the entire DOE HPC ecosystem. This tension between optimizing performance for a particular platform, while still being able to run with acceptable performance wherever the resources are available, is the crux of the challenge we call “performance portability”. This meeting was an opportunity to bring application developers, software providers, and vendors together to discuss this challenge and begin to chart a path forward.

  16. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    Science.gov (United States)

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  17. Restricción alimenticia y salbutamol en el control del síndrome ascítico en pollos de engorda: 1. comportamiento productivo y características de la canal

    OpenAIRE

    González, Juan M.; Maria Elena Suárez; Arturo Pro; Carlos López

    2000-01-01

    El síndrome ascítico es una de las causas de mayor mortalidad en pollos de engorda, afectando también sus características productivas. Se estableció un experimento para medir el efecto combinado de restricción alimenticia (0 ó 25 % menos del consumo normal) y salbutamol (0 ó 2 mg kg-1) en la incidencia del síndrome ascítico, comportamiento productivo y características de la canal de pollos de engorda. La restricción alimenticia fue del día 7 al 21 de edad y el salbutamol se adicionó al alimen...

  18. Cinnamaldehyde and eugenol change the expression folds of AKT1 and DKC1 genes and decrease the telomere length of human adipose-derived stem cells (hASCs: An experimental and in silico study

    Directory of Open Access Journals (Sweden)

    Abdorrahim Absalan

    2017-03-01

    Full Text Available Objective(s: To investigate the effect of cinnamaldehyde and eugenol on the telomere-dependent senescence of stem cells. In addition, to search the probable targets of mentioned phytochemicals between human telomere interacting proteins (TIPs using in silico studies. Materials and Methods: Human adipose derived stem cells (hASCs were studied under treatments with 2.5 µM/ml cinnamaldehyde, 0.1 µg/ml eugenol, 0.01% DMSO or any additive. The expression of TERT, AKT1 and DKC1 genes and the telomere length were assessed over 48-hr treatment. In addition, docking study was conducted to show probable ways through which phytochemicals interact with TIPs. Results: Treated and untreated hASCs had undetectable TERT expression, but they did affect the AKT1 and DKC1 expression levels (CI=0.95; P

  19. Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly.

    Science.gov (United States)

    Kim, Jung Hee; Hur, Kyu Yeon; Lee, Jung Hyun; Lee, Ji Hyun; Se, Young-Bem; Kim, Hey In; Lee, Seung Hoon; Nam, Do-Hyun; Kim, Seong Yeon; Kim, Kwang-Won; Kong, Doo-Sik; Kim, Yong Hwy

    2017-08-01

    Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 referral centers in Korea. We enrolled 134 patients with acromegaly (microadenomas, n = 15; macroadenomas, n = 119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n = 74) and Samsung Medical Center (n = 60) between January 2009 and March 2016. Remission was defined as having a normal insulin-like growth factor-1 and a suppressed growth hormone (GH) <1 ng/mL during an oral glucose tolerance test. Remission was achieved in 73.1% of patients, including 13 of 15 microadenoma patients (86.7%) and 86 of 119 macroadenoma patients (72.3%). A multivariate analysis to determine a predictor of biochemical remission demonstrated that absence of cavernous sinus invasion and immediate postoperative GH levels <2.5 ng/dL were significant predictors of remission (adjusted odds ratio [OR], 5.14; 95% confidence interval [CI], 1.52-17.3 and OR, 9.60; 95% CI, 3.41-26.9, respectively). After surgery, normal pituitary function was maintained in 34 patients (25.4%). Sixty-four patients (47.7%) presented complete (n = 59, 44.0%) or incomplete (n = 5, 3.7%) recovery of pituitary function. Hypopituitarism persisted in 20 patients (14.9%) and worsened in 16 patients (11.9%). Postoperatively, transient diabetes insipidus was reported in 52 patients (38.8%) but only persisted in 2 patients (1.5%). Other postoperative complications were epistaxis (n = 2), cerebral fluid leakage (n = 4), infection (n = 1), and intracerebral hemorrhage (n = 1). Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. SURGERY AND CARDIOVASCULAR SURGERY JOURNALS ANALYSIS

    Directory of Open Access Journals (Sweden)

    Alberto Schanaider

    2015-01-01

    Full Text Available Objective: To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. Methods: A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR, Elsevier/Scopus (SJR, and also Scielo databases were used. Results: Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5% and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. Conclusions: A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor.